Non-traffic Injuries Research Articles

Home and Other Nontraffic Injuries Among Children and Youth in a High-Income Middle Eastern Country

A trauma registry in the United Arab Emirates was used to ascertain nontraffic injuries of 0- to 19-year-olds. The registry's value for prevention was assessed. A total of 292 children and youth with nontraffic injuries were admitted for >24 hours at surgical wards of the main trauma hospital in Al Ain region during 36 months in 2003-2006. Injuries were analyzed by external cause, location, body part, and severity. Nontraffic represented 60% (n = 292) of child and youth injuries. Incidence/100 000 person-years was 91 for males, 43 for females. Unintentional included falls 65% (n = 191), burns 17% (n = 49), animal-related (mainly camel) 3% (n = 10), and others 10% (n = 29). Intentional accounted for 4% (n = 13). Falls affected all ages, burns mainly 1- to 4-year-olds. Of the injuries, 70% occurred at home. Most frequent and severe injuries measured by the Injury Severity Score and Abbreviated Injury Scale involved extremities. Prevention of home falls for all ages and burns of 1- to 4-year-olds are priorities. Registries should cover pediatric wards and include data on fall locations and hazardous products.

Trauma centre-based surveillance of non-traffic pedestrian collision injury among young children in California

ObjectiveEvery year in the US, 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...

Trends in the incidence of hospitalisation for injuries resulting from non‐traffic crashes in New South Wales, July 1998 to June 2007

To describe changes in the incidence of hospitalised injury for New South Wales residents involved in non-traffic crashes for the period 1 July 1998 to 30 June 2007. This study identified 37 480 NSW residents admitted to hospitals for injuries resulting from non-traffic crashes from the NSW Admitted Patients Data Collection during the study period. Injury rates were calculated by applying 2001 census-derived estimates of NSW population figures as the denominator, and directly adjusting to the age distribution of the 2001 Australian population. The significance of trends in rates was assessed by the per cent change annualised estimator. Age-standardised rates of hospitalisation for injuries, and trends by inpatient demographics, travel mode and severity of injuries. The annual rate of hospitalisation for injury showed a significant increase of 0.7% per annum (95% CI, 0.2% to 1.2%) for NSW residents involved in non-traffic crashes over 10 years. Annual hospitalisation rates for serious injuries increased by 2.2% (95% CI, 0.9% to 3.6%). The hospitalised injury rate for motorcyclists and pedal cyclists increased significantly by 3.3% per annum (95% CI, 2.4% to 4.2%) and 3.7% (95% CI, 2.6% to 4.9%), respectively, but the rate declined significantly for car occupants and pedestrians by - 8.3% per annum (95% CI, - 9.5% to - 7.0%) and - 2.2% (95% CI, - 4.2% to - 0.2%) respectively. The rate of hospitalisation for injury from non-traffic crashes increased significantly over time for NSW residents from 1998-99 to 2007-08, especially for serious injuries and injuries to motorcyclists and pedal cyclists. These findings call for continuing and specific effort to prevent road non-traffic injuries.

Hazard scenarios of truck drivers’ occupational accidents on and around trucks during loading and unloading

Recent epidemiological studies have shown that there is a clear need for efforts to prevent non-traffic occupational injuries among truck drivers. The objective of the present study was to establish the hazard scenarios for truck drivers during loading/unloading through analyses of text descriptions of accident processes. Focus was on accidents that were primarily related to movement/operation on and around the truck, which are particular to truck drivers. Special emphasis was placed on falls from heights, as this was shown to be the most frequent type of accident and a major cause of fractures among truck drivers. Analyses of text descriptions of 136 accidents, including 63 cases of fall from height, collected in one company over a period of three years, revealed that: (a) the major triggering factors for falls from heights on and around the truck were stepping off the edge at height (33.3%), wrong footing (27.0%), and loss of balance/control of wagon (15.9%); (b) the major triggering factors for accidents on and around the truck in general were slip/trip (44.1%) and defect/malfunction (14.7%). The present study identified four target areas for improving prevention of occupational accidents of truck drivers in connection with movement/operation on and around trucks during loading/unloading: (1) improvement of the procedures for unloading to reduce the risk of fall from the back-hatch lift, (2) improvements of shoes and housekeeping to reduce the risk of slip/trip, (3) improvement of truck maintenance, and (4) reconciliation of views on causes of accidents between employers and truck drivers as a first step for a dialogue for improving safety in the goods-transport branch.

Characteristics of farm injuries in Greece.

To assess the characteristics of occupational and leisure farm injuries in Greece. During a five-year period (1996-2000), 4,326 unintentional farm injuries have been recorded by the Emergency Department Injury Surveillance System in Greece. Data concerning demographic variables, accident conditions, and injury characteristics were collected by in person interviews. The data were analyzed by simple cross-tabulation and hierarchical cluster analysis. Injuries from falls on the same level are mainly lower-limb fractures and occur during the winter among older women. Falls from higher level concern migrant workers, who also tend to suffer severe multiple injuries, including concussions, particularly during autumn. Injuries resulting from cutting and piercing instruments, as well as from machinery, are generally open wounds in the upper-limbs, suffered by young migrant workers. Head injuries resulting from striking against an object are more generally spread across socio-demographic variables. Overexertion is the dominant mechanism for dislocations and sprains in the lower limbs. Snake and insect bites are common among younger migrant workers during summer, and they affect the upper limbs during manual work close to the ground. Non-traffic injuries from vehicles are frequently severe, involving head concussion of generally young individuals. In Greece, farm injuries are frequently serious and require hospitalization. These injuries show distinct patterns among older women (lower-limb fractures), young individuals (non-traffic vehicle-related injuries) and migrant workers (injuries from cutting and piercing instruments, falls from high level, and bites). Prevention strategies should give priority to these population groups. These prevention strategies should include guidance for poorly educated workers, including migrants, enforcement of safety regulations concerning farming machinery, and discouragement of risky farming activities among elderly individuals, particularly women.

Diagnosis and monetary quantification of occupational injuries by indices related to human capital loss: analysis of a steel company as an illustration

Prevention of occupational injuries is an important task of human resource management. In this study, new indices of human capital loss of occupational injury including cumulative injury rate, proportion of potential workdays lost, and potential salary lost were applied to the analysis of registry data of occupational injuries from 1986 to 1994 of a steel company in Taiwan. In addition, we compared these indices with disabling frequency rate and severity rate. The results showed that the average disabling frequency rate and cumulative injury rate of the whole company were 4.12 and 0.41, respectively; and the average disabling severity rate and proportion of potential workdays lost of the whole company were 563 and 229×10 −6, respectively, during 1986–1994. There was no consistent improvement in occupational safety in this period. The average potential salary lost of the whole company was more than US$ 2 million per year with a discount rate of 0.04, which was equivalent to 92 times of average annual income of a worker. The major monetary loss were due to non-traffic injuries of operators and traffic injuries of non-operators, which amounted to US$ 145 and 152 per person per year. As the new indices can provide additional information on lifetime occupational risk and human capital loss in monetary values, we concluded that they may be useful supplementary tools for monitoring and analyzing occupational injury data in a company.

Are traffic injuries disproportionally more common among tourists in Greece? Struggling with incomplete data

Data concerning injury hazards among tourists are difficult to obtain because estimates of person–time denominators are rarely available. Existing sources are limited to enumeration of injured or killed persons by nationality and type of injury and the analysis can only rely on proportional indicators. Since 1995, the Regional Hospital in the tourist island of Kerkyra (Corfu) has been covering all types of accidents including road traffic injuries, in the context of the Emergency Department Injury Surveillance System (EDISS). The catchment area of this hospital practically coincides with the island population. About 15% of all accidents are traffic-related among either permanent residents or Greek tourists, but they represent 40% among tourists of foreign nationalities. This is suggestive, but far from conclusive evidence, that traffic injuries may be more common among foreign tourists. There are indications that accidents among foreign tourists overall are slightly more serious. Among Greek tourists, the ratio between peak and non-peak period is similar for non-traffic injuries (7.4) and traffic injuries (6.8), whereas among foreign tourists the corresponding ratio is 9.2 for non traffic injuries and 15.0 for traffic injuries. This pattern is difficult to explain in terms other than an excess risk of traffic injuries among foreign tourists.

Fatal nontraffic injuries involving alcohol: A metaanalysis

Estimates of alcohol involvement in fatal injuries vary widely. For injuries other than those involving motor vehicles, no national data exist and the quality of regional data is limited. This study synthesizes US medical examiner studies of nontraffic fatalities for the purpose of estimating alcohol involvement by injury mechanism and intent. We reviewed 331 medical examiner studies published between 1975 and 1995 that reported nontraffic injury fatalities. These studies were identified from computerized bibliographic databases and by hand searching of reference lists from 26 review publications and the subject indices of 7 prominent journals. A final total of 65 articles (19.6%) met our inclusion criteria for analysis. National data on motor vehicle fatalities were used for comparison. A total of 7,459 unintentional injury deaths, 28,696 homicide cases, and 19,347 suicide cases were aggregated. The aggregate percentage tested for blood alcohol concentration (BAC) was highest among homicide cases (88.2%), followed by unintentional injury deaths (84.0%) and suicide cases (81.7%). The aggregate percentage determined to be intoxicated (BAC, >/=100 mg/dL) was highest among homicide cases (31.5%), followed by unintentional injury deaths (31.0%) and suicide cases (22.7%). Mean and median comparisons produced comparable findings. Fewer than one quarter of the 65 articles reported gender- and age-specific rates. Inconsistent reporting of gender and age-specific rates in fatal nontraffic injuries prevented their analysis by cause of death. Fatally injured motor vehicle drivers, however, demonstrated distinct variation in alcohol involvement by age and gender. This metaanalysis is the first systematic attempt to estimate alcohol involvement in fatal nontraffic injuries at the national level. It demonstrates that alcohol is an important factor in many fatal injuries and that its importance varies by cause of injury.

A longitudinal study of lifestyle factors as predictors of injuries and crashes among young adults

This study was part of the Dunedin Multidisciplinary Health and Development Study. This is a longitudinal study of the health, development and behaviour of a cohort of 1037 young people born in Dunedin, New Zealand between 1 April 1972 and 31 March 1973. Explanatory measures covering background, behavioural and personality factors were obtained at ages 15 and 18 and were used as potential predictors of outcomes reported at age 21. Four outcomes were considered: any crash, injury crash, non-injury crash, and serious injury (not motor vehicle related). Overall, very few lifestyle factors were important predictors of any of these outcomes. Factors that were shown to predict injury crashes differed from those that predicted non-injury crashes. Also, those that predicted a traffic crash differed from those that predicted a serious non-traffic injury. These results suggest that focusing injury prevention efforts on changing the lifestyles of young adults is unlikely to reduce overall crash risk, and would have little impact on the risk of serious injury.

An evaluation of the New Zealand Graduated Driver Licensing System

Young drivers have a disproportionately high risk of experiencing a road traffic crash. On 1 August 1987 a Graduated Driver's Licensing System (GDLS) was introduced in New Zealand. This system was designed to give young drivers (i.e. 15–24 years inclusive) experience in driving while being excluded from high risk driving situations. We sought to determine the impact of the GDLS on serious injury crashes. The source of the injury crash data was New Zealand's Health Information Services' national public hospital inpatient morbidity data files for the years 1979–1992 inclusive. We disaggregated the occupant data into three age groups 15–19 years, 20–24 years, and persons 25 years of age or older and compared their trends in injury. In order to determine whether the incidence of motor vehicle crashes was simply following trends in other injury events we also included two 15–19 year old non-traffic injury comparison groups. Using time series analyses we showed that the introduction of the GDLS was closely followed by substantial reductions in car crash injuries for all age groups, especially 15–19 year olds (23% reduction). After considering effects for older occupants we speculate that the effect is likely to be substantially less than 23%. An analysis of licensure data suggests that the reduction in crashes may, in large part, be attributable to an overall reduction in exposure.

Motorcycle & ATV Crashes in New Zealand Resulting in Death and Hospitalization III:Non-traffic Crashes

This is the third article in a series of three which describe the epidemiology ofmotorcycle and ATV crashes in New Zealand which result in death andhospitalization. The first article presented an overview of all motorcycle crashes and thesecond, traffic crashes. This article focuses on non-traffic crashes. The source of thefatality data was national electronic mortality data files for the years 1978 to 1987inclusive, complemented by coroners files. The source of morbidity data was nationalhospitalization (inpatient) data for the years 1980 through 1989. Four percent (n = 44)of all the motorcycling fatalities for the period 1978 through 1987 were non-trafficcrashes giving a mortality rate of 0.1/100,000 persons per year. Similarly, for the period1980 through 1989 there were 4,199 first admissions to public hospitals for thetreatment of non-traffic motorcycling injuries, giving a rate of 12.9/100,000 populationper year. Young males, especially those in the 15 through 19 age group, had the highestrates of injury, whereas 24% of the crashes involved persons less than 15 years of age.Occupational groups with high rates of injury were students, farmers, and metal andmachine trades workers. The most common (40%) injury was a fracture of a limb(lower: 1,176, upper: 510) followed by head injuries (26%). Forty-eight percent of theincidents were described as having occurred on a farm. In a further 20% of incidentsthere was some indication that the place of occurrence was being used as a motorsportvenue. There were more students injured on farms than farmers (811 versus 695). Anumber of priority areas for action and prevention strategies are discussed. Agerestriction on drivers and roll-over protection on four-wheeled motorcycles have beenidentified as two key means of reducing injury. Before vigorously pursuing any of theseit will be necessary to obtain more detailed information on motorcycle usage off roadand the circumstances of crashes.

Application of capture-recapture methodology to estimate the completeness of child injury surveillance.

This paper describes the use of the two sample capture-recapture method to estimate the completeness of ascertainment of injury events in both routine public hospital discharge statistics and in an active injury surveillance system. For all child pedestrian injuries public hospital discharge statistics were 90% complete and the active surveillance system 77% complete. For non-traffic child pedestrian injuries public hospital discharge statistics were 66% complete, the active surveillance system being 79% complete. Capture-recapture methods have the potential to improve the accuracy of traditional childhood injury surveillance systems.

Alcohol and non‐traffic unintended injuries

In a review of the English language literature on alcohol and unintentional injury we identified 21 studies on falls, 36 on drownings and 32 on burns from 1947-1986. The proportion of fatal and non-fatal fall victims who had been drinking ranged from 21-77%, and 18-53% respectively. In three more recent studies, 35-63% of persons fatally injured in falls had been drinking. In five other studies 13-37% of persons injured in non fatal falls had been drinking. In our earlier review of drowning studies with complete ascertainment and duration of submergence specified, 27-47% of those who drowned had positive BAC's. In eight subsequent studies, alcohol was identified in 21-47% of drowning deaths. In our earlier review alcohol was involved in 9-86% of burn deaths. In five more recent US studies, alcohol was found in 12-61% of fatally injured burn victims. Case control studies are needed to establish whether alcohol increases the risk of trauma. Studies are also needed of interventions to reduce the proportion of these injuries where alcohol is involved.

Non‐traffic child pedestrian injuries

All non-traffic child pedestrian deaths and injuries resulting in hospitalization in the Auckland region over a 5 year period were identified from coroner's and hospital records. There were eight deaths (0.77/100,000 children per year) and 91 hospital admissions (8.7/100,000 children per year). Close to half (48%) of the non-traffic pedestrian injury admissions had been misclassified as traffic pedestrian injuries. Eighty-seven per cent of the non-traffic pedestrian injury deaths and 93% of the injuries occurred in residential driveways, most often involving a child run over by a reversing vehicle. Further studies are required to determine the most effective strategies for the prevention of non-traffic child pedestrian injuries.

Correlation between serum ionised calcium and serum albumin concentrations in two hospital populations.

One quarter of 172 patients from two hospitals with no obvious disturbances of calcium homeostasis and with total serum calcium concentrations that were normal after adjustment for albumin concentration had low serum ionised calcium concentrations. The low values were not due to changes in pH but were associated with hypoalbuminaemia. Significant positive regressions of ionised calcium on albumin concentration were observed in patients from both hospitals and also in 48 healthy laboratory staff. Because the regressions did not differ between patients and healthy subjects the low ionised calcium values associated with hypoalbuminaemia are unlikely to have been of pathological importance. These findings indicate that interpreting serum ionised calcium concentrations in patients with a reduced serum albumin concentration on the basis of a reference range determined in subjects with a normal serum albumin concentration may be clinically misleading.