| Summary: | Background Injuries remain one of the leading causes of death and disability for children over the age of one year in the UK and socioeconomic differences persist in injury occurrence. Policy makers need to understand the distribution of injuries and their associated risk factors to address the issue. This thesis aims to summarise the evidence from cohort studies of injury occurrence and risk factors for injury in school aged children, to describe the injuries occurring to primary school aged children in an area of England, and to explore the relationship between secondary care attended injuries in those children and risk factors in the child, their family, their home and their neighbourhood. Methods A systematic literature review of cohort studies reporting injuries in school- aged children was undertaken. Data on injuries and risk factors was used from the Avon Longitudinal Study of Parents and Children (ALSPAC). Parent reported injury data collected four times between the ages of five and 11 years were coded and described. Multivariable logistic regression analyses of risk factors for secondary care attended injury were undertaken on the observed data and repeated on a dataset where missing values had been imputed. Results The review identified 44 papers from 18 cohort studies. Risk factors for injury were identified, and equivalent variables from ALSPAC included in analyses where possible. The distribution of 12,421 injury events in 5752 children in ALSPAC illustrated trends in injuries by type of injury, age and sex. Child factors such as male sex, having a previous injury treated in secondary care and behavioural problems were associated with increased risk of injury. Mothers with many life events and children living in privately rented accommodation had increased risks of injury. Children with two or more younger siblings had reduced risks of injury. Conclusions Few cohort studies have reported trends in child injury with age, collected information on the child's environment or reported associations between the environment and injury. This study addressed these issues. Limited evidence of environmental predictors for child injury were found, but factors in the child, their family and their home may usefully inform prevention initiatives.
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