Relative Risk Of Injury Research Articles

Bicycling injury hospitalisation rates in Canadian jurisdictions: analyses examining associations with helmet legislation and mode share

ObjectivesThe purpose of this study was to calculate exposure-based bicycling hospitalisation rates in Canadian jurisdictions with different helmet legislation and bicycling mode shares, and to examine whether the rates were...

Electromechanical delay of the hamstrings during eccentric muscle actions in males and females: Implications for non-contact ACL injuries

Sex differences in neuromuscular functioning has been proposed as one of the factors behind an increased relative risk of non-contact anterior cruciate ligament (ACL) injury in females. The aim of this study was to explore sex differences in electromechanical delay (EMD) of the hamstring muscles during eccentric muscle actions and during a range of movement velocities. This study recruited 110 participants (55 males, 55 females) and electromyography of the semitendinosus, semimembranosus and biceps femoris was determined during eccentric actions at 60, 120 and 240°/s. No significant sex differences were observed irrespective of muscle examined or movement velocity. Irrespective of sex EMD significantly increased with increasing movement velocity (P<0.01). There was no significant difference in the EMD of the 3 muscles examined. Our findings suggest that during eccentric actions of the hamstrings that there are no sex differences, irrespective of movement velocity. This would suggest that other factors are probably responsible for the increased relative risk of non-contact ACL injury in females compared to males.

Injury Risk Factors in Male Youth Soccer Players

YOUNG ATHLETES PARTICIPATING IN HIGH-INTENSITY SPORT DISPLAY AN INHERENT RISK OF SPORTS-RELATED INJURY, AND THIS IS HEIGHTENED AT VARIOUS STAGES OF GROWTH AND MATURATION. RECENT TRENDS HAVE HIGHLIGHTED A RANGE OF INJURY RISK FACTORS AND THE IMPORTANCE OF INJURY PREVENTION STRATEGIES WITHIN FEMALE SOCCER PLAYERS. HOWEVER, THERE IS A PAUCITY OF INFORMATION PERTAINING TO MALE YOUTH PLAYERS. THIS ARTICLE PROVIDES AN OVERVIEW OF THE AVAILABLE LITERATURE AND OUTLINES A RANGE OF RISK FACTORS THAT MAY INCREASE RELATIVE RISK OF INJURY IN MALE YOUTH SOCCER PLAYERS, INCLUDING GROWTH AND MATURATION, MOVEMENT SKILL, FATIGUE, AND PREVIOUS INJURY.

Effects of winter precipitation on automobile collisions, injuries, and fatalities in the United States

To better understand the links between winter precipitation (snow, sleet, and freezing rain) and travel risk, data on weather conditions and vehicle crashes, injuries and fatalities are gathered for 13 U.S. cities. A matched pair analysis is used to construct event-control pairs to determine the relative risk of crash, injury, and fatality. Winter precipitation is associated with a 19% increase in traffic crashes and a 13% increase in injuries compared to dry conditions. The type of winter precipitation (snowfall vs. freezing rain, ice pellets, or sleet) had no significant impact on the relative risk of crash. The relative risk of crash was significantly higher during the evening (1800–2359 local time) than during other times of the day. More intense precipitation led to increased relative risk of crash and injury compared to less intense precipitation. Relative risk of crash, injury, or fatality was not significantly higher during the first three winter precipitation events of the year as compared to subsequent events. The relative risk of both winter precipitation crash and injury showed no significant trend during the 1998–2008 period. Sensitivity of U.S. cities to winter precipitation varies from city to city in a manner that is not easily explained. Future research will be required to determine which safety interventions are most effective in each city and revise or expand safety programs appropriately.

Motion Analysis and the Anterior Cruciate Ligament: Classification of Injury Risk

Anterior cruciate ligament (ACL) injuries are common, catastrophic events that incur large expense and lead to degradation of the knee. As such, various motion capture techniques have been applied to identify athletes who are at increased risk for suffering ACL injuries. The objective of this clinical commentary was to synthesize information related to how motion capture analyses contribute to the identification of risk factors that may predict relative injury risk within a population. Individuals employ both active and passive mechanisms to constrain knee joint articulation during motion. There is strong evidence to indicate that athletes who consistently classify as high-risk loaders during landing suffer from combined joint stability deficits in both the active and passive knee restraints. Implementation of prophylactic neuromuscular interventions and biofeedback can effectively compensate for some of the deficiencies that result from poor control of the active knee stabilizers and reduce the incidence of ACL injuries.

Risk factors for injury in law enforcement officer vehicle crashes

Purpose – Vehicle crashes and being struck by vehicles are the leading causes of death among police. The purpose of this paper is to identify risk factors for injury in police officer vehicle crashes in order to help determine the most effective approaches to improve officer vehicle safety. Design/methodology/approach – The study entailed a cross-sectional survey of officer drivers involved in vehicle crashes from 16 local, county, and state law enforcement agencies across the USA over one year. The relative risk of injury for officers in crashes with a given characteristic relative comparison crashes without that characteristic was computed to determine which characteristics are more likely to be associated with injuries. Findings – The survey yielded 854 crashes, 90 of which involved injuries to the officer driver. Crash characteristics associated with a statistically significant increase in the risk of injury include multiple vehicle collisions, collision direction, officer vehicle type, officer vehicle being stopped, driving under emergency conditions, conducting traffic control or assisting motorists, not wearing a seat belt, and others. Most findings hold for all crashes and when minor crashes are excluded from the analysis. Originality/value – This study presents the first quantitative estimates of the risk factors for injury to law enforcement officers in vehicle crashes. Our findings indicate that seat belt use remains a critical safety intervention; driving under emergency conditions is high risk, though the reasons for this are unclear; better practices are needed to protect officers in stationary vehicles; agencies should carefully weigh the benefit of motorcycles against the vastly increased risk of injury they present; and that mobile data terminals are both a major distraction hazard and important source of injuries in crashes.

Prevention in dangerous industries: does safety certification prevent tree-faller injuries?

The aim of this study was to evaluate if safety certification reduces the risk of work injury among experienced manual tree-fallers. This study used a retrospective cohort study design. Experienced manual tree-fallers employed in the Canadian province of British Columbia (N=3251) between 2003-2008 were enumerated from a mandatory faller registry. Registry records with demographic and certification data were linked to workers' compensation claims for injury outcomes. Data were analyzed using discrete time survival analysis over a two-year period, centered on certification date with pre- and post-certification demarcated into four three-month periods. Models were adjusted for demographic, occupation/industry, previous injury, and seasonal/temporal effects. The relative risk (RR) of work injury during the post certification periods were elevated in comparison to the pre-certification reference period, but the 95% confidence intervals included "1" for all estimates by the end of follow-up, suggesting no statistically significant increased risk of injury. Results were consistent across different outcome measures of acute injury (ie, fracture or amputations) (N=186), musculoskeletal injury (ie, back strain) (N=137), and serious injury claims (ie, long duration, high cost and/or fatal) (N=155). Certification did not reduce the risk of work injury among experienced tree-fallers in the province of British Columbia. Non-statistically significant increases in the observed risk of work injury in the months immediately following certification may be attributable to an intervention effect or a methodological limitation related to a lack of individual-level, time-at-risk exposure data.

Valuing Reductions in Fatal Illness Risks: Implications of Recent Research.

The value of mortality risk reductions, conventionally expressed as the value per statistical life, is an important determinant of the net benefits of many government policies. US regulators currently rely primarily on studies of fatal injuries, raising questions about whether different values might be appropriate for risks associated with fatal illnesses. Our review suggests that, despite the substantial expansion of the research base in recent years, few US studies of illness-related risks meet criteria for quality, and those that do yield similar values to studies of injury-related risks. Given this result, combining the findings of these few studies with the findings of the more robust literature on injury-related risks appears to provide a reasonable range of estimates for application in regulatory analysis. Our review yields estimates ranging from about $4.2 million to $13.7 million with a mid-point of $9.0 million (2013 dollars). Although the studies we identify differ from those that underlie the values currently used by Federal agencies, the resulting estimates are remarkably similar, suggesting that there is substantial consensus emerging on the values applicable to the general US population. Copyright © 2015 John Wiley & Sons, Ltd.

Rear seat safety: Variation in protection by occupant, crash and vehicle characteristics

ObjectivesCurrent information on the safety of rear row occupants of all ages is needed to inform further advances in rear seat restraint system design and testing. The objectives of this study were to describe characteristics of occupants in the front and rear rows of model year 2000 and newer vehicles involved in crashes and determine the risk of serious injury for restrained crash-involved rear row occupants and the relative risk of fatal injury for restrained rear row vs. front passenger seat occupants by age group, impact direction, and vehicle model year. MethodData from the National Automotive Sampling System Crashworthiness Data System (NASS-CDS) and Fatality Analysis Reporting System (FARS) were queried for all crashes during 2007–2012 involving model year 2000 and newer passenger vehicles. Data from NASS-CDS were used to describe characteristics of occupants in the front and rear rows and to determine the risk of serious injury (AIS 3+) for restrained rear row occupants by occupant age, vehicle model year, and impact direction. Using a combined data set containing data on fatalities from FARS and estimates of the total population of occupants in crashes from NASS-CDS, logistic regression modeling was used to compute the relative risk (RR) of death for restrained occupants in the rear vs. front passenger seat by occupant age, impact direction, and vehicle model year. ResultsAmong all vehicle occupants in tow-away crashes during 2007–2012, 12.3% were in the rear row where the overall risk of serious injury was 1.3%. Among restrained rear row occupants, the risk of serious injury varied by occupant age, with older adults at the highest risk of serious injury (2.9%); by impact direction, with rollover crashes associated with the highest risk (1.5%); and by vehicle model year, with model year 2007 and newer vehicles having the lowest risk of serious injury (0.3%). Relative risk of death was lower for restrained children up to age 8 in the rear compared with passengers in the right front seat (RR=0.27, 95% CI 0.12–0.58 for 0–3 years, RR=0.55, 95% CI 0.30–0.98 for 4–8 years) but was higher for restrained 9–12-year-old children (RR=1.83, 95% CI 1.18–2.84). There was no evidence for a difference in risk of death in the rear vs. front seat for occupants ages 13-54, but there was some evidence for an increased relative risk of death for adults age 55 and older in the rear vs. passengers in the right front seat (RR=1.41, 95% CI 0.94–2.13), though we could not exclude the possibility of no difference. After controlling for occupant age and gender, the relative risk of death for restrained rear row occupants was significantly higher than that of front seat occupants in model year 2007 and newer vehicles and significantly higher in rear and right side impact crashes. ConclusionsResults of this study extend prior research on the relative safety of the rear seat compared with the front by examining a more contemporary fleet of vehicles. The rear row is primarily occupied by children and adolescents, but the variable relative risk of death in the rear compared with the front seat for occupants of different age groups highlights the challenges in providing optimal protection to a wide range of rear seat occupants. Findings of an elevated risk of death for rear row occupants, as compared with front row passengers, in the newest model year vehicles provides further evidence that rear seat safety is not keeping pace with advances in the front seat.

Injury risk prediction using elderly digital human body model

Frontal crash sled simulation is performed with Hybrid III dummy and elderly human body model to assess the relative high injury risk of older population. The sled model representing a typical driver side seat with a restraint system is validated against the test result. The current restraint design is tailored to the younger generation and found to be less effective for the older driver. The 48kph frontal crash simulation predicted AIS 4 level chest injury (7 rib fractures) of the elderly driver while 10 % risk of rib fracture was found with the Hybrid III dummy.

Community fire prevention via population segmentation modelling

In this paper we examine the use of population segmentation modelling for targeting fire prevention to the needs of the community. A population segmentation approach based upon socio-economic characteristics data was developed to provide a deeper understanding of the fire risks associated with different social groups by a partnership consisting of a UK fire and rescue service, a National Health Service trust, a local council, and a police force. This approach supported more targeted and co-ordinated community fire prevention measures by the agencies involved. This approach was used to target those most at risk, and improve intra-agency co-ordination and collaboration between the agencies involved. The modelling enabled differences in terms of the risk of fire related injuries and fatalities between the population segments to be examined. Overall, the research examines how and why population segmentation was undertaken by the fire and rescue service studied, and how this was implemented and used operationally to support fire prevention activities. The project was funded by the UK Department of Communities and Local Government.

Sex differences in injury during top-level international athletics championships: surveillance data from 14 championships between 2007 and 2014

BackgroundInjury incidence has been reported for international athletics championships from 2007 to 2012. However, it is unclear whether male or female athletes differ in risk and/or characteristics of injuries.ObjectiveTo compare...

The Association between Sleep Loss and Women's Wellness Decisions

Sleep loss is an important determinant of health status owing to its relationships with molecular, immune, and neural changes; these changes, in turn, are important etiological mechanisms for the development of cardiovascular, metabolic diseases and increased risk of accident related injuries. While the association between sleep loss and risk of weight gain is established, studies on the association between sleep loss and nutrition and physical activity are limited. The purpose of this research was to determine if there are significant associations between reported sleep variations and nutrition and physical activity level while recognizing the association between body mass index (BMI) and sleep loss. Data from the 2011 sleep-related questions captured by the Centers for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) was used to identify possible behavioral indicators related to sleep loss in women. Multiple logistic regression was used to assess the hypothesized associations between sleep loss and fruit and vegetable consumption and physical activity levels. The odds ratios for the association between fruit/vegetable intake and sleep loss and that of BMI and sleep loss were (OR =0.761, 95% CI =0.651, 0.889) and (OR = 1.108, 95% CI =0.972, 1.262), respectively. The odds ratio for the association between physical exercise and sleep loss was (OR = 0.991, 95% CI =0.864, 1.137). Having adjusted for relevant covariates, consumption of fruits and vegetables was significantly associated with sleep loss; physical activity was not significantly associated with sleep loss.

Recurrent Falls in the Elderly Iranian Population: Does the 25-hydroxyvitamin D Level Matter?

Serum vitamin D concentration has been implemented as a major contributing factor for increasing the risk of fall and fall related injuries in older adults. However, when prescribed and supplemented for these populations, the outcomes are controversial and in several cases no improvement has been reported in reducing the risk of recurrent fall. Therefore, the aim of this study is to examine the association between serum vitamin D concentration and recurrent falls in Iranian older adults. This prospective observational study was conducted in the emergency departments of two university hospitals. During this study, a cohort of 82 elderly participants who aged over 60 and suffered from an unintentional episode of falling; was evaluated after 6 month of their first ED visit.

Geographical analysis of socioeconomic factors in risk of domestic burn injury in London 2007–2013

PurposeThis study aims to explore the geographical distribution of burn injuries in Greater London and the association of socioeconomic factors in areas at risk. MethodsData on burn injury cases classified as occurring in patients’ own homes in Greater London and admitted to a specialised burns service for ≥1 day during a 7-year period were obtained from the International Burn Injury Database (iBID). Age- and gender-adjusted standardised incidence ratios (SIRs) were calculated for each Lower Layer Super Output Area (LSOA) in Greater London. Bayesian methods were used to calculate relative risks as best estimates of spatially-smoothed SIRs. ResultsOf a total of 2911 admissions to specialised burns services in Greater London in the study period, 2100 (72.1%) cases occurred in patients’ own homes. Percentage of ethnic minorities (p=0.005), Income Deprivation Affecting Children Index (p<0.001), Health Deprivation and Disability Score (p=0.031), percentage of families with 3 or more children (p=0.004) and Barriers to Housing and Services Score (p=0.001) remained independently associated with the relative risk of paediatric domestic burn injury in a multivariate linear regression model. Percentage of ethnic minorities (p<0.001), Health Deprivation and Disability Score (p<0.001) and Barriers to Housing and Services Score (p=0.036) remained independently associated with the relative risk of adult domestic burn injury in a multivariate linear regression model. ConclusionsSocioeconomic factors are associated with an increased risk of burn injury in Greater London, but may be more important in children than adults. The specific factors identified are ethnicity, poor general health, household structure, housing issues and income deprivation affecting children.

Relative risk of injury from acute alcohol consumption: modeling the dose-response relationship in emergency department data from 18 countries.

To update and extend analysis of the dose-response relationship of injury and drinking by demographic and injury subgroups and country-level drinking pattern, and examine the validity and efficiency of the fractional polynomial approach to modeling this relationship. Pair-matched case-cross-over analysis of drinking prior to injury, using categorical step-function and fractional polynomial analysis. Thirty-seven emergency departments (EDs) across 18 countries. A total of 13 119 injured drinkers arriving at the ED within 6 hours of the event. The dose-response relationship was analyzed by gender, age, cause of injury (traffic, violence, fall, other) and country detrimental drinking pattern (DDP). Estimated risks were similar between the two analytical methods, with injury risk doubling at one drink [odds ratio (OR) = 2.3-2.7] and peaking at about 30 drinks. Although risk was similar for males and females up to three drinks (OR = 4.6), it appeared to increase more rapidly for females and was significantly higher starting from 20 drinks [female OR = 28.6; confidence interval (CI) = 16.8, 48.9; male OR = 12.8; CI = 10.1, 16.3]. No significant differences were found across age groups. Risk was significantly higher for violence-related injury than for other causes across the volume range. Risk was also higher at all volumes for DDP-3 compared with DDP-2 countries. There is an increasing risk relationship between alcohol and injury but risk is not uniform across gender, cause of injury or country drinking pattern. The fractional polynomial approach is a valid and efficient approach for modeling the alcohol injury risk relationship.

A prospective epidemiological study of injury incidence and injury patterns in a Hong Kong male professional football league during the competitive season

The aim of this study was to investigate the match and training injury incidence, injury patterns and severity, and their monthly variation in a Hong Kong male professional football league. The study design was a prospective cohort study. Seven teams in the Hong Kong Football Association first division league and 152 players from 10 professional teams participated in this study. On a weekly basis throughout the 9-month season, time-loss injuries and individual exposure were collected from injury recorders team visits. Operational injury definitions and procedures followed the recommendations of a football consensus. The overall injury incidence was 7.4 injuries/1000 player hours and 296 injuries were recorded. The relative risk of match injury was 17 times greater than the risk of training injury [relative ratio (RR), 17.3; 95% confidence injury (CI), 11.6–25.7; p < 0.001]. Ankle sprain was the most common injury type (16.2% of all injuries) and 52% of these injuries were recurrent. Thigh strain was the second most common injury type with 82% of the injuries involving the hamstring muscle and 80% of hamstring strains were noncontact injuries. During the competitive season, the relative risk of injury was highest in October (RR, 6.8; 95% CI, 6.7–6.9; p < 0.001) and February (RR, 4.7; 95% CI, 4.3–5.2; p < 0.001). This highlighted that Hong Kong professional football has a high match injury incidence. The relative risk of injury was highest at the beginning of the competitive season. A prospective multicentre epidemiological study is warranted to examine regional differences in injury risks. Coaches, players, health professionals, and researchers should join their efforts to investigate the effect on injury incidence and injury pattern associated with the duration and content of the preseason period, and the number of friendly matches held during preseason.

Sleep-related factors and work-related injuries among farmers in Heilongjiang Province, People's Republic of China.

The association between sleep and work-related injuries among Chinese farmers has not been well studied. This study examined the impact of lack of sleep on agricultural work-related injuries among farmers in China. Data were from a cross-sectional survey of farm-workers in northeastern China. Information was obtained on injuries that occurred in 12 months prior to the survey, on eight sleep-related variables, and on socio-demographic variables. Logistic regression analyses were conducted to test the hypothesis that lack of sleep significantly increased the risk of work-related injuries after controlling for other injury-related risk- factors. Farmers who slept less than six hours per night were 59% more likely to be injured than those who slept more than eight hours per night (OR = 1.59; 95% CI = 1.04, 2.41). The odds of a work-related injury was 2.46 (1.56–3.89) for farmers who reported going to sleep after midnight at least once a week compared with farmers who reported going to sleep after midnight once a month. Farmers who reported having difficulty falling asleep or waking frequently during the night, who often having nightmares, or who experienced daytime sleepiness were at higher injury risk compared with the reference group after controlling for age, gender and alcohol consumption. Reduced sleep hours and poor sleep quality significantly increased the risk of work-related injuries in Chinese farmers. Sleep hours and sleep quality should be considered when assessing occupational safety among farmers.

Accelerometer and GPS-derived running loads and injury risk in elite Australian footballers.

The purpose of this study was to investigate the relationship between overall physical workload (global positioning systems [GPS]/accelerometer) measures and injury risk in elite Australian football players (n = 46) during a season. Workload data and (intrinsic) injury incidence were monitored across preseason and in-season (18 matches) phases. Multiple regression was used to compare cumulative (1-, 2-, 3-, and 4-weekly loads) and absolute change (from previous-to-current week) in workloads between injured and uninjured players for all GPS/accelerometer-derived variables: total distance, V1 distance (total distance above individual's aerobic threshold speed), sprint distance, force load, velocity load, and relative velocity change. Odds ratios (ORs) were calculated to determine the relative injury risk. Cumulative loads showed the strongest relationship with greater intrinsic injury risk. During preseason, 3-weekly distance (OR = 5.489, p = 0.008) and 3-weekly sprint distance (OR = 3.667, p = 0.074) were most indicative of greater injury risk. During in-season, 3-weekly force load (OR = 2.530, p = 0.031) and 4-weekly relative velocity change (OR = 2.244, p = 0.035) were associated with greater injury risk. No differences in injury risk between years of Australian Football League system experience and GPS/accelerometer data were seen. From an injury risk (prevention) perspective, these findings support consideration of several GPS/accelerometer running load variables in Australian football players. In particular, cumulative weekly loads should be closely monitored, with 3-weekly loads most indicative of a greater injury risk across both seasonal phases.

Worker compensation injuries among the Aboriginal population of British Columbia, Canada: incidence, annual trends, and ecological analysis of risk markers, 1987-2010.

BackgroundAboriginal people in British Columbia (BC) have higher injury incidence than the general population, but information is scarce regarding variability among injury categories, time periods, and geographic, demographic and socio-economic groups. Our project helps fill these gaps. This report focuses on workplace injuries.MethodsWe used BC’s universal health care insurance plan as a population registry, linked to worker compensation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence rate and Standardized Relative Risk (SRR) of worker compensation injury, adjusted for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We assessed annual trend by regressing SRR as a linear function of year. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics of Aboriginal communities with community SRR of injury by multivariable linear regression.ResultsDuring the period 1987–2010, the crude rate of worker compensation injury in BC was 146.6 per 10,000 person-years (95% confidence interval: 146.4 to 146.9 per 10,000). The Aboriginal rate was 115.6 per 10,000 (95% CI: 114.4 to 116.8 per 10,000) and SRR was 0.88 (95% CI: 0.87 to 0.89). Among those living on reserves SRR was 0.79 (95% CI: 0.78 to 0.80). HSDA SRRs were highly variable, within both total and Aboriginal populations. Aboriginal males under 35 and females under 40 years of age had lower SRRs, but older Aboriginal females had higher SRRs. SRRs are declining, but more slowly for the Aboriginal population. The Aboriginal population was initially at lower risk than the total population, but parity was reached in 2006. These community characteristics independently predicted injury risk: crowded housing, proportion of population who identified as Aboriginal, and interactions between employment rate and income, occupational risk, proportion of university-educated persons, and year.ConclusionsAs employment rates rise, so has risk of workplace injury among the Aboriginal population. We need culturally sensitive prevention programs, targeting regions and industries where Aboriginal workers are concentrated and demographic groups that are at higher risk.