School bus-related injuries among children and teenagers in the United States, 2001-2003

OBJECTIVE. The purpose of this work was to describe the epidemiology of nonfatal school bus-related injuries among children and teenagers aged ≤19 years in the United States. DESIGN/METHODS. Nationally representative data from the National Electronic Injury Surveillance System All-Injury Program operated by the US Consumer Product Safety Commission were analyzed. Case subjects included all of the patients in the National Electronic Injury Surveillance System All-Injury Program database who were treated in a hospital emergency department for a nonfatal school bus-related injury from 2001 to 2003. RESULTS. There were an estimated 51 100 school bus-related injuries treated in US emergency departments from 2001 to 2003, for a national estimate of 17 000 injuries (rate: 21.0 per 100 000 population) annually. Ninety-seven percent of children were treated and released from the hospital. Children 10 to 14 years of age accounted for the greatest proportion of injuries (43.0%; rate: 34.7) compared with all other age groups. Motor vehicle crashes accounted for 42.3% of all injuries, followed by injuries that occurred as the child was boarding/alighting/approaching the bus (23.8%). Head injuries accounted for more than half (52.1%) of all injuries among children <10 years of age, whereas lower extremity injuries predominated among children 10 to 19 years of age (25.5%). Strains and sprains accounted for the highest percentage of all injuries, followed by contusions and abrasions (28.3%) and lacerations (14.9%). More than three quarters (77.7%) of lacerations were to the head. CONCLUSIONS. This is the first study to describe nonfatal school bus-related injuries to US children and teenagers treated in US hospital emergency departments using a national sample. This study identified a much greater annual number of school bus-related injuries to children than reported previously.