bluuebunny/crossref_metadata_2025_split huggingface dataset:
Equestrian injuries: a five year review of hospital admissions in British Columbia, Canada
Authors: Sorli Janet M 
Published: October 2002

Aim—To determine the demographics of hospital admissions and mortality associated with equestrian activities in the 33 000 riders in British Columbia (BC).Method—Analysis of admission data from the Ministry of Health for the years 1991–96, review of information obtained from the Office of the Chief Coroner, and comparison of data from Canadian Hospitals Injury Reporting and Prevention Program.Results—The mean number of admissions per year was 390. Head injury was the most common cause of admission to hospital (20%) in BC. Females most often required admission (62%). Teenagers and children have a higher incidence of head injuries than the general population. The injury rate was 0.49/1000 hours of riding. There were three deaths per year, 1/10 000 riders; 60% were caused by head injury and females predominated.Conclusion—Head injuries and other serious injuries occur with equestrian activities and it is important for doctors, instructors, and parents to promote the use of appropriate safety equipment, including helmets, especially for children.
Socioeconomic differences in childhood injury: a population based epidemiologic study in Ontario, Canada
Authors: Faelker Taron , Pickett William , Brison Robert J 
Published: October 2002

Objective—To determine whether risks for childhood injury vary according to socioeconomic gradients.Design—Population based, retrospective study. The percentage of individuals living below the poverty line (described ecologically using census data) was the primary measure of socioeconomic status.Setting—Catchment area of a tertiary medical centre that provides emergency services to all area residents. Area residents aged 0–19 years during 1996 were included.Observations—Injuries that occurred during 1996 were identified by an emergency department based surveillance system. The study population was divided into socioeconomic grades based upon percentages of area residents living below the poverty line. Multiple Poisson regression analyses were used to quantify associations and assess the statistical significance of trends.Results—5894 childhood injuries were identified among 35 380 eligible children; 985 children with missing socioeconomic data were excluded. A consistent relation between poverty and injury was evident. Children in the highest grade (indicating higher poverty levels) experienced injury rates that were 1.67 (95% confidence interval 1.48 to 1.89) higher than those in the lowest grade (adjusted relative risk for grades 1-V: 1.00,1.10,1.22,1.42, 1.67; ptrend<0.001). These patterns were observed within age/sex strata; for home, recreational, and fall injuries; and for injuries of minor and moderate severities.Conclusions—Socioeconomic differences in childhood injury parallel mortality and morbidity gradients identified in adult populations. This study confirms that this health gradient is observable in a population of children using emergency department data. Given the population based nature of this study, these findings are likely to be reflected in other settings. The results suggest the need for targeted injury prevention efforts among children from economically disadvantaged populations, although the exact requirements of the optimal prevention approach remain elusive.
Effect of an older sibling and birth interval on the risk of childhood injury
Authors: Nathens Avery B , Neff Margaret J , Goss Christopher H , Maier Ronald V , Rivara Frederick P 
Published: October 2002

Objective—Certain family structures have been identified as putting children at high risk for injury. To further define children at highest risk, we set out to explore the effect of an older sibling and birth interval on the risk of injury related hospital admission or death.Methods—Data were analyzed using a case-control design. Cases and controls were identified by linking longitudinal birth data from Washington state (1989–96) to death certificate records and hospital discharge data obtained from the Washington State Comprehensive Hospital Abstract Reporting System and frequency matched in a 1:2 ratio on year of birth. Cases consisted of singleton children 6 years of age or younger who were hospitalized or died as a result of injury during the years 1989–96. Multivariate logistic regression was used to identify and adjust for confounding variables.Results—There were 3145 cases and 8371 controls. The adjusted odds ratio for injury in children with an older sibling was 1.50 (95% confidence interval 1.37 to 1.65). The effect was greatest in children under 2 years of age, and in those with a birth interval of less than two years. As the number of older siblings increased, so did the risk of injury, with the highest risk in children with three or more older siblings.Conclusion—These data suggest that the presence of an older sibling is associated with an increased risk of injury. The risk is highest in those with very short birth intervals. Potential mechanisms for this increased risk may relate to inadequate parental supervision. Pediatricians and other care providers need to be alert to these identifiable risk factors and then direct preventive strategies, such as home visits and educational programs, toward these families.
Urban residential fire and flame injuries: a population based study
Authors: DiGuiseppi C , Edwards P , Godward C , Roberts I , Wade A 
Published: October 2002

Background—Fires are a leading cause of death, but non-fatal injuries from residential fires have not been well characterised.Methods—To identify residential fire injuries that resulted in an emergency department visit, hospitalisation, or death, computerised databases from emergency departments, hospitals, ambulance and helicopter services, the fire department, and the health department, and paper records from the local coroner and fire stations were screened in a deprived urban area between June 1996 and May 1997.Result—There were 131 fire related injuries, primarily smoke inhalation (76%), an incidence of 36 (95% confidence interval (CI) 30 to 42)/100 000 person years. Forty one patients (32%) were hospitalised (11 (95% CI 8 to 15)/100 000 person years) and three people (2%) died (0.8 (95% CI 0.2 to 2.4)/100 000 person years). Injury rates were highest in those 0–4 (68 (95% CI 39 to 112)/100 000 person years) and ≥85 years (90 (95% CI 29 to 213)/100 000 person years). Rates did not vary by sex. Leading causes of injury were unintentional house fires (63%), assault (8%), clothing and nightwear ignition (6%), and controlled fires (for example, gas burners) (4%). Cooking (31%) and smoker's materials (18%) were leading fire sources.Conclusions—Because of the varied causes of fire and flame injuries, it is likely that diverse interventions, targeted to those at highest risk, that is, the elderly, young children, and the poor, may be required to address this important public health problem.
Injury death excesses in smokers: a 1990–95 United States national cohort study
Authors: Leistikow B N , Martin D C , Samuels S J 
Published: October 2002

Objectives—Assess injury death relative risks (RR), dose-response, and attributable fractions for current cigarette smokers (smokers) in a recent representative sample of the United States population without and with adjustment for (a) demographic and (b) additional behavioral risk factors.Setting—United States.Methods—National Health Interview Survey (NHIS) adult (ages 18+ years) interviewees from 1990 or 1991 were followed through 1995. Referents had never smoked a total of 100 cigarettes. Relative risks were estimated with Stata software's Cox proportional hazard regressions, using NHIS final weights and primary sampling units. The resulting RR and published data were used to estimate population smoking attributable fractions of injury deaths in the United States.Results—The crude, age-race-gender adjusted, and fully (demographic plus educational attainment, marital status, alcohol use level, and seat belt use) adjusted RRs for injury death in smokers were 1.86 (95% confidence interval (CI) 1.30 to 2.66), 1.60 (CI 1.12 to 2.29), and 1.42 (CI 0.99 to 2.05) respectively. Those RRs correspond to United States injury death smoking attributable fractions of 18%, 13%, and 9%, respectively. Those smoker/injury death RRs each showed a significant dose response relationship (p<0.030). Smokers' unadjusted unintentional injury, motor vehicle crash, and suicide RRs were 1.87 (CI 1.22 to 2.86), 2.14 (CI 1.12 to 4.11), and 2.17 (CI 1.02 to 4.62), respectively.Conclusions—Smokers in the United States have significant dose-response excesses of injury death, independent of age, race, gender, alcohol use, seat belt use, education, and marital status. This supports earlier studies suggesting that smoking may be a leading contributor to injuries and injury may be a leading burden from smoking, both nationally and globally.
Proposed explanations for excess injury among veterans of the Persian Gulf War and a call for greater attention from policymakers and researchers: Figure 1
Authors: Bell N S , Amoroso P J , Wegman D H , Senier L 
Published: October 2002

Introduction—Death rates among US veterans of the Persian Gulf War were lower than rates among non-deployed veterans and the US population at large, with the exception of injury deaths; returning veterans were at significantly greater risk of injury mortality. Similar patterns of excess injury mortality were documented among US and Australian veterans returning from Vietnam. In spite of these consistent findings little has been done to explain these associations and in particular to determine whether or not, and how, war related exposures influence injury risk among veterans returning home after deployments.Hypothesized pathways—Several potential pathways are proposed through which injury might be related to deployment. First, increases in injury mortality may be a consequence of depression, post-traumatic stress disorder, and symptoms of other psychiatric conditions developed after the war. Second, physical and psychological traumas experienced during the war may result in the postwar adoption of “coping” behaviors that also increase injury risk (for example, heavy drinking). Third, greater injury risk may be the indirect consequence of increased experiences of ill defined diseases and symptoms reported by many returning veterans. Fourth, veterans may experience poorer survivability for a given injury event resulting in greater mortality but not morbidity. Finally, the process that selects certain individuals for deployment may lead to a spurious association between deployment status and injury mortality by preferentially selecting individuals who are risk takers and/or exposed to greater hazards.Conclusions—More research and attention from policymakers is needed to clarify the link between deployment and postwar increased risk of injury.
Sports activities related to injuries? A survey among 9–19 year olds in Switzerland
Authors: Michaud P-A , Renaud A , Narring F 
Published: October 2002

Background—Most data on sports injuries are gathered in clinical settings so that their epidemiology in the general population is not well known.Objective—To explore the link between sports injuries with the type and the amount of sports activity and biological factors.Methods—In 1996, 3609 in-school adolescents 10–19 years (1847 girls and 1762 boys) participated in a regional survey. This included anthropometric measurements and a self administered questionnaire.Results—Altogether 28.2% of girls and 35.9% of boys reported one or more sports injuries during the previous year and 2.1% of girls and 6.5% of boys reported at least one hospitalization due to a sports injury. Using the mean rate of injuries as reference level, some sports are highly related to injury occurrence: body building (relative risk (RR) 1.7, 95% confidence interval (CI) 1.5 to 1.9), skateboarding and rollerskating (RR 1.6, 1.4 to 1.8), athletics (RR 1.5, 1.3 to 1.7), snowboarding (RR 1.5, 1.4 to 1.6), basketball (RR 1.3, 1.2 to 1.4), soccer (RR 1.3, 1.2 to 1.4), and ice hockey (RR 1.2, 1.1 to 1.3). Using a logistic regression, several variables associated with a higher risk of injury were identified: the amount of physical activity, high risk sports, and Tanner pubertal stages.Conclusion—The risk of sports injury increases not so much with age but with exposure to specific sports and with pubertal development.
Injury patterns in rural and urban Uganda
Authors: Kobusingye O , Guwatudde D , Lett R 
Published: October 2002

Objectives—To describe and contrast injury patterns in rural and urban Uganda.Settings—One rural and one urban community in Uganda.Methods—Community health workers interviewed adult respondents in households selected by multistage sampling, using a standardized questionnaire.Results—In the rural setting, 1673 households, with 7427 persons, were surveyed. Injuries had an annual mortality rate of 92/100 000 persons, and disabilities a prevalence proportion of 0.7%. In the urban setting 2322 households, with 10 982 people, were surveyed. Injuries had an annual mortality rate of 217/100 000, and injury disabilities a prevalence proportion of 2.8%. The total incidence of fatal, disabling, and recovered injuries was 116/1000/year. Leading causes of death were drowning in the rural setting, and road traffic in the city.Conclusion—Injuries are a substantial burden in Uganda, with much higher rates than those in most Western countries. The urban population is at a higher risk than the rural population, and the patterns of injury differ. Interventions to control injuries should be a priority in Uganda.
A population based study of unintentional firearm fatalities
Authors: Cherry D , Runyan C , Butts J 
Published: October 2002

Objectives—To describe the circumstances of fatal unintentional firearm injuries in a statewide population in a region of the United States with high firearm fatality rates and to compare to similar data from an earlier period in the same state.Methods—Analyses of North Carolina medical examiner database (1985–94) and review of medical examiner case reports (1990–94) and comparison to similar data from 1979–82.Results—A total of 390 unintentional shooting deaths occurred (0.59/100 000 population) between 1985–94 with the highest rate in the ages 15–24. Between 1990–94, handguns were responsible for 59% of these deaths compared to 40% in the 1979–82 period. Younger victims were more likely to be shot by family or friends, though, 53% of all deaths were self inflicted. In 45 cases, the person firing the weapon was reported to believe that the gun was unloaded or had the safety device activated.Conclusions—This study demonstrates changes in patterns of unintentional firearm fatalities in North Carolina in two decades, particularly the increase in incidence of events involving handguns. The results highlight the need for additional attention to efforts governing access to firearms, particularly handguns; technological advances in designing safer guns, and additional emphasis on safe storage policies and practices.
Hypothermia deaths in Jefferson County, Alabama
Authors: Taylor A J , McGwin G , Davis G G , Brissie R M , Holley T D , Rue L W 
Published: October 2002

Introduction—Some reported characteristics associated with hypothermia mortality include older age, alcohol consumption, male sex, and black race. The purpose of this paper is to present the epidemiology of hypothermia deaths in Jefferson County, Alabama.Methods—Autopsy reports maintained by the county coroner's office were abstracted for all cases with primary or underlying causes of death listed as “hypothermia” or “exposure to cold” between January 1983 and July 1999.Results—Sixty three hypothermia deaths occurred in Jefferson County during the study period. The mean age among cases was 68 years, 63.9% were male and 70% were of black race. Rates of hypothermia death were highest among black males, followed by black females, particularly blacks aged 80 years or older. Deaths occurring indoors were more common among older persons and outdoor deaths more common among younger persons. Thirty per cent of decedents tested positive for alcohol, 75% of whom were found outdoors. Nine decedents tested positive for drugs or medications. Approximately 90% of decedents were identified as having one or more chronic medical conditions. Excluding alcoholics, 52% of decedents had one or more chronic medical conditions.Conclusions—Hypothermia in Jefferson County, Alabama is a cause of death primarily affecting two distinct groups of individuals, elderly persons who develop hypothermia inside a dwelling and middle aged males who develop hypothermia out of doors and have consumed alcohol.
A geographic analysis of motor vehicle collisions with child pedestrians in Long Beach, California: comparing intersection and midblock incident locations
Authors: Lightstone A S , Dhillon P K , Peek-Asa C , Kraus J F 
Published: October 2002

Objectives—The purpose of this study was to use geographic information system (GIS) software to locate areas of high risk for child pedestrian-motor vehicle collisions in the city of Long Beach and to compare risk factors between midblock and intersection collisions.Methods—Children 0–14 years of age involved in a motor vehicle versus pedestrian collision that occurred on public roadways in Long Beach, CA, between 1 January 1992 and 30 June 1995, were identified retrospectively from police reports. The GIS software program, ArcView, was used for spatial analysis and distance calculations. χ2Tests were used to compare the distribution of the characteristics between intersection and midblock collisions.Results—The average annual incident and fatality rate was 183.3/100 000 children/year and 2.4/100 000 children/year, respectively. Children less than 5 years of age were significantly more likely to be hit at a midblock location while those aged 5–9 and 10–14 were more often hit at an intersection. Intersection collisions were more likely to occur on major arterials and local streets, and the driver to be the primary party at fault (p<0.001). While intersection incidents tended to occur further from the child's home (64.4%) the majority of midblock incidents (61.5%) occurred within 0.1 miles of the child's residence. For both midblock and intersection locations, pedestrian collisions tended to occur more frequently in those census tracts with a larger number of families per census tract—a measure of household crowding and density.Conclusions—Future studies taking into consideration traffic volume and vehicle speed would be useful to focus prevention efforts such as environmental modifications, improving police enforcement, and educational efforts targeted at parents of younger children. As GIS illustrative spatial relationships continue to improve, relationships between pedestrian collision sites and other city landmarks can advance the study of pedestrian incidents.
Drowsiness, counter-measures to drowsiness, and the risk of a motor vehicle crash
Authors: Cummings P , Koepsell T D , Moffat J M , Rivara F P 
Published: October 2002

Objectives—Knowledge of how different indicators of drowsiness affect crash risk might be useful to drivers. This study sought to estimate how drowsiness related factors, and factors that might counteract drowsiness, are related to the risk of a crash.Methods—Drivers on major highways in a rural Washington county were studied using a matched case-control design. Control (n=199) drivers were matched to drivers in crashes (n=200) on driving location, travel direction, hour, and day of the week.Results—Crash risk was greater among drivers who felt they were falling asleep (adjusted relative risk (aRR) 14.2, 95% confidence interval (CI) 1.4 to 147) and those who drove longer distances (aRR 2.2 for each additional 100 miles, 95% CI 1.4 to 3.3). Risk was also greater among drivers who had slept nine or fewer hours in the previous 48 hours, compared with those who had slept 12 hours. Crash risk was less for drivers who used a highway rest stop (aRR 0.5, 95% CI 0.3 to 1.0), drank coffee within the last two hours (aRR 0.5, 95% CI 0.3 to 0.9), or played a radio while driving (aRR 0.6, 95% CI .4 to 1.0).Conclusion—Drivers may be able to decrease their risk of crashing if they: (1) stop driving if they feel they are falling asleep; (2) use highway rest stops; (3) drink coffee; (4) turn on a radio; (5) get at least nine hours sleep in the 48 hours before a trip; and (6) avoid driving long distances by sharing the driving or interrupting the trip.
Mandatory helmet legislation and children's exposure to cycling
Authors: Macpherson A K , Parkin P C , To T M 
Published: October 2002

Background—Mandatory helmet legislation for cyclists is the subject of much debate. Opponents of helmet legislation suggest that making riders wear helmets will reduce ridership, thus having a negative overall impact on health. Mandatory bicycle helmet legislation for children was introduced in Ontario, Canada in October 1995. The objective of our study was to examine trends in children's cycling rates before and after helmet legislation in one health district.Setting—Child cyclists were observed at 111 preselected sites (schools, parks, residential streets, and major intersections) in the late spring and summer of 1993–97 and in 1999, in a defined urban community.Participants—Trained observers counted the number of child cyclists. The number of children observed in each area was divided by the number of observation hours, resulting in the calculation of cyclists per hour.Main outcome measure—A general linear model, using Tukey's method, compared the mean number of cyclists per hour for each year, and for each type of site.Results—Although the number of child cyclists per hour was significantly different in different years, these differences could not be attributed to legislation. In 1996, the year after legislation came into effect, average cycling levels were higher (6.84 cyclists per hour) than in 1995, the year before legislation (4.33 cyclists per hour).Conclusion—Contrary to the findings in Australia, the introduction of helmet legislation did not have a significant negative impact on child cycling in this community.
Cost effectiveness analysis of a smoke alarm giveaway program in Oklahoma City, Oklahoma
Authors: Haddix A C , Mallonee S , Waxweiler R , Douglas M R 
Published: October 2002

Objective—To estimate the cost effectiveness of the Lifesavers Residential Fire and Injury Prevention Program (LRFIPP), a smoke alarm giveaway program.Setting—In 1990, the LRFIPP distributed over 10 000 smoke alarms in an area of Oklahoma City at high risk for residential fire injuries. The program also included fire prevention education and battery replacement components.Methods—A cost effectiveness analysis was conducted from the societal and health care systems perspectives. The study compared program costs with the total costs of medical treatment and productivity losses averted over a five year period. Fatal and non-fatal residential fire related injuries prevented were estimated from surveillance data. Medical costs were obtained from chart reviews of patients with fire related injuries that occurred during the pre-intervention period.Results—During the five years post-intervention, it is estimated that the LRFIPP prevented 20 fatal and 24 non-fatal injuries. From the societal perspective, the total discounted cost of the program was $531 000. Total discounted net savings exceeded $15 million. From the health care system perspective, the total discounted net savings were almost $1 million and would have a net saving even if program effectiveness was reduced by 64%.Conclusions—The program was effective in reducing fatal and non-fatal residential fire related injuries and was cost saving. Similar programs in other high risk areas would be good investments even if program effectiveness was lower than that achieved by the LRFIPP.