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.     

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.     

Compulsory child restraint seat law and motor vehicle child occupant deaths and injuries in Japan 1994-2005

The purpose of child restraint seats (CRS) is to reduce the number of individuals killed or injured in motor vehicle (MV) crashes. Japanese Road Traffic Law 17-3-4 (April 2000) specifies a requirement that CRS be used for all children aged 0-5 years. The objective of this evaluation was to determine the legislative impact on fatalities in Japan for the period 1994-2005. Data were obtained from the Institute for Traffic Accident Research and Data Analysis. A time-series Poisson regression model was used to analyse the change (6 years pre/post) in incidence rate ratios of fatality and injury in MV crashes among children ages 0-5 years. Despite increases in CRS use, fatalities failed to decrease significantly after enactment of the law (incidence rate ratio: 0.80; 95% CI: 0.49-1.31). In 2005, 67% of children aged 0-5 years, who were killed as MV occupants were not seated in CRS. Between 2000 and 2005, the lack of CRS led to 43% of front seat passenger deaths, 54% of rear seat deaths, 143 children died in total and 500 + children were seriously injured. It was found that the compulsory CRS law enacted in April 2000 did not result in a statistically significant reduction in child MV occupant fatalities and injuries in Japan.     

Preventing unintentional childhood injury at home: injury circumstances and interventions

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.     

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.     

Risk factors and geographical heterogeneity in unintentional home injuries incidence rate: new evidence based on Multiscopo survey in Italy

Home injuries together, with road traffic accidents, are estimated to be the third cause of death in Italy (Arokiasamy and Krishnan 1994). However, as in most other countries, in Italy there is a lack of information on home injuries and on how differences in geographical patterns may influence the scope and magnitude of this phenomenon. By analysing a multipurpose large survey (Multiscopo) carried out annually, geographical heterogeneity in home injuries incidence rate can be investigated. The aim of this study is the assessment of possible differences in geographical patterns among the Italian regions making use of a re-analysis of Multiscopo home injury data. The study results show that Italian regions differ greatly in the number of home injuries. The geographical heterogeneity may be due to the unemployment rate and the incidence of poverty that is greater in the Southern and Insular regions than in other zones. Other socio-economic variables such as alcohol consumption can increase the risk of injury in the home. To prevent them it could be useful to organize campaigns aimed at increasing the awareness among people about this problem.     

Seating position and patterns of severely injured body parts among child passengers in motor vehicle crashes: Japan as a distinct case

ABSTRACT

This study describes injury patterns and outcomes related to the seating position of child passengers involved in motor vehicle crashes in Japan. Using data obtained from a national trauma registry database, we compared the occurrence of injuries by body parts, length of hospital stay and in-hospital deaths between front-seating and rear-seating among children. We analysed 166 children aged 0–5 years and 205 children aged 6–12 years. No significant differences were observed between front- and rear-seating for injured body parts, length of hospital stay or in-hospital deaths in the 0–5-year-old victims. Among those aged 6–12 years, rear-seating was associated with a higher incidence of head and chest injuries but the length of stay or in-hospital deaths did not differ. These findings contrast those of previous studies, which found that rear-seating reduces injury risk, possibly attributed to low age-appropriate restraint use among school-aged children in Japan.     

Incidence,patterns and risk factors for injuries among Ugandan children

There is limited epidemiological data on childhood injuries in developing countries. This study assessed the incidence, patterns and risk factors for injuries among children aged 0–5 years in Wakiso District, Uganda. To determine differences, chi-square and Wilcoxon rank sum tests were used. Risk factors were assessed using Poisson regression. Overall, information from 359 children of mean age 32 months (SD: 18.4) was collected. Annual incidence of injuries was 69.8 per 1000 children/year (95% CI 58.8–80.8). One fatal injury due to burns was reported. Incidence of injuries was less associated with being female (IRR: 0.56, 95% CI 0.34–0.90) and increasing age of the caretaker (IRR: 0.96, 95% CI 0.92–0.99). The high incidence of childhood injuries necessitates the need for interventions to reduce injuries among children.     

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   

Motala Municipality - a sustainable Safe Community in Sweden

An extensive research project concerning injury prevention was planned and initiated in Motala Municipality in the early 1980s. This article summarises 25 years of work for injury prevention and safety promotion in Motala. Evaluation of both process and effect were conducted based on a quasi-experimental study design, as well as cost-effectiveness and cost-benefit analyses of interventions. Initial evaluations results showed an annual incidence of injuries of 118.9/1000 citizens in 1983/1984 consisting of injuries at home (35%), sports injuries (18.9%), injuries at work (13.7%), traffic-related injuries (12.8%) and other injuries (19.5%). The annual social economic costs of injuries were estimated at 116 million Swedish crowns (SEK). By 1989, after two years of preventive work, the incidence of injuries was reduced by 13%. The greatest decrease was among the moderate severity category of injuries (41%). The social economic costs were thereby reduced by 21 million SEK per year. Since then, work with injury prevention has continued and annual evaluations have shown that the incidence of injuries, with some fluctuation, has continued to decrease up to the latest evaluation in 2008. The total decrease during the study period was 37%. This study shows that community-based injury prevention work according to the Safe Community model is a successful and cost-effective way of reducing injuries in the local community.     

The pattern and predictors of intentionally inflicted injuries on Greek adults; data from an Emergency Injury Surveillance System (EDISS)

Background Intentional injuries due to violence are both a social and a public health problem in most societies. This study assesses the patterns and some of the sociodemographic determinants of violence-related injuries among Greek adults. Methods Data recorded by the Emergency Department Injury Surveillance System (EDISS) during the two-year period 1996-1997 were used. This database relies on all age injury data collected in the emergency departments of three sentinel hospitals, covering both urban and rural population areas. Results Among 52026 recorded injuries, 1322 (3%) were violence related, excluding self-inflicted injuries, while the majority of injuries (28269) were attributed to home and leisure accidents. Weapons of any type were used only in 5% of violence-related injuries. In comparison to home and leisure injuries, the intentionally inflicted injuries occurred more frequently among men, among those 25-54 years old, and were particularly common among migrants and during late night and early morning hours. Violence-related injuries frequently occur in pubs, restaurants, cafeterias and other places of entertainment. However, 52% of violence-related injuries among women occurred at home. Intentional injuries were generally more severe than unintentional ones. Conclusions We conclude that violence is not a negligible public health problem in the Greek population, but is considerably less serious than in most other developed countries. In particular, firearms-related injuries represent a very small fraction of the generally low incidence of violence-related injuries in this Mediterranean country.     

New directions in injury surveillance: Development of a model for continuous monitoring of direct medical costs

Information on the costs of injuries is an important additional instrument in setting priorities for injury prevention. The importance of this instrument is increasingly being recognized by health policy makers. The objective of this study was to develop a model which continuously monitors the direct medical costs of injuries in The Netherlands. This model should provide information on the direct medical costs of injuries at any time and for any selection of injury categories. It is an incidence-based model according to the ‘bottom up’ principle. Homogeneous patient groupings with respect to health care use are defined. The groupings are based on existing classifications from the literature and the experience of medical experts, and are defined by means of seven criteria: nature of care provided, body region of the injury, type of injury, severity of injury, age, complications, and sex of the patient. Several cost elements are distinguished (e.g., general practitioner help, hospital care, nursing home care). For each cost element, relevant patient groupings are determined. The new Dutch Injury Surveillance System (LIS) for injuries treated in an A&E department is an important source for incidence data. This article presents the design of the model as adopted by the Working Group on the Costs of Injuries of the European Consumer Safety Association (ECOSA).     

Parental beliefs about supervising children when crossing roads and cycling

Pedestrian and cyclist injuries are significant public health issues, together accounting for 11-30% of road deaths in highly motorised countries. Children are particularly at risk. In Australia in 2009 11.4% of pedestrian deaths and 6.4% of cyclist deaths comprised children aged 0-16 years. Parental attitudes and level of supervision are important to children's road safety. Results from a telephone survey with parents of children 5-9 years (N?=?147) are reported. Questions addressed beliefs about preventability of injury, appropriate ages for children to cross the road or cycle independently and the frequency of holding 5-9 year old children's hands while crossing the road. Results suggest that parents believe most injuries are preventable and that they personally can act to improve their own safety in the home, on the road, at work, as well as in or on the water. Most parents (68%) indicated children should be 10 years or older before crossing the road or cycling independently. Parents were more likely to report holding younger children's hands (5-6 years) when crossing the road and less likely to do so for 7- to 9-year olds. There was a small effect of child gender, with parents more likely to hold a boy's hand than that of a girl.     

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.     

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.     

Parents' perceptions, attitudes and behaviours towards child safety: a study in 14 European countries

Injury is the leading cause of death for children 0- 19 years of age in Europe, accounting for 3.1 deaths per 10 000 children per year. The youngest children of the ages 0-4 years require the most protection in this age group, with 2.5 injury-related deaths per 10 000 children in Europe annually. As parents are the primary caregivers of children, it is necessary to learn more about parents' perceptions, attitudes and behaviours towards child safety. This study presents the findings of a 14-country study in Europe on this theme. A quantitative survey of parents of children aged 5 years or under was performed in 14 EU member states in order to enable better targeting of prevention efforts aimed at educating parents. The total sample size was 2088. The results show that 95% of parents reported that they personally take measures to avoid accidental injury to their children. Their top concern with regard to safety of their children was children being hit by a car. The most common response, when asked why some parents find it difficult to protect their children from accidental injury, was not being able to watch their children constantly. Lack of awareness or knowledge about the causes of accidents was the second response. Two-thirds of parents would like to see more help from the government to prevent childhood injuries. Three-quarters of parents agreed that child injuries can be avoided. It was concluded that parents want to be better informed about the causes of child accidents and about actions they and society can take to reduce injury-related risks to children.     

The Stockholm Manifesto. Creating a safe environment for children in Europe

The European Child Safety Alliance is an initiative of the European Consumer Safety Association with a network of child injury prevention organizations within 25 Member States in Europe. The Alliance, launched in 2001, focuses on strategies that assist in the reduction of injury related deaths and disability amongst children 0 to 18 years of age in the European Union Members States. The Alliance work is done in partnership with stakeholders from various disciplines involved in child injury prevention in order to promote a coordinated and consistent approach across Europe.