Children and teenagers who are assaulted at school account for nearly 90,000 emergency-room visits in the United States each year, new research finds.
Although school shootings garner much attention, it was rare for kids aged 5 to 19 to be injured by guns on campus, according to the study. Forty percent of injuries were bruises and scratches, and few injuries overall required hospitalization after a trip to the ER.
"[The number of injuries] 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 study lead author Dr. Siraj Amanullah, an assistant professor of emergency medicine and pediatrics at Brown University's Alpert Medical School.
"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," Amanullah said.
For the report, which was published online Jan. 13 in the journal Pediatrics, the researchers looked at statistics regarding emergency-room visits by young people in 66 U.S. hospitals from 2001 to 2008. They then estimated the number of injuries nationwide during that time based on those limited statistics.
Overall, more than 7 million ER visits were made because of injuries at school during the eight-year study period. More than 700,000 of those injuries were considered deliberate, the researchers said, accounting for about 92,000 ER visits a year on average.
And nearly all -- 96 percent -- of the injuries were from assaults, rather than self-harm or harm from someone like a police officer, the researchers said. This led to the conclusion that school assaults were behind an average of 88,000 ER visits a year.
The researchers found that kids aged 10 to 14, non-whites and boys had higher risks of being injured intentionally at school compared to kids of other age groups, whites and girls, respectively.
Intentional injuries outside school tended to be more severe (almost 3 percent involved firearms, compared to 0.08 percent at school), much more likely to have been committed by strangers or parents, and much more likely to have been self-inflicted.
The researchers called for "culturally appropriate preventive strategies."
Although the statistics don't say anything specific about bullying, Amanullah said bullies are one major target. "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.
Karen Liller, a professor at the University of South Florida who studies injuries in children, said the research adds to existing knowledge but is limited because of the lack of detail about how the injuries happened. "This precludes any detailed recommendation for tailored interventions," she said.
Liller said solutions will vary depending on factors such as policies and rules. "Parent involvement is often key, and this becomes more difficult as students age," she said.
It's also important to focus on accidental injuries in kids, Liller said. The new study is especially intriguing because it suggests that accidental injuries outside of school are more common in girls than boys, she said.
The study was not designed to assess whether these injuries represent an increase or decrease from previous decades.