Author(s): IMAI, N., KIDOKORO, T., Institution: NIPPON SPORT SCIENCE UNIVERSITY, Country: JAPAN, Abstract-ID: 2131

INTRODUCTION:
School-related injuries remain a major public health concern among children. Previous research has primarily focused on severe injuries requiring emergency care; however, these cases represent only a small portion of school injuries. Many injuries occur in everyday school life, and focusing only on severe cases may overlook the contexts in which injuries occur.
In Japan, all visits to the school healthcare room are systematically documented by Yogo teachers—certified school health professionals responsible for student health care. These records offer a unique opportunity to capture a broad range of school injuries. This study aimed to clarify when, where, among whom, and under what circumstances injuries occur among elementary school children using a mixed-methods approach combining healthcare records and Yogo teacher interviews.
METHODS:
This study was conducted at a public elementary school in Japan. We analyzed 396 injury-related healthcare room visits recorded between April 2023 and March 2024 among children in grades 1–6. Data included sex, grade, injury type, body part, location (e.g., playground or classroom), context (e.g., recess or class time), and month. Monthly injury rates were adjusted for school days.
A semi-structured interview with a Yogo teacher explored common injury situations and perceived causes. Data was transcribed and analyzed using qualitative content analysis to identify recurring themes.
RESULTS:
Grade 1 children accounted for 40% of all injury-related visits, and injury frequency decreased with increasing grade level. Boys were more frequently injured on the playground, whereas girls were more often injured in classrooms. For both sexes, recess was the most common context for injury occurrence. Most injuries were minor wounds such as cuts and abrasions. Monthly patterns showed higher injury rates in April, May, and August. These months corresponded to periods following long school breaks. Qualitative findings supported these patterns. According to the Yogo teacher, injuries often occurred when children suddenly engaged in vigorous play without sufficient physical readiness. Developing risk perception and over-immersion in competitive play were also described as contributing factors. Increases in injuries were particularly noted during periods when children’s physical activity levels rose rapidly.
CONCLUSION:
This study provides a comprehensive picture of injury occurrence in an elementary school using school healthcare records. Injuries showed clear patterns by grade, sex, timing, and context, with higher occurrence among younger children, during recess, and after long breaks. School health records can support the identification of high-risk periods and contexts and may help schools promote safer participation in daily physical activities while maintaining active school environments.