Non-traffic Injuries Research Articles

Sociodemographic distribution and correlates of nonfatal unintentional non-traffic-related injuries in Kenya: Results from the 2014 demographic and health survey.

Injuries are among the leading causes of mortality worldwide. There exists a paucity of nationally representative injury data from the sub-Saharan African region on the nature of injuries outside of road traffic contexts. The aim of this study was to estimate the prevalence of nonfatal unintentional injuries that occurred outside of the traffic environment among persons aged 15-54 years in Kenya. We used the 2014 Kenyan Demographic Health Survey data to estimate the prevalence of nonfatal unintentional injuries and their injury mechanisms. Binary logistic regression was used to estimate the odds of unintentional injuries and associated factors. Injury prevalence was three times higher among males (27.56%) compared to females (8.25%). The highest prevalence for females and males respectively was among those aged 15-19 years (9.80%) and (31.18%), rural residents (8.45%) and (30.05%) and those who consumed alcohol (18.13%), and (31.39%). For both females and males, the most frequent injuries were cuts (4.95%; 18.15%) and as result of falls (3.29%; 8.92%) respectively. Burns were more prevalent among females (1.65%) compared to males (0.76%). Among males, the demographic and contextual factors associated with nontraffic unintentional injuries were residing in a rural area (OR 1.33, 95% CI 1.14, 1.56), primary education (OR 2.02, 95% CI 1.48, 2.76), a higher wealth index (second quintile OR 1.41, 95% CI 1.19, 1.67) and consuming alcohol (OR 1.49, 95% CI 1.32, 1.69). Females who had completed primary, secondary (OR 2.43, 95% CI 1.92, 3.08) or higher education had higher odds of unintentional injuries. The findings mirror prior literature highlighting the clustering of demographic and behavioral factors which underlie predisposition to injuries outside of the traffic environment. Future nationally representative studies would benefit from deeper inquiry into and measurement of injury severity and health care utilization to inform strategic policy-relevant research.

Exploring Women’s Experience of Gender-Based Violence and Other Threats to Safety on Public Transport in Bangladesh

Equal access to safe transport is increasingly conceptualised as a fundamental right for women, with demonstrated impact on health outcomes, social and economic mobility, and societal participation. This study analysed qualitative and quantitative data to examine travel patterns and experiences among 200 women (aged between 18-64 years) using paid transport for work or educational purposes in Bangladesh. Results showed that the women faced multiple threats to their safety, including gender-based violence, harassment and crime, and traffic and non-traffic injury and that the use of paid transport was associated with high levels of anxiety and fear. Despite these circumstances, the women were captive travellers, forced to make transport choices based on price, availability, and ease of travel rather than safety. Unable to choose safe transports, the women attempted to mitigate risks by changing their travel pattern and behaviour, and by restricted their travel frequency. These findings are discussed within the context of women’s rights and mobility justice.

Epidemiological Characteristics of Traffic and Non-traffic Injuries and Quality of Emergency Medical Services in Southern Thailand

Objective: This study aimed to report the situation of injuries and emergency medical services in southern Thailand.Material and Methods: Data from the Injury Surveillance system of a Level 1 Trauma Center Hospital in lower southern Thailand during 2012-2016 were extracted. Trends in epidemiological characteristics of both traffic and non-traffic injuries and emergency medical services were described. Logistic regression was used for the analysis.Results: The number of patients admitted to emergency departments due to traffic and non-traffic injuries was stable over the five-year period (n=102, 840). Traffic injuries involving motorcycles and falls were the two leading causes of injury. Most were adults aged 19-60 years (62.5%). The most common risky behaviors were driving a motor vehicle without wearing a seatbelt (81.9%) and riding a motorcycle without wearing a helmet (71.7%). Alcohol and drug use were relatively low but significantly increased the odds of sustaining a severe/critical injury. Significant predictors of severe/ critical non-traffic injury included drowning [odds ratio (OR)=29.7, 95% confidence interval (CI)=11.9-74.7], self-harm/ suicide (OR=12.6, 95% CI=9.2-17.3), and bites/stings from poisonous animals (OR=8.1, 95% CI=6.1-10.8). The use of Emergency Medical Services (EMS) was low but increased over time. The main challenge was delivering appropriate EMS for different levels of injury. The percentage of health care staff who performed advanced life support appropriately for critically injured patients ranged from 95.5% to 100.0% while for severely injured patients, ranged from 93.9% to 100.0%.Conclusion: Traffic and non-traffic injuries were high and the use of EMS was still low in southern Thailand.

Morbidity Patterns of Non-Traffic Unintentional Injuries Among the Pediatric Age Group Attending the Emergency Department at King Abdul-Aziz Medical City, Riyadh, Saudi Arabia.

ObjectivesThe aim of this study is to measure the magnitude and describe morbidity pattern, management, and outcome of non-traffic unintentional injuries among a pediatric age group at a tertiary hospital in Riyadh, Saudi Arabia.Materials and MethodsThis is a retrospective descriptive cross-sectional study conducted at Emergency Department (ED) of King Abdul-Aziz Medical City, Riyadh, Saudi Arabia, including all pediatric patients aged 0 to 14 years who had non-traffic unintentional injuries and admitted to the ED from January 1, 2016, to December 31, 2017. The number of children included for the specified period was 491 patients.ResultsA total of 491 patients were included over the study period; the majority were males (64%). The most common injury types were fractures, dislocations, and subluxations (47.3%) followed by penetration injuries (21%) and burn injuries (17.5%). The most involved body site was the upper limbs (45.2%) followed by head and neck (24.2%) and lower limbs (17.3%). Fall was the leading mechanism of injuries (47.7%) followed by hot liquids and chemical exposure (14.5%). Most of the cases resulted in no significant disabilities (40%), 21.6% resulted in short-term disability, 24.2% had long-term disability, and 12.8% had permanent disabilities. There were six cases (1.2%) of mortality.ConclusionsNon-traffic unintentional pediatric injuries are common with significant morbidity and complications, and most of them are preventable. More efforts are needed to increase public awareness and to implement preventive measures at households and public places.

The interactive effect of location, alcohol consumption and non-traffic injury.

This study aimed to assess the extent to which the association between recent alcohol consumption and risk of non-traffic injury varies according to location at the time of the injury. Case-cross-over design. A total of 15 625 injury patients from 49 emergency departments (EDs) in 22 countries. Recent alcohol consumption and location at the time of the injury were assessed for when the injury occurred and for the same time 1week prior to this. The confounding and interactive effects of location were examined by estimating the adjusted odds ratio (OR) of injury from alcohol consumption adjusting for location and then by examining the alcohol consumption×location interaction. There were significant interactive effects of location and alcohol consumption on injury risk. For example, the ORs for volume 0.1-3.0 drinks and street/public place each were 3.0 and 14.2, respectively, whereas the OR for their joint effect was 44.1, suggesting a positive additive interaction [relative excess risk due to interaction (RERI)=27.9, P<0.05] and zero multiplicative interaction (OR=1.0, P=0.895). The interactions of alcohol consumption with drinking establishment location, work-place and other locations were mostly additive and negative on the multiplicative scale (e.g. for interaction between volume 0.1-3.0 drinks and drinking establishment location: RERI=1.19, P=0.529; multiplicative interaction OR=0.54, P<0.05). Location appears to influence the relationship between alcohol consumption and risk of injury. The association between alcohol consumption and injury appears to be greater in locations such as streets and public places compared with private residences.

Prevalence and risk factors associated with non-traffic related injury in the older population in Ghana: Wave 2 of the WHO Study on Global AGEing and adult health (SAGE).

Injuries are a significant cause of hospitalization in the older population, leading to a decline in physical activity and greater dependence on others. Compared to traffic related injury, relatively fewer studies have been conducted on non-traffic related injury in the older population in Ghana. This analysis provides a nationwide baseline prevalence and associated factors of non-traffic related injuries among older adults in Ghana. Data from the 2014–2015 nationally representative World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 2 was used. A final sample of 3461 older adults living in 2827 households was used in the statistical modelling. Predictors of injury were examined using both single-level and multilevel binary logistic regression models. The prevalence of non-traffic related injury found in this study was 3.74%. The odds of being injured decreased among females (OR = 0.66, 95% CI: 0.46, 0.95) compared to their male counterparts and those who rated their heath state as moderate (OR = 0.59, 95% CI: 0.38, 0.94). Depression was the only risk factor identified in the multivariable model (OR = 2.55, 95%CI: 1.38, 4.71). The study did not observe significant residual household-level variation in injury status. The role of depression as a risk factor suggests that interventions that aim to reduce non-traffic related injury in older adults should consider improving mental health.

Injury and depression among 212 039 individuals in 40 low- and middle-income countries.

Although injuries have been linked to worse mental health, little is known about this association among the general population in low- and middle-income countries (LAMICs). This study examined the association between injuries and depression in 40 LAMICs that participated in the World Health Survey. Cross-sectional information was obtained from 212 039 community-based adults on the past 12-month experience of road traffic and other (non-traffic) injuries and depression, which was assessed using questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview. Multivariable logistic regression analysis and meta-analysis were used to examine associations. The overall prevalence (95% CI) of past 12-month traffic injury, other injury, and depression was 2.8% (2.6-3.0%), 4.8% (4.6-5.0%) and 7.4% (7.1-7.8%), respectively. The prevalence of traffic injuries [range 0.1% (Ethiopia) to 5.1% (Bangladesh)], and other (non-traffic) injuries [range 0.9% (Myanmar) to 12.1% (Kenya)] varied widely across countries. After adjusting for demographic variables, alcohol consumption and smoking, the pooled OR (95%CI) for depression among individuals experiencing traffic injury based on a meta-analysis was 1.72 (1.48-1.99), and 2.04 (1.85-2.24) for those with other injuries. There was little between-country heterogeneity in the association between either form of injury and depression, although for traffic injuries, significant heterogeneity was observed between groups by country-income level (p = 0.043) where the pooled association was strongest in upper middle-income countries (OR = 2.37) and weakest in low-income countries (OR = 1.46). Alerting health care providers in LAMICs to the increased risk of worse mental health among injury survivors and establishing effective trauma treatment systems to reduce the detrimental effects of injury should now be prioritised.

Unintentional non-traffic injury and fatal events: Threats to children in and around vehicles

ABSTRACTObjective: There have been substantial reductions in motor vehicle crash–related child fatalities due to advances in legislation, public safety campaigns, and engineering. Less is known about non-traffic injuries and fatalities to children in and around motor vehicles. The objective of this study was to describe the frequency of various non-traffic incidents, injuries, and fatalities to children using a unique surveillance system and database.Methods: Instances of non-traffic injuries and fatalities in the United States to children 0–14 years were tracked from January 1990 to December 2014 using a compilation of sources including media reports, individual accounts from families of affected children, medical examiner reports, police reports, child death review teams, coroner reports, medical professionals, legal professionals, and other various modes of publication.Results: Over the 25-year period, there were at least 11,759 events resulting in 3,396 deaths. The median age of the affected child was 3.7 years. The incident types included 3,115 children unattended in hot vehicles resulting in 729 deaths, 2,251 backovers resulting in 1,232 deaths, 1,439 frontovers resulting in 692 deaths, 777 vehicles knocked into motion resulting in 227 deaths, 415 underage drivers resulting in 203 deaths, 172 power window incidents resulting in 61 deaths, 134 falls resulting in 54 deaths, 79 fires resulting in 41 deaths, and 3,377 other incidents resulting in 157 deaths.Conclusions: Non-traffic injuries and fatalities present an important threat to the safety and lives of very young children. Future efforts should consider complementary surveillance mechanisms to systematically and comprehensively capture all non-traffic incidents. Continued education, engineering modifications, advocacy, and legislation can help continue to prevent these incidents and must be incorporated in overall child vehicle safety initiatives.

Consistent association between hypnotics/sedatives and non-traffic injuries. Results from a national household survey

AimTo quantify the relationship between patterns of psychostimulants, hypnotics/sedatives and alcohol consumption and the frequency of unintentional non-traffic injuries (UNTIs) requiring medical assistant in Spain. MethodsWe carried out a cross sectional study using a randomized pooled sample from two household surveys on psychoactive drugs use (n=51,649 subjects aged 15–64 years). We estimated the magnitude of the association between the use of psychostimulants and hypnotics/sedatives in the last 12 months as well as alcohol consumption in the last 30days with the occurrence of UNTIs in the last 12 months (falls, knocks/bumps and cuts) by building several logistic regression models, which took into account the effect of sociodemographic characteristics and the use of other psychoactive drugs (including cannabis). The presence of interactions between age or gender with drug use was also assessed. ResultsPsychostimulants use was associated with a higher frequency of UNTIs (aOR=1.24; 95%CI:1.03–1.49). The strongest association was found with cuts (aOR=1.64; 95%CI:1.10–2.43). An association between hypnotics/sedatives and UNTIs was also found in each type of injury and was higher with regular use (>=30days) than with non-regular use (<30days). The age modified the association between hypnotic/sedatives and knocks/bumps, being higher in the 35–64 years group (aOR=2.34; 95%CI:1.78–3.06) than in the 15–34 years group (aOR=1.59; 95%CI:1.14–2.21). Regarding alcohol, an increased risk of UNTIs was also observed in all types of UNTIs, even with moderate use, being the association higher for cuts in heavy drinkers (aOR=2.41; 95%CI:1.63–3.57). ConclusionsOur results reveal a consistent relationship between hypnotics/sedatives and UNTIs, especially in regular users. Additional research should apply longitudinal designs to establish causal relationships and to gain an in-depth knowledge in this area in order to specific public health interventions.

Magnitude and Trends in Heavy Episodic Drinking, Alcohol-Impaired Driving, and Alcohol-Related Mortality and Overdose Hospitalizations Among Emerging Adults of College Ages 18-24 in the United States, 1998-2014.

This article estimates percentages of U.S. emerging adults ages 18-24 engaging in past-month heavy episodic drinking and past-year alcohol-impaired driving, and numbers experiencing alcohol-related unintentional injury deaths and overdose hospitalizations between 1998 and 2014. We analyzed national injury mortality data from coroner, census, and college enrollment statistics, the National Survey on Drug Use and Health, and the Nationwide Inpatient Sample. From 1999 to 2005, percentages of emerging adults ages 18-24 reporting past-month heavy episodic drinking rose from 37.1% to 43.1% and then declined to 38.8% in 2014. Alcohol-impaired driving rose from 24% to 25.5% and then declined to 16.0%. Alcohol-related unintentional injury deaths increased from 4,807 in 1998 to 5,531 in 2005 and then declined to 4,105 in 2014, a reduction of 29% per 100,000 since 1998. Alcohol-related traffic deaths increased from 3,783 in 1998 to 4,114 in 2005 and then declined to 2,614 in 2014, down 43% per 100,000 since 1998. Alcohol-related overdose deaths increased from 207 in 1998 to 891 in 2014, a 254% increase per 100,000. Other types of nontraffic unintentional injury deaths declined. Alcohol-overdose hospitalizations rose 26% per 100,000 from 1998 to 2014, especially from increases in alcohol/other drug overdoses, up 61% (alcohol/opioid overdoses up 197%). Among emerging adults, a trend toward increased alcohol-related unintentional injury deaths, heavy episodic drinking, and alcohol-impaired driving between 1998 and 2005 was reversed by 2014. Persistent high levels of heavy episodic drinking and related problems among emerging adults underscore a need to expand individually oriented interventions, college/community collaborative programs, and evidence-supported policies to reduce their drinking and related problems.

The Effects of Acute Cannabis Use on Nontraffic Injury Risk: Reviewing the Available Literature and Identifying Ways Forward.

Recent evidence has indicated that cannabis use before driving is associated with a modest but increased risk for traffic-related injuries. However, the question of whether recent cannabis use is associated with a greater risk for other types of injuries remains unanswered. Aiming to understand better how acute cannabis use might affect the risk for all causes of injury, we have summarized the limited data available in the literature on the risk of non-traffic injuries associated with recent cannabis use. Very few studies were able to provide estimate risks for all injuries or injuries other than those related to road traffic injuries, with the limited evidence available showing mixed findings. The only significant risk found (in only one study) suggests an inverse association between all injuries and cannabis use. Study designs are limited, and the majority of studies have neither data on acute cannabis use among injured individuals nor a valid control group for estimating injury risk attributable to cannabis. In conclusion, studies of the association between cannabis and non-traffic injuries present several limitations, particularly regarding sampling strategies, injury risk assessment for different causes of injury, and a dose-response risk relationship with injury. Further studies, incorporating better design for different causes of injury and drug testing, are required to reach firmer conclusions on the association between cannabis use and non-traffic injury risk.

Psychological Distress following Injury in a Large Cohort of Thai Adults.

IntroductionInjury and psychological distress are public health priorities because of their high occurrence in the population. This study examines the longitudinal effects of injury characteristics on psychological distress.MethodsStudy participants were enrolled distance learning Thai adults (N = 42,785 at 2013 follow-up) residing nationwide. We analysed 2009 and 2013 data. Injury questions included injury prevalence, causes and levels of severity. Distress was measured using the standard Kessler-6. To assess the risk for post-injury distress, we used multinomial logistic regression investigating psychological distress in 2013 as an outcome including injury categories in both 2009 and 2013 as predictors, adjusted for sociodemographic factors.ResultsOverall injury was predictive of psychological distress. Both types of injury (traffic and non- traffic) associated with increasing psychological distress. Those that had experienced both types of injuries in the previous year had higher odds of developing psychological distress compared to those who experienced just one type. In 2013, adjusted psychological distress odds ratios were 1.46 [95% Confidence Interval 1.14–1.87] for traffic injury only; 1.26 [1.13–1.40] for non-traffic injury only; and 2.71 [2.19–3.35] for both traffic and non-traffic injuries. Increasing frequency of injury and increasing injury severity were also linked to elevated psychological distress among our Thai cohort members.ConclusionsOur results revealed a significantly high risk of psychological distress following injury. With increasing occurrence of injury, especially traffic injuries in low and middle income countries such as Thailand, future policies should not only focus on physical care but also address psychological distress as an important consequence of injury.

Non-Fatal Injury in Thailand From 2005 to 2013: Incidence Trends and Links to Alcohol Consumption Patterns in the Thai Cohort Study.

BackgroundWe analyzed population-based injury trends and the association between injury and alcohol consumption patterns in Thailand, a middle-income country undergoing rapid social change.MethodsA nationwide cohort of 42 785 Thai adult Open University students, who were aged 15 to 87 years at enrolment, participated in cross-sectional assessments at baseline (2005) and 8 years later (2013). Incident non-fatal traffic and non-traffic injuries were recorded. Alcohol consumption patterns were categorized as follows: non-drinkers, occasional light drinkers, occasional heavy drinkers, regular drinkers, and ex-drinkers. Logistic regression was used to assess associations in 2005 and 2013 between injuries and alcohol consumption. We adjusted odds ratios (ORs) for socio-demographic factors, stress, health behaviors, and risk-taking behaviors.ResultsIncidence estimates in 2013 were standardized to the age structure of 2005: the standardized rates were 10% (95% confidence interval [CI], 9.32–9.89) for participants with at least one non-traffic injury and 5% (95% CI, 4.86–5.29) for those with at least one traffic injury. Both standardized incidences for non-traffic and traffic injuries were significantly lower than corresponding rates in 2005 (20% and 6%, respectively). Alcohol consumption was significantly associated with non-traffic injury in 2005, but the association disappeared in 2013. For example, non-traffic injury was associated with regular drinking (adjusted OR 1.17; 95% CI, 1.01–1.40) in 2005, but not in 2013 (adjusted OR 0.89; 95% CI, 0.73–1.10). In both survey years, traffic injury was not associated with occasional heavy drinking when adjusted for health and risk-taking behavior.ConclusionsWe examined non-fatal injury and the health-risk transition in Thailand in 2005 and 2013. Our data revealed decreases in alcohol consumption and non-fatal injury in the Thai Cohort between 2005 and 2013. Alcohol-related injury in Thailand today could be amenable to preventive intervention.

Evaluating the Impact of Criminalizing Drunk Driving on Road-Traffic Injuries in Guangzhou, China: A Time-Series Study.

BackgroundRoad-traffic injury (RTI) is a major public-health concern worldwide. However, the effectiveness of laws criminalizing drunk driving on the improvement of road safety in China is not known.MethodsWe collected daily aggregate data on RTIs from the Guangzhou First-Aid Service Command Center from 2009 to 2012. We performed an interrupted time-series analysis to evaluate the change in daily RTIs before (January 1, 2009, to April 30, 2011) and after (May 1, 2011, to December 31, 2012) the criminalization of drunk driving. We evaluated the impact of the intervention on RTIs using the overdispersed generalized additive model after adjusting for temporal trends, seasonality, day of the week, and holidays. Daytime/Nighttime RTIs, alcoholism, and non-traffic injuries were analyzed as comparison groups using the same model.ResultsFrom January 1, 2009, to December 31, 2012, we identified a total of 54 887 RTIs. The standardized daily number of RTIs was almost stable in the pre-intervention period but decreased gradually in the post-intervention period. After the intervention, the standardized daily RTIs decreased 9.6% (95% confidence interval [CI], 6.5%–12.8%). There were similar decreases for the daily daytime and nighttime RTIs. In contrast, the standardized daily cases of alcoholism increased 38.8% (95% CI, 35.1%–42.4%), and daily non-traffic injuries increased 3.6% (95% CI, 1.4%–5.8%).ConclusionsThis time-series study provides scientific evidence suggesting that the criminalization of drunk driving from May 1, 2011, may have led to moderate reductions in RTIs in Guangzhou, China.

Alcohol consumption and fatal injuries in Australia before and after major traffic safety initiatives: a time series analysis.

The associations between population-level alcohol consumption and fatal injuries have been examined in a number of previous studies, but few have considered the external impacts of major policy interventions. This study aims to quantify the associations between per capita alcohol consumption and traffic and nontraffic injury mortality rates in Australia before and after major traffic safety initiatives (the introduction of compulsory seat belt legislation [CSBL] and random breath testing [RBT] in 1970s). Using data from 1924 to 2006, gender- and age-specific traffic and nontraffic mortality rates (15 years and above) were analyzed in relation to per capita alcohol consumption using time series analysis. The external effects of policy interventions were measured by inserting a dummy variable in the time series models. Statistically significant associations between per capita alcohol consumption and both types of fatal injuries were found for both males and females. The results suggest that an increase in per capita alcohol consumption of 1 l was accompanied by an increase in traffic mortality of 3.4 among males and 0.5 among females per 100,000 inhabitants and an increase in nontraffic mortality of 3.0 among males and 0.9 among females. The associations between alcohol consumption and fatal injury rates varied across age groups. The introduction of CSBL and RBT was associated with significant reductions in traffic crash mortality in Australia, particularly for males and young people. The magnitude and distribution of the preventive effects from the reduction in population drinking on fatal injuries vary across different gender and age groups, with the strongest preventive impacts on fatal injuries among people aged 15 to 29 and 70 years and above. The mechanisms behind these effects are unclear from this study, but are likely to be due to the strong association between per capita consumption and heavy drinking.

Childhood psychosocial development and fatal injuries in Gauteng, South Africa.

In South Africa, injuries are the third leading cause of death and disability. Children are especially susceptible to unintentional injuries, especially pedestrian injuries, burns and drowning. Injury risk is informed by children's exposure to adverse environmental circumstances, and individual capacities dependent on developmental maturity. Boys are at greater risk than girls. This study investigates the incidence of fatal childhood injuries as well as sex differences across psychosocial development stages. Data on fatal injuries in Gauteng, South Africa's most populous province, were obtained from the National Injury Mortality Surveillance System. The analysis drew on Erikson's psychosocial theory of development which was used to create meaningful age groups. Age-specific population data from the 2011 Census were used to calculate rates, and significant differences were determined through the generation of risk ratios and confidence intervals. There were 5404 fatal injuries among children in Gauteng from 2008 to 2011. The average age of victims was 8.9 years, and the majority male (65.6%). In infancy, the mortality rates for all injuries and non-traffic unintentional injuries were significantly higher than for the other age groups. Burns were the most common cause of death in infancy and early childhood. Pedestrian injuries accounted for a third of mortality in preschool and school age, and homicide rates were significantly higher in adolescence than in the other developmental stages. For injuries in general, boys had significantly higher mortality rates than girls in all age groups except preschool. The only instance where the mortality rate for girls was significantly higher than for boys was for adolescent ingestion poisoning suicides. The exposure to environmental and social risks is differentially moderated with maturing age and levels of autonomy. The sex of the child also informs risk. The nature of these risks is important when considering child injury prevention strategies.

The Effect of Injuries on Health Measured by Short Form 8 among a Large Cohort of Thai Adults

IntroductionWe investigate the links between health and injury in Thailand. This is important because of the high burden of injury in transitional countries and limited information for public health.MethodsWe analyse 2005 baseline and 2009, 4-year follow-up data from distance learning students of Sukhothai Thammathirat Open University residing nationwide (n = 60569). Injury was reported for the past year in both periods. Medical Outcome Study Short-Form (SF-8™) health status was reported and Physical and Mental Component Summary Scores (PCS and MCS) were calculated. Analyses used covariate-adjusted multivariate linear regression.ResultsIn 2009, increasing numbers of traffic injuries (0, 1, 2, 3, 4+) associated with declining PCS scores (49.8, 48.4, 46.9, 46.2, 44.0), along with a similar monotonic decline for MCS scores (47.6, 46.0, 44.2, 42.7, 40.6). A similar (but smaller) dose-response gradient was found between non-traffic injuries and SF-8 scores. Longitudinal analyses showed those with incident injury (no injury 2005, injury 2009) had lower PCS and MCS scores compared to those with no injury in both periods. Individuals with reverting injury status (injury 2005, no injury 2009) reported improvement in PCS and MCS scores over the four-year period.ConclusionWe found significant and epidemiologically important associations between increasing injury frequency and worse health in the past year, especially traffic injuries. Longitudinal 2005–2009 results were supportive and revealed statistically significant adverse 4-year effects of incident injury on health. If injury reverted over four years, low initial scores improved greatly. Findings highlight the importance of injury prevention as a public health priority.

Causes of Mortality Among American College Students: A Pilot Study

This pilot study from self-selected institutions of higher education provides an estimate of the causes and rates of mortality among college students between the ages of 18 and 24 years old. One hundred fifty-seven 4-year colleges participated in an online survey of student deaths during one academic year. A total of 254 deaths were reported. The mortality rates (per 100,000) were as follows: total accidental injuries, 10.80; suicide, 6.17; cancer, 1.94; and homicide, 0.53. Within the accident and injury category, alcohol-related vehicular deaths (per 100,000) were 3.37 and alcohol-related nontraffic injuries were 1.49. Men had significantly higher rates of suicide (10.46) than women (2.34). Suggestions for future research and implications of these findings are discussed.

Association between cannabis use and non-traffic injuries

BackgroundThis study aimed to assess the association between cannabis use and unintended non-fatal injuries other than those caused by road crashes. MethodsCross-sectional data were collected from a nationwide sample of 27,934 subjects surveyed in 2005 in Spain: 14,699 persons aged 15–34 years and 13,235 aged 35–64 years. Logistic regression was used to obtain odds ratios (OR) between patterns of cannabis use and frequency of non-traffic injuries, adjusted for sociodemographic factors and for the use of alcohol, tobacco and other drugs. ResultsCannabis use in the last 12 months was associated with a higher frequency of injuries (OR=1.4; 95% CI: 1.2–1.7). The OR in older adults (35–64 year age group) was 1.8 and 1.3 in younger people (15–34 year age group). The strongest associations found were between weekly use of cannabis and injuries from knocks and bumps (OR=5.1; 95% CI 2.9–8.9) and those occurring outside work (OR=3.0; 95% CI 1.8–4.9) in the older adult population. ConclusionAlthough our analysis did not control for behavioural factors, cannabis use is independently associated with an increased frequency of non-traffic injuries, especially in the older adult population. These associations emphasise the need to carry out longitudinal studies addressing the causal links between cannabis use and unintended injuries.

Trauma Center-Based Surveillance of Nontraffic Pedestrian Injury among California Children

IntroductionEvery year in the United States, thousands of young children are injured by passenger vehicles in driveways or parking areas. Little is known about risk factors, and incidence rates are difficult to estimate because ascertainment using police collision reports or media sources is incomplete. This study used surveillance at trauma centers to identify incidents and parent interviews to obtain detailed information on incidents, vehicles, and children.MethodsEight California trauma centers conducted surveillance of nontraffic pedestrian collision injury to children aged 14 years or younger from January 2005 to July 2007. Three of these centers conducted follow-up interviews with family members.ResultsNinety-four injured children were identified. Nine children (10%) suffered fatal injury. Seventy children (74%) were 4 years old or younger. Family members of 21 victims from this study (23%) completed an interview. Of these 21 interviewed victims, 17 (81%) were male and 13 (62%) were 1 or 2 years old. In 13 cases (62%), the child was backed over, and the driver was the mother or father in 11 cases (52%). Fifteen cases (71%) involved a sport utility vehicle, pickup truck, or van. Most collisions occurred in a residential driveway.ConclusionTrauma center surveillance can be used for case ascertainment and for collecting information on circumstances of nontraffic pedestrian injuries. Adoption of a specific external cause-of-injury code would allow passive surveillance of these injuries. Research is needed to understand the contributions of family, vehicular, and environmental characteristics and injury risk to inform prevention efforts.