A1 Refereed original research article in a scientific journal
Trends in injuries over 20 years: a cross-national study of 954 298 adolescents from 31 European countries; 
Authors: Pickett, William; King, Nathan; Pagnotta, Valerie F; Donnelly, Peter D; Harel-Fisch, Yossi; Walsh, Sophie D; Ng, Kwok; Malinowska-Cieślik, Marta; Várnai, Dóra Eszter; Qirjako, Gentiana; Molcho, Michal
Publisher: Oxford University Press (OUP)
Publication year: 2026
Journal: European Journal of Public Health
Article number: ckag080
Volume: 36
Issue: 4
ISSN: 1101-1262
eISSN: 1464-360X
DOI: https://doi.org/10.1093/eurpub/ckag080
Publication's open availability at the time of reporting: Open Access
Publication channel's open availability : Open Access publication channel
Web address : https://doi.org/10.1093/eurpub/ckag080
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/527074933
Self-archived copy's licence: CC BY NC
Self-archived copy's version: Publisher`s PDF
Injuries are a leading public health priority within adolescent populations; however, few cross-national studies have examined their epidemiology over time. We described time trends in adolescent self-reported medically treated injury across 31 mainly European countries over 20 years, then explored whether observed temporal trends varied according to the prevalence of known behavioral risk factors. The data source included six cycles of the Health Behavior in School-aged Children study (2002–22; weighted n = 954 298, participants aged 11–15 years). Outcomes included self-reports of any and multiple medically treated injuries. Measures of behavioral risks included indicators of violence, substance use, and physical activity. Within countries reporting increases in injuries, variations in reported engagement in known behavioral risk factors were examined. Nearly half of adolescents reported at least one medically treated injury (47%–53% of boys; 38%–44% of girls) and nearly one quarter reported multiple injuries (23%–30% of boys; 16%–22% of girls). In the pooled analysis, temporal trends included increases in any medically treated injury for girls (all age groups) and boys (11 years only) and multiple injuries (boys and girls, all age groups). At the country-level, we observed more temporal increases than decreases. Increases in physical activity were observed coincident with observed injury trends. In one of the largest European analyses of its kind, we demonstrated the ongoing burden of adolescent injury. Persistently high rates of adolescent injuries are concerning, and the origins of temporal increases require an initial focus on sport and physical activity.
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Funding information in the publication:
Grant funding for the researchers involved in the development of this specific cross-national manuscript was provided by the Public Health Agency of Canada, and the Canadian Institutes of Health Research (Operating Grant MOP341188; Project Grant PJT-488331). V.F.P. is supported by a Canadian Institutes of Health Research Doctoral Canada Graduate Scholarship.
