A Cross-Sectional Survey of Unintentional Injuries Among 15-24-Year-Old Vocational School Youth From Pakistan Between 2021-2022

Abstract

There is a lack of recent data on the incidence of unintentional injuries and occupational injuries from Pakistan, among youth 15 to 24 years of age. This survey was conducted among vocational school youth in Peshawar, Pakistan (2021-22). Parental consent and assent were obtained for students <18 years of age. After obtaining consent, students were given a hard copy of the self-administered, World Health Organization community survey guide for injuries and violence questionnaire in a classroom session. Incidence Rate Ratios (IRR) were reported for unintentional and occupational injuries There were 547 youth of which [356 (54%)] were males. Majority [535 (97%)] of the students had received formal education before vocational training, while fathers had higher formal education [437(80%)], compared to mothers [326 (60%)]. The median family income of these vocational students was 30 000 Pakistani rupee (PKR) per month. Vocational youth mostly lived in crowded family settings with 239 participants (44%) living with ≥8 family members in the household. In terms of risk behaviors, there was minimal use of tobacco [532 (97.3%)] and minimal alcohol [9 (2%)]. Non-use of helmets was found in [273 (50%)], which was similar to seat belt non-use in [307 (56%)] of participants. Eight percent of students carried a gun for personal protection. Males had 3.24 times higher rates of road traffic injuries, 1.28 times higher rates of occupational injuries, and 1.63 times higher rates of unintentional injuries overall compared to their female counterparts. The 15 to 19 age group had significantly lower incidence of burns and falls compared to the 20 to 24 age group. Factors that increased the risk of unintentional injuries UI_T were tobacco use adjusted IRR = 1.25 (95% CI: 1.05-2.69, P = .049), not using a seat belt adjusted IRR = 1.3 (95% CI: 1.14-1.69, P < .001), lack of formal education prior to vocational training in the youth, adjusted IRR of 4.6 (95% CI: 1.12-18.91, P = .034), lack of father's education adjusted IRR = 4.71 (95% CI: 2.12-10.49, P < .001), lower family income (≤35 000 PKR) adjusted IRR = 2.04 ( 95% CI: 1.04-4.02, P = .039), larger household size (≥8 members), with an adjusted IRR of 3.59 (95% CI: 3.11-5.07, P < .001). In contrast, age ≤19 years showed a higher unadjusted risk (IRR = 2.05, 95% CI: 1-4.2, P = .049), but this association was not significant after adjustment (adjusted IRR = 1.61, 95% CI: 0.8-3.27, P = .184). Marital status and mother's education were not significantly associated with UI_T. This study on vocational youth in Pakistan highlights the critical need for targeted interventions. We recommend prioritizing stricter enforcement of traffic laws, implementing public awareness campaigns specifically for vocational youth, and providing subsidized safety equipment, such as helmets. Furthermore, integrating comprehensive road safety and health education into vocational training curricula is crucial. By addressing these critical areas, significant reduction in injury rates and improved safety and well-being of this vulnerable population may be realized.

Keywords: Pakistan; adolescents; occupational injuries; unintentional injuries; youth.