[Accidents and children]. / Urazy a deti.

BACKGROUND: The accident rate in the population, especially injuries to children and youths are in the forefront of attention in all the industrialized countries. The reason is that accidents are the main cause of all deaths in children of over one year of age and in adolescents and accident-linked morbidity in children is second only to diseases of the respiratory tract. The aim of the study was to obtain more exact data than those that were available in the Czech Republic previously and to create conditions for a draft of preventive measures that would bring rapid and effective results. METHODS AND RESULTS: The accident rate in children has been followed up in all age groups attending elementary school. The basic series was comprised of 192,832 children 6.0 to 15.11 years old. An accident was registered in 31 550 pupils. Registered were all accidents by the children in the course of one calendar year and had been treated by a physician. There has been found a statistically highly significant greater total accident rate in boys (18.7%) than in girls (13.9%) by the chi-square test P = 0.00001 at P < 0.05. The most frequent of injuries were fractures, dislocation of joints (55.2%) with girls being affected more frequently than boys. Most frequently the accidents took place at school (25.0%) and at home (21.5%). The greatest number of accidents took place during physical education and organized sports (29.4%) and during games unorganized sports (28.6%). A relatively large number of injuries was sustained in conflicts with a schoolmate (7.4%). CONCLUSION: Much greater attention should be devoted to the prevention of injuries in children, namely at home and at school, because it is not only a health problem that is in question, but also a social and economic one. Abroad, annual losses are estimated at thousands of millions of USD.

[Schoolchildren and accidents]. / Skolní deti a úrazy.

UNLABELLED: POINT OF DEPARTURE: The accident rate in the population, especially injuries to children and youths are in the forefront of attention in all the industrialised countries. The reason is that accidents are the main cause of all deaths in children of over one year of age and in adolescents and accident-linked morbidity in children is second only to diseases of the respiratory tract. The aim of the study was to obtain more exact data than those that were available in the Czech Republic previously and to create conditions for a draft of preventive measures that would bring rapid and effective results. METHODS AND RESULTS: The accident rate in children has been followed up in all age groups attending elementary school. The basic series was comprised of 190,396 children 6.0 to 15.11 years old. An accident was registered in 31,094 pupils. Registered were all accidents by the children in the course of one calendar year and had been treated by a physician. There has been found a statistically highly significant greater total accident rate in boys (18.63%) than in girls (13.92%) by the chi-square test P = 0,00000. The most frequent of injuries were fractures, dislocation of joints (55.5%) with girls being affected more frequently than boys. Most frequently the accidents took place at school (25.6%) and at home (22.6%). The greatest number of accidents took place during games and unorganised sports (30.2%) and during physical education and organised sports and school trips (29.0%). A relatively large number of injuries was sustained in conflicts with a schoolmate (8.3%). CONCLUSION: Much greater attention should be devoted to the prevention of injuries in children, namely at home and at school, because it is not only a health problem that is in question, but also a social and economic one. Abroad, annual losses are estimated at thousands of millions of USD.

[Accident-related mortality in 5- to 9-year-old children]. / Umrtnost 5-9letých detí na úrazy.

BACKGROUND: According to the WHO, insufficient attention is devoted to the problem of accident while more than one half of the death in children of 1 to 14 years of age in industrialized countries are caused by accidents. METHODS AND RESULTS: Nationwide statistical data from the Czech Republic have been evaluated and compared with those of selected European countries and the USA. In the years 1991-1993 average of 151 children died in the Czech Republic in the age group of 5- to 9-year olds. In 68 of them the cause of death was an injury that in almost half of the cases was due to a traffic accident. The trend in the mortality of children of the same age was assessed comparing the averages for 1950-1952 and 1991-1993. The overall mortality decreased by 68% while the greatest decline was in non-accident causes (75%). Mortality due to accidents decreased by 55% and that caused by motor vehicles by only 19%. The lowest mortality due to accidents was found in Sweden. CONCLUSIONS: The results show that mortality due to accidents and poisonings in younger school children in the Czech Republic is higher than, e.g. in Austria and Sweden. In order to be able to elaborate a draft of appropriate and effective preventive measures, it is necessary to obtain further information on accidents and poisonings in children that have not ended fatally.

Immunological findings in groups of children after compensatory measures.

In 200 children residing permanently in a region with a high level of atmospheric pollution, indicators of humoral immunity, salivary immunity and specific IgE antibodies were determined before and after 14 days' attendance at an "outdoor school" in rural areas with a very low level of atmospheric pollution. A marked reduction of elevated albumine levels, which are characteristic of irritation or even inflammation in the oral cavity or respiratory tract, was found, as well as increasing levels of Slg A and lysozyme in saliva. The two-week stay in the outdoor school resulted in decreased IgE specific antibodies of the respiratory type of allergy (CAP Phadiatop). In the group of atopic children there were found high total IgE levels, with a trend of depression after 2 weeks in the outdoor school. Higher values of some immunoglobulins were observed, while low levels of IgA were found in some children with high frequency of respiratory diseases. The irritant effect of polluted atmosphere and the quality of indoor atmosphere influence some immunological parameters in children.

Screening of the gasoline lead load in school children in the Czech Republic.

The determination of erythrocyte zinc protoporphyrin (ZZP) was implemented as an indirect method for assessing lead levels in the blood in the follow-up of Czech children regarding the lead load due to automobile traffic. Simultaneously, basic indicators of the red blood picture were studied. A screening study was conducted with 2668 school-age children residing permanently in three different regions of our country. The differences in basic hematological indicators, i.e. number of erythrocytes, hemoglobin content, hematocrit and red blood cell volume, like the differences in zinc protoporphyrin in the peripheral blood, did not confirm the initial hypothesis on the relatively greater load of the Czech child population due to lead from exhaust fumes of combustion motors. Also, no regional differences were observed. The differences found in the abovementioned indicators reflect the influence of an overall environmental pollution rather than that of a toxic effect of lead.

Albumin in the saliva--a significant indicator of the effect of "outdoor schools".

In 234 children residing permanently in a region with a high level of atmospheric pollution indicators of salivary immunity were studied as criteria for assessing the efficacy of applied compensatory measures. In the saliva SlgA, IgM, IgG, lysozyme, and albumin were determined. A marked reduction of elevated albumin levels which are characteristics of irritation or even inflammation in the oral cavity or respiratory tract was found in children who in the winter season spent some time in an unpolluted rural area. Statistically significant changes in IgM levels were demonstrated in these children.

[Cooperation between East Germany and Czechoslovakia in studying the effect of environmental pollution on school children]. / Zusammenarbeit zwischen der DDR und CSSR beim Studium des Einflusses der Umweltbelastung auf Schulkinder.

This report presents key outcomes of joint growth and development studies conducted in children permanently living in areas adversely affected by pollutants in air. Further attention is focussed on the evaluation of effects of some of the so-called compensatory measures applied in Czechoslovakia, namely a 3-week outdoor schooling organized for these children in the relatively clean recreational areas. The beneficial health effects of year's season and specifically of the spontaneous, active and sufficiently long outdoor exercise are documented in graphs. As it is pointed out in this context, children in the place of their permanent residence tend to have relative little exercise outdoor, may run an increased risk of exposure to indoor pollutants, and may suffer from passive smoking effects if their parents cannot refrain from smoking habits at home.

Growth and bone maturation in children from two regions of the F.R.G. differing in the degree of air pollution: results of the 1974 and 1984 surveys.

Growth and bone maturation criteria were used in this collaborative study to assess the potential health risk posed by excessive air pollutant emission. The study consisted of two surveys carried out 10 years apart. During this decade, a substantial emission reduction through the effective control efforts was achieved in the index area, but not so in the reference area where the situation remained virtually unchanged during this period. In terms of body height and height-weight proportionality, no significant differences were found between areas and years of investigation. In contrast, the bone age retardation encountered in the children from the polluted area was statistically significant, both at 1974 and 1984 surveys, despite the appreciable improvement in this developmental criterion for boys in 1984. This was true for both group mean values and the percentages of individuals exhibiting the bone maturation delay greater than 10 months.

Epidemiological studies regarding the effects of air pollution.

Studies on large samples of the population are an indispensable prerequisite for investigations into the validity and reliability of threshold levels stipulated for atmospheric pollutants purity under real conditions. Children represent suitable groups for such studies, also in the context of meaningful and effective prophylaxis. Epidemiological studies conducted over several years show that there are differences between the anthropometric, hematological and immunological parameters of subjects living in regions with major pollution loads and in so-called "clean air" regions. Conclusions are drawn regarding the work performed by national hygiene authorities, and a method is proposed for the continuation of epidemiological studies in qualitatively and quantitatively differently loaded regions as a contribution to establishing a uniform register of effects.