Home-related injuries among under-five-year children and mothers' care regarding injury prevention in rural areas

This cross-sectional study was conducted in rural areas of Twiserkan (Toyserkan) County, in Iran, to assess factors associated with home-related injuries among under-five-year children and their mothers’ care regarding injury prevention. Mothers who had their under-five-year-old children injured within a 12-month period were identified from recorded information in Twiserkan Health Center. Then, data were gathered using pre-tested questionnaire and through interview with injured children's mothers. The questions were about characteristics of the children's injuries and their mothers’ care regarding injury prevention, using PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation) model with focus on knowledge and attitude; enabling and reinforcing factors; and mothers' preventive behaviours. The study results showed that 197 out of 210 total identified mothers took part in the study. The reported injuries were 11.68%, 39.09%, and 49.24%, respectively, for severe, moderate, and mild cases. Fall was the most frequent injury with 35%. Among PRECEDE model constructs, there was a statistically significant correlation between mothers' knowledge and injury severity among children. Home-related injuries are an important health problem among study population and their prediction and prevention are necessary. Enhancement of mothers’ knowledge can be helpful to improve child injury prevention.     

An epidemiological study of injury in a low socioeconomic context: implications for prevention

Epidemiological information identifying injury magnitude and risks is vital for the development of prevention and safety promotion programmes, especially for low income, marginalised communities where the incidence of injury tends to be disproportionately high. This paper, accordingly, reports on a household survey, conducted in an informal settlement southwest of Johannesburg, South Africa, and designed to gather epidemiological data for the purposes of informing the development of appropriate community-based injury prevention and safety promotion programmes. Data were collected for a one-year period prior to October 1998. An analysis of the data identified the causes of injuries, which residents were most at risk, and where and when injuries most often occurred. By way of conclusion, we make a few recommendations for preventive measures.     

Valuing consumer safety

Snowboarding is quickly becoming a popular sport at alpine resorts. In contrast to alpine skiing, where injuries to the knee and thumb are most common, the wrist (and forearm) and ankle are the most frequently injured body regions for snowboarders. Unfortunately, the rapid international growth of the sport has not been matched by detailed epidemiological evaluation of the injuries specific to snowboarding or the countermeasures to prevent them. The aim of this paper is to critically review the literature describing injury prevention measures, or countermeasures, for snowboarding. In doing so, it provides an evaluation of the extent to which these countermeasures have been demonstrated to be effective or associated with the occurrence of new types of injuries. Few countermeasures specific for snowboarding were found to have been formally evaluated. The countermeasures to which some attention has been paid are boots, bindings, wrist guards, skill level and methods of falling. Skill level and the other injury countermeasures apply more generally across the sport. Recommendations for countermeasure implementation include: education for snowboarders, adherence to snow conduct and safety codes, preparing snowboarders for their activity and maintenance of parks and runs. Recommendations for improved data collections include: standardising and maintaining existing data collections, collecting information about equipment used by snowboarders and monitoring injury trends. Further biomechanical and epidemiological research needs to be undertaken on knee/ankle and wrist/forearm injuries. Evaluation of countermeasures needs to keep pace with the rapid developments in this field. Particular attention should be directed towards evaluations of the role of wristguards, boots/bindings, fall technique and lessons in preventing injuries. Given the rapidly increasing popularity of the sport, the need for the safety equipment to be evaluated would seem to be a priority, along with identification of the mechanisms of injury.     

Vulnerability of motorcycle riders and co-riders to injuries in multi-occupant crashes

In developing countries, most motorcycles are ridden with more than one occupant. The objective of this study was to establish the relative vulnerability of riders and co-riders to injury and determine the injury risk factors in multi-occupant motorcycle crashes. Between January and December 2010, we collected crash and injury data from victims of multi-occupant motorcycle. It is a hospital-based study. The probability of sustaining injuries was similar for co-riders and riders, but co-riders were more likely to sustain severe injuries. Occupants of >2-occupant motorcycles were also more likely to be involved in risky behaviours like not wearing helmet and speeding than those on 2-occupant motorcycles. Occupants of motorcycles on which there were more than two occupants were at an increased risk of sustaining injuries compared with occupants of motorcycles with only two occupants (OR: 2.1, 95% CI: 1.1–4.3). Motorcycle co-riders were more vulnerable to severe injuries than riders. The significance of the study finding to prevention was discussed.     

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.     

Study of kite string injuries in Western India

A prospective analysis of 104 patients (outdoor and indoor) with manja (powdered glass coated kite string) injury from January 2011 to January 2015 was carried out at Civil Hospital Ahmedabad. All patients were analysed for mode and severity of injury, site of injury, associated injuries, activity being performed when injury occurred, the clinical diagnosis and treatment required. Analysis of collected data revealed that majority of the injuries occurred while driving or in pedestrians with the neck being the most commonly affected body part. Males were more commonly affected with most of the victims in the age group of 16–45 years. Injuries sustained while driving tended to be more severe. All injuries were recorded in the month of January. No deaths were reported, but potentially fatal injuries did occur. Most of the injuries were superficial and could be prevented or mitigated by either protective clothing or by use of protective devices on vehicles, which should be implemented to reduce the morbidity of such injuries in the future. There were no ethical issues or vested interests associated with the study.     

Knowledge,attitudes, and practices of family physicians and nurses regarding unintentional injuries among children under 15 years in Cairo,Egypt

Unintentional injuries are a leading cause of death among children, especially in developing countries. Lack of reliable data regarding primary health care professionals' role in childhood unintentional injury prevention hinders the development of effective prevention strategies. A survey of 99 family physicians and nurses from 10 family health centres sought to develop insight into their knowledge, attitudes, and practices regarding unintentional injury prevention for children <15 in Cairo, Egypt. Approximately, 60% were familiar with the terms unintentional injuries and injury prevention. Falls and road traffic crashes were identified as primary causes of childhood injuries by 54.5%. While >90% agreed injury prevention counselling (IPC) could be effective, only 50.5% provided IPC. Lack of time and educational materials were the leading barriers to provision of IPC (91.9% and 85.9%, respectively), while thinking counselling is not part of their clinical duties was the least perceived barrier (9.1%). There is a large disconnect between providers' knowledge, attitudes and practices regarding IPC, more training and provision of counselling tools are essential for improving IPC by Egyptian medical providers.     

On the epidemiology of injury in developing countries: A one-year emergency room-based surveillance experience from León,Nicaragua

Background Regularly available data has been shown to be inadequate for developing, implementing, and evaluating injury prevention and control programs in Nicaragua. A specific prevention-oriented local injury surveillance system has therefore been set up in the city of León. Objectives The aim of this paper is to describe the epidemiology of fatal and non-fatal injuries over a one-year period in a well-defined local population in Nicaragua, as emerging from the perspective of emergency room and inpatient treatments over a one-year period. Methods A hospital-based injury surveillance system was established to collect data for different levels of severity. All treated unintentional and intentional injuries were registered, including information on the external causes according to the ICD-9. Results Of all emergency room visits, 15.9% (9,970) were injuries. For every death due to injuries, there were 31 hospital admissions and 253 emergency room visits. Home and street/roads were the main arenas for the accidents. The estimated underreporting rate was about 6%, and in 20.3% of the cases, no E-code was assigned. The overall incidence and mortality rates were 56.2 per 1,000 and 20 per 100,000 inhabitants, respectively. However, comparison with a parallel household survey showed that the reporting rate of the surveillance system is only about 9%. The overall ratio of male to female injury rates was 2.1 to 1. The main causes of non-fatal injuries were falls, whereas the main cause of death was traffic accidents. Conclusions Hospital discharge and emergency room data systems are effective and feasible means for collecting the data needed to prevent injuries. However, in a country like Nicaragua with limited access to hospital health services, it is necessary to supplement such a system with additional sources of information in order to gain a more comprehensive picture of injury occurrence.     

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.     

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.     

Deaths and hospitalisation from fireworks injuries

Statement of the Problem Little is known about the severity of fireworks injuries and no international reviews have been conducted. This study aimed to document and describe the severity of fireworks injuries and the implications for prevention in several countries. Method This retrospective epidemiological study of fireworks-related deaths and hospitalisations obtained injury surveillance data and vital statistics from Australia, the Netherlands, New Zealand and the United States. Of three further countries approached, none was able to supply the full dataset. Results From 1991 to 1995, there were 22 deaths involving fireworks in the United States, 5 in the Netherlands and none in Australia or New Zealand. Except in 1994, the Netherlands had higher admission rates from fireworks injuries than Australia, New Zealand and the United States. Overall, Australia experienced the lowest admission rates. Australian injuries may also have been less severe. Males and children &lt;15 years of age accounted for most admissions. Fatal injuries were mostly to males aged 15-44 years. Conclusions Deaths from fireworks injuries are rare in Australia and New Zealand. Differences in rates and in some characteristics of admitted cases were observed between countries. This study should serve as a benchmark and a pilot to future studies. International comparisons will require enhanced epidemiological data, possibly by collaborative prospective data collection, with appropriate quality control, rather than routinely collected data. Such studies should include developing countries, where the manufacture and use of fireworks is widespread. Since differences may relate to regulatory control and exposure, these should be documented.     

Economic analysis of injury prevention--applying results and methodologies from cost-of-injury studies

Injuries pose an economic problem of immense proportion to communities in every society. The economic burden from injuries can be quantified through cost-of-injury studies, using techniques adopted from cost-of-illness research. This study explores the feasibility of applying results and methodologies from existing cost-of-injury studies in economic analyses of injury prevention interventions and programmes. The literature on cost-of-injury studies and economic appraisals of injury prevention efforts was examined to elicit studies that calculated injury costs. Studies were accepted for inclusion if they included an analysis of the costs of all injuries occurring in a geographical area (community, region or country) during a specific time period, employed a societal perspective and an incidence-based costing approach and were conducted in industrialized countries. There were 12 studies that met the inclusion criteria. The average total cost per injury case was USD $3536, while the average share of indirect to total cost per injury case was 71%. However, the cost figures showed wide variation across the studies. Based on the limited similarity of findings from the studies, it was concluded that it is not feasible to apply results and methodologies from existing cost-of-injury studies. The cost estimators described in this study could possibly be adapted for use as reference points in economic analyses of existing programmes, but any other uses should be approached with caution. Locally obtained data are needed for reliable economic analyses of injury prevention interventions and programmes.     

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   

Economic analysis of injury prevention – applying results and methodologies from cost-of-injury studies

Injuries pose an economic problem of immense proportion to communities in every society. The economic burden from injuries can be quantified through cost-of-injury studies, using techniques adopted from cost-of-illness research. This study explores the feasibility of applying results and methodologies from existing cost-of-injury studies in economic analyses of injury prevention interventions and programmes.

The literature on cost-of-injury studies and economic appraisals of injury prevention efforts was examined to elicit studies that calculated injury costs. Studies were accepted for inclusion if they included an analysis of the costs of all injuries occurring in a geographical area (community, region or country) during a specific time period, employed a societal perspective and an incidence-based costing approach and were conducted in industrialized countries. There were 12 studies that met the inclusion criteria.

The average total cost per injury case was US$3536, while the average share of indirect to total cost per injury case was 71%. However, the cost figures showed wide variation across the studies. Based on the limited similarity of findings from the studies, it was concluded that it is not feasible to apply results and methodologies from existing cost-of-injury studies. The cost estimators described in this study could possibly be adapted for use as reference points in economic analyses of existing programmes, but any other uses should be approached with caution. Locally obtained data are needed for reliable economic analyses of injury prevention interventions and programmes.     

Patterns of injuries and motor-vehicle traffic accidents in Athens

The extremely high cost of motor-vehicle accidents in public health leads to the necessity of a better injury data collection in the Accident and Emergency Hospital Departments. The 'Asclepeion' of Voula Hospital covers the southeastern suburban areas of the greater Athens area (1,000,000 population). The aim of this study is to present information on the pattern of injuries in Athens, in order to understand the magnitude of the problem and develop rational prevention programmes. Specially trained health visitors of the Emergency Department Injury Surveillance System (EDISS) interviewed in person every injured victim who was brought into the Emergency Service of the 'Asclepeion' of Voula Hospital. The study was performed during a 3-year period, from 1996 to 1998; 4564 persons were interviewed. Traffic accidents were more frequent on weekdays with a seasonal peak in July and among young Greeks (aged 25 - 34 years). The usual type of injuries seen in vehicle-accident victims were cerebral contusion and concussion, while in motorcycle-accident victims, head contusion and fractures. The most common reasons for the accident were excessive speed, poor condition of road, inattention, abstraction or drowsiness and drug effects. A total of 29.8% of motorcycle drivers and 5.7% of motorcycle passengers wore a helmet and 26.3% of car drivers and 14.1% of car passengers were using seatbelts. The identification of road traffic injury patterns can contribute to the development of injury prevention measures and guide rational preventive interventions that can reduce the incidence of these injuries. The EDISS system established at 'Asclepeion' of Voula Emergency Service can provide useful and accurate information about this serious and multidimensional problem of Greek Public Health.     

Using local injury surveillance for community-based injury prevention: an analysis of scandinavian WHO safe community and canadian safe community foundation programmes

Injury surveillance is widely recognized as a critical prerequisite for effective injury prevention, yet few studies have investigated its use by community-based injury prevention programmes. This study examined the extent to which local injury data were collected, documented, analysed, linked to injury prevention action and used for evaluation among WHO Safe Communities in Scandinavia (25 programmes) and the Canadian Safe Community Foundation (SCF) network (16 programmes). For each programme, a key informant with relevant local knowledge was selected to respond to an emailed questionnaire. The study demonstrates that community-based injury prevention programmes experience difficulties accessing and effectively utilizing local injury surveillance data. The findings suggest that the responding SCF programmes approach injury prevention more scientifically than the Scandinavian WHO-designated Safe Community programmes, by making greater use of injury surveillance for assessment, integration into prevention strategies and measures, and evaluation. Despite study limitations, such as the low response rate among Canadian programmes and a large number of non-responses to two questions, the results highlight the importance of, and need for, greater use of local injury surveillance.     

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.     

The mortuary as a source of injury data: progress towards a mortuary data guideline for fatal injury surveillance

To help bridge the obstacle of inadequate injury fatality data in low and medium income countries (LMICs) a simple cost effective system for mortuary surveillance of fatal injuries is being developed in consultation with the WHO. This will inform, direct and monitor injury prevention (IP) interventions and policies in LMICs. This article uses CDC's 'attributes of a successful surveillance system' to describe the process, the barriers and solutions in development of this mortuary data guideline. The consultative process utilised generated feedback from key stakeholders including forensic pathologists, Ministry of Health officials and injury prevention experts. An International Advisory Group was also convened to guide the guideline development. These assisted the adjustment of the proposed guideline to maximise flexibility, acceptability and stability; whilst minimising resource implications. Representativeness and the securing of government support perhaps remain the most significant challenges. Consultation with the advisory group and the wider stakeholders has been effective in developing a widely acceptable, user-friendly, low resource data form to gather useful data. Further strategies to overcome barriers need to be developed over the course of the pilot study and this should be done in consultation with the advisory group and stakeholders.