Road safety hazards for children while commuting to school: Findings from a pilot study in Karachi, Pakistan.

INTRODUCTION: Road traffic injuries are a leading cause of mortality and morbidity among children. Travelling to and from school is a major risk exposure for children around the globe. OBJECTIVE: The purpose of this study was to assess road traffic injury hazards for school children during dropp-off or picked-up times. METHODS: This observational cross-sectional study included 94 public and private schools in Karachi, Pakistan. A structured observational tool was used to collect data on school demographics, the road traffic environment, infrastructure, injury hazards in vehicles used by school children, and child pedestrian injury risk and road use behaviors. RESULTS: A total of 860 observations of school children, drivers of vehicles transporting children, schools, and vehicles were recorded. Most schools (n = 83, 88%) did not have designated parking spaces around the school; only one public school had a parking area. Only one private school had a zebra crossing around the school premises. Very few schools (n = 13, 14%), mostly private (n = 12) had pedestrian sidewalks. Only 35 (18%) adult motorcyclists, out of 199, were wearing a helmet, and eight (6%), out of 145, car passengers were wearing seatbelts. Compressed natural gas (CNG) cylinders were installed in 83 (35%), out of 235, observed vehicles. The remaining 152 (65%) did not have CNG cylinders or they were not visible to our data collectors. In 55 (23%) observations, bus passengers stepped off the bus in the middle of the road. Most pedestrians (n = 266, 99.5%) did not use a Zebra crossing. More than a quarter (n = 74, 28%) of pedestrians looked left and right before crossing the road. CONCLUSION: While traveling to school, either by walking or taking vehicular trips, children face many road traffic injury hazards in Karachi. Pedestrians and passengers exhibited risky behaviors while using roads. Further initiatives are advised from a public health viewpoint aiming at minimizing transport-related hazards.

Injury hazard assessment in schools: Findings from a pilot study in Karachi, Pakistan.

INTRODUCTION: Injuries are a major public health concern and one of the leading causes of death and disability worldwide. Childhood injuries contribute to a major proportion of this burden. OBJECTIVE: To identify injury hazards within school premises and playgrounds in Karachi, Pakistan. METHODS: This observational cross-sectional study took place in 107 public and private schools of Karachi, Pakistan using a self-structured standard injury risk assessment tool. This tool was developed after an extensive literature review, expert consultation, and field visits to a few local schools. Data related to school demographics, administrative data and injury hazards within the school boundaries were collected in schools offering education from nursery to secondary grades (through 10th grade, matriculation). Descriptive analysis were calculated. RESULTS: Out of 107 schools, only 12 were recording school-related injuries. A quarter (25%) of schools had some type of disaster drill exercises and built-in fire exits. Fire alarms were placed in 10 schools (9%), all of which were private. In 16 schools (15%), students had access to rooftop doors. There were multiple injury hazards in the school playgrounds. More than half of the schools had hazardous playground surfaces, such as slippery, concrete and uneven ground. Over 80% of schools were not supervising the children during playtime and did not have a separate play area for children under 6 years old. In 38 schools (22%), there were multiple injury hazards in the play rides, such as broken equipment, rusted parts, and sharp edges. Moreover, nine schools (7%) had loose nuts, bolts, edges, belts, steps, or rails in their play rides. Inside, almost a quarter (24%, n = 76) of schools did not have proper insulation of electric wires. Protruded metal nails, which could be high risk for prick and cut injuries, were observed in 20% of the observed furniture. CONCLUSION: In conclusion, there are multiple injury hazards in the private and public schools of Karachi, Pakistan.

Adolescent school injuries and classroom sex compositions in German secondary schools.

BACKGROUND: School injuries are an important adolescent health problem. Previous research suggests that relevant risk behaviors for school injuries, risk-taking and aggression, are highly susceptible to peer effects. Specifically, evidence suggests that the ratio of men and women in peer groups (sex ratio) affects individuals' propensity for aggression and risk-taking. However, potential associations of classroom sex ratios with adolescent school injury risks have not been studied so far. The purpose of this paper is to investigate the association of classroom sex compositions with adolescent school injuries. METHODS: We investigate the association of classroom sex ratios with school injuries in a longitudinal survey dataset containing 13,131 observations from 9,204 adolescent students (ages 13-16) from secondary schools in Germany. The data also allow us to identify injuries due to aggressive behavior and analyze these injuries in detail. We use multilevel logistic regression models to analyze risks of both overall and aggression-related school injuries. RESULTS: Adolescent students' risk for school injuries is significantly and positively associated with male-skewed classroom sex ratios (OR = 1.012, p=0.012). Specifically, the risk of sustaining a school injury increases by 33.5 percent when moving from the 10th to the 90th classroom sex ratio percentile. Moreover, we find an even stronger positive association between male-dominated classrooms and aggression-related injury risks (OR = 1.022, p=0.010). Compared to classroom sex ratios at the 10th percentile, the risk of an aggression-related injury is 78 percent higher in classrooms with a sex ratio at the 90th percentile. Finally, we find that both boys' and girls' injury risks equally increase with a higher proportion of male students in their classroom. CONCLUSIONS: Our findings indicate that sex composition of classrooms is an important contextual factor for adolescent school injuries, in particular school injuries resulting from aggression. These findings illustrate the need to integrate a contextual perspective on school injuries among adolescent students both into research and into intervention planning.

School environment and school injuries.

BACKGROUND: Although injuries at school are an important issue in public health, environmental factors in schools and school yards have seldom been the focus of school injury research. The goal of our investigation was to examine the effect of environmental factors on school injuries. METHODS: Nine comprehensive Finnish schools registered school injuries over a period of two school years. Injuries were classified as being associated with environmental factors, suspected environmental factors, and others. The consensus between two independent classifiers was 81%. RESULTS: A total of 722 injuries were classified. In 11.6% of these injuries, the physical environment factor was evident, and in 28.1% of the injuries, physical environment was suspected of being a contributory risk factor. Thus the physical environment of the school was a contributing factor in over a third (39.7%) of injuries occurring in the school, on the school yard or during the journey to, or from school. In this study, conducted in Finland, ice on the ground was mentioned most frequently as an environmental risk factor. CONCLUSION: In Finland, the Nordic weather conditions are not taken into account in the school yard and playground plans as they ought to from the safety point of view. An initiative has been launched on a mandatory wintertime master plan for every school yard.