The changing epidemiology of dog bite injuries in the United States, 2005–2018

Abstract

Background In 2018, the most recent year for which data are available, dog bites ranked as the 13th leading cause of nonfatal emergency department visits in the United States. As dog ownership spirals upwards in the United States, it is important to continue to monitor the epidemiology of dog bite injuries. This study provides contemporary data on the incidence of dog bites injuries in the United States and in New York and profiles individuals who have been treated for dog bites in emergency departments. The study also examines the demographic correlates of the rate of injuries at the neighborhood level in New York City and maps the rate in each neighborhood. Methods At the national level, the study examines longitudinal data on dog bite injuries from 2005 to 2018 gathered by the Centers for Disease Control and Prevention. For New York, the study analyzes data for 2005–2018 collected by the New York State Department of Health. A negative binomial regression analysis was performed on the state data to measure the simultaneous effects of demographic variables on the incidence of dog-related injuries. A thematically shaded map of the rate of dog bite injuries in New York City’s neighborhoods was created to identify neighborhoods with higher-than-average concentration of injuries. Results In both the United States and New York the rate of dog-bite injuries increased from 2005 to 2011 and then underwent a significant decline. Injuries due to dog bites, however, still remain a sizable public health problem. Injuries are more prevalent among school-age children, inhabitants of less-densely populated areas, and residents of poorer neighborhoods. In New York City, poorer neighborhoods are also associated with fewer dogs being spayed or neutered. Conclusions To reduce the rate of dog bite injuries, prevention programs – particularly those which center on teaching the dangers of canine interactions with humans – should be targeted at children. Dog bite injuries tend to be clustered in identifiable neighborhoods. Dog bite prevention programs and stricter enforcement of dog laws can target these neighborhoods.

Pediatric patients with dog bites presenting to US children’s hospitals

“…Lower-income patients may seek care in ED more frequently for minor injuries relative to those with higher incomes, for reasons related to medical literacy, access to care, and insurance coverage (Kutner et al 2003 ); as such, this group may present with a higher proportion of lower-acuity injuries overall relative to the middle two quartiles. Nonetheless our findings compare with data suggesting that dog bite injuries (regardless of severity) are associated with lower socioeconomic status (Loder 2019 ; Rhea et al 2014 ; Tuckel and Milczarski 2020 ). Income may serve as a proxy for factors which correlate with dog bite injury.…”

“…Income may serve as a proxy for factors which correlate with dog bite injury. For example, income correlates with rurality and may also serve as a proxy for pet ownership or family size (where a larger family may prevent closer supervision of individual children) (Loder 2019 ; Tuckel and Milczarski 2020 ). Additionally, dog breed factors may play a role in explaining our findings in relation to income and insurance status.…”

“…Our associations with respect to race, ethnicity, and income require additional investigation to better characterize the severity of specific dog bites injuries and identify at-risk populations. As retrospective or registry-based studies of dog bite injuries are frequently limited at characterizing the specific nature of injuries or their precipitating causes (such as dog breed and location of injury, such as if the patient was bitten by a family dog, a neighbor’s pet, or a stray animal) (Ramgopal et al 2018a ; Bykowski et al 2017 ; Tuckel and Milczarski 2020 ), prospective work will likely be required to characterize injuries and elucidate specific risk factors.…”

Epidemiological profile of dog attacks to patients under 14 years old assisted at the pediatric referral emergency unit of a tertiary hospital in Campinas, Brazil

“…A study developed in Italy reported mongrel dogs as the most frequently breed involved in accidents with children ( 12 ), which agrees with our study. Among the reported breeds, Pit Bull was the most prevalent, which agrees with most of the literature ( 7 , 14 , 17 , 22 – 25 , 27 , 28 , 30 , 32 , 33 , 35 ). Curiously, Poodle dogs were the third breed most cited, despite being a breed considered suitable for families with children and not highly reported in the literature about dog bites.…”

“…Our study showed that boys are more likely to be bitten by dogs, this fact had been previously reported ( 3 , 5 , 7 , 12 – 15 , 17 , 18 , 24 , 25 , 27 – 30 ). To the best of our knowledge, only one large study developed in the United States of America reported a higher number of girls involved in accidents with dogs ( 6 ).…”