Injury Prevention Measures Research Articles

The financial cost of injuries and their association with team success in professional men's cricket.

To quantify the direct and indirect costs associated with injuries in professional men's cricket from 2015/16 to 2021/22 and to report the association between the cost of injuries and team success. Retrospective cohort study. Injury insurance claims were obtained for cricket-related injuries to determine direct costs. Player's salary cost whilst injured was calculated from total salary expenditure, number of players, seasonal days and days lost to injury from prospective injury recording. A linear mixed model was used to assess the association between team success (County Championship points) and cost of injury. The average annual total cost of injuries per team was £167,447 (±£20,678), comprising £38,127 (±£24,000) injury insurance costs, £40,007 (±£23,977) injured players salary costs and £89,243 medical staff costs. Hand injuries incurred the highest number of claims and lumbar spine injuries accounted for the largest cost. Approximately 7 % of players' annual salary was earned whilst injured. The cost of injury was negatively associated with team success in Division 1; those with a two SD higher injury cost (£58,561) accrued 28 fewer points (95 % CI -54, -2) on average. The association in Division 2 teams was unclear (two SD increase (£53,339): +15 points [95 % CI: -10, 41]). These data support the implementation of effective injury prevention measures for lumbar spine, hand and knee injuries to reduce injury rates and subsequent costs. Highlighting the financial and team performance costs of injuries may help to engage key stakeholders in injury prevention initiatives.

Male-assisted training and injury patterns: hypergraph-enhanced analysis of injuries in women's water polo.

The aim of this study is to compare the injury patterns of female water polo players before and after the implementation of the Male-Assisted Female Training (MAFT) program. The study seeks to identify key factors influencing these changes and propose corresponding injury prevention measures. We utilized pattern analysis and classification techniques to explore the injury data. A Hypergraph Neural Network (HGNN) was employed for pattern extraction, where each athlete was represented as a node in a hypergraph, with node dimensions capturing high-order relational embedding information. We applied the graph Laplacian operator to aggregate neighborhood features and visualize structural and feature differences in hypergraphs based on different influencing factors. Additionally, we introduced graph structure regularization to improve classification accuracy and prevent overfitting in the relatively small dataset, enhancing our ability to identify critical factors affecting injury types. The analysis revealed significant differences in injury patterns before and after the MAFT program, with specific influencing factors being identified through both pattern recognition and classification techniques. The classification models, supported by graph structure regularization, achieved improved accuracy in distinguishing key features that contributed to changes in injury types. These findings provide insights into the critical factors influencing injury patterns in female water polo players and highlight the effectiveness of the MAFT program in mitigating certain injury risks. Based on the identified features, we propose targeted preventive measures to reduce injury incidence, particularly in relation to changes brought about by the MAFT training mode. Further research is needed to refine these measures and explore their long-term effectiveness.

“Retrospective epidemiological study on musculoskeletal injuries in amateur football athletes in Greece”

ABSTRACT Injuries in football affect team performance, players’ quality of life, and careers. While research mainly targets professionals, limited data exists for amateur players, especially in Greece. Methodological differences and variations in preparation and technique make applying professional injury data to amateurs uncertain. This study aimed to investigate the injury profile, sports history, and training routines of amateur male football players in Greece over one competitive season. It was conducted as a retrospective cross-sectional study using an electronic questionnaire to survey 222 amateur players aged 18–44 years. Among them, 70.7% reported at least one injury. A total of 220 injuries were recorded, with an incidence rate of 5.3 injuries per 1000 hours of play. Most injuries occurred during matches, predominantly affecting the lower limbs, with the posterior and inner thighs being the most common injury sites. Players were found to be 6.6 times more likely to sustain injuries in matches (12.1 injuries/1000 hours) than in training sessions (1.8 injuries/1000 hours). Strains were identified as the most common type of injury, often resulting from running/sprinting. These findings underscore the importance of implementing specific injury prevention measures in amateur football leagues in Greece to minimise the risks and severity of injuries among players.

Analysis of Concussions with Persisting Symptoms Caused by Motor Vehicle Crashes in 136 Vehicle Occupants Shows that Females Are Vulnerable Road Users.

At the Canadian Concussion Centre, we treated 136 patients from 2000 to 2020 who sustained concussion plus persisting concussion symptoms (C+PCS) as motor vehicle occupants involved in motor vehicle crashes (MVCs). This center specializes in the treatment of patients with C+PCS. The objective of the present study was to identify strategies for preventing concussion among vehicle occupants involved in MVC. Indeed, this is the first study focused on C+PCS in MVC occupants, and our main purpose was to evaluate the effectiveness of onboard concussion prevention strategies. In this retrospective, consecutive cohort of 136 patients with C+PCS, we examined the patients' demographic and injury features in relation to the nature of the MVC including speed, direction of impact, and availability, deployment, and effectiveness of onboard occupant safety measures including seatbelts, head restraints, and airbags. The most frequent combination of factors was a belted female driver of an automobile struck from behind by another automobile. Surprisingly, the entire patient cohort comprised more females (69.1%) than males (30.9%), and rear-end collision was the most common type in females. Most injured occupants of both sexes were wearing seatbelts, but only a minority of the crashes caused airbag deployment. The seven most common symptoms were headache (84.6%), anxiety (72.8%), sensitivity to light (70.6%), memory problems (69.9%), sensitivity to noise (66.2%), irritability (56.6%), and depression (55.9%). Whiplash was a frequent associated injury in both sexes. Complete recovery from C+PCS was rare, and most patients with known follow-up continued to suffer from persisting symptoms for months to years. The median symptom duration for all 136 patients was 30.0 months (interquartile range: 16.8-56.0 months). Based on these findings, we conclude that females are indeed vulnerable road users with respect to C+PCS, and our literature search showed that there had been some previous evidence of increased injury risk of other injuries in female occupants. We recommend that additional prevention strategies are required to reduce the post-crash acceleration-deceleration "bobble-head" movement of the head on trunk causing both concussion and whiplash as has been accomplished in auto racing. Also, these prevention measures must be investigated in crash studies that include low-to-high speed rear-end collisions using anthropometrically appropriate models of male and female occupants reflecting the range of sizes of both sexes. There is a need for more concussion brain injury prevention research focusing on the vulnerability of female occupants, which has not been sufficiently addressed even though the deficiency was identified many years ago. The sex inequity of current onboard motor vehicle concussion brain injury prevention measures especially with respect to females should be addressed by governments and the automobile and insurance industries.

Mechanisms and control measures of low temperature storage-induced chilling injury to solanaceous vegetables and fruits.

Low temperature storage is widely used for storage and transportation of fruits and vegetables after harvest. As a cold-sensitive fruit vegetable, post-harvest solanaceous vegetables and fruits are susceptible to chilling injury during low temperature storage, which reduces its sensory quality and edible quality and shortens its storage period, thus leading to huge economic losses. Therefore, it is an essential to clarify the occurrence mechanism of chilling injury caused by low temperature storage in solanaceous vegetables and fruits, and to propose corresponding prevention and control measures for chilling injury. In recent years, a series of progress has been made in the research on chilling injury prevention and control and low temperature stress tolerance of solanaceous vegetables and fruits. This paper describes the chilling injury symptoms of postharvest solanaceous vegetables and fruits, clarifies the physiological and biochemical mechanisms in the chilling injury process, the molecular mechanisms, and prevention and control measures, and summarizes the latest research advancements on chilling injury and chilling tolerance regulation of solanaceous vegetables and fruits, which can provide valuable references for low temperature storage and chilling injury prevention and control measures of solanaceous vegetables and fruits.

The advance of research on rhythmic gymnastics

This study conducted a systematic review of the existing literature on rhythmic gymnastics. Through searching databases such as PubMed, Web of Science, and Scopus, 37 out of 2319 articles were selected, covering training and physical fitness, nutrition and metabolism, as well as sports injuries and rehabilitation. The findings revealed that: (1) Core physical training significantly enhanced athletes’ performance; (2) Inadequate nutritional intake was prevalent; (3) The incidence of sports injuries was high, particularly those resulting from overtraining. The conclusion emphasizes the need to enhance strength training, optimize nutritional management, and further investigate injury prevention and rehabilitation measures to enhance athletes’ performance and health status.

Research on the prevention of joint and muscle injuries in competitive sports by scientific sports—Table tennis as an example

Table tennis is the most popular sport among all people, which damages every joints of the body to a certain extent, and is an example of scientific sports analysis and popularization. Analyzing the causes of joint and muscle injuries in table tennis and seeking effective preventive measures can not only reduce the incidence of sports injuries, but also ensure that athletes keep a high level of competitive state in high-intensity and long-term training and competition to a certain extent, and prolong their sports life. From two aspects of traditional sports injury prevention measures and the design of a multi-data fusion management rehabilitation robot, the prevention of muscle injury in competitive sports has been studied in depth.

EPIDEMIOLOGY OF INJURIES AND ASSOCIATED RISK FACTORS IN ATHLETES PARTICIPATING IN 2022 AEROBIC GYMNASTICS WORLD CHAMPIONSHIPD CHAMPIONSHIP ATHLETES

Exercise is described as a preventive and therapeutic strategy against various diseases. However, competitive sports practice is associated with an increased risk of injuries, particularly with specialization and more intense training at younger ages. Given the importance of surveillance and epidemiological studies to protect athletes’ health, our study aimed to describe the prevalence of injuries among athletes at the 2022 Aerobic Gymnastics World Championship (WCH) and to understand the intrinsic and extrinsic risk factors that may contribute to these injuries. Athletes participating in WCH 2022 were invited to complete a retrospective injury questionnaire covering the past 12 months of their training schedule. Descriptive statistic data were used to analyze all variables in the study. Seventy-three percent of athletes reported sustaining injuries, with an average of 1.6 ± 1.5 injuries occurring one to three times in the past year. The most common injuries were muscle injuries, joint sprains, stress fractures, and contusions, with the lower limbs being the most affected, followed by the upper body and trunk. Regarding injury risk factors, a significant number of athletes reported experiencing psychological stress (p=0.043) and concerns about individual protection equipment (p=0.042). Given that the type of injury and affected body region seem to be related to sports-specific movements, the impact absorption of the floor and footwear should be studied further. Additionally, injury prevention measures should include coping strategies to manage stress effectively.

Risk Factors Related to the Development of Full-thickness Pressure Injuries in Hospitalized Pediatric Patients.

Current pediatric pressure injury (PI) prevention measures are based on risk factors related to PI development in adults. Children offer a unique concern for PI development because their bodies are still developing, and their skin responds differently to external pressure. To explore risk factors for the development of full-thickness PIs in children aged 21 weeks' gestation to 21 years. This retrospective, observational, correlational study included 799 hospitalized children who developed a PI. The pediatric and adult PI risk factors used in the study were identified from the International Pressure Ulcer Prevention and Treatment Guideline. A stepwise multivariate logistic regression model was used. Multivariate analyses revealed that risk factors for predicting a full-thickness PI varied by age. For children aged 38 weeks to 12 months, risk factors included tissue perfusion and oxygenation: generalized edema, conditions of the OR, and nutrition deficits. For children aged 1 to 7 years, fragile skin status was a risk factor. For youth aged 8 to 21 years, the two risk factors were tissue perfusion and oxygenation: decreased oxygenation and extracorporeal membrane oxygenation. Across the total sample, extracorporeal membrane oxygenation, tissue perfusion and oxygenation: decreased oxygenation and malnutrition were risk factors for predicting a full-thickness PI. Full-thickness PI risk factors differ among the ages of pediatric patients.

The epidemiology of employee injuries in a monitoring sentinel unit of a coastal area in China:A nine-year retrospective analysis of clinical data

The epidemiology of injury among subgroups of minors, older adults, students, and athletes has previously been investigated; however, studies investigating employee-related injuries are limited. We aimed to retrospectively analyze the epidemiological characteristics and dynamic change trends of injury among employees over a nine-year period in a coastal area in China to provide a reference for formulating injury prevention and control measures among employees. All 14,168 employee injury cases registered in a hospital injury monitoring system were analyzed from January 2013 to December 2021. The male-to-female sex ratio of the employee injury cases was 3.52:1. The floating-to-registered residence population ratio was 2.05:1. March, May, July, and September–October were peak months for employee injuries. Within the day, the injury cases of employees reached five peaks at 0800, 1000, 1500, 1800, and 2000 h. The highest five causes of injury were falling, blunt injuries, motor vehicle accidents, sharps injuries, and non-motor vehicle accidents. The highest five injury types were fracture; concussion or contusion of the brain; injury from a sharp instrument, bite, or open wound; contusion or abrasion; and sprain or strain. The main locations of the injuries were roads and streets, industrial and building sites, and homes. Vulnerable body regions included the upper limbs, lower limbs, head, trunk, and multiple regions. The independent predictors of all outcomes were census register classification; age; injury causes, locations and types; vulnerable body regions; and injury severity; on multivariate logistic regression analysis (P < 0.05). The average durations of missed work in the different injury outcome groups due to injuries among employees were 50.21, 42.57, 44.57, and 38.20 days, respectively. The average number of missed work days due to injuries was 49.77 days, with an increasing annual trend (F = 79.872, P < 0.01). The average hospitalization cost for employee injuries was ¥16250.37, with a decreasing annual trend (F = 4.621, P < 0.01). The average length of hospitalization was 15.22 days, with a decreasing annual trend (F = 76.657, P < 0.01), and the average number of days of missed work due to injuries was 49.77 days, with an increasing annual trend (F = 79.872, P < 0.01). The correlation coefficients showed a significant positive correlation between the average length of hospitalization and average hospitalization expenses, with an increasing trend from 2014 to 2021 (P < 0.05). Most employee injuries occurred in the male and floating populations. Targeted intervention measures should be implemented according to the epidemiological characteristics of injuries in relation to different populations, sexes, and ages to prevent and control injuries.

A randomized controlled trial of a housing intervention to reduce endocrine disrupting chemical exposures in children

Few studies have considered household interventions for reducing endocrine disrupting chemical (EDC) exposures. We conducted a secondary analysis of a randomized controlled trial, originally designed to reduce lead exposure, to evaluate if the intervention lowered EDC exposures in young children. Study participants were children from the Cincinnati, Ohio area (n = 250, HOME Study). Prenatally, families received a housing intervention that included paint stabilization and dust mitigation, or as a control, injury prevention measures. At 24-months, we measured organophosphate esters (OPEs) and phthalates or their metabolites in dust and urine. We measured perfluoroalkyl substances (PFAS) in dust and serum at 24- and 36-months, respectively. We assessed associations between dust and biomarker EDCs using Spearman correlations, characterized EDC mixtures via principal components analysis, and investigated treatment effects using linear regression. To mitigate selection bias, we fit statistical models using inverse probability of retention weights. Correlations between dust EDCs and analogous biomarkers were weak-to-moderate (ρ’s ≤ 0.3). The intervention was associated with 23 % (95 % CI: −38, −3) lower urinary DEHP metabolites and, in a per-protocol analysis, 34 % lower (95 % CI: −55, −2) urinary MBZP. Additionally, among Black or African American children, the intervention was associated with lower serum concentrations of several PFAS (e.g., −42 %; 95 % CI: −63, −8 for PFNA). Household interventions that include paint stabilization and dust mitigation may reduce childhood exposures to some phthalates and PFAS in Blacks/African Americans. These findings highlight the need for larger studies with tailored and sustained housing interventions.

Epidemiology of orthopedic injuries among inpatients admitted at a tertiary teaching and referral hospital in Kenya: a retrospective cross-sectional study

BackgroundOrthopedic injuries are serious and continue to be a concern for healthcare systems worldwide. Approximately 90% of the estimated traumatic injuries occur in low- and middle-income countries. In Kenya, there is a dearth of information on orthopedic injury patterns that could be used to prioritize injury prevention measures and to help hospital management teams allocate resources appropriately. The purpose of this study was to determine the epidemiology of orthopedic injuries admitted to Kenyatta National Hospital.MethodsThis was a retrospective cross-sectional study. Overall, 720 charts were reviewed. Data were analyzed using frequency distribution, pearson chi-square test and logistic regression.ResultsOverall, 85% were aged 15–64 years. Approximately 80% were male, married or single. Patients with primary or secondary education composed 72%. Road traffic accidents (59.4%) and falls (24.7%) were the most common mechanisms of injury. A total of 99.9% of the inpatients were Kenyans. Open injuries were 40.1%. Lower limb (67.4%) and upper limb (26.9%) injuries were the most common. Inpatients aged 15–24 years were 74% less likely to have upper limb injuries than those aged 0–14 years (p = 0.023). However, those aged 15–24 years were 19.250 times more likely to have spine injuries than those aged 0–14 years (p = 0.008). Males were 68.6% and 51.2% less likely to have pelvic injury and comorbidities, respectively, than females (p < 0.001). Patients with secondary and tertiary education were 2.016 (p = 0.003) and 2.3 (p < 0.001) times more likely to have upper limb injuries, respectively, than those with no or preschool education. Similarly, those with tertiary education were 2.079 times more likely to have comorbidities than those with no or preschool education (p = 0.017).ConclusionMost of the inpatients with orthopedic injuries were young, male involved in Road traffic accidents and therefore Kenya National Transport and Safety Authority needs to enforce road safety measures to reduce road carnage. Those with higher education and children were more likely to have upper limb injuries. Females were more likely to have pelvic injuries and co-morbidities. Lower and upper limb injuries were the most common injuries and this should guide resource allocation in management of orthopedic injuries.

Epidemiologic Trends in Maxillofacial Trauma Surgery in Germany-Insights from the National DRG Database 2005-2022.

Background: Maxillofacial trauma (MFT) caused by falls, interpersonal violence or traffic accidents leading to fractures of different facial regions, including the midface and the mandible, are common clinical conditions requiring open reduction and internal fixation. The aim of this study was to analyze the incidence and time trends in MFT-associated surgeries regarding different facial regions in the German healthcare system over time. Materials and methods: Nationwide data regarding the national diagnosis-related group (DRG) inpatient billing system was received from the German Federal Statistical Office for the years 2005-2022. We estimated the age-gender standardized incidence of MFT-associated procedures classified by the Operation and Procedure Classification System (OPS) and evaluated age- and gender-adjusted time trends using Poisson regression analysis. Results: The total standardized incidence rate of MFT-associated procedures in the observational period 2005-2022 was 25.1 (♀13.3; ♂37.5) per 100,000 person-years within a slight significant annual decrease of 0.5%. A significant increase in the incidence of MFT-related procedures within the observational period was found in older adults from 60 to 79 years (+55.1%; ♀+54.8%; ♂+56.3%) and elderly patients over 80 years (+66.7%; ♀+59.1%; ♂+85.1%). Other significant trends are decreases in MFT-related procedures performed in children from 0-14 years (-28.1%; ♀-30.3%; ♂-27.3%) and young adults between 15 and 35 years (-20.4%; ♀-7.3%; ♂-22.5%). Conclusions: MFT-associated surgery is a persisting challenge in the German healthcare system. There is an ongoing transition in MFT-associated surgeries from younger to older patients beyond the scope of demographic change, highlighting the increasing importance of interdisciplinary treatment of patients with pre-existing conditions in maxillofacial surgery. Implementation of injury prevention measures might be beneficial in this population.

Health Problems of Professional Ballet Dancers: an Analysis of 1627 Weekly Self-Reports on Injuries, Illnesses and Mental Health Problems During One Season

BackgroundSeveral studies have investigated injuries of (pre-)professional ballet dancers, however most used a medical-attention and/or time-loss definition and did not analyse the prevalence of all health problems. The aim was to analyse the frequency and characteristics of all self-reported physical and mental health complaints (i.e. injuries, illnesses and mental health problems) of professional ballet dancers during one season.MethodsThree professional ballet companies were prospectively monitored weekly during one season with the Performing artist and Athlete Health Monitor (PAHM). Numerical rating scales (ranging 0–10) were used for severity of musculoskeletal pain, all health problems and impairment of the ability to dance at full potential in the previous seven days. If dancers rated the severity of their health problems or their impairment greater than 0, they were asked to answer specific questions on the characteristics of each health problem.ResultsOver a period of 44 weeks, 57 dancers (57.9% female) filled in 1627 weekly reports (response rate of 64.9%), in which 1020 (62.7%) health problem were registered. The dancers reported musculoskeletal pain in 82.2% of the weeks. They felt that their ability to dance at their full potential was affected due to a health problem in about every second week (52.6%) or on at least 29.1% of the days documented in the weekly reports. Almost all dancers (96.5%) reported at least one injury, almost two thirds (64.9%) an illness and more than a quarter (28.1%) a mental health problem. On average, every dancer reported 5.6 health problems during the season. Most of the 320 health problems were injuries (73.1%), 16.9% illnesses and 10.0% mental health problems. Injuries affected mainly ankle, thigh, foot, and lower back and were mostly incurred during rehearsal (41.6%) or training (26.1%). The most frequent subjective reasons of injury were “too much workload” (35.3%), “tiredness/exhaustion” (n = 22.4%) and “stress/overload/insufficient regeneration” (n = 21.6%).ConclusionPreventive interventions are urgently required to reduce the prevalence of health problems and especially injuries of professional dancers. Injury prevention measures should regard the balance of the load capacity of professional dancers and the workload in training, rehearsals and performances.

Firefighters' muscle activity change during firefighting training program.

Research on muscle activity to reduce injuries during firefighting training has getting increasing attention. The purpose of this study was to assess the activity changes in nine muscles of firefighters during the seven firefighting training programs, and to analyze the influence of different firefighting training programs on muscle activity. Ten healthy male firefighters were recruited to measure the field surface electromyographic activities (including the percentage of Maximum Voluntary Contraction electromyography (% MVC) and the integrated electromyography value (iEMG)) during all the firefighting training programs. The results showed that the electromyographic activity of gastrocnemius (GA) was stronger in climbing the hooked ladder and climbing the six-meter long ladder training programs. Arms, shoulders, and lower limb muscles were more activated, myoelectric activities were more intense, and fatigue in these areas was more likely to occur during climbing five-story building with loads. Compared with other muscles, erector spine (ES) had a higher degree of activation during different postures of water shooting. The Borg scale scores of shoulders, trunk, thighs and calves were also higher. After completing all training programs, GA, tibialis anterior (TA), trapezius (TR), and ES were strongly activated, and all muscles had obvious force. The % MVC and iEMG analyses correspond well with the Borg Scale score. The results can provide certain reference for reducing the musculoskeletal injury of firefighters, carrying out scientific training and formulating effective injury prevention measures for them.

Evaluation of the effectiveness of preventive nursing measures for pressure injuries in patients in the neurology intensive care unit.

Patients in neurology intensive care units (ICU) are prone to pressure injuries (PU) due to factors such as severe illness, long-term bed rest, and physiological dysfunction. PU not only causes pain and complications to patients, but also increases medical burden, prolongs hospitalization time, and affects the recovery process. To evaluate and optimize the effectiveness of pressure injury prevention nursing measures in neurology ICU patients. A retrospective study was conducted, and 60 patients who were admitted to the ICU of the Department of Neurology were selected and divided into an observation group and a control group according to the order of admission, with 30 people in each group. The observation group implemented pressure injury prevention and nursing measures, while the control group adopted routine care. Comparison between observation and control groups following pressure injury prevention nursing intervention revealed significantly lower incidence rates in the observation group compared to the control group at 48 h (8.3% vs 26.7%), 7 d (16.7% vs 43.3%), and 14 d (20.0% vs 50.0%). This suggests a substantial reduction in pressure injury incidence in the observation group, with the gap widening over time. Additionally, patients in the observation group exhibited quicker recovery, with a shorter average time to get out of bed (48 h vs 72 h) and a shorter average length of stay (12 d vs 15 d) compared to the control group. Furthermore, post-intervention, patients in the observation group reported significantly improved quality of life scores, including higher scores in body satisfaction, feeling and function, and comfort (both psychological and physiological), indicating enhanced overall well-being and comfort following the implementation of pressure injury prevention nursing measures. Implementing pressure injury preventive care measures for neurology ICU patients will have better results.

Application of an integrated behaviour-change model on grandparental adherence towards childhood domestic injury prevention in Hong Kong: a longitudinal study

Background/purposeEvery year, unintentional injury claims thousands of children’s lives and causes disabilities in many more. For very young children, these injuries often occur at home. The risks of domestic injury...

Death at Dreamworld: Ten pathways to disaster and failure to learn

AbstractDeaths in workplace incidents – of both workers and members of the public – normally spark a number of official responses, including coronial inquests. In many instances, however, these investigations have examined the incident in isolation from the wider context of hazards in that industry and are rarely informed by the extensive research literature on health and safety, and death and disaster, at work. In this examination of a tragic theme park disaster in 2016, we demonstrate that applying a wider lens and drawing on the ‘ten pathways model’ not only provides a more compelling explanation of how and why safety measures failed but may also inform more fatality and injury prevention measures. Drawing on James Reasonʼs concept of latent failures, the ten pathways model identifies latent failures that are repeatedly associated with death and disaster in workplaces across different industries. Using the Dreamworld coronial inquest findings and other related source material, this paper finds that at least nine and possibly all ten pattern failures were present in the Thunder River Rapids ride disaster at the Dreamworld theme park and contributed to the deaths of four visitors. In particular, it highlights the corroding effects of poor maintenance, inadequate management systems, and regulatory failure. The paper also raises questions about why theme parks as high-hazard workplaces marked by injuries, deaths, and ‘near misses’ were not subject to more rigorous oversight prior to the event and how regulatory failures might best be addressed.

Perspectives of Ballet Dancers on Causes of Their Injuries and Implementation of Injury Preventive Measures by Ballet Teachers and Masters.

Ballet dancers have a high injury risk. We aimed to gain insight into the causes for acute and overuse injuries in ballet dancers and the level of implementation of injury prevention by ballet teachers/masters, as perceived by dancers. An international cross-sectional online-survey was based on the Fit-to-Dance Questionnaire and literature. Adult amateur, pre-professional, and professional ballet dancers reported the perceived causes of their injuries sustained in the previous 2 years. Multiple answers per injury were possible. Also, dancers rated the level of implementation of measures to prevent injury by their ballet teachers and ballet masters based on 21 items using a 5-point Likert scale. Causes were analyzed per-injury as well as per-dancer. 188 ballet ensembles and 51 dance organizations were contacted, from which 192 ballet dancers (mean age 27 ±7.8 yrs, 83% females) responded. 119 dancers (62%) reported 203 acute and 164 (85%) reported 469 overuse injuries. Fatigue was the most frequently perceived cause for acute injuries in the per-injury (n=89, 43.8%) and per-dancer analysis (n=63, 32.8%). For overuse injuries, pressure from the teacher/master was most frequently perceived as cause in the per-injury analysis (n=240, 51.2%), specifically in pre-/professional dancers (n=233, 61.3%). In the per-dancer analysis, fatigue/overtraining scored highest for overuse injuries (n=107; 55.7%). Other causes were previous/repetitive injuries (acute-per-injury 26.1%, acute-per-dancer 22.4%; overuse-per-injury 46.3%, overuse-per-dancer 53.1%) or erroneous dance technique (acute-per-injury 24.6%, acute-per-dancer 21.9%; overuse-per-injury 47.8%, overuse-per-dancer 45.3%). With regard to perceived level of implementation of injury preventive measures by ballet teachers/masters to prevent musculoskeletal injuries, 2 items received high ratings, 12 moderate ratings and 6 low ratings. Fatigue and pressure accounted for the majority of perceived causes for injuries. Perceived support by ballet teachers/masters regarding injury prevention was moderate to low. Future research should focus on the awareness, attitudes, and the important role of ballet teachers/masters for injury prevention in dancers.

EMS injury cause codes more accurate than emergency department visit ICD-10-CM codes for firearm injury intent in North Carolina.

The timeliness, accuracy, and completeness of data for firearm injury surveillance is crucial for public health surveillance efforts and informing injury prevention measures. While emergency department (ED) visit data can provide near real-time information on firearms injuries, there are concerns surrounding the accuracy of intent coding in these data. We examined whether emergency medical service (EMS) data provide more accurate firearm injury intent coding in comparison to ED data. We applied a firearm injury definition to EMS encounter data in NC's statewide syndromic surveillance system (NC DETECT), from January 1, 2021, through December 31, 2022. We manually reviewed each record to determine intent, and the corresponding manual classifications were compared to the injury cause codes entered in the EMS data and to ED visit records where EMS-ED record linkage was possible. We then calculated the sensitivity, specificity, positive and negative predictive values for each intent classification in SAS 9.4 using the manually reviewed intent classifications as the gold standard. We identified 9557 EMS encounters from January 1, 2021, through December 31, 2022 meeting our firearm injury definition. After removing false positives and duplicates, 8584 records were available for manual injury classification. Overall, our analysis demonstrated that manual and EMS injury cause code classifications were comparable. However, for the 3401 EMS encounters that could be linked to an ED visit record, sensitivity of the ED ICD-10-CM codes was low for assault and intentional self-harm encounters at 18.2% (CI 16.5-19.9%) and 22.2% (CI 16-28.5%), respectively. This demonstrates a marked difference in the reliability of the intent coding in the two data sources. This study illustrates both the value of examining EMS encounters for firearm injury intent, and the challenges of accurate intent coding in the ED setting. EMS coding has the potential for more accurate intent coding than ED coding within the context of existing hospital-based coding guidance. This may have implications for future firearm injury research, especially for nonfatal firearm injuries.