Abstract 33

Background/aims - Traditional epidemiologic approaches for the identification of risk factors for childhood injuries usually refer to parameters that remain stable over time. In this study, the case-crossover design was used in order to evaluate the risk for childhood injuries due to exposure to transient intellectual exertion or emotional distress, as well as to quantify the well-known excess injury risk associated with strenuous physical activity. Subjects and measurements - All 156 children aged 8 to 14 years who were hospitalized as a result of an injury in the A. Kyriakou University Children's Hospital of Athens were interviewed in person. The structured questionnaire covered sociodemographic variables as well as information about the exposure to risk factors with short-term effect during the 26 hours preceding the accident. The experience of each child during the 2-hour interval preceding the accident was compared with his or her experience during the previous twelve 2-hour intervals. Data were analyzed using the conditional logistic regression in order to control for possible confounding factors. Results - The adjusted odds ratios were: 24.2 for children with a history of strenuous physical activity, 9.0 for intellectual exertion, 2.6 for involvement in family quarrels, 3.8 for school examination and 3.4 for a strongly pleasant event. No statistical risk elevations were found for other parameters that were examined. Conclusion - Transient exposures to several factors such as strenuous physical activity or psycho-emotional distress are important components in the causation of childhood accidents.