Comparing unintentional and intentional injuries in a school setting.

This study determined the incidence of violence-related injuries in an urban school district, and compared characteristics of unintentional and intentional school injuries. A sample of student Accident Report Forms completed for a school district in 1997 were reviewed for demographic characteristics of the student and injury characteristics. Injuries were categorized as unintentional, intentional, or of unknown intent. Annual incidence rates of injury per 100 students were calculated by intention, grade, and gender. Comparisons between unintentional and intentional injuries were made using odds ratios and 95% confidence intervals. Of 11,674 annualized injuries, 77.2% were unintentional, 16.8% were intentional, and 6.0% were of unknown intent. The overall annualized injury rate was 1.74 injuries per 100 students/year. The unintentional injury rate was almost five times the intentional injury rate of 0.29 injuries per 100 students/year. High school students had both the highest unintentional and intentional injury rates. Males in all grade levels had the highest rates of injury. Most injuries occurred during school hours. Intentional injuries were almost three times more likely to be associated with unstructured play or after school playground hours; were less likely to be witnessed events; and were more likely to occur on the surrounding school grounds than unintentional injuries. Unintentional injuries represent a greater risk to school children than do intentional injuries. A potential area to focus interventions for intentional injuries are modifications of the school environment and surrounding grounds to improve supervision and monitoring.