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How are Children Hurt At School? An Analysis of Emergency Room Admission Data

Posted in Personal Injury

How are children hurt at school?

The 2023-2024 school year has already started in some districts and will be in full swing across the country by early September. A new school year is full of excitement, but it also brings the risk of students getting injured while on campus.

What do you need to know about school injuries as your kids return to class this fall?

To answer that question, The Fine Law Firm analyzed records of school injuries collected by the National Electronic Injury Surveillance System (NEISS), a database maintained by the U.S. Consumer Product Safety Commission that uses a sample of emergency departments to estimate the total number of emergency department visits nationwide caused by certain consumer products or other factors.

NEISS data estimates that nearly 2.4 million people were taken from U.S. schools to the hospital from January 2017 through December 2021, even with a significant dip in 2020 and early 2021 while many schools went remote as a COVID-19 precaution.

Boys are much more likely to get injured at school than girls.

One trend that stands out is that male students require emergency medical treatment significantly more often than female students. In fact, on the median day during the time period we looked at, nearly 50% more boys than girls were taken from school to the emergency department.

Injuries are more common early in the school year.

Additionally, many of the days with most injuries occur in the fall semester. We’ll set aside 2020 and 2021 because seasonality data is skewed by school closings, but in each year from 2017-2019, 42% of the total injuries occurred after September 1st — and at least seven of the 10 days with the most student emergency department visits each year fell in the fall.

Rolling 30-day average of injuries for selected year

Sports are a frequent source of school injuries, but so are floors and stairs.

One likely reason that boys are injured more often than girls, and that so many injuries take place in the fall semester, is that the two most common sources of injuries requiring students to head to the emergency room are football and basketball, which account for more than 20% of the total emergency department visits by students — an estimated 250,000 injuries or more for each sport.

Soccer and volleyball, as well as exercise and other unspecified sports/recreational activity, are also on the list of the top 10 sources linked to school injuries, along with floors, stairs, ceilings and walls, and playground climbing apparatus like monkey bars — all of which were linked to at least 50,000 injuries from 2017-2021.

Here are the most common sources linked to school injuries:

Activity/product Est. injuries, 2017-2021 Most common diagnosis
#1 Basketball 261,000 Strain/sprain (36%)
#2 Football 257,000 Strain/sprain (25%)
#3 Other sports/recreation 193,000 Strain/sprain (34%)
#4 Playground climbing apparatus 118,000 Fracture (49%)
#5 Floors/flooring materials 108,000 Internal injury (27%)
#6 Stairs/steps 88,000 Strain/sprain (31%)
#7 Soccer 84,000 Strain/sprain (27%)
#8 Other exercise 67,000 Strain/sprain (37%)
#9 Interior ceilings/walls 64,000 Internal injury (22%)
#10 Volleyball 59,000 Strain/sprain (42%)

Sports occupying several of the top spots on the list of injury causes could also explain part of the gap between boys and girls. While female participation in high school sports has been on the rise for decades, there were still nearly 1.2 million more boys participating in athletics.

Sprains and strains are the most common injury, but the source of the injury can change that.

Sprains or strains and fractures, which occur commonly in athletic contexts, are the most frequent types of school injuries that require emergency department visits, making up more than one-third of the incidents in the NEISS data.

But the context of the injury matters. For example, injuries caused by floors or ceilings are significantly more likely to involve internal injuries, while nearly half of injuries incurred on the monkey bars are fractures. And football is responsible for a little over 10% of the total injuries, but it accounts for more than 20% of the concussions.

Use the interactive below to explore the most common types of injury for each of the most frequent causes.

Overall, close to 30% of school injuries involve the head or face, where lacerations (cuts) and internal injuries are more common. Another 15% of injuries are to knees and ankles, where strains and sprains are the most common — in fact, more than 70% of ankle injuries at schools are strains or sprains. An additional 9% of school injuries involve fingers, where fractures are the most frequent outcome.

Use the interactive below to see the most common types of injuries to different parts of the body.

Fortunately, the overwhelming majority of school injuries — even when they require a trip to the hospital — are not very serious. 97% of the injuries in the NEISS dataset are either treated on an outpatient basis or examined and released without need for further treatment. An additional 2% of school-related injuries are either admitted to the hospital where they are initially taken or transferred to a different facility for treatment. And fewer than 1 in 42,000 school injuries — an estimated 57 nationwide from 2017 through 2021 — were fatal.

Data sources and methodology

Data comes from the National Electronic Injury Surveillance System, which uses data collected from 100 hospitals’ emergency departments as a probability sample to estimate the number of injuries associated with specific consumer products or activities. We looked at any injuries that indicated that they took place in a school setting from January 2017 through December 2021.

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