Differences In Injury Risk Research Articles

Reactive Strength Index Scores Are Associated With Injury Risk And Game Performance In Female Collegiate Volleyball Players

PURPOSE: The reactive strength index (RSI) is a measure used by coaches to quantify an athlete’s explosiveness. The RSI score is calculated based on one’s drop vertical jump (DVJ) performance (RSI = jump height [m]/ contact time [sec]). The purpose of this study was twofold. The first purpose of this study was to evaluate the ability of preseason RSI scores to discriminate injury risk in female collegiate volleyball (VB) players. The second purpose was to evaluate correlations between preseason RSI scores and game statistics. METHODS: 117 female collegiate VB players representing 3 levels of competition participated. Reflective markers were applied to the pelvis and the lower extremities. Athletes performed 3 DVJ from a 30.48 cm box. Subjects were instructed to drop off the box, land with one foot on each force plate (BP 600600 force plate, ATMI, Watertown, MA), and then immediately upon landing jump as high as possible. Reflective marker and force data was collected simultaneously with an 11 camera Qualisys motion system (Gothenburg, Sweden) at 100 Hz for the 3D marker data and 1000 Hz for the force plates. Visual3D (C-Motion, Germantown, Maryland) was used to create the kinematics and kinetics. A receiver operator characteristic curve was constructed to identify a cutoff score for subsequent risk analysis. Relative risk was calculated to determine the difference in injury risk between two groups based on cutoff score dichotomization. The Pearson product-moment correlation coefficient was calculated to determine the relationship between preseason RSI scores and game statistics. RESULTS: Mean preseason RSI scores were 0.88 m/s (± 0.31). Athletes with a lower preseason RSI score (0.9125 m/s or less) were 4 times more likely (relative risk = 4.4 [95% CI: 1.0, 18.4]; p-value = 0.022) to experience a noncontact time-loss injury to the low back or lower extremities during the season. There was a significant correlation between preseason RSI score and kills/set (r = 0.369; p-value = 0.000) and points/set (r = 0.360; p-value = 0.000). CONCLUSIONS: The RSI measure should be collected as part of a preseason screening clinic to identify female collegiate VB players at risk for a noncontact time-loss injury to the low back or lower extremities. The RSI score could also be used by VB coaches when evaluating current and future athletes.

Are riders of electric two-wheelers safer than bicyclists in collisions with motor vehicles?

Electric two-wheelers (E2Ws) have become newly popular transportation tools with the associated growing traffic safety concerns. E2W riders and bicyclists behave similarly as vulnerable road users (VRUs), while exhibited dissimilarities in riding postures and interactions with the two-wheelers. Existing epidemiology reveals prominent differences in injury risks between E2W riders and other vulnerable road users in collisions with motor vehicles. The objective of this study is to investigate the factors influencing kinematics and head injury risks of two-wheeler rides in two-wheeler-vehicle collisions and compare between E2W-vehicle and bicycle-vehicle collisions. Via multi-body modeling of two two-wheeler types, two vehicle types, and three rider statures in MADYMO, twelve collision scenarios were developed. A simulation matrix considering a range of impact velocities and relative positions was performed for each scenario. A subsequent parametric analysis was conducted with focus on the kinematics and head injury risks of two-wheeler riders. Results show that the head injury risk increased with vehicle moving velocity, while the two-wheeler velocity and relative location between rider and vehicle prior to the collision exhibited highly non-linear influence on the kinematical response. The rider with larger stature had higher possibilities to miss head impact on the vehicle. In collisions with the sedan, E2W riders would sustain lower head injury risks with lower contacting velocity on the windshield than bicyclists. While in collisions with the SUV, E2W riders would sustain increasing head injury risks due to the higher structural stiffness at contact, and the risk level was about the same as bicyclists. The findings revealed the loading mechanisms behind the different head injury risks between E2W riders and bicyclists.

Relationships Among PlayerLoad, High-Intensity Intermittent Running Ability, and Injury Risk in Professional Rugby League Players.

To examine relationships among physical performance, workload, and injury risk in professional rugby league players. Maximal-effort (n = 112) and submaximal (n = 1084) running performances of 45 players were recorded from 1 club over 2 consecutive seasons. Poorer and better submaximal running performance was determined by higher and lower exercise heart rates, respectively. Exponentially weighted moving averages and daily rolling averages were used to assess microtechnology-derived acute and chronic field-based workloads. The associations among within-individual submaximal running performance, workload, and noncontact lower-limb injury were then investigated. The injury risk associated with poorer submaximal performance was "likely" greater than stable (relative risk = 1.8; 90% confidence interval, 0.9-3.7) and better submaximal performance (relative risk = 2.0; 90% confidence interval, 0.9-4.4). Compared with greater submaximal performance, poorer performance was associated with lower chronic workloads (effect size [d] = 0.82 [0.13], large) and higher acute:chronic workload ratios (d = 0.49 [0.14], small). Chronic workload demonstrated a "nearly perfect" positive relationship with maximal-effort running performance (exponentially weighted moving average, R2 = .91 [.15]; rolling average, R2 = .91 [.14]). At acute:chronic workload ratios >1.9, no differences in injury risk were found between rolling average and exponentially weighted moving average methods (relative risk = 1.1; 90% confidence interval, 0.3-3.8; unclear). Reductions in submaximal running performance are related with low chronic workloads, high acute:chronic workload ratios, and increased injury risk. These findings demonstrate that a submaximal running assessment can be used to provide information on physical performance and injury risk in professional rugby league players.

The association between disability and unintentional injuries among adolescents in a general education setting: Evidence from a Swedish population-based school survey

BackgroundUnintentional injuries are the leading cause of death among adolescents. Adolescents with disabilities may be particularly vulnerable with an increased risk of unintentional injuries. ObjectiveTo study the association between a set of disabilities and unintentional injury risks among adolescents, accounting for comorbidity, subjective disability severity and sex. MethodCross-sectional data from a Swedish national school survey including 4,741 students (15 and 17-year olds) conducted in 2016 was analyzed using log-binomial generalized linear models. ResultsWe found a 33% increased risk of injury the last 12 months and a 53% increased risk of injury leading to hospitalization for adolescents with any disability compared to their peers with no disability. The differences in injury risk were greater for girls than boys. There was a dose-response relationship between disability severity and injury risk. In analyses adjusted for sociodemographic factors and comorbidity, attention-deficit/hyperactivity disorder (ADHD) and epilepsy were associated with an increased risk of injury the last 12 months, risk ratios [RR] were 1.41 (95% Confidence Interval [CI] 1.08–2.97) and 1.79 (95% CI 1.10–1.81) respectively. Autism spectrum disorder was associated with a decreased injury risk the last 12 months (RR = 0.43, CI 0.2–0.92). ADHD, mobility impairment and visual impairment were associated with hospitalization due to injury during lifetime. ConclusionsThere was an increased risk of unintentional injuries for adolescents with disabilities compared to their non-disabled peers, specifically for individuals with ADHD, epilepsy, visual impairment and mobility impairment. Injury prevention strategies may include adapting the physical environment and medical treatment.

Gender differences in the spatial–temporal variability between walking and running

The pattern of gender differences in gait variability has not yet been well examined. The aim of the present study was therefore to investigate gender differences in the spatial–temporal variability between walking and running. Twenty healthy recreational active individuals (ten males/ten females) were instructed to walk for 5 min at a constant speed of 4.0 km/h and then run for 5 min at 8.4 km/h on a treadmill. Walking and running kinematic data were collected during the 5 min. CV of duration [F (1,18) = 7.61, p < 0.01], CV of rate [F (1,18) = 7.56, p < 0.01], and CV of stance [F (1,18) = 33.49, p < 0.001] were significantly greater during running comparing to walking in both genders. Furthermore, CV of swing was significantly greater through running compared to walking only in women p < 0.05. This study elucidates greater variability during running in females than males. The greater variability through running in females comparing to males might make them more prone to lower limb injury. These results may be useful in understanding the underlying mechanism contributing to differences in injury risk in males and females.

To Couple or not to Couple? For Acute:Chronic Workload Ratios and Injury Risk, Does it Really Matter?

We examined the association between coupled and uncoupled acute:chronic workload ratios (ACWR) and injury risk in a cohort of 28 elite cricket fast bowlers (mean±SD age, 26±5 yr). Workloads were estimated using the session rating of perceived exertion (session-RPE). Coupled ACWRs were calculated using a 1-week acute workload and 4-week chronic workload (acute workload was included in the chronic workload calculation), whereas uncoupled ACWRs used the most recent 1-week acute workload and the prior 3-week chronic workload (acute workload was not included in the chronic workload calculation). A nearly perfect relationship (R2=0.99) was found between coupled and uncoupled ACWRs. Using a percentile rank method, no significant differences in injury risk were found between the coupled and uncoupled ACWR. Higher ACWRs were associated with increased injury likelihood for both coupled and uncoupled methods, however there were no significant differences in injury risk between coupled and uncoupled ACWRs. Our data demonstrates that both coupled and uncoupled ACWRs produce the same injury likelihoods. Furthermore, our results are consistent with previous studies: higher ACWRs are associated with greater risk, irrespective of whether acute and chronic workloads are coupled or uncoupled.

Growing pains: Maturity associated variation in injury risk in academy football

Reducing injuries to youth players is of primary importance to academies, as injuries can result in a significant loss in both training and match time, as well as, negatively affecting player development. In total, 76 talented young football players were analysed over two full competitive seasons. The injury incidence and burden for all non-contact and overuse injuries were recorded. Exposure was calculated as the total number of competitive matches hours played. Somatic maturation was estimated by expressing the current height of each player as a percentage of their predicted adult height [Roche, A. F., Tyleshevski, F., & Rogers, E. (1983). Non-invasive measurements of physical maturity in children. Research Quarterly for Exercise and Sport, 54(4), 364–371.]. The period of circa-peak height velocity (PHV) (24.5 injuries per 1000 h) was associated with a significantly higher injury incidence rate and burden compared to pre-PHV (11.5 injuries per 1000 h; RR:2.15, 95%CI:1.37–3.38, P < .001). No significant differences in injury risk between maturity timing groups were observed. The interaction effect between maturity status and maturity timing confirmed there is a risk period circa-PHV, but this was not dependent on maturity timing. The main practical application of this study is that football academies should regularly assess the maturity status of young footballers to identify those players with increased susceptibility to injury. Moreover, academies should individualise training and injury prevention strategies based on maturation.

Prediction of injury risks and features among scooter riders through MADYMO reconstruction of a scooter-microvan accident: Identifying the driver and passengers

In dealing with a scooter-related traffic accident with rider death, it is necessary to identify the driver responsible for the accident. This study aimed to reconstruct the kinematics of a scooter–microvan accident involving three riders and explored the differences in injury risks and characteristics of the scooter driver and passengers. We reconstructed a real accident by using MADYMO multi-body simulation software. Moreover, we designed two-variable simulation experiments to analyze how the velocity and impact angle of the microvan are related to the injuries of the three riders. When the microvan speed is set at 18 km/h and that of the scooter is set at 28.8 km/h, the simulated kinematics correlates well with real accident data, and the impact positions and injury parameters correlate well with the actual injuries. When the impact angle is smaller than 30° and the microvan impact velocity is lower than 40 km/h, the head injury of the driver is more life-threatening than the corresponding injuries of the rear passengers. When the impact angle is 15° and the microvan impact velocity is in the range of 0–20 km/h, the femur fracture risk is higher for the driver than for passengers. As the impact angle increases to 45°, passengers have a higher risk of femur fracture than the driver in the velocity range of 0–10 km/h. This impact velocity range becomes 0–30 km/h at an impact angle of 60° and then 40–70 km/h at an impact angle of 90°. Our study shows that the multibody method can reconstruct accidents and predict the different injury features and risks between the driver and passengers, which is useful in identifying the driver.

Differences in injury risk and characteristics of injuries between novice and experienced runners over a 4-year period

ABSTRACTObjectives: Running is increasingly popular, but also carries a high injury risk, especially in novice runners. This study investigates differences in incidence and characteristics of running-related injuries (RRIs) between novice and experienced runners in the open population, in order to adapt to more specific needs for future prevention programs.Methods: Data were obtained from Injuries and Physical Activity in the Netherlands (IPAN), a Dutch questionnaire on injuries, physical activity, and sports. A representative sample of runners (n = 4621) from IPAN, including 1405 novice runners, was used to assess injury incidence rates, anatomical site, onset and need for medical attention of RRIs. Participants who started running during the past 12 months were defined as ‘novice’ runners. ‘Experienced’ runners are participants who had been running for more than 1 year.Results: Of the 4621 runners, 41,8% were female. The average age was 34.2 years. From 2010 to 2013, a total of 416 injuries were reported. The incidence of RRIs was significantly higher in novice runners compared with experienced runners: 8.78 (8.59–8.96) vs. 4.24 (4.11–4.37) per 1000 h running. In both novice and experienced runners, most RRIs were located at the knee (30.5%) and lower leg (17.8%), with the Achilles’ tendon less frequently injured in novice runners (2.3% vs. 8.4%, p = 0.031). Novice runners sustained more medical attention injuries (36.8%) than experienced runners (29.2%) (p > 0.132).Conclusions: In total, over 30% of all (novice and experienced) runners, suffered from RRI within 1 year. Novice runners reported more injuries per 1000 h of running in comparison to experienced runners. A tendency toward receiving medical attention more frequently was found in novice runners compared to experienced runners. In view of this higher injury incidence of RRIs and healthcare consumption in novice runners, more studies are needed to develop effective injury prevention programs for novice runners.

The Combined Effect of Cigarette Smoking and Fitness on Injury Risk in Men and Women.

Prior studies have identified cigarette smoking and low fitness as independent risk factors for injury; however, no studies have evaluated the combined effect of cigarette smoking and fitness on injury risk. To evaluate the combined effect of cigarette smoking and fitness on injury risk in men and women. This is a secondary analysis of data collected from US Army recruits (n = 2000) during basic combat training within the United States in 2007. Physical training and fitness, cigarette smoking, and prior injury data were obtained from questionnaires, whereas demographic and injury data were obtained from medical and basic combat training unit records. Chi-squared tests were used to assess differences in injury risk by fitness level and cigarette smoking. Relative risk values were calculated with 95% confidence intervals. The primary findings showed that smokers experienced 20%-30% higher risk of injury than nonsmokers. In addition, higher aerobic and muscular fitness was generally not protective against injury between least fit and more fit smokers. However, higher fitness was protective against injury between least and more fit nonsmokers, with least fit nonsmokers being 30%-50% more likely to experience an injury than fit nonsmokers. This study revealed that higher aerobic and muscular fitness was not protective against injury among smokers; however, it was protective against injury among nonsmokers. Further implementation of smoking cessation programs may be beneficial for military and civilian personnel who are required to be physically fit in order to carry out their job responsibilities. Male and female smokers experienced significantly higher risk of injury than nonsmokers. Although higher fitness is protective against injury in nonsmokers, the protective effect of fitness is lost among smokers. In an attempt to reduce injury risk among military and emergency personnel, smoking cessation programs should be further implemented among both more fit and less fit smokers.

Alternative reproductive strategies in white-throated sparrows are associated with differences in parasite load following experimental infection.

Immune defences often trade off with other life-history components. Within species, optimal allocation to immunity may differ between the sexes or between alternative life-history strategies. White-throated sparrows (Zonotrichia albicollis) are unusual in having two discrete plumage morphs, white-striped and tan-striped. Within each sex, white-striped individuals are more aggressive and provide less parental care than tan-striped individuals. We extended immunocompetence handicap models, which predict sex differences in immunity and parasitism, to hypothesize that infection susceptibility should be greater in white-striped than tan-striped birds. We inoculated birds of both morphs with malarial parasites. Contrary to our prediction, among birds that became infected, parasite loads were higher in tan-striped than white-striped individuals and did not differ between the sexes. Circulating androgen levels did not differ between morphs but were higher in males than females. Our findings are not consistent with androgen-mediated immunosuppression. Instead, morph differences in immunity could reflect social interactions or life-history-related differences in risk of injury, and/or genetic factors. Although plumage and behavioural morphs of white-throated sparrow may differ in disease resistance, these differences do not parallel sex differences that have been reported in animals, and do not appear to be mediated by differences in androgen levels.

Sex-related differences in coordination and variability among foot joints during running

BackgroundWomen, as compared with men, have a higher proportion of injuries in the ankle/foot region. However, the reason for this sex-related difference in foot injuries remains unclear. Recently, joint coordination and variability of coordination have been suggested to be a critical index for defining both the state of injury and the potential risk of injury. The purpose of this study was to investigate sex-related differences in coordination and variability among the foot joints during running.MethodsTwelve healthy men and 12 healthy women ran on a treadmill. A modified vector coding technique was used to identify coordination and variability among foot joints involving the shank, rearfoot, midfoot, and forefoot segments, and categorized into the following four coordination patterns: in-phase with proximal dominancy, in-phase with distal dominancy, anti-phase with proximal dominancy, and anti-phase with distal dominancy.ResultsThere were no differences in all spatiotemporal parameters and in the foot strike angle between men and women. Coordination of variability of the foot joints during running was similar between men and women, but the anti-phase with proximal dominancy in proportion of frontal rearfoot-shank vs. midfoot-rearfoot couple (men; 7.2%, women; 13.9%) and midfoot-rearfoot vs. forefoot-midfoot couple (men; 18.6%, women; 39.8%) in women was significantly increased compared to that in men. Other all coordination of the foot joints during running differed between men and women, and effect sizes of these parameters were all large.ConclusionThe results may be useful for understanding the underlying mechanism contributing to differences in injury risk in men and women, and may provide novel data on foot joint coordination and variability that could be used as reference data for both biomechanical and clinical running studies.

COL5A1 gene variants previously associated with reduced soft tissue injury risk are associated with elite athlete status in rugby

BackgroundTwo common single nucleotide polymorphisms within the COL5A1 gene (SNPs; rs12722 C/T and rs3196378 C/A) have previously been associated with tendon and ligament pathologies. Given the high incidence of tendon and ligament injuries in elite rugby athletes, we hypothesised that both SNPs would be associated with career success.ResultsIn 1105 participants (RugbyGene project), comprising 460 elite rugby union (RU), 88 elite rugby league athletes and 565 non-athlete controls, DNA was collected and genotyped for the COL5A1 rs12722 and rs3196378 variants using real-time PCR. For rs12722, the injury-protective CC genotype and C allele were more common in all athletes (21% and 47%, respectively) and RU athletes (22% and 48%) than in controls (16% and 41%, P ≤ 0.01). For rs3196378, the CC genotype and C allele were overrepresented in all athletes (23% and 48%) and RU athletes (24% and 49%) compared with controls (16% and 41%, P ≤ 0.02). The CC genotype in particular was overrepresented in the back and centres (24%) compared with controls, with more than twice the odds (OR = 2.25, P = 0.006) of possessing the injury-protective CC genotype. Furthermore, when considering both SNPs simultaneously, the CC–CC SNP-SNP combination and C–C inferred allele combination were higher in all the athlete groups (≥18% and ≥43%) compared with controls (13% and 40%; P = 0.01). However, no genotype differences were identified for either SNP when RU playing positions were compared directly with each other.ConclusionIt appears that the C alleles, CC genotypes and resulting combinations of both rs12722 and rs3196378 are beneficial for rugby athletes to achieve elite status and carriage of these variants may impart an inherited resistance against soft tissue injury, despite exposure to the high-risk environment of elite rugby. These data have implications for the management of inter-individual differences in injury risk amongst elite athletes.

The Association Between Fall Frequency, Injury Risk, and Characteristics of Falls in Older Residents of Long-Term Care: Do Recurrent Fallers Fall More Safely?

Although a fall is a necessary prerequisite to a fall-related injury, previous studies suggest that frequent fallers are at lower injury risk for a given fall. We tested the hypotheses that differences in protective responses or the circumstances of falls underlie differences in injury risk with fall frequency. We analyzed video footage of 897 falls experienced by 220 long-term care residents (mean age 82 ± 9 years) to identify the cause of imbalance, activity leading to falling, direction of fall initiation, balance recovery and fall protective responses, and occurrence of impact to the head or hip. We further obtained injury information from the facilities' fall registration. We used generalized estimating equation models to examine the association between quartiles of fall frequency, injury risk, and fall characteristics. Residents with the highest fall frequency group (Q4; ≥5.6 falls/year) were less likely to sustain an injury per fall. They were less likely to fall during walking and more likely to fall during stand-to-sit transfers. Residents in the lowest fall frequency group (Q1; <1.15 falls/year) were more likely to fall during walking, and walking was associated with an increased risk for injury. When compared to less frequent fallers, more frequent fallers had a lower risk for injury per fall. This appeared to be explained by differences in the circumstances of falls, and not by protective responses. Injury prevention strategies in long-term care should target both frequent and infrequent fallers, as the latter are more mobile and apt to sustain injury.

Injuries in Children with Autism Spectrum Disorder: Study to Explore Early Development (SEED).

This study examined caregiver-reported medically-attended injuries among 30-68 month old children with autism spectrum disorder (ASD) compared to general population (POP) and non-ASD developmental disorders (DD) controls in the Study to Explore Early Development. Injuries were common in ASD cases (32.3%) as well as POP (30.2%) and DD (27.8%) controls; most resulted in an emergency visit or hospitalization. After accounting for sociodemographic, health, IQ and behavior differences, odds of injury in ASD cases were significantly higher than DD controls but similar to POP controls. Attention problems mediated the relationships. Clinicians caring for children with both ASD and attention problems should consider providing targeted safety advice. Differences in injury risk between children with ASD vs. other developmental disorders need further study.

Risk factors for football injuries in young players aged 7 to 12years.

Football (soccer) is very popular among children. Little is known about risk factors for football injuries in children. The aim was to analyze potential injury risk factors in 7- to 12-year-old players. We collected prospective data in Switzerland and the Czech Republic over two seasons. Coaches reported exposure of players (in hours), absence, and injury data via an Internet-based registration system. We analyzed time-to-injury data with extended Cox models accounting for correlations on team- and intra-person levels. We analyzed injury risk in relation to age, sex, playing position, preferred foot, and regarding age-independent body height, body mass, and BMI. Further, we analyzed injury risk in relation to playing surface. In total, 6038 player seasons with 395295hours of football exposure were recorded and 417 injuries occurred. Injury risk increased by 46% (Hazard Ratio 1.46 [1.35; 1.58]; P<.001) per year of life. Left-footed players had a higher injury risk (Hazard Ratio 1.53 [1.07; 2.19]; P=.02) for training injuries compared to right-footed players. Injury risk was increased in age-adjusted taller players (higher percentile rank). Higher match-training ratios were associated with a lower risk of match injuries. Injury risk was increased on artificial turf (Rate Ratio 1.39 [1.12; 1.73]; P<.001) and lower during indoor sessions (Rate Ratio 0.68 [0.52; 0.88]; P<.001) compared to natural grass. Age is known as a risk factor in older players and was confirmed to be a risk factor in children's football. Playing surface and leg dominance have also been discussed previously as risk factors. Differences in injury risks in relation to sex should be investigated in the future.

CATASTROPHIC INJURY INCIDENCE RATES IN SOUTH AFRICAN RUGBY UNION: ARE THERE REGIONAL DIFFERENCES?

BackgroundSouth Africa has 14 Provincial Rugby regions ('Unions'). Although rugby-related catastrophic injuries have been reported at 2.0 per 100 000 players per year, the comparative risk between each of these...

Injury Patterns among Elite Football Players: A Media-based Analysis over 6 Seasons with Emphasis on Playing Position.

The study objective was to describe the types, localizations and severity of injuries among first division Bundesliga football players, and to study the effect of playing position on match and training injury incidence and severity, based on information from the public media. Exposure and injuries data from 1 448 players over 6 consecutive seasons were collected from a media-based register. In total, 3 358 injuries were documented. The incidence rate for match and training injuries was 11.5 per 1 000 match-hours (95% confidence interval [CI]: 10.9-12.2), and 61.4 per 100 player-seasons (95% CI: 58.8-64.1), respectively. Strains (30.3%) and sprains (16.7%) were the major injury types, with the latter causing significantly longer lay-off times than the former. Significant differences between the playing positions were found regarding injury incidence and injury burden (lay-off time per incidence-rate), with wing-defenders sustaining significantly lower incidence-rates of groin injuries compared to forwards (rate ratio: 0.43, 95% CI: 0.17-0.96). Wing-midfielders had the highest incidence-rate and injury burden from match injuries, whereas central-defenders sustained the highest incidence-rate and injury burden from training injuries. There were also significant differences in match availability due to an injury across the playing positions, with midfielders sustaining the highest unavailability rates from a match and training injury. Injury-risk and patterns seem to vary substantially between different playing positions. Identifying positional differences in injury-risk may be of major importance to medical practitioners when considering preventive measures.

Injury risks in schoolchildren with attention-deficit/hyperactivity or autism spectrum disorder: Results from two school-based health surveys of 6- to 17-year-old children in Sweden

IntroductionInjuries are one of the leading causes of death and disability among children in Sweden and attention-deficit/hyperactivity disorder (ADHD) has previously been associated with an increased risk of injury in pediatric populations elsewhere in the world. Current evidence regarding the possible link between autism spectrum disorder (ASD) and injury risk appears limited, even though some potentially risk-increasing symptoms overlap. The purpose of this study was thus to study the association between both ADHD and ASD concerning the risk of injury among Swedish schoolchildren. MethodsTwo samples were used: a population-based register study containing data from 18,416 children ranging from the ages of 6–17years collected by school nurses during 2012/2014 (Survey A), and a national cross-sectional study of 3202 ninth-grade children (~15years old) collected from 92 schools in 2011 (Survey B). The data were analyzed using χ2-tests and log-binomial generalized linear models to obtain risk ratios (RR), comparing cases reportedly affected by ADHD or ASD to unaffected controls. ResultsAfter adjusting for confounders, ADHD was associated with a 65% increased risk of injury (RR 1.65 [95% CI: 1.32–2.05] in Survey A, and a 57% increased risk of injury (RR 1.57 [95% CI: 1.27–1.95]) in Survey B. ASD was not significantly associated with any differences in injury risk (RR 0.81 [95% CI: 0.57–1.14]). ConclusionsThe results indicate that there is an elevated injury risk among Swedish schoolchildren with ADHD but not for children with ASD. Future studies should focus on causal mechanisms mediating the association between ADHD and injuries in order to facilitate injury prevention strategies. Practical applicationsParents and teachers of schoolchildren with ADHD should be made aware of the elevated injury risks associated with the diagnosis. Safety experts and injury control professionals should consider the development of specialized prevention strategies in order to reduce these risks.

A cohort study of regional migration and the risks of attempted suicide and violent assault injury

ObjectivesWe study the association between changing residence and risks of attempted suicide and violent assault injury in Alberta, Canada. Our primary objective is to understand whether a change in residence...