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IP Online First, published on May 30, 2013 as 10.1136/injuryprev-2012-040625 Brief report
Injuries among adolescents in the United Arab Emirates Caroline Barakat-Haddad,1 Ayesha Siddiqua2 1
Department of Anthropology, University of Toronto Scarborough, Toronto, Ontario, Canada 2 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada Correspondence to Dr Caroline Barakat-Haddad, Department of Anthropology, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario, Canada M1C 1A4;
[email protected] Received 5 September 2012 Revised 22 March 2013 Accepted 29 April 2013
To cite: Barakat-Haddad C, Siddiqua A. Inj Prev Published Online First: [please include Day Month Year] doi:10.1136/ injuryprev-2012-040625
ABSTRACT This study examines the profile of injuries among adolescents in the United Arab Emirates (UAE) and identifies related factors associated with injury. A crosssectional study design determined incidence of injury for a sample of 6363 adolescents. Data collected information on injury in the past 12 months, sociodemographic, behavioural and sensory data. Logistic regression modelling was used to examine predictors of physical injury for the past 12 months. Among participants, 18% experienced injury; the three top causes include accidental falls (38%), being struck by an object or person (18%), and motor vehicle injuries (MVI) (13%). The majority of injuries took place at the participant’s home and surrounding area. Identified risk factors that are amenable for prevention include smoking behaviour, exposure to smoking, physical activity profile, family income, and speeding behaviour. Our findings highlight the need for public health policies and education programmes that reduce injury among the UAE adolescent population.
resulting from injury can present lifelong challenges to adolescents and their caregivers.7 To date, injury among the UAE adolescent population has been largely understudied. Using the socio-ecological model of health, this study aims: (i) to determine the incidence of injury among the UAE adolescent population; (ii) to examine the main causes of injury; (iii) to develop a profile of locations where injury took place; and (iv) to examine demographic, socioeconomic, and behavioural predictors of injury among the UAE adolescent population.
METHODS Data source and design This study utilises data from the National Study of Population Health in the UAE (NSPHUAE) (2007– 2009) programme that was developed in collaboration with the UAE Ministry of Education. A crosssectional survey was developed and administered on over 6300 adolescent children who range in age between 13 and 20 years old, and who attend public and private schools in the country.
INTRODUCTION
Sampling procedure
Adolescence is a period of development between the onset of puberty and adulthood, when an individual undergoes extensive physical, psychological, emotional and personality changes. These changes may have an impact on the health risks of adolescents through certain behavioural choices or inevitable exposures. Globally, almost half of all adolescent deaths occur due to injury.1 Injuries related to accidental fall, being struck by an object or person and road traffic injury (RTI) are particularly relevant among adolescents. Accidental falls and RTI are the most common causes of injury among children and adolescents.2 3 Being struck by objects has been reported as a major cause of sports and occupational injuries among American adolescents.4 5 In Canada, ‘struck by or against something’ was one of the main causes of hospitalisations in adolescents between 1986 and 2003.6 While injury mortality has been decreasing in high-income countries, a similar trend is not observed in developing nations such as the UAE.7 In 2008, 30% of total years of life lost in the UAE were due to injury.8 This is almost double the regional average, which stands at 14%. Although the risk of injury is spread across the entire UAE population, injury-related morbidity and mortality among the adolescent sub-population is of particular importance. First, UAE adolescents constitute over 16% of the national population.9 Second, injury-related morbidities and mortalities in this sub-population result in a large burden on the healthcare system. Finally, long-term disability
A stratified sampling strategy based on school enrolment data from the UAE Ministry of Education identified the need to select 147 private and public schools from 10 educational zones. Schools were selected randomly by lottery using an updated list of schools as per the UAE Ministry of Education. For schools that had more than one class per grade level, the fishbowl lottery method was used to select the class.
Barakat-Haddad C, et al. Inj Prev 2013;00:1–7. doi:10.1136/injuryprev-2012-040625 Copyright Article author (or their employer) 2013. Produced
Ethics and administration Ethical approval was obtained from the UAE Ministries of Education and Health. Social workers were trained to administer one component of the survey on students from three classes from each participating school (one class from each of Grades 10, 11 and 12) during a spare period in a classroom setting. Information letters were sent to parents a couple of days prior to survey administration. These letters outlined the research objectives and methods, and asked for participation consent. The second component was sent with the participant overnight to seek parental assistance in completing data related to residential characteristics and medical diagnosis for parents and siblings. Detailed information in relation to the number of schools sampled, response rates and student demographics has been published elsewhere.10
Outcome variables Outcome variables are based on responses to three items modified from the Canadian Community
by BMJ Publishing Group Ltd under licence.
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Brief report Table 1 Demographic and socioeconomic profiles of the study participants (n=6363) Variable
Local (n=3066)
Expatriate (n=3157)
Total (n=6363)
Sex (% male)*** Mean age (years) Attending public school (%)*** Born in UAE (%)*** Property tenure (% own property)*** Mean age of property (years) Index for residential crowding†*** Location of residence*** Abu Dhabi (%) Ajman (%) Dubai (%) Fujairah (%) RAK (%) Sharjah (%) UAQ (%) Ethnicity‡ UAE (%) GCC (%) Arab/Middle East (%) Arab/Africa (%) South East Asia (%) Western (%) No nationality (%) Others (%) Parental marital status*** Married (%) Widowed (%) Separated/divorced (%) Father’s employment*** Government (%) Private (%) Self-employed (%) Not employed/retired (%) Mother’s employment*** Government employee (%) Private employee (%) Self employed (%) Not employed (%) Household monthly income ≤AED 2000 (%) >2000 and ≤5000 AED >5000 and ≤8000 AED >8000 and ≤10000 AED >10000 and ≤12000 AED >12000 and ≤15000 AED >15000 and ≤20000 AED >AED 20000 Household income>AED 15000§*** Father’s education (% completed high school)*** Mother’s education (% completed high school)***
40 16 90 97 88 14 0.20–3.89
48 16 33 53 15 14 0.00–18.33
44 16 61 75 51 14 0.00–3.67
42 3 9 11 13 17 2
51 5 9 5 7 19 1
47 4 9 8 10 18 2
100 NA NA NA NA NA NA NA
NA 11 30 19 33 2
