Injury Prevention最新文献

Farmers are exposed to various risks due to the nature of the agricultural environment, and occupational injuries occur consistently. Hence, this study aimed to investigate the characteristics and predictors of major non-fatal occupational injuries among farmers by analysing incidents of non-fatal occupational injuries resulting in at least 1 day off work using the Korean Agricultural Workers' Occupational Disease and Injury Survey data. Multivariate logistic regression was performed to identify the predictors of agricultural occupational injuries, and the results indicated that the risk for non-fatal injuries was higher among older individuals, individuals with pre-existing physical limitations and individuals who use agricultural machinery. The predictors were generally similar for most types of non-fatal injuries. By type of injuries, the risk for trip or slip was higher among women than men. The risk for injuries caused by excessive force or motion was higher among farmers doing rice farming, which is substantially mechanised, than field crop farmers or livestock farmers. The risk of falling from a height was higher among male orchard and greenhouse farmers. The risk of solo farm vehicle crash was higher among male farmers, older farmers, rice farmers, farmers with pre-existing physical limitations and farmers using agricultural machinery. The findings of this study may be useful for developing tailored policies and supportive projects for the Korean farmer population.

Background: Since 2014, drowning has received increased political attention. Translating this political commitment to saving lives needs policy-supported evidence-informed interventions. An evidence gap map (EGM) was developed, which aims to facilitate the strategic prioritisation of future research and efficient commissioning of interventions.

Methods: Available evidence was sought by searching four electronic databases using drowning key terms from 2005 to 2023. Peer-reviewed studies, which measured the outcome of a drowning prevention intervention, were included in the EGM. Classification of interventions was guided by the WHO's recommendations for drowning prevention interventions and strategies. Intervention outcomes were classified into health, social, economic, policy and other supporting outcomes.

Results: 49 intervention studies were identified. Of these, 25 studies were conducted in high-income countries (HICs), 19 in low- and middle-income countries (LMICs), 3 in both HICs and LMICs and 2 were not country specific. Interventions, which used community education, were the most common (n=29, 27%), followed by teaching school-age children swimming and water safety skills (n=13, 12%) and others combined (n=66, 61%). Majority of interventions focused on process outcomes such as knowledge acquisition (n=42, 39%) in comparison with objective outcomes such as incidence of drowning mortality (n=21, 19%). No studies reported on interventions that manage flood risks.

Conclusions: Knowledge gaps of effective drowning prevention interventions were identified using an EGM, emphasising the need for methodological advancements reporting on outcomes measures, implementation research and targeted research among high-risk populations in LMICs.

Objective: The study objective was to examine if interventions changing access to lethal means are associated with changes in suicide deaths and/or attempts by conducting a systematic review of controlled intervention studies.

Methods: Authors searched key databases (PubMed, PsycInfo, CINAHL) from inception to March 2024 for longitudinal controlled intervention studies with at least one contemporaneous comparator group evaluating the impact of interventions changing access to lethal means on suicide attempts and/or deaths in a primarily adult population. Reviewers dually screened articles, then extracted study characteristics and assessed methodological quality.

Results: Researchers screened 8522 studies and 36 articles met eligibility for inclusion. Most studies evaluated the impact of population-level firearm interventions on suicide deaths and found that stricter regulations were associated with a small reduction, if any, in total and/or firearm-specific suicide deaths. The ecological level of analysis precluded individual-level causal inference. Findings within interventions targeting methods other than firearms were limited, mixed and/or inconclusive. Notably, no high-quality randomised controlled trials (RCTs) were identified that met our eligibility criteria.

Conclusion: Future studies should use an RCT design or advanced statistical causal inference techniques to further elucidate the effectiveness of these interventions on suicide deaths and/or attempts.

Prospero registration number: CRD42022364775.

Background: Traumatic brain injury (TBI) is a common injury in children. Previous literature has demonstrated that TBI may be associated with supervision level. We hypothesised that primary caregiver employment would be associated with child TBI.

Methods: A retrospective cross-sectional study was performed for children aged 0-17 using the National Survey of Children's Health (NSCH) 2018-2019. The NSCH contains survey data on children's health completed by adult caregivers from randomly selected households across the USA. We compared current TBI prevalence between children from households of different employment statuses. Current TBI was defined by survey responses indicating a healthcare provider diagnosed TBI or concussion for the child and the condition was present at the time of survey completion. Household employment status was categorised as two caregivers employed, two caregivers unemployed, one of two caregivers unemployed, single caregiver employed and single caregiver unemployed. Multivariable logistic regression was performed, controlling for sociodemographic factors.

Results: Of 56 865 children, median age was 10 years (IQR: 5-14), and 0.6% (n=332) had a current TBI. Children with TBI were older than children without TBI (median 12 years vs 10 years, p<0.001). On multivariable regression, children with at least one caregiver unemployed had increased odds of current TBI compared with children with both caregivers employed.

Conclusions: Children with at least one caregiver unemployed had increased TBI odds compared with children with both caregivers employed. These findings highlight a population of families that may benefit from injury prevention education and intervention.

Background: Easy firearm access increases injury risk among adolescents. We evaluated the acceptability and feasibility of improving knowledge of a 3 min safe firearm storage education video in the paediatric emergency department.

Methods: We conducted a single-centre block trial in a large paediatric emergency department (August 2020-2022). Participants were caregivers of adolescents (10-17 years) in firearm-owning households. First block participants (control) completed a baseline survey about child safety behaviours (including firearms). Second block participants (intervention) completed a baseline survey, watched the safe firearm storage video and evaluated acceptability. Participants completed a 3-month follow-up survey about firearm safety behaviours and knowledge recall. Demographic and clinical variables were compared between the intervention and control groups using Fisher's exact and χ² tests. McNemar's test was used to compare firearm storage behaviours at the initial and 3-month visit within each group.

Results: Research staff approached 1264 caregivers; 371 consented to participate (29.4%) and 144 (38.8%) endorsed firearm ownership. There were 95 participants in the control group and 62 in the intervention group. Follow-up was lower in the intervention group (53.7% vs 37.1%, p=0.04). Among participants viewing the video, 80.3% liked the video and 50.0% felt they learnt something new from the video.

Conclusions: Video-based firearm education in a paediatric emergency department is acceptable among a population of caregivers of adolescents with household firearms. This is a higher-risk group that may uniquely benefit from consistent education in the paediatric emergency department. Further study with larger populations is needed to evaluate intervention effectiveness.

Trial registration: The study was registered with ClinicalTrials.gov (NCT05168878).

Objectives: To analyse factors influencing the American public's preferences for changes to teenage driver licensing requirements.

Methods: We employed a discrete choice experiment (DCE) with 808 participants from National Opinion Research Center's AmeriSpeak panel to assess preferences for two existing elements (on-road testing and intermediate licensure period) and a new feature (driver monitoring with telematics during the intermediate licensure period) of licensing system. Multinomial and mixed logit models were used to estimate preference weights, marginal rates of substitution and the relative importance of each attribute.

Results: Among 730 respondents who completed all DCE choice tasks, we found robust support for changes to teenage driver licensing requirements, with preferences varying by individual characteristics. Respondents expressed a high baseline support for changes to teen driving licensure policies. They favoured testing, prioritising easy tests and opposed prolonged driver monitoring and extended intermediate licensure periods. Baseline preference weights exhibited substantial heterogeneity, emphasising the diversity of public preferences. The marginal rates of substitution revealed a preference for extended driver monitoring over an extended intermediate licensure period. An easy test was valued at 2.85 times more than a hard one. The most influential attributes were the length of intermediate licence period and testing requirements, with the former twice as important.

Conclusions: Our study found robust support for reforms to teenage driver licensing requirements, favouring easier on-road driving tests over an extended period of intermediate licensure and driver monitoring. Public preferences for licensing systems need to be balanced with the broader policy objectives including optimising mobility and maximising safety.

Background: Integrating and advancing health equity are a core tenant of the Centers for Disease Control and Prevention's mission. Comprehensive frameworks that clearly conceptualise equity are needed to prioritise and inform the advancement of health equity within public health.

Methods: To help meet this need, the investigative team developed The Continuum of Health Equity Practice & Science (The Continuum). The Continuum was developed in two phases: (1) an initial survey distributed to internal CDC Division of Injury Prevention investigators, and (2) a review of public health frameworks and the current health equity evidence base.

Results: The Continuum is a framework that includes seven key components of health equity and ultimately aims to guide public health practice and research towards the advancement of health equity. To illustrate its usefulness, we provide an example using adolescent suicide for each component of The Continuum and demonstrate how this may inform efforts to advance health equity.

Conclusion: With a specific focus on conceptualising health equity and addressing systemic inequities, The Continuum may be used to inform efforts to advance equity in injury prevention and beyond.

Background: Research is scarce on unintentional femur fractures in children under 2 years of age, with many studies focusing on intentional injuries in this age group. This cross-sectional observational study aimed to characterise unintentional femur fractures in very young children evaluated in emergency departments and reported to a nationally representative database involving consumer products.

Methods: Emergency department visits in children with a femur fracture, under 2 years of age, from 2017 to 2021 were queried from the National Electronic Injury Surveillance System. Case narratives were reviewed to assess eligibility criteria and to create novel variables in addition to those included in the dataset.

Results: An estimated 8891 children under age 2 in the USA were treated for femur fractures related to a consumer product or part of the home environment from 2017 through 2021 (95% CI 6900 to 10 881). The highest incidence was during 2020 (2138; 95% CI 1392 to 2883). Femur fractures most often involved furniture (3155; 95% CI 2201 to 4108), while some involved items specifically designed for babies. Falls on stairs contributed to an estimated 1584 femur fractures (95% CI 1031 to 2137), most often when someone fell while carrying the child. More than half of these fractures resulted in hospitalisation.

Conclusion: Caution should be used when leaving babies around certain household items, even those that may seem safe or designed for babies. Stairs and furniture are significant household hazards even before children become mobile.

Introduction: Household energy transitions have the potential to reduce the burden of several health outcomes but have narrowly focused on those mediated by reduced exposure to air pollution, despite concerns about the burden of injury outcomes. Here, we aimed to describe the country-level incidence of severe cooking-related burns in Ghana and identify household-level risk factors for adults and children.

Methods: We conducted a national household energy use survey including 7389 households across 370 enumeration areas in Ghana in 2020. In each household, a pretested version of the Clean Cooking Alliance Burns Surveillance Module was administered to the primary cook. We computed incidence rates of severe cooking-related burns and conducted bivariate logistic regression to identify potential risk factors.

Results: We documented 129 severe cooking-related burns that had occurred in the previous year. The incidence rate (95% CI) of cooking-related burns among working-age females was 17 (13 to 21) per 1000 person-years or 8.5 times higher than that of working-age males. Among adults, the odds of experiencing a cooking-related burn were 2.29 (95% CI 1.02 to 5.14) and 2.40 (95% CI 1.04 to 5.55) times higher among primary wood and charcoal users respectively compared with primary liquified petroleum gas users. No child burns were documented in households where liquified petroleum gas was primarily used.

Conclusion: Using a nationally representative sample, we found that solid fuel use doubled the odds of cooking-related burns compared with liquified petroleum gas. Ghana's efforts to expand access to liquified petroleum gas should focus on safe use.

Background: Americans increasingly perceive that homes with guns are safer than those without, and physician counselling about in-home firearm safety and injury risks occurs infrequently, despite encouragement from major medical organisations (eg, American Medical Association, American Academy of Pediatrics). Safety counselling that does occur may be limited to gun owners at high risk of injury; however, given the increasing rates of first-time gun ownership in the USA, understanding attitudes toward firearms and firearm safety messaging among persons who may become firearm owners is needed to inform and support continued injury prevention efforts.

Methods: Survey data from a cross-section of firearm owners (n=396) and non-owners (n=551) collected in February 2023 was used to examine differences in perceptions about the safety of firearm households, openness toward firearm safety counselling and comfort with law enforcement compared with physician firearm safety discussions.

Results: Over three-quarters of current and possible future gun owners agreed that firearms make homes safer, compared with just over one-third of non-owners. All three groups favoured law enforcement over physicians for firearm safety messengers and were more comfortable speaking with law enforcement than physicians about firearm safety.

Discussion and conclusion: Public health and injury prevention safety counselling that combines messaging from law enforcement and medical perspectives may be similarly accessible for both current firearm owners and those considering owning firearms in the future.