Evaluating the short-term effect of ambient temperature on non-fatal outdoor falls and road traffic injuries among children and adolescents in China: a time-stratified case-crossover study

Abstract

● A study assessing the temperature-injury relationship was conducted among students.

● The maximum risks of injury appeared at moderate temperatures.

● The temperature effect on outdoor falls was greater in older students.

Although studies have suggested that non-optimal temperatures may increase the risk of injury, epidemiological studies focusing on the association between temperature and non-fatal injury among children and adolescents are limited. Therefore, we investigated the short-term effect of ambient temperature on non-fatal falls and road traffic injuries (RTIs) among students across Jiangsu Province, China. Meteorological data and records of non-fatal outdoor injuries due to falls and RTIs among students aged 6–17 were collected during 2018–2020. We performed a time-stratified case-crossover analysis with a distributed lag nonlinear model to examine the effect of ambient temperature on the risk of injury. Individual meteorological exposure was estimated based on the address of the selected school. We also performed stratified analyses by sex, age, and area. A total of 57322 and 5455 cases of falls and RTIs were collected, respectively. We observed inverted U-shaped curves for temperature-injury associations, with maximum risk temperatures at 18 °C (48th of daily mean temperature distribution) for falls and 22 °C (67th of daily mean temperature distribution) for RTIs. The corresponding odds ratios (95% confidence intervals) were 2.193 (2.011, 2.391) and 3.038 (1.988, 4.644) for falls and RTIs, respectively. Notably, there was a significant age-dependent trend in which the temperature effect on falls was greater in older students (P-trend < 0.05). This study suggests a significant association between ambient temperature and students’ outdoor falls and RTIs. Our findings may help advance tailored strategies to reduce the incidence of outdoor falls and RTIs in children and adolescents.

Graphical abstract

Keywords

Ambient temperature / Fall / Road traffic injury / Student / China

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