Child injury as a life-cycle issue Injuries are responsible for close to 3%of the nearly 11 million deaths that occur annually in children under the age of 5 years.Although in the case of infants under 1 year,injury only represents 1-1.5%of all deaths,for those aged 1-4 years,the proportion rises to 6%.As a cause of death,injury continues to increase in significance as children age:for children aged 5-9 years injury is associated with 25%of deaths,and for those aged 10-14 years,injury accounts for almost a third of deaths(31%).The proportion of deaths due to injury for those aged 15-17 years is likely to be the same as,or higher than,that for those aged between 10 and 14 years(1).On average,for children in the age group 5-14 years,injury accounts for more than a quarter(27%)of all deaths worldwide. The finding that injury prevalence is highly associated with age and stage of development is not surprising. In fact,the rate of injuries rises the moment babies start to move and explore their world.This is because children inhabit a world built for adults but interact and deal with the world differently to adults.Their size mass,bodily proportions and surface-to-mass ratio are all factors that contribute to increasing their risk of dying from a specific type of injury.For example,a hot liquid scald of a given size is likely to be more dangerous to a child than to an adult because of the greater proportion of skin affected;likewise,the toxic dose of a poisonous substance is lower for children because of their smaller mass.Exploration of their surroundings is an essential part of a child's development but it is this very exploration-combined with their lack of understanding of hazards and the nature of their immediate environment-that places them at risk:a baby explores its world by putting things in its mouth oblivious to any harm that might accrue from so doing or steps onto water not understanding that it is not solid.The ability to judge hazards takes time to develop and in very young children its absence further increases their risk of injury. The stage of development of a child,how a child interacts with the world and the different activities it undertakes as it matures all help to explain the strong association between life-stage and the rate and type of injury.For instance,among those aged under 1 year,fires,road traffic crashes,drowning and falls are the leading causes of injury death.In the 1-4 year age group,as children start to move more independently,drowning becomes the leading cause of injury-related death followed by road traffic crashes and fires,all three of which combined account for two thirds of injury deaths.Similarly,most injury deaths in young children can be categorized as unintentional,but as children age the proportion of intentional injury begins to rise.Whereas in children under 10 years of age intentional injury only accounts for around 5%of injury deaths,in those aged 10-14 years,the percentage rises to about 15%.Above 15 years of age,as many as one third of injury deaths are classified as intentional. Child injury and gender Injury and injury death are also highly associated with gender.In the under fifteens,there are,on average, 25%more injury deaths among boys than there are among girls(1).A number of factors contribute to the male excess in injury mortality,including differences in exposure to hazards,behaviour and socialization as well as differences in social treatment. The gender difference varies by the type of injury and also by age.The number of male deaths exceeds that of females in nearly all categories of injury,with the exception of fire-related bums(see figure on page 7).The female excess in fire-related bums is particularly noticeable in certain parts of the world,where female adolescent deaths can exceed males by more than 50%(1).In the low-income countries of the Easter Mediterranean Region,for example,flame death rates for females aged 10-14 years are 60% higher than those for males (1).a finding which can be attributed,at least in part,to the fact that the responsibility for cooking-mainly on open fires-falls to young girls and women,many of whom wear traditional-style,flammable clothing 6




























































































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