{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:53Z","timestamp":1789448573178,"version":"build-2803163510"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the distribution of injury mechanisms and occurrence locations among hospital-recorded injury cases and assess their associations with recorded demographic and contextual characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective study, we analyzed routinely collected injury-surveillance records from 22 reporting units in Lanshan District, Linyi, China. Records from 2021 through 25 November 2025 were eligible. After excluding four records with sex coded as unknown\/other, one structurally malformed record, and one exact duplicate, 68,311 records remained. Mechanism and occurrence location were classified into seven and eight mutually exclusive categories, respectively. Multinomial logistic regression estimated relative risk ratios (RRRs) for category comparisons, adjusted for sex, age, occupation, calendar year, season, injury intent, and documented alcohol and psychotropic-substance status. Leave-one-reporting-unit-out analyses assessed the stability of the main comparisons. Modified Poisson models with reporting-unit-clustered standard errors and Cramer\u2019s\n                      <jats:italic>V<\/jats:italic>\n                      were used in sensitivity and descriptive analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Males contributed 40,433 records (59.19%). Blunt injuries were the most common mechanism (52,468; 76.81%); residences (29,529; 43.23%), roads\/streets (22,346; 32.71%), and industrial\/construction locations (10,829; 15.85%) were the most common locations. The principal demographic comparisons were broadly consistent across reporting-unit deletion analyses. Males had higher sharp-versus-blunt (RRR 2.02, 95% CI 1.45\u20132.82) and industrial\/construction-versus-residence RRRs (RRR 2.68, 95% CI 2.27\u20133.18), and a lower road\/street-versus-residence RRR (RRR 0.87, 95% CI 0.83\u20130.92). Compared with adults aged 35\u201364\u202fyears, those aged 15\u201334\u202fyears had higher sharp-versus-blunt (RRR 1.61, 95% CI 1.02\u20132.53) and road\/street-versus-residence RRRs (RRR 1.41, 95% CI 1.16\u20131.70). Alcohol and psychotropic-substance estimates were imprecise and sensitive to reporting-unit removal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sex and age were associated with the composition of mechanisms and locations among hospital-recorded injury cases. The findings describe the surveillance case series and do not estimate population incidence or causal effects. Behavioral indicators should be interpreted as exploratory because positive records were sparse and disproportionately concentrated in the largest reporting unit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1907077","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:26:35Z","timestamp":1789446395000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Injury mechanisms and occurrence locations among hospital-recorded cases in Lanshan District, Linyi, China, 2021\u20132025"],"prefix":"10.3389","volume":"14","author":[{"given":"Yong","family":"Ding","sequence":"first","affiliation":[{"name":"Key Laboratory of Birth Defect Prevention and Control, Women and Children\u2019s Hospital of Linyi","place":["Linyi, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Liu","sequence":"additional","affiliation":[{"name":"Linyi Lanshan District Center for Disease Control and Prevention","place":["Linyi, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoxia","family":"Wang","sequence":"additional","affiliation":[{"name":"Linyi Lanshan District Center for Disease Control and Prevention","place":["Linyi, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Cao","sequence":"additional","affiliation":[{"name":"Key Laboratory of Birth Defect Prevention and Control, Women and Children\u2019s Hospital of Linyi","place":["Linyi, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiqing","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Public Health, Linyi Traditional Chinese Medicine Hospital","place":["Linyi, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"ref1","first-page":"1204","article-title":"Diseases and injuries collaborators global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the global burden of disease study 2019","volume-title":"Lancet","author":"GBD","year":"2019"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"i96","DOI":"10.1136\/injuryprev-2019-043494","article-title":"Global injury morbidity and mortality from 1990 to 2017: results from the global burden of disease study 2017","volume":"26","author":"James","year":"1990","journal-title":"Inj Prev"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.1016\/S0140-6736(19)30427-1","article-title":"Mortality, morbidity, and risk factors in China and its provinces, 1990\u20132017: a systematic analysis for the global burden of disease study 2017","volume":"394","author":"Zhou","year":"2019","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1056\/NEJMra1109343","article-title":"Injuries","volume":"368","author":"Norton","year":"2013","journal-title":"N Engl J Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1765","DOI":"10.1016\/S0140-6736(08)61367-7","article-title":"Injury-related fatalities in China: an under-recognised public-health problem","volume":"372","author":"Wang","year":"2008","journal-title":"Lancet"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"340","DOI":"10.21037\/tp-21-387","article-title":"Epidemiology of unintentional injury in children admitted to ICU in China mainland: a multi-center cross-sectional study","volume":"11","author":"Ye","year":"2022","journal-title":"Transl Pediatr"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1186\/s13018-022-03159-5","article-title":"Upper limb pediatric fractures in 22 tertiary children\u2019s hospitals, China: a multicenter epidemiological investigation and economic factor analysis of 32,832 hospitalized children","volume":"17","author":"Qiu","year":"2022","journal-title":"J Orthop Surg Res"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1089\/neu.2021.0275","article-title":"Epidemiological characteristics of older patients with traumatic brain injury in China","volume":"39","author":"Yang","year":"2022","journal-title":"J Neurotrauma"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"4647102","DOI":"10.1155\/2022\/4647102","article-title":"Characteristics and outcomes of shared bicycle-related injuries from a large emergency medical Centre in China, 2017\u20132021","volume":"2022","author":"Chen","year":"2022","journal-title":"Emerg Med Int"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e166","DOI":"10.1017\/dmp.2022.86","article-title":"Epidemiological characteristics, risk factors, and preventive measures of occupational injuries among commercial couriers in China before and during the COVID-19 pandemic","volume":"17","author":"Shi","year":"2022","journal-title":"Disaster Med Public Health Prep"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e14046","DOI":"10.7717\/peerj.14046","article-title":"Analysis of road traffic injuries and casualties in China: a ten-year nationwide longitudinal study","volume":"10","author":"Qi","year":"2022","journal-title":"PeerJ"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1186\/s12887-022-03661-z","article-title":"Risk factors of in-home unintentional injuries among 0-6-year-old children in Changsha city of China: a cross-sectional survey based on Bronfenbrenner's ecological system theory","volume":"22","author":"Ma","year":"2022","journal-title":"BMC Pediatr"},{"key":"ref13","volume-title":"Injury Surveillance Guidelines","author":"Holder","year":"2001"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/j.injury.2014.12.013","article-title":"The National Injury Surveillance System in China: a six-year review","volume":"46","author":"Duan","year":"2015","journal-title":"Injury"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/j.burns.2023.08.007","article-title":"Development of an electronic burns register: digitisation of routinely collected hospital data for global burns surveillance","volume":"50","author":"Bebbington","year":"2024","journal-title":"Burns"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e296","DOI":"10.1371\/journal.pmed.0040296","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"4","author":"von Elm","year":"2007","journal-title":"PLoS Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e1001885","DOI":"10.1371\/journal.pmed.1001885","article-title":"The REporting of studies conducted using observational routinely-collected health data (RECORD) statement","volume":"12","author":"Benchimol","year":"2015","journal-title":"PLoS Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1016\/j.jclinepi.2006.01.014","article-title":"Review: a gentle introduction to imputation of missing values","volume":"59","author":"Donders","year":"2006","journal-title":"J Clin Epidemiol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"b2393","DOI":"10.1136\/bmj.b2393","article-title":"Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls","volume":"338","author":"Sterne","year":"2009","journal-title":"BMJ"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.1503\/cmaj.110977","article-title":"Missing covariate data in clinical research: when and when not to use the missing-indicator method for analysis","volume":"184","author":"Groenwold","year":"2012","journal-title":"CMAJ"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1093\/aje\/kwh090","article-title":"A modified Poisson regression approach to prospective studies with binary data","volume":"159","author":"Zou","year":"2004","journal-title":"Am J Epidemiol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"317","DOI":"10.3368\/jhr.50.2.317","article-title":"A practitioner\u2019s guide to cluster-robust inference","volume":"50","author":"Cameron","year":"2015","journal-title":"J Hum Resour"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.jclinepi.2021.01.008","article-title":"Framework for the treatment and reporting of missing data in observational studies: the treatment and reporting of missing data in observational studies framework","volume":"134","author":"Lee","year":"2021","journal-title":"J Clin Epidemiol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1136\/ip.5.3.231","article-title":"The changing approach to the epidemiology, prevention, and amelioration of trauma","volume":"5","author":"Haddon","year":"1999","journal-title":"Inj Prev"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1136\/ip.4.4.302","article-title":"Using the Haddon matrix: introducing the third dimension","volume":"4","author":"Runyan","year":"1998","journal-title":"Inj Prev"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1111\/j.1360-0443.2006.01462.x","article-title":"Acute alcohol use and the risk of non-fatal injury in sixteen countries","volume":"101","author":"Borges","year":"2006","journal-title":"Addiction"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.drugalcdep.2010.02.011","article-title":"The more you drink, the harder you fall: a systematic review and meta-analysis of acute alcohol consumption and injury or collision risk","volume":"110","author":"Taylor","year":"2010","journal-title":"Drug Alcohol Depend"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/S0376-8716(03)00202-3","article-title":"Injury risk associated with cannabis and cocaine use","volume":"72","author":"Macdonald","year":"2003","journal-title":"Drug Alcohol Depend"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1016\/j.jsr.2004.08.005","article-title":"Have young workers more injuries than older ones? An international literature review","volume":"35","author":"Salminen","year":"2004","journal-title":"J Saf Res"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1907077\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:26:36Z","timestamp":1789446396000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1907077\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":29,"alternative-id":["10.3389\/fpubh.2026.1907077"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1907077","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]},"article-number":"1907077"}}