An Epidemiological Study Of Primary Students' Injury In Immigrant Schools

Background: Injury is a serious public health problem in the world,but also a major cause of injury,disability and death of children and adolescents.Around 950,000 children and adolescents under the age of 18 died from injury every year in the world.In China,migrant workers are a special vulnerable group,more and more attention has been paid to the injury of their children.According to the sixth national census,the total number of migrant children in mainland China is 35.81 million Studies at home and abroad show that the injury frequency of migrant children is higher than that of local schools,and the problem of migrant children's school students' injury is serious.Therefore,in this study,in Yixing city,the injury questionnaire survey was conducted on the migrant students,by cross-sectional study,case-control study and cohort study,analyzing the diferences of the migrant children school students and related risk factors,and put forward several specific prevention strategies and measures,enrich migrant children school students risk factors of epidemiology,to reduce migrant students' damage for injury prevention.Objectives:1.To understand the basic demographic investigate,such as family environment,caregivers,whether the students have behavioral problems,and the mothers' emotions during pregnancy,etc.,and to understand the current situation of students' injury in migrant schools and the influencing factors of students' injury in migrant schools.2.Case control study was conducted to explore the factors affecting the injury of students from migrant schools.3.A one-year follow-up study was conducted on the children of migrant workers in schools to further explore the injury-related factors.Methods:1.Cross-sectional study: using the method of cluster random sampling,all classes from grade 1 to grade 5 in one local school and two migrant schools in Yixing city were selected as the survey samples.With the assistance of Yixing Center For Disease Control And Prevention,investigators participating in our study were trained.The survey included characteristics of students,Rutter behavior scale,family basic information,primary caregivers,primary caregivers' education and parenting style to the students,and injuries suffered by the students in the past year.2.Case-control study: The injured students in the schools of migrant workers' children in this investigation were regarded as the case,according to the method of 1:1 case control matching,the migrant students who are the same gender and grade as the case in this investigation,and who have not been injured in the previous year as the control group are randomly selected.3.Cohort study: 1 038 students from migrant schools were selected as the exposed group and 1 403 students from local schools as the non-exposed group.A one-year follow-up was conducted for 6 times to observe the injury incidence of all the follow-up students in migrant schools and local schools,including the number of injuries suffered by the student in the past two months,the reason for the injury,whether the student injury was intentional,the nature of the injury,the injury site,the injury involvement system,the injury severity,and the injury outcome.Results:1.Cross-sectional study: A total of 2,513 students were selected in this survey,and 2,441 valid questionnaires were obtained after sorting out,with an effective rate of 97.13%.The injury rate of students from migrant schools was 19.94%,higher than that of students from local schools(15.54%).The injury of migrant children's school students may be related to the following factors:grade,the situation of school pickup and drop-off,students' main caregivers,caregivers' health status,students' attitudes toward caregivers before exams,whether they have behavioral problems,long-term foster care when they are 0-3 years old,their mothers' emotional happiness during pregnancy,their mothers' emotional depression during pregnancy,and their mothers' emotional fear or anxiety during pregnancy.2.Case-control study:Univariate Logistic regression analysis showed that seven variables,including the pick-up and drop-off from school,primary caregivers of students,health status of caregivers,behavioral problems of students,emotional happy of mothers during pregnancy,emotional depression of mothers during pregnancy,and emotional fear or anxiety of mothers during pregnancy,were significant risk factors of student injury(P < 0.05).Multivariate Conditional Logistic regression analysis showed that maternal depression during pregnancy(OR=4.141,95%CI: 1.312-13.069),caregiver's education level,caregiver's intermediate personality(OR= 2.278,95%ci: 1.224-4.241),caregiver's extroversion personality(OR= 2.497,95%CI: 1.254-4.972)and other factors were the main risk factors for injury of migrant students.3.Cohort study: Among the 1 038 students in migrant schools,217 were injured,a total of 385 times,and the injury rate was 37.09%.Among the 1 403 students in the local school,263 had injuries,a total of 465 times,with an injury rate of 33.14%.The two independent samples in the non-parametric test showed no significant difference in the injury prevalence between migrant schools and local schools(P>0.05).The main place where the injury occurred was at home(43.73%).Damage occurs when students mainly leisure activities(29.31%)and on foot(18.97%),unintentional injuries intent(accident)(66.18%),nature of the injuries mainly to damp down/bruise(29.37%),injury site mainly for lower limbs(27.88%),upper limbs(22.31%),head(16.73%),injuries involving the system is motor system(25.42%)and injuries severity is mitigated injury(82.28%),injuries result mainly processing after departure from the hospital(52.29%).Univariate analysis found the following factors were statically: gender,grade,school transport situation,the caregiver's education level,primary care health and primary care for the children's education mode,children's learning counselling caregivers given,whether children have behavioral problems,pregnant mother happy mood in the single factor analysis was statistically significant(P < 0.05).The results of multinomial logistic regression analysis showed that behavioral problems in children(OR=2.927,95%CI: 1.697-5.048)were the influential factors with statistical significance in the multinomial logistic regression analysis of the first injury(P < 0.05).When the number of injury was 2,the outcome variable was analyzed by multinomial Logistic regression,and there were no statistically significant influencing factors;No school transport(OR=3.508,95%CI: 1.663-7.402),school bus transport(OR=2.398,95%CI: 1.186-4.846),punishment was the main education method for the child by the primary caregivers(OR=2.830,95%CI: 1.068-7.499),and mother's mood was happy during pregnancy(OR=2.105,95%CI: 1.053-4.205)were the statistically significant influencing factors in the multinomial logistic regression analysis of the three injuries(P < 0.05).Conclusion:1.The high incidence of injury in migrant schools is one of the important public health problems threatening the health of students.2.In the case control study,maternal depression during pregnancy,caregiver's education level,caregiver's intermediate personality,and caregiver's extraversion personality were risk factors for injury of migrant children's school students.3.In the cohort study,the risk factors of injury to migrant children's schools were: children having behavioral problems,not picking up the children to school by foot,school bus picking up,the main caregiver's education mode to the children was mainly punishment,and the mother's unpleasant pregnancy.