Temporal factors and the incidence of physical abuse in young children: decreased nonaccidental trauma during child abuse prevention month Neal J. Thomas a,b, ⁎ , Michele L. Shaffer b , Susan Rzucidlo c , Beverly J. Shirk c , Mark S. Dias d a Division of Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Children's Hospital and Pennsylvania State University College of Medicine, Hershey, PA 17033, USA b Department of Health Evaluation Sciences, Penn State Children's Hospital and Pennsylvania State University College of Medicine, Hershey, PA 17033, USA c Division of Pediatric Surgery, Department of Surgery, Penn State Children's Hospital and Pennsylvania State University College of Medicine, Hershey, PA 17033, USA d Division of Pediatric Neurosurgery, Department of Neurosurgery, Penn State Children's Hospital and Pennsylvania State University College of Medicine, Hershey, PA 17033, USA Abstract Background/Purpose: Educational efforts have been shown to decrease the incidence of abusive injuries. Information related to factors that associate with child abuse would further these educational efforts. We undertook this study to determine the influence of temporal factors and a national preventative program on the incidence of abusive injuries in young children. Methods: The Pennsylvania Trauma Outcome Study database was queried for all children 36 months old or younger admitted with abusive injuries. Data collected included day, month, and season. Data were analyzed by Poisson regression. Results: Six hundred seventy-two cases of child abuse were reported, with a linear increase in the number of cases per year (P b .001). Sunday had fewer abuse cases admitted than any other day of the week (risk ratio, 0.70; P = .008). Younger children were less likely to be injured during April, which is National Child Abuse Prevention Month, and more likely to be injured during August and October (all P b .05). Conclusions: We observed fewer inflicted injuries in young children on Sundays, and during April. The causes for these significant variations deserve further study. © 2007 Elsevier Inc. All rights reserved. Index words: Child abuse; Prevention; Pediatrics; Pennsylvania Child abuse is a leading cause of pediatric morbidity and mortality [1]. Although abusive injuries can occur in a child of any age, those younger than 3 years are the most likely to be injured enough to require hospitalization [2], and many survive with serious long-term sequelae [3]. From a societal perspective, the economic costs of abusive injuries are significant as well. Many of these abused children require www.elsevier.com/locate/jpedsurg These data were presented in abstract form at The Society of Critical Care Medicine's 34th Critical Care Congress, Phoenix, AZ, January 15-19, 2005. ⁎ Corresponding author. Pediatric Critical Care Medicine, Penn State Children's Hospital, Hershey, PA 17033, USA. Tel.: +1 717 531 5337; fax: +1 717 531 0809. E-mail address: nthomas@psu.edu (N.J. Thomas). 0022-3468/$ – see front matter © 2007 Elsevier Inc. All rights reserved. doi:10.1016/j.jpedsurg.2007.05.032 Journal of Pediatric Surgery (2007) 42, 1735–1739