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     

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.     

Victims of road accidents with serious injuries and dependence on some individual,climatic and infrastructure factors on federal highways in Brazil

Abstract

Road or urban traffic accidents in Brazil have a large presence in external causes of mortality. The main goal of this study is to discover significant factors in the incidence of accidents on Brazilian highways based on a database with information on each person injured on federal highways in Brazil reported by the Federal Highway Police. Some factors are considered in the study as cause of the accident, type of accident, stage of the day, weather condition, highway type, highway facility, age of the victim, gender of the victim and type of vehicle. From the obtained results of chi-square tests and logistic regression models, it was observed statistical dependence (p?<?0.05) of the occurrence of injured people with serious injuries and the factors cause of the accident, type of accident, day, highway type and vehicle type. Considering the dead victims, the covariates age, time of day, highway type, highway facility, gender and type of vehicle showed significance (p?<?0.05). These results are of great interest for authorities to increase road enforcement, improve highway facilities and target the production of vehicles with better safety standards.     

A case-control study on risk factors of domestic accidents in an elderly population

The aim of this study was to evaluate the combined influence of several lifestyle, health and housing factors in the occurrence of home injuries (HIs) among the elderly. The subjects were recruited from 10 hospitals in Rome, Italy. This study is a paired case-control study. Cases included subjects, aged 65-85 years, who visited the Emergency Department for an HI and were subsequently hospitalised (15 September 2004-30 June 2005). Controls were the subjects of the same gender, age (±3 years) and area of residence of cases. A conditional logistic regression model was used for analysing the variables obtained. In this study, we enrolled 107 hospitalised cases. It was found that the living room was the place where 33% of the accidents occurred. Eighty-seven per cent of the accidents were falls, and 33% of the accidents were the immediate consequence of sudden malaise. One-half of the cases reported one or more leg fractures. The variables that were independently associated with HI were poor household illumination, poor emotional status, regular physical activities and housekeeping activities. We conclude that this study shows the areas of intervention to target HI prevention activities.     

Benzodiazepines and falling injuries in the elderly

Abstract

Objective: To investigate the use of benzodiazepines (BD) in relation to the risk of falling injuries in an elderly population (65 yrs. or older)

Design: An unmatched case-control study. Setting: The town of Pori, Finland

Participants: 380 subjects aged 65 years or over, who presented for medical treatment due to a fall during the 12 months from Sept. 1987 to Aug. 1988, and 342 controls, 65 years or older, selected from the population register. The control subjects were examined according to a schedule that corresponded in time (time of day, day of the week and month) to the time-distribution of falls in an earlier study

Outcome measure: All falls leading to medical treatment. BD use was determined from the serum, and the type of BD was determined by interviews and controlled from patient records

Results: We found a tendency toward a dose-response relationship between the serum BD concentration and the occurrence of falling injury. The risk of faling injury related to short-acting BDs was increased 5-fold and that for other BDs 2-fold compared to the risk among those without any BD in the serum. Conclusion: The results indicate that BD use is associated with falls in the elderly, and that short-acting BDs seem to be associated with falls more often. The results suggest caution in the use of BDs in the elderly.     

Analyses of non-fatal accidents in an opencast mine by logistic regression model – a case study

Accidents cause major damage for both workers and enterprises in the mining industry. To reduce the number of occupational accidents, these incidents should be properly registered and carefully analysed. This study efficiently examines the Aegean Lignite Enterprise (ELI) of Turkish Coal Enterprises (TKI) in Soma between 2006 and 2011, and opencast coal mine occupational accident records were used for statistical analyses. A total of 231 occupational accidents were analysed for this study. The accident records were categorized into seven groups: area, reason, occupation, part of body, age, shift hour and lost days. The SPSS package program was used in this study for logistic regression analyses, which predicted the probability of accidents resulting in greater or less than 3 lost workdays for non-fatal injuries. Social facilities-area of surface installations, workshops and opencast mining areas are the areas with the highest probability for accidents with greater than 3 lost workdays for non-fatal injuries, while the reasons with the highest probability for these types of accidents are transporting and manual handling. Additionally, the model was tested for such reported accidents that occurred in 2012 for the ELI in Soma and estimated the probability of exposure to accidents with lost workdays correctly by 70%.     

The epidemiology of head injuries in Sweden from 1987 to 2000

The purpose of the present study was to evaluate the variability in the annual head injury incidence rate in Sweden from 1987 to 2000. It was hypothesized that the annual incidence rate would decrease over time due to a variety of primary preventive strategies that have been introduced in Swedish society. We used the Hospital Discharge Register at the National Board for Health and Welfare and head injury codes 800-804, and 850-854 from ICD9 system and S2.0-S2.9, and S6.0-S6.9 codes from ICD-10 system. We evaluated the patterns of age, gender, external cause of injury (E-code), type of injury, length of hospital stay, and trends over time. Head injuries due to transportation collision were reduced over the 14-year period analysis. Falls persisted as the dominant cause of head injury. Overall, men had 2.1 times the incidence of head injury compared to women. There was a decline in younger ages experiencing a head injury over this interval, while the number of head injuries among elderly people increased over time. Concussion was about three times more frequent than fractures. Hematoma and diffuse or focal contusions had a much lower incidence rate than concussion. Concussions and fractures decreased over time. Diffuse or focal injuries showed a steady rate of occurrence over the study interval while hematoma increased. Although length of hospital stay varied widely from zero to more than 50 days, 73.6% of hospital days were confined to two days or less. The incidence rate is stable over this time frame. While head injuries attributable to transportation accidents decreased, falls made up an increasing proportion of head injuries. Since we observed an increase in head injuries among elderly, primary prevention strategies may need to be targeted at this age group, and at preventing falls.     

Pattern of childhood falls in a low-income setting: a cross-sectional study in Dar es Salaam

The objective was to determine patterns and circumstances of childhood falls in a low-income setting in Dar es Salaam, Tanzania. This cross sectional study is based on a household survey conducted in July 2009.

A total of 3927 children up to age 18 from 1928 households in 15 sampled wards were surveyed through a structured questionnaire. The current study includes information regarding fall occurrence, socio-demographic and economic factors. Data were analysed using chi-square, t-test and logistic regression. Male children had 42% higher odds of falls compared to females, and rural residents had more than two times higher odds compared to urban residents. Falls occurred three times more among age group 1–4 and two times more among age group 5–9 compared to those between 15 and 18 years. Most falls occurred outdoors (62%) while playing (51%) with boys being over-represented. Females and children aged 1–4 years fell more from stairs whereas most infants fell from furniture. Male gender, younger age groups and rural residence were significant factors for fall injuries. The circumstances in which these falls occur also differ significantly. Intervention efforts should emphasise these patterns.     

Retrospective research into accidents

Abstract

In retrospective research into accidents, a victim's or spectator's account of what happened may differ from what actually occurred, as a consequence of memory processes. It seems that, due to limited time and money resources, current insights in retrospective research are not always fully employed in accident research. This paper demonstrates how existing insights into the collection of retrospective data can be incorporated in accident research, and illustrates how this actually works out in practice.

A review of the literature shows that various precautions can be taken to minimize the influences of memory processes. These precautions have been included in the development of a method of accident investigation. Accidents (n=42) were studied in a video-recorded reconstruction on the site, followed by an open interview using a checklist. The accident data have been examined with respect to indications for bias. The findings show that the demonstrations may differ from the unknown actual occurrences, for example, because people were still wearing bandages at the time of investigation on the site. Interference by video- and sound-recordings appears to be limited. Analysis of within-subject differences in repeated demonstrations of the accident shows that more than half of the subjects display differences in the three demonstrations.

The limitations and benefits of the method developed are discussed in relation to conventional methods of accident research, such as mail questionnaires and telephone interviews. The paper concludes with a plea for the inclusion of empirical analyses or at least a discussion of possible bias in findings from accident research.     

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.     

BUILDING RELATED HOME ACCIDENTS: A PRELIMINARY STUDY

In the period August 1975 to July 1977 the Building Research Station undertook a pilot study to obtain data on home accidents in co-operation with the Watford General Hospital. Subject to precautions regarding medical confidentiality, information was recorded on patients who attended the Accident and Emergency Department of the hospital following an accident in or around a dwelling. In order to facilitate comparison with data on fatalities, use was made of the International Classification of Diseases ‘External Cause of Injury’ system to categorize accident events. It was found that the four main types of non-fatal accident were falls, accidents caused by cutting or piercing instruments, by striking against or being struck by objects, and by hot substances and steam. The study also showed that building features and services might rank relatively highly in terms of the frequency with which they become involved as agents in accidents when compared to other common household items.     

Preventing falls in the elderly living in a deprived area: Evaluation of a community intervention

Statement of the Problem While greatly easing the shopping process for parents, transportation of children in shopping carts also represents a hazard for injuries. Effective accident prevention measures would therefore be desirable. Methods 137 shopping cart-related accidents, the 138 victims of which presented to an Austrian Pediatric Surgical Casualty Department over a period of nine years, were reviewed retrospectively by analysis of the patient charts and of 79 questionnaires returned, correctly filled in, by the family. Results The yearly number varied between 10 and 21 without a falling trend. While 43% of the children were 2 years of age or younger, 18% were older than 4. Three-quarters of the latter had been placed inside the trolley although the maximum permitted weight is 15 kg. Falls out of the trolley comprised two-thirds of all accidents, with the child standing up as the leading cause; these were mostly falls from the basket, followed in almost 20% of cases by toppling over of the entire shopping cart. The youngest children – almost all regularly placed in the integrated seat – were at a special risk for this kind of accident, which frequently occurred in the car park. Lessons learned from the accidents were limited almost exclusively to behavioral changes implemented by the parents. Current European Standards have obviously not taken the main accident mechanisms into account, even though these have repeatedly been described in the literature. Conclusion We believe that technical improvements in the present shopping cart design are desirable to reduce the risk of accidents. Our main suggestions include: solid child seats with integrated footrests, obligatory installation and use of safety belts, and construction of trolleys with a lower center of gravity and a broader wheel base.     

Preventive product safety – monitoring accidental injuries related to consumer products in the European Union

Objectives. To measure GPs' and paediatricians' expectations, attitudes, priorities and demands in the area of promoting safety and preventing accidents in the home involving children under 15 years of age.

Methods. A phone survey of a random sample of GPs and paediatricians in the French-speaking community of Belgium (Wallonia and Brussels) conducted in the course of September and October 2000.

Results. Close to two-thirds of the physicians surveyed stated that they had been contacted at least once in the 2 weeks preceding the survey to handle an injury. Of the physicians, 80% mention accident prevention after a childhood injury, but only 46% mention it during a routine consultation (whatever the reason of the latter may be). The main obstacles to mentioning prevention during routine consultation put forward by the interviewees are: 1) reasons for consultations that do not permit such an approach (79%); 2) the fact that injuries are not priorities for them (66%); 3) the lack of interesting materials to provide the subject with documentation (63%); 4) the unsuitability of the place where the contact occurs for such discussion, given the time required (56%); 5) insufficient information on the subject (41%); and 6) the patient's lack of interest (39%). An overwhelming majority (98%) nevertheless feel that they have a role to play in preventing children's accidents in the home, with 72.5% seeing this as informative (recommendation on safety rules). More than two-thirds of the respondents feel that they have enough requisite information to play such a role. Those who declare that they have not enough information (34%) proposed some priority subjects about which they would like to find information or additional information to be more effective in preventing accidents. The information needs mentioned most frequently were a systematic review of the risks, of the effective prevention strategies and epidemiological data.

Conclusions. The present study clearly reveals the interest of physicians for accident prevention and puts forward the current obstacles to offering prevention advice during routine consultation. The obstacles mentioned are fairly comparable to those mentioned in other studies, namely, because the reason for the visit does not give such an opening, the lack of appropriate materials and information, the lack of time, the patient's lack of interest, the fact that the issue is not a priority, etc. The problem of lack of priority for certain practitioners underlines the importance of making accident mortality and morbidity statistics available to doctors in order to improve their perception of the magnitude of the problem. The lack of interesting education materials and useful information seems to be a major reason for their failure to carry out such prevention work successfully. These factors should thus be taken into account when developing any policy and/or programme aimed at ‘using’ GPs and paediatricians in the prevention strategies that are adopted.     

Injuries among preschool children in the federal state of Brandenburg in relation to social factors – 1997–1999

The aim was to determine the epidemiology and risk factors of childhood and young adult injuries among long-term Afghan refugees in Pakistan. A stratified cluster study was undertaken on a random sample of refugee households from June to July 2002. The Afghan Refugee Injury Survey was administered to the head of the household and recorded all injuries among household members within the last 3 months. Crude injury incidence was 12.3 per 1000 population among those aged 0?–?29 years (age groups 0?–?4, 5?–?14 and 15?–?29 years). Those aged 15?–?29 years had the highest injury rate (18.3 per 1000) closely followed by those aged 5?–?14 (12.3 per 1000) and much higher than the 0?–?4 years category (2.3 per 1000). Falls accounted for most injuries (48%) with both road traffic injuries and assaults accounting for 15%. The 15?–?29 year age group (odds ratio?=?9.1) and those educated informally or for less than 6 years (odds ratio?=?2.10), were associated with injury (p?相似文献   

Profile of injury cases admitted to a tertiary level hospital in south India

Injuries now rank among the leading causes of morbidity and mortality the world over. Injuries are steadily increasing in developing countries like India. Systematic and scientific efforts in injury prevention and control are yet to begin in India. Data on injuries are very essential to plan preventive and control measures. The objective of this study is to know the profile of the injury cases admitted to M S Ramaiah hospital, Bangalore, India, using a cross-sectional study design for six months, i.e. from Oct 2008 to April 2009. The mean age of the study population was 35.3 years (SD = 15.38), 69.1% were injured in road traffic accidents (RTA), 28.7% due to falls and 2.2% due to burns. Nearly 14.4% were under the influence of alcohol. Nearly 73.6% of RTA cases were two-wheeler users, 48.5% had not followed sign boards and 56.5% had not obeyed the one-way rules, 63.5% of the two-wheeler users did not use helmets. Also, 38% of two wheelers had two pillion riders, whereas 57% of four-wheeler users had not used a seat belt. Among falls, 58% occurred at home, 49% occurred due to slippery surface. Road traffic accidents were the most common cause for injuries, in which two wheelers were most commonly involved. Strict enforcement of traffic rules and education on road safety are very essential to prevent injuries.     

Trends and characteristics of injuries in the State of Qatar: hospital-based study

Injuries account for a large burden of mortality and morbidity in the State of Qatar. No comprehensive study has been conducted on all types of injuries in the State of Qatar. The objective of this study was to determine the trend in the number, incidence and pattern of injuries in the State of Qatar. This hospital-based study is a retrospective analysis of 53,366 patients treated at the accident and emergency and trauma centres for injuries during the period from 2006 to 2010. Injuries were determined according to the ICD 10 criteria. The details of the entire trauma patients who were involved in occupational/domestic injuries were extracted from the database of the Emergency Medical Services (EMS), Hamad Medical Corporation. Our results demonstrated that the rates of injury remained relatively stable in the State of Qatar over the five–year period. Those most at risk of injury were non-Qatari males who were below 30 years. Road traffic accidents (RTA) (36.7%) followed by falls causing back injuries (11.0%) were the most common types of injuries during the period. Most of the injuries occurred at the head for both males (17.7%) and females (13.5%); this was consistently the case across all of the age groups. The greatest proportion of RTA (21.2%), industrial machinery injuries (16.4%), construction injuries (15.5%), recreational sporting injuries (20.5%) and beach/sea/ocean injuries (15.0%) resulted in head injuries. Intervention efforts need to be aimed at reducing occupational injuries, RTA injuries and work–related hazards in the State of Qatar.     

Does poverty lead to non-fatal unintentional injuries in rural Vietnam?

The aim of this study was to identify associations between poverty at the household level and unintentional injury morbidity. A cohort consisting of 24,874 person-time episodes, representing 24,776 people living in 5,801 households (classified into rich, middle income and poor by local authorities in 1999) was followed during 2000, in order to identify and assess non-fatal unintentional injuries. Incidence rate ratios were calculated using a Poisson regression model. The results showed that poverty was a risk factor for unintentional injuries generally. When looking at different types of injury, poverty was a risk for home, work and "other" injuries, protective for school injuries, while the risk of traffic injuries was not affected. The results also showed that communes in mountainous areas were at higher risk for home, work and other injuries. Overall, poverty was associated with unintentional injury morbidity. However, the relationship varied by sex, age and type of injury. Specifically, poverty increased the risk for children and elderly people being injured at home, and for adults (15-59 years) being affected by work injuries.