“We cannot accept these injuries as just accidents that will happen.
If a disease were killing our children at the rate that unintentional injuries are, the public would be unbelievably outraged and demand that this killer be stopped.” – C. Everett Koop, former United States Surgeon General, 2001
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Child injuries are a worldwide public health issue. The World Health Organization (WHO) report (2008) on child injury prevention1 found that 830,000 children below 18 years die each year from unintentional injuries, which are the leading cause of death for children above nine years. Published data from the 2008 WHO report shows that the majority of unintentional fatal injuries in children aged below 18 years worldwide are caused by road traffic injuries, drowning, and fire-related burns.
In addition to fatal injuries, globally, tens of millions of children require hospital care every year for non-fatal injuries, resulting in injury-related, long-term disabilities which are costly to the healthcare system and have significant impact on patients’ entire families. The Global Childhood Unintentional Injury Study2 in five countries showed that almost half the children under the age of 12 who had suffered an unintentional injury severe enough to require emergency room treatment were left with some form of disability after discharge.
In Singapore, the 1990 to 2017 Burden of Disease study showed that injuries caused 10.7 per cent of total disability-adjusted life years (DALYs) in 2017, with the percentage of total DALYs due to injuries increasing throughout childhood to peak in young adults3.
Top causes of child injury mortality in Singapore
Data from KK Women’s and Children’s Hospital (KKH) showed that from 2012 to 2023, the top three causes of child injury deaths in children 16 years and below (Figure 1) were due to:
Figure 1. Child injury deaths by cause for children zero to 16 years (2012-2023)
Drowning
Water safety tips for parents and caregivers:
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Figure 2a. Yearly incidence of child drowning (2012-2023)
Figure 2b. Age distribution of child drowning cases (2012-2023)
Figure 2c. Water body in which drowning occurred (2012-2023)
Notes:
Falls from height
Fall prevention tips for parents and caregivers:
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Figure 3a. Yearly incidence of child falls from height (2012-2023)
Figure 3b. Age distribution of child falls from height (2012-2023)
Figure 3c. Locations of child falls from height (2012-2023)
Figure 3d. Site of child falls from height within buildings (2012-2023)
Figure 3e. Intent of falls from height
Road Traffic Injuries
Car safety tips for parents and caregivers:
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Figure 4a. Yearly incidence of child road traffic injury cases (2012-2023)
Figure 4b. Age distribution of child road traffic injuries (2012-2023)
Figure 4c. Type of child road user injured in road traffic collision (2012-2023)
Figure 4d. Children and adolescents injured in road traffic collisions correlated with use of restraints5
Child injuries are preventable
Child injuries are highly preventable. The World Health Organization report on child injury prevention1 highlights the preventability of unintentional child injuries and the effectiveness of intervention strategies, using a combination of broad approaches to reduce the child injury burden:
This is important because primary injury prevention costs much less than treating a child for a preventable injury. KKH published data from 2011 to 2017 showed a median cost of SGD$8,361 for inpatient neuro-rehabilitation of moderate to severe traumatic brain injury, with 53 per cent of these patients involved in motor vehicle accidents and 35 per cent having suffered falls.7 Figure 5 combines data from the 2008 WHO World Report1 and the 2014 United States Children’s Safety Network cost-outcome analysis for injury prevention programmes8 and provides an overview of cost-effective strategies that would reduce unintentional injuries and save lives.
Figure 5. Financial savings from injury prevention interventions1,8
Expenditure of US$1 on | Savings (US$) in direct and indirect healthcare costs |
Child car restraints | 29-71 |
Bicycle helmets | 29-48 |
Injury prevention counselling by paediatricians | 10 |
Poison control services | 7 |
Road safety improvements | 3 |
A safer Singapore for future generations
Injury Prevention Resources | |
General child safety:
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Water safety: https://www.kkh.com.sg/patient-care/conditions-treatments/submersion-injuriesopens in a new tab | |
Road safety:
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Child injury prevention infographics co-developed by Health Promotion Board and KKH (available on HPB Parent Hub) | |
Infographic Title | Online Link |
Child-proofing your home | https://go.gov.sg/child-proofing-home-kkhopens in a new tab |
Make a splash! Water safety tips | opens in a new tabhttps://go.gov.sg/water-safety-kkhopens in a new tab |
Weaning your baby safely | https://go.gov.sg/weaning-safely-kkhopens in a new tab |
Child fall prevention | https://go.gov.sg/child-fall-prevention-kkhopens in a new tab |
Seek alternatives to screen time (Toy safety) | https://go.gov.sg/toy-safety-kkhopens in a new tab |
Preventing burns | https://go.gov.sg/preventing-burns-kkhopens in a new tab |
Let's make playtime fun and safe (Playground safety) | https://go.gov.sg/playground-safety-kkh |
References
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Acknowledgements
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English
KKH Injury Surveillance Report 2024.pdf