Health Behaviour and Accidents in School-Age – A Longitudinal Survey

Project No. FF-FP 0347


completed 06/2021


The central goal of the GUS study was to identify the causes of accidents and injuries in the school environment. Analyses of accidents based on accident statistics provide valuable information. However, they cannot be used to establish causal inferences. This is due to the fact that these statistics only contain information on people who have had an accident. Thus, a comparison with a "control group" that has not suffered an accident or injury is not feasible. In addition, the number of characteristics included in the accident statistics is limited, so that in particular the influence of latent variables, such as personality traits or psychological dispositions, cannot be investigated. Finally, the cross-sectional character of previous studies limits the possibility of deciphering causal structures in relation to the occurrence of accidents and injuries. The GUS-study aimed at uncovering these causal patterns of school injuries by conducting a panel study.


By conducting a nationwide (with the exception of Bavaria and Hamburg) representative panel survey of about 10,000 schoolchildren over six survey waves, predictors of injuries in the school environment could be identified on the basis of individual injury biographies. In order to confine the subject of the study, the focus was on injuries that occured in the school context. A central distinction was made between injuries in school sports, on the schoolyard, in the school building and on the way to and from school. The analysis strategy employed the use of bi- and multivariate analysis methods that are adequate for panel data as well as for the specific data structure with different levels of analysis.


In particular, the up-taking or expansion of a club sport activity leads to a higher probability of injuries in the school context. An increased willingness to take risks on the part of the students has an effect in the same direction. According to our results, the improvement of the general condition of the school is particularly important in reducing injuries in the schoolyard and in the school building. The strongest protective factor is the mental health of the students. An improvement (from the 25th to the 75th percentile) in mental health and well-being reduces the likelihood of injuries to students in school sports by up to 12 percent, on the schoolyard by up to 24 percent, and on the way to and from school by up to 27 percent. These are remarkable effects that can be observed uniformly in all places where injuries in schools can occur. Based on these longitudinal analyses, an investment in measures to increase mental well-being is indicated. The multi-level analyses also indicate that the greatest potential for injury prevention can be seen at the level of individual students.

Here, on average, one third of the differences in school injury incidence occur. Almost two thirds of the variance must be regarded as situational and random processes. School characteristics play only a minor role and are responsible for a maximum of six percent of the differences in school injury incidence. Finally, detailed analyses of injuries during school sports and on the way to and from school indicate at-risk groups and further potential for preventive measures.

Last Update:

12 Jan 2024


Financed by:
  • Deutsche Gesetzliche Unfallversicherung e. V. (DGUV)
Research institution(s):
  • Fachhochschule Frankfurt am Main

public service

Type of hazard:

mechanical hazards, work organization/safety and health management


prevention, accident causes, education

Description, key words:

Health Behaviour, Accidents School-Age, Longitudinal Survey

Further information

Klocke, A.; Stadtmüller, S.: Two generations later: New evidence on health equalisation in youth. Social Science & Medicine, 342, 116522, 2024

Stadtmüller, S.; Klocke, A.; Giersiefen, A.; Lipp, R.; Wacker, C.: Approaching the Causes of Unintentional Injuries in the School Environment: A Panel Analysis of Survey Data From Germany. Journal of School Health, 2021. Online: DOI: 10.1111/josh.13112

Filser, A.; Stadtmüller, S.; Lipp, R. et al.: Adolescent school injuries and classroom sex compositions in German secondary schools. BMC Public Health 22, 62, 2022