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Paper text:
population growth and increased use of cars in everyday life make each day prone to new accidents and events in everyone 's life .
adolescents are threatened by several accidents when they enter the new world of adulthood , separate from families , are individually present in the community more often , lack the knowledge of rules and have the risk - taking spirit .
the share of such damages and their related costs is higher in developing , and low - income countries in that 8.5 million annual deaths worldwide result from accidental damages .
accidents constitute 12% of the global burden of diseases and are the third major cause of death and the primary cause of death in 1 to 40-year - old people .
schools have a major contribution in incidents because their construction site is not safe in 60.8% of cases , and only 56.9% have safe stairs .
the most common incidents for students by location can be classified into three categories : ( a ) traffic accidents , ( b ) home accidents , and ( c ) environment accidents .
school is one of the environments where the child spends the most time with groups of peers as well as younger and older children .
school can pave the grounds for debilitating accidents and even lead to death of children due to certain circumstances such as the accumulation of a large number of children , their developmental profile ( growth induced mood and physiologic changes ) , the difficulty in monitoring them , particular environmental conditions such as stairs , hallways , school yards , playground , and probably gym etc .
, events are generally one of the problems of childhood that are increasingly growing . accidents often occur and sometimes victims are school students .
school - aged children and adolescents may be more vulnerable than others to life events due to their developmental stage , so they need special attention .
it has been shown that a lot of damage occurs to students during school hours .
children and adolescents are the most vulnerable group in this regard , and their disability creates a profound stagnation in social activities .
the range of damage is also widespread including physical , psychological , and economic effects that progress in community like a huge wave .
obviously , the prevention of accidents is not possible without organizing and planning fundamental measures , therefore , one of the most important steps in planning to prevent accidents is to conduct studies on accidents and incidents . preventing from children 's injuries has a major role in keeping them safe , and safety can not be achieved unless causes of damage are known and then necessary preventive measures are considered .
given no extensive study has been conducted to determine the prevalence of school accidents at this education and age level in recent years , this study was conducted for the proper and focused planning on school accidents and reducing the most prevalent ones and those prioritized by education office .
a cross - sectional study was conducted on 7000 middle school students 1114 years old resident in isfahan province by a multistage cluster sampling . using the sample size formula with z = 0.95 , p = 0.05 , d = 1.46 , and the data obtained from the accident registration office in provincial health center and the incidence of accidents in this age group in 2007 , at first the total number of middle school students in the province were determined ( 188,562 students ) , and then the sample size ( n = 7000 ) and students in this educational level in each city were identified . the names of students were determined for questioning by identifying the sample size in each city , the number of urban and rural samples , the list of middle schools separately for each city , determining sample size in every school , and ultimately using students list and random number table . for data analysis ,
similar regions in terms of cultural , social , and economic conditions that had a small number of samples were merged , and the results were generalized to both cities .
this study was conducted in 20092010 in isfahan province except cities of kashan and aran - bidgol .
the questionnaire face and content validity was determined by 7 experts . to determine questionnaire reliability ,
two schools were selected at random , and 30 students were questioned , so cronbach 's alpha was found as 75% and its reliability was confirmed .
incomplete questionnaires ( i.e. questionnaires with inappropriate answers , incorrect response , irrelevant answers and out of discussion or questionnaire without answer ) were excluded from the analysis . if a questionnaire was excluded , another matching student with the same gender , age , and grade of the same school was replaced .
the questionnaire included questions on age , gender , education and occupation of parents , city name , the middle school name , accident type , accident time , the location of accident , and the injured body part . by choosing experienced questioners , training them , and giving them a 5-item guideline , we controlled the interview confounding factor and uniformed data collection . during the questioning
coordinators in each city entered the data into epi6 software ( centre of disease control and prevention ) after collecting and encoding the data .
, chicago , il ) was used to analyze the data with descriptive statistics ( including the absolute frequency , percentage , frequency distribution tables and figures ) and analytic statistics ( chi - square ) .
the total sample size was 7000 , which came to 6933 given that incomplete questionnaires were excluded . 

table 1 showed participants characteristics according to region , gender , age , parents education and occupation .
frequency distribution of middle school students questioned according to region , gender , age , parents education and occupation data in table 2 indicate that there is no statistically significant relationship between residential area and school accidents ( p = 0.168 ) , but a significant relationship was observed between the school accident and gender ( p < 0.001 ) .
frequency distribution of school accidents based on gender and urban - rural region in middle school of 6933 subjects questioned , 3739 students ( 53.9% ) stated that they had an accident within the school , and 732 students ( 10.6% ) had an accident on the commuting route . according to figure 1 , workshop had the highest rate of accidents at school where students activity is supervised by a trainer or teacher .
frequency distribution of accident location in middle school students frequency distribution of injured body part in middle school
results showed that a high percentage of students were injured in school accidents and a few on the commuting route .
most accidents are preventable by observing safety measures at schools . in 1981 , the incidence of school related injuries was reported 1020% .
it is reported that most traumas in children younger than 15 years occur at home and school .
, gender has an effect on school accidents , and school accidents occur more among boys than among girls . of under-15 children with trauma referred to alzahra hospital
the most common type of accident ( 32% ) was falling . in this research ,
the main reasons for nonfatal injuries were falling , animal bite , accidents , falling objects , and burning .
it was shown that falling ( 64.2% ) was the most common cause of dental trauma in nigerian children .
falling of this group of children ( students , workers , farmers , and salespeople ) is more than other nonworking children . in the present research ,
the percentage of height and stair accidents , which might be similar to falling accidents was rarely seen . in a research conducted on incident patterns of children younger than 15 years who had accidents in mazandaran province in 19992000
, it was revealed that falling ( 30.1% ) and road accidents ( 26.6% ) were the most common accidents .
however , in this study , 1.7% of students stated that they had falling accident at school . regarding incidence rate of school accidents in elementary schools in kerman province ,
the following results were obtained : the causes of accidents : falling 34.3% , running 49.8% , violent movements 30.3% , physical fight 28% , using cold weapon 1.9% and sports field accidents 20.7% .
most ( 60% ) children had multiple injuries , 24% had contusion , and 10.7% had fractures .
most accidents ( 81% ) were remedied at school , 12.65% were treated as outpatient , and 5.4% needed hospitalization .
the hospital stay duration was 76 days and absenteeism after the accident was 134 days .
accidents mentally engage the family and school , cause physical suffering for children and can have a negative effect on their educational progress due to absenteeism .
furthermore , other studies confirm our findings about the injured body part especially hands and arms . according to a study conducted at the shiraz university of medical sciences on the extent and causes of accidents in middle school students , accidents in the age range of 517 years
the incidence rate of accidents was 1.2% totally , 0.6% in girls and 1.49% in boys .
the highest rate of injury was related to hands and arms among other body parts .
these data indicated that the incidence of accidents was more among students of the first grade in middle school .
children have so much energy ; therefore , they are constantly engaged in physical activity . when the child reaches school age , injuries due to school accidents
are observed as falling , injuries due to exercise or physical activity and physical fights . to reduce deaths from accidents in students , especially drowning and falling , efficient safety , and preventive measures
traumatic dental injuries are very common in school students , and falling has been its major cause .
children are always at home , at school and in the community , and these places should have high health and safety standards .
the results of this research showed that many schools have a small area per capita .
only 53.2% of schools had the desired standards with respect to the number of students .
it has been observed that a proper sleep at night has a key role in resistance to diseases , injury prevention , and mood stability .
a significant relationship was observed between the incidence of injuries and disorders and length of time in school children .
the incidence of nontraffic accidents was reported for 91/100000 for boys and 43/100000 for girls , and 65% were due to falling , 17% due to burning , 3% due to animal - related injuries , and 1% due to other cases . falling ( 30.1% ) and
meanwhile in this study , 1.7% of students stated that they had fallen in school .
hands and arms have the highest rate of injury among other body parts . the data of this study indicate that the incidence of accidents was more among students of the first grade in middle school . in this study ,
the incidence rate of accidents was 1.2% in total , 0.6% in girls and 1.49% in boys .
the incidence rate of accidents in middle schools of shiraz compared to the research conducted in canada is significantly lower . as the incidence rate of accidents was higher in students of the first grade in middle school , special attention
should be given to younger students , and they should be instructed toward healthy and low - risk activities . furthermore , development of safe educational environment and a proper behavioral culture in students for break hours are very effective in reducing accidents .
hence , more parental or caregivers care and monitoring play an important role in reducing injury in the morning . teachers and schools authorities
can also prevent such injuries by training and giving necessary advice and attention to children 's behavior .
background : adolescents are being threatened by several accidents because of entering the new world of adulthood , separation from families , a greater presence in community individually , the lack of knowledge of rules and risk - taking spirit of adolescents , and events . 
 the contribution of these damages and their related costs are higher in developing and low - income countries . 
 the current study was conducted for proper planning focused on reducing accidents that have the highest incidence , evaluating school events , determining the place and time that most accidents happened to students and determining the body part injured.methods:a cross - sectional study using a multistage cluster sampling was conducted on 6933 students 1114 years old ( middle school ) in 20092010 in isfahan province . 
 the data were collected through observation and a researcher - made questionnaire and then entered into the epi6 software , and analyzed by the spss 11.5 software and the statistical test of chi-square.results:the findings showed that 49.9% of students were girls ( n = 3462 ) and 50.1% ( n = 3471 ) were boys , 84.5% of students ( 
 n = 5860 ) were living in urban areas and 15.5% of students ( 
 n = 1073 ) were living in rural areas . 
 frequency distribution of incidents was 53.9% ( 3739 cases ) at school and 10.6% ( 732 cases ) on the commuting route . 
 the most injured body part was hand with 1018 cases ( 18.5% ) and foot with 1267 cases ( 23.1% ) , and mostly they were injured in boys.conclusions:the findings showed that a high percentage of students were injured at school , where the first step to prevent the incidence of such preventable incidents at school is to secure workshop environments and school yards .