In Norway, road safety regulations have reduced moderate to severe traumatic brain injuries in children

Semi Truck Driving on Road

Traumatic brain injury (TBI) is one of the most common causes of morbidity and mortality among children worldwide. Although the vast majority of head injuries sustained by children are classified as “mild,” or concussion, the remaining 10 percent of moderate to severe injuries pose serious risk of death and disability. Despite the significant health problems associated with pediatric TBI, few studies have focused exclusively on the incidence of moderate to severe injuries. Because mild TBI and moderate/severe TBI carry significantly different risks of permanent injury or death, there is a critical need for research that specifically examines the frequency and outcomes of more severe injuries.

To address this gap in current TBI research, a team of researchers conducted a study to estimate the of incidence moderate to severe TBI in Norwegian children and adolescents. They identified 145,395 children who were hospitalized in one region of Norway between 2004 and 2014. Of these children, only 71 were admitted for moderate to severe TBI or passed away from their injuries before reaching the hospital. Based on these figures, the researchers estimated that the rate of moderate or severe TBI together is only 4 to 8 per 100,000 children. Hospital records indicated that half of children who sustained moderate TBI were injured after falling, and half of children who died of TBI were injured in motor vehicle accidents. Boys were more likely to sustain TBI than girls, and children ages 15 to 16 were at highest risk of injury and death.

Although the results of this study aligned with previous evidence that adolescents aged 15 to 16 are at highest risk, this study’s estimate of pediatric TBI incidence is significantly lower than figures provided by previous studies, which have estimated that the incidence is as high as 159 per 100,000 children. The researchers attributed this discrepancy to Norway’s relatively strict road traffic safety laws, which have significantly decreased injury and death among the Norwegian population by improving vehicle and road standards, mandating seat belt use, and strictly enforcing drunk driving laws. Critically, the results of this study suggest that well-implemented road safety regulations can substantially decrease the rate of TBI-related deaths and disabilities, reducing the enormous public health burden associated with moderate to severe head injuries.

Olsen M, Vik A, Lund Nilsen TI, et al. Incidence and mortality of moderate and severe traumatic brain injury in children: A ten year population-based cohort study in Norway. European Journal of Pediatric Neurology. (2019).

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