Risk Of Acute Injury Research Articles

The effects of a brief, water-based exercise intervention on cognitive function in older adults.

Physical inactivity is a modifiable risk factor for accelerated cognitive decline in older adults. Water-based exercise provides the same physiological benefits as land-based exercise with reduced risk of acute injury. The current study evaluated the effects of a brief, water-based exercise intervention on cognitive functioning and cardiovascular fitness in a group of community dwelling older adults. The exercise group (n = 27, M(age) = 63.26 ± 7.64, 78% female) attended one moderate intensity water aerobics class per day for six consecutive days whereas the control group (n = 33, M(age) = 65.67 ± 6.69, 75% female) continued their typical routine. Neuropsychological and cardiovascular fitness tests were given the week before and the week after the intervention to both groups. The exercise group demonstrated significant improvements in cardiovascular fitness, as well as executive function, attention, and memory over controls. This suggests a brief exercise program can provide benefits for older adults.

Does tinnitus, hearing asymmetry, or hearing loss predispose to occupational injury risk?

Objective: To determine the relative contributions of tinnitus, asymmetrical hearing loss, low frequency hearing loss (pure tone average of 0.5, 1, 2, 3 kHz; PTA.5123), or high frequency hearing loss (pure tone average of 4, 6 kHz; PTA46), to acute injury risk among a cohort of production and maintenance workers at six aluminum manufacturing plants, adjusting for ambient noise exposure and other recognized predictors of injury risk. Design: Retrospective analysis. Study sample: The study considered 9920 workers employed during 2003 to 2008. The cohort consisted of 8818 workers (89%) whose complete records were available. Results: Adjusting for noise exposure and other recognized injury predictors, a 25% increased acute injury risk was observed among workers with a history of tinnitus in conjunction with high-frequency hearing loss (PTA46). Low frequency hearing loss may be associated with minor, yet less serious, injury risk. We did not find evidence that asymmetry contributes to injury risk. Conclusion: These results provide evidence that tinnitus, combined with high-frequency hearing loss, may pose an important safety threat to workers, especially those who work in high-noise exposed environments. These at risk workers may require careful examination of their communication and hearing protection needs.

Stop gambling with your hearing

In 2014, the National Hearing Conservation Association took its chances and held its 39th annual conference, titled Stop Gambling with your Hearing, in Las Vegas. The authors who contributed to this issue of the International Journal of Audiology demonstrated that they could be relied upon to deliver a royal flush when it comes to advancing research and knowledge for worker hearing loss prevention. The papers that we were privileged to shepherd through the review process share common themes: epidemiologic and workplace assessments of hearing and new methods to better assess hearing and the effects of wearing hearing protection upon the speech intelligibility and localization. Hearing loss prevention starts with education and testing. The study by Flamme et al. has expanded the work from last year’s supplement, considering how audiometric testing may be changed. Will pure-tone audiometry become passe? The potential to integrate hearing testing with hearing protector fit-testing seems natural, and combining testing with training in the use of personal protection technology makes sense. Without question, occupational hearing conservation programs must begin with engineering noise controls to reduce exposures for at risk workers. Cantley et al. explored the relationship between hearing loss and tinnitus and workplace injury. They found an increased risk of acute injury among workers with tinnitus and high-frequency hearing loss. Although their research does not draw strong correlations between tinnitus and increased incidence of workplace injury, the communication needs of hearing impaired workers cannot be overlooked. Helleman et al. considered the effects of interrupted exposures to loud music at night clubs - often cited as a potential cause of hearing loss. Their research suggests that quiet zones within clubs little effect on the hearing of the subjects they evaluated. However, providing club patrons a place to get out of the noise was still thought to be important because high noise levels present a risk in and of themselves. Hong et al. investigated the relationships between occupational exposures and hearing among elderly Latino Americans. They concluded that a reduction of occupational exposure to noise and chemicals will have a positive impact on better hearing later in life. Worker adoption of hearing protection use is challenged by the effect of attenuation on communication. When passive hearing protection is worn properly, it further degrades the ability of a hearing impaired worker to communicate. Giguere et al. investigated the effect of hearing protection on communication for persons with various degrees of hearing impairment. Sound restoration hearing protection had positive benefits for both impaired and normal hearing persons. Whereas Giguere used the Hearing in Noise Test (HINT) to estimate Speech Reception Threshold, Hiselius et al. utilized the Call-sign Acquisition Test (CAT) to determine the effect of different amounts of hearing protection on communication ability. Hiselius’ approach proved to be an efficient means of assessing several products. Both methods are useful for determining worker communication needs and abilities with a system that could be implemented in conjunction with hearing protection fit testing. In addition to affecting speech intelligibility, hearing protection use can critically impact localization ability. Casali and Robinette investigated the performance of different electronic hearing protectors on localization for groups who received varying amounts of training. They demonstrate that localization ability improved after listeners acclimated to hearing the world through a new set of filters. Finally, we consider the effect of diet and dietary supplements on hearing. Rosenhall provides evidence that high quality diet is associated with better hearing and high frequency hearing. Although establishing such correlations is complex and not conclusive, good dietary habits appear to be important to maintaining hearing health. We invite you to read this special supplement and consider how you may implement new techniques within your practice of hearing loss prevention. We wish to highlight and thank our sponsors who contributed to the supplement: National Hearing Conservation Association, National Institute for Occupational Safety and Health, and Safe-in-Sound Excellence in Hearing Loss Prevention Award™ along with Roger Angelelli, Council for Accreditation in Occupational Hearing Conservation (CAOHC), Honeywell Inc., and HTI Inc..

Associations between employee and manager gender: impacts on gender-specific risk of acute occupational injury in metal manufacturing

BackgroundPrior research has shown increased risk of injury for female employees compared to male employees after controlling for job and tasks, but have not explored whether this increased risk might be moderated by manager gender. The gender of one’s manager could in theory affect injury rates among male and female employees through their managers’ response to an employee’s psychosocial stress or through how employees differentially report injuries. Other explanations for the gender disparity in injury experience, such as ergonomic factors or differential training, are unlikely to be impacted by supervisor gender. This study seeks to explore whether an employee’s manager’s gender modifies the effect of employee gender with regards to risk of acute injury.MethodsA cohort of employees and managers were identified using human resources and injury management data between January 1, 2002 and December 31, 2007 for six facilities of a large US aluminum manufacturing company. Cox proportional hazards models were employed to examine the interaction between employee gender and whether the employee had female only manager(s), male only manager(s), or both male and female managers on injury risk. Manager gender category was included as a time varying covariate and reassessed for each employee at the midpoint of each year.ResultsThe percentage of departments with both female and male managers increased dramatically during the study period due to corporate efforts to increase female representation in management. After adjustment for fixed effects at the facility level and shared frailty by department, manager gender category does not appear to moderate the effect of employee gender (p = 0.717). Manager category was not a significant predictor (p = 0.093) of time to first acute injury. Similarly, having at least one female manager did not modify the hazard of injury for female employees compared to males (p = 0.899) and was not a significant predictor of time to first acute injury (p = 0.601).ConclusionsPrior findings suggest that female manufacturing employees are at higher risk for acute injury compared to males; this analysis suggests that this relationship is not affected by the gender of the employee’s manager(s).

There is No Need to Avoid Resistance Training (Weight Lifting) until Physeal Closure

The physis, or growth plate, is relatively weaker than the surrounding bone; as a result, individuals with immature skeletons are at risk for growth plate injury from forces that would not harm an adult. Based on the knowledge that immature growth plates are weaker than adult growth plates, it is not known with certainty whether or not adolescents can participate safely in resistance training programs. Because medical literature does not definitively answer if it is safe for adolescents to pursue strength-training programs, we previously surveyed 500 experts in sports medicine to determine whether they agreed with the statement “resistance training (‘weight lifting’) should be avoided until physeal closure.” Overall, respondents answered that “this statement is very likely false.” In this article, we interpret the experts' survey responses by reviewing the basic and clinical sciences implicit in the question, as well as the literature regarding adolescent outcomes. Although the avoidance of resistance training by adolescents is theoretically appealing, we found that the data indicate properly supervised weight programs are not associated with increased risk of acute injury. However, the literature offers no insight about the long-term implications of weight lifting on growth plates. In sum, the expert consensus from our survey that strength training is safe for individuals with immature skeletons is consistent with data from medical literature.

Dance Partner or Dance Floor?: Exogenous Factors Resulting in Accidents in Professional Dancers

Injury prevention in professional dancers is very important due to the high risk for acute injuries posing a threat to dancers' careers. Causative factors of acute injuries in professional dance can be divided into exogenous and endogenous factors. Although both are known in professional dance, there is still a lack of data to have a differentiated view. The aim of this study is to analyze exogenous factors resulting in work accidents of professional dancers. The data for the evaluation were obtained from work accident reports (n = 1,438, female 722, male 716) from six Berlin Theatres. Evaluation and descriptive statistics were conducted by SPSS 18 and Excel 2007. About half (48.5%, n = 698) of all work accidents are caused by exogenous factors. The "dance partner" is the most common exogenous factor (39.9%), followed by the dance floor (28.24%) and props (13.6%). The lower extremity is the most frequent structure injured in either sex (male 47.3%, female 61.3%), followed by the upper extremity in females (14.6%) and spine in male dancers (19.8%). The stage is the most common injury location in both genders (males 63.9%, females 56.8%). Acute injuries caused by exogenous factors were particularly sustained during performances (males 58.8%, females 50.5%) and during rehearsals (males 33%, females 39.9%). This study shows the key significance of exogenous factors in acute injuries in professional dance. Preserving the dancers' health and preventing injuries takes top priority, and therefore, interventions in the artistic work cannot be ruled out when preventive measures are implemented.

Acute Injury Risk and Severity in Indoor Climbing—A Prospective Analysis of 515,337 Indoor Climbing Wall Visits in 5 Years

Rock climbing's popularity continues to rise, with people of all ages regularly participating in the sport. Climbing literature suggests climbers get injured mostly in their upper extremities. Most studies on climbing injury analysis are conducted retrospectively, with all the inherent problems of a retrospective setup (no exact time collection, biased injury perception, etc). Prospective data are still missing. We prospectively evaluated all attendees of a major German indoor climbing gym in Stuttgart, Germany, with bouldering and lead climbing facilities. Attendee's age, sex, and time spent climbing were electronically recorded on each visit. All acute injuries were graded using the Medical Commission of the Union Internationale des Associations d'Alpinisme Score. Injury cause, belayers' and climbers' experience, and outcome were additionally analyzed. During a 5-year period (2007-2011), 515,337 visits to the climbing wall were registered, of which 63.6% were by male visitors, 36.4% female, within an age of 8-80 years (median, 34 years). The average time of climbing was 2 hours 47 minutes. Thirty climbing injuries were recorded, 22 were in male and 8 in female climbers with a total mean age of 27.5 ± 10.6 years. Acute injuries happened in 6 cases while bouldering, in 16 cases while lead climbing, in 7 cases while top roping, and in 1 case as a third person (not climbing or belaying) while watching another climber. Bouldering injuries were mostly the result of falls onto the mat, whereas in lead and top rope climbing various scenarios happened. Fifteen (50%) injuries were Medical Commission of the Union Internationale des Associations d'Alpinisme grade 2, 13 (43%) were grade 3, and 2 (7%) were grade 4, with no fatalities. The overall injury rate was 0.02 injuries per 1000 hours of climbing activities. This was the first study to accurately record time spent indoor climbing digitally and evaluate the acute injuries prospectively in a large cohort. There were few injuries sustained, suggesting indoor climbing has a low risk of acute injury per 1000 hours of participation. The injuries were of minor to moderate injury severity, and no fatalities occurred. Several injuries could have been avoided, and further injury-prevention concepts should be developed.

The Injury Experience at the 2010 Winter Paralympic Games

The objective of this study was to examine incidence proportion and the characteristics of athlete injuries sustained during the 2010 Vancouver Paralympic Games. Descriptive epidemiological study. All medical venues at the 2010 Vancouver Paralympic Games, Canada. A total of 505 athletes from 44 National Paralympic Committees participating in the 2010 Vancouver Winter Paralympic Games. Baseline covariates included sport specificity (ie, ice sledge hockey, alpine skiing, Nordic skiing, wheelchair curling), gender, age, and disability classification. All injuries that occurred during the 2010 Vancouver Paralympic Games. "Injury" was defined as any sport-related musculoskeletal complaint that caused the athlete to seek medical attention during the study period, regardless of the athlete's ability to continue with training or competition. The Injury Surveillance System identified a total of 120 injuries among 505 athletes [incidence proportion = 23.8% (95% confidence interval, 20.11-27.7)] participating in the 2010 Winter Paralympic Games. There was a similar injury incidence proportion among male (22.8%) and female (26.6%) athletes [incidence rate ratio = 1.1 (95% confidence interval, 0.7-1.7)]. Medical encounters for musculoskeletal complaints were generated in 34% of all sledge hockey athletes, 22% of alpine ski racers, 19% of Nordic skiers, and 18% of wheelchair curling athletes. The Injury Surveillance System identified sport injuries in 24% of all athletes participating in the 2010 Winter Paralympic Games. The injury risk was significantly higher than during the 2002 (9.4%) and 2006 (8.4%) Winter Paralympic Games. This may reflect improved data collection systems but also highlights the high risk of acute injury in alpine skiing and ice sledge hockey at Paralympic Games. These data will assist future Organizing Committees with the delivery of medical care to athletes with a disability and guide future injury prevention research.

Injury Risk Evaluation in Sport Climbing

The aim of this study was to quantify and rate acute sport climbing injuries. Acute sport climbing injuries occurring from 2002 to 2006 were retrospectively assessed with a standardized web based questionnaire. A total number of 1962 climbers reported 699 injuries, which is equivalent to 0.2 injuries per 1 000 h of sport participation. Most (74.4%) of the injuries were of minor severity rated NACA I or NACA II. Injury distribution between the upper (42.6%) and lower extremities (41.3%) was similar, with ligament injuries, contusions and fractures being the most common injury types. Years of climbing experience (p<0.01), difficulty level (p<0.01), climbing time per week during summer (p<0.01) and winter (p<0.01) months were correlated with the injury rate. Age (p<0.05 (p=0.034)), years of climbing experience (p<0.01) and average climbing level (p<0.01) were correlated to the injury severity rated through NACA scores. The risk of acute injuries per 1 000 h of sport participation in sport climbing was lower than in previous studies on general rock climbing and higher than in studies on indoor climbing. In order to perform inter-study comparisons of future studies on climbing injuries, the use of a systematic and standardized scoring system (UIAA score) is essential.

A nine‐test screening battery for athletes: a reliability study

Studies have shown that reduced neuromuscular control or strength increases the risk of acute injuries. It is hypothesized that a non-functional movement pattern can predispose for injuries. In the present paper a detailed description of a test battery consisting of nine different tests to screen athletic movement pattern is provided. The aim was to evaluate the inter- and intra-rater reliability of the test battery on a group of male elite soccer players. Twenty-six healthy elite soccer players (17-28 years) were screened. Eighteen participated at a second occasion 7 days later. No significant difference (P=0.31) was found between test occasion 1 (LS means 18.3, 95% confidence interval 14.9-21.7) and test occasion 2 (18.0, 14.4-21.7) in the mean total score of the test battery. No significant difference in the inter-rater reliability was found between the eight physiotherapists at the two test occasions. The intra-class correlation coefficient was 0.80 and 0.81, respectively. The test battery showed good inter- and intra-rater reliability. The screening battery is easy to use for familiarized professionals and requires minimal equipment. However, further studies are needed to confirm the validity of the test battery in injury prevention, rehabilitation and performance enhancement.

Risk of injury on third-generation artificial turf in Norwegian professional football

BackgroundArtificial turf is used extensively in both recreational and elite football in areas with difficult climatic conditions.ObjectiveTo compare the risk for acute injuries between natural grass (NG) and third-generation artificial...

Injury risk on artificial turf and grass in youth tournament football

The aim of this prospective cohort study was to investigate the risk of acute injuries among youth male and female footballers playing on third-generation artificial turf compared with grass. Over 60,000 players 13-19 years of age were followed in four consecutive Norway Cup tournaments from 2005 to 2008. Injuries were recorded prospectively by the team coaches throughout each tournament. The overall incidence of injuries was 39.2 (SD: 0.8) per 1000 match hours; 34.2 (SD: 2.4) on artificial turf and 39.7 (SD: 0.8) on grass. After adjusting for the potential confounders age and gender, there was no difference in the overall risk of injury [odds ratio (OR): 0.93 (0.77-1.12), P=0.44] or in the risk of time loss injury [OR: 1.05 (0.68-1.61), P=0.82] between artificial turf and grass. However, there was a lower risk of ankle injuries [OR: 0.59 (0.40-0.88), P=0.008], and a higher risk of back and spine [OR: 1.92 (1.10-3.36), P=0.021] and shoulder and collarbone injuries [OR: 2.32 (1.01-5.31), P=0.049], on artificial turf compared with on grass. In conclusion, there was no difference in the overall risk of acute injury in youth footballers playing on third-generation artificial turf compared with grass.

Body mass index and the risk of acute injury in adolescents

To evaluate the relationship between body mass index (BMI) and acute injury in adolescents. An analysis of cross-sectional data from the Canadian Community Health Survey (CCHS) Cycle 3.1 collected by Statistics Canada in 2005 was conducted. The CCHS is a population-based survey that collects information pertaining to the Canadian population health status, health care use and health determinants. The CCHS Cycle 3.1 included 132,221 respondents, of whom 12,317 were 12 to 17 years of age. Multivariate logistic regression was used to estimate the odds of injury occurrence by BMI categories (obese, overweight and neither). The association between overweight and obese BMI levels and injury occurrence in the bivariate model was not significant after adjusting for sex, health status, activity levels and socioeconomic status (OR=1.10 [95% CI 0.97 to 1.24] for overweight and OR=1.12 [95% CI 0.92 to 1.37] for obesity). A subanalysis of those with an injury in the past 12 months found an elevated odds of experiencing multiple injuries in the overweight group, after adjusting for age, health status and physical activity level (OR=1.43 [95% CI 1.16 to 1.77]). An increased risk of acute injury in obese and overweight adolescents was not observed. However, the subgroup analysis suggested that multiple injuries are relatively frequent in the overweight BMI group.

Skating on thin ice: a study of the injuries sustained at a temporary ice skating rink

In recent years, ice skating and temporary ice skating rinks have become increasingly popular. Regular elite competitors are known to be at risk of both acute and chronic injuries. It may be postulated that skaters at the temporary rinks are at high risk of acute injuries from falls due to both their lack of expertise and the inherent dangers of ice skating. Injuries sustained at skating rinks present a significant burden to local healthcare resources, in particular orthopaedic departments. For the first time, Cambridge hosted such a facility from November 24, 2007 through January 6, 2008. We sought to identify the most common injuries encountered and to quantify the orthopaedic burden. All Emergency Department or Fracture Clinic attendances for an eight-week period from the opening of the rink were investigated. Details of age, sex, injury and management were recorded for the 84 patients who sustained ice rink related injuries. A total of 85 injuries were recorded in 84 patients. Of these injuries 58% were fractures, of which 98% involved the upper limbs. Seven patients (8% of all injuries) required admission for operative fixation. On average, two injuries per day were seen in the Emergency Department or Fracture Clinic, with an average of one orthopaedic admission per week. It is evident that the ice rink in Cambridge has had an impact on local healthcare resources. The vast majority of injuries affected the upper limbs and were sustained following a fall on the out-stretched hand. We therefore encourage the education of skaters as to how to break their falls more safely and recommend the use of wrist protectors as a primary preventative measure.

Shock wave lithotripsy: advances in technology and technique.

Shock wave lithotripsy (SWL) is the only noninvasive method for stone removal. Once considered as a primary option for the treatment of virtually all stones, SWL is now recognized to have important limitations that restrict its use. In particular, the effectiveness of SWL is severely limited by stone burden, and treatment with shock waves carries the risk of acute injury with the potential for long-term adverse effects. Research aiming to characterize the renal response to shock waves and to determine the mechanisms of shock wave action in stone breakage and renal injury has begun to suggest new treatment strategies to improve success rates and safety. Urologists can achieve better outcomes by treating at slower shock wave rate using a step-wise protocol. The aim is to achieve stone comminution using as few shock waves and at as low a power level as possible. Important challenges remain, including the need to improve acoustic coupling, enhance stone targeting, better determine when stone breakage is complete, and minimize the occurrence of residual stone fragments. New technologies have begun to address many of these issues, and hold considerable promise for the future.

The Epidemiology and Aetiology of Injuries in Sailing

Sailors are at risk of injury and an understanding of the risks and causes of injury are important in helping to reduce their frequency and severity. Injuries are specific to the class of sailing. In elite Olympic-class sailing the incidence of injury is approximately 0.2 injuries/athlete/year, with the lumbar and thoracic spine and the knee most commonly injured. Poor hiking technique and inadequate leg strength are thought to predispose the knee to injury. Injuries in novice and recreational sailing are predominantly acute in nature with contusions and abrasions typically occurring as a result of collisions with the boom or other equipment during manoeuvres. The only report of injuries in Paralympic-class sailing found a high rate of approximately 100 injuries/1000 days of sailing, likely due to severe sailing conditions. The majority of injuries were chronic in nature, predominantly sprains and strains of the upper extremity. The risk of windsurfing injury ranged from 1.1 to 2.0 injuries/person/year, with the majority of injuries being acute, typically due to impact with equipment. Severe injuries are frequent, with competitive male windsurfers often admitted to hospital for treatment. Chronic lower back injuries are also common in windsurfers and may be related to prolonged lordosis (lumbar extension) of the spine while 'pumping' the sail. In professional big-boat sailing, America's Cup studies have reported an incidence of approximately 2.2 injuries/1000 hours of sailing, with one study reporting a higher incidence of injury during fitness training sessions (8.6 injuries/1000 hours of fitness training). The main cause of injury seems to be non-specific overuse, with joint and ligament sprains and tendinopathies being the most common. Grinders and bowmen are at greatest risk of injury, with the repetitive nature of 'grinding' a contributing factor. In round-the-world offshore racing, 1.5 injuries/person/round-the-world race (amateur), and 3.2 injuries/person/race (professional) have been reported, with the majority being impact injuries (e.g. contusions, lacerations, fractures and sprains). Helmsmen experience mostly upper-limb overuse injuries as a result of 'steering', while mastmen and bowmen are at greater risk of acute injuries. Illnesses and non-injury-related complaints account for a large proportion of medical conditions in these events. Sailors of all classes and abilities seem to be at risk of injury, particularly from acute impacts with equipment that might be reduced by wearing protective clothing and more ergonomic boat design. High repetition activities, such as hiking, pumping, grinding and steering, are major causes of overuse injury in experienced sailors. Informed coaching of correct technique and appropriate progression of physical and technical developments are required. Competitive sailors should undergo regular health screening with specific strengthening of high-risk muscle groups, synergists and stabilizers. The scarcity of analytical studies of sailing injuries is a major concern, and there is a need for thorough prospective studies.

Die 200- bis 400 m-Brustlage dominiert bei Knieüberlastungsschäden im Schwimmsport

We hypothesized that pool swimming has a low risk for acute injuries; however overuse injuries are predominant, depending on exposure time and swimming discipline. 341 elite swimmers (19 +/- 11 years, BMI 20.3 +/- 3) were enrolled. Swimming was performed at mean since 10.1 +/- 8 years with 3.8 units every week during 43 weeks every year. The overall pool swimming injury rate was 0.39 / 1000 h. Overuse injuries (0.22 / 1000 h) were more frequent than acute injuries (0.17 / 1000 h). The upper extremity was involved more frequently (0.11 / 1000 h) than the trunk (0.067 / 1000 h) or the lower extremity (0.085 / 1000 h). Knee pain was predominant (0.17 / 1000 h) followed by shoulder overuse injuries (0.11 / 1000 h). Especially the 200 - 400 m breaststroke event had a fivefold higher risk for knee pain (relative risk, RR 5.1, p = 0.001). Freestyle had a reduced relative risk for knee pain (RR 0.5, p = 0.03), where shoulder overuse syndromes were predominant. Butterfly increased acute shoulder injury with RR 4.4 (p = 0.004), cervical spine injuries (RR 4.0, p = 0.03) and lower back pain (RR 2.5, p = 0.011). Swimming for more than four times a week had a higher risk for knee injuries (RR 2.1) and shoulder injuries (RR 4.0). We found that stretching was associated with a fivefold reduced risk for overuse knee injuries. Competitive swimming is a reasonable safe sport, where overuse injuries are predominant. 200 - 400 m breaststroke events increase the risk for knee overuse injuries more than other disciplines. Training for more than four times a week increases the risk twofold for knee and fourfold for shoulder overuse injuries.

Incidence of Acute Injury Related to Fitness Testing of U.S. Army Personnel

This study documented the incidence of acute injuries related to the Army Physical Fitness Test (APFT). A questionnaire was administered to 1,532 soldiers after they completed a biannual APFT. Self-reported injury responses determined the rates of injuries resulting from the push-up, sit-up, and 2-mile run events and were classified into three categories, i.e., all injuries, performance-limiting injuries, and time-loss injuries. A total of 117 soldiers (injury rate, 7.6%) reported sustaining an injury (all injuries), with 11% attributed to the push-up event, 56% to the sit-up event, and 32% to the run event. Forty-six of these injuries reportedly limited performance (injury rate, 3.0%), and 11 soldiers received a duty-limiting profile (time-loss injury rate, 0.7%), which did not differ among events. Injury rates were not significantly associated with the number of sit-ups performed per week or the number of days per week a soldier participated in physical training and were not greater for soldiers who trained specifically for the APFT. History of previous injury was a significant risk factor for injury. The push-up, sit-up, and run events of the APFT do not pose a considerable acute injury risk to active duty soldiers.

Aeroallergens, allergic rhinitis, and sedating antihistamines: Risk factors for traumatic occupational injury and economic impact

The U.S. workplace injury burden is significant. Our objective was to assess the particular impact of aeroallergen, allergic rhinitis, and antihistamine exposures and side effects on the risk of traumatic work-related injuries, and the associated economic impact. This is an observational case-control study with 1,223 acute traumatic injury cases that are compared to 1,202 chronic back injury controls. Structured telephone interviews were conducted in 1998 and 1999 on Workers' Compensation applicants injured in 1997. Antihistamine use and pollen levels were measured 2 weeks prior to the injury date. Sedating antihistamine exposures elevated acute injury risk (main effect OR: 2.93). A significant increase in traumatic injury risk was observed for combined sedating antihistamine and high pollen exposures among subjects with physician and self-diagnosed allergic rhinitis (OR: 2.41). Direct medical costs associated with this increased risk were estimated at $143 million in 2001. Workers with physician-diagnosed allergic rhinitis have as high a reliance on sedating antihistamines as do self-diagnosed and self-medicating nasal allergy sufferers. High pollen exposures along with sedating antihistamine use may confer significant additional injury risks among allergic rhinitis sufferers. Medical management "best practices" of diagnosed allergic rhinitis should include avoidance of sedating antihistamines to minimize acute, traumatic injury risks.

The incidence of injuries in elite junior figure skaters.

There has been rapid growth in the technical and physiologic demands made on skaters who perform more and more difficult jumps, spins, lifts, throws, and free skating movements. To investigate the frequency of injuries and overuse syndromes in elite junior skaters. Questionnaire. During four consecutive Junior World Figure Skating Championships and the Croatia Cup, we interviewed 236 female and 233 male skaters by questionnaire to determine the frequency of injuries and overuse syndromes. Fifty-nine of the female skaters (25%) and 65 of the male skaters (27.9%) reported sustaining acute injuries; 101 female (42.8%) and 106 male (45.5%) skaters reported overuse syndromes. Low back pain was reported by 19 female and 23 male skaters. The most frequent acute injury was ankle sprain. In singles female skaters, the most frequent overuse injury was stress fracture (19.8%), followed by jumper's knee (14.9%). In singles male skaters, jumper's knee (16.1%) was the most frequent injury, followed by Osgood-Schlatter disease (14.2%). More than 50% of injuries in young singles figure skaters involved overuse syndromes. Pairs skaters and ice dance skaters had a higher risk of acute injury than overuse syndrome because of falls from lifts and throw jumps. Programs to improve postural alignment, flexibility, and strength, especially during the asynchronous period of bone and soft tissue development, should be instituted to prevent and reduce overuse syndromes.