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Descriptive study of dog bites in France Severity factors. Factors of onset of sequelae. Circumstances. Results of a survey conducted by InVS and Zoopsy in 2009–2010
Abstract
An interdisciplinary epidemiological survey was undertaken on dog bites in France from May 1, 2009 to June 30, 2010. Medical information was collected from eight emergency services, and a telephone questionnaire was conducted by veterinary behaviorists. A second questionnaire was conducted 1 month after the dog bite to determine how the bite wound had healed.
In children, dog bites were more frequent on the head and neck, but the lesions were more severe in adults. Bites were more numerous and more severe when the victim knew the dog that bit them. No association was found between the severity of the bite and the type of dog that bit, including breed, sex and weight.
In adults, bites occurred primarily as a result of the victim trying to separate two fighting dogs, whereas children were bitten when they interacted with a familiar dog. Among those who responded to the follow-up questionnaire 1 month after the bite, 39% reported sequelae. Aesthetic sequelae were the majority (80%) of sequelae reported. Women and adults reported more sequelae than did men and children. Measures should be adopted based on the results of this survey.
... Although several studies indicated that the bites are more sustained by males, both in adults and in children ( Ozanne-Smith et al., 2001 ;Kaye et al., 2009 ;Kallo et al., 2020 ), the opposite was also reported ( Oxley et al., 2018 ). Besides, it was found that the differences between genders depended on the age of the person involved in the dog bite incident, for instance, while the men were bitten more than the women at an age between 30 and 39 years, while after an age of 60 years, women were bitten more than men ( Sarcey et al., 2017 ). Our results indicated that most of the people who were bitten were female (78.1%) which is in agreement with another study carried out locally in Portugal ( Vargas et al., 2013 ). ...
... Although severe bite accidents occur infrequently, they may have a huge negative impact on the quality of life of those who were bitten and their families. Sequelae can be very significant and have long-lasting or even permanent consequences, with the potential for physical ( Sarcey et al., 2017 ), aesthetic ( Eppley and Schleich, 2013 ;Sarcey et al., 2017 ), and psychological damage ( De Keuster et al., 2006 ). For instance, children suffering from highseverity attacks should be considered at risk for the development of post-traumatic stress disorder ( Kishore et al., 2020 ). ...
... Although severe bite accidents occur infrequently, they may have a huge negative impact on the quality of life of those who were bitten and their families. Sequelae can be very significant and have long-lasting or even permanent consequences, with the potential for physical ( Sarcey et al., 2017 ), aesthetic ( Eppley and Schleich, 2013 ;Sarcey et al., 2017 ), and psychological damage ( De Keuster et al., 2006 ). For instance, children suffering from highseverity attacks should be considered at risk for the development of post-traumatic stress disorder ( Kishore et al., 2020 ). ...
Dog bites are a public health problem worldwide, and Portugal is not an exception. Thus, it is fundamental to develop effective prevention programs and interventions strategies using evidence-based information. Therefore, in the present study, we investigated single dog bite incidents in Portugal retrospectively through an online survey. To the best of our knowledge, this is the first study analyzing dog bite consequences for both people and dogs at a national level in Portugal. A total of 729 valid responses of bite incidents were received. The characteristics of the people, dogs, and consequences of the incidents for both were analyzed. The mean age of the people was 28.2 years (range: 9 months - 89 years), and 78.1% of the people were female. The majority of dogs involved were male (71.1%), and were familiar to the person (78.7%). More than half of the bites were on the upper extremities (58.1%). In 78.3% of the incidents, the bites did not require medical intervention. Among the incidents requiring medical care, 18.6% of the incidents required surgical intervention. Single bites were more frequent (87.2%). While 75% of the single bite incidents resulted in minor injury, this number was reduced to 61% for multiple bite incidents. Children who are under 12 years old had a relatively higher number of head injuries (22.3%) than the other age groups. While in 58.3% of the incidents, nothing happened to the dog as a consequence, eleven dogs (1.9%) were euthanized. The odds of major injuries leading to the dog´s euthanasia were 4.3 times higher than that of the minor injuries (95% confidence intervals (CI95), 1.3 - 14.2). Biting is a natural and preventable behavior, that deserves better mitigation strategies with a deeper understanding of the risk and protective factors. The results of this study contribute to creating a scientific basis for the investigation of dog bites in Portugal.
... Il faut remarquer également que de nombreux auteurs distinguent des contextes inter-spécifiques ou intra-spécifiques lors de l'émission d'une morsure. Les experts ont traité majoritairement les contextes interspécifiques (humain-chien), importants en termes de santé publique, mais aussi les contextes intra-spécifiques, puisqu'un conflit entre deux chiens peut, lorsque le propriétaire tente de séparer les deux protagonistes, être à l'origine de morsure(s) (Sarcey et al. 2017) parfois très graves (Darkaoui et al. 2017 ...
... Parmi cinq publications (Schalamon et al. 2006 ;Sarcey et al. 2017 ;Ricard et al. 2010 ;Bernardo et al. 1998 ;, présentant des cas de morsures dans les hôpitaux, seule l'étude de Schalamon et al. (2006) rapporte les fréquences de morsure par race (ou type racial) au pourcentage de l'effectif estimé de ces races (ou types raciaux) dans la population générale canine. Schalamon et al. (2006) ont analysé 341 cas d'enfants mordus par un chien (hôpital pédiatrique en Autriche). ...
... Dans huit services d'urgence d'hôpitaux français, Sarcey et al. (2017) ont analysé 485 accidents de morsure de personnes. Dans cette étude, 6 % (22/357) des chiens responsables des morsures étaient des chiens de catégories 1 et 2 au sens de la réglementation française. ...
Advice of the French Food Safety Agency on the risk of dog bites and the relevance of breed specific laws made by a subgroup of the Animal Health and Welfare Committee. An evaluation of risk process : identification of the hazard, evaluation of risk i.e emission X expostion and consequences. Advice given on demand of Department of Agriculture related to Laws of 1999, 2007 and 2008 concerning dangerous dogs. Relevance of categorization of dog breeds is discussed as well as the methods of behavioural evaluation.
... Barrios et al. (2021) reported on dog bites in Chile but covered only one yearst' worth of data. Comparing data on dog bites could be biased because of socioeconomic, demographic and sociocultural factors (Babazadeh et al., 2016;Barrios et al., 2021;Benavides et al., 2019;Overall & Love, 2001;Quirk, 2012;Rosado et al., 2009;Sarcey et al., 2017). ...
... The age of the victims in the year of the pandemic (median 26.0 ± 1.0 95% CI) was also lower than that of previous years (median age: 28.0 ± 1.0 95% CI) (p < 0.0001). In accordance with reports from other countries such as Spain, France, the United States and Chile (Barrios et al., 2021;Overall & Love, 2001;Quirk, 2012;Rosado et al., 2009;Sarcey et al., 2017), the under 14 years of age group received most bites. The behaviour of children, lack of understanding of dogs' body language prior to the aggression and lack of adult supervision are some of the reasons that may explain the higher incidence of bites in this age group (Overall & Love, 2001;Quirk, 2012). ...
Background:
Dog bites to people are a serious public health problem. Limited information exists at the country level in Latin America. The COVID-19 pandemic changed people's lifestyles and their relationship with pets, and this could potentially affect the incidence of dog bites injuries.
Objective:
The main objectives of our study were to determine the prevalence of dog-bite injuries in Uruguay from 2010 to 2020 and to compare the prevalence in 2020 to that of pre-pandemic years.
Methods:
Cross-sectional study. Dog-bite notifications for the 2010 and 2020 period were analysed using data from the Uruguayan Ministry of Public Health.
Results:
The annual dog-bite injury rate for the 2010-2020 period was 87.51 per 100,000 people. The frequency of bites varied with the victims' sex, with males accounting for 51.8% of the bites (p < 0.0001), and with age, with a higher frequency of bites in the ≤14 years old age group (p < 0.01). The frequency of dog bites was also higher in spring and summer than in autumn (p < 0.0001). There was no statistical difference in the frequency of dog-bite injuries when comparing 2020 with the pre-COVID-19 pandemic years.
Conclusions:
In Uruguay, the frequency of dog-bite injuries varied with season and with the age and sex of the victim. In the first year of the COVID-19 pandemic, the number of people bitten by dogs was no different than that of previous years. This is the first study in Latin America to report national rather than regional data and to include all age groups.
... The importance of reliable data such as ICD codes is evident. For example, in 2017, a group of researchers estimated the number of fatal dog attacks in France by using media reports media to 20 attacks in 30 years [24]. The Eurostat data instead revealed 79 fatal attacks in 17 years, an almost 7-fold difference. ...
... Our data did not contain such information, but previous studies that have used media reports, court cases and surveys have gained some insights into the circumstances surrounding fatal dog attacks (e.g. [5,24], see also "Aspects of the attacking dog" below). ...
We analyzed fatal dog attacks in Europe 1995–2016 using official death cause data from Eurostat. The data comprised the number of fatalities assigned The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) code W54 "bitten or struck by dog", which includes deaths due to direct attacks but which excludes many complications following dog bites, such as rabies. In 2016, dogs killed 45 Europeans, which translates to an incidence of 0.009 per 100,000 inhabitants. This is comparable to estimates from the USA (0.011), and Canada (0.007), but higher than Australia (0.004). The number of European fatalities due to dog attacks increased significantly at a rate of several percent per year. This increase could not be explained by increases in the human or the dog populations. By taking all fatalities reported 1995–2016 into account, we investigated the effects of age, gender and geography. First, children, including infants, were common victims, but also middle-aged and the elderly, while people between ages 10 and 39 were rarely killed by dogs. Second, boys and men were overrepresented, but only in certain age groups and in certain parts of Europe. Third, there were large national and regional differences, both in the effects of gender and in incidences, which ranged from 0 to 0.045 per 100,000 inhabitants. This study of dog-related fatalities at a European level is the first of its kind and forms a basis for more detailed, national studies.
... Tierärzte, Tierpfleger und Jäger) besonders hoch; sie werden überwiegend im Bereich der oberen oder unteren Extremitäten verletzt (Jacobs 2013;Owczarczak-Garstecka et al. 2019). Andererseits laufen vor allem Kinder Gefahr, von Hunden gebissen zu werden; ihre Verletzungen sind überwiegend im Bereich des Kopfes und des Nackens zu finden (Touré et al. 2015;Sarcey et al. 2017;Essig et al. 2019) und ziehen häufig auch eine Beeinträchtigung der psychischen Gesundheit nach sich (Peters et al. 2004;De Young et al. 2016). Am häufigsten betroffen sind Jungen im Alter von 0-9 Jahren (Weiss et al. 1998;Overall & Love 2001;Matthias et al. 2015). ...
A historical review of the development of muzzles shows that the requirements for these devices, which are anchored in modern animal protection and security police law, were discussed as early as the beginning of the 20 th century. As muzzles are regarded as a safe means of preventing bites, security police legislation imposes far-reaching obligations on muzzles for dogs in public spaces. We have collected initial information on problems related to the safety of muzzles or individual muzzle types. In 2022, we conducted a survey of dog trainers and veterinarians in Austria and Germany to gather information on incidents in which muzzled dogs caused a (bite) injury. We also collected information on the popularity of certain muzzle types among dog owners and on the recommendations of different muzzle types by dog trainers. There have been 63 reported incidents involving muzzled dogs that resulted in a bite or other injury to a human or other animal. During the (biting) incident, the dogs wore muzzles made of biothane (27 %), leather (25.4 %), metal (22.2 %) or hard plastic (9.5 %). More than 60% of bite injuries with muzzles made of bio-thane and hard plastic led to perforation of skin and
tissue, while more than 50 % of injuries with muzzles
made of leather had no tissue perforation. Bites with
muzzles made of metal generally (78.6 %) resulted
in impact injuries. At initial consultations, dog owners
mostly used muzzles made of hard plastic, followed
by muzzles made of biothane or metal. Dog trainers
recommended muzzles made of biothane, followed by
muzzles made of metal or hard plastic.
The results show that the safety of individual muzzle
types is sometimes overestimated, as muzzle-wearing
dogs can also cause bite injuries and there are differences
between the muzzle types with regard to the
severity of (bite) injury. Our results suggest that mesh
muzzles made of metal should be recommended for
dogs with a body weight of approx. 20 kg or more.
... Most bites occurred between the ages of 8 and 12, differing from previous reports revealing the highest biting rate among children aged between 5 and 9 (QUIRK, 2012;BASCO et al., 2020). The profile of the attacking dogs was consistent with previous results (FLINT et al., 2017;SARCEY et al., 2017), comprising a male, adult dog that was large in size. German shepherds are often reported as the breed most commonly involved in biting incidents involving children (SCHALAMON et al., 2006;KHAN et al., 2020), as also seen in our sample. ...
Although children are the most frequent victims of dog bites, gaps remain in understanding of the factors that lead to biting incidents. Using a retrospective and victim self-report questionnaire, risk factors for dog bites with respect to younger and older children in Slovenia are examined. The results showed that younger children were more commonly bitten in a non-public place, outside or inside a house when the owner was absent. They had approached and interacted with a dog they knew, which had a history of aggression and had displayed tense or aggressive behaviour before the bite. Older children were mainly bitten outside in a public space, when the owner was not there. They were approached and bitten by an unknown dog while running or cycling, while entering the dog's personal space, or it was completely unprovoked. The dog involved had a history of aggression and before the bite the victims had neither interacted nor attempted to interact with the dog. These results suggest that the risk factors for dog bites involving children might be age-related calling for due attention and further assessment.
... Most bites occurred between the ages of 8 and 12, differing from previous reports revealing the highest biting rate among children aged between 5 and 9 (QUIRK, 2012;BASCO et al., 2020). The profile of the attacking dogs was consistent with previous results (FLINT et al., 2017;SARCEY et al., 2017), comprising a male, adult dog that was large in size. German shepherds are often reported as the breed most commonly involved in biting incidents involving children (SCHALAMON et al., 2006;KHAN et al., 2020), as also seen in our sample. ...
Using a web-based questionnaire with 29 close- and open-ended questions about 400 self-reported dog-biting incidents in Slovenia, this research investigated the contexts of dog bites, focusing on characteristics of the dogs and the descriptions of the situations to identify the main risk factors for the occurrence of dog bites. Even though it has been suggested that most dog bites occur during initially non-aggressive interactions with the dog (e.g., during petting, playing), in our study we discerned a wide variety of contexts, including those in which the person did not intend to interact with the dog. Most victims reported unprovoked bites during fast movements near the dog, while coming into close proximity, and during incidents without a reason. These incidents more likely occurred in public than private places and were associated with purebred dogs with a history of aggression.
... More than 300 individuals died from dog attacks in the US from 1979 to 1998 [5]. In France, 20 bite-related fatalities have occurred in the past 30 years [6]. In Italy, from 1984 to 2020, 58 individuals died from dog attacks ( [7]-data from media reports of 2009-2020). ...
Dog biting events pose severe public health and animal welfare concerns. They result in several consequences for both humans (including physical and psychological trauma) and the dog involved in the biting episode (abandonment, relocation to shelter and euthanasia). Although numerous epidemiological studies have analyzed the different factors influencing the occurrence of such events, to date the role of emotions in the expression of predatory attacks toward humans has been scarcely investigated. This paper focuses on the influence of emotional states on triggering predatory attacks in dogs, particularly in some breeds whose aggression causes severe consequences to human victims. We suggest that a comprehensive analysis of the dog bite phenomenon should consider the emotional state of biting dogs in order to collect reliable and realistic data about bite episodes.
... This may be attributed to a higher engagement of risk-taking behaviors in males than females (Mathews and Lattal, 1994). In this study, no significant difference in incidence rates was observed between genders, which is similar to results reported by Sarcey et al. (2017). ...
Dog bites are a worldwide public health concern that can cause serious injury, psychological trauma, disease and death while also affecting animal welfare. This study analyzes dog bite injury data from a clinical file audit performed at Primary Health Care Clinics in three remote Indigenous communities within Far North Queensland, Australia, over the period from 1st January, 2006, to 31st December, 2011. There were 229 dog bite presentations involving 201 individuals. An overall incidence rate of 16.5 per 1,000 population was found across the communities. Incidence rates were highest in 35- to 44-year-olds, did not vary with gender of victim, varied between communities, and significantly decreased after the strengthening of alcohol restrictions midway through the study period. Development of a specific dog bite monitoring system through the Primary Health Care Clinics could enhance knowledge of human-dog interactions, assist in the development of mitigation strategies to reduce dog bites, and determine their effectiveness.
... The researchers concluded that victims were most commonly bitten by male dogs which people either own or have had frequent contact with, and the bite occurred in the dog's home, and the risk factors were victim invading the dog's territory, victim seen as a threat to the dog, and jealous dog. Similar results were obtained in a French study [11], children were more frequent bitten when they interacted with a familiar dog. ...
The inspection protocols of the Swedish police, based on the Act (2007:1150) on Supervision of Dogs and Cats, were used to examine the characteristics of 101 seized dogs, their owners, and the circumstances in which the attacks occurred. Most common reasons to seize a dog was that the dog owner was not following a previous order or ban, or that the dog had attacked and caused damage to humans or animals. The most common circumstances of the attacks involved dogs that escaped from gardens, unleashed dogs on walks and attacks by dogs on a leash. Bull breeds caused the highest number of injuries, the most serious injuries, and they were most often categorized as high risk, followed by Rottweilers and German Shepherds. Affenpinscher, Chihuahua, Cocker Spaniel, Japanese Spitz, Pug, Shih Tzu, Shetland Sheepdog and Golden Retriever were identified as victim breeds. The seized dogs had caused substantial harm to humans, animals, and their environment. The largest proportion of dogs returned to owners occurred in the Stockholm region.
Accidents involving dog bites to humans have high incidence worldwide. According to studies conducted in different countries, dogs are responsible for 60%-95% of all bites. This type of incident is a growing public health issue in Chile and an important economic burden for health systems. The problems that arise from bites include physical injuries, psychological trauma, and zoonosis. The objective of the present study was to characterize epidemiologically all bite incidents in Chile that were recorded in 11 public emergency services and analyze the information provided in health care forms from 5195 bites recorded in six regions of Chile. Our results show that dogs were responsible for 91.6% of bite incidents. The victim knew the offending dog in most cases (63.7%). The highest percentage of people bitten was between ages 5 and 9 years, with a rate of 125 bites per 100,000 inhabitants (P ≤ 0.05). 86.6% of the cases in the study were single bites. Although the national health system has records of bite-related incidents, few studies provide relevant information on animal bites. This is a public health issue and we should know the magnitude of the problem, the species responsible for the bite, and the context in which accidents occur. The information obtained from the analyses performed in this study can contribute to develop prevention and control programs for bites, both in Chile and in other countries with similar sociocultural characteristics.
Canine aggression poses serious public health and animal welfare concerns. Most of what is understood about breed differences in aggression comes from reports based on bite statistics, behavior clinic caseloads, and experts’ opinions. Information on breed-specific aggressiveness derived from such sources may be misleading due to biases attributable to a disproportionate risk of injury associated with larger and/or more physically powerful breeds and the existence of breed stereotypes. The present study surveyed the owners of more than 30 breeds of dogs using the Canine Behavioral Assessment and Research Questionnaire (C-BARQ), a validated and reliable instrument for assessing dogs’ typical and recent responses to a variety of common stimuli and situations. Two independent data samples (a random sample of breed club members and an online sample) yielded significant differences among breeds in aggression directed toward strangers, owners and dogs (Kruskal–Wallis tests, P
To describe the circumstances of dog bites to adults in New Zealand, in order to better understand factors associated with these bites.
A questionnaire was sent to 1,800 adults aged > or =16 years who had made claims to the Accident Compensation Corporation (ACC) in 2002 as a result of dog bites.
Five hundred and thirty-five questionnaires were returned; 50% of respondents were male, and 30% of bites were reported to local authorities. Most injuries were to the legs or hand. More people were bitten by male dogs than female dogs. A disproportionate number of bites took place in rural areas, but the most common locations for attacks were streets/walkways, and the victim's home. Protection of territory, accidental bites, fear, and pain were considered to be the most common reasons for dogs to bite.
Many victims were bitten in situations that could have been avoided.
A child experiencing an event of threatening or catastrophic nature may experience considerable post-traumatic psychological distress. Dog bites present an important public health problem and are a frequent cause of physical trauma in children. Physicians who manage paediatric trauma may not be vigilant of the high risk of psychological stress in children exposed to a physical injury.
A 4-year-old white girl of Greek origin, with a dog-bite related trauma was admitted to the University Hospital of Crete, Greece, for surgical repair and intravenous antibiotic therapy due to extensive lesions. Exposure to the traumatic event triggered the onset of an unusual psychological response, selective mutism and acute post-traumatic stress disorder.
There is limited literature discussing the psychological effect of dog bites in children. Parents and physicians involved in pediatric physical trauma need to be more familiar with post-traumatic behavioral reactions. Awareness of the potential development of such reactions may result in early detection and effective management of children at risk.
As part of an evaluation of Dutch breed specific legislation, data were collected from dog bite victims (1078) and dog owners (6139) using Internet surveys. The incidence rate of dog bites and details of incidents (victims, injuries, circumstances and aggressors) are reported and the justification for using breed specific measurements to deal with dog bites are considered. For aggressors, attack records for breed groups and popular breeds were established by calculating breed risk indices using a reference population. Several breeds and breed groups were over- and under-represented in the biting population and there was a mismatch between risk indices and the then-current legislation. Mitigation strategies should not be based on attack records (since this would lead to the rejection of a significant proportion of the canine population) but on the circumstances of the incidents. Preventative measures must focus on a better understanding of how to handle dogs.
This article reviews studies of different dog bites directed toward people. Typical bite events are summarized by describing the characteristics of the dog, victim, and wound; serious bites (severe and fatal bites) are described separately. Suggestions for the prevention of dog bites are presented.
To summarize breeds of dogs involved in fatal human attacks during a 20-year period and to assess policy implications.
Dogs for which breed was reported involved in attacks on humans between 1979 and 1998 that resulted in human dog bite-related fatalities (DBRF).
Data for human DBRF identified previously for the period of 1979 through 1996 were combined with human DBRF newly identified for 1997 and 1998. Human DBRF were identified by searching news accounts and by use of The Humane Society of the United States' registry databank.
During 1997 and 1998, at least 27 people died of dog bite attacks (18 in 1997 and 9 in 1998). At least 25 breeds of dogs have been involved in 238 human DBRF during the past 20 years. Pit bull-type dogs and Rottweilers were involved in more than half of these deaths. Of 227 reports with relevant data, 55 (24%) human deaths involved unrestrained dogs off their owners' property, 133 (58%) involved unrestrained dogs on their owners' property, 38 (17%) involved restrained dogs on their owners' property, and 1 (< 1%) involved a restrained dog off its owner's property.
Although fatal attacks on humans appear to be a breed-specific problem (pit bull-type dogs and Rottweilers), other breeds may bite and cause fatalities at higher rates. Because of difficulties inherent in determining a dog's breed with certainty, enforcement of breed-specific ordinances raises constitutional and practical issues. Fatal attacks represent a small proportion of dog bite injuries to humans and, therefore, should not be the primary factor driving public policy concerning dangerous dogs. Many practical alternatives to breed-specific ordinances exist and hold promise for prevention of dog bites.
To describe the extent of the dog bite problem in New Zealand for the period 1989 to 2001.
Fatalities and cases requiring public-hospital treatment identified from the New Zealand Health Information Service databases.
There was one fatality and 3119 hospitalisations, an average of 240 per year. Those most at risk were males and children under 9 years of age. The incidence rate of dog bites has continued to increase from that reported previously. There has been a increase in recent years but it is difficult to determine whether this is real effect or an artefact of coding.
Dog bite injuries represent a significant public health problem in New Zealand. Ongoing monitoring is required to determine if dog control policies are having the intended effect.
This study aimed to estimate the incidence and characteristics of injuries caused by dogs and cats in the population of a major Italian city.
The clinical records of all patients attending the emergency department (ED) were obtained from the two main hospitals of the city, covering an estimated population of over half a million. A case was defined as a patient admitted for bite or scratch injuries caused by dogs, cats, or other mammals between 1 January 2000 and 31 December 2002. For each case, the information collected included age and sex of the patient, the anatomical site of the injury, and the species of the animal involved.
The average yearly incidence of dog and cat bite/scratches was 58.4 and 17.9 cases per 100 000 residents, respectively. Admissions peaked during the summer months. Dogs accounted for 76.9% and cats for 19.7% of cases. Dog injuries were significantly more common in males and younger individuals. Children younger than 9 years had a significantly higher risk of being bitten on the head, face, or neck. Conversely, injuries from cats were significantly more common in females and older people.
Surveillance of injuries caused by dogs and cats could provide useful information for planning and evaluating public health interventions. Collection of data from hospital EDs may be an appropriate, simple, and quick tool for monitoring the phenomenon and evaluating the associated risk factors.
This study focuses on the pattern of incidence, mechanisms, and circumstances of accident and injury in a series of pediatric patients who sustained dog bites.
In our retrospective survey, the medical charts of all children who were younger than 17 years and sought medical attention after a dog bite between 1994 and 2003 were reviewed. To obtain the total number of each dog breed in the administrative district, we analyzed 5873 files from the community dog registers. For establishment of a risk index, the representation of a dog breed among the total canine population was divided by the frequency of dog bites from this breed.
A total of 341 children (mean age: 5.9 years) were identified. The annual incidence of dog bites was 0.5 per 1000 children between 0 and 16 years of age. Incidence was highest in 1-year-old patients and decreased with increasing age. The relative risk for a dog attack by a German shepherd or a Doberman was approximately 5 times higher than that of a Labrador/retriever or cross-breed. The vast majority (82%) of the dogs were familiar to the children. Most (322; 94%) of the children had injuries to 1 body region; in the remaining 19 (6%) children, up to 3 body regions were injured. Of 357 injuries, the face, head, and neck region was the leading site affected (50%). Inpatient treatment was required in 93 (27%) patients.
Dog bites in children are frequent and influenced by the breed-related behavior of dogs, dog owners, children, and parents. Therefore, prevention strategies should focus on public education and training of dogs and their owners. Children who are younger than 10 years represent the high-risk group for dog attacks.
To characterise and provide nationally representative estimates of persons with non-fatal horse related injuries treated in American emergency departments.
The National Electronic Injury Surveillance System All Injury Program (NEISS-AIP) is a stratified probability sample comprising 66 hospitals. Data on injuries treated in these emergency departments are collected and reported. NEISS-AIP data on all types (horseback riding and otherwise) of non-fatal horse related injuries from 2001 to 2003 were analysed.
An estimated 102,904 persons with non-fatal horse related injuries (35.7 per 100,000 population) were treated in American emergency departments each year from 2001 to 2003 inclusive. Non-fatal injury rates were higher for females (41.5 per 100,000) than for males (29.8 per 100,000). Most patients were injured while mounted on a horse (66.1%), commonly from falling or being thrown by the horse; while not mounted, injuries most often resulted from being kicked by the horse. The body parts most often injured were the head/neck region (23.2%), lower extremity (22.2%), and upper extremity (21.5%). The most common principal diagnoses were contusions/abrasions (31.4%) and fractures (25.2%). For each year that was studied, an estimated 11 502 people sustained traumatic brain injuries from horse related incidents. Overall, more than 11% of those injured were admitted to hospital.
Horse related injuries are a public health concern not just for riders but for anyone in close contact with horses. Prevention programmes should target horseback riders and horse caregivers to promote helmet use and educate participants about horse behaviour, proper handling of horses, and safe riding practices.
To describe the epidemiology of mammal (human and non-human) bite injuries in Victoria. PARTICIPANTS, DESIGN AND SETTING: Retrospective case series of injuries recorded in the Victorian Emergency Minimum Dataset (VEMD) (1998-2004) and deaths recorded in the National Coroners Information System (1 July 2000 - 1 June 2006).
Frequency, nature and outcome of injury as a function of mammal, victim demographics and season.
Of 12 982 bite injuries identified in the VEMD, dogs, humans, and cats were implicated in 79.6%, 8.7%, and 7.2% of cases, respectively. Dog bite injuries were commonly sustained to the hands/wrists (31.3%) and face/head (25.4%); cat bites to the hands/wrists (67.6%) and arms (16.0%); and human bites to the hands/wrists (37.1%), arms (20.5%) and face/head (20.4%). Males comprised 73.7% and 56.3% of human and dog bite victims, respectively, while females comprised 64.1% of cat bite victims. A third of dog bite victims (33.4%) were children aged 14 years or less. Most human bite victims (79.8%) were adults aged 20-49 years, inclusive. More injuries were sustained on weekends and during the summer, 55.4% of injuries occurred in the home, and 11.6% of patients required hospital admission. Dog bites resulted in three deaths.
Mammal bite injuries are common and often require inpatient care. Patterns of bite injuries relate to the type of mammal involved. These epidemiological data will inform prevention initiatives to decrease the incidence of mammal bites.
To identify physical traits of biting dogs and characteristics of injured persons and dog owners associated with bite situations for use in public health prevention activities.
Retrospective cohort study.
Licensed dog and dog bite report data from June 30, 2002, to July 1, 2003, that were obtained from Animal Control Services of Multnomah County, Oregon.
To determine the canine and human factors associated with dog bite injuries, the number of bites, dog and injured person characteristics, and the overall canine population were evaluated. Dog owner characteristics at the block group level were defined by use of geographic information system software through 2000 census information based on place of residence.
During the study period, 636 dog bites were reported to Animal Control Services, and 47,526 dogs were licensed in Multnomah County. Risk factors associated with biting dogs included breed (terrier, working, herding, and nonsporting breeds), being a sexually intact male, and purebred status. Male children aged 5 to 9 years had the highest rate of injury (178 bites/100,000 children). Biting dogs were more likely than nonbiting dogs to live in neighborhoods where the residents' median incomes were less than the county median income value ($41,278).
Dog bites continue to be a source of preventable injury. Prevention programs should target owners of sexually intact male and purebred dogs and owners who live in lower income neighborhoods.
The increase in aging populations has implications for the provision of health and social services. A preventative approach is taken to address this problem by examining a mechanism that can enhance physical health and reduce minor ailments.
Participants in 10 focus groups discussed physical, psychological, and social benefits associated with human-dog interactions.
Interaction between humans and dogs is a mechanism that can enhance the physical and psychological health of elderly citizens and promote a social support network between dog owners. In turn, dependence and impact on health and social services are alleviated.
The social and community consequences of promoting dog ownership in the elderly are addressed, and it is concluded that the benefits of dog ownership should be promoted among the elderly and acknowledged by relevant agencies.
Information was obtained by telephone interview from 100 dog owners whose dog had bitten a person, and from 134 victims of bites by a dog not owned by the victim. Three-quarters of the victims were female and aged from 21 to 60 years. The majority of the dogs were owned, male, two to six years old, over 10 kg in bodyweight and belonged to the popular breeds: collies, cocker/springer spaniels, terrier breeds, Jack Russell terriers, German shepherd dogs, golden retrievers and crossbreeds. The numbers of bites by the different breeds indicated that those that inflicted the most bites were the popular breeds rather than the breeds with any greater propensity to bite. Most attacks were rapid single bites and in 50 per cent of the cases, neither the owner nor the victim was able to identify any signal of the dog's intention to bite. Overall, 21 per cent of the incidents were rated as 'serious' and 2 per cent as 'life threatening'. One fifth of the dogs were euthanased as a result of the incident. Half the incidents required professional medical assistance for the victim. Almost half the incidents took place while the victim was walking or passing close to the dog's territory, or while the victim was interacting with the dog at home.
In Canada, public debates on dog attacks are dominated by studies from the United States. An electronic search of media reports in the Canadian Newsstand database, for the years 1990 to 2007, identified 28 fatalities from dog-bite injuries. Predominant factors in this case series were owned, known dogs; residential location; children's unsupervised access to area with dogs; and rural/remote areas, including aboriginal reserves in the prairies. A higher proportion of sled dogs and, possibly, mixed-breed dogs in Canada than in the United States caused fatalities, as did multiple dogs rather than single dogs. Free-roaming dog packs, reported only from rural communities, caused most on-reserve fatalities. Future studies are needed to assess if this rural/urban divide is observed in nonfatal attacks and if the breeds that bite in Canada are different from the breeds that killed. Breed representation in this paper and, perhaps, multiple-dog overrepresentation should be understood in the context of the overall Canadian dog population.
Context.— Dog bites that result in injuries occur frequently, but how frequently
dog bite injuries necessitate medical attention at a hospital or hospital
admission is unknown.Objective.— To describe the incidence and characteristics of dog bite injuries treated
in US emergency departments (EDs).Design.— Emergency department survey from the National Center for Health Statistics
National Hospital Ambulatory Medical Care Survey for 1992 to 1994.Patients.— National probability sample of patients visiting EDs.Main Outcome Measure.— Incidence of dog bites treated in EDs, defined as a cause of injury
recorded as the E-code E906.0.Results.— The 3-year annualized, adjusted, and weighted estimate of new dog bite–related
injury visits to US EDs was 333687, a rate of 12.9 per 10000 persons (95%
confidence interval [CI], 10.5-15.4). This represents approximately 914 new
dog bite injuries requiring ED visits per day. The median age of patients
bitten was 15 years, with children, especially boys aged 5 to 9 years, having
the highest incidence rate (60.7 per 10000 persons for boys aged 5 to 9 years).
Children seen in EDs were more likely than older persons to be bitten on the
face, neck, and head (73% vs 30%). We estimated that for each US dog bite
fatality there are about 670 hospitalizations and 16000 ED visits.Conclusions.— Dog bite injuries are an important source of injury in the US population,
especially among children. Improved surveillance and prevention of dog bite–related
injuries, particularly among children, are needed.
This paper analyses behavioural and management history data provided by 100 owners of dogs that had bitten a person. The data was obtained by telephone interview of volunteer dog owners. Two sub-sets of data were created using 21 dogs having no history of perceived aggressive behaviour prior to the reported bite incident and 79 that had a record of aggression. Statistically significant predictors of aggressive behaviour included owners reprimanding the dog by physical and verbal means, owners allowing the dog to initiate play and to win tug-of-war games. Management predictors during the 2 months leading up to a bite incident included allowing the dogs onto household furniture and feeding the dog directly from the family table. Behavioural predictors included not being trusted with children, not responding to basic commands, variable obedience to different people and variable degrees of obedience depending on the location. Additional behavioural predictors included displays of problem behaviours such as destructiveness and barking only when family members were present, displays of fearful reactions in specific circumstances and excessive displays of specific behaviours. Multivariate analysis revealed a significant association between a number of these predictors and aggressive behaviour. Other findings included owner tolerance of significant degrees of aggressive behaviour, inadequate or ineffective obedience training, biting of adult household members and the possible influence of ad libitum feeding on the behaviour of the dog.
The characteristics of 227 biting dogs, their homes, and their victims were gathered in a detailed telephone survey of general veterinary clientele in the Canadian provinces of New Brunswick, Nova Scotia, and Prince Edward Island. All of the dogs had bitten either someone living in the same household, or someone who was a frequent visitor and was well known to the dog. There were 117 male and 110 female dogs included in this case series. Significantly more female dogs were neutered (P=0.03), 58% of the dogs were purebred, and the most commonly reported breed was the Labrador Retriever (n=15). The mean number of people living in each home was 3.13 (S.D.±0.08). Aggression which would traditionally be defined as dominant or possessive had been demonstrated by 75.6% of the dogs in at least one of 17 specific situations outlined in the questionnaire. Dogs with a history of this type of aggression were significantly older (P=0.02) and of lower body weight (P
In order to determine risk factors for biting behaviour by dogs in a household setting, a detailed telephone survey of dog owners was undertaken using individuals selected from a cross-sectional population of veterinary clientele in the Canadian provinces of New Brunswick, Nova Scotia, and Prince Edward Island. Interviews were successfully completed with 515 of 640 individuals selected from a study population of 3226 dogs by a formal random process. For the purpose of risk factor analysis, 227 biting and 126 non-biting dogs were selected according to strict criteria to evaluate the association of potential risk factors with biting behaviour. Biting behaviour was carefully defined in the telephone interview to avoid including activity associated with playful mouthing by the dog. All dogs were at least 6 months of age. Both the mean weight and age of biting dogs were significantly lower (P
It is known that pet dogs can act as catalysts for human social interactions, and it has been suggested that this may enhance feelings of well-being. Two studies were carried out to establish the robustness of this effect. In Study 1, a highly trained dog was used to ensure that the dog itself did not solicit attention from passers-by, and data were collected across a range of normal daily activities in which a dog could be included, not confined to conventional dog walking areas as in previous studies. Being accompanied by a dog increased the frequency of social interactions, especially interactions with strangers. In Study 2, also using a trained dog, a different (male) participant observer was dressed either smartly or scruffily. Although there were significantly more interactions when he was smartly dressed, the greatest effect was between the Dog present and No Dog conditions irrespective of the handler's dress. It is concluded that the social catalysis effect is very robust, which opens the way for investigating possible consequences of the effect for wellbeing and health.
The effectiveness and suitability of legislation regarding the issue of dangerous dogs, especially those targeting so-called “dangerous breeds” (DB), have been the object of a lot of criticism. However, the shortage of scientific studies in this field makes an objective assessment of the impact of current legislation difficult. In the present study, dog bite-related incidents from Aragón (Spain) were analyzed for a 10-year periods (1995 to 2004). With the aim of assessing the impact of the Spanish Dangerous Animals Act on the epidemiology of dog bites, data from the non-legislated (1995 to 1999) and the legislated period (2000 to 2004) were compared in 2 different areas (low- and high-populated areas). According to the results, the population density did exert a significant effect on the incidence of dog bites, whereas the legislation in force did not. Popular breeds such as the German shepherd and crossbreed dogs accounted for the great majority of the incidents during the 2 periods of study. Specifically, the German shepherd proved to be over-represented significantly among the canine population. Dogs in the dangerous breeds list, on the other hand, were involved in a small proportion of the incidents both before and after the introduction of legislation. The present results suggest that the implementation of the Spanish legislation exerted little impact on the epidemiology of dog bites. Besides the scarce effectiveness, the results suggest that the criteria to regulate only so-called DB were unsuitable and unjustified. It is hoped that this study will be helpful in the elaboration of future regulation measures in this matter.
We used population-based hospital discharge data to describe hospitalizations resulting from dog bites in California from 1991 through 1998, when there were 6676 such hospitalizations (average 835 per year; range 732 to 930), and the annual cumulative incidence for all ages was 2.6 per 100 000. Children had more than twice the risk of adults, and Asians had lower rates than Whites. Children aged 0 to 9 years were more likely to suffer wounds to the head and face.
Children are the most frequent victims of dog bites presenting to hospital emergency departments (ED), but there are gaps in understanding of the circumstances of such bites. The objective of this study was to characterise the behavioural circumstances of dog bites by interviewing children ≤17 years (or parent proxies for children ≤6 years) presenting with dog bite injuries to The Children's Hospital of Philadelphia about the bite incident, its setting and associated interactions. Of 203 children enrolled, 51% were <7 years old and 55% were male. 72% of children knew the biting dog. Most bites to younger children occurred during positive interactions, initiated by the child, with stationary, familiar dogs, indoors. Most older bitten children had been active (eg, outdoors), unfamiliar with the dog and not interacting. Whereas face bites predominated (70%) in the younger group (<7 years), bites to extremities predominated (72%) in the older group. Recognition of the two distinctive behavioural and circumstantial subgroups of dog bites that emerged can lead to more effective prevention strategies.
Dog attacks are a major public health concern worldwide. Dogs bite over 4 million people resulting in the hospitalization of 6000 to 13,000 people each year in the United States. Rarely deaths may occur after an attack.
This study utilized the compressed mortality files from CDC WONDER to evaluate deaths from dog attacks over the 27-year period 1979-2005.
An average of approximately 19 deaths was reported annually from dog attacks during this time period. Males and children less than 10 years of age had the highest rate of death from dog attacks. Deaths have been reported in 49 states with Alaska reporting the highest death rate from dog attacks. The number of deaths and death rate from dog attacks appear to be increasing.
Deaths from dog attacks appear to be increasing as the population of both humans and dogs has increased during this time period. Children have the greatest risk of death. There is a need for a national reporting system on dog bites to fully capture the extent of fatalities and look at risk factors surrounding the attack. The development of effective prevention practices is dependent upon examination of these risk factors.
Dog bites are a significant public health problem among children. The purpose of this study was to examine the hospital incidence, hospital charges, and characteristics of dog bite injuries among children by age group and hospitalization status who were treated at our health care system to guide prevention programs and policies.
An electronic hospital database identified all patients younger than 18 years who were treated for dog bites from 1999 to 2006. Demographics, injury information, hospital admission status, length of stay, hospital charges, and payer source were collected. A further review of the narrative part of the inpatient electronic database was examined to identify owner of the dog, type of dog, and circumstances surrounding the incident.
During 8 years, 1,347 children younger than 18 years were treated for dog bites. The majority were treated and released from the emergency department (91%). Of the 66 children (4.9%) requiring inpatient admission, the median length of stay was 2 days. Victims were frequently male (56.9%) and <8 years (55.2%). Children younger than 5 years represented 34% of all dog bite victims, but 50% of all children requiring hospitalization. Thirty-seven percent of all children admitted to the hospital were bitten by a family dog. The cost of direct medical care during the study was $2.15 million.
Dog bite visits comprised 1.5% of all pediatric injuries treated in our hospital system during the study period. The majority (91%) of all dog bite visits were treated and released from the emergency department. Injuries to the head/neck region increased the odds of requiring 23 hour observation (OR, 1.95) and age less than 5 years increased the odds of being admitted as an inpatient (OR, 3.3).
The purpose of this paper is to analyse the effects of cranial size and shape in domestic dogs (Canis familiaris) on predicted forces of biting. In addition to continuous size-shape analysis, nine size-shape groups were developed based on three skull shape categories and three skull size categories. Bite forces were predicted from measurements made on dried skulls using two lever models of the skull, as well as simple models derived by regression analysis. Observed bite force values were not available for the database used in this study, so only comparisons between categories and models were undertaken. The effects of shape and size on scaled predicted bite forces were evaluated. Results show that bite force increases as size increases, and this effect was highly significant (P < 0.0001). The effect of skull shape on bite force was significant in medium and large dogs (P < 0.05). Significant differences were not evident in small dogs. Size x shape interactions were also significant (P < 0.05). Bite force predictions by the two lever models were relatively close to each other, whereas the regression models diverged slightly with some negative numbers for very small dogs. The lever models may thus be more robust across a wider range of skull size-shapes. Results obtained here would be useful to the pet food industry for food product development, as well as to paleontologists interested in methods of estimating bite force from dry skulls.
The urban pet population has increased considerably in France during the last twenty years. Two main questions need to be answered regarding rabies and other bite transmitted zoonoses: What is the actual incidence rate of dog and cat bites in an urban area; and how sensitive is the animal bite reporting system? To answer these questions, four surveys were conducted in the Lyon area, France, in 1989: 1) an analysis of the consultation reports to the Pasteur Institute and of the bite reports sent by veterinarians to the local veterinary services for 1987 and 1988; 2) a survey of 10 veterinary clinics located in the Lyon area and an analysis of their bite reports for the period May 1987-April 1989; 3) a questionnaire survey to 175 clients of these veterinary clinics; 4) a street survey of a random sample of the Lyon adult population (310 questionnaires). Bite incidence rates ranged from 10/100,000 persons/year for rabies post-exposure treatments to 37.5/100,000 persons/year for reported bites. However, less than half of the bite reports from the ten veterinary clinics were submitted to the veterinary services. The surveys conducted among pet owners and the general population indicated that, overall, bites were common events (3.4%) and occurred more often in pet owners (8.6%). In 74% of the cases, victims belonged to the pet owner's family and one fourth of the accidents occurred when playing with the pet. However, 12% of the accidents resulted from apparently unprovoked aggressions.(ABSTRACT TRUNCATED AT 250 WORDS)
A recent survey of patients attending an Accident and Emergency (A&E) department serving several economically depressed Thanet coastal towns found that around 3 per 1000 of the resident population attended each year for the treatment of dog bite injuries (Thomas and Banks, 1990). We report a study of dog bite injuries treated in the A&E department serving Salisbury, a small prosperous Cathedral city, and surrounding villages. In comparison with Thanet, age specific incidence rates for dog bites show a similar pattern but only about half the overall incidence. Some reasons for these findings are suggested and extrapolations for national treatment figures are made.
Dog bites in children, although a genuine problem, have as yet been little studied in France from the viewpoint of epidemiology. A detailed study of 184 bites leading to management in a rabies control centre provided preliminary data on individual characteristics and behaviors of the dogs and children, as well as on features of the environment (place and time) that seem to be specifically associated with dog attacks on children. Increased insight into these risk factors should prove useful for the preventive information of children, parents, and dog owners.
This comparative prospective study of mammalian bites attending one urban Accident and Emergency department before the implementation of the Dangerous Dogs Act 1991 and again 2 years later, was to see the effect of the Act on the pattern of injury. The study comprised a simple questionnaire detailing the injury, the implicated species, and the treatment or referral if applicable. In both groups studied (before and after implementation of the Act) 134 consecutive bites were recorded, contributing 1.2 per cent and 1.23 per cent of total attendances during these respective periods. Dogs were found to bite most commonly: in the pre-legislative group 73.9 per cent were due to dog bites and in the post-legislation group 73.1 per cent. In both groups studied, human bites occurred as the second most common mammalian bite; 17.9 per cent in the pre-legislation group and 12.7 per cent in the post-legislation group. Human bites were as common as those from the most implicated breed of dog. In general human bites were found to require more active treatment and specialist referral. The study demonstrates the vast majority of such injuries are treated within Emergency departments. This study also shows how dangerous breeds compare with others that bite, demonstrating that these breeds contribute to only a small proportion of these injuries. This comparative study clearly demonstrates little impact on rate of attendances for such injuries since the introduction of the 1991 Act. If legislation aims to reduce and prevent injury from animal bites, in its present form it does little to protect the public; this study suggests a wider control of the dog population may be required.
To estimate the magnitude of the dog bite problem in the US.
Data on dog bites were gathered as part of a 1994 national telephone survey of 5,238 randomly dialed households. Data were weighted to provide national estimates.
The weighted total number of dog bites was 4,494,083 (estimated incidence = 18/1,000 population); of these, 756,701 persons sustained bites necessitating medical attention (incidence rate = 3/1,000). Children had 3.2 times higher medically attended bite rates than adults (6.4/1,000 children v 2/1,000 adults).
More attention and research needs to be devoted to the prevention of dog bites. Potential prevention strategies include: educational programs on canine behavior, especially directed at children; laws for regulating dangerous or vicious dogs; enhanced animal control programs; and educational programs regarding responsible dog ownership and training. Unfortunately, the relative or absolute effectiveness of any of these strategies has not been assessed. Continuing surveillance for dog bites will be needed if we are to better understand how to reduce the incidence of dog bites and evaluate prevention efforts.
Dog bites that result in injuries occur frequently, but how frequently dog bite injuries necessitate medical attention at a hospital or hospital admission is unknown.
To describe the incidence and characteristics of dog bite injuries treated in US emergency departments (EDs).
Emergency department survey from the National Center for Health Statistics National Hospital Ambulatory Medical Care Survey for 1992 to 1994.
National probability sample of patients visiting EDs.
Incidence of dog bites treated in EDs, defined as a cause of injury recorded as the E-code E906.0.
The 3-year annualized, adjusted, and weighted estimate of new dog bite-related injury visits to US EDs was 333687, a rate of 12.9 per 10000 persons (95% confidence interval [CI], 10.5-15.4). This represents approximately 914 new dog bite injuries requiring ED visits per day. The median age of patients bitten was 15 years, with children, especially boys aged 5 to 9 years, having the highest incidence rate (60.7 per 10000 persons for boys aged 5 to 9 years). Children seen in EDs were more likely than older persons to be bitten on the face, neck, and head (73% vs 30%). We estimated that for each US dog bite fatality there are about 670 hospitalizations and 16000 ED visits.
Dog bite injuries are an important source of injury in the US population, especially among children. Improved surveillance and prevention of dog bite-related injuries, particularly among children, are needed.
Dog bite injuries in children are a preventable health problem. To characterize this type of injury, we have undertaken to define demographic criteria and patterns of injury inflicted by dogs in our pediatric population. A retrospective chart review was conducted of pediatric patients with dog bite injuries admitted to a Level I pediatric trauma center from January 1986 through June 1998. Patient demographics, canine characteristics, and hospital patient data were collected and analyzed using the Excel program and appropriate statistical methodology. There were 67 patient records reviewed. Thirty-eight (57%) of the patients were male, and 29 (43%) were female. There were 43 (64%) white children, 22 (33%) African-American children, and 2 (3%) Hispanic children. The average age of the children was 6.2 +/- 4.2 years, with an average weight of 23.3 +/- 13.7 kg. More than half the attacks occurred in the afternoon and 55 per cent of these attacks were documented as "unprovoked" attacks. Thirty-one (46%) of these attacks involved family pets, and 30 (45%) dogs were known to the attacked child. The head and neck was involved in greater than 67 per cent of these injuries. Pit bulls caused 25 per cent of the bite injuries. Large dogs were responsible for 88 per cent of the attacks. Forty-four (66%) patients required operative intervention. Twenty-eight of these patients had multiple anatomical areas injured. There were 44 procedures involving the head and neck, 21 involving extremities, and 6 involving other areas of the body. All patients 5 years of age and under had head and neck injuries. Dog bite injuries requiring admission occur more in male children. Caucasian and African American children were the majority of children affected. The children under 5 years of age suffered the most devastating injuries. More than half of these attacks were not provoked. More than two-thirds of the injuries to these children involved the head and neck. We conclude that effective prevention strategies must stress careful supervision of young children and the family or neighbor's dog, a scenario that may easily lead to complacency and set the stage for a severe injury.
Dog bites account for a significant number of traumatic injuries in the pediatric population that often require medical treatment. Although agent, host, and environmental characteristics of dog bites have been well documented, no attempt has been made to compare these characteristics by patient age group. The purpose of this study is to determine if differences exist in agent, host, and environmental characteristics among younger (< or =6 y) and older (>7 y) patients treated in a pediatric emergency department (ED) for dog bites. Findings from our study could be used to develop age-specific strategies for dog bite prevention.
The epidemiologic triad of agent/host/environment formed the theoretical framework.
The study setting was the ED at Children's Hospital of Pittsburgh. Patients were enrolled between 1999 and 2000 and were identified through a review of ED records (n = 386) of children sustaining dog bites. Records were abstracted with a researcher-designed and validated form for agent (eg, breed, number of biting dogs, owner, rabies status), host (eg, age, gender, number and location of bites, treatment), and environmental (eg, bite month and time, bite location, events leading to the bite, ZIP code) characteristics. Data were analyzed using descriptive and inferential statistical tests.
Children younger than 6 years constituted 52.8% (n = 204) of the sample. As compared with older children, a higher proportion of younger children were bitten by their family dog (chi2 = 27.64, P = 0.001) whose rabies shots were up to date (chi2 = 12.08, P = 0.034). A higher proportion of younger children were bitten on the face (chi2 = 49.54, P = 0.000) and were bitten in their own homes (chi2 = 16.075, P = 0.013).
Young children frequently sustain dog bites from their family dog in their own homes. Injuries typically involve severe lacerations to the face. Prevention strategies for young children include close supervision of child-dog interactions.
Of 22 children who were victims of dog bite, 12 had symptoms of posttraumatic stress disorder 2 to 9 months after the bite. Violent dog attacks inflicting multiple and/or deep wounds were associated with risk of posttraumatic stress disorder.
To determine incidence of child-related dog bites and sensitivities of 3 county health department dog-bite surveillance systems.
Retrospective study.
Child-related dog-bite data obtained from surveillance systems of 3 counties in Georgia in the year 2000.
To characterize the sensitivity of health department dog-bite surveillance systems, 9 other potential sources of dog-bite records that matched records by victim name, age, gender, and incident date were evaluated. The number of reported bites and the most productive sources for identifying additional cases were determined. The Chandra Sekar-Deming capture-recapture method was used to estimate the number of unreported bites, and estimates of dog-bite incidence rates were made.
40, 36, and 185 dog bites were reported in the 3 counties, respectively. Capture-recapture calculations estimated an additional 9, 5, and 128 dog bites in these counties, respectively. Local health departments recorded 45.5% to 82.5% of dog bites. Local hospital emergency departments, police departments, and a rabies-testing laboratory received additional reports. Among these data sources, local hospital emergency department records were the best source for identifying additional cases.
Dog bites are a preventable cause of childhood injuries, and surveillance is a critical tool for tracking childhood dog bites in the community. Counties should use combined data from local health departments, local hospital emergency departments, and police departments to implement or revise dog-bite prevention programs.
Unlabelled:
The study was conducted to determine the characteristics of child victims of dog bite accidents. Pediatricians and nurses prospectively collected standardized information on all child victims of dog bites brought in for treatment to six hospital emergency departments (three urban university teaching hospitals and three rural hospitals). One hundred completed questionnaires were collected and analyzed. The frequency of dog bites brought for care to the emergency departments was equivalent to about one-quarter of all road traffic casualties and one-third of burns at home. Of the 100 victims, 65 were bitten at home, and 35 in a public place. The bite accidents that occurred at home concerned children with a median age of 5 years, who were without adult supervision at the time of the accident. The children who were bitten by dogs in public places had a median age of 9 years. For 77 bites, the dog was not familiar to the child. Based on the history, it appeared that 56 out of 65 accidents at home and 11 out of 35 in public places resulted mainly from the children's or adult's behavior.
Conclusion:
To reduce the frequency of dog bites both at home and in public places, education could be the preventive measure with the highest priority. Out of 100 accidents, 67 children might not have been bitten had they and their parents been adequately educated on safe conduct towards dogs.
This paper reviews three studies that have been conducted in Belgium on dog bites on children. (1) A telephone study revealed that 22/1000 children <15 years of age were victims of dog bites annually. (2) Data on the characteristics of dog bites were collected prospectively over a period of 8.5 months in six hospital emergency departments. "Dangerous dogs" were not responsible for the majority of the accidents. In 67/100, incidents documented, the bites appeared to be triggered by an interaction of the child. Education appeared to be the preventive measure with the highest priority. (3) Among 22 child victims of dog bites, 12 had symptoms of post-traumatic stress disorders some seven months following the accident. Based on these local studies, several initiatives have been undertaken to favour both primary and secondary prevention measures. An appropriate psychological preventive intervention should be offered to all victims of dog bites.
Dog bites are the second most costly public health problem in the United States with half of all Americans being bitten in their lifetime. Approximately 17 to 18 percent of dog bite injuries receive medical attention. Between 1998 and 2002, Kansas City, Missouri, residents made 3,467 emergency department visits for dog bite trauma and 96 individuals were hospitalized. We report the principal diagnoses for those visits and admissions. Median hospital charges for emergency department services and hospitalizations were $300 per visit and $4,698 per admission. We discuss deficiencies in the reporting of animal bites as well as recommended community efforts in reducing the burden of dog bite trauma.
The domestic dog is one of the most commonly owned, and widely utilized, animals in today's society. This paper provides an overview of research that has explored the relationship between the domestic dog and human well-being.
The article initially concentrates on the value of dogs for physical health in humans, exploring the evidence that this species can prevent us from becoming ill, facilitate our recovery from ill-health, and even serve as an early warning system for certain types of underlying ailment including cancer, oncoming seizures and hypoglycaemia. The paper then examines the relationship between dogs and psychological health in humans, exploring the ability of this species to aid the disabled and serve as a therapist to those in institutional settings such as hospitals, residential homes and prisons. Weaknesses in the existing research in this area are highlighted throughout the article.
Taken together, the studies reviewed suggest that dogs can have prophylactic and therapeutic value for people.
Dog bites are a common problem. The purpose of this study was to determine the characteristics of dog bites and their emergency department management in a Canadian pediatric population, and to provide treatment and prevention recommendations.
The charts of all children <or=16 years of age presenting with a dog bite to either of the 2 tertiary emergency departments in Edmonton, Alberta, between 1998 and 2002 were retrospectively reviewed.
Overall, 287 cases were reviewed; 145 boys (50.5%) and 142 girls (49.5%). The mean age was 7.4 years. The patient's face was the most frequently bitten site (58.5%, n = 168), followed by an extremity (35.5%, n = 102). Most bites required sutures (54.5%, n = 155), and 72 (25.1%) were classified as severe, based on suture number (>10 sutures, n = 69), associated fractures (n = 4), operating room repair (n = 21) or fatality (n = 1). The mean age of children with severe bites was significantly lower than children with mild bites (6.3 v. 7.8 yr, p < 0.01). Most patients were treated solely in the emergency department (84.7%, n = 243); however 44 (15.3%) were admitted to hospital and required a total of 144 days of inpatient care. Signs of infection were described in 16 cases (5.6%); of these 8 had received 2 or more prior doses of antibiotics. Public health or police notification was documented in 56 cases (19.5%), and safety or preventive discussion was documented in 3 cases (1.0%).
Dog bites in Canadian children are common, often serious or even lethal, and not always managed ideally. Preventive discussion and public health contact is infrequently documented and likely seldom occurs. In addition to medical care, emergency department staff should provide and document preventive guidance and ensure involvement of public health or police when indicated.
The aim of this study was to determine the pattern of dog bites seen at the emergency department of a university hospital. The information will be used to plan prevention and enhance management strategies.
All patients (younger than 22 years) assessed at the emergency department between January 2003 and December 2004 with a discharge diagnosis of animal bites were identified through the computerized discharge network.
One hundred forty-four incidents of animal bites (82 males and 62 females) occurred over the 2-year period. Eighty-nine percent was due to dog bites. Among the dog bite victims, the mean age was 11.82 years (SD, 6.39 years; range, 0.06-21.83 years). Family dogs were only involved in 15% of cases. The species of dogs were not recognized in three fifths, and attacks provoked in two fifths of victims. Most bites (90%) of bites involved only single anatomical sites. The extremities were commonly involved (right upper limb [23%], left upper limb [16%], right lower limb [35%], left lower limb [20%]). Torso (4%) and genitalia (0.8%) were uncommonly involved. Pain, erythema, bleeding, and bruising were common symptoms, but 60 patients were asymptomatic at presentation. Compared with older patients, children younger than 10 years had a much higher risk of facial injuries (25% vs. 2%, P = 0.0002; odds ratio, 21.8, 95% confidence interval, 2.9-455.9) and were more likely to be triaged as being urgent (P = 0.01). Most attacks were trivial and did not require hospitalization. Antirabies treatment was given in approximately half, analgesics in two fifths, and antibiotics in one fourth.
In mammalian attacks, canines are most commonly involved. Most injuries are trivial, and the limbs are usually involved. However, younger children are at higher risk of facial injuries. Extent of pain and adverse psychological impacts are typically not documented in the emergency assessment.
Few dog bite risk factor studies have been conducted. This veterinary clinic-based retrospective cohort study was aimed at identifying human-canine environmental risk factors for non-play bites in Kingston, Jamaica (660) and San Francisco (SF), USA (452). Data were analysed using modified Poisson regression with confounders selected using directed acyclic graphs (DAGs) and the change-in-estimate procedure. Dogs acquired for companionship were more likely (RR=1.66; 95% CI 1.02-2.70) to bite than those acquired for protection. Routinely allowing a dog into the presence of visitors was also positively associated with it biting. A dog sleeping in a family member's bedroom was a risk factor for biting in Kingston (RR=2.54; 95% CI 1.43-4.54) but not in SF, while being able to leave the yard unaccompanied was a risk factor for biting in SF (RR=3.40; 95% CI 1.98-5.85) but not in Kingston. Overall, dogs which were less restricted in their interactions with humans were at elevated risk for biting. An observed association with dog bites in one cultural setting might not exist in another.
Dog bites in humans are a complex problem embracing public health and animal welfare. To prevent dog bites it is necessary to have comprehensive epidemiological data that allow the identification of associated risk patterns. This study was aimed at investigating the problem posed by dog bites in Spain. The epidemiology of medically attended dog bite-related incidents reported in Aragón was analysed from 1995 to 2004. Bite incidents were mostly associated with: (1) low-population areas (71.3/100,000 inhabitants); (2) males and children, particularly those aged 5-9; (3) single injuries directed to the head and neck area in children and to the extremities in adults; (4) young, male, medium to large, owned dogs that were known to the victim; (5) summer months, and (6) specific circumstances such as human interference with knocked down and fighting dogs. In the light of these risk patterns, a wide range of specific preventive measures could be proposed.
Severity factors of dog bites in emergencies. Multicenter survey, France, mai 2009-juin 2010. National Health Survey Institute
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