Greater Risk Of Injury Research Articles

The effect of super-sized passenger vehicles on walking and cycling

BACKGROUND AND AIM: Passenger vehicles are putting on weight world-wide. We aim to estimate the effects of this trend on the safety and attractiveness of walking and cycling in cities, focussing especially on the spectacular rise of the light truck (known as a double cab ute in New Zealand). METHODS: Review of relevant literature, analysis of secondary data sets including new vehicle sales, the New Zealand Household Travel Survey and manufacturer data sheets, police crash data, thematic analysis of advertising and product promotion, ad hoc roadside survey. RESULTS:Light truck and SUV sales are increasing rapidly in most countries. Mostly these vehicles are promoted for carrying, towing and exploring off road. Travel surveys show that in fact most trips are not work-related and do not require special towing and carrying capacity. On the whole these vehicles seldom go off-road but are commonly used in cities for car-like trips, with higher emissions of NOx and CO2. With increasing mass and power, injury rates amongst occupants are falling, but the risk to other road users may be increasing: a pedestrian struck at ≥50 kph by a ute or SUV in New Zealand is 2.3 times more likely to be fatally injured than if struck by a car. The most popular ute in New Zealand (the Ford Ranger) occupies 30% more road space than the most popular car, and therefore more commonly obstructs footpaths and bike lanes and leaves a smaller gap when passing on narrow city streets. CONCLUSIONS:Passenger vehicles in New Zealand and many other countries are super-sizing: increased pollution, greater injury risk, and domination of road space make it even more difficult to promote walking and cycling in cities. KEYWORDS: active transport, physical activity, injury

Occupational Injuries among Latino/a Immigrant Cattle Feedyard Workers in the Central States Region of the United States.

Agriculture is a dangerous industry with high rates of occupational injuries. Immigrants comprise the majority of the hired agricultural workforce in the United States, and these workers may be at a higher risk for job-related injuries. This study addressed the frequency, characteristics, and risk factors of occupational injuries among Latino immigrant cattle feedyard workers. Data were collected through structured interviews with Latino immigrant cattle feedyard workers in Kansas and Nebraska (n = 243; 90.9% male). Descriptive statistics and logistic regression were used to identify risk factors for injury. Nearly three-fourths of participants (71.2%) reported having experienced one or more injuries in the past while working on a cattle feedyard. The most frequent types of reported injuries, including those not requiring medical care, were bruises/contusions (40%), cuts/lacerations (21%), and sprains/strains (12%). These injuries were mainly caused by animals/livestock (33%), chemicals (23%), falls (12%), and tools (9%). Significant risk factors for injury included male gender (OR 5.9), being over age 35 (OR 2.6), working on a large or an extra-large feedyard (OR 5.4), having 11 or more employees on the feedyard (OR 3.6), and working more than eight hours a day (OR 4.7). Having received safety training was also associated with greater risk of injury in a univariable model (OR 2.6). Cattle feedyard workers are at high risk for injury and require more effective preventive measures.

Stress analysis of the thoracolumbar junction in the process of backward fall: An experimental study and finite element analysis.

The aim of the present study was to evaluate the biomechanical mechanism of injuries of the thoracolumbar junction by the methods of a backward fall simulation experiment and finite element (FE) analysis (FEA). In the backward fall simulation experiment, one volunteer was selected to obtain the contact force data of the sacrococcygeal region during a fall. Utilizing the fall data, the FEA simulation of the backward fall process was given to the trunk FE model to obtain the stress status of local bone structures of the thoracolumbar junction during the fall process. In the fall simulation test, the sacrococcygeal region of the volunteer landed first; the total impact time was 1.14±0.58 sec, and the impact force was up to 4,056±263 N. The stress of thoracic (T)11 was as high as 42 MPa, that of the posterior margin and the junction of T11 was as high as 70.67 MPa, and that of the inferior articular process and the superior articular process was as high as 128 MPa. The average stress of T12 and the anterior margin of lumbar 1 was 25 MPa, and that of the endplate was as high as 21.7 MPa, which was mostly distributed in the back of the endplate and the surrounding cortex. According to the data obtained from the fall experiment as the loading condition of the FE model, the backward fall process can be simulated to improve the accuracy of FEA results. In the process of backward fall, the front edge of the vertebral body and the root of vertebral arch in the thoracolumbar junction are stress concentration areas, which have a greater risk of injury.

Sport participation and injury rates in high school students: A Canadian survey of 2029 adolescents

Introduction: The objective of this study is to examine sport and recreational (S&R) activity participation and injury rates (IR) in high school students (ages 14–19). Methods: High school students (N = 24 schools, n = 2,029; 958 male, 1,048 female, 23 identified ‘other’ or missing; ages 14–19) in Alberta completed a web-based survey during class (October 2018–March 2019). Students identified their top three sports for participation in the past year. Primary outcome measures included IR for (a) any S&R-related injury, (b) most serious S&R-related injury resulting in medical attention, and (c) most serious injury resulting in restriction from S&R for at least one day. Results: In total, 1763/2029 (86.89%) respondents [861/958 (89.87%) male, 886/1048 (84.54%) female, 16/23 (69.57%) identifying as ‘other’ or missing] participated in an S&R activity in the past year. Top sports for male participation were basketball (33.08%; 95% CI 27.67–39.00), ice hockey (20.46%; 95% CI 14.87–27.47), and soccer (19.42%; 95% CI 15.67–23.80). Top sports for female participation were dance (22.52%; 95% CI 17.98–27.82), basketball (18.32%; 95% CI 14.32–23.14), and badminton (17.84%; 95% CI 13.35–23.43). Of the 1,971 students completing the S&R injury question, 889 reported at least one injury during the past year [(IR = 45.10 injuries/100 students/year (95% CI 39.72–50.61)]. The medical attention IR was 29.09 injuries/100 students/year (95% CI 24.49–34.17) and time loss IR was 36.00 injuries/100 students/year (95% CI 30.47–41.93). Conclusions: High school student S&R IRs are high with 29% of adolescents reporting at least one medical attention injury within the past year. Injury prevention strategies targeting youth are necessary. Practical Application: Participation in S&R activities has multiple physical, psychological, and health benefits for adolescents, but some S&R activities also have greater risks of injury. This study informs the next sports to target for implementation of optimal prospective surveillance and injury prevention strategies among high school aged students.

INNOVATIVE USE OF CORRUGATED RUBBER DRAIN FOR NERVE PROTECTION

Background: Nerves are at great risk of injury during orthopaedic surgeries. Such injuries lead to major disability in patients. Based on the various studies on patients suffering from such injuries during surgeries, we studied a list of factors leading to intra-operative nerve injuries. One factor leading to such injuries is application of various materials around nerves to protect them, which may cause undue traction on nerves. Methods: We conducted a study in 25 patients operated for different fractures and used corrugated rubber drain to protect nerves during various surgical procedures. Results: With this innovative use of easily available corrugated rubber drain,we observed that none of our patients suffered from intra-operative nerve injury. observed that none of our patients suffered from intra-operative nerve injury. Conclusion: Our aim is to introduce the use of corrugated rubber drain to protect nerves from injuries during various surgical procedures. Although, a thorough understanding of anatomy, meticulous dissection and appreciation of pathoanatomy in fracture surgery is of utmost importance to reduce the risk of iatrogenic injuries.

Relationships Between Lateral Limb Bias, Turnout, and Lower Limb Injury in a Female Pre-Professional Ballet Dancer Population.

Dancers are known to have specific limb preferences when they dance and commonly experience lower limb injury, especially early in their training. The primary aim of this study was to determine and examine the relationships between lateral limb bias, perceived turnout profile, and lower limb injury history in female pre-professional ballet dancers using current definitions of lateral bias, leg dominance, and the concept of "working" and "supporting" legs in dance. A cross-sectional survey design with retrospective recall of 12-month injury history was employed. An online questionnaire was distributed to female dancers between the ages of 16 and 21 years who were training in classical ballet at the pre-professional level in Australia. The questionnaire gathered information regarding laterality, perceived turnout asymmetry, and self-reported 12-month injury profile. Descriptive and correlation analyses were employed to describe dancer profiles and determine relationships between the three variables. Thirty-two dancers participated. The majority of participants (67%) had right-side dominance and most indicated the right leg as their preferred supporting leg (86.7%) and working leg (60%). A total of 17 participants (53.1%) reported at least one injury in the preceding 12-month period and the side injured was significantly correlated with leg dominance (rS = 0.595, p = 0.012), with the majority of injuries also affecting the preferred supporting and working leg. Dancer perceptions regarding turnout range were correlated with their perceptions of leg dominance (rS = 0.556, p = 0.001), but no statistically significant associations were found between perceptions of turnout range and injury side. In pre-professional dancers, the dominant and the preferred supporting or working leg tend to be the same leg, and the results suggest that the dominant and preferred supporting and working leg of dancers are at greatest risk of injury.

INCIDENCE OF INJURIES IN SOCCER PLAYERS – MAPPINGFOOT: A PROSPECTIVE COHORT STUDY

ABSTRACT Introduction: Although the positive effects of physical activity on global health are well documented, sports practice is associated with a greater risk of injury; in professional soccer in particular, the risk is substantial. Objective: The primary objective of this study was to investigate the incidence of injuries among male athletes competing in the regional soccer championship. The secondary objective was to determine the prevalence of injuries. Methods: In this prospective cohort study, level of evidence II, the incidence and prevalence of injuries were assessed using an adapted version of the UEFA Champions League Study questionnaire. Results: This study included 310 male athletes from ten teams, aged 26.53±4.75 years, height 180.93±6.49 cm, and weight 79.32±8.29 kg, with a 4-month follow-up. Ninety-two injuries were recorded, representing a prevalence of 29.68% injuries. The body part most frequently injured was the lower limbs (86.9%). The main types of injuries were muscle tear/strain (37.0%), sprain/ligament (19.6%), and other injuries (14.1%). The injuries were mainly caused during run/sprint (33.7%), kick (12.0%) and jumping/landing (6.5%). The incidences of injuries were 15.88±8.57, 2.04±1.09, and 3.65±1.50 injuries/1000h of exposure during matches, training, and matches/training, respectively. Time-loss over the season was between 1 and 50 days, and the severity of the injuries was as follows: light (25%), minor (22.8%), moderate (43.5%) and severe (8.7%). Conclusion: This study suggests that there is a higher incidence of injuries during matches compared to training, among male regional soccer championship players. The lower limbs are the body part most affected, with a higher prevalence of rupture/strain in the thigh region, during running/sprinting. Level of evidence II; Prospective Cohort Study .

Influence of Side Uncertainty on Knee Kinematics of Female Handball Athletes During Sidestep Cutting Maneuvers.

Noncontact anterior cruciate ligament ruptures generally occur during unanticipated sidestep cutting maneuvers when athletes have their visual attention focused on the opponent. The authors investigated the influence of uncertainty related to the side to perform the sidestep cutting maneuver on knee kinematics of female handball athletes. A total of 31 female handball athletes performed the sidestep cutting maneuver during anticipated and uncertain conditions. During the uncertain condition, visual cues indicated the direction of the reactive sidestep cutting maneuver. Between-condition differences were compared using the Student t test for paired samples calculated with statistical parametric mapping. Lower knee flexion angle was detected during the uncertain condition compared with the anticipated condition for the nondominant limb (0%-8% of the sidestep cycle). Knee abduction was larger during the uncertain condition for both the dominant (15%-41% of the sidestep cycle) and nondominant (0%-18% of the sidestep cycle) limbs compared with the anticipated condition. The nondominant leg showed higher knee abduction (36%-68% of the sidestep cycle) during the uncertain condition compared with the anticipated condition. The athletes' approach velocity was slower during the uncertain condition. The uncertain condition impacted knee kinematics and potentially positioned the joint at greater risk of injury by decreasing the flexion angle in the nondominant leg and increasing the joint valgus bilaterally.

Infrared thermal imaging monitoring on hands when performing repetitive tasks: An experimental study.

The monitoring of infrared thermal images is reported to analyze changes in skin temperature in the hand fingers when repetitive work is performed to know which finger has a greater risk of injury, besides, the recovery time is analyzed regarding the initial temperature and its relationship with age, sex, weight, height if practice sports, and Body Mass Index (BMI) per individual. For the above, an experimental test was carried out for 10 minutes on a repetitive operation that takes place in the telecommunications industry and 39 subjects participated in which an infrared thermal image of the dorsal and palmar part of both hands was taken in periods of 5 minutes after the 10-minute test has elapsed. The results show that none of the participants recovered their initial temperature after 10 minutes of the experimental test. In addition, it was found that there is a relationship between skin temperature and sex, and that age influences the recovery of temperature. On the other hand, the thumb, index, and middle fingers have a higher risk of injury in the analyzed task. It is concluded that performing repetitive work with all the fingers of the hand does not show that all they have the same risk of injury, besides that, not all the variables studied affect the recovery of temperature and its behavior.

The Hammer and the Nail: Biomechanics of Striking and Struck Canadian University Football Players

This study sought to evaluate head accelerations in both players involved in a football collision. Players on two opposing Canadian university teams were equipped with helmet mounted sensors during one game per season, for two consecutive seasons. A total of 276 collisions between 58 instrumented players were identified via video and cross-referenced with sensor timestamps. Player involvement (striking and struck), impact type (block or tackle), head impact location (front, back, left and right), and play type were recorded from video footage. While struck players did not experience significantly different linear or rotational accelerations between any play types, striking players had the highest linear and rotational head accelerations during kickoff plays (p ≤ .03). Striking players also experienced greater linear and rotational head accelerations than struck players during kickoff plays (p = .001). However, struck players experienced greater linear and rotational accelerations than striking players during kick return plays (p ≤ .008). Other studies have established that the more severe the head impact, the greater risk for injury to the brain. This paper’s results highlight that kickoff play rule changes, as implemented in American college football, would decrease head impact exposure of Canadian university football athletes and make the game safer.

Sex Influence on the Functional Recovery Pattern After a Graded Running Race: Original Analysis to Identify the Recovery Profiles.

This study investigated the sex influence on the acute and delayed fatigue effects of a 20 km graded running race. Eighteen recreational runners, 10 women and 8 men, completed the race. The testing protocol included five sessions: a week before the race (PRE), 35 ± 15 min after (POST), 2 h, 2 and 4 days (2D and 4D) later. Each session included uni- and bilateral maximal isometric voluntary contractions of the knee extensors (MVC), a squat jump (SJ), and a drop jump (DJ). Acute and delayed muscle soreness (DOMS) were evaluated for the quadriceps, hamstring and triceps surae muscle groups. The 2D and 4D sessions included also a horizontal force-velocity test (HF-V) performed under five resistive conditions. For each test, a set of key variables was computed to characterize the lower limb functional recovery. Mixed ANOVA analyses revealed significant (sex × time) interactions, with larger acute drops for men in MVCs and earlier recovery for women in the bilateral MVC (p < 0.001) and DJ (p < 0.05) tests. Only women reported DOMS for the hamstrings at 2D (p < 0.001) and showed small improvements in pure concentric SJ (p < 0.05) and HF-V (p < 0.01) tests at 4D. As expected, DOMS disappeared prior to the complete functional recovery. These results confirmed the combined influence of testing task and sex on the functional recovery pattern while supporting a lesser and faster recovery in women. The originality of this study lies in the complexity and sex-dependence of the functional recovery pattern revealed by a multiple factorial analysis which was used to identify the most discriminating tests and variables in the recovery pattern. The obtained clusters highlighted some recovery profiles associated with greater risks of injury when starting to run again. However, the lack of sex × time interaction for normalized values emphasizes the major influence of men’s initially higher functional values compared to women.

Can prior instruction successfully alter the tackle type executed by a player?

The tackle is the in-game activity with the greatest risk for injury in collision sports. Qualitative match analysis has associated injury risk with tackle technique (e.g. tackle height, head position before contact). This exploratory study used gold-standard three-dimensional (3D) motion capture to investigate whether prior instructions to a tackler to execute different torso tackle types altered their tackle technique. Fifteen amateur-level rugby code players performed four sets of 10 tackle trials after instructions from an expert coach: two Australian National Rugby League (NRL) coaching manual instructions on upper and lower torso tackle height (UpperNRL, LowerNRL); and two novel variants that altered the tackler’s contact with the ball carrier’s upper torso ( UpperPop) via a vertical ‘pop action’, or mid-torso ( MidTorso) via increasing the contact height to the mid-torso. 3 D motion capture confirmed a favourable ‘head up and forward’ gaze focus on ball carrier before contact and a ‘straight back’ posture was more evident in UpperPop instruction than other instructions, with the least flexion for the head, trunk, trunk-pelvis, thoracolumbar and lumbopelvic (p &lt; 0.01). MidTorso also attained a more optimal ‘head up and forward’ and a ‘straight back’ posture than a LowerNRL (p &lt; 0.001). ‘Leg drive on contact’ revealed ankle, hip (p &lt; 0.01) and thigh angles (p &lt; 0.05) differences, likely to reflect the UpperPop ‘pop action’ instruction than other instructions. For coaches, this study demonstrated that amateur-level rugby-code players could follow instruction from an expert coach to execute tackling techniques within a session. Inclusion of tackle specific coaching instruction training program may be a viable injury reduction strategy.

Injury Rates in Major League Baseball During the 2020 COVID-19 Season.

Background:The 2020 Major League Baseball (MLB) season was drastically altered because of the COVID-19 pandemic. The changes included an extended layoff between March and July as well as a shortened preseason.Purpose/Hypothesis:To determine the incidence and epidemiology of MLB injuries in the abbreviated 2020 season compared with prior seasons. We hypothesized that there was an increase in the overall injury rate in the 2020 season compared with the 2018-2019 seasons and that it equally affected all body regions.Study Design:Descriptive epidemiology study.Methods:The MLB transactions database was queried to find players who had been placed on the injury list between 2018 and 2020. Injuries were categorized into upper extremity, lower extremity, spine/core, and other injuries. Incidence per 1000 athlete-exposures was calculated for the prior 2 seasons (2018-2019) and for the 2020 season separately. Incidence for each category was also calculated separately for pitchers and fielders. Incidence rate ratios (IRRs) and confidence intervals were used to compare injury rates in 2018-2019 versus 2020. The z test for proportions was used to determine significant differences between injury incidences.Results:In 2020, the overall incidence rate per 1000 athlete-exposures was almost twice the rate compared with the 2 seasons before COVID-19 (8.66 vs 5.13; IRR, 1.69 [95% CI, 1.53-1.87]; P < .001). Injury incidence increased similarly in 2020 for both pitchers (IRR, 1.68 [95% CI, 1.47-1.91]; P < .001) and fielders (IRR, 1.68 [95% CI, 1.45-1.96]; P < .001). Increases in injury incidence were seen in the upper extremity, spine/core, and other injury categories; however, the incidence of the lower extremity did not change significantly.Conclusion:There was a significant increase in injury incidence for both pitchers and fielders in 2020. Injury rates increased in anatomic zones of the upper extremity and spine/core but were not significantly changed in the lower extremity. The overall increase in injury rate suggests that irregular or insufficient sport-specific preparation prior to the start of the season placed athletes at a greater risk of injury when play resumed.

Accumulative Competitive Season Training Stress Affects Neuromuscular Function and Increases Injury Risk in Uninjured D1 Female Athletes.

Previous research has shown that acute competition training stress negatively affects neuromuscular function which can perpetuate a predisposition to injury. This study's aim was to investigate the effect of accumulated competition training stress effect on neuromuscular function and incidence of increased injury risk in uninjured female D1 soccer players. Neuromuscular function was evaluated in fifteen female division I soccer athletes who played >85% of competitive season competitions who were tested for mobility/stability, leg length symmetry, and vertical power at three different points across the competitive season (pre, mid, and post time blocks). Leg length symmetry was measured from the anterior superior iliac spine to the lateral malleolus prior to Y-balance testing. The Y-balance testing measures unilateral anterior, posteromedial, and posterolateral reach achieved in single leg stance using metrics that include L/R normalized composite reach (NCOMP), L/R normalized antiorior reach (NANT), and L/R NCOMP/NANT segmental differences across time. Injury risk was evaluated using validated objective criteria that included: (NCOMP total reach <94% of limb length*3), (NANT reach distance <84% leg length) along with NCOMP and NANT asymmetries >4.0. Maximal vertical power (MVP) was measured via vertical jump. Multiple repeated measures ANOVAs evaluated NCOMP, NANT, MVP, and leg length symmetry across time with LSD post hoc testing when relevant (X ± SD). A significant main effect was found [F(1, 14) = 62.92, p < 0.001; η2 =0.82] with training stress and neuromuscular function without affecting maximal vertical power. Eighty percent of subject's bilateral NCOMP scores fell below the YBT reach standard at midseason (ES = 0.95, p = 0.02) while all subjects NANT reach distance remained below the reach threshold (ES = 0.74, p = 0.003) indicating a 6.5× and 2.5× greater injury risk, respectively. Competition stress affected neuromuscular function without affecting maximal power, which negatively impacted stability and increased injury risk.

Training Young Horses: The Science behind the Benefits.

Simple SummaryOf common debate among equine professionals and enthusiasts alike, is whether entering race training at two years of age is detrimental or beneficial to the animal’s career and growth. This literature review evaluates epidemiological studies to elucidate that two-year-old horses are not at greater risk of injury compared to older horses. Horses which enter race training at two years of age are, in fact, found to have greater earnings and longer race careers. This review also tackles the impact that exercising an animal at two years of age or younger has on bone, articular cartilage, and tendons. Numerous studies on growing animals have found confinement to be detrimental to normal musculoskeletal growth. However, exercise of dynamic nature in moderate distances, such as that attained with pasture access or prescribed sprints, is beneficial to musculoskeletal development and may prevent injuries when entering race training. Based on scientific evidence, the research cited in this review supports the training and racing of two-year-old horses and advises caution in the use of medications such as corticosteroids.Conflicting research and anecdotal evidence have created disagreement among equestrians as to whether two-year-old horses should be trained and raced. The objective of this literature review is to evaluate epidemiological studies, as well as physiological data on equine bone, articular cartilage, and tendons to better determine the impact of training and racing two-year-old horses. The evaluation of numerous studies on the topic provides evidence that a horse which is trained or raced as a two-year-old has a lower risk of injury and better adapted tissues for the rigors of racing. Unfortunately, the current prolific use of pain-mitigating substances in the racing industry does place horses, including young cohorts, at greater risk of injury, and should be used with caution.

High baseball loads induce shoulder and elbow injuries among high school baseball pitchers: a prospective study

Studies on the relationship between baseball loads (practice, training, and competition hours) and shoulder and elbow injuries among high school pitchers are limited. Therefore, this study included 92 male high school baseball pitchers and evaluated their preseason shoulder and elbow conditions. All participants completed a self-recorded questionnaire regarding baseball load, presence of shoulder pain or elbow pain, or both, and pitching limitations due to shoulder and/or elbow pain experienced daily to determine the occurrence of injuries and record the baseball load. The optimal load cutoff value was determined using a receiver operating characteristic curve analysis. Participants were categorized into high-load and low-load groups according to the aforementioned cutoff value. The Kaplan–Meier method was used to obtain time-to-event curves, and cox proportional hazards models were used to calculate the hazard ratios for injury rates. The cutoff value of the average baseball load was 324.4 min per day. A high load (> 5.5 h/day) led to a 2.6-times greater risk of injuries and 3.3-times earlier occurrence of injuries than a low load (< 5.5 h/day). Therefore, a high load is a risk factor for shoulder and elbow injuries in high school baseball pitchers.

A small number of daily pitches induces shoulder and elbow injuries among high school baseball pitchers: a prospective study

Baseball players frequently injure their shoulders and elbows. Preseason risk factors for such injuries have been relatively well studied, but in-season risk factors are less known, and the relationship between the number of pitches and the incidence of such injuries in baseball pitchers of any level is unclear. Identifying the risk factors related to the number of daily pitches is particularly important to prevent baseball-related arm injuries among young pitchers. Thus, we prospectively investigated the relationship between the number of daily full-power pitches in high school baseball pitchers and the incidence of shoulder and elbow injuries. We observed that a small number of daily full-power pitches, < 30 pitches per day, in high school baseball pitchers, significantly increased the risk of shoulder and elbow injuries: these players had a 2.3-times greater risk of injuries and a 45-day earlier occurrence of injuries than those pitching ≥ 30 pitches per day. Although unexpected, this was plausible as continuous daily pitching is required to maintain physical condition in growing and maturing high school pitchers. These findings may form the basis for establishing guidelines regarding the appropriate number of daily pitches required to prevent shoulder and elbow injuries in high school baseball pitchers.

Opportunities for improving the safety of dairy parlor workers

One aspect of a successful dairy business is attracting and retaining skilled staff. The ability to do this is influenced by workplace attractiveness, one aspect of which is worker comfort and safety. Working with heavy machinery and animals makes dairy farming a dangerous occupation relative to many other sectors. Milking is the most time-consuming task on pasture-based dairy farms, and the parlor is the logical site of a number of injuries, although little is known about their causes or their relationship to parlor design and management. To investigate worker safety further, we conducted an on-farm survey on New Zealand dairy farms between December 2018 and March 2019. The survey had 3 objectives: to identify common causes of injuries relating to milking; to describe variations in milking parlor design and management practices on dairy farms; and to identify management and parlor factors that contribute to milking injuries. Analysis of accident compensation data from the state-run accident insurer for a 5-yr period from July 2013 to June 2018 was a fourth objective. Accident claims identified as related to milking through a key word search averaged NZ$252 (NZ$1 was equivalent to US$0.60 on May 19, 2020) per claim for non-severe injuries and NZ$9,334 per claim for severe injuries, for a total of NZ$1.95 million per year. A total of 136 injuries were reported on 99 of the 560 farms surveyed, and accident insurance claims were made for 53 of these injuries. The survey found that 48% of injuries occurred while workers were attaching clusters: typically soft-tissue and fracture injuries to fingers, hands, wrists, and arms. Injuries to these body parts represented the greatest cost (51% of the annual insurance cost) and identified safe cluster attachment as an area of focus for reducing milking injuries. Potential low-cost solutions include improved cluster design and a hand-arm guard. We identified a clear seasonal trend that coincided with busy periods in a seasonal block calving system, suggesting that options to reduce fatigue in spring may be beneficial; however, the number of hours worked or number of consecutive days worked were not associated with the number of milking injuries. Those aged 20-29 yr had more injuries relative to their proportion of the workforce, indicating that more training may be beneficial (e.g., setting ergonomic milking routines). Female workers were at greater risk of injury than males; this finding may have been related to the height of the animal relative to the height of the milker.

Injury risk curves in far-side lateral motor vehicle crashes by AIS level, body region and injury code

Objective The objective of this study was to develop injury risk curves as a function of change in vehicle velocity for occupants in far-side lateral motor vehicle crashes (MVCs) by AIS level, body region, and specific AIS codes that commonly occur in this crash mode. Methods The National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) years 2000–2015 database was queried, resulting in 4,495 non-weighted far-side crashes. For each case, occupant age, sex, and the following metadata were collected: vehicle model year, vehicle body type, lateral delta-v, normalized PDOF, multiple impacts, belt use, seat position, object contacted, striking vehicle body type, maximum crush extent and side airbag deployment. Multivariable logistic regression was used to develop risk curves for AIS 2+ through 5+ injuries, AIS 2+ injuries by body region (head, thorax, lower extremity), and for each of the 10 most frequent far-side AIS 2+ injuries. Significant covariates were determined by backwards elimination (p < 0.05). The full dataset and a subsampled dataset of only cases with side airbag deployment were used to develop risk curves. Results For AIS 2+ through 5+ injury, greater delta-V was associated with greater injury risk (OR’s: 2.48–3.66 per 11.9 kph increase) and belt use was associated with lower risk (OR’s: 0.04–0.36 compared to unbelted). Multiple impacts were significant predictors of increased AIS 3+, 4+ and 5+ injury risk (OR’s: 2.56, 2.27 and 2.83 compared to single impact). For AIS 2+ body region injuries, lateral delta-V and maximum CDC extent were positively associated with increased head, thorax and lower extremity injury risk while belt use was associated with lower risk. Increased lateral delta-v, unbelted status, and greater maximum CDC extent frequently increased injury risk for the most common far-side injuries. Side airbag deployment was not a significant covariate for the injury risk models. Conclusions The resulting risk models expand upon previous literature gaps to provide a more comprehensive view of contributors to injury risk for occupants in far-side MVCs. This study yields risk curves based on the latest available NASS-CDS data.

Comparison of injuries in multiple and single event crashes

Objective: Compare injuries for occupants in multiple event (ME) crashes where a less severe event preceded a more severe event to occupants in similar single event (SE) crashes. Methods: Occupants in ME crashes from NASS-CDS years 2000–2015 where the most severe event occurred subsequent to a less severe event were matched to occupants in SE crashes where the SE was similar to the most severe event in the ME crash. Occupants were matched based on occupant, vehicle, and crash characteristics and were compared across 21 detailed body regions using conditional logistic regression. Finite element (FE) simulations were performed with human surrogate models (detailed GHBMC and Hybrid III) and in both low- and high-speed conditions (n = 8 total simulations). At each speed, the crash simulations with both human body models reproduced a common multidirectional ME crash scenario, where the second impulse was more severe and similar to the SE impulse. Relative injury risk was assessed, and ME versus SE were computed and compared to those from the field data. Results: 1,663 ME occupants were matched to 3,217 SE occupants. ME occupants had higher MAIS2+ and MAIS3+ injury risk, and showed directionally higher injury risk in all but one body region. Eleven out of the 27 injury groups had higher injury risk in ME (false discovery rate (FDR)<0.1; all p-values < 0.0427). Increased injury risk was seen in some injuries to the head, thorax, lumbar spine, shoulder, and lower extremity (odds ratios >1.54). In FE simulations, ME displayed larger anterior and lateral displacement compared to SE. Head and thorax injury risk was increased in ME simulations by up to 5-fold. The detailed GHBMC and Hybrid III exhibited different kinematics and injury risk across all simulations, as did low- and high-speed conditions. Conclusions: The field data and FE simulations suggest that a first, less severe crash event results in occupants having greater injury risk when they are involved in a second, more severe crash event than if they were involved only in the second event. Several factors could cause this increase in injury risk, such as improper interaction with safety systems and airbags after the first event renders the occupant out-of-position.