Spinks, A., Wasiak, J., et al. (2008). Ten-year epidemiological study of pediatric burns in Canada. Journal of Burn Care & Research, 29(3), 482-8.
Burn injuries are a devastating type of trauma that often has long-term physical and psychological consequences. This study reports on the incidence rates, demographics, and external causes of all burn-related deaths and hospital admissions among Canadian children aged 0-19 years from 1994-2003. Data on burn-related fatalities were collected from Statistics Canada, hospital admissions data were taken from the Canadian Institute of Health Information, and population estimates were derived from Canadian census data. Differences in the frequency and severity of burns were analyzed using analysis of variance and chi-square statistical tests.
Findings revealed that over the 10-year period examined, 494 children died and 10,229 were admitted to hospitals for burn-related injuries. The highest fatality rate was among children aged one to four years. Males were about twice as likely to be burn victims as females within all age groups, indicating that males' greater exposure to burn injury hazards were present in infancy and peaked during adolescence. Scalding by hot liquids and vapour was the cause of half of all paediatric burns. Overall, and in each age group, there was a significant decline in burn injuries over the 10-year period. Results also showed a relatively low incidence rate (1.33%) of intentional burns.
Limitations of this study include: the reliability of administrative data, as the rigor with which such data is audited is questionable compared to data collected for research purposes; possible misclassification of external causes due to revisions made to the coding system in the last three years of reported time; and a lack of detailed information about the situations leading to the burn injury. The results suggest a clear reduction in the number of burn injuries requiring hospital admission which may be partly attributable to increased safety initiatives, burn prevention education, and improved burn treatment.
Valencia-Rojas, N., Lawrence, H. P., et al. (2008). Prevalence of early childhood caries in a population of children with history of maltreatment. Journal of Public Health Dentistry, 68(2), 94-101.
Child maltreatment and early childhood caries (ECC) have some common features including high prevalence rates, shared risk factors, and long-term consequences. The aim of this retrospective study was to determine the prevalence of ECC's in an identified population of abused and neglected children in Toronto, Ontario. The sample consisted of 66 preschool-aged children admitted to the care of the Children's Aid Society of Toronto (CAST) who were referred for a dental evaluation from 1991 to 2004. Data on 3,185 schoolchildren collected by the Ministry of Health and Long-term Care from the general population of Toronto was used as the comparison group. Dental and social workers' records were examined.
Results showed that approximately 58% of the abused/neglected sample had ECC's compared to only 30% among the comparison group. The proportion of children with untreated caries was 57% among "neglected" children (n = 53) and 62% in physical/sexual abuse cases (n = 13). Logistic regressions, controlling for age, sex, and type of abuse, revealed that children with Crown ward status and those in CAST care more than once were significantly less likely to have experienced caries.
These findings indicate that there are higher levels of tooth decay among abused/neglected children in the CAST than in the general population of 5-year-olds in Toronto. However, the study also revealed that CAST services had a protective effect on children's oral health, as evidenced by the lower likelihood of caries among Crown wards and those admitted to CAST more than once. The implication of the study results are that child protection services should investigate possible dental neglect in physical/sexual abuse and neglect cases and that there is a need for dental treatment and oral health promotion among this population. Limitations of the study include its retrospective nature, poor statistical power due to the small sample of CAST children, and incomplete measurement of relevant sociodemographic factors (namely socioeconomic status).