Chapter 12 Serious unintentional injury and death

Key statistics at a glance

Serious childhood injuries

  • In 2009–2010 there were an estimated 22,805 incidents involving 0–17 year olds that resulted in an admission to a NSW hospital due to injury (‘serious injury’), of which 93.6 per cent were unintentional injuries.[1]
    • The most common known location where unintentional injuries occurred was in the home.[2]
    • 15–17 year olds were more likely than 1–4 years olds to be seriously injured, as were male children compared with female children, and Aboriginal children compared with non-Aboriginal children.
    • Children living in remote areas were more likely than children living in major cities to be seriously injured, as were children in third and fourth quintiles of socioeconomic disadvantage compared with children in the least disadvantaged (first) quintile.[3]
  • Over the ten year period to 2009–2010 the rate of serious unintentional childhood injuries in NSW remained fairly steady.

Home

  • In 2009–2010 an estimated 4,300 incidents involving children aged 0–17 years that resulted in a hospital admission due to unintentional injury occurred in the home. [4]
    • 48.0 per cent were involved in an unidentified leisure activity and 32.1 per cent were involved in a vital activity such as sleeping or eating.
    • 28.0 per cent of injuries in the home were to the head, 14.9 per cent were to the elbow and forearm and 11.3 per cent to the wrist or hand.
    • Children aged 1–4 years had the highest rate of unintentional injuries at home. Male children were more likely than female children, and Aboriginal children more likely than non-Aboriginal children, to be injured at home.
    • Children living in remote areas were more likely than children living in major cities to be seriously injured at home.
    • Compared with children in the least socioeconomically disadvantaged (first) quintile, those in all other quintiles of socioeconomic disadvantage were more likely to be seriously injured at home. [5]
    • The North Western and the Murrumbidgee regions had the highest rates of serious injuries across all areas in NSW; while Central Western Sydney, Blacktown and Outer Western Sydney had the highest rates of serious injury of all areas in Sydney.
  • Over the ten year period to 2009–2010 the number of incidents of serious injury that occurred at home appears to have slightly declined.

Sport or athletic areas

  • In 2009–2010, an estimated 2,495 incidents involving children aged 1–17 years that resulted in a hospital admission due to unintentional injury occurred at a sport or athletics area.[6]
    • 68.5 per cent were involved in team sports at the time of injury.
    • 27.4 per cent of injuries were to the elbow and forearm, 20.8 per cent to the knee and lower leg, 19.2 per cent to the head and 12.3 per cent to the wrist and hand.
    • Male children were more likely than female children to be seriously injured at sport or athletics areas; and rates of injury in sport or athletics areas increased steadily with age.
    • Children living in inner regional areas were more likely than children living in major cities to be seriously injured at sport or athletics areas.
    • Compared with children in the least socioeconomically disadvantaged (first) quintile, children in the second and fourth quintiles were more likely to be seriously injured at sport or athletics areas, while children in the most disadvantaged (fifth) quintile were less likely to experience such injury. [7]
    • Murrumbidgee had the highest rate of children seriously injured at sport or athletics area of all NSW regions, and Outer Western Sydney and St George–Sutherland had the highest rates in Sydney.
  • Over the ten year period to 2009–2010 the number of incidents of serious injury that occurred at a sport or athletics area has remained steady.

School

  • In 2009–2010, an estimated 1,453 incidents involving children aged 5–17 years that resulted in a hospital admission due to unintentional injury occurred at school.[8]
    • 32.2 per cent were involved in leisure activities and 30.3 per cent in team sports at the time of the injury.
    • 43.4 per cent of injuries were to the elbow and forearm, 15.2 per cent to the head and 12.3 per cent to the wrist and hand.
    • Male children were more likely than female children to be seriously injured at school, as were 5–8 year olds compared with 15–17 year olds.
    • Compared with children in the least socioeconomically disadvantaged (first) quintile, children in the most and second most disadvantaged (fifth and fourth) quintiles[9] were less likely to be seriously injured at school.
    • Murrumbidgee had the highest rate of children seriously injured at school in NSW, and the Northern Beaches and Blacktown had the highest rate in Sydney.
  • Over the ten year period to 2009–2010 the number of incidents of serious injury that occurred at school fluctuated.

Street or highway

  • In 2009–2010 an estimated 1,275 incidents involving children aged 1–17 years that resulted in a hospital admission due to unintentional injury occurred on a street or highway.[10]
    • 28.9 per cent of injuries were to the head, 16.9 per cent to the elbow and forearm, 13.0 per cent to the knee and lower leg and 10.4 per cent to the abdomen, lower neck, spinal and pelvic area.
    • Male children were more likely than female children; 5–8 year olds, 9–14 year olds and 15–17 year olds were more likely than 1–4 year olds; and Aboriginal children were more likely than non-Aboriginal children to be seriously injured on a street or highway.
    • Compared with children in the least socioeconomically disadvantaged (first) quintile, those in all other quintiles of socioeconomic disadvantage were more likely to be seriously injured on a street or highway. [11]
    • Rates of serious injury on a street or highway increased with geographic remoteness, with children living in remote and very remote areas the most likely to have been injured.
    • The North Western region had the highest rate of children seriously injured on a street or highway of all areas of NSW, and Blacktown and Outer Western Sydney had the highest rates in Sydney.
  • Over the ten year period to 2009–2010 the number of incidents of serious injury that occurred on a street or highway appears to have slightly declined.
  • In 2010, 843 drivers aged 16–17 years were involved in a crash that resulted in their injury or death.
    • 17 year old drivers were more likely than 16 year old drivers to be injured or die in a crash, as were male drivers as compared with female drivers, and P1 licence drivers as compared with Learner licence drivers.
    • 16–17 year old motorcyclists were more likely than 16–17 year old car drivers to be injured or die in a crash.
    • The Far West and North Western regions of NSW and the Central Coast region of Sydney had the highest rate of drivers aged 16–17 years who were injured or died in a crash.
  • Over the nine year period to 2010, the rate of drivers aged 16–17 years injured or killed in a crash has declined.

Natural environment

  • In 2009–2010 an estimated 509 incidents that resulted in a hospital admission for children aged 1-17 years due to unintentional injury occurred in a natural environment.[12] [13]
    • At the time of injury, 44.2 per cent of these children were involved in individual water sports, 21.6 per cent in other leisure activities and 10.6 per cent in wheeled motor sports.
    • 18.3 per cent of injuries were to the ankle and foot, 17.1 per cent were to the head and 13.4 per cent were to the knee and lower leg.
    • Male children were more likely than female children to be seriously injured in the natural environment, as were 9–14 year olds and 15–17 year olds compared with 1–4 year olds.
    • Children living in regional areas were more likely than children living in major cities to be seriously injured in the natural environment.
    • Compared with children in the least socioeconomically disadvantaged (first) quintile, children in the second quintile and the most disadvantaged (fifth) quintile were less likely to be injured in the natural environment. [14]
    • The Illawarra had the highest rate of children seriously injured in the natural environment of all NSW regions, and the Northern Beaches and Central Coast had the highest rates in Sydney.
  • Over the eight year period to 2009–2010 there was a slight increase in the number of children seriously injured in a natural environment.

Farm

  • In 2009–2010 an estimated 230 incidents involving children aged 0–17 years that resulted in a hospital admission due to unintentional injury occurred on farms. [15]
    • 34.7 per cent were involved in wheeled motor sports, 25.3 per cent in unspecified leisure activities and 15.8 per cent in equestrian activities.
    • 24.8 per cent of injuries were to the head and 14.8 per cent to the elbow and forearm.
    • Male children were more likely than female children to be seriously injured on a farm, and rates of serious injury increased steadily with age.
    • Children living in inner regional, outer regional areas, remote and very remote areas were more likely than children living in major cities to be seriously injured on a farm.
    • Compared with children in the least socioeconomically disadvantaged (first) quintile, those in all other quintiles of socioeconomic disadvantage were more likely to be seriously injured on a farm. [16]
    • Far West NSW was the area of NSW with the highest rate of children seriously injured on a farm.

Workplaces

  • In 2009–2010 an estimated 106 incidents involving children aged 9–17 years that resulted in a hospital admission due to unintentional injury occurred in workplaces.[17] 
    • 40.5 per cent occurred in the manufacturing industry, 32.0 per cent in wholesale and retail trade, and 21.4 per cent in construction.
    • 60.4 per cent of injuries that occurred in the workplace were to the wrist and hand.
    • Male children were more likely than female children, 15–17 year olds were more likely than 9–14 year olds, and Aboriginal children were more likely than non-Aboriginal children to be seriously injured at a workplace.
    • Children living in inner regional and outer regional areas were more likely than children living in major cities to be seriously injured at a workplace.
    • Compared with children in the least socioeconomically disadvantaged (first) quintile, children in the second, third and fourth quintiles of socioeconomic disadvantage were more likely to be seriously injured at a workplace. [18]
    • Murrumbidgee had the highest rate of children seriously injured at a workplace out of all areas in NSW, and Outer Western Sydney and Outer South Western Sydney had the highest rates in Sydney.
  • Over the eight year period to 2009–2010 rates of serious injury that occurred at a workplace fluctuated.
  • In 2009–2010 there were 417 notifications of workplace injuries concerning 15–17 year olds made to WorkCover.
    • 90.2 per cent resulted in a temporary disability of less than six months.
    • 7.2 per cent resulted in a permanent disability.
    • 2.4 per cent resulted in a temporary disability of six months or more.

Unintentional injury deaths

  • In 2010, 64 children aged 0–17 years died due to unintentional injury.
    • Transport incidents were the most common cause of death by injury, accounting for 35 deaths, with over half of these pertaining to children who were passengers.
    • Accidental drowning was the next most common cause of death by injury, accounting for a total of 14 deaths.

Trends in major categories of unintentional deaths

  • Over the 15 year period to 2010, the number of children aged 0–17 years who died from an unintentional injury has decreased.
    • The number of children aged 0–17 years who died in transport incidents has decreased.
Further information about childhood injury can be found in the Commission’s report Serious childhood community injury in New South Wales. This report considers injury occurrence by both unintentional and intentional causes of injury, and outlines factors such as age, sex, and injury severity for each injury cause.  The report was written for the Commission by the National Injury Surveillance Unit of the Australian Institute of Health and Welfare. 

Introduction

Injury has a major, but often preventable, impact on the well-being of children in NSW, and Australia as a whole. While it is normal for children to take risks and sustain injuries as they develop, serious injury can cause pain, distress and trauma to both children and their families, and can lead to lasting disability. While the death rate from injury in the Australian population as a whole, including children, is trending downwards, death and hospitalisation rates of children are an ongoing concern. Rates of hospitalisation of NSW children for injuries arising from poisoning (pharmaceuticals and other substances), drowning, transport related injury and assault decreased significantly over the ten years to 2009-2010. Injury arising from other causes such as falls, exposure to heat, fire, smoke and hot substances remained relatively stable over this period.

This chapter examines serious injuries to NSW children, the places where these injuries occur, and death as an outcome of injury.[19] The data presented are drawn from existing collections, and established state, national or international measures are reported. Some additional information is provided to fill data gaps identified through the work of the NSW Commission for Children and Young People. The term ‘serious injury’ in this chapter is used to denote those injuries that resulted in an admission to hospital.

There are many possible perspectives from which to consider the factors involved in childhood injury. The data presented in this chapter are provided by the location in which the injury occurred, where this is known.[20]  This is to assist with the development of prevention initiatives, which may be location-specific in nature. The report Serious childhood community injury in New South Wales considers injury occurrence by the cause of injury, providing a useful complement to the information in this chapter. This report was undertaken for the Commission by the National Injury Surveillance Unit of the Australian Institute of Health and Welfare.   

The data in this chapter are made available as a resource for policy and service delivery professionals working in both government and non-government settings to enhance knowledge about children’s lives. Since the purpose of reporting these data is to inform the development of legislative, policy, program and service delivery responses and support their continuous improvement, many of the measures point to deficits or problem areas. While deficit measures miss the positive aspects of children’s lives, such measures assist to identify areas where prevention efforts should be targeted, and highlight equity and efficiency concerns.

Finally, the reader should be aware that what is reported in this chapter is a subset of what is known about unintentional injuries of children, or what could be known. Most data in this chapter are drawn from the NSW Admitted Patient Data Collection (APDC), which provides data on admissions to all hospitals in NSW[21]. However, only a small proportion of all injury cases result in admission to a hospital. Many injured children go to Emergency Departments and are not admitted; some are seen by a general practitioner, some die before reaching hospital, a larger number of generally minor cases may not receive any medical treatment at all or are managed by friends, family members, school staff and so on. Other data sources used to supplement this chapter, namely the RTA Crashlink Data Collection (Crashlink)[22], WorkCover data collection, and the NSW School Students Health Behaviours (SSHB) survey, cover some of these information gaps. Nonetheless, hospital admissions and deaths resulting from injury provide a useful focal point for consideration, since these represent the cases with the most serious impact on the mortality and morbidity of children in NSW.

In general, readers should keep in mind that all survey and administrative data sources have some limitations.[23] Administrative data may not be complete, and survey data should be read as estimates only. Both survey and administrative data reveal associations between variables, but these should not be interpreted as causal relationships.

Injury prevention and control was endorsed as a National Priority Area by the Australian Health Ministers in 1986 in recognition of the national burden of injury. The National Public Health Partnership’s (NPHP) National Injury Prevention and Safety Promotion Plan: 2004 – 2014 is the key strategic document at a national level dealing with injury prevention. This Plan takes a life stages approach, identifying priority areas specific to children and young people.

Keeping people healthy and out of hospital is outlined as a goal in NSW 2021: A plan to make NSW number one.

Serious childhood injuries

In 2009–2010 there were an estimated 22,805 incidents involving 0–17 year old NSW children that resulted in an admission to a NSW hospital due to injury (‘serious injury’). Unintentional injuries made up 93.6 per cent (21,340) of these admissions (Table A12.1 (XLSX 331.5KB)).

The rate of serious unintentional childhood injuries remained fairly steady over the period 2000–2001 to 2009–2010. The highest rate was in 2003-2004, at 14.3 serious injuries per 1,000 children aged 0–17 years. The lowest rate was in 2008–2009, at 12.5 serious injuries per 1,000 children aged 0–17 year (Figure 12.1) (Table A12.3 (XLSX 331.5KB)).

Figure 12.1: Incidents of serious unintentional injury involving NSW children aged 0–17 years by year, NSW, 2000–2001 to 2009–2010

Source: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health (Table A12.3 (XLSX 331.5KB))

When the statistical significance of age, sex, Aboriginal identity, geographic location and socioeconomic disadvantage are considered:

  • compared with 1–4 year olds:
    • 9–14 had the same rate of serious injury.
    • children aged less than 1 year were 0.5 times as likely to be seriously injured.
    • 5–8 year olds were 0.9 times as likely to be seriously injured.
    • 15–17 year olds were 1.2 times more likely to be seriously injured.
  • male children were 1.9 times more likely than female children to be seriously injured.
  • Aboriginal children were 1.3 times more likely to be seriously injured than non-Aboriginal children.
  • compared with children living in major cities:
    • children living in inner regional areas were 1.2 times more likely to be seriously injured
    • children living in outer regional areas were 1.4 times more likely to be seriously injured
    • children living in remote areas were 1.9 times more likely to be seriously injured.
  • compared with children in the least socioeconomically disadvantaged (first) quintile, children in both the third and fourth quintiles were 1.1 times more likely to be seriously injured (Table A12.1 (XLSX 331.5KB))[24].

Injuries can occur in many settings including the home, school, work, playgrounds and sports fields, parks and roads. In 2009–2010 the most common place in which serious unintentional injuries occurred was at home (41.5%) (Figure 12.2) (Table A12.2 (XLSX 331.5KB))[25].

Figure 12.2: Top seven places of occurrence of serious unintentional injury sustained by NSW children aged 0–17 years, NSW, 2009–2010

Source: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health (Table A12.2 (XLSX 331.5KB))

Analysis of demographic differences

One demographic characteristic of ongoing interest is the cultural background of children, particularly Aboriginal and Torres Strait Islander children. Throughout this chapter, ‘Aboriginal’ is used to refer to both Aboriginal and Torres Strait Islander people. Aboriginal or Torres Strait Islander status is recorded for all admissions in the APDC based on self-identification. While the SSHB collects information on Aboriginality, the small sample size limits regular reporting of Aboriginal children separately to non-Aboriginal children. Crashlink and WorkCover do not collect information on Aboriginality.

Injury rates among children with a disability may also be of particular interest.  However, none of the data sources included in this chapter collect information on the presence of disability, and so specific data for this group are not presented.

Home

Homes have a number of hazards including potential threats from electricity, unused medications, hot water, chemicals and various other substances, windows, balconies, heaters, and barbecues. Many causes of injury in the home have been linked to environmental factors, design, including the design of particular products, and poor understanding by the carer or parent of the importance of child supervision in relation to these hazards (Kidsafe NSW, 2011).

Injuries in the home include poisoning, falls including from windows, burns and scalds, drowning, and injuries that result from motor vehicles. Most of these injuries are preventable (Peden et al, 2008).

Results from the Admitted Patients Data Collection

In 2009–2010 there were an estimated 4,300 incidents that occurred in the homes of children aged 0–17 years that resulted in a hospital admission due to unintentional injury (Table A12.4 (XLSX 331.5KB)) .[26]

Over the period 2000–2001 to 2009–2010, the number of incidents of serious injury that occurred at home appears to have slightly declined. The lowest rates were in 2008–2009 and 2009–2010 when 2.6 children in every 1,000 children were injured (Figure 12.3) (Table A12.8 (XLSX 331.5KB)).

Figure 12.3: Incidents of serious unintentional injury in the home involving NSW children aged 0–17 years by year, NSW, 2000–2001 to 2009–2010

Source: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health; ABS population data (Table A12.8 (XLSX 331.5KB)).

In 2009–2010, children were involved in a range of activities at the time of their injury at home.[27] Where the activity was specified, the most common activities children were involved in were:

The most common regions of the body to which injuries were sustained in the home included:

When the statistical significance of age, sex, Aboriginal identity, socioeconomic disadvantage and remoteness are considered:

  • male children were 1.4 times more likely than female children to be seriously injured at home
    • children aged 1–4 years had the highest rate of serious injuries in the home (5.93 per 1,000). Compared with 1–4 year olds:
    • children aged less than 1 year were 0.6 times as likely to be seriously injured at home
    • 5–8 year olds were 0.4 times as likely to be seriously injured at home
    • 9–14 and 15–17 year olds were 0.2 times as likely to be seriously injured at home (Figure 12.4) (Table A12.4 (XLSX 331.5KB)).

Figure 12.4: Incidents of serious unintentional injury in the home involving NSW children aged 0–17 years by age, NSW, 2009–2010

Source: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health (Table A12.4 (XLSX 331.5KB)).

  • Aboriginal children were 1.8 times more likely to be seriously injured at home compared with non-Aboriginal children
  • compared with children living in major cities:
    • children living in regional areas were 1.3 times more likely to be seriously injured at home
    • children living in remote areas were approximately 2.1 times more likely to be seriously injured at home.
  • compared with children in the least socioeconomically disadvantaged (first) quintile:
    • children in the second quintile were 1.2 times more likely to be seriously injured at home
    • children in the third quintile were 1.5 times more likely to be seriously injured in the home
    • children in the fourth quintile were 1.4 times more likely to be seriously injured at home
    • children in the most disadvantaged (fifth) quintile were 1.5 times more likely to be seriously injured at home (Table A12.4 (XLSX 331.5KB)).[28]

The geographic areas in NSW with the highest rate of children seriously injured at home were North Western (4.1 per 1,000 children) and Murrumbidgee (4.0 per 1,000 children) (Figure 12.5) (Table A12.7 (XLSX 331.5KB)).

Figure 12.5: Incidents of serious unintentional injury in the home involving NSW children aged 0–17 years by Statistical Division, NSW, 2009–2010

Source: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health and ABS population data (Table A12.7 (XLSX 331.5KB)).

Within Sydney, the areas with the highest rate of children seriously injured at home were Central Western Sydney (3.2 per 1,000 children), Blacktown (3.1 per 1,000 children), and Outer Western Sydney (3.1 children in every 1,000 children) (Table A12.7 (XLSX 331.5KB)).

Much public attention has been given to certain types of injuries that occur at home. Three that may be of particular interest to readers are those serious injuries that occurred due to low-speed run-overs, those due to drowning or submersion in a swimming-pool or bathtub, and those that involved a fall from a balcony or window.

Low-speed run-overs

Of the cases recorded in 2009–2010 where the location of injury is known, 25 children were injured by a motor vehicle moving around the home.[29] The majority of these children (15) were under 5 years old, 40 per cent (9) were under 2 years old. 

Drowning or submersion in a swimming-pool or bathtub

37 children were injured at home by accidental drowning or submersion. Of these, 20 incidents occurred in a swimming-pool, and seven incidents occurred in a bathtub, and the remainder occurred in other locations.[30]  Three-quarters (15) of the swimming-pool drowning injuries were incurred by children aged less than 5 years old. This age group also accounted for almost all (6) the bathtub drowning injuries, with over half (4) incurred by infants.[31]

Falls from balconies or windows

1,941 children were injured at home from a fall. Falls from a building or structure accounted for 118 (6.1%) of these injuries. Among these, 39 children fell from a balcony or verandah, and 25 fell out of a window.[32] Almost three quarters (28) of these children were aged 1 to 4 years old.

Results from the School Students Health Behaviours (SSHB) survey

In 2008, among students aged 12–17 years that reported experiencing an injury in the last six months, 23.9 per cent were injured at home (Table A12.9 (XLSX 331.5KB)).

When the statistical significance of age, sex, geographic location and socioeconomic disadvantage are considered:

  • students aged 12–15 years were significantly more likely than students aged 16–17 years to have incurred their injury at home (25.0% compared with 20.6%)
  • female students were significantly more likely than male students to have incurred their injury at home (27.3% compared with 21.2%)
  • students in the least disadvantaged (first) quintile of socioeconomic disadvantage[33] were significantly less likely to have incurred their injury at home, compared with the overall student population aged 12–17 years (19.2% compared with 23.9%)
  • students living in urban health areas were no more likely to have incurred their injury at home compared with students living in rural health areas
  • students in the Sydney West Area Health Service[34] region were significantly less likely to have incurred their injury at home, compared with the overall student population aged 12–17 years (19.7% compared with 23.9%) (Table A12.10 (XLSX 331.5KB)).

There was no significant change between the 1996 and 2008 surveys in the proportion of students injured in the last six months who were injured at home. However, there was a significant increase in the proportion of injuries incurred at home among students aged 16–17 years (15.9% to 20.6%) (Table A12.11 (XLSX 331.5KB)).

Sport or athletic areas

Sport and recreational activities are important for children's health and well-being and provide opportunities for social connections and development. They provide opportunities for children to learn, including experiential learning from exposure to risks. While injuries can have major consequences for children so too can lifestyles that remove children from any exposure to risk to prevent potential injury.

Results from the Admitted Patients Data Collection

In 2009–2010 there were an estimated 2,495 incidents that occurred at a sport or athletic field to children aged 1–17 years that resulted in a hospital admission (Table A12.12 (XLSX 331.5KB)) .[35]

Over the period 2000–2001 to 2009–2010 the number of incidents of serious injury that occurred at a sports or athletic field has remained steady. The lowest rate was in 2008–2009 when 1.5 children in every 1,000 children were injured (Figure 12.6) (Table A12.16 (XLSX 331.5KB)).

Figure 12.6: Incidents of serious unintentional injury at a sports or athletic field involving children aged 0–17 years by Statistical Division, NSW, 2009–2010

Source: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health; ABS population data (Table A12.16 (XLSX 331.5KB)).

In 2009–2010 children were involved in a range of activities at the time of injury.[36] Where the activity was specified, the most common activity children were involved in was team sports (68.5%) (Table A12.13 (XLSX 331.5KB))

The most common regions of the body to which injuries were sustained at a sport or athletic field were:

When the statistical significance of age, sex, Aboriginal identity, socioeconomic disadvantage and remoteness are considered:

  • male children were 4.7 times more likely to be seriously injured at sport or athletics areas compared with female children
  • compared with 1–4 year olds:
    • children aged 5–8 years were 6.3 times more likely to be seriously injured at sport or athletics areas.
    • children aged 9–14 years were 33.2 times more likely to be injured at sport or athletics areas.
    • children aged 15–17 years were 49.8 times more likely to be injured at sport or athletics areas
  • there was no significant difference between the rates of serious injury sustained by Aboriginal children and non-Aboriginal children at a sport or athletics field
  • compared with children living in major cities, children living in inner regional areas were 1.3 times more likely, and children living in outer regional areas 1.6 times more likely, to be seriously injured at sport or athletics areas
  • compared with children in the least socioeconomically disadvantaged (first) quintile:
    • children in the second quintile were 1.1 times more likely to be seriously injured at sport or athletics areas
    • children in the fourth quintile were 1.2 times more likely to be seriously injured at sport or athletics areas
    • children in the most disadvantaged (fifth) quintile were less likely (0.8 times) to be seriously injured at sport or athletics areas (Table A12.12 (XLSX 331.5KB)).[37]

The geographic area in NSW with the highest rate of children seriously injured at a sport or athletics areas was Murrumbidgee (3.5 children in every 1,000 children) (Figure 12.7) (Table A12.15 (XLSX 331.5KB)).

Figure 12.7: Incidents of serious unintentional injury at a sports or athletic field involving children aged 0–17 years by Statistical Division, NSW, 2009–2010

Sources: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health and ABS population data (Table A12.15 (XLSX 331.5KB)).

Within the Sydney region, the areas with the highest rate of children seriously injured at sport or athletics areas were Outer Western Sydney (2.3 children in every 1,000 children) and St George–Sutherland (2.0 children in every 1,000 children) (Table A12.15 (XLSX 331.5KB)).

Results from the School Students Health Behaviours survey

In 2008, among high school students aged 12–17 years who reported incurring an injury in the last six months, 43.3 per cent were injured at a sports facility (Table A12.17 (XLSX 331.5KB)).

When the statistical significance of age, sex, geographic location and socioeconomic disadvantage are considered:

  • students aged 16–17 years were significantly more likely than students aged 12–15 years to have incurred their injury at a sports facility (50.2% compared with 41.0%)
  • male students were no more likely than female students to have incurred their injury at a sports facility (Table A12.17 (XLSX 331.5KB))
  • there were no differences in the proportion of students who were injured at a sports facility among areas of socioeconomic disadvantage[38], between urban and rural health areas, or among area health services[39] (Table A12.17 (XLSX 331.5KB) and Table A12.18 (XLSX 331.5KB)).

Between 1996 and 2008 there was no significant change in the proportion of students injured in the last six months who were injured at a sports facility (Table A12.19 (XLSX 331.5KB)).

School

Children spend a significant amount of their time at school, averaging around seven hours a day, five days a week. Schools play a major role in the lives of students and are responsible for providing environments where children can develop and learn. In providing this environment schools must balance the trend to protect and intervene with opportunities for students to exercise their autonomy and take risks (Gill, 2007:64).

Results from the Admitted Patients Data Collection

In 2009–2010 there were an estimated 1,453 incidents that occurred at school involving children aged 5–17 years that resulted in a hospital admission (Table A12.20 (XLSX 331.5KB))[40].

Over the period 2000–2001 to 2009–2010 the number of incidents of serious injury that occurred at school has fluctuated. The lowest rate was in 2000–2001 when 1.0 in every 1,000 children were injured (Figure 12.8) (Table A12.24 (XLSX 331.5KB)).

Figure 12.8: Incidents of serious unintentional injury at school involving children aged 0–17 years by year, NSW, 2000–2001 to 2009–2010

Sources: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health and ABS population data (Table A12.24 (XLSX 331.5KB)).

In 2009–2010, these children were involved in a range of activities at the time of injury.[41] Where the activity was specified the most common activities were:

The most common regions of the body to which injuries were sustained included:

When the statistical significance of age, sex, Aboriginal identity, socioeconomic disadvantage and remoteness are considered:

  • male children were 2.3 times more likely to be seriously injured at school compared with female children
  • compared with 15–17 year olds, 5–8 year olds were 1.9 times more likely to be seriously injured at school
  • there was no significant difference between Aboriginal children and non-Aboriginal children
  • compared with children in the least socioeconomically disadvantaged (first) quintile, children in both the second most disadvantaged and most disadvantaged (fourth and fifth) quintiles[42] were less likely (0.8 times) to be seriously injured at school (Table A12.20 (XLSX 331.5KB)).

The geographic area in NSW with the highest rate of children seriously at school was Murrumbidgee (2.6 per 1,000 children) (Figure 12.9) (Table A12.23 (XLSX 331.5KB)).

Figure 12.9: Incidents of serious unintentional injury at school involving NSW children aged 0–17 years by Statistical Division, NSW, 2009–2010

Sources:  Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health and ABS population data (Table A12.23 (XLSX 331.5KB)).

Within Sydney, the areas with the highest rate of children seriously injured at school were Northern Beaches (1.7 per 1,000 children) and Blacktown (1.6 per 1,000 children) (Table A12.23 (XLSX 331.5KB)).

Results from the School Students Health Behaviours survey

In 2008, among high school students aged 12–17 years who reported incurring an injury in the last six months, 18.6 per cent were injured at school (Table A12.25 (XLSX 331.5KB)).

When the statistical significance of age, sex, socioeconomic disadvantage and geographic location are considered:

  • students aged 12–15 years were significantly more likely than students aged 16–17 years to have incurred their injury at school (20.7% compared with 12.4%)
  • male students were no more likely than female students to have incurred their injury at school
  • there were no significant differences among socioeconomically disadvantaged groups, between urban and rural areas, or among children living in different geographic regions (Table A12.25 (XLSX 331.5KB) and Table A12.26 (XLSX 331.5KB)).

Between 1996 and 2008 there has been no significant change in the proportion of students injured in the last six months who had incurred their injury at school (Table A12.27 (XLSX 331.5KB)).

Street or highway

Streets or highways were the fourth most common place of occurrence of serious injury among children[43].  Factors that place young children particularly at risk of road-related injuries include their curious nature, unpredictable behavior, and small size.  For older children, attitudinal and other social psychological factors are known to play a role, particularly where these lead to risk-taking behaviour around traffic.

Results from the Admitted Patients Data Collection

In 2009–2010 there were an estimated 1,275 incidents that occurred on a street or highway involving children aged 1–17 years that resulted in a hospital admission (Table A12.28 (XLSX 331.5KB)) .[44]

Over the period 2000–2001 to 2009–2010 the number of incidents of serious injury that occurred on a street or highway appears to have decreased slightly. The lowest rate was in 2008–2009 when 0.7 in every 1,000 children were injured (Figure 12.10) (Table A12.31 (XLSX 331.5KB)).

Figure 12.10: Incidents of serious unintentional injury on a street or highway involving children aged 0–17 years by year, NSW, 2000–2001 to 2009–2010

Sources: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health; ABS population data (Table A12.31 (XLSX 331.5KB)).

The most common regions of the body to which injuries were sustained were:

  • head (28.9%)
  • elbow and forearm (16.9%)
  • knee and lower leg (13.0%)
  • abdomen, lower back, lumbar spine and pelvis (10.4%) (Table A12.29 (XLSX 331.5KB)).

When the statistical significance of age, sex, Aboriginal identity, socioeconomic disadvantage and remoteness are considered:

  • male children were 2.0 times more likely than female children to be seriously injured on a street or highway
  • compared with 1–4 year olds, 5–8 year olds were 1.9 times more likely to be seriously injured on a street or highway, 9–14 year olds are 3.3 times more likely and 15–17 year olds 7.5 times more likely
  • Aboriginal children were 1.7 times more likely to be seriously injured on a street or highway compared with non-Aboriginal children.
  • compared with children living in major cities, children living in inner regional areas were 1.3 times more likely, children living in outer regional areas 1.4 times more likely, children in remote areas 4.1 and very remote areas 4.5 times more likely to be seriously injured on a street or highway
  • compared with children in the least socioeconomically disadvantaged (first) quintile:[45]
    • children in the second least disadvantaged quintile were 1.3 times more likely to be seriously injured on a street or highway
    • children in the third quintile were 1.8 times more likely to be seriously injured on a street or highway
    • children in the fourth quintile were 1.7 times more likely to be seriously injured on a street or highway
    • children in the most disadvantaged (fifth) quintile were 1.6 times more likely to be injured on a street or highway (Table A12.28 (XLSX 331.5KB)).

The geographic area in NSW with the highest rate of children seriously injured on a street or highway was North Western NSW (1.9 per 1,000 children) (Figure 12.11) (Table A12.30 (XLSX 331.5KB)).

Figure 12.11: Incidents of serious unintentional injury on a street or highway involving children aged 0–17 years by Statistical Division, NSW, 2009 – 2010

Sources: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health and ABS population data (Table A12.30 (XLSX 331.5KB)).

Within Sydney, the areas with the highest rate of children seriously injured on a street or highway were Blacktown (1.4 per 1,000 children) and Outer Western Sydney (1.1 per 1,000 children) (Table A12.30 (XLSX 331.5KB)).

Results from the School Students Health Behaviours survey

In 2008, among high school students aged 12–17 years who reported experiencing an injury in the last six months, 5.7 per cent were injured on a street or road (Table A12.32 (XLSX 331.5KB)).

A greater proportion of students aged 16-17 years incurred their injury on a road or street than those aged 12–15 years (6.6% and 5.4%). Male students (7.0%) were more likely than female students to have incurred their injury on street or road (4.1%).

Between 2005 and 2008 there was no change in the proportion of students injured in the last six months who had incurred that injury on a street or road (Table A12.32 (XLSX 331.5KB)).

Results from Crashlink

In 2010, 843 drivers aged 16–17 years were involved in a crash that resulted in their injury or death (Table A12.33 (XLSX 331.5KB)).

When the statistical significance of age, sex, licence status, type of vehicle and geographical location are considered:

  • drivers aged 17 years were 8.2 times more likely to be injured or die in a crash than those aged 16 years
  • male drivers were 1.4 times more likely to be injured or die in a car crash compared with female drivers
  • drivers aged 16–17 years with a P1 licence were 12.6 times more likely to be injured or die in a crash than drivers aged 16–17 years with a Learners licence
  • compared with car drivers aged 16–17 years, motorcyclists aged 16–17 years were 5.9 times more likely to be injured or die in a crash.

The geographic areas in NSW with the highest rate of drivers aged 16–17 years who were injured or died in a crash were Far West and North Western NSW (9.7 and 9.3 per 1,000 drivers aged 16–17 years) (Figure 12.12) (Table A12.34 (XLSX 331.5KB))

Figure 12.12: Crash incidents resulting in injury or death of drivers aged 16–17 years by NSW Statistical Division, NSW, 2010

Notes: Drivers with an unknown or unauthorised licence status were excluded. Drivers with a licence status higher than normally allowed for their age have been excluded. Drivers who resided outside NSW or on Lord Howe Island have been excluded. Drivers with an unknown residence or sex were excluded. Both Motor Vehicle Drivers and Motorcyclists have been included.

Source: RTA Crashlink Data Collection 2011 & RTA customised request (2011) (Table A12.34 (XLSX 331.5KB)).

Within the Sydney area, the area with the highest rate of drivers aged 16–17 years who were injured or died in a crash was the Central Coast (9.3 per 1,000 drivers aged 16–17 years) (Figure 12.13) (Table A12.34 (XLSX 331.5KB)).

Figure 12.13: Crash incidents resulting in injury or death of drivers aged 16–17 years by Sydney Statistical subdivision, NSW, 2010

Notes: Drivers with an unknown or unauthorised licence status were excluded. Drivers with a licence status higher than normally allowed for their age have been excluded. Drivers who resided outside NSW or on Lord Howe Island have been excluded. Drivers with an unknown residence or sex were excluded. Both Motor Vehicle Drivers and Motorcyclists have been included.

Source: RTA Crashlink Data Collection 2011 (Table A12.34 (XLSX 331.5KB)).

There has been a decline in the rate of drivers aged 16–17 years injured or killed in a crash between 2001 and 2010. The lowest rate was in 2009 at 6.0 per 1,000 drivers aged 16–17 years (Figure 12.14) (Table A12.35 (XLSX 331.5KB)).

Figure 12.14: Crash incidents resulting in injury or death of drivers aged 16–17 years, NSW, 2001–2010

Notes: Drivers with an unknown or unauthorised licence status were excluded. Drivers with a licence status higher than normally allowed for their age have been excluded. Drivers who resided outside NSW or on Lord Howe Island have been excluded. Drivers with an unknown residence or sex were excluded. Both Motor Vehicle Drivers and Motorcyclists have been included. Drivers may be counted twice if they have both a Motor Vehicle and a Motor cycle licence.

Source: RTA Crashlink Data Collection 2011 & RTA customised request (2011) (Table A12.35 (XLSX 331.5KB)).

Within NSW four areas saw an increase over the period 20002001 to 20092010 in the number of young drivers aged 16–17 years who were injured or killed while driving. The biggest increase was in the Far West (38.0%), followed by the Murray (16.8%), Northern (10.3%) and North Western NSW (9.9%). Sydney (-5.5%) and South Eastern NSW (-4.8%) saw the biggest decrease.

Within Sydney four areas saw an increase over the period 2000–2001 to 2009–2010 in young drivers aged 16–17 years who were injured or killed while driving. The biggest increase was in Inner Western Sydney (21.2%), followed by Lower Northern Sydney (16.4%), Inner Sydney (9.1%) and the Central Coast (1.0%). St George (-8.4%) saw the biggest decrease in young drivers aged 16–17 years who were injured or killed while driving over the period 2000–2001 to 2009–2010. This was followed by Outer South Western Sydney (-5.8%) and the Eastern Suburbs (-5.1%) (Table A12.34 (XLSX 331.5KB)).

Natural environment

Contact with the natural environment provides opportunities for new sensory experiences and exploratory learning for children. Research suggests that humans have an in-built affinity for nature, and experience of such environments is thought to stimulate healthy physiological and psychological development (Johnson 2007). Though these experiences are important, consideration should be given to minimizing risks of serious injury through the use of appropriate equipment and supervision.

Results from the Admitted Patients Data Collection

In 2009–2010 there were 509 incidents resulting in serious unintentional injury that occurred in a natural environment that involved children aged 0–17 years (Table A12.36 (XLSX 331.5KB)). [46] [47]

Between 2002–2003 and 2009–2010 there was a slight increase in the rate of children seriously injured in a natural environment (Figure 12.15) (Table A12.40 (XLSX 331.5KB)).

Figure 12.15: Incidents of serious unintentional injury in natural environments involving NSW children aged 0–17 years by year, 2002–2003 to 2009–2010

Sources: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health; ABS population data (Table A12.40 (XLSX 331.5KB)).

In 2009-2010, these children were involved in a range of activities at the time of injury[48]. Where the activity was specified the most common activities were:

The most common regions of the body to which injuries were sustained included:

  • ankle and foot (18.3%)
  • head (17.1%)
  • knee and lower leg (13.4%)
  • elbow and forearm (10.8%)
  • wrist and hand (10.4%) (Table A12.38 (XLSX 331.5KB)).

When the statistical significance of age, sex, Aboriginal identity, socioeconomic disadvantage and remoteness are considered:

  • male children were 2.5 times more likely to be seriously injured in the natural environment compared with female children
  • compared with 1–4 year olds, 9–14 year olds were 3.5 times and 15–17 year olds 4.3 more likely to be seriously injured in the natural environment
  • there was no statistically significant difference between Aboriginal and non-Aboriginal children
  • children living in inner regional areas were 1.3 times more likely, and outer regional areas 1.4 times more likely, to be seriously injured in the natural environment compared with children living in major cities
  • compared with children in the least socioeconomically disadvantaged (first) quintile:
    • children in the second least disadvantaged quintile were only 0.7 times as likely to be seriously injured in the natural environment
    • children in the most disadvantaged (fifth) quintile were only 0.5 times as likely to be seriously injured in the natural environment
    • the rates of serious injury among children in the other quintiles did not significantly differ (Table A12.36 (XLSX 331.5KB)).

The geographic area in NSW with the highest rate of children seriously injured was the Illawarra (0.6 per 1,000 children) (Figure 12.16) (Table A12.39 (XLSX 331.5KB)).

Figure 12.16: Incidents of serious unintentional injury in a natural environment involving NSW children aged 0–17 years by Statistical Division, NSW, 2009–2010

Sources: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health and ABS population data (Table A12.39 (XLSX 331.5KB)).

Within Sydney, the areas with the highest rate of children seriously injured in the natural environment were Northern Beaches (0.7 per 1,000 children) and Central Coast (0.5 per 1,000 children) (Table A12.39) (XLSX 293.2KB).

Farm

Farms can be great places for children to live, grow and develop, but the safety of children on farms is a major concern (Farmsafe Australia, 2005).

Living on a farm can present a number of risks for children. These may include: unfenced dams, and rivers, falls from a horse or contact with a large farm animal, injuries from vehicles used on farms such as off-road motorcycles and agricultural vehicles such as tractors (Kreisfeld, 2008).

Results from the Admitted Patients Data Collection

In 2009–2010 there were 230 incidents that occurred on farms that involved children aged 0–17 years that resulted in hospitalisation (Table A12.41 (XLSX 331.5KB)) .[49]

Between 2000–2001 and 2009–2010 the rate of children seriously injured on a farm has remained fairly steady (Figure 12.17) (Table A12.45 (XLSX 331.5KB)).

Figure 12.17: Incidents of serious unintentional injury on a farm involving NSW children aged 0–17 years by year, 2002–2003 to 2009–2010

Sources: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health; ABS population data (Table A12.45 (XLSX 331.5KB)).

In 2009–2010, these children were involved in a range of activities at the time of injury.[50] Where the activity was specified, the most common activities were:

  • wheeled motor sports (34.7%)
  • unspecified leisure activities (25.3%)
  • equestrian activities (15.8%)
  • working for an income (12.6%) (Table A12.42 (XLSX 331.5KB)).

The most common regions of the body to which injuries were sustained included:

When the statistical significance of age, sex, Aboriginal identity, socioeconomic disadvantage and remoteness are considered:

  • male children were 1.6 times more likely than female children to be seriously injured on a farm
  • compared with 1–4 year olds, 5–8 year olds were 2.1 times, 9–14 year olds 4.3 times, and 15–17 year olds 5.2 times more likely to be seriously injured on a farm.
  • there was no statistically significant difference in the rates of Aboriginal and non-Aboriginal children injured on farms
  • compared to children living in major cities, children living in inner regional areas were 8.5 times more likely, children in outer regional areas 23.9 times, children in remote areas 44.0 times more likely, and children in very remote areas 103.7 times more likely to be seriously injured on a farm
  • compared with children in the least socioeconomically disadvantaged (first) quintile:[51]
    • children in the second least disadvantaged quintile were 3.2 times more likely
    • children in the third quintile were 4.4 times more likely
    • children in the fourth quintile were 6.2 times more likely
    • children in the most disadvantaged (fifth) quintile were 4.6 times more likely to be seriously injured on a farm (Table A12.41 (XLSX 331.5KB)).

The geographic area in NSW with the highest rate of children seriously injured on a farm was Far West (0.78 per 1,000 children) (Figure 12.18) (Table A12.44 (XLSX 331.5KB)).

Figure 12.18: Incidents of serious unintentional injury on a farm involving NSW children aged 0–17 years by Statistical Division, NSW, 2009–2010

Sources: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health and ABS population data (Table A12.44 (XLSX 331.5KB)).

Workplaces

A study on children at work undertaken by the Commission for Children and Young People (2005) asked children aged 12–16 years 'Have you ever been injured at work or doing your job'. About 40.1 per cent of the children who worked reported been injured at work, and of those 7.4 per cent sustained a serious work injury. The most common injuries sustained were burns, open wounds, sprains and strains, and superficial injuries. The most common locations for these injuries were the hands, arms and legs.

The study also found that while these data were not easily comparable with data on adult occupational injury, the rate of injuries sustained by children appear to be similar, if not higher, than those sustained by adults.

The 2001 National Health Survey (ABS, 2003) found that five per cent of employees older than 15 years report one or more recent injuries at work. 1.6 per cent of children in this study were hospitalised, which is likely to be a higher rate than for adults Australia-wide, though the figures are not directly comparable (National Occupational Health and Safety Commission, 2004).

Other Australian studies have also report that workplace injuries are a significant health issue for children. Scott and colleagues (2004) found that in Queensland, children aged 10–17 years accounted for 3.6 per cent of all workplace injury presentations to emergency departments. Children aged 15–17 years, taking into account number of hours worked, were twice as likely to sustain workplace injuries requiring treatment in a hospital emergency department.

Results from the Admitted Patients Data Collection

In 2009–2010 there were 106 incidents that occurred in workplaces that involved children aged 9–17 years that resulted in a hospitalisation (Table A12.46 (XLSX 331.5KB))[52].

Between 2002–2003 and 2009–2010 the rate of serious injury among children in the workplace has fluctuated (Figure 12.19) (Table A12.50 (XLSX 331.5KB)).

Figure 12.19: Incidents of serious unintentional injury in the workplace involving NSW children aged 9–17 years by year, 2002–2003 to 2009–2010

Sources: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health; ABS population data (Table A12.50 (XLSX 331.5KB)).

In 2009–2010, the most common industries that young people were working in at the time of injury were:[53]

The most common regions of the body to which injuries were sustained included:

When the statistical significance of age, sex, Aboriginal identity, socioeconomic disadvantage and remoteness are considered:

  • male children were 8.2 times more likely than female children to be seriously injured at a workplace
  • compared with 9–14 year olds, 15–17 year olds were 66 times more likely to be seriously injured at a workplace
  • Aboriginal children were 1.9 times more likely than non-Aboriginal children to be seriously injured at a workplace
  • compared with children living in major cities, children living in inner regional areas were 2.9 times, and outer regional areas 3.4 times more likely to be seriously injured at a workplace
  • compared with children in the least socioeconomically disadvantaged (first) quintile:[54]
    • children in the second quintile were 3.2 times more likely to be seriously injured at a workplace
    • children in the third quintile were 2.5 times more likely to be seriously injured at a workplace
    • children in the fourth quintile were 3.5 times more likely to be injured at a workplace.
  • there was no statistically significant difference between children in the most and least disadvantaged quintile (Table A12.46 (XLSX 331.5KB)).

The geographic area in NSW with the highest rate of children seriously injured at a workplace was the Murrumbidgee (1.0 per 1,000 children) (Figure 12.20) (Table A12.49 (XLSX 331.5KB)).

Within Sydney, the areas with the highest rate of children seriously injured at a workplace were Outer Western Sydney (0.3 per 1,000 children) and Outer South Western Sydney (0.2 per 1,000 children) (Table A12.49 (XLSX 331.5KB)).

Figure 12.20: Incidents of serious unintentional injury at a workplace involving NSW children aged 9–17 years by Statistical Division, NSW, 2009–2010

Sources: NSW Commission for Children and Young People calculations based on NSW Admitted Patient Data Collection, NSW Department of Health and ABS population data (Table A12.49 (XLSX 331.5KB)).

Results from WorkCover

In 2009–2010 there were 417 notifications of workplace injuries concerning 15–17 year olds made to WorkCover. Most of these notifications concerned injuries that resulted in a temporary disability of less than six months (90.2%). However, a sizable proportion resulted in a permanent disability or a temporary disability of six months or more (7.2% and 2.4%). During this period one injury had a fatal outcome (0.2%) (Table A12.51 (XLSX 331.5KB)). 

Unintentional injury deaths

The incidence of deaths due to injury for children and young people is a key indicator of children's health and safety.

The NSW Child Death Review Team (CDRT) collection holds the best source of information on unintentional injury deaths. The CDRT collection is a population-based surveillance system covering the deaths of children who are usually resident in NSW.

In 2010, the deaths of 64 children were due to unintentional injury. Most deaths occurred in transport incidents (35 deaths, or 2.2 deaths per 100,000 children aged 0–17 years) (Table A12.53 (XLSX 331.5KB)) followed by accidental drowning (14 deaths, or 0.9 deaths per 100,000 children aged 0–17 years) (Table A12.54 (XLSX 331.5KB)). 

Over half of the children who died in a transport incident were passengers (54.3%). Drivers and pedestrians accounted for the majority of the remaining deaths (22.9% and 20.0%) (Table A12.55 (XLSX 331.5KB)).

Eight of the drowning deaths occurred in the home, two in a bathtub and six in a swimming pool. A further five deaths occurred in a natural body of water (Table A12.56 (XLSX 331.5KB)).

The remaining 15 children died from unintentional injuries resulting from the following causes:

  • house fires (four deaths)
  • unintentional poisoning (four deaths)
  • sporting injuries (three deaths)
  • death following medical procedures (two deaths)
  • falls (one death)
  • crush injuries (one death).

The CDRT Annual Report 2010 reports on the number and rates of death among different demographic groups. The statistical significance of these differences are not reported, and the small absolute numbers involved mean that these figures should be interpreted with caution.  The figures related to transport and drowning are reproduced in (Table A12.53 (XLSX 331.5KB) and Table A12.54 (XLSX 331.5KB)).

Trends in major categories of unintentional deaths

Over the period 1996–2010 the number of children aged 0–17 years who died from an unintentional injury has decreased (Figure 12.21) (Table A12.52 (XLSX 331.5KB)).

Figure 12.21: Children aged 0–17 years who died from selected unintentional injuries by type and year of registration, NSW, 1996–2010

Source: NSW Child Death Review Team Annual Report, 2011 (Table A12.52 (XLSX 331.5KB)).

Over the period 1996–2010 the number of children aged 0–17 years who died in transport incidents has decreased. This decrease can be seen across all types of transport incidents (Figure 12.22) (Table A12.55 (XLSX 331.5KB)).

Figure 12.22: Children aged 0–17 years who died in NSW in a transport incident by type and year of registration, 1996–2010

Source: NSW Child Death Review Team Annual Report, 2011 (Table A12.55 (XLSX 331.5KB)).

Trend analysis which compared child deaths in the period 2001-2005 with the period 1996-2000[55] found that there had been:

  • a 43 per cent decline in the likelihood of pedestrian deaths.[56] The decline was most evident for pedestrian deaths associated with traffic incidents[57]
  • a 39 per cent decline in the likelihood of a driver death[58]
  • a 13 per cent decline in the likelihood of dying as a passenger in a motor vehicle [59](NSW CDRT, 2008).

Over the period 1996–2010 the number of children aged 0–17 years who died from for drowning incidents has decreased (Figure 12.23) (Table A12.56 (XLSX 331.5KB)).

Figure 12.23: Children aged 0–17 years who died in NSW in a drowning incident by type and year of registration, 1996–2010

Source: NSW Child Death Review Team Annual Report, 2011 (Table A12.56 (XLSX 331.5KB)).

Trend analysis which compared child deaths in the period 2001-2005 with the period 1996-2000[60] found that there had been:

  • a 47 per cent decline in the likelihood of drowning in a natural body of water[61]
  • no significant differences in the likelihood of drowning in a private pool (NSW CDRT, 2008).

References

ABS. (2003). National Health Survey 2001. . Cat. No: 4363.0.55.002 Canberra: Australian Bureau of Statistics.

Australian Institute of Health and Welfare (AIHW). 2008. Australia's health 2008. Cat. no. AUS 99. Canberra: AIHW.

Farmsafe Australia. (2005). Child Safety on Farms. Online, accessed 9 December 2011 www.farmsafe.org.au/index.php?article=content/for-farmers/child-safety-on-farms

Gill, T. (2007). No Fear growing up in a risk adverse society. Calouste Gulbenkian Foundation.

Johnson, P. (2007).  ‘Growing physical, social and cognitive capacity: Engaging with natural environments’, International Education Journal, 8(2), 293-303.

Kidsafe NSW. (2011). Home Safety. Online, accessed 9 December 2011. www.kidsafensw.org/homesafety/index.htm

Kreisfeld, R. (2008). Hospitalised farm injury among children and young people, Australia 2000–01 to 2004–05. NISU Briefing, 12, 1–23.

National Occupational Health and Safety Commission. (2004). The cost of work-related injury and illness for Australian employers, workers and the community. Canberra: NOHSC. Online, accessed 9 December 2011 www.safeworkaustralia.gov.au/AboutSafeWorkAustralia/WhatWeDo/Publications/Documents/179/CostOfWorkRelatedInjuryIlness_2004.pdf

National Public Health Partnership (2005), The National Injury Prevention and Safety Promotion Plan 2004-2014, Commonwealth of Australia, Canberra

NSW Child Death Review Team. (2008). Trends in Child Deaths in New South Wales 1996–2005 NSW Commission for Children and Young People: Sydney.

Peden, M. Oyegbite, K. Ozanne-Smith, J. Hyder, A. Branche, C. Rahman, AKM . Rivara, F. and Bartolomeos, K (Eds). (2008). World Health Organization: World report on child injury prevention. Geneva, Switzerland.

Scott, D, Hockey, R, Spinks, D, Barker, R & Pitt, R. (2004). ‘Childhood pedestrian injury in Queensland’, Injury Bulletin, no. 82, June 2004, Queensland Injury Surveillance Unit, Brisbane.



[1] This chapter does not cover ‘intentional’ injury, which can be defined as injury resulting from a deliberate act such as assault, self-harm or suicide.  Data on self-harm and suicide can be found in the ‘Health and well-being’ chapter, and data on assault, abuse and neglect can be found in the ‘Children and crime’ chapter.  The primary data source for this chapter, the NSW Admitted Patients Data Collection (APDC), classifies injuries as ‘unintentional’ or ‘intentional’ using the ICD-10-AM coding system.   The Commission is aware that the distinction between intentional and unintentional injury is not always clear-cut, and that the risk factors for intentional and unintentional injuries are often similar.
[2] Note that around half of all serious injury cases were recorded with an unspecified or missing place of occurrence.
[3] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[4] Note that around half of all serious injury cases were recorded with an unspecified or missing place of occurrence. This figure is therefore likely to underestimate the true incidence of serious injuries that occurred at home.
[5] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[6] Note that around half of all serious injury cases were recorded with an unspecified or missing place of occurrence. This figure is therefore likely to underestimate the true incidence of serious injuries that occurred at sport or athletics areas.
[7] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[8] Note that around half of all serious injury cases were recorded with an unspecified or missing place of occurrence. This figure is therefore likely to underestimate the true incidence of serious injuries that occurred at school.
[9]The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[10] Note that around half of all serious injury cases were recorded with an unspecified or missing place of occurrence. This figure is therefore likely to underestimate the true incidence of serious injuries that occurred on a street or highway.
[11] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[12] A child was determined to be injured at a natural environment where the place of occurrence was recorded as an area of still water, stream of water, large area of water, beach, forest, desert, or other specified countryside  (ICD-10AM codes Y92.80 to Y92.86 inclusive).
[13] Note that around half of all serious injury cases were recorded with an unspecified or missing place of occurrence. This figure is therefore likely to underestimate the true incidence of serious injuries that occurred in the natural environment.
[14] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[15] Note that around half of all serious injury cases were recorded with an unspecified or missing place of occurrence. This figure is therefore likely to underestimate the true incidence of serious injuries that occurred on a farm.
[16] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[17] Note that around half of all serious injury cases were recorded with an unspecified or missing place of occurrence. This figure is therefore likely to underestimate the true incidence of serious injuries that occurred in workplaces.
[18] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[19] This chapter does not cover ‘intentional’ injury, which can be defined as injury resulting from a deliberate act such as assault, self-harm or suicide.  Data on self-harm and suicide can be found in the ‘Health and well-being’ chapter, and data on assault, abuse and neglect can be found in the ‘Children and crime’ chapter.  The primary data source for this chapter, the NSW Admitted Patients Data Collection (APDC), classifies injuries as ‘unintentional’ or ‘intentional’ using the ICD-10-AM coding system.   The Commission is aware that the distinction between intentional and unintentional injury is not always clear-cut, and that risk factors for intentional and unintentional injuries are often similar.
[20] Note that around half of all serious injury cases (n=10,821) were recorded with an unspecified or missing place of occurrence. These cases are therefore not included within location-specific sections of the chapter.
[21] All inpatient separations (discharges, transfers and deaths) to Public (including Psychiatric), Private, and Repatriation Hospitals, Private Day Procedures Centres and Public Nursing Homes.
[22] RTA is now Transport NSW, Roads and Maritime Services
[23] Survey data are subject to sampling and non-sampling errors.  Administrative data may be subject to item non-response, transcription errors, coding errors, clerical and editing errors and data conversion errors.  The APDC, Crashlink and WorkCover are all administrative data sources.  The SSHB is a survey.
[24] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[25] Note that around half of all serious injury cases were recorded with an unspecified or missing place of occurrence.
[26] Note that this figure is likely to underestimate the true incidence, since location was only identified in about half of all serious injury hospitalisation cases.
[27] During the period 2009-2010, the activity was unspecified for 73.2 per cent of cases.
[28] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[29] A child or young person was determined to have been injured by a motor vehicle where the ICD- 10-AM (6th edition) external cause code was ‘Pedestrian injured in transport accident’ (W01 – W09).  The speed at which the vehicle was moving is not recorded.  It is assumed that motor vehicle accidents that occur at home are likely to be low-speed.
[30] A child or young person was determined to have been injured by accidental drowning or submersion where the ICD- 10-AM (6th edition) external cause code was ‘Accidental drowning and submersion’ (W65 – W74).
[31] Children aged less than one year.
[32] A child or young person was determined to have been injured in a fall from a balcony or window where the ICD- 10-AM (6th edition) external cause codes were ‘Fall from or through balcony or veranda’ (W13.0) and ‘Fall out of or through window’ (W13.1).
[33] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[34] On the 1st January 2011 Local Health Districts (LHD) replaced Area Health Services (AHS) as the NSW Health geographic area. See Appendix Maps of NSW geographical areas used in reporting.
[35] Note that this figure is likely to underestimate the true incidence, since location was only identified in about half of all serious injury hospitalisation cases
[36] During the 2009–2010 period the activity was unspecified for 3.85 per cent of the cases.
[37] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[38] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[39] On the 1st January 2011 Local Health Districts (LHD) replaced Area Health Services (AHS) as the NSW Health geographic area. See Appendix Maps of NSW geographical areas used in reporting.
[40] Note that this figure is likely to underestimate the true incidence, since location was only identified in about half of all serious injury hospitalisation cases.
[41]During the 2009-2010 period the activity was unspecified for 50.0 per cent of the cases.
[42] The NSW Department of Health uses five groupings (quintiles): the least disadvantaged areas are in the first group and the most disadvantaged areas are in the fifth group.
[43] This category includes pavements and cycleways.
[44] Note that this figure is likely to underestimate the true incidence, since location was only identified in about half of all serious injury hospitalisation cases
[45] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[46] A child was determined to be injured in a natural environment where the place of occurrence was recorded as an area of still water, stream of water, large area of water, beach, forest, desert, or other specified countryside  (ICD-10AM codes Y92.80 to Y92.86 inclusive).
[47] Note that around half of all serious injury cases were recorded with an unspecified or missing place of occurrence. This figure is therefore likely to underestimate the true incidence of serious injuries that occurred in the natural environment.
[48] During the period 2009-2010 the activity was unspecified for 42.6 per cent of the cases.
[49] Note that this figure is likely to underestimate the true incidence, since location was only identified in about half of all serious injury hospitalisation cases
[50] During the 20092010 period the activity was unspecified for 58.7 per cent of the cases.
[51] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[52] Note that this figure is likely to underestimate the true incidence, since location was only identified in about half of all serious injury hospitalisation cases.
[53] Industry was unspecified for 60.4 per cent of the cases.
[54] The NSW Department of Health uses five groupings (quintiles) of socioeconomic disadvantage. The least disadvantaged areas are in the first quintile and the most disadvantaged areas are in the fifth quintile.
[55] Deaths of children aged 0-17 years in NSW
[56] IRR = 0.574*** 90% CI: 0.444 – 0.742
[57] IRR = 0.531*** 90% CI: 0.398 –0.708
[58] IRR = 0.605** 90% CI: 0.442 – 0.828
[59] IRR = 0.872 90% CI: 0.731 – 1.039
[60] Deaths of children aged 0-17 years in NSW
[61] IRR = 0. 529** 90% CI: 0.360 – 0.777