Injury Prevention最新文献

Background: Drowning is the leading cause of death among children aged 0-17 years in rural Bangladesh, resulting in over 14 438 deaths annually-an average of 43 deaths per day. This study aims to identify socioeconomic, demographic and environmental factors linked to child drowning deaths in Northern Bangladesh-a region of high poverty, which is behind in overall socioeconomic indicators compared with other regions in the country.

Methods: We conducted a cross-sectional survey through purposive sampling to identify child fatal and non-fatal drownings among a total of 18 004 households, comprising 71 185 people, in 2 unions in Northern Bangladesh. Interviews were conducted between January and March 2024 with the households that experienced child drownings in the region. We employed a mixed-methods approach to data collection, using quantitative analysis to examine socioeconomic, demographic and environmental factors, alongside qualitative analysis to explore situational factors associated with drownings in the region.

Results: Through household visits, a total of 117 households were identified that faced child drowning incidents, comprising 84 fatal (71.8 %) and 33 non-fatal (28.2 %) drownings between 2018 and 2023. The households that faced drownings were comparatively of lower income groups, had lower rates of education and were mostly engaged in agriculture and other domestic work. In 2023, the number of drowning incidents was 34. Out of 117 drownings, 95% occurred between 9:00 and 15:00 hours, and more than 82% occurred between June and October. Out of 117 drowning incidents, approximately 97% of children did not know how to swim prior to the incident. Out of 117 respondents, 73.5% stated that they did not teach their child how to swim. Of those who taught their child to swim, the average age for learning to swim was 8.33 years. Out of 84 child drowning deaths, 75% were male and 25% were female, and the average age was 3.9 years. Out of the 84 fatal drowning deaths, 72.6% occurred in ponds.

Conclusion: Identification of socioeconomic, demographic and environmental factors associated with child drownings will help to develop feasible prevention strategies and interventions in the region.

Background: Many injury deaths are related to the environment. This study examined the impact of ambient temperature on external causes of death in Yunnan Province.

Methods: Data on external causes of death and meteorological information were collected from 2014 to 2020 across 129 counties and districts of Yunnan Province. We estimated associations of the years of life lost (YLL) and its attributable fraction (AF) with temperature using a distributed lag non-linear model in each city and then pooled them in a multivariate meta-regression.

Results: This study included 191 115 external causes of death and daily YLL was 2338.1 years. The relationship between mean temperature and YLL was found to be U-shaped. The AF of the YLL was 12.65% (95% empirical CI (eCI) 7.80% to 16.45%), 18.54% (95% eCI 8.91% to 23.56%) and 15.79% (95% eCI 8.83% to 20.07%) for external causes of death, traffic accidents and other external causes, respectively. Most of the disease burden was attributed to heat temperature. In the disease burden caused by temperature, males, individuals under 75 years old and those of Han ethnicity were mainly affected by heat temperature; individuals over 75 years old and minority populations were mainly affected by cold temperatures. Non-farmers are more affected by temperature than farmers.

Conclusions: The findings suggest that ambient temperature impacts external causes of death, and the results vary by gender, age, ethnicity and occupation. The study shows the importance of implementing preventive measures targeting both the general population and vulnerable groups in order to address external causes of death in future adaptation policies.

Objective: To examine concussion experiences and knowledge among top-level youth karate athletes.

Methods: This cross-sectional study collected data during the 12th World Karate Championships for cadets, juniors and under-21 athletes (held in Konya, Turkey, 2022). All 1414 registered athletes from 95 countries were invited to complete a 16-item paper-based questionnaire assessing demographic data, concussion history and concussion knowledge prior to the competing at the tournament. χ² and Fisher's exact tests were used to analyse differences by sex, age group and continental karate federation.

Results: A total of 654 athletes (46.3% response rate), including 286 (43.7%) females and 368 (56.3%) males, participated in the study, with 29.9% reporting one or more concussions during participation in karate training or competition. Older age groups (under 21 years) reported significantly higher concussion rates than younger athletes (56.9% vs 31.1% juniors and 24.7% cadets; p<0.001). Concussion knowledge revealed considerable gaps, with only 24.5% of athletes correctly identifying a concussion and 68.9% believing loss of consciousness was required for a concussion diagnosis. Misconceptions varied significantly across geographical regions, with Asian and African athletes demonstrating the greatest need for targeted education. Female athletes demonstrated better concussion reporting attitudes than males (60.4% vs 48.9%, p=0.004).

Conclusions: This study highlights the prevalence of concussions and significant knowledge gaps among top-level youth karate athletes, emphasising the need for tailored educational interventions to improve concussion recognition and management within the karate community.

Background: Unintentional injuries among older adults represent a significant public health challenge, particularly in low-resource settings. This study aimed to estimate the prevalence of unintentional injuries among older adults in Tamil Nadu, identify associated risk factors and develop a prediction model for unintentional injuries.

Methods: A cross-sectional study was conducted among older adults in Tamil Nadu, India, and used probability proportional to size sampling. Data were collected via a semistructured questionnaire. The receiver-operating characteristic curve was created to show the probability of the occurrence of unintentional injuries among older adults.

Results: Among 995 older adults, 13.9% reported having unintentional injuries. Among those injured, about 49% of all injuries were due to falls. The best cut-off point for predicted probability was found to be 0.88 for a sensitivity of 81% and a specificity of 61%, from receiver-operating characteristic curve. The regression analysis showed that fear of falling (4.5 times higher risk), being tribal (3.15 times higher risk), female gender (1.98 times higher risk) and alcohol consumption (1.95 times higher risk) significantly increased chance of unintentional injury.

Conclusions: The study highlighted the critical need to prioritise the prevention of unintentional injuries among older adults, particularly focusing on high-risk populations such as those from low socioeconomic and tribal communities. The use of receiver-operating characteristic curve in this study provides a robust and reliable method for predicting unintentional injuries in older adults in India, offering actionable insights for healthcare professionals and public health planners, if validated in future studies.

Background: The Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) conducts inspections of Federal Firearms Licensees (FFLs) to ensure compliance with federal laws in an effort to keep the public safe from firearm violence. However, the criteria for which FFLs are inspected lacks transparency, potentially signalling inefficiencies or biases.

Methods: We extracted data on FFL inspections and violations (2016-2017) requiring remedial action from the Gun Store Transparency Project database and the ATF's FFLs listings. Using a generalised linear mixed model with a random effect for states and robust SE, we estimated the census tract and state level predictors of 1) the likelihood of the ATF inspecting an FFL and 2) among those inspected, the likelihood of a violation.

Results: Of the 93,420 FFLs, 22 921 were inspected and 2392 had violations requiring remedial action. Increased likelihood of inspection was statistically significantly associated with higher levels of poverty, lower median income, greater non-White population percentages, and older census tract median ages. The sole predictor of an FFL receiving a violation requiring remedial action was the state's firearm law permissiveness.

Discussion: ATF inspections disproportionately targeted communities with higher poverty, lower median income, larger non-White populations, and older demographics. This indicates potential racial and socioeconomic biases, diverting attention from jurisdictions with more lenient firearm laws where violations were more likely to occur.

Conclusion: The ATF needs to reassess the influence of potential biases on its strategies for selecting FFLs for inspections and instead focus on risk-based assessments in order to promote public safety.

Background: Insufficient and impaired sleep are common in adolescents and can adversely impact health and well-being. One likely consequence of poor sleep is a risk of unintentional injuries, yet the evidence base is limited for such relationships. We, therefore, documented contemporary sleeping behaviours of young people in Canada and examined relationships between these behaviours and risks for injury.

Methods: A cross-sectional study was employed using records from the 2017/2018 Canadian Health Behaviour in School-aged Children study (n=21 745). Indicators of poor sleep (insufficient sleep on school and non-school days, impaired sleep, daytime sleepiness) and annual reports of medically treated injuries (any, serious) were obtained. Descriptive and hierarchical modified Poisson regression analyses were performed to explore these relationships, while controlling for potential confounders.

Results: Insufficient sleep, impaired sleep and daytime sleepiness were reported by 11.3-35.3% of adolescents; variations in these estimates were observed by gender. Sleep indicators were modestly but consistently associated with risks for the occurrence of 'any injury', whereas impaired sleep and daytime sleepiness were the only meaningful and significant risk factors for 'serious injuries' in adjusted models (prevalence ratio range: 1.18-1.30). The analysis of interactions revealed boys with insufficient sleep on non-school days as well as impaired sleep to have higher injury risks compared with girls.

Discussion and conclusions: Impaired sleep and its effects have emerged as a quiet epidemic, affecting up to one-third of Canadian adolescents and being associated with risks for injury. Sleep hygiene may therefore act as a plausible focus for clinical and public health initiatives to mitigate injury risks.

Background: Syndromic surveillance, which provides real-time data, may provide timely drowning surveillance compared with hospital discharge data where the release of data may be delayed. We compared data on hospital visits for unintentional drowning identified in hospital discharge and syndromic surveillance data sets for accuracy and completeness.

Methods: We compared data for hospital visits for unintentional drowning identified in the Texas Health Care Information Collection hospital discharge and syndromic surveillance data sets for metropolitan Houston, Texas, USA from 2019 to 2021. Hospital visits included emergency department-only visits and hospital admissions. We compared time-series visualisation of hospital visits between data sets. Injury burden, demographics and intercounty distribution of drowning patients were compared using the Pearson correlation coefficient for continuous data and the Pearson χ² goodness-of-fit test for categorical data.

Results: We identified 860 hospital discharge visits and 929 syndromic surveillance visits (quarterly median (IQR): 64.0 (26.8-117.5); 54.5 (28.0-132.3), respectively) for unintentional drowning. Time-series visualisation showed a high correlation between syndromic surveillance and hospital discharge visits (correlation coefficient: 0.93 (95% CI: 0.77 to 0.98)). There were small differences by race, ethnicity and county for all ages and for paediatrics and large differences by sex for all ages in the number of unintentional drowning hospital visits identified within the data sets.

Conclusions: Regional unintentional drowning burden and trends are highly correlated between syndromic surveillance and hospital discharge data. Small differences by race, ethnicity and county and large differences by sex in the number of unintentional drowning hospital visits were identified between data sets. Syndromic surveillance is useful for real-time surveillance of unintentional drowning.

Background: Neighbourhood-level social determinants of health ('SDOHs') have been linked to negative health outcomes which may include elevated risk of firearm-related injury. This study investigates whether certain SDOHs, including average drive time to trauma hospitals, are associated with increased risk of firearm-related violence and death.

Methods: We execute a cross-sectional examination of pooled firearm incidents (2018-2023) and the relationship of neighbourhood-level SDOHs across the state of South Carolina using negative binomial count regression models.

Results: Findings indicate that neighbourhood disadvantage, residential mobility, per cent black, the percentage of older housing units, lack of technology access and lack of insurance access were all positively associated with an increased risk of firearm victimisation and death. The relationship between neighbourhoods with longer drive times of firearm incidents to trauma hospitals and firearm-related death was significantly moderated by the per cent black of residents within census tracts.

Conclusions: Public health neighbourhood risk factors that are detrimental to individuals' physical health are also associated with increased risk of firearm victimisation. Longer drive times from trauma hospitals increase the risk of death and this relationship disproportionately affects black Americans. The built environment of neighbourhoods and extended drive times to trauma centres 'doubly disadvantages' historically disadvantaged populations.

Objective: The objective of this study is to assess whether experiencing homelessness may be associated with future risk of injury death and characterise these injury deaths by homelessness status among veterans who received healthcare through the US Department of Veterans Affairs (VA).

Methods: A retrospective cohort study was conducted among 6 128 921 veterans (399 125 homeless and 5 729 796 non-homeless) who received VA healthcare between 2017 and 2020 and were followed until 2021 using linked data from VA's Corporate Data Warehouse, Homeless Operations Management System and the VA/Department of Defense Joint Mortality Data Repository. Injury death rates were estimated by homelessness status with 95% CIs using the exact Poisson method. Multivariable Cox regression models were applied to estimate HRs with 95% CI for homelessness as a predictor of injury deaths, controlling for demographic, clinical, substance use and mental health characteristics.

Results: The injury-specific mortality rate (per 100 000 person-years) was estimated at 254.4 (95% CI 252.5 to 256.4) and was higher among homeless (453.3 (95% CI 443.3 to 463.5)) versus non-homeless (239.9 (95% CI 237.9 to 241.9)) veterans. There were disparities in anatomical sites and injury type by homelessness status. Injury-related risk of death was twice as high among veterans with versus without a homelessness experience (adjusted HR 1.93, 95% CI 1.88 to 1.98).

Conclusion: Homeless veterans may be at high risk for specific patterns of injury death. Injury prevention efforts should target exposures that distinguish this vulnerable population from other veterans seeking VA healthcare services.

Introduction: Road traffic injuries are a significant public health issue in low-income and middle-income countries. This study was designed to explore the pattern and factors associated with road traffic injury in a high-risk zone of Bangladesh.

Method: This mixed-method study included a total of 363 road traffic injury victims for the quantitative component, and 10 traffic-related officials and 10 drivers for the qualitative element. Data were collected using a pretested questionnaire, key informant interviews and a focus group discussion using a focus group discussion guide. Quantitative and qualitative analyses were done using Stata V.17 and NVivo V.12, respectively.

Results: Most participants were male, illiterate and young (<30 years) with age averaging 31.50±9.16 years. Of all road traffic injury victims, most had mild (45.18%) injuries, and the least had severe (5.79%) injuries, with head being the most common site (34.44%). The highest proportion of injuries were sustained by motor vehicle drivers (57.58%), followed by cyclists/rickshaw pullers (22.59%) and passengers (19.83%). Most vehicles were new (75.21%), and the rest were old (24.79%). Nearly one-third of the participants did not know about driving rules. The presence of knowledge was associated with less severe injury (p=0.031) compared with the absence of knowledge. The qualitative component of the study identified several factors related to road traffic injury, including driver factors (lack of sleep, bad driving habits and lack of helmets), driving activity factors (ignoring rules, overtaking, crossing speed limits and using bright headlights), road-related factors (broken roads, unplanned curves and angles, the need for spacious streets and the lack of appraisal of previous crash records) and traffic control factors (stringent traffic rules, effective implementation and training on using speed guns).

Conclusion: The factors related to road traffic injury identified in this study could be used to plan targeted interventions for road safety improvement.