Injury Trends Research Articles

Trends in Intentional and Unintentional Firearm Injuries in Pediatric Trauma Patients: An 11-Year Retrospective Study

IntroductionIn 2020, firearm injuries became the leading cause of death in children and adolescents and have continued to increase despite injury prevention strategies. The information obtained about these injuries is often limited to the demographic and clinical data required for trauma registries, which often lack granularity regarding the circumstances leading to the use of a firearm. The purpose of this study is to analyze admissions for firearm injuries according to intention and social vulnerability to enable the creation of targeted prevention strategies. MethodsThis is a retrospective cohort study using trauma registry data from a single institution from 2012 to 2022. Patients were stratified by a mechanism into unintentional, intentional, and self-inflicted firearm injuries based on chart review. Demographics were compared between groups and the overall trauma population. Social Vulnerability Index data were obtained from the Centers for Disease Control and Prevention registry. ResultsOf the 13,197 trauma patients admitted from January 2012 to December 2022, 153 were related to firearm injuries (1.2%). Relative to the overall trauma population, patients with firearm injuries were predominantly older (9.7 versus 7.4 y, P < 0.001), male (74% versus 61%, P < 0.001), Black (43% versus 17%, P < 0.001), and insured via Medicaid or another government subsidized program (62% versus 48%, P < 0.001). Injuries were classified as intentional (53%), unintentional (44%), and self-harm (1%). Unintentional injuries more frequently resulted in death (17.6% versus 8.6%), although this difference was not enough to reach the statistical significance. The proportion of intentional injuries increased significantly in the 2020-2022 period relative to previous years (P = 0.032). ConclusionsVulnerable populations have experienced a disproportionate increase in firearm violence starting in 2020. Unintentional injuries are a significant source of mortality in the pediatric population and represent a vital target for future injury prevention strategies.

Injury and Illness Trends in the National Hockey League Following an Abrupt Cessation of Play.

The National Hockey League (NHL) saw an unprecedented disruption to the competitive calendar due to the COVID-19 pandemic in March of 2020. Returning to play following an abrupt cessation of activity is a known risk factor for athletes. To analyze the occurrence and severity of events (injury and illness) in the NHL and to understand any differences in occurrence and severity between pre-pandemic seasons and seasons that immediately followed. Descriptive Epidemiology Study. Using a retrospective cohort inclusive of all players on active rosters in the NHL between 2016-2023, public access injury and illness data were collected. Outcome measures included event incidence, period prevalence, and severity (mean days lost; MDL), as well as incidence rate ratio (IRR) comparing pre- and post-pandemic seasons. IRR for illness peaked in December 2021 (IRR = 62.46; 95% CI 13.65 to 285.91). Incidence of upper body injuries was significantly higher in 2020-21 (IRR = 1.70, p = 0.001) and 2021-22 (IRR = 1.40, p = 0.044) compared to pre-pandemic seasons (Incidence = 17.58 injuries / 1000 player-hours). Injury incidence increased as the 2022-23 season progressed (p = 0.004); injury incidence was stable across all other seasons. Mean days lost (MDL) to injury was higher in 2020-21 (MDL = 18.12, p < 0.001), 2021-22 (MDL = 18.46, p = 0.015), and 2022-23 (MDL = 18.12, p < 0.001) compared to pre-pandemic seasons (MDL = 17.34). Incidence of upper body injuries increased in the 2020-21 and 2021-22 NHL regular seasons while it decreased significantly in the 2022-23 regular season compared with the four pre-pandemic seasons. This suggests a need to examine if modifiable risk factors exist for determining optimal return to play strategies following an abrupt cessation of play. 3.

Incidence, trend and distribution of transport-related injuries reported to health facilities in the Volta Region of Ghana, 2019 to 2023

BackgroundTransport injuries are a global public health concern, causing 1.35 million deaths and over 20 million non-fatal injuries annually. Low- and middle-income countries, particularly countries in Africa, are experiencing an increase in fatalities. Ghana and the Volta Region are not exempted from the burden, prompting targeted interventions. In the development of these interventions, epidemiological data analysis is needed to identify areas for action. This study aimed to analyze the distribution, trends, and incidence of transport-related injuries in the Volta Region of Ghana.MethodSecondary data was analyzed to describe transport-related injury cases and deaths in the Volta Region of Ghana from 2019 to 2023. Transport-related injuries were obtained from the monthly out-patient morbidity report form whereas transport related deaths were obtained from the inpatient morbidity and mortality, and cause of death report forms. Descriptive data analyses were performed and reported as frequencies, proportions, ratios, and choropleth maps.ResultOf the 33,415 transport-related injury cases reported between 2019 and 2023, 25 were fatal. The highest proportion of cases, 35.8% (35.3–36.4), was among persons aged 20–34 years. About 66.0% (65.5–66.5) of all the cases involved males. The cumulative incidence was 387 injuries per 100,000 population with the highest incidence recorded in 2021. The incidence of cases declined from 357 per 100,000 population in 2019 to 320 per 100,000 population in 2023. The death rate was stable over the period with the highest of 1.2 per 1000 recorded in 2019 and declined from 1.2 per 1000 in 2019 to 0.9 per 1000 in 2023. Most, 56% of the deaths were reported in district hospitals.ConclusionThe study showed a decreasing trend in the incidence of transport injuries, but a steady mortality rate in the Volta Region. Young adults were the highest affected group. There is the need for increased road safety campaigns and further research.

Trends in parcel delivery driver injury: Evidence from NEISS-Work

Introduction: The rise of e-commerce has rapidly increased the proportion of goods delivered directly to customers’ homes. These increases have placed notable demands on delivery personnel, with potential health and safety consequences. In this paper, we examined trends in parcel delivery driver injury through analyses of injuries treated in emergency departments (ED) in the United States from 2015 through 2022. Methodology: We explored trends among Couriers and Messengers as well as Postal Service personnel as designated by Bureau of Census (BOC) industry codes. We estimated counts and rates of injuries per 10,000 full time worker equivalents and examined demographics (e.g., age, sex) and other characteristics (e.g., source of injury, injury diagnosis) associated with these injuries. Results: We found that: (1) ED-treated injury rates between 2015 and 2022, among both the Postal Service and Couriers and Messengers, have demonstrated an upward trajectory, contrasting with overall U.S. industry injury rates, which have trended downward; and (2) while ED-treated injury rates for these industries have taken different paths over time, both industries’ ED-treated injury rates have converged toward a position much higher than average. Moreover, we found that female personnel and young personnel disproportionately experienced ED injuries. Conclusions: In addition to calling attention to worrying injury trends among delivery drivers, we conclude that the current data landscape prevents the development of a nuanced picture of injury trends and hazards. These limits inhibit exploration of many specific hazards, and therefore preventive measures that would be designed based on such specific exploration. Practical Applications: Our results serve both as a foundation toward improved safety practices in an industry that continues to experience rapid changes and as a step toward motivating updated data collection and dissemination practices that could help understanding of the modern workplace injury landscape.

Evaluating Injury and Illness Trends in Federal and Postal Service Employees Using Workers’ Compensation Claims Data 2007-2022

Evaluating Injury and Illness Trends in Federal and Postal Service Employees Using Workers’ Compensation Claims Data 2007-2022

Shoulder injury patterns and trends in the national football league: an epidemiological analysis.

Athletic movements in American football render the shoulder vulnerable to injury. The aim of this study was to explore the epidemiology of shoulder injuries in the National Football League (NFL). Injury data from the 2019-2022 seasons were extracted from official NFL website and secondary resources. Injury parameters included type, severity, week, position and other demographic characteristics. Injury rates were calculated per 1000 athletic exposures (AE) and statistical analyses were used to determine whether any significant differences exist in injury patterns across different positions and types. A total of 6732 injuries were reported during our study period, of which 452(6.7%) were attributed to the shoulder, leading to an injury rate of 4.5 per1000 AE. Linebackers, cornerbacks, wide receivers, and safety positions had significantly higher numbers of shoulder injuries than other defensive and offensive positions. Most injuries were mild (66%, P<0.001). Muscular (40.9%) and ligamentous (37.4%) injuries were the most common injury types. Fractures and ligamentous injuries were significantly more severe than muscular and other injuries (P<0.05). Even though week 17 had the highest mean number of shoulder injuries at 10.75/season, there was no apparent shoulder injury distribution trend across the football season. Shoulder injuries are common in American football. Introducing a deidentified injury registry that provides detailed injury information in the NFL may help develop better prevention strategies and protocols.

Injury Characteristics Among Japanese International Athletes: Report on the Pre-competition Medical Check-Up Data of the Japanese Olympic Committee.

Introduction Injury trends among international athletes across sports remain underexplored in out-of-competition settings, particularly among Asians. The aim of this descriptive epidemiological study is to investigate the characteristics of injuries among Japanese international athletes during pre-competition medical check-ups from 2008 to 2019. Methods We analyzed the medical check-up data of candidates for international multi-sport events according to the International Olympic Committee consensus statement. At the medical check-up, athletes' injuries were categorized into two groups based on clinical assessment. "Injuries" refer to conditions that necessitate immediate treatment or further detailed examination. On the other hand, "complaints" encompass both such "injuries" and conditions for which treatment has already commenced, allowing athletes to continue participating in competitions or training while still requiring ongoing medical monitoring. The cohort was categorized into youth and adult groups, with adults defined as those aged ≥18 years. Results Overall, 10,854 athletes (4,966 females, 45.8%; 5,888 males, 54.2%; median age 22.0 {20.0-25.0} years, 56 sports) were enrolled; 2,333 "injuries" were registered (21.5 "injuries" per 100 athletes). The "injury" prevalence was 16.2% (95% CI, 0.16-0.17) and significantly associated with females (odds ratio {OR} 1.21; 95% CI, 1.09-1.34) and adult group (OR, 1.35; 95% CI, 1.08-1.69) based on binomial logistic regression analysis. Of a total of 10,027 "complaints" (92.4 "complaints" per 100 athletes), the "complaint" prevalence was 55.3% (95% CI, 0.54-0.56) and higher in females (OR, 1.44; 95% CI, 1.33-1.55) and adult group (OR, 1.50; 95% CI, 1.29-1.75). Stratified by sport, male soccer players had a higher "injury" prevalence than females (95% CI, 0.45-0.98), whereas females had a higher "injury" prevalence in hockey (1.70-7.29) and fencing (1.12-5.44). The "complaint" prevalence was higher in females for athletics, skiing, swimming, hockey, judo, badminton, fencing, water polo, weightlifting, and golf. There was no significant difference between the sexes in other sports. The knee ("injury," 20.1%; "complaint," 20.2%), lumbosacral (15.5%; 17.0%), ankle (13.0%; 15.4%), and shoulder (13.0%; 12.1%) were most commonly affected. The injury proportion ratio for the ankle was "injury"/"complaint" 0.82 (95% CI, 0.72-0.94), with the ankle "complaint" proportion being higher than "injury." When stratified by injury location and sex, knee "injury" was more common in males (206 in females vs. 262 in males; 95% CI, 0.59-0.88), whereas ankle "complaint" was more common in females (842 in females vs. 700 in males; 95% CI, 1.04-1.29). Conclusion This is the first cross-sectional report of injuries in Asian international athletes outside of competition periods. Injury prevalence was higher in females than in males and in adults than in youths. Sex differences in injury varied by site and severity. These findings may suggest the need for more tailored injury prevention and performance support strategies for international competitions.

Abdominal Oblique and Rectus Muscle Injuries in Major and Minor League Baseball Players: An Updated Epidemiological Review.

Abdominal musculature injuries comprise the third most prevalent time-loss injury across professional baseball. Despite increased awareness and prevention attempts in the recent decade, the trends of these abdominal injury numbers in Major League Baseball (MLB) are not fully understood. To update the trends in oblique and intercostal injuries, analyze the impact of these injuries based on time out of play, and identify factors that correlate with increased injury severity to help with recovery time prognostication for the sports medicine community. Descriptive epidemiology study. Using the MLB Health and Injury Tracking System, the authors identified all abdominal and core musculature injuries that resulted in time out of play in MLB and Minor League Baseball (MiLB) between the 2011 and 2021 seasons. These were filtered for injuries that resulted in ≥1 days missed (DM) during spring training, the regular season, and postseason. A Student t test was utilized to assess for significant differences for all normally distributed values. Regression analysis was utilized for determining change over time. For all statistical comparisons, the threshold for alpha was set to P < .05. During the study period between 2011 and 2021, there were 4560 total abdominal injuries among 3401 athletes. When filtered for in-season, time-loss injuries defined as spring training, regular season, and postseason, there were 2890 injuries. Of these, 1928 were oblique injuries, 453 were intercostal injuries, and 115 were rectus injuries. The number of oblique injuries each season increased for all of baseball (P < .001), as well as for MLB (P = .009) and MiLB (P = .012) individually. Of the 1928 oblique injuries, 498 (26%) oblique injuries occurred at the MLB level and 1430 (74%) occurred at the MiLB level. Batting and pitching-related injuries comprised 860 (45%) and 729 (38%) oblique injuries, with a total of 18,455 DM and 20,891 DM, respectively. This corresponded to a mean of 22 DM for batting injuries and 29 DM for pitching injuries (mean difference, 7.2; 95% CI, 5.27-9.13; P < .001). This decade-long study on professional baseball revealed a significant increase in abdominal oblique injuries across MLB and MiLB, with the largest number of injuries observed in the 2021 season. Meanwhile, there was a significant decrease in intercostal injuries across professional baseball during these years. Such injuries continue to pose challenges, leading to substantial DM per injury and affecting players from various positions.

Trends in Ulnar Collateral Ligament Injuries and Surgery From 2010 to 2019: An Analysis of a National Medical Claims Database.

Ulnar collateral ligament (UCL) injuries have been on the rise for the past 3 decades. Current epidemiological studies on the incidence of UCL injuries have been limited to state or regional data. To utilize a large national claims database to determine the rates of UCL injuries and UCL surgical procedures over the past decade (2010-2019) and whether there has been a change in UCL surgical procedure patterns in the United States. Descriptive epidemiology study. The PearlDiver patient claims database was used to identify UCL injuries occurring from 2010 and 2019 that were sustained by male patients between 10 and 34 years of age. The study cohort was divided into 5 age groups (10-14, 15-19, 20-24, 25-29, and 30-34 years). Primary outcomes included the number of patients in each age group who sustained a UCL injury, the number of patients in each age group who underwent surgery, and the mean time from injury to surgery. A total of 19,348 UCL injuries occurred between 2010 and 2019, and 13% required a surgical intervention. Most of the injuries (54%) occurred in the 15- to 19-year group. Patients in the 20- to 24-year group were more likely to undergo surgery versus the 15- to 19-year group. Results demonstrated a trend toward delayed surgical interventions in patients in the 20- to 24-year group in the latter part of the decade. Data suggested that male patients <20 years account for the majority of UCL injuries, while male patients aged between 20 and 24 years are most likely to undergo surgery. Despite a number of targeted injury-prevention strategies and rule changes in sports, the UCL injury rate remained high. Therefore, there is a clear and present need to continue to develop UCL injury-prevention strategies for the younger population.

Accounts of Spine and Paraspinal Disease While Playing Golf

The twisting motion associated with the golf swing puts the intervertebral discs and the paraspinal musculature under stress. The objective of this study was to characterize the spinal and paraspinal pathologies associated with golf and their outcomes. The National Electronic Injury Surveillance System (NEISS) was queried for emergency department visits between 2003-2023 for golf-related injuries with body part codes "neck", "upper trunk", and "lower trunk", which includes the cervical, thoracic, and lumbar spine, respectively. Narratives were screened for relevance and reports related to spinal and paraspinal injuries were included. Weighted survey analysis was utilized to construct national estimates. Injury and diagnosis trends were analyzed using binomial logistic regression, and time trends were analyzed with a linear model. P-value of < 0.05 was considered significant. A total of 1441 relevant samples led to a national estimate of 69,153 emergency department visits for golf-related spinal-/paraspinal injuries between 2003-2023. The weighted mean age of those injured was 52.8 years, and the majority were male (85%, 95% CI 83-87). Strain was the most diagnosed injury (57.5%, 95% CI 54-61). Those aged > 55 years constituted more injuries than any other age group (50.1%, 95% CI 47-53). Injuries in the lumbar region accounted for most cases (76.9%, 95% CI 74-80). Injury frequency did not change over the years (p= 0.54), although the age of injury did increase over time (p < 0.001). Golf-associated paraspinal injuries are more common than neurological injuries, necessitating study into their mechanisms and onset.

Time trends in work-related MSK injury admissions in Victoria: Effects of the COVID-19 pandemic

BackgroundWork-related musculoskeletal (MSK) injuries pose significant challenges to workers' health, productivity, and healthcare systems. Increased working from home since the onset of the COVID-19 pandemic may have affected the incidence and prevalence of work-related MSK injuries. Despite workers' compensation systems providing valuable data, underreporting remains a concern, necessitating additional data sources such as hospital admissions to better understand the burden of MSK injuries. ObjectiveTo determine time trends in the rates of hospitalization due to work-related MSK injuries in Victoria, Australia, before and during the COVID-19 pandemic. MethodsRetrospective administrative data analysis was conducted using data from the Victorian Admitted Episodes Dataset (VAED). Adults (aged 15+ years) hospital admissions between July 2012 and June 2022 were included. Interrupted time series analysis was employed to evaluate changes in monthly incidence rates of hospital admissions for work-related MSK injuries before and during the pandemic. ResultsA total of 67,689 index hospital admissions for work-related MSK injuries were recorded in the study period, with an average of 6,769 annually. Acute injuries were predominant during the pandemic, accounting for 63.6 % of cases compared to 60.1 % before the pandemic. Over ten years, the average annual incidence rate of acute MSK injuries was 13.20 cases per 10,000 workers, while cumulative injuries showed a rate of 8.62 cases per 10,000 workers. Comparing pre-pandemic and pandemic periods, the average annual incidence rate of acute MSK injuries increased, while cumulative injuries decreased. ConclusionThe study observed a gradual decrease in the overall incidence rate of hospital admissions for cumulative work-related MSK injuries over the last decade. Despite expectations of disruptions, no significant deviations in MSK injury trends were observed following the onset of the COVID-19 pandemic in Victoria, Australia.

The 10-year decreasing trend of youth soccer head injuries and concussions presenting to U.S. emergency departments

ABSTRACT Objectives Nearly 3 million children participate in youth soccer annually in the United States. Popularity of youth soccer within recent years has prompted investigation describing youth-soccer concussion trends presenting to United States emergency departments (EDs). Methods Data from National Electronic Injury Surveillance System were analyzed for soccer players 2–18 years old sustaining concussions from January 2013 to December 2022. Patient data included age, sex, mechanism of injury, setting (practice vs. game), diagnosis, loss of consciousness, and disposition. Raw data were used to calculate national estimates based on assigned statistical sample weight of each hospital. Results A total of 80,582 youth soccer concussions were diagnosed in US EDs (51.0% female, 49.0% male). The most common mechanism of injury was head to ball (31.0%). On average, overall concussions decreased by 572 per year (p = 0.02). Head to body concussions decreased by 169 per year (p < 0.01) and head to ground concussions decreased by 155 per year (p < 0.01). No changes per year in concussion trends for head to ball, head to head, not specified, and other mechanisms. Exclusion of years 2020 and 2021 (COVID), demonstrated decreases in concussions for head to body by 125 (p = 0.01) and head to ground mechanisms by 135 per year (p = 0.01). Conclusion There is a decreasing trend in youth soccer head injuries and concussions presenting to US emergency departments from 2013 to 2022. The trends from this study indicate that heading may be the most important aspect of soccer-related concussions presenting to US emergency departments. This study contributes to the growing literature regarding concussions in youth soccer athletes.

Trends in Upper Extremity Saw Injuries From 2003 to 2022.

Saws are a common source of upper extremity injury. There have been several commercial and government-mandated safety mechanisms designed to reduce the number of saw injuries. We aim to assess the trends in the incidence and impact of saw-related upper extremity injuries over the last 2 decades. The National Electronic Injury Surveillance System database was queried from January 2003 to December 2022 for upper extremity injuries caused by saws. Summary statistics for primary body part injured and diagnosis were calculated. Linear regression was performed to evaluate trends in the number of injuries over time. An estimated 1.38 million injuries (weighted) presenting to emergency departments were reported from January 2003 to December 2022. Patients had a mean age of 50.5 ± 18.1. Digits (82.2%) accounted for most injuries, followed by hands (11.9%). The lower arm (3.4%), wrist (1.66%), shoulder (0.3%), elbow (0.2%), and upper arm (0.2%) accounted for fewer injuries. There was a downtrend in number of saw injuries over the study period (R = 0.83, R2 = 0.69, p < .001). Subgroup analysis showed decreases in number of injuries to fingers (R = -0.82, R2 = 0.67, p < .001) and wrists (R = -0.61, R2 = 0.37, p = .004). The most common diagnoses were lacerations (69.7%), fractures (12.6%), and amputations (9.9%). Upper extremity saw injuries have significantly decreased over the last 20 years. The fingers and hands account for the vast majority of saw injuries, resulting most commonly in lacerations, fractures, and amputations. IV.

Insights from a hospital database: injuries among children under 6 years old due to falls

Abstract Background Pediatric injuries represent a significant public health concern globally, contributing to substantial morbidity and mortality among children. In Georgia, limited data exists regarding pediatric injuries. The aim of the study was to analyze epidemiological characteristics and trends of pediatric injuries among children aged under 6 years who received treatment in hospitals across whole country. Methods NCDC hospitalization database for 2015-2022 was used for the study. Results Over the study period, a total of 5979 children under the age of 6 received treatment in all hospitals across Georgia. The highest number of hospital admissions were registered in 2019. 60% were boys and 40% were girls of the hospitalized patients. Boys were predominant across all age groups, with the highest proportion among children aged 5 years old. There was a significant variation in hospital admissions according to the seasons, with the highest admissions occurrence in summer. As for the cause of admission, 37% resulted from falls on the same level, 10% from falls between different levels, 7% involved falling from a bed, 4% from falling out or through a building, and 4% from falling down stairs. The cause of falls was unspecified in 23%. In 72% of cases, the injured body part was the head, 17% were upper extremity injuries, and 7% were lower extremity injuries. Of the patients, 90% recovered, 2% discontinued treatment, 8% were transferred, and the outcome was fatal for 0.23% of patients. Among the fatal cases, 36% resulted from falls from, out of, or through a building, 29% from falls between different levels, 14% from falling or jumping, 7% from falls involving a bed, and 7% from falls on the same level. Conclusions These findings underscore the importance of preventive measures, especially regarding fall prevention, to reduce the incidence of pediatric injuries in Georgia. Key messages • There was a significant variation in hospital admissions according to the seasons, with the highest admissions occurrence in summer. • These findings underscore the importance of preventive measures, especially regarding fall prevention, to reduce the incidence of pediatric injuries in Georgia.

Analysis of traffic injury trends, and strategies for road safety promotion in Lithuania

Abstract Every year, about 1.3 million people die on the world’s roads. The aim of the study was to analyze the mortality trends from traffic injuries, and to discuss strategies for the prevention of road traffic injuries and road safety promotion in Lithuania. A longitudinal study was conducted, and regression analysis was applied. The study showed that, when analyzing the changes in mortality from the main causes of death over 2009-2019, the greatest progress in mortality reduction was observed in the category of deaths from external causes; whereas, the number of deaths from diseases of the circulatory system did not change, and the number of deaths from malignant tumors increased slightly. In Lithuania, the death rate from traffic injuries per 100,000 inhabitants decreased significantly over a 50-year period (1971-2020) (in the whole population, and in the subgroups of men and women). In Lithuania, during the fifty-year period (1971-2020), pedestrian mortality rates decreased significantly in the whole population, and children and adolescents (0-14, 15-19, and 0-19 years). Over 1998-2020, road traffic injury deaths decreased significantly in children age groups 0-14, 15-19, and 0-19. After exploring the preventive strategies used for road safety promotion, it was revealed that the most effective results were achieved, when education, safe environment creation, and legislation with enforcement were used. It was important to create a safe engineering environment, to separate pedestrian and bicycle paths from high-speed traffic on roads, to improve the visibility of road users, to apply measures that reduce driver’s fatigue, and to combat the usage of mobile phones while driving. Preventive activities were aimed at alcohol control, speed limitation, education of safe behavior of drivers, promotion of safe cars operation. The usage of safety belts and safety seats, helmets for motorcyclists and cyclists were increased through legislative and educational measures.

Injury risk in foreign workers: a proposal for a prevention plan in South Tuscany

Abstract Background There are nearly 2.3 million foreign workers in Italy, many of whom hold low-skilled and heavy jobs that expose them to greater safety risks. The aim of the study is to analyze data on the accident phenomenon by using information flows from the national work accident insurance institute, in order to ensure a safe and inclusive work environment. Methods The total number of foreign workers’ accidents in the South Tuscany during the five-year period 2017-2021 was quantified. General injury trend was assessed, breaking down the events by province (Siena, Arezzo, Grosseto), year of occurrence and severity. We analyzed the events by nationality of the injured ones and by severity of compartment. Results A total of 38,254 occupational accidents were recorded, of which 6,172 (16.13%) occurred to foreign workers. Compared to the incidence of foreigners residing in the reference territory, the accident figure is 16.13% out of the 10.5% resident population. The majority involve people from Eastern Europe (60.8%). The most representative nationalities are: Romania (1,477 events), Albania (1,022), Morocco (404), Macedonia (341), Kosovo (264), Tunisia (190) and India (170). Romanian workers are the population most affected by occupational injuries in Southeast Tuscany with 1,477 events. Agriculture is the predominant sector with 17.7% of total injuries. Conclusions Information flows on foreign workers’ accidents is the starting point for specific design of prevention plans (supervision, assistance, research, information and training, awareness raising) aimed at reducing specific accident risk factors. Language and cultural differences represent an element of possible conditioning of risk perception, which must be considered in an effective design of safety training courses for foreigners. Key messages • The study of accident information flows of foreign workers provides the basis for specific design of prevention plans in order to reduce accident risk factors. • Language and cultural differences must be considered in an effective design of safety training courses for foreigners.

Treestrand-Related Injuries Outnumber Projectile-Related Injuries in Arkansas Hunters, 1993-2022.

Epidemiologic data on hunting-related injuries is sparse. Most published studies in this arena come from case reports or case series from a trauma department or state trauma registry. Relatively few of the studies have attempted to calculate rates of injury by demographic characteristics or hunting-related activities. In this study, we summarize the epidemiologic trends in hunting-related injuries in Arkansas over the last 30 years. A descriptive analysis of hunter injury data collected by the Arkansas Game and Fish Commission from 1993 to 2022 was performed. Analyses showed that the overall number of hunting-related injuries decreased by 0.16 per 100,000 licensees per year during the study period (P=0.0009). Projectile-related injuries decreased by 0.24 per 100,000 licensees (P=0.00001), and treestand-related injuries increased by 0.06 per 100,000 licensees (P=0.02) during the same time (both trends P<0.00001). treestand-related injuries now account for two thirds of all hunting-related injuries reported to the Arkansas Game and Fish Commission. Among hunters subject to hunter education certification mandates, compliance was 48.7%. Although projectile-related hunting injuries have decreased in Arkansas in the last 30 years, treestand-related hunting injuries have increased. These injuries are largely preventable if the hunter follows treestand safety recommendations (such as using a body harness and tether at all times when off the ground), as recommended by the Treestand Manufacturers of America. In addition, implementing strategies to improve compliance with hunter education certification also may help reduce injury rates.

Mechanisms and Trends in Women's Lacrosse Head and Musculoskeletal Injuries: A 15-Year Review of National Injury Data.

Head injury rates in lacrosse may be higher among women compared with men. Understanding these trends can guide appropriate injury prevention for female athletes. Injuries most commonly involve the head, with no significant decline over the study period; contact with other players would be the most common injury mechanism. Descriptive epidemiological. Level 3. The National Electronic Injury Surveillance System (NEISS) was queried (January 1, 2008 to December 31, 2022) for women's lacrosse injuries presenting to United States (US) emergency departments (EDs). Patient demographics, injury diagnosis, body part injured, disposition, and clinical narrative were extracted. The provided narrative identified the mechanism of injury. Linear regression analysis assessed trends over time. An estimated 57,635 women's lacrosse injuries occurred during the study period extrapolated from 1899 evaluated NEISS cases. The mean age was 15.81 ± 5.35 years, with 68.3% of injuries sustained by high school (14- to 18-year-old) players. Over one-third of all injuries were to the head (national estimate [NE], 19,358; 33.6%), followed by the ankle (NE, 10,475; 18.2%), then the knee (NE, 6969; 12.1%). Strain/sprains were most common (NE, 19,402; 33.7%) followed by closed head injury (CHI)/sports-related concussion (SRC) (NE, 11,794; 20.5%) and contusion/abrasion (NE, 10,605; 18.4%). ED presentations of CHIs/SRCs and fractures remained elevated with no significant decline over the study period (P > 0.05), despite a significant decrease in strains/sprains and contusions/abrasions (P < 0.01 and P = 0.01, respectively). The most common injury mechanism was collision/contact with another player (NE, 10,664; 18.5%). An estimated one-third of women's lacrosse players in the study sample had a head injury. CHIs and SRCs accounted for 20.5% of all injuries. Given the high proportion of contact-related head injuries, headgear mandates and improved player safety protocols may be warranted.

Trends in Acute Kidney Injury Related Deaths in the US from 1999 to 2020

Background Acute kidney injury requiring dialysis is linked to long-term care demands, higher hospital mortality, and increased healthcare expenses. We aim to assess nationwide trends and regional variations in acute kidney injury-related mortality in the US. Materials and Methods We used death certificates from the CDC WONDER database (1999-2020) to calculate age-adjusted mortality rates (AAMRs) and annual percent change (APC). The data were stratified by year, gender, race/ethnicity, and geographic region. Results From 1999 to 2020, there were a total of 4,599,652 deaths attributed to acute kidney injury. The AAMR for acute kidney injury-related deaths surged from 11.4 in 1999 to 20.1 in 2020. Men consistently exhibited higher AAMRs than women throughout the study period (overall AAMR in men: 20.1; women: 13.2). When examining average AAMRs by race/ethnicity, Black/African Americans recorded the highest rates at 21.9, followed by American Indian or Alaskan Native (16.4), Whites (15.6), Hispanics (14.5), and Asian/Pacific Islander (10.7). Significant regional disparities were observed, with the southern region reporting the highest AAMR (17.2) and non-metropolitan areas having higher AAMRs than metropolitan areas (18.3 vs. 15.6). States in the top 90th percentile for acute kidney injury deaths included Indiana, Kentucky and South Carolina, which had nearly double the AAMR compared to states like New York, Utah, and Vermont. Conclusion In the last two decades, the United States has experienced a troubling increase in acute kidney injury-related deaths, emphasizing the urgent need for targeted and equitable healthcare interventions to address persistent disparities in gender, race, geography, and urbanization.

Epidemiology and regional variance of traumatic peripheral nerve injuries in Sweden: A 15-year observational study.

Traumatic peripheral nerve injuries pose significant challenges to healthcare systems and individuals, affecting sensory function, causing neuropathic pain, and impairing quality of life. Despite their impact, comprehensive studies on the epidemiology and regional variance of these injuries are scarce. Understanding the incidence, trends, and anatomical distribution of such injuries is essential for targeted interventions and resource allocation. This observational study utilized register-based data from the Swedish National Patient Register covering the period from 2008 to 2022. Incidence rates, trends, and anatomical distribution of traumatic peripheral nerve injuries were analyzed using descriptive statistics, Poisson regression modeling, and regional comparisons. Higher incidences of peripheral nerve injuries were observed among men compared to women across all age groups. The hand and wrist were the most commonly affected sites. Regional variations in incidence rates were evident, with some regions consistently exhibiting higher rates compared to others. Notably, a decreasing trend in injuries was observed over the study period. This study underscores the importance of targeted interventions and preventive strategies, considering sex, age, and regional disparities. Further research incorporating individual patient-level data is warranted to enhance our understanding and inform tailored interventions to reduce the burden of these injuries.