Safety of playgrounds in The Netherlands

Abstract

In this paper the results are presented of a national survey on playground safety in The Netherlands. Thirteen trained inspectors each inspected 51 playgrounds in their own region. In total, 663 playgrounds with 7150 pieces of playground equipment were subjected to an inspection. The following safety criteria were inspected: entanglement, surfacing material, installation and maintenance aspects. The results show that one out of every three pieces of playground equipment fail on one or more criteria. The number of pieces of equipment that fail in playgrounds operated by local authorities or recreational companies is higher than that in playgrounds operated by voluntary associations. The smaller the playground the higher the number of failures per piece of equipment

The time has come for experts to provide the operators with information which will improve the safety level. More funding should be provided for the local authorities to prevent the occurrence of accidents.     

Testing impact attenuation on California playground surfaces made of recycled tires

This study was conducted to determine whether rubberized playground surfaces made of recycled tires comply with state-mandated standards for impact attenuation (measured with an accelerometer), and whether their properties change in response to temperature or time. The Head Impact Criterion (HIC) standard of 1000 was found to be a more sensitive indicator of compliance than the G(max) standard of 200(g). Of 32 playgrounds tested, 22 (69 percent) failed the HIC standard. As the heights of playground structures increased, so did the likelihood that the rubberized surface below would fail the HIC standard. Rubberized surfaces gave stable readings for the first three months following installation, and higher values in response to increasing surface temperature. An excessively high percentage of playground surfaces made of recycled tires failed the state-mandated standards designed to prevent serious head injury from falls. Future failures might be prevented by requiring installers to perform post-installation testing to verify compliance.     

Height, fun and safety in the design of children's playground equipment

The study reported in this paper adopted a holistic design approach to investigate issues associated with height related playground injuries from a users' perspective. The main objective was to gain an understanding of the relationship between height and fun so as to establish practical guidelines for addressing the causes of height related injuries whilst maintaining the attributes of playground equipment that children find fun and challenging. Results show that, on the one hand, the risk of injury increases when height is coupled with the use of upper body strength and, on the other hand, that coordination is a greater source of fun and challenge than height for children. Accordingly, it is suggested that the level of risk of injury attached to children's playground equipment can be reduced when the use of lower body strength and coordination are combined with lower free fall heights.     

Swing accidents within the European region

Abstract

This study was conducted to gain greater awareness and understanding of the issues and events which lead to swing accidents; in particular, to provide indices for determining preventive measures concerning swing accidents by means of analyzing accident data. A secondary objective was to find out the potential use for data collected by means of the European Home and Leisure Accident Surveillance System (EHLASS)

All twelve Member States of the European Community in 1993 were asked for information on accidents involving swings recorded by EHLASS. Eight countries provided information on a total of more than 5,000 accidents. Based on this information it was concluded that every year in the European Community about 70,000 people have to be treated at an Accident and Emergency Department for an injury due to a swing, i.e. eleven victims per 10,000 children up to fifteen years of age. On average, half of the accidents involving playground equipment refer to swings. Swing accidents result in general in more severe injuries (based on the proportion of hospital admissions and fractures) than other home and leisure accidents recorded by EHLASS. Three quarters of the accidents refer to falls from a height. The location varies largely from country to country. The most common injuries are arm fractures and contusions of the head. The paper also goes into the differences noted for the countries included in the analyses. It is concluded that accidents involving swings result in severe injuries and form a serious problem, especially for children up to fifteen years of age. Many similarities between the countries were noted, except for the location of the accident. EHLASS has a considerable potential to make a substantial contribution to consumer safety in Europe     

Factors associated with urban non-fatal road-accident severity

This paper reports on the factors associated with non-fatal urban-road accident severity. Data on accidents were gathered from the local traffic police in the City of Palermo, one of the six most populated cities in Italy.

Findings from a mixed-effects logistic-regression model suggest that accident severity increases when two young drivers are involved, road traffic conditions are light/normal and when vehicles crash on a two-way road or carriageway. Speeding is more likely to cause slight or serious injury even when compared to a vehicle moving towards the opposite direction of traffic. An accident during the summer is more likely to result in a slight or serious injury than an accident during the winter, which is in line with evidence from Southern Europe and the Middle East.

Finally, the severity of non-fatal accident injuries in an urban area of Southern Europe was significantly associated with speeding, the age of the driver and seasonality.     

Effects of ethyl alcohol on injuries severity according to injury severity scales in pedestrian fatal injury in traffic crashes

Abstract

Introduction: The dominant cause of injuries in traffic crashes. A significant portion of them affects victims under the influence of ethyl alcohol. The goal of the studies was to assess the correlation between the state of sobriety and the severity of injuries expressed by injury severity scales in fatal pedestrian victims of traffic crashes. Research Material and Method: The data were obtained from the Warsaw Medical University's Department of Forensic Medicine. The analysis covered the data for 2009–2013 and included 200 fatal pedestrian victims hit by passenger cars. The assessment of the effect of risk factors on injury severity expressed in terms of injury severity scales such as Life Threat Indicator (LTI), International Classification based Injury Severity Score (ICISS), Injury Severity Score (ISS) and New Injury Severity Score (NISS), was made using adequately selected methods of statistical analysis. Results: As alcohol concentration increases in women, the values of LTI, ICISS-10 and ICISS-15 decrease, which denotes more severe injuries. In the ISS and NISS, the effect of alcohol concentration on the severity of injuries turned out to be negligible. However, these injuries are significantly heavier in women than in men. According to all the scales used, the older the victims, the milder injuries cause their death. Conclusions: The studies show that ethyl alcohol concentration may harm injury severity, especially in the case of women. The assessment of the severity of injuries in traffic crash victims is significantly influenced by their age and gender. The more risk factors the scale takes into consideration, the more precise is the assessment.     

Product involvement in do-it-yourself maintenance injury

Abstract

PROBLEM Numerous activities to promote bicycle safety have been implemented in Norway. The overall effect of these activities has not been evaluated.

method Information about cases of bicycle-related injuries occurring in 1990-1993 was obtained from prospective registration of all injuries treated by hospitals and emergency clinics in four urban centers in NORWAY. Incidence was calculated per number of cyclists, based on data obtained from the 1992 National Bicycle Survey. Temporal changes in injury severity and in age-specific incidence (per bicycle riders) of all injuries, upper-head injuries, other injuries, injuries due to bicycle-motor vehicle collision, and injuries leading to inpatient treatment were analyzed by logistic regression analysis.

RESULTS 3,893 injuries occurred in the study population in 1990-1993. The average annual incidence was 33.1 per 10,000 population aged 4 years and higher, or 47.9 per 10,000 bicyclists. No significant secular trends were found for any of the analyzed parameters.

CONCLUSIONS Bicycle safety promotion measures implemented during 1990-1993 did not significantly reduce the risk of bicycle-related injury in Norway. Effective bicycle safety programs should be implemented, based on the positive experiences from other countries. Injury surveillance systems appear to be a useful tool for evaluating injury prevention programs.     

Socio-economic differentials in injury risk

The aim was to highlight the role of childcare products as causes for mild brain injury (concussion) in small children (0-4 years of age) and to determine the most dangerous products. By childcare products this report means the following items: child and baby furniture, nursing tables, baby walkers, toys, baby carriages, sport equipment for children, playground equipment and security equipment for children. The data were derived from the EHLASS (European Home and Leisure Accident Surveillance System) for 1998 and 1999 and covered a restricted population of Sweden (approximately 5 per cent). According to this register 182 mild brain injuries (concussions) were recorded following a fall, an accident or a blow to the head among children (0-4 years of age) during 1998 and 158 for 1999. Of those injuries, childcare products were the cause of the accident in 84 (46 per cent) and 76 (48 per cent) cases respectively for 1998 and 1999. The number of children admitted for hospital care was 68 (57/84) and 74 (56/76) per cent respectively. The home was the most common place of the accident and play and leisure activity were the most common activities. More than 50 per cent of these accidents took place during daytime. The product type that caused most accidents was nursery furniture and, in this category, the baby walker was the most dangerous. The product type that caused the second most frequent accidents was playground equipment.     

Clustering-based classification of road traffic accidents using hierarchical clustering and artificial neural networks

Artificial neural networks (ANNs) have been widely used in predicting the severity of road traffic crashes. All available information about previously occurred accidents is typically used for building a single prediction model (i.e., classifier). Too little attention has been paid to the differences between these accidents, leading, in most cases, to build less accurate predictors. Hierarchical clustering is a well-known clustering method that seeks to group data by creating a hierarchy of clusters. Using hierarchical clustering and ANNs, a clustering-based classification approach for predicting the injury severity of road traffic accidents was proposed. About 6000 road accidents occurred over a six-year period from 2008 to 2013 in Abu Dhabi were used throughout this study. In order to reduce the amount of variation in data, hierarchical clustering was applied on the data set to organize it into six different forms, each with different number of clusters (i.e., clusters from 1 to 6). Two ANN models were subsequently built for each cluster of accidents in each generated form. The first model was built and validated using all accidents (training set), whereas only 66% of the accidents were used to build the second model, and the remaining 34% were used to test it (percentage split). Finally, the weighted average accuracy was computed for each type of models in each from of data. The results show that when testing the models using the training set, clustering prior to classification achieves (11%–16%) more accuracy than without using clustering, while the percentage split achieves (2%–5%) more accuracy. The results also suggest that partitioning the accidents into six clusters achieves the best accuracy if both types of models are taken into account.     

Improved portable circular power saw safety performance through riving knife design modification

Abstract

This study on portable circular power saw safety focused on body contact with an under-work protruding blade. Three guard were evaluated relative to injury severity, including two innovations and an unguarded saw with below-work configuration typically identical to one with a riving knife. Innovations consisted of riving knife modifications, including an ‘extended’ riving knife or ‘riving ring’, and a riving ring plus outrigger. Injury severity was simulated using human finger prostheses as test specimens.

Thirty single-specimen trials were conducted per experimental setup. For each trial the experimenter operated the saw, simulating a woodworking cut. An assistant fed specimens into the blade contact zone. After 90 trials, two medical raters ranked simulated severities using a five-level classification. Severities for riving ring plus outrigger proved significantly less than for a riving ring alone, which in turn caused significantly less severe injuries than a riving knife.

On the basis of severity level frequencies, it was concluded that the riving ring plus outrigger, which produced no injuries, represents the safest alternative tested. A riving ring without outrigger, which produced a significant number of minor injuries, represents minimally acceptable guarding.

The conventional riving knife, which generated significantly more finger-contact mutilation incidents than the other designs, was the most dangerous configuration. The research results do not detract from the significant benefits of riving knives relative to kickback prevention. However, both modified riving knife designs also possess identical kickback-prevention features.     

Accident risk analysis based on motorway exposure: an application of benchmarking technique for human safety

Abstract

Accident risk analysis for human safety and infrastructural improvement are key requirements of the engineering sector. The purpose of this paper is to identify and prioritize problematic segments of roads based upon the risk evaluation concept and to focus on the severity of accidents regarding human life loss and easy manoeuvring. This study includes the concept of considering road segments as decision-making units for application of data envelopment analysis (DEA) technique which has no compulsion of the distribution function and critical assumptions, unlike the multiple regression models. According to the proposed methodology, a section of Motorway (M-2) Lahore-Islamabad has been analyzed. Out of 200 segments under consideration, 99 segments were selected with at least one accident and one injury or fatality. Furthermore, for risk calculation and ranking of road segments, the DEA technique along with the cross-risk matrix method was applied. This optimization technique could not only be helpful in ranking but also technical decision-making and prioritizations for safety improvement, policymaking and budget allocation.     

Characteristics and risk factors for accident injury in Canada from 1986 to 1996: an analysis of the Canadian Accident Injury Reporting and Evaluation (CAIRE) database

This study analyzed the database of Canadian Accident Injury Reporting and Evaluation (CAIRE) for the injuries reported from January 1986 to March 1996 in seven provinces at children's or general hospitals in Canada. In order to describe the characteristics of injuries, we compared the different categories of injuries by sex and by age groups, identified patterns of injuries, and detected the products causing injury to Canadian people. The results showed that there were 130,489 injury cases in Canada during the 10 years from 1986 to 1996. The 10–19 year age group had 57,582 cases, representing 44.13% of total injuries, and making it the group with the highest occurrence of injuries. The male injury rate (69.75%) was significantly higher than the female rate (30.25%) (P = 0.0001). Six areas were identified as priorities for intervention: 1) injuries occurring on playgrounds among children and youth; 2) sports and playground apparatus injuries and injuries sustained in transit among young people; 3) the top five causes of injuries; 4) diagnosis and treatment of injuries; 5) consumer products and safety; and 6) nature and physical sites of injuries. Further work is needed in: evaluating injury causes, comparing the results with reports from other countries and the necessary approaches and prevention measures to reduce and control injury occurrences to improve the quality of consumer products, and to protect the health of the population in Canada.     

Skiing and snowboarding injuries and their impact on the emergency care system in South Tyrol: a restrospective analysis for the winter season 2001–2002

Objectives. To evaluate the incidence and the pattern of skiing and snowboarding injuries in South Tyrol and their impact on the emergency medical system in the winter season 2001–2002 in an attempt to rationalize and improve the emergency care and assist in prevention strategies.

Methods. All medical records of patients referred to our emergency department (ED) that sustained a skiing or snowboarding injury during the study period were retrospectively reviewed. Age, sex, local or non-local residency, type of injury, data and time of accident, type of transport to the hospital, hospital admission or ED discharge, Injury Severity Score, outcome (including mortality) were evaluated. On site mortality data were obtained from the emergency call-center registry. Ski resorts utilization was estimated from the data published by the Regional Office of Cable Transport.

Results. For the period analyzed approximately 2,500,000 skier and snowboarder days were recorded in the whole region of which about 500,000 were attributed to the four nearby ski resorts that refer to our hospital. Of the 1087 patients, 794 were skiers and 294 were snowboarders. Snowboarders were younger than skiers (mean age 20 and 36 respectively, p = 0.001). Females were equally represented in the two groups. Male patients, children, senior skiers and non-local residents suffered from more severe injuries than their corresponding classes (p < 0.01, p = 0.002, p = 0.02, p = 0.000 respectively). Critical injuries (ISS ≥ 25) were homogeneously spread in the groups, with the exception of the non-local resident patients that showed a higher incidence (p < 0.02). No difference in severity was found between skiers and snowboarders. The incidence was 2.05 per 1,000 skier-days. Mortality rate was 1.6 per 1,000,000 skier-days. The pattern of injury was different: snowboarders showed more forearm and wrist trauma and skiers more lower extremity injuries. 208 patients were hospitalized and the mean length of stay was 4.5 days. Head trauma and fractures were the most common diagnosis of admission. The lack of field triage led to 12% of unjustified helicopter transfer and 9.6% of avoidable ambulance transport.

Conclusions. Incidence, pattern of injuries and mortality from skiing and snowboarding accidents in South Tyrol resemble those reported in other part of the world. Nevertheless, strategies for prevention are needed. The routine use of helmets should be enforced by law. Dangerous behaviors should be prosecuted. Skiers and snowboarders should be made aware that skiing beyond their technical ability can be life-threatening.     

Risk assessment of maintenance operations: the analysis of performing task and accident mechanism

Maintenance operations cover a great number of occupations. Most small and medium-sized enterprises lack the appropriate information to conduct risk assessments of maintenance operations. The objective of this research is to provide a method based on the concepts of task and accident mechanisms for an initial risk assessment by taking into consideration the prevalence and severity of the maintenance accidents reported. Data were gathered from 11,190 reported accidents in maintenance operations in the manufacturing sector of Andalusia from 2003 to 2012. By using a semi-quantitative methodology, likelihood and severity were evaluated based on the actual distribution of accident mechanisms in each of the tasks. Accident mechanisms and tasks were identified by using those variables included in the European Statistics of Accidents at Work methodology. As main results, the estimated risk of the most frequent accident mechanisms identified for each of the analysed tasks is low and the only accident mechanisms with medium risk are accidents when lifting or pushing with physical stress on the musculoskeletal system in tasks involving carrying, and impacts against objects after slipping or stumbling for tasks involving movements. The prioritisation of public preventive actions for the accident mechanisms with a higher estimated risk is highly recommended.     

Neck injuries among the elderly in Sweden

Neck injuries are some of the most important injuries as they have the potential to influence the spinal cord. A previous national survey of neck injuries in Sweden revealed that injury incidence was increasing for the population over 65 years of age, although it was decreasing for the population as a whole. The aim of this study was therefore to further clarify the magnitude, severity, and external causes of neck injuries in the elderly people in Sweden. A national incidence study, with focus on the age group above 65 years, was undertaken with data from the injury surveillance program at the Swedish National Board of Health and Welfare. The investigation includes cervical vertebral fractures reported between 1987 and 1999, and cervical soft tissue injuries from 1997 to 1999. Data in the hospital discharge register were reported in ICD9 from 1987 to 1996, while data from 1997 to 1999 were reported in ICD10. During the study period 4168 cervical injuries occurred of which 341 were fatal. People above 65 years of age made up 17% of the population and sustained 30% of all cervical injuries and 43% of all fatal cervical injuries. Half of the cervical injuries were axis (C2) fractures. Lower vertebral fractures occurred in 16% of the cases and atlas (C1) fractures in 11%. The cervical soft tissue injuries amount to 19% of all injuries. Fall accidents account for the majority (71%) of the accidents. There is an increasing trend for fall accidents resulting in neck injuries. The male population has a higher incidence for neck fractures than females, disregarding the external cause of injury. The upper cervical injuries are the most common, have the longest hospital treatments, and seem to be caused mainly by low energy falls. Further research is needed to understand the mechanisms of these injuries and in this aspect engineering could contribute with valuable knowledge, through accident simulations with numerical models. The increasing incidence of fall injuries calls for further preventive actions. The public sector should implement preventive strategies to reduce the number of extrinsic accidents, while the health care sector should focus on preventing intrinsic accidents with individual actions for each patient.     

Accidental injuries among the elderly within the Vienna community: Epidemiology,risk factors and preventive measures

Abstract

Unintentional injuries ('accidents’) among elderly people are a significant burden in public health because such accidents happen frequently and because the proportion of older age groups in the population will continue to rise during the coming decades. One aim of this study, which was done in Vienna, the capital of Austria, was to broaden the preventive concept, adding lifestyle and living conditions to already well-known risk factors following the health promotion approach. Furthermore, characteristics that predispose older residents to accidents should be identified in order to design preventive measures for reducing injuries in this age group.

809 interviews with people 60 years of age and over were conducted, concerning accidents, outcomes of accidents, physical fitness, drug intake, type of house or dwelling, equipment in the household incorporating safety features, psychological well-being and social relations. The information collected was used to draw cross-sectional comparisons between participants who reported having experienced at least one accident in the previous 12 months and those who did not. Furthermore, the accident incidents were classified into 2 groups: incidents without injuries and injurious accidents. The latter served as a base for the epidemiology of injuries for people 60 years of age and over within the Vienna community.

20% of all senior citizens suffer at least one unintentional injury every year, in addition to which 8% experience critical incidents (mostly falls) without injury. Most accidents occur at home or involve pedestrians in public traffic areas. Over 90% of all accidents are falls, and 20% result in fractures. The most important risk factors for accidents in the elderly are gender, increasing age, poor physical fitness and low physical activity, the type of household and household equipment, poor psychological well-being, low income and loneliness.

The findings regarding falls suggest some possible opportunities for reducing the risk of falls by improving buildings and dwellings of the elderly. A promising attempt at practical implementation of these findings is being conducted by the Vienna-based Austrian Institute for Home and Leisure Safety in cooperation with the Vienna City Council. These two organizations are implementing a long-term program that aims at mobilizing institutions and organizations involved in working with the elderly.     

Road accidents involving bicycles: configurations and injuries

This study analyzed the most common types of accident involving bicycles and compared the frequency of injuries. The data source was the database of German In-Depth Accident Study (GIDAS). Cases consist of bicycles and their riders involved in accidents between 2000 and 2010. In most collisions, the bicycle impacted with a car. The percentage of injured bicyclists was higher in collisions with a heavy vehicle and decreased when the bicycle impacted with lighter vehicles. A high percentage of injured bicyclists in single accidents was observed; the most severe injury was more frequently to head and extremities. Accidents involving a car and a bicycle with the right of way in a bicycle path represented about 20% of involved and injured bicyclists. The ten most frequent configurations represented about 60% of involved and injured bicyclists. These results contribute to understand the dangerous scenarios for bicyclists and to suggest preventive actions.     

Safety concerns related to modular/prefabricated building construction

The US construction industry annually experiences a relatively high rate of fatalities and injuries; therefore, improving safety practices should be considered a top priority for this industry. Modular/prefabricated building construction is a construction strategy that involves manufacturing of the whole building or some of its components off-site. This research focuses on the safety performance of the modular/prefabricated building construction sector during both manufacturing and on-site processes. This safety evaluation can serve as the starting point for improving the safety performance of this sector. Research was conducted based on Occupational Safety and Health Administration investigated accidents. The study found 125 accidents related to modular/prefabricated building construction. The details of each accident were closely examined to identify the types of injury and underlying causes. Out of 125 accidents, there were 48 fatalities (38.4%), 63 hospitalized injuries (50.4%), and 14 non-hospitalized injuries (11.2%). It was found that, the most common type of injury in modular/prefabricated construction was ‘fracture’, and the most common cause of accidents was ‘fall’. The most frequent cause of cause (underlying and root cause) was ‘unstable structure’. In this research, the accidents were also examined in terms of corresponding location, occupation, equipment as well as activities during which the accidents occurred. For improving safety records of the modular/prefabricated construction sector, this study recommends that future research be conducted on stabilizing structures during their lifting, storing, and permanent installation, securing fall protection systems during on-site assembly of components while working from heights, and developing training programmes and standards focused on modular/prefabricated construction.