950,000 children worldwide killed by injury, violence
By Elizabeth Landau
(CNN) -- The summer that her family bought a soft-sided pool, Charisse Nurnberg of Assaria, Kansas, tried to keep her children safe from water-related injuries. She kept all the doors locked and would even have her young son Matt wear a life jacket while he played inside.
But one day in August 2002, 3-year-old Matt got into the pool unsupervised. An ambulance rushed him to the hospital, but it was too late. He had drowned.
"You don't think it can happen to you, you think you've got things under control, and it just happens to other people," Charisse Nurnberg said. "It is just, I think, probably about the most horrible experience a parent can live through."
New reports from the World Health Organization and the Centers for Disease Control and Prevention show that deaths by unintentional injury, such as drowning, are a growing problem worldwide. More than 950,000 of those younger than 18 are killed annually by injury or violence; about 830,000 of them die from unintentional injury.
"Even for those of us working in the field, we were taken aback by that number," said Dr. Adnan Hyder, associate professor at Johns Hopkins University's Bloomberg School of Public Health and one of the editors for the WHO report. "Some of that is an underestimate, frankly speaking."
In the United States, an average of about 12,000 people aged 19 and younger died from unintentional injuries each year from 2000 to 2006, the CDC report said. Males' injury death rates were nearly twice as high as those of females, the report said.
Injury rates were highest for American Indian and Alaska natives in the United States and lowest for Asian or Pacific islanders, the report said. States with the lowest injury death rates were in the Northeast. See how different states compare »
For nonfatal injuries in the United States, about 9.2 million children per year had an initial emergency department visit for an unintentional injury, the CDC report said.
Generally, in high-income countries, injuries account for 40 percent of all child deaths, the WHO report said. But low-income and middle-income countries bear most of the burden; 95 percent of all child injuries occur in those areas, the report said.
"Something good is happening in high-income countries in terms of prevention, which is not happening in many other countries," said Dr. Junaid Razzak, chairman of the Department of Emergency Medicine at Aga Khan University in Karachi, Pakistan.
Road crashes are the No. 1 cause of injury and death among children globally, claiming 260,000 lives annually, the report said. Drowning follows as the second leading cause of death, killing more than 175,000 children a year, and is the top cause of injury and death in Asia.
Burns, falls and poisoning were also in the top five leading causes of death by unintentional injury, the report said. Africa has the highest overall rate for unintentional injury deaths, 10 times higher than in many high-income countries.
Razzak, who wrote a chapter of the WHO report, said he sees a significant number of children with head injuries sitting in the laps of their parents in cars or motorcycles in Pakistan.
He also mentioned falling televisions as another source of injury or even death among kids in Pakistan. Children also commonly fall from the roofs of buildings while playing, he said.
The WHO report recommends that each country develop a child-injury prevention and control policy connected to other child health strategies, taking into account the needs of all children. It also urges countries to strengthen their health system capacities to provide requisite care to injured children.
Minimum drinking-age laws, seat-belts, motorcycle helmets and graduated driver licensing systems are some proven interventions to promote road safety, the report said.
For drowning, four-sided fencing around swimming pools, personal floatation devices and immediate resuscitation are some ways to prevent fatal injury, the report said.
Nurnberg said that for pool safety, she warns against putting even a drop of water in a pool until there is a fence around it. She also recommends installing an alarm that makes a sound whenever any door opens and said parents should not just rely on watching and listening.
"My husband was actually outside when it happened," she said. "I think we envision with drowning things that we see on TV and in movies, that splashing and yelling, and that just doesn't happen. He didn't hear the break of the water."
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