Objectives. This study examined the type of injury, fall heights and measures of impact attenuation of surfaces on which children fell from horizontal ladders and track rides. Method. All injured children who presented to two children's hospitals and received medical attention following a fall from a horizontal ladder or track ride in a public school or park during 1996–1997 were interviewed and the playground visited. Results. The number of children who fell from horizontal ladders and track rides and presented to hospitals with injury was 118. Of those children, 105 were injured when they hit the ground and data were available on 102 of those playground undersurfaces. Fractures to the arm or wrist were the most common injury. The median height fallen by children was 1930 mm, 73% of injuries were from falls greater than 1800 mm. In 41% of sites, the surface was deficient in impact absorbing properties for the height of the equipment. Fractures were no more likely on loose surfaces than other surfaces, such as rubber matting (p = 0.556) but more prevalent on compliant than non-compliant surfaces. Relative to falls occurring on noncompliant surfaces, the odds of a fracture occurring on a compliant surface was 2.67 (95% CI 0.88–8.14). Conclusions. Modification of the height of horizontal ladders and track rides to 1800 mm is preferable to removal of such equipment. The prevalence of fractures on compliant surfaces suggests that the threshold of 200 g or 1000 head injury criteria (HIC) needs to be revisited, or additional test criteria added to take account of change in momentum that is not presently accounted for with either g-max on HIC calculations.

(2004). Next steps in cross-cultural research on intimate partner violence. Injury Control and Safety Promotion: Vol. 11, No. 2, pp. 139-140.

The purpose of this study was to compare parents’ and children’s attitudes and habits towards use of bicycle helmets and car seat belts. We hypothesized that parental perception of their children’s safety practices did not reflect actual behavior and further, that parental practices, rather than their beliefs about a particular safety practice, have a greater affect on their child’s risk-taking behavior. The study population consisted of children in grades four and five and their parents/guardians. Participation in the cross-sectional study was voluntary and confidential anonymous questionnaires were used. In separate and independent surveys, children and parents were questioned in parallel about their knowledge, habits and attitudes toward bicycle helmet use and car safety practices. In the study, 731 students participated with 329 matched child-parent pairs. Ninety-five percent of the children own bicycles and 88% have helmets. Seventy percent of parents report their child always wears a helmet, while only 51% of children report always wearing one (p < 0.05). One-fifth of the children never wear a helmet, whereas parents think only 4% of their children never use one (p < 0.05). Parents report their children wear seat belts 92% of the time while 30% of children report not wearing one. Thirty-eight percent of children ride bicycles with their parents and wear their helmets more often than those who do not ride with their parents (p < 0.05). Parents who always wear a seat belt are more likely to have children who sit in the back seat and wear a seat belt (p < 0.05). Parents’ perceptions of their children’s safety practices may not be accurate and their actions do affect their children’s. Injury prevention programs that target both parents and children may have a greater impact on reducing risk-taking behaviors than working with each group in isolation.

The purpose of this analysis was to quantify the magnitude of death and disability from drowning and near-drowning worldwide and to provide epidemiological data on which to base prevention efforts. All data are from the Global Burden of Disease 2000 (Version 1) estimates in which deaths and disabilities are based on the WHO International Classification of Diseases. Extrapolations were made by age, sex, and WHO region. The six WHO regions of the world were further divided into high-income, and low- and middle-income based on the 1998 World Development indicators. According to the GBD 2000 data, an estimated 449,000 people drowned worldwide (7.4 per 100,000 population) and a further 1.3 million Disability Adjusted Life Years (DALYs) were lost as a result of premature death or disability from drowning. 97% of drownings occurred in low- and middle-income countries. Although 38% of drownings occurred in the Western Pacific Region, Africa had the highest drowning mortality rate (13.1 per 100,000 population). Males had higher drowning mortality rates than females for all ages and in all regions. Children under the age of 5 years had the highest drowning mortality rate for both sexes in all of the WHO regions except for Africa, where children aged 5 to 14 years had the highest mortality rate. World-wide, for children under the age of 15 years, drowning accounted for a higher mortality rate than any other cause of injury. Drowning is a significant problem worldwide particularly for children under the age of 15 years. Low- and middle-income countries have the highest rates of drowning and account for more than 90% of such fatalities. Primary prevention efforts should thus be focused on these countries where many children who cannot swim drown in large bodies of water.

(2003). Feasibility of routine collection of injured worker occupational information in hospital emergency departments. Injury Control and Safety Promotion: Vol. 10, No. 4, pp. 261-262.

Neck injuries are some of the most important injuries as they have the potential to influence the spinal cord. A previous national survey of neck injuries in Sweden revealed that injury incidence was increasing for the population over 65 years of age, although it was decreasing for the population as a whole. The aim of this study was therefore to further clarify the magnitude, severity, and external causes of neck injuries in the elderly people in Sweden. A national incidence study, with focus on the age group above 65 years, was undertaken with data from the injury surveillance program at the Swedish National Board of Health and Welfare. The investigation includes cervical vertebral fractures reported between 1987 and 1999, and cervical soft tissue injuries from 1997 to 1999. Data in the hospital discharge register were reported in ICD9 from 1987 to 1996, while data from 1997 to 1999 were reported in ICD10. During the study period 4168 cervical injuries occurred of which 341 were fatal. People above 65 years of age made up 17% of the population and sustained 30% of all cervical injuries and 43% of all fatal cervical injuries. Half of the cervical injuries were axis (C2) fractures. Lower vertebral fractures occurred in 16% of the cases and atlas (C1) fractures in 11%. The cervical soft tissue injuries amount to 19% of all injuries. Fall accidents account for the majority (71%) of the accidents. There is an increasing trend for fall accidents resulting in neck injuries. The male population has a higher incidence for neck fractures than females, disregarding the external cause of injury. The upper cervical injuries are the most common, have the longest hospital treatments, and seem to be caused mainly by low energy falls. Further research is needed to understand the mechanisms of these injuries and in this aspect engineering could contribute with valuable knowledge, through accident simulations with numerical models. The increasing incidence of fall injuries calls for further preventive actions. The public sector should implement preventive strategies to reduce the number of extrinsic accidents, while the health care sector should focus on preventing intrinsic accidents with individual actions for each patient.

The burden of road traffic injuries in the People’s Republic of China is increasing as evidenced by trends since 1951. Data from the National Statistical Office, Ministry of Communications and the Traffic Administration Bureau were analyzed. Absolute numbers of crashes, fatalities, and injuries, as well as fatalities per 100,000 population and motorization (number of vehicles per 1000 population) were used as indices to measure trends. Regional variations in trends and the characteristics of people injured or killed were also analyzed. Road traffic crashes increased 68- fold, from around 6000 in 1951 to 413,000 in 1999. Excessive speed was the main reported cause of the crashes. The injuries increased 56-fold – from around 5000 to 286,000 – and fatalities 97-fold – from 852 to around 84,000 – over the same period. The crash, fatality and injury rates also increased after 1985, due to increased motorization spurred by rapid economic growth. The number of four-wheel motor vehicles increased from 60,000 in 1951 to just under a million four-wheel motor vehicles in 1975 and to 10 million in 1987. The number of four-wheel motor vehicles then rose to 50 million in 1999, with an additional 30 million motorcycles. The increase in motorization and fatalities affected all the provinces. Road traffic injuries are the leading cause of death for populations up to the age of 45 years and the leading cause of working-life years lost in China.

The objective was to conduct a comparative evaluation of two injury surveillance systems in operation in the Accident and Emergency departments of public hospitals in Jamaica. The evaluation was conducted at 12 hospitals across Jamaica offering varying levels of service delivery. It was designed in three phases: (1) a retrospective review of surveillance system data; (2) prospective process evaluation; (3) system environment evaluation. These data were analysed to determine the sensitivity and specificity of the manual Accident & Emergency Statistical Report (A&ESR) versus the computer-based Patient administration system/Jamaica injury surveillance system (PAS/JISS), and to determine an injury registration rate. Results showed a variation from 8% to 27% in injury registration rates at the hospitals reviewed. The sensitivity of the computer-based PAS ranged from 29.7% to 97.1% while the sensitivity of the manual system ranged from 22.1% to 100%. The computer-based system generally detected a greater percentage of injuries. Problems were identified with missing data fields in the computer-based system, while problems of recording and transcription were identified in the manually-based system. Recommendations were made to improve data quality in both data collection systems. Although shortcomings were identified with the A&ESR, the system is performing the function for which it was designed, that of tracking A&E workload. The PAS/JISS is more user-friendly and a truer reflection of the injury situation.