Epidemiology of school accidents during a six school-year period in one region in Poland

Background: The aim of the study was to analyse the incidence of school accidents in relation to school size, urban/rural environment and conditions of physical education classes. Methods: 202 primary schools with nearly 50,000 students aged 7–15 years were studied during a 6-year period in the Wocawek region in Poland. Results: There were in total 3274 school accidents per 293,000 student-years. Accidents during breaks (36.6%) and physical education (33.2%) were most common. Most frequently accidents took place at schoolyard (29.7%), gymnasium (20.2%), and in the corridor and stairs (25.2%). After adjustment for students' age and sex, student–staff ratio and duration of school hours, urban environment increased the probability of accident (OR: 1.25; 95% CI: 1.14–1.38). Middle-size schools (8–23 classes) had similar accident rate as small schools (OR: 0.93; 95% CI: 0.83–1.04), while schools with 24–32 classes (OR: 1.26; 95% CI: 1.10–1.43) and with 33 classes (OR: 1.36; 95% CI: 1.17–1.58) had increased accident rate. Presence of a gymnasium was also associated with increased probability of accident (OR: 1.49; 95% CI: 1.38–1.61). Conclusions: Urban environment, larger school-size and equipment with full-size gymnasium are important and independent risk factors for school accidents. These findings provide some new insights into the epidemiology of school-related accidents and may be useful information for the planning of strategies to reduce accident incidence in schools.