United States Hospital Emergency Research Articles

49,000 Avocado Cutting Injuries.

Objectives: In the United States (US), avocado consumption has increased dramatically since the year 2000. Despite media attention concerning injuries resulting from cutting or pitting avocados, such injuries have not been monitored systematically. The current study is the first to estimate the number of people with avocado cutting injuries presenting to US hospital emergency departments. Methods: We utilized cross-sectional data from the US Consumer Product Safety Commission's (CPSC) National Electronic Injury Surveillance System (NEISS). We used keyword searches of case narrative text to identify avocado cutting and pitting injuries from 2000 to 2017. Sampling weights were applied to generate national estimates of avocado cutting injuries. Results: From 2000 to 2017, there were an estimated 49,331 avocado cutting injuries presenting to US emergency departments (95% CI 34,178-64,483). The increase in these injuries appears to coincide with increases in per capita avocado consumption. Avocado cutting injuries now constitute nearly 2% of knife-related injuries presenting to US hospital emergency departments. Conclusions: Due to the increase in avocado cutting injuries and the severity of these injuries, more systematic surveillance is needed as well as improved safety measures.

National estimates of poisoning events related to liquid nicotine in young children treated in US hospital emergency departments, 2013\u20132017

BackgroundAn estimated 2 million youth (in 2017) and 7.9 million adults (in 2015) reported currently using electronic nicotine delivery systems (ENDS). Reports of poisoning events related to liquid nicotine (e-liquids) in ENDS have been on the rise, but current, nationally-representative estimates of hospital-treated poisoning cases related to e-liquid nicotine exposure in the United States (US) are lacking.FindingsWe used National Electronic Injury Surveillance System (NEISS) data from 2013 to 2017 to calculate national estimates with 95% confidence intervals (CIs) of poisoning incidents related to e-liquid nicotine exposure. From 2013 to 2017, an estimated 4745 poisoning cases related to e-liquids among children under age five were treated in US hospital emergency departments; the number of cases increased from 181 (95% CI: 0–369) in 2013 to 1736 (95% CI, 871–2602) in 2015 and then decreased to 411 (95% CI, 84–738) in 2017. Most of the cases were treated and released; 4.1% were admitted to the hospital. The most common route of exposure was through ingestion (96.9%), and 2.6% of the cases were through dermal exposure. The highest amounts of e-liquids or nicotine ingested were 118.2mL, 1 bottle, and 100 mg, and the most common symptoms (63.6%) related to nicotine poisoning were nausea and vomiting.ConclusionsThis study provides national estimates of poisoning cases associated with nicotine exposure from e-liquids among children under age five. Findings on e-liquid volume or nicotine dose, when available, provide important insights into exposures associated with toxicity in children. Since NEISS data do not include product codes specific to ENDS or provide information on poisoning severity, we used general keywords to capture these events, which might underestimate the population burden. Information from this study may complement efforts, such as public education, to prevent unintended exposure to nicotine in e-liquids among children.

Play at Your Own Risk: Sport and the Injury Epidemic

Each year, more than 30 million children and adolescents participate in organized sports in the United States (US), and more than 4.3 million nonfatal sports- and recreation-related injuries are treated in US hospital emergency departments. Two types of activity-related injuries, in particular, that we study in the Bone and Joint Injury Prevention and Rehabilitation Center at the University of Michigan are anterior cruciate ligament (ACL) injuries and head injury and concussion. Knee ACL injuries are occurring in epidemic-like proportions. In the US alone there are approximately 200,000 new ACL injuries at a total cost of over $1 billion per year. ACL-injured patients are at a significant risk of developing early onset osteoarthritis. Exacerbating the concern is the increase in ACL injury rates in youth and adolescents; particularly girls can experience ACL injury rates from two to five times greater than boys in the same sport. In addition, 3.8 million sports- and recreation-related concussions occur in the US each year. Significantly more research is needed, but intriguing findings are surfacing. For example, high school athletes’ recovery times for a concussion are longer than college athletes’ recovery times. Moreover, high school athletes who sustain a concussion are 3 times more likely to sustain a second concussion. Preliminary studies state suggest women have a higher risk for head injury and post concussion syndrome due to potentially weaker neck muscles, different muscle activation patterns, and hormone variations. Three key questions must be answered to understand these and other sports-related injuries: 1) What is the magnitude of the epidemic? 2) What are the causes of injury? and 3) What can we do to prevent injuries? Without a greater awareness of the injury risk and a better understanding of the injury mechanisms, the risk of sport-related injuries may escalate in the coming years. Participation in sport can be beneficial for adults and children to promote exercise and healthy lifestyles. The benefits of exercise include decreasing the incidence of cardiovascular disease, obesity, osteoporosis, and diabetes and fostering a healthy image for children and youth. Although exercise and physical activity can have major benefits, some disadvantages do exist, including the