States Consumer Product Safety Commission Research Articles

Poster 390: Combat Sports Related Upper Extremity Injuries Presenting to Emergency Departments in the United States: A NEISS Database Study

Objectives: Combat sports continue to be a popular form of recreation within the United States. With this continually increasing popularity and participation comes an increase in associated injuries as well. Despite this, there remains a paucity of studies characterizing injury patterns, types, and anatomic distributions of injuries sustained during participation in combat sports, thus necessitating further investigation. The goal of this study is to provide an updated description of injuries within combat sports, specifically to the upper extremity and presenting to US emergency departments (EDs). It is our hope that this information may be utilized by participants and trainers to help develop preventative strategies, as well as by health care professionals to diagnose patients and provide the appropriate treatment more readily and accurately. Methods: A retrospective analysis was performed utilizing data from the United States Consumer Product Safety Commission’s (CPSC) National Electronic Injury Surveillance System (NEISS) between 2003 and 2022. Data were limited to product codes 1200 (unclassified sports or recreational activity), 1207 (boxing), 1270 (wrestling), and 3257 (martial arts). The year designation variable was added to each year’s remaining dataset, and all years were concatenated into a single compiled dataset containing 84,812 observations. Beginning in 2019, the NEISS database updated their gender designations to include sexes which were unidentified or non-binary. Designations of unidentified or nonbinary genders were removed from the dataset, reducing the sample size to 84,807 observations. Data were then filtered to include only injuries of the upper extremity, reducing sample size to 29,364. Anatomic regions of interest included shoulder, upper arm, elbow, forearm, wrist, hand, and fingers. Narratives were reviewed to remove unclassified injuries that did not describe a combat sport of any type, injuries where the reference was to a different primary cause, or terminology overlap. For example, boxing injuries occurring from punching bag arcade games were excluded. Finally, several diagnoses were excluded, such as contusion, crushing injuries, dermatitis, puncture wounds, hematomas, hemorrhages, and other/not stated. Diagnoses of interest included dislocations, fractures, and strains/sprains. The final sample size was 12,642. Injury rates for specific injury types and upper extremity subregions were described as percentages of total injuries, both within each sport category and across all sports. Injury rates were also assessed on a year-by-year basis, and year-to-year variation within and between sports was assessed using chi-square tests. Results: Of the 12,642 upper extremity injuries for which patients presented to US EDs between the years 2003 and 2022, nearly half were sustained from wrestling (6230, 49.3%) whereas the remaining half were more evenly distributed between boxing (3318, 26.2%) and martial arts (3094, 24.5%). There was a significant effect of time on injury distributions by sport (chi-square test: X2 =80.89, P < 0.001). Even when accounting for the years during COVID-19, significant differences between sports and over time were still detected. When assessing anatomic regions injured by sport, wrestling unsurprisingly accounted for most shoulder (59.5%), upper arm (67.7%), elbow (75.3%), forearm (57.6%), and finger (50.3%) injuries given the amount of overall wrestling injuries compared to boxing and martial arts. Boxing, however, accounted for most hand (64.1%) and wrist (37.7%) injuries, despite fewer overall injuries compared to wrestling. The most frequently injured regions within boxing, wrestling, and martial arts were the hand (40.1%), shoulder, (33.8%), and shoulder (28%), respectively. Regarding injury types, wrestling accounted for the highest percentage of each type, including dislocations (55.7%), fractures (46.9), and strains/sprains (50%). Remaining frequencies for dislocations, fractures, and strains/sprains were roughly equal in distributions for boxing and martial arts. Strains/sprains were much more common than dislocations in each sport as well, with a ~4:1 ratio in boxing, and a ~3:1 ratio in wrestling and in martial arts. The most common specific injuries (anatomic region + injury type) sustained across all sports were shoulder strain/sprain (14.7%), followed by hand fractures (13.1%), wrist strain/sprain (9.5%), finger fractures (8.7%), forearm fractures (7.2%), shoulder dislocation (7.1%), finger strain/sprain (6.4%), shoulder fractures (6.2%), wrist fractures (5.4%), and elbow strain/sprain (5.0%). Wrestling accounted for most of these injuries; however, boxing accounted for the majority of hand fractures and dislocations, as well as strains/sprains of the wrist and upper arm. Conclusions: This study demonstrates significant variability in pattern and location of injuries sustained from wrestling, boxing, and martial arts. By providing updated insight regarding the temporal trends and injury patterns to the upper extremity in boxing, wrestling, and martial arts, this study may assist in the efforts to continue advancing safety measures in a group of sports that continues to gain interest in the United States.

Barriers: Location, Functionality, and Method of Access in Childhood Pool/Spa Submersion Incidents, United States, 2000-2017

Drowning is a leading cause of fatality among children in the United States, and residential pools/spas currently account for as much as 80% of these submersion incidents. This study reviewed narrative case reports obtained from the United States Consumer Product Safety Commission (CPSC) to understand barrier location, type, and functionality as methods of pool/spa access for childhood submersion incidents. Retroactive analysis of 1,523 fatal and non-fatal submersion incidents among children aged 13 years old and younger was conducted using the CPSC in depth investigation dataset from 2000-2017. Narrative descriptions were coded according to the attributes of barrier location, functionality, and method of access; to our knowledge, these characteristics of barriers have not been previously investigated to this depth. Outcomes indicate that consumer education campaigns should target households with swimming pools/spas and reiterate key findings that (1) submersion incidents occur even when barriers are present and (2) the importance of multiple layers of protection against unauthorized pool/spa access. Additionally, improved documentation of barriers is imperative to better understand and prevent drowning among children.

536 Firework Injuries in Pediatric Patients: A 15 Year Review

Abstract Introduction The United States Consumer Product Safety Commission (CPSC) estimated that 15,600 firework-related injuries were treated in US hospital emergency departments during calendar year 2020 and that there has been a trend of increased injuries from 2005-2020. The goal of this project was to look at the experience of one center with a large referral network, to identify trends and opportunities. Methods A retrospective chart review was performed to analyze data points including mechanism, age, sex, TBSA, injury locations, procedures performed, outcomes and complications length of stay, and services involved. The burn registry was utilized to identify cases throughout a 15-year period. Results During this period, 24 pediatric patients required admission for firework injuries. Eighty-four percent were males compared to 16% in females. Most injuries (67%) occurred while the patient was holding the firework and lighting it as opposed to being struck by a firework. Most of the injuries had small TBSA percentages (84% < TBSA of 15). In addition, most were referred from outside facilities. Most common sites of injury included the hands and face, followed by the eyes. Sixty percent of patients required operative intervention for their injuries, some requiring multiple surgeries. The average length of stay was 2 days, while 8 patients stayed longer than 5 days. Ninety-two percent were admitted to the burn service with additional specialty consultants. Most children required multiple follow up visits. Conclusions Firework related injuries in children result in significant injury often requiring surgical procedures along with a long outpatient treatment course. This work highlights a need for continued advocacy, education, an intervention. This program uses a curriculum and process for children who are injured due to setting fires. The program is evaluating a similar model of intervention and 1:1 counseling for children injured due to fireworks. Applicability of Research to Practice This project is applicable to practice as it highlights the continued opportunity for intervention and prevention for firework related injuries. The trends are not decreasing, and the injuries are significant. Evaluation of a model for youth who have fireworks related injuries, similar to the youth fire-setting program, would be a beneficial next step.

Recalls.gov: Your Online Resource for Recalls

The United States Food and Drug Administration, National Highway Traffic Safety Administration, United States Environmental Protection Agency, The United States Department of Agriculture, United States Coast Guard, and United States Consumer Product Safety Commission joined together to provide alerts for the American people when products are unsafe, hazardous, or defective. While in need of an update, Recalls.gov provides one web page where consumers can obtain recall information, report a dangerous product, and learn important safety updates to stay healthy.

Contamination by hazardous elements in low-priced children's plastic toys bought on the local markets of Karachi, Pakistan.

Children's plastic toys may contain toxic metals to which infants and young children can be orally exposed and may pose acute or chronic adverse health effects. This research aims to evaluate the total metal concentrations (TMCs) of Pb, Cd, Cr, Ni, Zn, Cu, and Mn in children's plastic toys bought in the local markets of Karachi, Pakistan, and compare TMCs to different toy safety regulatory limits. A total of 44 children's plastic toys sourced in the Karachi local markets were analyzed by an atomic absorption spectrophotometer for contamination of hazardous elements. Toy samples were divided into two groups: plastic toys (DCT) and plastic toys with paints or coatings (DPCT). For plastic toys, 83% (19) of samples had TMCs that exceeded European Union (EU) toy safety regulation limits for Pb, and 65% (15) of samples that exceeded for Cd. For plastic toys with paints or coating, 43% (9) of samples had TMCs that exceeded EU migration limits for Pb and 24% (5) for Cd. More than 20 samples exceeded the United States Consumer Product Safety Commission (US CPSC), Canadian, and Bureau of Indian Standards (BIS) toy safety regulation limits. In toy samples (n = 44), very high TMCs of Pb (64%), Cd (45%), Cr (5%), and Ni (2%) were observed. Zn, Cu, and Mn TMCs existed but were below the regulation limits. The contamination levels of Pb, Cd, Cr, and Ni and smaller extent of Zn, Cu, and Mn still pose health issues in children and may cause serious problems in their health.

An Updated Look at Television-Related Pediatric Head and Neck Injuries: Safer Products and a Shifting Paradigm.

Television tip-over injuries have been designated a top-five hidden home hazard by the United States Consumer Product Safety Commission. In this study the authors utilize the National Electronic Injury Surveillance System (NEISS) Database to provide an updated look at television-related head and neck injuries in the United States pediatric population. The NEISS Database was accessed for all television-related head and neck injury reports from January 2000 to December 2018 in patients under 18 years of age. Demographic data including age, sex, and race were also obtained. Narrative descriptions of each injury were also individually reviewed and categorized by specific type of injury. Miscoded reports were excluded. Between January 2000 and December 2018, 5944 NEISS reports of television-related injuries met inclusion criteria, corresponding to an estimated total of 159,785 injuries nationally during this period. The average patient age at time of evaluation was 4.11 years with a male predominance of 61.3%. Total number of injuries - and weighted national estimates - remained relatively stable between 2000 and 2006, peaking in 2009 (450 reported cases, 12,004 estimated national total). Between 2009 and 2018 the number of reported injuries, and corresponding national estimates, saw a 75.8% and a 72.1% decrease, respectively. Television-related head and neck injuries have declined dramatically in the United States since 2009. The underlying cause of this decline is likely multifactorial, and additional steps to improve the safety of these products are necessary to continue to ensure the safety of all children in the United States.

Managing head injury risks in competitive skateboarding: what do we know?

ObjectivesThe broad objective of this paper is to inform policy, practice and research regarding the management of head injury risks in competitive skateboarding. The main motivation for the current study...

Unpowered Scooter-Related Injuries among Adolescents and Adults in the United States 2007-2017

United States Consumer Product Safety Commission (CPSC) reported a 700% increase in Emergency Department (ED) visits for injuries attributed to unpowered scooter use from January through October 2000. Our objective is to investigate injuries associated with the use of unpowered scooters among adolescents from the age of >9 years to 20 years in the National Electronic Injury Surveillance Study (NEISS) data set from 2007-2017. We analyzed unpowered scooter-related injuries in the NEISS data set using variables: SCOOTER, INJURED, AFTER, OFF, AT and IN; the product code for injuries related to unpowered scooters is 1329, and age ≥9 years and 9 - 19 - <99 years. Distribution by race: White 39.65%, Not Specified (NS) 38.94%, Black/African American 13.98% and Others (Asian, American Indians, Alaskan natives, Native Hawaiians, and Pacific Islanders) 7.43%. Body parts injured: head 16.19%, followed by face 8.49%, finger 8.30%, lower trunk 8.30%, ankle 5.60%, upper trunk 5.35%, internal injuries 0.99% and others 14.28%. Most of the injuries were mild: Treated and Discharged 89.80%, Hospitalized 7.68%, and Death in ED 0.05%. The locations of injuries were: Occurred at Home 43.47%, UNK 29.78%, Sports 12.63%, Public 6.49%, School 5.35%, and Street 2.22%. Injury trend: a rise until 2010, a decline until 2015 and, then a sharp rise through 2017. Injuries from the use of unpowered scooters are a rising threat that should be given attention. Outcome: Most of the injuries 69.80% were mild treated and discharged, 7.68% were hospitalized, while death in ED was 0.05%. Whereas: Transfer to referral hospital was about the same as in adults. Although most of these injuries were minor, head injuries could lead to more serious problems, and severe injuries could be life-threatening.

Increasing Burden of Youth Baseball Elbow Injuries in US Emergency Departments

Background:Youth athletes are starting sports earlier and training harder. Intense, year-round demands are encouraging early sports specialization under the perception that it will improve the odds of future elite performance. Unfortunately, there is growing evidence that early specialization is associated with increased risk of injury and burnout. This is especially true of pediatric and adolescent baseball players.Purpose/Hypothesis:The purpose of this investigation was to analyze national injury trends of youth baseball players. We hypothesized that while the total number of baseball injuries diagnosed over the past decade would decrease, there would be an increase in adolescent elbow injuries seen nationally. A further hypothesis was that this trend would be significantly greater than other injuries to the upper extremity and major joints.Study Design:Descriptive epidemiology study.Methods:Injury data from the National Electronic Injury Surveillance System, a United States Consumer Product Safety Commission database, were analyzed between January 1, 2006, and December 31, 2016, for baseball players aged ≤18 years. Data were collected on the location of injury, diagnosis, and mechanism of injury.Results:Between 2006 and 2016, an estimated 665,133 baseball injuries occurred nationally. The mean age of the injured players was 11.5 years. The most common injuries diagnosed included contusions (26.8%), fractures (23.6%), and strains and sprains (18.7%). Among major joints, the ankle (25.6%) was most commonly injured, followed by the knee (21.3%), wrist (19.2%), elbow (17.7%), and shoulder (16.2%). The incidence of the ankle, knee, wrist, and shoulder injuries decreased over time, while only the incidence of elbow injuries increased. A linear regression analysis demonstrated that the increasing incidence of elbow injuries was statistically significant against the decreasing trend for all baseball injury diagnoses, as well as ankle, knee, wrist, hand, and finger injuries (P < .05). Additionally, the only elbow injury mechanism that increased substantially over time was throwing.Conclusion:The current investigation found that while the incidence of baseball injuries sustained by youth players is decreasing, elbow pathology is becoming more prevalent and is more commonly being caused by throwing. Given that the majority of elbow injuries among adolescent baseball players are overuse injuries, these findings underscore the importance of developing strategies to continue to ensure the safety of these youth athletes.

Trends in All-terrain Vehicle Injuries From 2000 to 2015 and the Effect of Targeted Public Safety Campaigns.

All-terrain vehicles (ATVs) represent a notable portion of orthopaedic injuries presenting to emergency departments (EDs) in the United States. Public awareness campaigns have targeted these injuries, and this study sought to examine the effect of the 2007 American Academy of Orthopaedic Surgeons public safety campaign on ATV use. The United States Consumer Product Safety Commission National Electronic Injury Surveillance System (NEISS) was used to obtain national estimates of ATV and dirt bike injuries for the years 2000 to 2015. ED visits resulting from ATV injuries and dirt bike injuries were identified using NEISS product codes (ie, 3285-3287, 3296, and 5036). Patient demographics, injury-related data, and total annual case numbers were estimated. Chi-square tests and logistic regression were used for comparative analyses as appropriate. All statistical analyses were performed using SAS statistical software v.9.4 (SAS Institute). Statistical significance was set at P < 0.05 a priori. Beginning in 2000, the incidence of ATV injuries consistently increased over time and peaked in 2007 (54.1/100,000 people). Since 2007, the incidence of ATV injuries has consistently decreased (33.7/100,000 people in 2015). The frequency of ATV injuries differed significantly (P < 0.001) by age group, with children aged 14 to 17 years experiencing the highest incidence of ATV injury (2.8× national average). ATV injuries were also more common in males (2.7× national average; P < 0.001). The most common injuries were contusions and abrasions (25.3%), fractures (24.5%), and lacerations (11.4%). The decreased rate of ATV injury beginning in 2007 did not differ significantly (P = 0.81) from a comparative decrease in dirt bike-related injuries. This study provides the most current data on ATV injuries presenting to EDs in the United States. The rate of ATV-related injuries has steadily decreased since 2007, which corresponds to the American Academy of Orthopaedic Surgeons public awareness campaign. However, the reasons for this decrease are likely multifactorial. Children aged 14 to 17 years are at high risk of ATV-related injuries, with orthopaedic injuries accounting for a notable proportion.

Brazilian Jiu Jitsu, Judo, and Mixed Martial Arts Injuries Presenting to United States Emergency Departments, 2008-2015.

Limited research has systematically examined injuries resulting from Brazilian Jiu Jitsu (BJJ), Judo, and mixed martial arts (MMA), especially when compared to more well-known or -established martial arts. These three combative sports differ substantially regarding their rules and techniques. BJJ emphasizes ground positioning and submission, Judo rewards throwing an opponent on their back with submission ending the match, and MMA emphasizes knocking out or forcing the submission of one's opponent. We examined injuries, among people of any age, experienced from participation in BJJ, Judo, and MMA. We analyzed data from the United States (U.S.) Consumer Product Safety Commission National Electronic Injury Surveillance System to create estimates of injuries presenting to U.S. emergency departments (EDs). We compared injury profiles between sports, including estimated numbers of injuries, their site, type, and mechanism. Participation in BJJ, Judo, and MMA resulted in an estimated 39,181 injuries presenting to U.S. EDs from 2008 through 2015. Strains and sprains were the most common diagnoses for BJJ and Judo participants, whereas abrasions/contusions were the most commonly diagnosed MMA injury. Being struck resulted in the majority of injuries for all three sports. The head was the most injured body region for BJJ and MMA, whereas the leg was the most injured body region for Judo. Finally, the majority of BJJ and Judo injuries occurred during noncompetitive grappling, whereas most MMA injuries occurred during competition. Our study adds to the limited literature examining injuries from BJJ, Judo, and MMA using data from a probability sample and is an initial step towards understanding the national burden of injury from participation in these sports. Given the quantity and severity of injuries sustained by participants, additional research is needed to assess the riskiness of participation and the effectiveness of interventions, such as improved personal protective gear and mats, as a means to prevent commonly occurring injuries.

The Impact of Body Checking on Youth Ice Hockey Injuries.

Background:Body checking is a common cause of youth ice hockey injuries. Consequently, USA Hockey raised the minimum age at which body checking is permitted from the Pee Wee level (11-12 years old) to the Bantam level (13-14 years old) in 2011.Purpose/Hypothesis:The purpose of this investigation was to determine the impact of body checking on the distribution of injuries reported in youth ice hockey players. We hypothesized that the elimination of body checking at the Pee Wee level would lower the frequency of serious injuries, particularly concussions.Study Design:Descriptive epidemiology study.Methods:Injury data from the National Electronic Injury Surveillance System (NEISS), a United States Consumer Product Safety Commission database, were analyzed for Pee Wee and Bantam players between January 1, 2008 and December 31, 2010 and again between January 1, 2013 and December 31, 2015. Data on the location of injury, diagnosis, and mechanism of injury were collected. The location of injury was categorized into 4 groups: head and neck, upper extremity, lower extremity, and core. Diagnoses investigated included concussions, fractures, lacerations, strains or sprains, internal organ injuries, and other. The mechanism of injury was broken down into 2 categories: checking and other.Results:Between the 2008-2010 and 2013-2015 seasons, overall injuries decreased by 16.6% among Pee Wee players, with injuries caused by body checking decreasing by 38.2% (P = .012). There was a significant change in the distribution of diagnoses in the Pee Wee age group during this time frame (P = .007): strains or sprains, internal organ injuries, and fractures decreased in frequency, while the number of concussions increased by 50.0%. In the Bantam age group, recorded injuries decreased by 6.8%, and there was no change in the distribution of the location of injury, diagnosis, or mechanism of injury (P > .05).Conclusion:There was an observed reduction in the total number, mechanism, and type of injuries when body checking was eliminated from the Pee Wee level. There was, however, an unexpected increase in the number of concussions.

Types of Objects in the Sleep Environment Associated With Infant Suffocation and Strangulation

ObjectiveTo investigate the circumstances of death and types and roles of objects present in the sleep environment at the time of death for infants who died from suffocation or strangulation during sleep. MethodsThis study analyzed 1736 reported incidents of accidental suffocation and strangulation in bed (ASSB) of infants younger than 1 year of age. These fatalities occurred from 2000 through 2012 and were reported to the United States Consumer Product Safety Commission. ResultsThe mean age of ASSB death was 3.76 months (SD, 2.51). Infants younger than 5 months accounted for 67.3% (1168 of 1736) of all reported fatalities and 58.3% (1009 of 1731) were male. Deceased infants were often found in a crib or bassinet (30.6%; 383 of 1253) or in the prone orientation (84.9%; 595 of 701). The most common objects associated with infant ASSB were pillows (24.5%; 425 of 1736), mattresses (21.0%; 364 of 1736), blankets (13.1%; 228 of 1736), and walls (11.5%; 199 of 1736). Wedged (43.3%; 616 of 1424) or positioned on top of an object (25.9%; 369 of 1424) were the most common positions associated with death. Infants were often found wedged between a mattress and wall (30.2%; 181 of 599) or oriented face-down or prone on top of a pillow (52.2%; 187 of 358). Sleep surface sharing was associated with 6.5% (112 of 1736) of ASSB deaths. ConclusionsPillows and blankets are objects in sleep environments frequently associated with unintentional suffocation and strangulation of infants. Increased efforts should be made to remove these and other objects from sleep environments of infants.

Understanding risk factor patterns in ATV fatalities: A recursive partitioning approach

IntroductionAlthough there are hundreds of ATV-related deaths each year in the United States, contributing factors have not been clearly identified. The purpose of this study was to investigate associations between factors contributing to ATV fatalities using the agent–host–environment epidemiological triangle. MethodIncident reports of ATV fatalities occurring between 2011 and 2013 were obtained from the United States Consumer Product Safety Commission (CPSC). Narrative reports included details of the decedent and a description of the ATV crash. A chi-square automatic interaction detector (CHAID) analysis was performed for three major risk factors representing each facet of the epidemiologic triangle: helmet use (host), type of crash (agent), and location where death occurred (environment). The output of the CHAID analysis is a classification tree that models the relationship between the predictor variables and a single outcome variable. ResultsA total of 1193 ATV fatalities were reported to the CPSC during the 3-year study period. In cases with known helmet and/or drug and alcohol use status, descriptive statistics indicated helmets were not worn in 88% of fatalities and use of alcohol or drugs was present in 84% of fatalities. Reoccurring factors within the CHAID analysis included age, helmet use, geographic region of the country, and location (e.g., farm, street, home, etc.) at the time of death. Within the three CHAID models, there were seven significant partitions related to host, one related to agent, and eight related to the environment. ConclusionsThis research provides a model for understanding the relationship between risk factors and fatalities. The combination of the CHAID analysis method and the epidemiologic triangle allows for visualization of the interaction between host–agent–environment factors and fatalities. Practical applicationsBy modeling and characterizing risk factors associated with ATV fatalities, future work can focus on developing solutions targeted to specific factions of ATV users.

Epidemiology of lawnmower-related injuries in children: A 10-year review

BackgroundLawnmower-related injuries (LMI) in children are commonly disfiguring and usually preventable. Owing to concerns about the large number and severity of pediatric LMI, we sought to describe the current epidemiology of these injuries in the United States. MethodsData were obtained from the 2004 to 2013 National Electronic Surveillance system of the United States Consumer Product Safety Commission for children ≤20 years old. Demographic, injury pattern, and treatment data were analyzed. ResultsThere were an estimated 93,508 LMI, with an incidence of 9,351 LMI per year. The hand and/or fingers (30.1%), lower extremity (16.8%), and face and/or eye (14.0%) were the body parts most commonly injured. Amputations (relative risk [RR]: 11.5; 95% confidence interval [CI]: 11.00 to 12.10; P < .0001) and fractures (RR: 2.82; 95% CI: 2.64 to 3.00; P < .0001) were more likely to require hospitalization. ConclusionsThe estimated annual incidence of LMI in children has remained unchanged over the past decade, and has remained constant when compared with a previous 15-year review using Consumer Product Safety Commission data for the same age group. Reinforcement of prevention strategies and manufacturer redesign of lawnmowers are long overdue.

The Children’s Playgrounds in Apartments and Terrace Housing Areas: Places of Leisure or Failure?

Colourful playgrounds are made for the young children. But, aren’t they being provided for leisure or failure? This paper has conducted an assessment on the children’s playgrounds that located in the housing areas of apartments and terraces. Such study is ubiquitous in the developed world, however, in Malaysia this topic is neglected, the children’s playgrounds are presumed to be in good conditions because they were assessed at a distance. An observational survey was conducted on 57 children’s playgrounds in the playing areas of apartments and terrace housings scattered in several cities of West Peninsular Malaysia. The safety checklist and playground grading forms which were used as the main survey instruments was modified based on the original checklist from the United States Consumer Product Safety Commission and the grading system was adapted from the United States National Program for Playground Safety. The safety evaluations stressed on four elements; the surfacing materials, drainage, general hazards and equipment maintenance. The result, most of the playgrounds were struggled to comply with the safety checklists. Significant problems and faulty issues on equipment were composed in the form of graphical images to enhance the discussions. Half of the sampling population managed to get the minimum C grades and only to be rated as the average playgrounds. If Malaysia’s playgrounds are prioritized not on safety and neglecting their equipment maintenance, the number of failure playgrounds will surely increase and so does the playground accidents.

232 EPIDEMIOLOGY OF SPORTS RELATED GENITO-URINARY INJURIES PRESENTING TO EMERGENCY ROOMS

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery III1 Apr 2012232 EPIDEMIOLOGY OF SPORTS RELATED GENITO-URINARY INJURIES PRESENTING TO EMERGENCY ROOMS Patrick B. Fisher, Herman S. Bagga, MD Gregory E. Tasian, MD MSc Nadya M. Cinman, MD Charles E. McCulloch, PhD Jack W. McAninch, andMD Benjamin N. BreyerMD MAS Patrick B. FisherPatrick B. Fisher San Francisco, CA More articles by this author , Herman S. BaggaHerman S. Bagga San Francisco, CA More articles by this author , Gregory E. TasianGregory E. Tasian Philadelphia, PA More articles by this author , Nadya M. CinmanNadya M. Cinman San Francisco, CA More articles by this author , Charles E. McCullochCharles E. McCulloch San Francisco, CA More articles by this author , Jack W. McAninchJack W. McAninch San Francisco, CA More articles by this author , and Benjamin N. BreyerBenjamin N. Breyer San Francisco, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.287AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To study the epidemiology of sports-related genito-urinary (GU) injuries presenting to emergency departments (ED) in the US. METHODS A retrospective analysis was conducted of the National Electronic Injury Surveillance System (NEISS) of the United States Consumer Product Safety Commission between 2002 – 2010. The NEISS is a stratified probability sample of hospital emergency departments in the United States and its territories. Data collected from the NEISS sample can be used to produce national estimates of the number of consumer products-related injuries treated in hospital EDs. A total of 4,563 sports related ED visits were documented over nine years. Data were analyzed using Stata (Ver 12.0) to accommodate the complex sample survey design, grouped by theme and coded to describe and compare case characteristics. RESULTS Between 2002 and 2010, an estimated 133,706 (95% CI 109,252-158,161) individuals presented to the ED with GU injuries related to sports. Of those affected, 69% were male and 31% were female. An estimated 90,314 (95% CI 72,885-107,745) children sustained sports-related GU injuries, the most common of which involved bicycles (33%), swimming/diving (11%), football (6%), sporting vehicles including scooters (6%) and basketball (5%). The majority of injuries were sustained in the 4-7 year old (30%), 8-11 year old (28%) and 12-15 year old (23%) age categories. In the adult population, an estimated 43,391 injuries were sustained (95% CI 33,880-52,903). The most common causes of injury were bicycles (25%), sports vehicles including scooters and ATVs (11%), basketball (6.4%), baseball/softball (5%) and swimming/diving (5%). Of adult sports injuries the majority occurred in the 19-28 year old (49%) and 28-45 (34%) age categories. In all age groups the most common mechanism of injury was contusion (34%) followed by laceration (22%). The most commonly injured organs were the testicles (27%), female external genitalia (21%), and scrotum (13%). More injuries were observed between April and September relative to the winter months. CONCLUSIONS Our results suggest that GU injuries related to sports are prevalent in both the adult and pediatric populations. Bicycles, in particular, account for the majority of sports-related GU injuries in both populations with swimming, sporting vehicles and common team sports accounting for a significant proportion of injuries. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e96 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patrick B. Fisher San Francisco, CA More articles by this author Herman S. Bagga San Francisco, CA More articles by this author Gregory E. Tasian Philadelphia, PA More articles by this author Nadya M. Cinman San Francisco, CA More articles by this author Charles E. McCulloch San Francisco, CA More articles by this author Jack W. McAninch San Francisco, CA More articles by this author Benjamin N. Breyer San Francisco, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Biomonitoring Equivalents for di-isononyl phthalate (DINP)

Biomonitoring Equivalents (BEs) are defined as the concentration or range of concentrations of a chemical or its metabolite in a biological medium (blood, urine, or other medium) that is consistent with an existing health-based exposure guideline such as a reference dose (RfD) or tolerable daily intake (TDI). BE values can be used as a screening tool for the evaluation of population-based biomonitoring data in the context of existing risk assessments. This study reviews available health based risk assessments and exposure guidance values for di-isononyl phthalate (DINP) from Health Canada, the United States Consumer Product Safety Commission (US CPSC), and the European Food Safety Authority (EFSA). Controlled dosing data reporting the urinary excretion fractions of major DINP metabolites following administration of labeled DINP are reviewed, and BE values corresponding to the available exposure guidance values are derived assuming chronic, steady-state intake and excretion at those exposure values. The BE values range from 1500 to 3600 μg/L (1900–4600 μg/g creatinine) based on the sum of three oxidative metabolites. Sources of uncertainty relating to both the basis for the BE values and their use in evaluation of biomonitoring data, including the transience of the biomarkers relative to exposure frequency, are discussed. The BE values derived here can be used as screening tools for evaluation of population biomonitoring data for DINP in the context of existing risk assessments and can assist in prioritization of the potential need for additional risk assessment efforts for DINP relative to other chemicals.

Unintentional Child Poisonings Treated in United States Hospital Emergency Departments: National Estimates of Incident Cases, Population-Based Poisoning Rates, and Product Involvement: Franklin RL, Rodgers G. Pediatrics 2008;122:1244–51

This study from the United States (US) Consumer Product Safety Commission evaluated unintentional poisoning rates by consumer products among children < 5 years of age who were treated at hospital emergency departments (EDs). From a sample of approximately 2% of US hospitals, all of whom report to the National Electronic Injury Surveillance System, the authors estimated the nationwide incidences of poisoning in this age group. A total of 3145 reports were made to the system over a 1-year period. This represented more than 86,000 poisoned children treated in EDs or an estimated 429.4 injuries per 100,000 children < 5 years old.

Epidemiology of Playground Equipment-Related Injuries to Children in the United States, 1996–2005

The objective of this study is to describe the epidemiology of playground equipment-related injuries. This is a retrospective analysis of data for children 18 years old and younger from the National Electronic Injury Surveillance System of the United States Consumer Product Safety Commission for 1996 through 2005. There were an estimated 2,136,800 playground equipment-related injuries to children 18 years and younger treated in hospital emergency departments in the United States during the 10-year period. The leading mechanism of injury was falls (75.1%), followed by impact/striking (10.5%), cutting/ pinching/crushing (7.7%), entrapment/ entanglement (1.4%), trip/slip (1.1%), and other/ unknown (4.1%). The leading type of injury sustained by patients was a fracture (35.4%), followed by contusion/ abrasion (19.6%) and laceration (19.6%). The consistency of the large annual number of playground equipment-related injuries to children is evidence that more needs to be done to prevent these injuries. More research should be conducted to develop and implement arm fracture-specific criteria for surface performance.