Bicycle-related injuries: Injury,hazard, and risk patterns

Abstract

This paper provides the results of a U.S. Consumer Product Safety Commission (CPSC) study to determine the circumstances involved in bicycle-related injuries treated in U.S. hospital emergency rooms. It also includes information from a CPSC exposure survey of the U.S. population of bicycle users and their patterns of bicycle and helmet use. Together, these data were used to identify and evaluate risk factors currently associated with bicycle use in the United States

Risk models identified factors specifically associated with injuries to children and to adults. Children were at particular risk of injury, and appeared to be especially vulnerable to head injury. In addition, the risk of injury for children was significantly increased when riding in non-daylight conditions. For both adults and children, there was a higher risk of injury on streets than in such areas as bike paths or unpaved surfaces. While some problems associated with bicycle assembly, operation, and maintenance were observed, the data did not suggest that any mechanical remedy is likely to reduce injuries substantially.     

Injury incidence,risk perception and product-related safety behavior among 18- and 45-year-olds

Abstract

Adolescents generally have twice the injury incidence of adults. This increased risk of injury may partly be a consequence of the types of activities performed, the level of exposure to products and the safety behavior. The purpose of this paper was to identify possible predictors for the increased injury risk of adolescents compared to adults. To this end, all 18- and 45-year-olds in a major city in Norway received a questionnaire asking for information on injury experience, level of use and risk perceptions concerning 14 specific products, and the adoption of safety measures; 686 18-year-olds and 81 o 45-year-olds answered the questionnaire. The adolescents reported a higher injury incidence as compared to adults for all the listed products. The difference was significant even after controlling for level of use. Adolescents also had higher levels of risk perception and decreased adoption of safety measures as compared to adults. Females reported less injuries but higher levels of risk perception than males. Females also adopted more safety measures. An important finding from this study was that adolescents, as compared to adults, also expose themselves to increased risk levels when ‘ordinary’ products are concerned, and not only in terms of well-known high-risk activities (driving fast, skiing downhill, etc.). This tends to support the idea that more general factors or dimensions of risk-related behaviors may exist which should be accounted for in the planning of injury prevention activities.     

Product-related injuries at home

Abstract

The current study was undertaken in order to highlight the most typical circumstances and products related to home injuries and to establish the extent to which any patterns found in domestic injuries were age or gender related.

Injury data were taken from a community-based injury surveillance register built up over a one-year period in a Swedish county. Injury incidence by gender and age was calculated, and typical injury patterns were identified through the multivariate analysis of nine characteristics of the injuries.

Home-injury incidence was found to be higher for males than females in all younger age categories except 7-15 years, and for females than males in the oldest age category (65+). Seven typical injury patterns were identified, and their associations with age group and gender established.

The patterns emerging from the study demonstrate that injuries in home settings are simultaneously product, age and gender related, which points to a combination of risk groups and safety planning problems. The results suggest that home injuries are incurred in many specific locations and under a wide variety of circumstances. Accordingly, the question of safety promotion at home needs to be addressed in a global and environmental manner. It is necessary to reflect on the ways in which domestic building structures, items of equipment and products can be designed so as to be conducive to domestic safety.     

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     

Child injuries in land vehicles that do not require restraints

Abstract

The goal of this study was to determine the injury profiles of Canadian children who presented to the Emergency Department from 1990 to 2016 due to an injury caused while traveling in a form of land transportation that did not require child restraint. A case series was conducted using data from the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP). Children who were injured while travelling on land transportation for which child restraint is not required, who presented to a Canadian Emergency Department that participates in eCHIRPP between April 1, 1990 to August 29, 2016, were included. Overall, 1856 children sustained 2139 injuries (mean age: 9.8?years (SD 4.5), 45.5% male). The majority of children were injured on a school bus (49.3%). The most commonly injured body part was the head or neck (52.6%). The most common type of injury was a superficial or open wound (33.1%), followed by traumatic brain injury (19.3%). Overall, 39.4% of injuries required no treatment in hospital. Overall, approximately 70 children presented to eCHIRPP EDs per year on a land transportation vehicle that does not require restraints. Biomechanical studies are needed to improve safety on land transportation vehicles that do not require seatbelts.     

Twenty-five years of bicycle helmet promotion for children in Skaraborg District, Sweden

The purpose of this study is to describe some of the results of a long-term bicycle helmet campaign for children in Skaraborg District, Sweden. The hospital discharge data for bicycle-related injuries occurring in children under the age of 15 were reviewed, to assess changes in patterns for head and other body injuries. The study shows that head injuries to children as a result of bicycle injuries were reduced between 94 and 99% in the study areas. The tremendous gains in safety for children who ride bicycles in Skaraborg District were the result of not only national policy changes that occurred in the latter half of this study period but also the result of local collaborations based on the Safe Communities model, which were organised during the first part of the study period.     

Incidence and characteristics of unintentional injuries among children in a resource limited setting in Kampala,Uganda

ABSTRACT

Given that little is known about the epidemiology of unintentional injuries in children in low-income countries, this study sought to determine the incidence and characteristics of unintentional injuries among children aged ≤18 years in a slum community in Uganda. From a household survey, the incidence and odds ratios for factors associated with unintentional injury characteristics were calculated. Of 1583 children, 706 had suffered 787 unintentional injuries yielding an annual incidence rate of 497 injuries per 1000 children. Commonest injuries were cuts, bites or open wounds (30.6%) and bruises or superficial injuries (28.6%) with majority (75.5%) occurring at home. Boys were more likely to be injured at school (AOR 4.34; 95% CI 1.22–15.54) and to be injured from falls (AOR 1.41; 95% CI 1.01–1.96). Older children (12–18 years) were more likely to suffer from fractures (AOR 2.37; 95% CI 1.26–4.43), concussions and organ system injuries (AOR 3.58; 95% CI 1.03–12.39) and cuts, bites or open wounds (AOR 2.05; 95% CI 1.21–3.48). Older children were less likely to suffer burns or scalds as compared to the young children (AOR: 0.23; 95% CI 0.11–0.50). Unintentional injury incidence rate was high among children with most occurring in the homes.     

Safety survey of Iran's mines and comparison to some other countries

The increasing development of mining activities in Iran makes it necessary to have a closer look at the safety issues. Analysis of different incidents and damages in mines can be helpful for the adoption of suitable approaches to prevent the incidents. In this study, safety statistics of Iran's mines in 2011 and 2012 were assessed and important incidents and injuries happening to employees for 12 different groups of minerals were evaluated and eventually compared to the situation of some other countries. According to the obtained results, the average incidence probability in Iran's mines was calculated to be 0.18 for 2011 and the incidence probability of coal, copper and iron ore mines was greater than others. The injury rate of Iran's mines was 106 and 164 out of 10,000 persons for 2011 and 2012, respectively, and the maximum values of injury rate belonged to coal, dimension stone and aggregate mines. Also, it turned out that the fatal rate per 100 tons of production had the highest values in chromite and coal mines. Besides, comparison of injury rate and the fatal rate in Iran and some countries showed that the safety situation in Iran's mines was in a fair condition.     

Epidemiologic features and intervention effect of fall injury among rural school-aged children in southwest China: a short-term cohort study

ABSTRACT

Falls are the top one type in all unintentional injuries. In this study, we aim to explore the epidemiological characteristics of falls and assess the intervention effect. Our research had interviewed 2854 rural children in southwest China. Then, we used School–Family–Individual (SFI) comprehensive education model to conduct an intervention among 1506 children and follow up them for one year. The changes in injury knowledge and incidence rate before and after intervention were compared. We found the fall injury was 37.32% (178/477) and ranked top one in the total injuries. After intervention, the children's fall-injuries-related knowledge was significantly increased by 15.29 percent (P < 0.001). While falls incidence significantly decreased after- intervention (6.24% vs. 3.93%; P < 0.001). From the results we concluded that the falls rate was high and was the prior reason of all injuries. SFI intervention model can effectively reduce the incidence of the fall injury.     

Impact of the Safe Community program in Harstad on the incidence of injuries

Objectives Since 1987, the Harstad community in Norway has run an injury prevention program according to the Safe Community approach. The effectiveness of this approach in reducing injury rates is poorly documented. The aim of this study was to evaluate the impact of the Harstad program on the incidence of injuries. Methods We used data from the National Injury register of Norway and compared age-adjusted incidence rates and standardized rate ratios of injuries in Harstad and three control communities for the period 1992-1997. Results Harstad had the second highest rates for both all injuries and fractures. No reduction in the incidence of injuries in Harstad was observed from 1992-1997. The injury rates in 1992-1997 were similar to the rates recorded in 1985/86. Conclusions The injury prevention program in Harstad has not reduced overall injury rates. The Safe Community concept is an organizational strategy, but implementation of proven and targeted risk reduction measures will be needed if community-based programs are to result in risk reductions.     

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.     

Global road safety

New Zealand's (NZ) preschoolers carry the greatest injury burden among children aged 0–14 years. These injuries commonly occur at home. To identify how NZ addresses child injury the 1990s national injury datasets and associated free text were examined retrospectively, NZ injury circumstances and interventions were compared to internationally recognised hazards and best practice, and whether NZ interventions addressed common circumstances of injury was assessed. Certain injuries, often associated with activities of daily living, were not addressed by interventions, although most interventions advocated internationally are implemented in NZ. Possible reasons for main injuries not being addressed were the specificity and variable effectiveness of interventions, normality of many injury circumstances, difficulties in evaluating complex environments, and the need for active intervention. There is considerable scope for NZ to improve its child safety. It is unlikely that simple solutions will be found for complex circumstances in which injury events occur. Strategies to address multifaceted problems requiring changes to personal, social and societal factors are required, with evaluation methods able to match their complexity.     

Child and young adult injuries among long-term Afghan refugees

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 < 0.05) after adjustment for age, gender, occupation and education. Occupation was not associated with injury at a statistically significant level. Afghan refugee children and young adults are disproportionately affected by injuries, especially falls, than children in developed countries. Appropriate injury prevention strategies must be implemented among refugee camps with long-term refugees as part of their health programmes.     

A comparison of parent and child perspectives about barriers to and facilitators of bicycle helmet and booster seat use

Abstract

To date, little work has compared similarities and differences between parent and young people’s perceptions of barriers to and facilitators of bicycle helmet and booster seat usage. Our goal was to conduct such a comparison in order to inform future safety campaigns. Eleven focus groups with a total of 68 parents and 11 focus groups with a total of 76 young people were conducted. Recruitment was conducted and focus groups were held in diverse neighbourhoods to facilitate participation by families from a variety of cultural, linguistic, and socioeconomic backgrounds. Overall, parents and their children agreed on 50% of the barriers identified for bicycle helmet use and approximately 40% of the barriers for booster seats. Barriers common to both types of equipment for parents and children included comfort, style and design, and fear of teasing. Common facilitators included perceived safety, and comfort. While there was considerable overlap between the perspectives of parents and young people, there were also differences, underscoring the importance of addressing both perspectives. The barriers and facilitators identified were modifiable to a large extent; based on these, recommendations for future injury prevention campaigns were outlined.     

Regional strategies for injury prevention: Experiences from six county-wide programs in Sweden∗

Abstract

Community approaches predominate in safety promotion, and most experience has been gained at the local municipal level. Regional and national programs are also underway, partly influenced by the same theoretical and methodological principles as applied locally. In this paper, six already initiated regional (county-wide) injury prevention programs in Sweden are examined with regard to strategic considerations and in the light of principles discussed in the literature. It is argued that the community approach is less suitable for larger settings, such as counties, and that there is a need for additional and complementary approaches for higher societal levels and formal governmental and administrative structures.     

Design and construction of an Unintentional Injury Risk Index (UIRI) to measure frequency and severity of accidental injuries in Europe

ABSTRACT

In today's Risk Society, accidental injuries are considered an important public health problem. To design coherent programmes aimed at reducing risk, it is necessary to measure the magnitude of this phenomenon with its changing meaning –from random misfortune to foreseeable and preventable risk. To calculate the total volume of accidental injuries in Europe, the empirical aim of this article, we have designed an adequate measurement instrument: the Unintentional Injury Risk Index (UIRI) counts both the probability (incidence) and the consequences (severity) of injuries. The index calculated for EU countries in 2009 revealed that accidents caused injuries and suffering equivalent to 96.4 deaths per 100,000 population. Based on the index, other specific indices can be calculated, such as personal proneness, country risk or site hazard indices, useful for deepening knowledge on the risk factors for unintentional injuries.     

Sports injuries and injury-preventive behavior related to hockey and volleyball in the Netherlands

Abstract

In a survey of hockey and volleyball players, the number and nature of sports injuries, the percentage of players taking injury-preventive measures (warming up before and cooling down after playing and the use of gum-shields and knee caps) and the main reasons for taking these measures have been assessed by self-reports in a questionnaire. The questionnaire for hockey players was answered by 635 respondents, the questionnaire for volleyball players by 711 players. For both hockey players and volleyball players, an incidence of about 500 injuries per 1000 players per year was found. Almost all volleyball players warmed-up before the last game played and 86% wore knee caps. About 25% of all hockey- and volleyball players took part in cooling down after this game. A gum-shield was used by 25% of the hockeyplayers. Surprisingly, players who took part in cooling down appeared to have a higher number of injuries than those who did not.     

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   

Export diversification,mean-reversion of exports,and stability of export–growth causality

ABSTRACT

This study proposes a five-step statistical procedure to examine a linkage among export diversification, mean-reversion of exports, and stability of the export–growth causality. This linkage was assessed for France, Norway, and Switzerland between 1980Q1 and 2016Q4. The findings indicated that the mean-reversion tendency of the export sectors in France and Switzerland was stronger than in Norway, which highlighted the important role of export activities for economic growth in France and Switzerland. Also, the causal relationship between exports and economic growth in Norway was found to be more unstable than in France, but more stable than in Switzerland.