Is perceived failure in school performance a trigger of physical injury? A case-crossover study of children in Stockholm County.

• OBJECTIVES: To investigate whether perceived failure in school performance increases the potential for children to be physically injured. SUBJECTS: Children aged 10-15 years residing in the Stockholm County and hospitalised or called back for a medical check up because of a physical injury during the school years 2000-2001 and 2001-2002 (n = 592). METHODS: A case-crossover design was used and information on potential injury triggers was gathered by interview. Information about family socioeconomic circumstances was gathered by a questionnaire filled in by parents during the child interview (response rate 87%). RESULTS: Perceived failure in school performance has the potential to trigger injury within up to 10 hours subsequent to exposure (relative risk = 2.70; 95% confidence intervals = 1.2 to 5.8). The risk is significantly higher among pre-adolescents and among children from families at a higher education level. CONCLUSIONS: Experiencing feelings of failure may affect children's physical safety, in particular among pre-adolescents. Possible mechanisms are perceptual deficits and response changes occasioned by the stress experienced after exposure.

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