Estimate Injury Rates Research Articles

Incidence and Player Risk Factors for Injury in Youth Football

To estimate the incidence of injuries in youth football and to assess the relationship between player-related risk factors (age, body size, biological maturity status) and the occurrence of injury in youth football. Prospective over two seasons. Two communities in central Michigan. Subjects were 678 youth, 9-14 years of age, who were members of 33 youth football teams in two central Michigan communities in the 2000 and 2001 seasons. Certified athletic trainers (ATCs) were on site to record the number of players at all practices and home games (exposures) and injuries as they occurred. A reportable injury (RI) was defined by the criteria used in the National Athletic Trainers' Association (NATA) survey of several high school sports. Estimated injury rates (95% confidence intervals) per athlete exposures (AE) and per number of athletes were calculated for practices and games by grade. Player risk factors included age, height, weight, BMI and estimated maturity status. Estimated injury rates and relative risks of injury during practices and games by grade; logistic regression to evaluate relationships between player-related risk factors and risk of injury. A total of 259 RIs, 178 in practice and 81 in games, were recorded during the two seasons. Practice injury rates increased with grade level, while game injury rates were similar among fourth through fifth grade and sixth grade players and about twice as high among seventh and eighth grade players. The majority of RIs during the two seasons was minor (64%); the remainder was moderate (18%) and major (13%). Injured fourth through fifth grade players were significantly lighter in weight and had a lower BMI; otherwise, injured and non-injured players within each grade did not differ in age, body size and estimated biological maturity status. Logistic regressions within grade revealed no significant associations between injury and age, height, BMI, and maturity status. Game injury rates are higher than practice injury rates, and the incidence of injury tends to increase with grade level. Age, height, BMI and maturity status were not related to the risk of injury in youth football players.

Injuries at Work in the US Adult Population: Contributions to the Total Injury Burden

We estimated the contribution of nonfatal work-related injuries on the injury burden among working-age adults (aged 18-64 years) in the United States. We used the 1997-1999 National Health Interview Survey (NHIS) to estimate injury rates and proportions of work-related vs non-work-related injuries. An estimated 19.4 million medically treated injuries occurred annually to working-age adults (11.7 episodes per 100 persons; 95% confidence interval [CI]=11.3, 12.1); 29%, or 5.5 million (4.5 per 100 persons; 95% CI=4.2, 4.7), occurred at work and varied by gender, age, and race/ethnicity. Among employed persons, 38% of injuries occurred at work, and among employed men aged 55-64 years, 49% of injuries occurred at work. Injuries at work comprise a substantial part of the injury burden, accounting for nearly half of all injuries in some age groups. The NHIS provides an important source of population-based data with which to determine the work relatedness of injuries. Study estimates of days away from work after injury were 1.8 times higher than the Bureau of Labor Statistics (BLS) workplace-based estimates and 1.4 times as high as BLS estimates for private industry. The prominence of occupational injuries among injuries to working-age adults reinforces the need to examine workplace conditions in efforts to reduce the societal impact of injuries.

Injuries in Youth Football

1885 PURPOSE: To estimate injury rates and variation in injury by grade, severity, type and position in a youth football population. Surveys of youth participants generally lack suitable exposure data for practices and competitions to permit estimates of injury rates. METHODS: Participants (n = 354, 9–14 years) in two community youth football leagues in mid-Michigan were followed throughout a single season, mid-August through October. Grade in school was the unit of competition. A certified athletic trainer was on sight for practices and home games to record exposure statistics and injuries as they occurred; injuries occurring in road games were reported by coaches and verified the next day by the trainers. The sample was split into younger (4–6th grades) and older (7–8th grades) groups for analysis. RESULTS: Estimated injury rates were significantly higher in 7–8th (16.2/1000 athlete exposures) compared to 4–6th (7.5/1000 athlete exposures) grades (p<0.001). Among 7–8th grade players, defensive linemen and defensive backs had a significantly higher frequency of injuries compared to respective positions in the 4th-6th grade players (p = .014). There were no significant differences in injuries by severity and type and in severity by position between the 4–6th and 7–8th grades. General trauma constituted 40% of all injuries (50% in 4–6th and 36% in 7–8th grades), and the majority of injuries were classified as minor (80% in 4–6th and 72% in 7–8th grades). CONCLUSIONS: Estimated injury rates increase with grade and probably age. Most injuries in youth football are minor and similarly distributed between grades. There are no clear trends in the distribution of injuries by type and in severity by position. Supported by the National Athletic Trainers' Association Foundation (Grant Number 300R001) and a Wohlgamuth Fellowship at Michigan State University.

Injuries in Youth Football

1885 PURPOSE: To estimate injury rates and variation in injury by grade, severity, type and position in a youth football population. Surveys of youth participants generally lack suitable exposure data for practices and competitions to permit estimates of injury rates. METHODS: Participants (n = 354, 9–14 years) in two community youth football leagues in mid-Michigan were followed throughout a single season, mid-August through October. Grade in school was the unit of competition. A certified athletic trainer was on sight for practices and home games to record exposure statistics and injuries as they occurred; injuries occurring in road games were reported by coaches and verified the next day by the trainers. The sample was split into younger (4–6th grades) and older (7–8th grades) groups for analysis. RESULTS: Estimated injury rates were significantly higher in 7–8th (16.2/1000 athlete exposures) compared to 4–6th (7.5/1000 athlete exposures) grades (p<0.001). Among 7–8th grade players, defensive linemen and defensive backs had a significantly higher frequency of injuries compared to respective positions in the 4th-6th grade players (p = .014). There were no significant differences in injuries by severity and type and in severity by position between the 4–6th and 7–8th grades. General trauma constituted 40% of all injuries (50% in 4–6th and 36% in 7–8th grades), and the majority of injuries were classified as minor (80% in 4–6th and 72% in 7–8th grades). CONCLUSIONS: Estimated injury rates increase with grade and probably age. Most injuries in youth football are minor and similarly distributed between grades. There are no clear trends in the distribution of injuries by type and in severity by position. Supported by the National Athletic Trainers' Association Foundation (Grant Number 300R001) and a Wohlgamuth Fellowship at Michigan State University.

Injuries among skiers and snowboarders in Quebec.

Snow sports such as skiing and snowboarding are recognized as hazardous, but population-based injury rates or specific risk factors have been difficult to estimate as a result of a lack of complete data for both numerator and denominator. We used data from 3 surveys to estimate the number of participants and annual number of outings in Quebec by age, sex, activity, and calendar year. Injuries reported by ski patrollers were used to estimate injury rates among skiers and snowboarders for the head and neck, trunk, upper extremity, and lower extremity. Head-neck and trunk injury rates increased over time from 1995-1996 to 1999-2000. There was a steady increase in the rate of injury with younger age for all body regions. The rate of head-neck injury was 50% higher in snowboarders than in skiers (adjusted rate ratio [ARR] = 1.5; 95% confidence interval = 1.3-1.8). Women and girls had a lower rate of head-neck injury (0.73; 0.62-0.87). Snowboarders were twice as likely as skiers to have injuries of the trunk (2.1; 1.7-2.6), and more than 3 times as likely to have injuries of the upper extremities (3.4; 2.9-4.1). Snowboarders had a lower rate of injury only of the lower extremities (0.79; 0.66-0.95). Snowboarder collision-related injury rates increased substantially over time. Except for lower extremity injuries, snowboarders have a higher rate of injuries than skiers. Furthermore, collision-related injury rates have increased over time for snowboarders. Targeted injury prevention strategies in this group seem justified.

Work-related injuries in residential and drywall carpentry.

Findings are reported on the first two years of an active injury surveillance project designed to test the utility of active injury investigations in identifying causes of injury among a large cohort of carpenters who did residential building and drywall installation. Occupational Safety and Health Administration recordable injuries were reported by participating contractors. Injured union carpenters were interviewed by experienced journeymen trained in a standard questionnaire protocol. Enumeration of workers and hours worked were provided by the union. These data allowed the definition of a dynamic cohort of 4429 carpenters, their hours worked, detailed information on the circumstances surrounding recordable injuries, and possible preventive measures from the perspectives of the injured worker and an experienced journeyman investigator. The overall estimated injury rate (16.9 per 200,000 hours worked) was considerably higher than recent Bureau of Labor Statistics rates despite less than complete ascertainment of injuries. Injuries most commonly involved being struck by or against something, manual materials handling injuries, and falls. Manual materials handling injuries often involved very heavy objects or tasks and were injuries carpenters most often reported needs for adequate help and coordinated team work to prevent. Falls from heights occurred from a variety of surfaces and were not just injuries of inexperience. Carpenters reported the need for more attention to common fall protection practices, such as the use of more toe boards and guardrails. Poor housekeeping was involved in the majority of same level falls, as well as some manual materials handling injuries.

BODY SIZE AND INCIDENCE OF INJURY IN YOUTH FOOTBALL

PURPOSE: To exmine body size (height, weight, body mass index) as a risk factor for injury in youth football and to estimate injury rates in a youth population. METHODS: Two community youth football leagues in mid-Michigan comprising 354 male youth football players, 9–14 years of age, were followed throughout the course of an entire season (mid-August through October). Teams were designated by grade level in school (4th û 8th grade). Heights and weights were measured at the beginning of the season and the body mass index (BMI) was calculated. Each league was covered by a certified athletic trainer throughout the entire season. Exposure data were recorded for practices and games, and injuries were documented during all practices and home games as they occurred. RESULTS: There was a difference in the likelihood of becoming injured by grade level, age, height, weight, and the BMI in the total sample. However, within grade groups, there was no difference in the likelihood of being injured. Injury rates were higher in games than in practices for all grade levels. Seventh and eigth grade teams had a higher estimated injury rate in practices and in games than 4th, 5th, and 6th grade teams. CONCLUSION: Even thought there is considerable variability in body size among youth football participants, body size per se does not seem to influence the likelihood of being injured in youth football.

A population-based assessment of pediatric all-terrain vehicle injuries.

To describe the types of injuries sustained by children who ride all-terrain vehicles (ATVs), to estimate the hospital charges associated with these injuries, and to determine adherence to existing rules and regulations governing ATV use. Analysis of statewide hospital admissions (1992-1996) and emergency department (ED) visits (1996) in Utah. All patients who were younger than 16 years and had an external cause of injury code for ATV use were included. In 1996, 268 ED visits by children involved an ATV. Boys were twice as commonly injured as girls (male:female ratio: 2.1:1), and skin and orthopedic injuries were most frequent. The median ED charge was $368, and ED charges for these patients totaled $138 000. From 1992 to 1996, 130 children were hospitalized as a result of injuries sustained during ATV use, with median charges of $4240 per admission. Male to female ratio was 2.7:1, and the average age was 11.2 +/- 3.6 years. Mean injury severity score was 8.0 +/- 6.0, and median length of stay was 2 days (range: 0-43 days). Orthopedic injuries were most frequent, but 25% (n = 32) of children sustained head or spinal cord injury. Most children (94%) were discharged from the hospital, but 8 children died as a result of their injuries. Utah regulations prohibit children who are younger than 8 years from driving an ATV and advise against carrying passengers on ATVs. However, 25% (n = 15) of all injured children who were younger than 8 were driving the ATV when injured, and 15% (n = 60) of injured children were passengers on ATVs. Four of the 8 fatally injured children were younger than 8, and all were driving the ATV at the time of the crash. Finally, the estimated injury rate per 100 registered ATVs is significantly higher for children than for adults (3.41 vs 1.71). ATV use results in significant injuries to children. Efforts to educate parents regarding the risks of ATV use, proper supervision, and use of safety equipment are warranted. Manufacturers of ATVs should continue to improve the safety profile of these inherently unstable vehicles.

Incidence and costs of 1987-1994 childhood injuries: demographic breakdowns.

Injuries pose a threat to health and well-being and are a major source of medical spending in the United States for children and youth 0 to 21 years of age. This study provides national estimates of the incidence of fatal and nonfatal childhood injuries and comprehensive cost estimates by age, gender, race, family income, metropolitan residence, and place of incident. Eight years of National Health Interview Survey data (1987 to 1994) were used to estimate nonfatal injury incidence rates among children and youth 21 years of age and younger. The survey documents all medically attended or temporarily disabling injuries within the 2 weeks before the interview. Injuries were defined as diagnoses 800-995 in the International Classification of Diseases, Ninth Revision, excluding late effects cases. Fatality counts came from 1994 Vital Statistics. Estimates of the costs of injuries (1994 US dollars) included medical spending, lost future work, and lost quality of life. Medical payments included spending on hospital and professional services, rehabilitation, prescriptions, home health care, and medical equipment. Lost future work and lost quality of life consisted of the present value of work that children will be unable to do as adults if they are killed or permanently disabled combined with the pain and suffering that children and their families experience because of the injury. Cost estimates excluded parental income losses from work missed, property damage, legal costs, and insurance claims-adjustment costs related to permanent disability and death. INCIDENCE. A total of 3,073 injury episodes for 3,058 children were obtained from 8 years of National Health Interview Survey data. This represents 20.6 million children in the United States who were injured each year, or approximately 25 per 100 children. This translates to 56,000 nonfatal injury episodes each day that require medical attention or limit children's activity. For fatal injuries, the rate was 38 children per 100,000. The nonfatal injury rate for males (mean: 30; 95% confidence interval [CI]: 29,31) was higher than the rate for females (mean: 20; 95% CI: 19,21); the fatal injury rate for males was more than twice that of females. Injury rates increased with age. Children 0 to 9 years of age had the lowest rate of nonfatal injury. Rates for nonfatal injury among children 0 to 4 years of age were lower (mean: 20; 95% CI: 18,21) than those for the 5 to 9 age group (mean: 22; 95% CI: 20, 23). However, the rate for fatal injuries (21 per 100,000) among the 0 to 4 age group was higher than the 5 to 9 age group (9 per 100,000). Nonfatal injury rates for children 10 years of age and older were higher, with the highest estimated injury rates in late adolescence (15-19 years; mean: 31; 95% CI: 29,33). Nonfatal injuries occurred at higher rates among white children (mean: 27; 95% CI: 26,28) than black children (mean: 19; 95% CI: 17,21) or children from other racial backgrounds (mean: 13; 95% CI: 10,16). The reverse was true for fatal injuries, with higher fatality rates among black children (59 per 100,000). Children in families with incomes under $5,000 had the highest rate of nonfatal injury (mean: 31; 95% CI: 27,35), followed by those in the $35,000 to $49,999 income range (mean: 25; 95% CI: 23,27). The rate of nonfatal injuries in the other income brackets were fairly similar, with those in the highest income bracket having the lowest rate (mean: 14; 95% CI: 13,15). Fatality rates by family income were not available. The nonfatal injury rate in nonmetropolitan areas (mean: 10; 95% CI: 9,11) was higher than in metropolitan areas (mean: 8; 95% CI: 7,8); the same was true for fatal injury rates (33 per 100,000 in nonmetropolitan areas vs 25 in metropolitan areas). Males consistently had higher injury rates than females across all places of injury. Youth 15 years of age and older had higher rates for injuries that occur on the public roads, in recreatio

Motor vehicle accidents in patients with an implantable cardioverter-defibrillator

This study was designed to examine driving safety in patients at risk for sudden death after implantation of a cardioverter-defibrillator. Cardioverter-defibrillators are frequently implanted in patients at high risk for sudden death. Despite concern about the safety of driving in these patients, little is known about their actual motor vehicle accident rates. Surveys were sent to all 742 physicians in the United States involved in cardioverter-defibrillator implantation and follow-up. Physicians were questioned about numbers of patients followed up, numbers of fatal and nonfatal accidents, physician recommendations to patients about driving and knowledge of state driving laws. Surveys were returned by 452 physicians (61%). A total of 30 motor vehicle accidents related to shocks from implantable defibrillators were reported by 25 physicians over a 12-year period from 1980 to 1992. Of these, nine were fatal accidents involving eight patients with a defibrillator and one passenger in a car driven by a patient. No bystanders were fatally injured. There were 21 nonfatal accidents involving 15 patients, 3 passengers and 3 bystanders. The estimated fatality rate for patients with a defibrillator, 7.5/100,000 patient-years, is significantly lower than that for the general population (18.4/100,000 patient-years, p < 0.05). The estimated injury rate, 17.6/100,000 patient-years, is also significantly lower than that for the general public (2,224/100,000 patient-years, p < 0.05). Only 10.5% (30 of 286) of all defibrillator discharges during driving resulted in accidents. Regarding physician recommendations, most physicians (58.1%) ask their patients to wait a mean (+/- SD) of 7.3 +/- 3.4 months after implantation or a shock before driving again. The motor vehicle accident rate caused by discharge from an implantable cardioverter-defibrillator is low. Although restricting driving for a short period of time after implantation may be appropriate, excessive restrictions or a total ban on driving appears to be unwarranted.

Compensating payments and hazardous work in union and nonunion settings

This paper extends the results of past research on estimated compensating payments and estimated injury rate equations for the union and nonunion sectors. It allows for both simultaneity in the determination of income and safety and structural differences in their determinants across the two sectors. Although union settings are found to maintain larger compensating payments for hazardous work than nonunion settings, they also appear to contain higher injury rates, all else constant. A fuller understanding of these results will require further analysis of the differing institutional mechanisms for compensation and safety determination in union and nonunion labor markets.

Ski Injuries in 1972-1973

During the 1972-1973 season, 792 consecutive skiing injuries were observed at a Vermont ski area. Injury data included type and site of injury, age, sex, and skiing ability. The estimated injury rate, 3.4/1,000 skier-days, was consistent with a 12-year rate. Ankle fractures and sprains have decreased, but upper extremity injuries have shown a corresponding increase. Intermediate and expert skiers were involved in a higher proportion of total injuries. These trends are explained by basic principles of energy transfer and improved ski equipment and education. ( JAMA 230:1423-1425, 1974)