Based on national survey data, researchers estimated
there were more than 7 million ER visits due to in-school injuries
in the U.S. between 2001 and 2008. One in 10 resulted from physical
altercations with classmates.
"It appears to be concerningly high, especially when you realize
that such a substantial number of injuries are occurring in the
school setting where safety measures are already in place," said Dr.
Siraj Amanullah. He led the study at Alpert Medical School of Brown
University in Providence, Rhode Island.
Kids who were injured in physical fights at school and sent to the
ER were twice as likely to be hospitalized as those who had
accidental injuries. For injuries that happened outside of school,
the odds of hospitalization were more than five times higher for
That suggests bullying injuries might be more severe than other
injuries, Amanullah told Reuters Health.
ER visits related to violence in school declined from about 200,000
in 2003 and 2004 combined to 150,000 in 2007 and 2008, the authors
report in Pediatrics.
But those numbers are still troubling, Amanullah said, because
bullying is often underreported, and there are equally important
non-physical forms of bullying as well.
"Intentional injuries still pose a significant health care and
public health burden may it be inside or outside the school
setting," he said. "There is a need to continue addressing this
issue at various levels, at home, at school and in the medical care
setting, and there is a need to ramp up our existing prevention and
safety strategies especially in the school setting, a presumed safe
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Boys as well as black, Hispanic and American Indian children were
the most likely to visit an ER due to bullying. That's in line with
previous research on physical bullying.
Bullying prevention programs might need to be targeted to these
kids, and to those between age 10 and 14, who were also particularly
at risk, Amanullah said.
The most common injuries resulting from violence were to the head
and neck, and they were as likely to be simple cuts and bruises as
serious brain trauma. About 90 percent of kids who went to the ER
due to physical bullying said a friend or acquaintance hit them as
opposed to a stranger.
"Parents and physicians need to talk to children about violence and
bullying in and out of school and try to address the issue at
various levels just like prevention efforts for any other medical
illness," Amanullah said.
"As we become aware of the disparities, one of the ways to address
prevention is to involve the victims of such injuries in developing
the appropriate preventive strategies."
Pediatrics, online Jan. 13, 2014.
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