Injury Prevention最新文献

Objectives: Individuals (ie, respondents) subject to domestic violence protection orders have threatened or engaged in one form of violence perpetration and may be at increased risk for experiencing others forms of violence, including violent death.

Methods: Using a cohort of granted domestic violence protection orders in King County, Washington, USA, from 2014 to 2020 (n=3543), we calculated standardised mortality ratios for violent death, including suicide, homicide, legal intervention and undetermined intent, comparing domestic violence protection order respondents to King County residents adjusting for year, age, sex, and race and ethnicity through indirect standardisation.

Results: There were 66 deaths among domestic violence protection order respondents; 25.8% were violent deaths and 52.9% of violent deaths involved firearms. The standardised mortality ratio for violent death was 3.71 (95% CI: 2.16 to 5.93) among domestic violence protection order respondents compared with King County residents.

Conclusion: The domestic violence protection order process may provide an opportunity for referrals to services to address shared risk factors for violence perpetration and victimisation.

Objective: Injuries and poisoning are leading causes of US morbidity and mortality. This study aimed to update medical and work loss cost estimates per injured person.

Methods: Injuries treated in emergency departments (ED) during 2019-2020 were analysed in terms of mechanism (eg, fall) and intent (eg, unintentional), as well as traumatic brain injury (TBI) (multiple mechanisms and intents). Fatal injury medical spending was based on the Nationwide Emergency Department Sample and National Inpatient Sample. Non-fatal injury medical spending and workplace absences (general, short-term disability and workers' compensation) were analysed among injury patients with commercial insurance or Medicaid and matched controls during the year following an injury ED visit using MarketScan databases.

Results: Medical spending for injury deaths in hospital EDs and inpatient settings averaged US$4777 (n=57 296) and US$45 678 per fatality (n=89 175) (2020 USD). Estimates for fatal TBI were US$5052 (n=5363) and US$47 952 (n=37 184). People with ED treat and release visits for non-fatal injuries had on average US$5798 (n=895 918) in attributable medical spending and US$1686 (11 missed days) (n=116 836) in work loss costs during the following year, while people with non-fatal injuries who required hospitalisation after an ED injury visit had US$52 246 (n=32 976) in medical spending and US$7815 (51 days) (n=4473) in work loss costs. Estimates for non-fatal TBI were US$4529 (n=25 792), US$1503 (10 days) (n=1631), US$51 241 (n=3030) and US$6110 (40 days) (n=246).

Conclusions and relevance: Per person costs of injuries and violence are important to monitor the economic burden of injuries and assess the value of prevention strategies.

Background: Maritime transportation remains one of the most hazardous industries globally, with work-related incidents posing significant risks.

Material and method: This research investigates onboard occupational injuries in the Turkish maritime sector, focusing on cases between 2013 and 2024. The study analyzes onboard injuries using the Human Factors Analysis and Classification System and Multiple Correspondence Analysis.

Results: The study reveals that human error, inadequate supervision and insufficient organisational processes are primary contributors, particularly in dry bulk vessel operations. A lack of adequate rescue operations is noted, leading to high fatality rates. Furthermore, the analysis identifies a significant issue of under-reporting, especially in less severe events and near misses, limiting the industry's ability to address and mitigate occupational risks effectively.

Conclusions: By improving reporting practices and addressing organisational failures, this study emphasises the need for stronger safety measures, more targeted training and better rescue preparedness to reduce the frequency and severity of occupational injuries and enhance the overall safety of maritime workers.

Introduction: Road traffic injuries (RTIs), particularly motorbike injuries, are one of the leading causes of death worldwide and have been a serious concern in low- and middle-income countries like Bangladesh. Therefore, this study aimed to assess the level of knowledge and practices on road safety measures among motorbikers in Dhaka, Bangladesh.

Methods: This cross-sectional study was conducted from January 2022 to December 2022 among 350 motorbikers of Dhaka city via a series of face-to-face interviews. Motorbikers who regularly ride a motorcycle were interviewed about their road safety knowledge and practices through a two-stage cluster sampling technique. Frequency distribution, independent sample t-test and one-way analysis of variance (ANOVA) were performed in data analysis.

Results: Out of the 350 motorbikers, only 54.6% had good knowledge and 16.9% had poor knowledge on the signs and safety regulations of roads. Moreover, only 50.6% of respondents followed good practices while 23.4% followed poor practices of road safety measures. One-way ANOVA analysis demonstrates that the average knowledge score was significantly (p<0.05) higher among higher-educated, unmarried and non-smokers. Additionally, higher education level, non-smoking status and being Muslim were significantly (p<0.05) associated with good road safety practices.

Conclusions: The overall good knowledge level and practices of road safety measures among the motorbikers was not satisfactory although the majority of them knew individual signs and regulations. Therefore, this study suggests that education and strict enforcement of traffic rules may increase their knowledge and practice behaviour regarding road safety which in turn would minimise traffic injuries and fatalities.

Background: There is a rising burden of severe and fatal outcomes resulting from button battery exposures (ingestions or insertions). We summarised current evidence following button battery exposures in children and provided pooled prevalence estimates for key clinical characteristics, complications and risk estimates for predictors.

Methods: MEDLINE, Embase and Scopus databases were searched up to 19 May 2023. Included studies described complications of button battery exposures in children aged <18 years and reported prevalence data, an OR estimate or allowed OR calculation. Random effects models were used to estimate pooled estimates and event rates.

Findings: Forty-four articles (3125 children) were included in the analysis. Battery exposures were more common in males (59%) and young children. For ingestions, batteries were most often located in the stomach (43%). Mucosal damage (46%) and oesophageal stricture (10%) were the most common complications. Most (60%) children were asymptomatic at presentation. When symptoms were present, vomiting (26%) and dysphagia (18%) were the most common. Duration of ingestion to removal increased the likelihood of any complication; OR 3.71 (95% CI 1.11 to 12.42) for ≥10 hours and 5.12 (95% CI 1.79 to 14.67) for ≥12 hours. Battery diameter ≥20 mm was associated with any complication OR 4.34 (95% CI 1.16 to 16.27) and oesophageal location OR 18.66 (95% CI 6.99 to 49.82). Death was associated with oesophageal impaction OR 15.52 (95% CI 2.40 to 100.27). For insertions, nasal septal perforation was the most common complication (13%).

Interpretation: Button batteries are a potentially fatal domestic hazard particularly for young children. Increased prevention efforts through safer battery design are needed to mitigate this risk.

Background: Communities experiencing more social vulnerability are disproportionately harmed by environmental disasters, disease, and injury. This cross-sectional study examined whether US county-level vulnerability scores were associated with 2019 passenger vehicle occupant or pedestrian death rates.

Methods: County-level vulnerability was measured by 2020 Centers for Disease Control and Prevention Social Vulnerability Index scores. Scores were based on 16 community-level characteristics categorised into 4 themes: socioeconomic status; household characteristics; race and ethnicity and housing type and transportation. Counties were divided into quartiles from least to most vulnerable, based on the score distribution among all counties. Deaths were identified from the 2019 Fatality Analysis Reporting System. Death rates per 100 000 population were stratified by vulnerability quartile and urbanicity. Large central metropolitan county results used the second least vulnerability quartile as reference.

Results: Among 328 320 065 people across 3140 counties, there were 22 942 occupant and 6272 pedestrian deaths. Occupant death rates were higher in most vulnerable counties compared with least for all urbanicity levels (large central metropolitan: 4.0 vs 2.8; large fringe metropolitan: 7.4 vs 5.2; medium/small metropolitan: 8.9 vs 7.0; non-metropolitan: 18.5 vs 12.2) with disparities prominent in counties experiencing more socioeconomic and household vulnerability. Pedestrian death rates were highest in most vulnerable counties compared with least (large central metropolitan: 2.5 vs 1.4; large fringe metropolitan: 3.3 vs 1.0; medium/small metropolitan: 2.8 vs 0.8; non-metropolitan: 2.4 vs 0.9) with disparities prominent for all four vulnerability types.

Conclusions: Tailoring prevention strategies to communities experiencing infrastructure inadequacies, improving safe transportation options and reducing poverty may help reduce crash death disparities.

Background: Measuring the impact of non-fatal injuries and violence is essential for informed public health policy-making and communications. This study aimed to generate new health-related quality of life data for a prominent US non-fatal injury surveillance source using disability weights derived from general population survey estimates.

Methods: Disability weights reflecting severity as measured on a 0 (no disability) to 1 (death) scale, for 47 natures of injury from the Global Burden of Diseases, Risk Factors and Injuries Study (GBD) were mapped to 492 injury types in the US National Electronic Injury Surveillance System - All Injury Program (NEISS-AIP). The matching of GBD natures of injury to NEISS-AIP injury types was based on the underlying definitions for each injury diagnosis.

Results: The average disability value weighted by incidence for all NEISS-AIP types was 0.073 (95% uncertainty interval: 0.050-0.097), and the range by injured body part and diagnosis was 0.006-0.408. Injuries that impacted large or critical body parts (lower trunk, upper trunk, head and neck) had the highest disability weights. Internal injuries, crushing, burns, nerve damage and fractures had higher disability weight values than lacerations, avulsions and contusions. The three most common NEISS-AIP non-fatal injury types during 2015-2020 were poisoning, internal injuries of the head and face lacerations, with disability weights of 0.163 (0.109-0.227), 0.168 (0.112-0.232) and 0.018 (0.010-0.029), respectively.

Conclusions: Mapping of publicly available disability weights data to a prominent non-fatal injury surveillance source can improve opportunities to measure and communicate the health and economic impact of injuries and violence.

Background: Chronic kidney disease (CKD), often coexisting with various systemic disorders, may increase the risk of falls. This study aimed to investigate the associations between grip strength and fall injuries among patients with CKD, and whether these associations differ by sociodemographic and lifestyle factors.

Methods: We included patients with CKD from the China Health and Retirement Longitudinal Study. Multivariable logistic regression was used to evaluate the association between handgrip strength and fall injuries. Receiver operating characteristic (ROC) was employed to evaluate the predictive ability of handgrip strength for fall injuries.

Results: A total of 657 participants with CKD were included, and the prevalence of fall injury rates was 26.5%. After adjustment, for each 1 kg increase in right handgrip strength, the fall incident rate decreased by 3% (OR 0.97, 95% CI 0.94 to 1.00, p=0.023). Further analysis revealed a negative linear association between right handgrip strength and fall injuries, and the area under the ROC curve was 0.606 (95% CI 0.558 to 0.654, p<0.001).

Conclusions: Our study found a negative linear correlation between right handgrip strength and fall injuries rate among patients with CKD. Right handgrip strength could serve as a simple, low-cost screening tool for identifying patients with CKD at elevated risk of falls.

Objectives: To assess the impact of the COVID-19-related stay-at-home (SAH) order in North Carolina (NC) on suicide mortality.

Methods: We used controlled interrupted time series to examine weekly suicide death rates before, during and after the SAH order compared with 2015-2019 rates.

Results: Between 1 January 2020 and 30 March 2020, the suicide death rate in NC was stable. On SAH order implementation, there was an immediate decline in the suicide rate of 2.0 deaths per 100 000 person-years (PYs) (95% CI -7.7, 3.7) during the first SAH week, relative to combined weekly data 2015-2019, followed by a sustained decline of 1.0 death per 100 000 PYs (95% CI -2.0, 0.1) per week over the eight weeks under SAH. On lifting the SAH order, we observed an immediate increase in suicide (3.7 per 100 000 PYs (95% CI -0.7, 8.2)) and from that point through the end of 2020, suicide mortality increased at a rate of 0.7 per 100 000 PYs (95% CI -0.2, 1.6) per week.

Conclusions: During the SAH period, suicide mortality declined for 8 weeks but returned to prior rates after the SAH order was lifted. Increased family supervision and decreased access to lethal means may explain the observed reduction in suicide during the SAH order.

Background: Participation in swimming lessons may reduce drowning among young children (aged 1-5 years). We examined minimum and mean ages at which young children demonstrate components of unsupported water competency (without parent/instructor assistance) and the degree of improvement associated with different numbers of formal group swim lessons through two projects.

Methods: Young children were enrolled in swim instruction programmes offered by a nationally recognised organisation. In project 1, four to eight 30-minute formal group swim lessons were offered. Project 2 increased the number to 12-18 lessons. We observed and categorised pre-/post-lesson developmental levels of components of water competency.

Results: Significant improvements from pre- to post-test were observed across all water competency components in both projects. During project 1, the youngest age category in which we observed unsupported water entry and water exit behaviours was 1-1.9 years. The youngest age category during which we observed unsupported breath control, back flotation/buoyancy and changing body orientation behaviours was 2-2.9 years old. The greatest improvement occurred in water exit, followed by breath control. Most children did not achieve unsupported water competency except in water entry and exit. Children achieved more advanced unsupported behaviours as age increased. Children enrolled in more lessons (12-18) acquired more components and more advanced levels of water competency than children in fewer lessons (4-8).

Conclusion: Although swim skills improved in both projects, more research is needed to determine the optimal number of swimming lessons and the best methods of teaching lessons to young children for most to reach unsupported water competency levels.