Every year, thousands of children and adolescents aged 0–18 across Australia present to an emergency department (ED) or are hospitalized for an injury or poisoning incident. Injury hospitalizations are the third leading contributor to the burden of disease for children and adolescents aged 0–19 years. Injuries sustained during childhood can have profound and lifelong effects on health and development.

Released today by the Australian Institute of Health and Welfare (AIHW), “Injuries in children and adolescents” explores around 604,000 ED presentations and 89,000 injury hospitalizations that occurred in 2021–22. The report covers the main types, causes, and severity of injuries experienced by Australians aged 0–18 years.

Falls caused the highest number of injury hospitalizations across all age groups, except for 16- to 18-year-olds, where transport (including pedal cycles, motorbikes, and cars) was the leading cause.

Contrary to the previous five years of data, the age-standardized rate of injury hospitalization among children and adolescents decreased from 2017–18 to 2021–22.

Falls cause the highest number and rate of injury hospitalizations

“In children and adolescents, 1 in 3 hospitalizations in 2021–22 were caused by a fall,” said AIHW spokesperson Dr. Heather Swanston.

“Playground equipment was the most common cause of falls among children, with hospitalization rates being highest among children aged 5–9 years.”

Among infants, nearly 1 in 4 falls involve a bed. More than 1 in 5 occurred while being carried or supported by another person.

The most common type of fall for 13- to 18-year-olds was due to colliding with, or being pushed by another person.

While falls caused the highest number of injury hospitalizations for children and adolescents, adults are over twice as likely to be hospitalized for a fall.

Fractures are the most common type of injury among children.

“More than half of injuries caused by falls resulted in fractures, with fractures accounting for more than a third of injury hospitalizations among children and adolescents,” said Dr. Swanston.

“Nearly half of fractures presenting to the ED involve the shoulder and upper limb. For children aged 5–9, this increases to over 3 in 5.”

For fractures overall, children aged 10–12 had the highest rate of emergency department presentations, while adolescents aged 13–15 had the highest rate of hospitalizations.

After fractures and open wounds, poisoning or toxic effects were the next most common cause of injury hospitalizations. This was the only type of injury where girls were more likely than boys to be hospitalized. The leading type of poisoning among girls (44%) was poisoning by nonopioid analgesics, antipyretics and antirheumatics. These drugs include aspirin, paracetamol and ibuprofen.

Children are at greater risk of certain injuries according to developmental stage

The most common injuries diagnosed at an ED for children under the age of nine were head injuries.

Infants aged 0–1 had the highest rate of injury hospitalizations caused by choking and suffocation, with inhaled food being the most common cause.

Children aged 1–4 had the highest rate of injury hospitalizations caused by drowning and submersion, and were most likely to drown or have a near-drowning experience in a swimming pool.

Adolescents aged 13–15 are 2.1 times more likely than adults to be hospitalized for an injury caused by drowning and submersion. Around half of these cases occurred in natural water, such as the ocean or a lake.

Adolescents aged 13–18 are 3.4 times more likely than adults to be hospitalized for injuries caused by intentional self-harm. Over 4 in 5 of these hospitalizations were for girls.

Adolescents aged 16–18 were 1.6 times more likely than adults to be hospitalized for injuries caused by transport (including pedal cycles, motorbikes, and cars), while adolescents aged 13–15 were 1.4 times more likely.

The 16–18 age group had the highest rates of injury hospitalization overall.

The report presents information on the nearly 604,000 emergency department (ED) presentations and 89,000 injury hospitalizations that occurred across Australia among children aged 0–18 between 2021–22. This report does not include information on injuries among children that did not result in ED presentations or hospitalizations—there are many more cases treated by general practitioners, allied health professionals or outpatient clinics that are not reflected in this report.

Provided by Australian Institute of Health and Welfare (AIHW)