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Injury Leading Cause of Childhood Death, Study Indicates

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Homicide is the leading cause of death from injury among children under the age of 1, a new national study has found.

The study, which charted death rates of children from causes other than illness, also found that the suicide rate for children between the ages of 10 and 14 more than doubled between 1980 and 1985, and that motor-vehicle injuries caused 37 percent of all injury-related childhood deaths.

The state-by-state study, conducted by researchers at the Johns Hopkins School of Public Health, found that injuries caused approximately 10,000 deaths annually over the six-year period--making injury the leading cause of childhood death in the country.

According to the report, published in the March issue of the American Journal of Public Health, there are wide regional, racial, and sexual differences in the types and numbers of fatal injuries sustained by children.

The researchers found that childhood deaths caused by injuries were three times as likely in Alaska, which had the highest rate in the nation, as in Massachusetts, which had the lowest rate.

Injury-death rates were lowest for Asian Americans and whites, and highest for Native-American children. Black babies less than 12 months old were 2.5 times more likely than white babies to die from injuries, the study found.

The analysis also showed that 1.7 boys were killed by injuries for every girl involved in a fatal accident.

An 'Epidemic'

The new findings appear to underscore the contention of witnesses at a recent Congressional hearing that federal and state policymakers should do more to protect children from accidents.

At what was billed as the first hear4ing ever held on the subject, experts told lawmakers last month that serious and often fatal accidents involving children are an "epidemic" that could largely be prevented.

Surgeon General C. Everett Koop told members of the Senate Subcommittee on Children, Family, Drugs, and Alcoholism that each year 19 million children under the age of 15--or one out of every four--are injured seriously enough to require medical attention. Of those, 100,000 become permanently disabled, he noted.

Relatively few programs have been undertaken to reduce the number of childhood injuries, Dr. Koop said. The reason, he argued, is that the public mistakenly views accidents as being "random but nevertheless inevitable" events.

"It's not fate that randomly throws an infant through the window of the family car," he said. "Rather, it is the fact that the parent did not strap the child in an infant seat in the rear of the car and did not drive defensively on the highway."

Witnesses said the most frequent childhood injuries are those related to guns, fires, and drowning; motor vehicles; bicycles; choking on the small parts of toys; farm machinery; and all-terrain vehicles.

To limit future accidents, the experts recommended that federal and state officials adopt aggressive injury-prevention programs, including safety education for parents, teachers, and pediatricians.

Officials also should adopt tougher laws and regulations geared to children's safety, they said, targeting such areas as toys, car safety, farm machinery, and smoke detection.

The Congress has already begun to look more closely at the issue. Bills introduced in both the Senate and the House would require the Consumer Product Safety Commission to develop warning labels for all toys containing small parts.

Two new studies, published in the February issue of Pediatrics, offersupport for stepped-up efforts to prevent injuries. In the first study, researchers found that 75 percent of accidents in day-care centers run by the Los Angeles school district could have been prevented with only a modicum of care.

The second study suggests that many childhood deaths in rural areas may have been caused by a lack of adult supervision.--ef

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