Child and adolescent injury in the United States: How occupational injuries fit in

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Abstract
Injury is the leading cause of death in adolescence, with the highest rates for 15- to 19-year-olds, an age span also marked, for many, by entry into the workforce. Occupational injuries affecting youth occur in the context of the larger problem of injury affecting children and adolescents. An understanding of the broader context can help to guide efforts to control occupational injuries. Nonfatal injuries vastly exceed fatal ones, but more is known about the latter. Injuries are the leading cause of death in the U.S. for ages 1 to 44 years. The proportion of child and adolescent deaths due to injury has risen for several decades; injury rates have been stable while deaths from natural causes have declined. Injury patterns vary with age, race, and sex, and also internationally. The two leading causes of injury deaths for U.S. adolescents are motor vehicle occupant injury (related largely to alcohol) and homicide (related largely to firearms). Contemporary injury prevention approaches focus on means to prevent the transfer of damaging amounts of energy to potential victims. The most effective approaches are passive (engineering/environmental) and/or require one-time-only behaviors. Prevention of child and adolescent occupational injuries will need to build on approaches that have been successful for other child and adolescent injuries, as well ones that have been successful for adult occupational injuries. A multidisciplinary approach will be needed.