1. Background Hospital episodes statistics (HES) provide comprehensive information on children admitted to hospital with injuries. For example, in the 5-year period 1998-2003, falls accounted for 4,638 (31%) of emergency admissions through accident and emergency (A&E) departments for boys aged 10-14 in the South West. While these data are useful in describing causes of childhood morbidity in the South West, they only include cases admitted to hospital and therefore represent the tip of the iceberg of childhood morbidity due to injury. A&E attendance data capture a greater proportion of injuries in childhood than hospital admission through A&E. The South West Injury Surveillance System (South West Public Health Observatory) began compiling A&E attendance data from hospital sites throughout the South West in 2002. Aim We present data on A&E attendance in the South West, to describe the pattern of childhood morbidity due to injury in the South West. Method The underlying reasons for attending A&E amongst 0-19 year olds were recorded at eleven hospital sites in the South West during a one-year period (2003/4) based on a total of 128,000 attendances. The number of attendances due to four specific causes of injury are presented by age and gender. The ward of residence could be linked to deprivation scores for nine hospital sites, and reasons for attendance are examined by deprivation quintile based on 100,000 A&E attendances at these hospital sites. Results Figure 1 presents four underlying causes of A&E attendance amongst 0-19 year olds in the South West – sports injuries, road traffic accidents, assault and deliberate self-harm. Each of these causes except deliberate self-harm is more common in boys than girls. These four reasons for attendance each account for 1% or less of attendances amongst 0-4 and 5-14 year olds with the exception that 8% of attendances amongst 5-14 year olds result from sports injuries. Amongst 15-19 year olds, 9% of attendances are due to sports injuries, 4% to road traffic accidents, 3% to assaults, and 2% deliberate self-harm. Figure 2 shows the percentage of A&E attendances (0-19 years) due to the same four causes by deprivation quintile. There is a clear decrease in the percentage of attendances due to sports injuries with increasing deprivation, the most striking differences being in the least and most deprived quintiles. This is likely to reflect levels of participation in organised sports. The proportion of attendances due to assault appears to increase with deprivation, probably illustrating greater levels of violence in more deprived areas. There is no clear pattern across deprivation quintiles for either road traffic accidents or deliberate self-harm. Figure 1. Number of A&E attendances (and % of all attendances) for 0-19 year olds at 11 hospital sites in the South West* in a 1-year period 2003/4 and in each age/sex group due to: a) sports injuries, b) road traffic accidents, c) assault, and d) deliberate self-harm * Cheltenham General Hospital, Gloucestershire Royal Hospital, Cirencester Hospital, Stroud General Hospital, Dilke Memorial Hospital, United Bristol Healthcare NHS Trust, Southmead Hospital, Frenchay Hospital, Weston General Hospital, Royal Bournemouth Hospital, Royal Cornwall Hospital (Truro) b) Road traffic accidentsa) Sports injuries c) Assaultd) Deliberate self-harm Figure 2: A&E attendance for 0-19 year olds at 9 hospital sites in the South West* in a 1-year period 2003/4. Underlying reason for attendance by Townsend deprivation quintile of residence * Cheltenham General Hospital, Gloucestershire Royal Hospital, Cirencester Hospital, Stroud General Hospital, Dilke Memorial Hospital, United Bristol Healthcare NHS Trust, Southmead Hospital, Frenchay Hospital, Weston General Hospital Injury in children in the South West: A&E attendance data Isabelle Bray 1, 2 Wendi Slater 3 Paul Brown 3 Julia Verne 3 Correspondence to: Issy.Bray@bristol.ac.uk Acknowledgements: This poster is based on an unpublished bulletin written for the South West Public Health Observatory, on which helpful comments were received from Brendan Yates and Mary Shaw 1Department of Social Medicine, University of Bristol 2Government Office for the South West 3South West Public Health Observatory Conclusion These data highlight the importance of injuries resulting in A&E attendance amongst 5-19 year olds. The analyses by gender, age group and deprivation quintile suggest specific areas for intervention (e.g. sports injuries in boys aged 5-19, physical assault towards boys aged 15-19 in more deprived areas). Though this process of data collection is in its early stages, these data give a useful snapshot of causes of A&E attendance. As the completeness of reporting improves, the South West Injury Surveillance System will provide valuable information on childhood morbidity in the region.