Injury Prevention Experts Research Articles

Mountain Biking Injuries Requiring Trauma Center Admission: A 10-year Regional Trauma System Experience

Mountain biking has become an increasingly popular recreational and competitive sport with increasingly recognized risks. The purpose of this study was to review a population based approach to serious injuries requiring trauma center admission related to mountain biking, identify trends and develop directions for related injury prevention programs. Three trauma centers in the Greater Vancouver area exclusively serve a major mountain bike park and the North Shore Mountains biking trails. The Trauma Registries and the patient charts were reviewed for mountain bike injuries from 1992 to 2002. The data were analyzed according to demographics, distribution, and severity of injuries, and need for operative intervention. Findings were reviewed with injury prevention experts and regional and national mountain-biking stakeholders to provide direction to injury prevention programs. A total of 1,037 patients were identified as having bicycling-related injuries. Of these, 399 patients sustained 1,092 injuries while mountain biking. There was a threefold increase in the incidence of mountain biking injuries over a 10-year period. Young males were most commonly affected. Orthopedic injuries were most common (46.5%) followed by head (12.2%), spine (12%), chest (10.3%), facial (10.2%), abdominal (5.4%), genitourinary (2.2%), and neck injuries (1%). High operative rate was observed: 38% of injuries and 66% of patients required surgery. One patient died from his injuries. Injury prevention programs were developed and successfully engaged the target population. Mountain biking is a growing cause of serious injuries. Young males are principally at risk and serious injuries result from intended activity and despite protective equipment. Injury prevention programs were developed to address these concerns.

THE RISK OF INJURY AND VEHICLE DAMAGE SEVERITY IN VEHICLE MISMATCHED SIDE IMPACT CRASHES IN BRITISH COLUMBIA

As occupant protection offered by new passenger vehicles has improved, there has been growing concern about the harm that some vehicle designs may inflict on occupants of other vehicles with which they collide. Preceding analyses of crash statistics have clearly demonstrated the incompatibility between passenger sedan cars (PS) and pick-up trucks (PU) involved in side impact crashes in British Columbia. A comparison of light truck and passenger car crashes in previous literature reveals that light truck vehicles inflict greater harm than passenger cars for a number of reasons including their greater weight, stiffer structure, and higher ride height. These features place occupants of passenger cars at a disadvantage should they be involved in a collision with a light truck vehicle. The injury risk for passenger sedan car occupants is greater than the risk for pick-up truck occupants in two-vehicle crashes (Odds Ratio (OR) 1.87; 95% Confidence Interval (CI) 1.38-2.52). In addition, the risk of vehicle damage severity was increased for passenger cars compared with pick-up trucks (write off vehicle-OR 5.35; 95% CI 3.75-7.63, severely damaged vehicles-OR 5.87; 95% CI 4.79–7.19, moderately damaged vehicles-OR 2.86; 95% CI 2.44–3.36). There is strong justification for injury prevention experts and policy makers to step up motor vehicle crash injury prevention advocacy by implementing evidence-based policies to reduce rates of injury as a result of passenger sedan cars and pick-up trucks involved in side impact crashes in the province of British Columbia.

Product-Oriented Approaches to Reducing Youth Gun Violence

Injury prevention experts have suggested that gun manufacturers could reduce youth violence by changing the design of guns. Product safety features could make guns more difficult for children to fire unintentionally and more difficult to use if stolen or obtained illegally. This article gives a brief history of efforts to make safer, smarter guns and assesses the potential of the product safety approach for reducing youth gun violence. Among the article's key findings: Research from the injury prevention field suggests that changing product design may be more effective in preventing injuries than trying to change personal behaviors; Existing product safety technologies for guns could reduce unintentional gun injuries, especially to young children. In addition, emerging technologies will enable gun manufacturers to "personalize" guns, which could prevent unauthorized users of any age from firing the weapons. Personalization could decrease access to guns by adolescents; Gun manufacturers have been slow to incorporate safety features into their products; but legislative, regulatory, and litigation efforts are under way to mandate safer guns. The authors envision a future when the law requires product safety features--including personalization--on all new firearms. These product safety features have the potential to reduce both intentional and unintentional firearm injury and death.

Scalding, Dust Mites and Lice, and Your Washing Machine

To the Editor. As part of routine anticipatory guidance, it is suggested that pediatricians counsel parents to keep tap water temperature below 120°F.1 In a recent article,2 a panel of injury prevention experts agreed that lowering hot water temperature was one of four of the highest priority strategies. This recommendation is supported by the fact that there are annually about 5000 hot tap water scalding injuries to children in the United States, according to the Burn Foundation.3Two problems with turning down the hot water temperature do occur. First, if one is interested in killing dust mites or lice in bedclothes or other fabrics, water at 140°F or more is required.4Furthermore, many automatic dishwashers will not operate properly at temperatures below 140°F. Detergent will be left on dishes and glasses (“etching”) and the dishwasher will eventually become plugged by the retained materials. Only in recent years have dishwashers become available with a feature that thermostatically heats the incoming water to higher temperatures.5 At present, Kenmore is the one washing machine manufacturer that produces a model with a similar feature.What is the solution to the problem? Memry Corporation6 of Brookfield, Connecticut, makes a device that attaches to faucets and automatically shuts off when the water temperature exceeds 120°F. Placing these devices in areas where children are likely to come in contact with hot water should provide the required safety without sacrificing the need for water at high temperatures for the dishwasher and washing machine. The price of these devices is not excessive (about $12 for sink faucets, $25 for tub faucets, and $14 for showerheads). Nonetheless, cost might be a problem for indigent families.For families without automatic dishwashers, the lower hot water temperatures could be used. Higher settings could be used for the times when hot water cycles are required for eliminating lice and mites from clothing. There would, of course, be the potential for a scalding accident while the higher setting was in place or if one forgot to turn down the higher setting after raising it.

Pediatric injury prevention counseling priorities.

Child health care providers have a unique opportunity to conduct injury prevention counseling but limited empirical evidence for choosing prevention strategies. Efficient use of time requires that prevention strategies of higher priority be discussed before lower priority strategies. Our aim was to assess consensus among experts about the prioritization of prevention strategies for office based injury prevention counseling for parents of children under age two. We used a modified Delphi technique with 23 childhood injury prevention experts nationwide. Participants were blinded to the identities of each other. The first questionnaire, distributed via facsimile transmission, consisted of open ended questions about prevention strategies participants believe should be included and their prioritization methods. The second questionnaire was closed ended and based on the results of the first. Seventeen injury problems and 21 prevention strategies were suggested for counseling. Participants emphasized environmental strategies over more active, educational ones. Motor vehicle occupant injuries and car seats were given high priority scores by all participants. Smoke detectors, lowering the hot water heater temperature, and pool fencing also received high priority ratings. Participants based their decisions on the severity of the injury, the frequency with which the injury occured, and the availability of environmental strategies. However, they disagreed about the relative importance of these factors. Time constraints and parents' inability to absorb information led them to suggest limiting, to fewer than four, the number of prevention strategies addressed at any one visit. This study illustrates areas of consensus as well as unresolved dilemmas about pediatric injury prevention counseling. A rational decision making approach to prioritizing elements of clinical counseling is needed. Meanwhile, clinicians can use the findings of this study to derive their own judgments.