Injuries associated with... SCHOOL BUSES

Entire CHIRPP database, as of May 1995, under 20 years of age

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SUMMARY (356 records)

Injuries associated with school buses were most common (48.3%) among children 10 to 14 years of age and 55.9% of these injuries were sustained by boys. These injuries occurred most often in the fall (37.1%), on weekdays and between the hours of noon and 4 p.m. Patients were injured most frequently (17.7%) while entering or leaving the bus. The most common type of injuries was abrasion/bruising/inflammation (40.9%) and (37.2%) of injuries were to the head. Injuries requiring advice only or minor treatment accounted for 64.3% of patients, 30.0% of patients needed medical follow-up after leaving the emergency department, 5.3% were admitted to hospital and one patient suffered fatal injuries.

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SPECIFICATIONS OF THE SEARCH

A May 1995 search of the entire CHIRPP database (423,663 records) was conducted. The age restriction was 19 years of age or younger. Records were selected if the text fields contained the following strings "SCHOOL BUS," "AUTOBUS SCOLAIRE" or "AUTOBUS D'ECOLE." Selected records were then scanned and eliminated if the reference to a school bus was incidental to the injury. Injuries to children who had just disembarked from or were about to get on a school bus and were struck by another vehicle were included. Injuries to children waiting for a school bus were not included. The total number of records identified was 356.

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OVERALL OCCURRENCE

The proportion of records in the entire CHIRPP database accounted for by injuries associated with school buses was 0.10%, with little variation from year to year.

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AGE AND SEX DISTRIBUTION OF INJURED PERSONS

	NUMBER	PERCENT OF INJURIES	% MALE*
0-4 years	20	5.6	65.0
5-9 years	132	37.1	56.8
10-14 years	172	48.3	55.8
15-19 years	32	9.0	46.9
Total	356	100.0	55.9

* Of all injuries to people younger than 20 years of age in the CHIRPP database, 59.1% are to males.

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SEASON DURING WHICH INJURY OCCURRED

	NUMBER	PERCENT OF INJURIES
Fall (Sept.-Nov.)	132	37.1
Spring (March-May)	90	25.3
Winter (Dec.-Feb.)	87	24.4
Summer (June-August)	47	13.2
Total	356	100.0

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TIME AT WHICH INJURY OCCURRED

	NUMBER	PERCENT OF INJURIES
Midnight to 8 a.m.	10	2.8
8 a.m. to Noon	68	19.1
Noon to 4 p.m.	135	37.9
4 p.m. to 8 p.m.	66	18.5
8 p.m. to Midnight	28	7.9
Unknown	49	13.8
Total	356	100.0

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HOW THE INJURY OCCURRED

The following is a list of frequently occurring circumstances and factors in school bus injuries. Each case has been assigned to only one category and percentages are based on 356 persons injured. Category assignment is based on the level of detail available in the description of the injury.

	NUMBER	PERCENT OF INJURIES
Injured while entering or exiting the bus	63	17.7
Bus involved in motor vehicle accident	54	15.2
Horseplay or inappropriate activity (victim or participant)	44	12.4
Hurt while fighting (victim or participant)	40	11.2
Other passenger fell on/bumped into patient	29	8.1
Bus stopped, braked,turned (sudden movement)	24	6.7
Hit/run over by a school bus	17	4.8
Hit against window or seat	14	3.9
Injured while walking or standing on bus	13	3.7
Caught finger or hand in window or other fitting	11	3.1
Hit by object thrown or swung by other	9	2.5
Hit by vehicle other than the school bus (incl. bicycle)	8	2.2
Bus door closed on	7	2.0
Other	14	3.9
Unspecified	9	2.5
Total	356	100.0

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NATURE OF INJURY AND BODY PART INJURED

	NUMBER		PERCENT OF INJURIES
Abrasion, bruising or inflammation		153	40.9
arm, hand or finger	51
head or neck	50
leg or foot	27
trunk	23
internal organ	2
Sprain		78	20.9
head or neck	27
leg or foot	26
arm, hand or finger	17
trunk	8
Cut, laceration or puncture		50	13.4
head or neck	32
arm, hand or finger	12
leg or foot	6
Fracture		49	13.1
arm, hand or finger	31
leg or foot	7
trunk	6
head or neck	5
Concussion		13	3.5
Dislocation, subluxation		9	2.4
arm, hand or finger	5
leg or foot	4
Minor head injury		5	1.3
Multiple system trauma		4	1.1
Haemorrhage		3	0.8
eye	1
arm	1
abdomen	1
Crushing injury		3	0.8
skull	1
face	1
finger	1
Bite		2	0.5
arm	1
trunk	1
Dental injury		2	0.5
Brain injury		2	0.5
Asphyxiation		1	0.3
Total		374	100

* Up to three injuries may be specified for each record. Forty patients (11.2%) sustained more than one injury.

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TREATMENT PROVIDED

	NUMBER	PERCENT OF INJURIES
Left without being seen	0	0.0
Advice only, or treatment with no need for follow-up	229	64.3
Treated, follow-up required	107	30.0
Admitted to hospital	19	*5.3
Fatal injury	1	0.3
Total	356	100.0

* The percentage of injuries to people younger than 20 years of age in the CHIRPP database that resulted in hospital admission is 6.0%.

** Fatalities counted by CHIRPP include only those patients who were dead on arrival at the emergency department or who died in the emergency department. They do not include people who died before they could be taken to hospital or those who died after hospital admission.

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PROFILE OF PATIENTS ADMITTED TO HOSPITAL AND FATALITIES

Of the 19 patients admitted to hospital, 12 were males; 11 were children (5-9 years), 5 were older children (10-14 years) and 3 were adolescents (15-19 years). Six patients suffered concussions, 5 patients sustained fractures (2 pelvis, 1 skull, 1 tibia or fibula, 3 patients suffered multiple system trauma, 1 face or forehead), one patient suffered a brain injury, one patient had an inflammation of the lower back, one patient suffered a sprain of the neck, one patient had a hemorrhage of the eye and another suffered asphyxiation. A total of 9 patients were injured when they were struck by a school bus. Two patients were struck by cars after getting off the school bus. Two patients were passengers in school buses involved in a motor vehicle crash. Two patients were injured when on school buses when they were jumped on or pushed by other children on the bus. Two patients were injured when they fell (1 on the floor, 1 against a seat) when the school bus made a sudden movement. One patient was shot in the eye by a BB gun while on a school bus and one patient aspirated a piece of carrot he was eating. One patient, a boy 6 years of age, suffered a fatal brain injury when he fell under the wheel of a school bus while running to catch the bus.