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School Bus–Related Injuries Among Children and Teenagers in the United States, 2001-2003

^a Center for Innovation in Pediatric Practice
^e Center for Injury Research and Policy, Columbus Children's Research Institute, Children's Hospital, Columbus, Ohio
^b Office of Statistics and Programming, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
^c Section of Developmental Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana
^d Department of Emergency Medicine, Center for Trauma and Injury Prevention Research, University of California, Irvine, California

OBJECTIVE. The purpose of this work was to describe the epidemiology of nonfatal school bus–related injuries among children and teenagers aged 19 years in the United States.

DESIGN/METHODS. Nationally representative data from the National Electronic Injury Surveillance System All-Injury Program operated by the US Consumer Product Safety Commission were analyzed. Case subjects included all of the patients in the National Electronic Injury Surveillance System All-Injury Program database who were treated in a hospital emergency department for a nonfatal school bus–related injury from 2001 to 2003.

RESULTS. There were an estimated 51100 school bus–related injuries treated in US emergency departments from 2001 to 2003, for a national estimate of 17000 injuries (rate: 21.0 per 100000 population) annually. Ninety-seven percent of children were treated and released from the hospital. Children 10 to 14 years of age accounted for the greatest proportion of injuries (43.0%; rate: 34.7) compared with all other age groups. Motor vehicle crashes accounted for 42.3% of all injuries, followed by injuries that occurred as the child was boarding/alighting/approaching the bus (23.8%). Head injuries accounted for more than half (52.1%) of all injuries among children <10 years of age, whereas lower extremity injuries predominated among children 10 to 19 years of age (25.5%). Strains and sprains accounted for the highest percentage of all injuries, followed by contusions and abrasions (28.3%) and lacerations (14.9%). More than three quarters (77.7%) of lacerations were to the head.

CONCLUSIONS. This is the first study to describe nonfatal school bus–related injuries to US children and teenagers treated in US hospital emergency departments using a national sample. This study identified a much greater annual number of school bus–related injuries to children than reported previously.

Key Words: school bus • injury • traffic crash • transportation • trauma

Abbreviations: NHTSA—National Highway Traffic Safety Administration • ED—emergency department • NEISS—National Electronic Injury Surveillance System • AIP—All Injury Program • TRB—Transportation Research Board • NTSB—National Transportation Safety Board

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