This document follows the practice of the UN Convention on the Rights of the Child,which stipulates that a 'child'means every human being below the age of 18 years(3).When referring to the problem of injury in children and adolescents,however,the focus of attention is primarily on those aged 1-17 years(injury being a less significant cause of death for infants under the age of 1 year). Injury classification Injuries can be classified in a number of ways,either according to Classification of injuries whether or not they are deliberately inflicted (and by whom),and/or according to the mechanism of the injury(see adjacent box).In most WHO,following the International cases,the classification of injury by intent is fairly straightforward. Classification of Disease(ICD-10),uses the However,in relation to children,it is more likely that there will be following classification scheme for injuries some"grey"area.For example,a child losing their balance and falling 9: into a fire clearly constitutes an unintentional injury,but if the fall Unintentional(i.e."accidental"),for example: occurs when the child has been left unsupervised for long periods or road traffic crashes, after the child has been struck,then the question of neglect or abuse falls, arises.In terms of the intention to harm,the gradient ranges from burns,flame,scalds, actively intending to hurt or harm a child at one end of the spectrum drowning, through to neglect,where a child is injured through lack of reasonable poisoning, care or failure to protect.at the other. animal bites. Intentional (i.e.deliberate),for example: interpersonal violence(e.g. Patterns of injury homicide,sexual violence), self-harm(e.g.attempted suicide, Overall,the leading causes of injury death among children and self-mutilation). adolescents are road traffic crashes,drowning,fire-related burns, Legal interventions self-harm and violence (see figure below).It is important to note that War,civil insurrection the pattern of non-fatal injuries is very different to that of injury deaths. Undetermined intent For example,falls are commonly a leading cause of injury but not necessarily a leading cause of injury death. INJURY DEATHS IN CHILDREN AND ADOLESCENTS UNDER THE AGE OF 15 YEARS,BY CAUSE, 2002 Other*28% Road Traffic 26% Self-inflicted 2% Violence 4% Drowning 20% Poisons 5% Falls 5%- Burns 10% *"Other"includes deaths due to smothering,choking,venomous animals,electrocution,firearm incidents and war. Source:WHO Global Burden of Disease project for 2002,version5. 5





























































































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