Swiss Council for Accident Prevention

Abstract Pediatric injuries are common and associated with individual suffering and costs for the healthcare systems and society. The incidence of injuries among children in Switzerland has so far been insufficiently monitored. Emergency department patient records can be a valuable database to assess medically relevant injuries and gain information for monitoring and evidence-based prevention. The talk will outline our stepwise development of a machine-learning program for a pediatric injury monitoring system and lessons learnt. In this feasibility study we draw on electronic case histories of children treated for injuries between 2018 and 2022 at the University Children’s Hospital Zürich emergency department (N= to 30’884). The ML- approach follows different steps: step 1. utility evaluation of electronic pediatric patient records regarding ML and injury monitoring and prevention requirements in a test-sample of 100 electronic pediatric case histories; step 2. choice/adaptation of coding tree; step 3. coder training and inter-coder reliability testing; step 4. manual annotation of a sub-sample (n 1000) of the electronic pediatric patient records, step 5. design and testing of the ML program in an iterative process, and step 6. performance testing in a random sample of pediatric patient records. First lessons learnt indicate that electronic case history data contain relevant data and fulfill requirements for monitoring and prevention purposes. The IDB coding system proved too complex and detailed for the pediatric data base, providing too few examples for the ML-learning process, and needed to be adapted. Initial data analyses indicate the majority of cases are classified as less severe (73%) and only few (<1%) as very severe but the later provide the most detailed data. ML is a promising approach and makes use of hospital data for a national monitoring of pediatric injuries in Switzerland.

BackgroundFatality tops the injury pyramid. Knowledge of the extent and nature of fatal sports injuries is a key element in prevention. However, those data were not available for a long time in Switzerland. Like other countries, Switzerland has a mortality database, but with 3 major shortcomings: it is almost impossible to identify sports fatalities with the International Statistical Classification of Diseases and Related Health Problems 10th version (ICD-10) external causes; data are entered with a time lag of three years; and fatal injuries in tourists are not recorded.ObjectiveTo estimate the extent of sports fatalities in Switzerland.DesignWe retrieved data from a registry of sports fatalities established in 2000, by the Swiss Council for Accident Prevention BFU. The main source of data was a standardized query, conducted by a Swiss media agency. The registry was supplemented and validated with data from partner organizations, like the Swiss Alpine Club or the Swiss Life Saving Organization. Sports, age, sex, date, time, location of fatal injury, and numerous other characteristics were encoded.SettingRecreational sports.ResultsSince 2000, 3397 fatalities were registered (179 annually, SD: 26; 83% males). The mean age was 45 y (SD: 19). Among the fatally injured, 32% were tourists from abroad. Most deaths occurred while mountain hiking, mountaineering, and climbing, followed by swimming in open water and backcountry skiing.ConclusionsThe sports fatality registry established by the Swiss Council for Accident Prevention is an important, valid supplement to existing injury data. It allows detailed, up-to-date analyses of fatal sports injuries, which supports the priorities of the BFU’s nationwide prevention strategy.

BackgroundWrist injuries are the most common type of injury sustained while snowboarding, with 2500 Swiss snowboarders injuring their wrist or forearm annually. The effectiveness of wrist protectors in preventing these injuries is scientifically proven, yet the use of wrist protectors has decreased 17% over the last 10 years, to 25% in 2018.ObjectiveTo identify barriers to the use of wrist protectors among Swiss snowboarders in order to promote their use in the future via specific measures.DesignFace-to-face interviews were conducted on the slopes of 21 ski resorts in Switzerland in the 2017/18 winter season using a standardized questionnaire including information about demographics, snowboarding skills, and snowboarders’ behaviour regarding the use of wrist protectors.SettingRecreational sport.Participants721 snowboarders (mean age: 28±9.1 years, 34% females) residing in Switzerland (aged ≥15 years) were included in the study. The response rate was 79%.Main outcome measurementsThe prevalence of and barriers to wrist protector use.ResultsIn this study, a total of 16% of the snowboarders used wrist protectors. We found a difference between adolescents (15–17 years) and adults (≥18 years): 28% vs. 15% (p=0.001). However, no difference was found concerning sex or skill level. The most important barriers to the use of wrist protectors were a belief that they increase injury risk (22%), that they aren’t effective (18%), or that they are uncomfortable (16%).ConclusionsIn Switzerland, snowboarders are badly informed about the efficacy of wrist protectors and a minority of snowboarders use them. Therefore, further efforts will be taken in Switzerland to adequately inform non-users. Future prevention measures are planned to ensure that only effective protectors are available on the market and to target the lack of knowledge among snowboarders and suppliers.

The wrist is the most frequently injured body region among snowboarders. Studies have shown that the risk of sustaining a wrist injury can be reduced by wearing wrist protection. Currently, there are a wide variety of wrist protection products for snowboarding on the market that offer a range of protective features. However, there are no minimum performance standards for snowboarding wrist protectors worldwide. The International Society for Skiing Safety convened a task force to develop a White Paper to evaluate the importance and necessity of a minimum performance for all wrist protectors used in snowboarding. The White Paper outlines the need for a general framework for a harmonized international standard and reviews the existing evidence. Therefore, this White Paper may serve as a common base for future discussions. The broader goal of developing and implementing such a standard is to reduce the incidence and the severity of wrist injuries in snowboarding without increasing the risk of adverse events, such as upper arm or shoulder injury. The European standard for inline skating wrist protectors (EN 14120) can serve as a starting point for efforts related to a standard for snowboard wrist protectors, but certain modifications to the standard would be required. It is hypothesized that implementation of a snowboarding wrist protector standard would result in fewer and less severe wrist injuries in the sport and could translate into more riding days for healthy snowboarders and significant health-care costs savings.

The aim of this study is to examine the correlation between helmet use and on-slope ski conduct. During the months of February and March 2009, eight trained interviewers asked 1550 skiers and snowboarders at 20 ski resorts in the German and French speaking parts of Switzerland a series of questions. The skiers and snowboarders were asked about their reasons for wearing or not wearing a helmet and about their behavior and conduct on the slopes. Three categories of people were identified: (1) Helmet wearers, (2) those who do not wear a helmet but intend to buy one, and (3) those who do not wear a helmet and have no intention of buying one. After assessing the outcome of the survey by performing a variance analysis, significant differences were found between the self-reported on-slope conduct of the helmet wearers and those who choose not to wear a helmet. No difference in self-rated ski conduct was found between the two categories of people not wearing a helmet. A stepwise multivariate logistic regression was used to compare the different control factors on self-reported risk behavior. To summarize, by becoming a helmet wearer, skiers and snowboarders tend to demonstrate a greater degree of willingness to take risks on the slopes. For this reason, the theory of risk compensation cannot be entirely ruled out. More importantly, however, independent variables such as age, gender, number of falls per day, or years of experience were found to make a far greater contribution toward helping us understand a person's willingness to take risks while skiing or snowboarding.