Circumstances and factors associated with accidental deaths among children, adolescents and young adults in Cuiabá, Brazil

Martins, Christine Baccarat de Godoy; Mello-Jorge, Maria Helena Prado de

doi:10.1590/1516-3180.2013.1314459

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Original Article • São Paulo Med J. 131 (4) • 2013 • https://doi.org/10.1590/1516-3180.2013.1314459 linkcopy

Circumstances and factors associated with accidental deaths among children, adolescents and young adults in Cuiabá, Brazil

Circunstâncias e fatores associados às mortes por causas acidentais entre crianças, adolescentes e jovens em Cuiabá, Brasil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

CONTEXT AND OBJECTIVE Analysis on accidents from the perspective of population segments shows there is higher incidence among children, adolescents and young adults. Since the characteristics and circunstances of the event are closely related to educational, economic, social and cultural issues, identifying them may contribute towards minimizing the causes, which are often fatal. The aim here was to identify the environmental, chemical, biological and cultural factors associated with deaths due to accidents among children, adolescents and young adults in Cuiabá, in 2009.

DESIGN AND SETTING This was a descriptive cross-sectional study conducted in Cuiabá, Mato Grosso, Brazil.

RESULTS Thirty-nine accidental deaths of individuals aged 0 to 24 years were examined: 56.4% due to traffic accidents; 25.6%, drowning; 10.3%, aspiration of milk; 5.1%, falls; and 2.6%, accidentally triggering a firearm. Male victims predominated (82.1%). The presence of chemical, environmental and biological risk factors was observed in almost all of the homes. Regarding cultural factors and habits, a large proportion of the families had no idea whether accidents were foreseeable events and others did not believe that the family's habits might favor their occurrence. Delegation of household chores or care of younger siblings to children under the age of 10 was common among the families studied.

CONCLUSION The results point towards the need to have safe and healthy behavioral patterns and environments, and to monitor occurrences of accidents, thereby structuring and consolidating the attendance provided for victims.

Accidents; Child; Risk factors; Mortality; Epidemiology

Accidental cause (subgroup) and proportion (%) in relation to total deaths	Victim's age (in years)	n (f)	(%) in relation to the subgroup of cause	Frequency by gender
Ground transportation accident (22) 56.4%	10 to 14	2	9.1	(1) Male(1) Female
	15 to 19	9	40.9	(8) Male(1) Female
	20 to 24	11	50.0	(10) Male(1) Female
Drowning (10) 25.6%	1 to 4	2	20.0	(2) Male
	5 to 9	1	10.0	(1) Male
	15 to 19	2	20.0	(1) Male(1) Female
	20 to 24	5	50.0	(5) Male
Accidental breathing risk (4) 10.3%	< 1 year	4	100.0	(2) Male(2) Female
Fall (2) 5.1%	15 to 19	2	100.0	(2) Male
Inanimate mechanical force (1) 2.6%	5 to 9	1	100.0	(1) Female
Total deaths		39	100.0	Male = 32 (82.1%) Female = 7 (17.9%)

Accidental cause	Part of the day in which the event occurred										P-value
	Morning		Afternoon		Evening		Night		Total
	n	%	n	%	n	%	n	%	n	%
Transport accident	12	54.5	3	13.6	3	13.6	4	18.2	22	100.0
Drowning	1	10.0	9	90.0	-	-	-	-	10	100.0
Milk aspiration	2	50.0	-	-	2	50.0	-	-	4	100.0
Fall	2	100.0	-	-	-	-	-	-	2	100.0
Accidental triggering of firearm	-	-	1	100.0	-	-	-	-	1	100.0
Total	17	43.6	13	33.3	5	12.8	4	10.3	39	100.0	0.0002

Accidental cause	Part of the week in which the event occurred								P-value
	Beginning of the week		Middle of the week		End of the week		Total
	n	%	n	%	n	%	n	%
Transport accident	2	9.1	13	59.1	7	31.8	22	100.0
Drowning	1	10.0	1	10.0	8	80.0	10	100.0
Milk aspiration	-	-	4	100.0	-	-	4	100.0
Fall	-	-	2	100.0	-	-	2	100.0
Accidental triggering of firearm	-	-	1	100.0	-	-	1	100.0
Total	3	7.7	21	53.8	15	38.5	39	100.0	0.0016

Environmental factors observed in the victims' homes	Yes		No
Environmental factors observed in the victims' homes	n	%	n	%
Sharp-pointed devices within children's reach	39	100.0	-	-
Tools within children's reach	39	100.0	-	-
Plastic bags within children's reach	39	100.0	-	-
Matches/lighters within children's reach	39	100.0	-	-
Access to bathroom	39	100.0	-	-
Access to laundry	39	100.0	-	-
Access to kitchen	39	100.0	-	-
Access to stove	39	100.0	-	-
Access to hot products	39	100.0	-	-
Verandas without protection	39	100.0	-	-
Access ramps without protection	37	94.9	2	5.1
Piles of firewood, tiles, bricks or planks in the backyard	37	94.9	2	5.1
Fan with exposed blades	37	94.9	2	5.1
Furniture at the window	35	89.7	4	10.3
Cookware with handle projecting out from stove	35	89.7	4	10.3
Garbage bins without lid	35	89.7	4	10.3
Access to electric wiring/sockets	35	89.7	4	10.3
Tablecloths with long tips	34	87.2	5	12.8
Buckets/basins/bath containing water	34	87.2	5	12.8
Objects on the stairs	34	87.2	5	12.8
Toys and objects scattered over the floor	33	84.6	6	15.4
Loose rugs	33	84.6	6	15.4
Hammocks suspended at 1.0 to 1.5 m from the ground	33	85.0	6	15.0
Windows without protection	31	74.5	8	20.5
Wet floors	31	74.5	8	20.5
Slippery floors	31	74.5	8	20.5
Stove in area without ventilation	31	74.5	8	20.5
Pans with lids that do not fit	27	69.2	12	30.8
Glassware and cans within children's reach	27	69.2	12	30.8
Staircases with protection	27	69.2	12*	30.8*
Access to machinery/equipment	24	61.5	15	38.5
Uneven floor	24	61.5	15	38.5
Swimming pool without protection	8	20.5	31†	79.5†
Open water tank	7	17.9	32‡	82.1‡
Wire fences	4	10.3	35	89.7
Open cesspool	2	5.1	37‡	94.9‡
Firearm at home	1	2.6	38	97.4

	Yes		No
	n	%	n	%
Chemical factors observed in the victim's home
Cleaning products within children's reach	39	100.0	-	-
Solvents within children's reach	39	100.0	-	-
Poison within children's reach	39	100.0	-	-
Cosmetics within children's reach	39	100.0	-	-
Hygiene products within children's reach	39	100.0	-	-
Medicines within children's reach	39	100.0	-	-
Cleaning product in food bottle	33	84.6	6	15.4
Poison in food bottle	31	79.5	8	20.5
Volatile products within children's reach	26	66.7	13	33.3
Solvent in food bottle	27	69.2	12	30.8
Volatile product in food bottle	19	48.7	20	51.3
Biological factors observed in the victim's homes
Animals	32	82.1	7	17.9
Plants within children's reach	19	48.7	20	51.3
Tall grass	17	43.6	22	56.4
Tree in yard	3	7.7	36	92.3
Family habits and cultural factors
Children play on roof/stair/veranda	39	100.0	-	-
Children run kites in the street (under electric wiring)	38	97.4	1	2.6
Parents delegate household chores to children < 10 years	38	97.4	1	2.6
Parents delegate the care for younger siblings to child	38	97.4	1	2.6
Parents usually supervise the child in the water	30	76.9	9	23.0
Parents usually use a walker for small children	27	69.2	12	30.8
Family habits favor accidents	20	51.3	19	48.7
Parents usually leave child alone on bed/sofa/diaper changing table	17	43.6	22	56.4
Parents usually supervise the child during leisure activities	10	25.6	29	74.4
Accidents are foreseeable and preventable	3	7.7	36	92.3

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[TFN01t03] ^*
There were no stairs in the home.

[TFN02t03] ^†
There was no swimming pool in the home;

[TFN03t03] ^‡
There was no water tank/cesspool in the home.