An evaluation of nursing tasks.

PubMed

Baptiste, Andrea

2011-01-01

Functional capacity evaluations have been criticized as being too general in theory and not being accurate enough to determine what tasks an employee can perform. This paper will describe results of a descriptive study that was conducted in a laboratory setting to objectively determine the physical demands of patient transfer tasks performed by nurses. Fifty three tasks were analyzed and broken down into sub-tasks to quantify the peak force required to perform each sub-task in order to determine which tasks pose healthcare workers at highest risk of injury. Dissecting the transfer task into segments allows us to see which part of the task requires high forces on the part of the caregiver. The task can then be modified to eliminate the risk of injury to the caregiver. This modification can be accomplished by using healthcare technology, such as floor based or overhead lifts, friction reducing devices, sit to stand lifts, properly designed slings, and motorized beds/trolleys. Technological solutions are available for some of these high risk tasks and should be implemented where applicable to reduce the force demand and eliminate or reduce the risk of injury to healthcare workers in nursing.

Older siblings as potential supervisors of younger siblings: sibling supervisors' recognition of injury-risk behaviours and beliefs about supervisee risk taking and potential injury outcomes.

PubMed

Morrongiello, B A; Schell, S L; Stewart, J

2015-07-01

Past research has shown that increased injury risk for supervisees during sibling supervision is in part due to the supervision practices of older siblings. The current study used a photo sorting task to examine older siblings' recognition of injury-risk behaviours, their perceived likelihood of supervisees engaging in, or being injured while engaging in, these behaviours, and awareness of past risk-taking behaviours of supervisees. Mothers completed the same measures and an interview about sibling supervision in the home. Mothers reported that sibling supervision occurred most frequently in the kitchen, living room, and children's bedrooms, for approximately 39 min/day, and that the more time the children spent together in a room, the more frequently the older sibling supervised the younger one. The most common reasons mothers gave for why sibling supervision was allowed included beliefs that the older child knows about hazards and unsafe behaviours and that the child could provide adequate supervision. Photo sort results revealed that older siblings were able to correctly identify about 98% of risk behaviours, with these scores significantly higher than what mothers expected (79%). However, compared with mothers, older siblings were less aware of risk behaviours that their younger siblings had engaged in previously. In addition, mothers rated supervisees as 'fairly likely' both to engage in risk behaviours and to experience an injury if they tried these behaviours, whereas sibling supervisors rated both supervisee risk behaviour and injury outcomes as 'not likely' to occur. Older siblings showed good knowledge of hazards but failed to realize that younger children often engage in injury-risk behaviours. Efforts to improve the supervision practices of sibling supervisors need to include changing their perception of supervisees' injury vulnerability and potential injury severity, rather than targeting to increase knowledge of injury-risk behaviours per se. �

Do exercises used in injury prevention programmes modify cutting task biomechanics? A systematic review with meta-analysis.

PubMed

Pappas, Evangelos; Nightingale, Elizabeth J; Simic, Milena; Ford, Kevin R; Hewett, Timothy E; Myer, Gregory D

2015-05-01

Some injury prevention programmes aim to reduce the risk of ACL rupture. Although the most common athletic task leading to ACL rupture is cutting, there is currently no consensus on how injury prevention programmes influence cutting task biomechanics. To systematically review and synthesise the scientific literature regarding the influence of injury prevention programme exercises on cutting task biomechanics. The three largest databases (Medline, EMBASE and CINAHL) were searched for studies that investigated the effect of injury prevention programmes on cutting task biomechanics. When possible meta-analyses were performed. Seven studies met the inclusion criteria. Across all studies, a total of 100 participants received exercises that are part of ACL injury prevention programmes and 76 participants served in control groups. Most studies evaluated variables associated with the quadriceps dominance theory. The meta-analysis revealed decreased lateral hamstrings electromyography activity (p ≤ 0.05) while single studies revealed decreased quadriceps and increased medial hamstrings activity and decreased peak knee flexion moment. Findings from single studies reported that ACL injury prevention exercises reduce neuromuscular deficits (knee valgus moment, lateral trunk leaning) associated with the ligament and trunk dominance theories, respectively. The programmes we analysed appear most effective when they emphasise individualised biomechanical technique correction and target postpubertal women. The exercises used in injury prevention programmes have the potential to improve cutting task biomechanics by ameliorating neuromuscular deficits linked to ACL rupture, especially when they emphasise individualised biomechanical technique correction and target postpubertal female athletes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: Mechanisms of injury and underlying risk factors.

PubMed

Alentorn-Geli, Eduard; Myer, Gregory D; Silvers, Holly J; Samitier, Gonzalo; Romero, Daniel; Lázaro-Haro, Cristina; Cugat, Ramón

2009-07-01

Soccer is the most commonly played sport in the world, with an estimated 265 million active soccer players by 2006. Inherent to this sport is the higher risk of injury to the anterior cruciate ligament (ACL) relative to other sports. ACL injury causes the most time lost from competition in soccer which has influenced a strong research focus to determine the risk factors for injury. This research emphasis has afforded a rapid influx of literature defining potential modifiable and non-modifiable risk factors that increase the risk of injury. The purpose of the current review is to sequence the most recent literature that reports potential mechanisms and risk factors for non-contact ACL injury in soccer players. Most ACL tears in soccer players are non-contact in nature. Common playing situations precluding a non-contact ACL injury include: change of direction or cutting maneuvers combined with deceleration, landing from a jump in or near full extension, and pivoting with knee near full extension and a planted foot. The most common non-contact ACL injury mechanism include a deceleration task with high knee internal extension torque (with or without perturbation) combined with dynamic valgus rotation with the body weight shifted over the injured leg and the plantar surface of the foot fixed flat on the playing surface. Potential extrinsic non-contact ACL injury risk factors include: dry weather and surface, and artificial surface instead of natural grass. Commonly purported intrinsic risk factors include: generalized and specific knee joint laxity, small and narrow intercondylar notch width (ratio of notch width to the diameter and cross sectional area of the ACL), pre-ovulatory phase of menstrual cycle in females not using oral contraceptives, decreased relative (to quadriceps) hamstring strength and recruitment, muscular fatigue by altering neuromuscular control, decreased "core" strength and proprioception, low trunk, hip, and knee flexion angles, and high

[Temporary employment and health: a multivariate analysis of occupational injury risk by job tenure].

PubMed

Bena, Antonella; Giraudo, Massimiliano

2013-01-01

To study the relationship between job tenure and injury risk, controlling for individual factors and company characteristics. Analysis of incidence and injury risk by job tenure, controlling for gender, age, nationality, economic activity, firm size. Sample of 7% of Italian workers registered in the INPS (National Institute of Social Insurance) database. Private sector employees who worked as blue collars or apprentices. First-time occupational injuries, all occupational injuries, serious occupational injuries. Our findings show an increase in injury risk among those who start a new job and an inverse relationship between job tenure and injury risk. Multivariate analysis confirm these results. Recommendations for improving this situation include the adoption of organizational models that provide periods of mentoring from colleagues already in the company and the assignment to simple and not much hazardous tasks. The economic crisis may exacerbate this problem: it is important for Italy to improve the systems of monitoring relations between temporary employment and health.

Injury Risk Assessment of Extravehicular Mobility Unit (EMU) Phase VI and Series 4000 Gloves During Extravehicular Activity (EVA) Hand Manipulation Tasks

NASA Technical Reports Server (NTRS)

Kilby, Melissa

2015-01-01

Functional Extravehicular Mobility Units (EMUs) with high precision gloves are essential for the success of Extravehicular Activity (EVA). Previous research done at NASA has shown that total strength capabilities and performance are reduced when wearing a pressurized EMU. The goal of this project was to characterize the human-space suit glove interaction and assess the risk of injury during common EVA hand manipulation tasks, including pushing, pinching and gripping objects. A custom third generation sensor garment was designed to incorporate a combination of sensors, including force sensitive resistors, strain gauge sensors, and shear force sensors. The combination of sensors was used to measure the forces acting on the finger nails, finger pads, finger tips, as well as the knuckle joints. In addition to measuring the forces, data was collected on the temperature, humidity, skin conductance, and blood perfusion of the hands. Testing compared both the Phase VI and Series 4000 glove against an ungloved condition. The ungloved test was performed wearing the sensor garment only. The project outcomes identified critical landmarks that experienced higher workloads and are more likely to suffer injuries. These critical landmarks varied as a function of space suit glove and task performed. The results showed that less forces were acting on the hands while wearing the Phase VI glove as compared to wearing the Series 4000 glove. Based on our findings, the engineering division can utilize these methods for optimizing the current space suit glove and designing next generation gloves to prevent injuries and optimize hand mobility and comfort.

Constraints influencing sports wheelchair propulsion performance and injury risk.

PubMed

Churton, Emily; Keogh, Justin Wl

2013-03-28

The Paralympic Games are the pinnacle of sport for many athletes with a disability. A potential issue for many wheelchair athletes is how to train hard to maximise performance while also reducing the risk of injuries, particularly to the shoulder due to the accumulation of stress placed on this joint during activities of daily living, training and competition. The overall purpose of this narrative review was to use the constraints-led approach of dynamical systems theory to examine how various constraints acting upon the wheelchair-user interface may alter hand rim wheelchair performance during sporting activities, and to a lesser extent, their injury risk. As we found no studies involving Paralympic athletes that have directly utilised the dynamical systems approach to interpret their data, we have used this approach to select some potential constraints and discussed how they may alter wheelchair performance and/or injury risk. Organism constraints examined included player classifications, wheelchair setup, training and intrinsic injury risk factors. Task constraints examined the influence of velocity and types of locomotion (court sports vs racing) in wheelchair propulsion, while environmental constraints focused on forces that tend to oppose motion such as friction and surface inclination. Finally, the ecological validity of the research studies assessing wheelchair propulsion was critiqued prior to recommendations for practice and future research being given.

Constraints influencing sports wheelchair propulsion performance and injury risk

PubMed Central

2013-01-01

The Paralympic Games are the pinnacle of sport for many athletes with a disability. A potential issue for many wheelchair athletes is how to train hard to maximise performance while also reducing the risk of injuries, particularly to the shoulder due to the accumulation of stress placed on this joint during activities of daily living, training and competition. The overall purpose of this narrative review was to use the constraints-led approach of dynamical systems theory to examine how various constraints acting upon the wheelchair-user interface may alter hand rim wheelchair performance during sporting activities, and to a lesser extent, their injury risk. As we found no studies involving Paralympic athletes that have directly utilised the dynamical systems approach to interpret their data, we have used this approach to select some potential constraints and discussed how they may alter wheelchair performance and/or injury risk. Organism constraints examined included player classifications, wheelchair setup, training and intrinsic injury risk factors. Task constraints examined the influence of velocity and types of locomotion (court sports vs racing) in wheelchair propulsion, while environmental constraints focused on forces that tend to oppose motion such as friction and surface inclination. Finally, the ecological validity of the research studies assessing wheelchair propulsion was critiqued prior to recommendations for practice and future research being given. PMID:23557065

Injury risk in professional boxing.

PubMed

Bledsoe, Gregory H; Li, Guohu; Levy, Fred

2005-10-01

Although a popular endeavor, boxing has fallen under increased scrutiny because of its association with traumatic brain injury. However, few studies have investigated the overall epidemiology of boxing injuries from representative samples, and no study has ever documented the incidence of injuries in female boxers. This study is a review of professional boxing data from the state of Nevada from September 2001 through March 2003. Medical and outcome data for all professional boxing matches occurring in Nevada between September 2001 and March 2003 (n = 524 matches) were analyzed on the basis of a pair-matched, case-control design. Cases were boxers who received an injury during the boxing matches. Boxers who were not injured served as control subjects. Both conditional and unconditional logistic regression models were used to assess risk factors for injury. The overall incidence rate of injury was 17.1 per 100 boxer-matches, or 3.4 per 100 boxer-rounds. Facial laceration accounted for 51% of all injuries, followed by hand injury (17%), eye injury (14%), and nose injury (5%). Male boxers were significantly more likely than female boxers to receive injuries (3.6 versus 1.2 per 100 boxer-rounds, P = 0.01). Male boxing matches also ended in knockouts and technical knockouts more often than did female matches (P < 0.001). The risk of injury for those who lost the matches was nearly twice the risk for the winners. Those who lost by knockout had double the risk of injury compared with those who lost by other means. Neither age nor weight was significantly associated with the risk of injury. The injury rate in professional boxing matches is high, particularly among male boxers. Superficial facial lacerations are the most common injury reported. Male boxers have a higher rate of knockout and technical knockouts than female boxers. Further research is necessary to determine the outcomes of injury, particularly the long-term neurologic outcome differences between sexes.

Estimated injury risk for specific injuries and body regions in frontal motor vehicle crashes.

PubMed

Weaver, Ashley A; Talton, Jennifer W; Barnard, Ryan T; Schoell, Samantha L; Swett, Katrina R; Stitzel, Joel D

2015-01-01

Injury risk curves estimate motor vehicle crash (MVC) occupant injury risk from vehicle, crash, and/or occupant factors. Many vehicles are equipped with event data recorders (EDRs) that collect data including the crash speed and restraint status during a MVC. This study's goal was to use regulation-required data elements for EDRs to compute occupant injury risk for (1) specific injuries and (2) specific body regions in frontal MVCs from weighted NASS-CDS data. Logistic regression analysis of NASS-CDS single-impact frontal MVCs involving front seat occupants with frontal airbag deployment was used to produce 23 risk curves for specific injuries and 17 risk curves for Abbreviated Injury Scale (AIS) 2+ to 5+ body region injuries. Risk curves were produced for the following body regions: head and thorax (AIS 2+, 3+, 4+, 5+), face (AIS 2+), abdomen, spine, upper extremity, and lower extremity (AIS 2+, 3+). Injury risk with 95% confidence intervals was estimated for 15-105 km/h longitudinal delta-Vs and belt status was adjusted for as a covariate. Overall, belted occupants had lower estimated risks compared to unbelted occupants and the risk of injury increased as longitudinal delta-V increased. Belt status was a significant predictor for 13 specific injuries and all body region injuries with the exception of AIS 2+ and 3+ spine injuries. Specific injuries and body region injuries that occurred more frequently in NASS-CDS also tended to carry higher risks when evaluated at a 56 km/h longitudinal delta-V. In the belted population, injury risks that ranked in the top 33% included 4 upper extremity fractures (ulna, radius, clavicle, carpus/metacarpus), 2 lower extremity fractures (fibula, metatarsal/tarsal), and a knee sprain (2.4-4.6% risk). Unbelted injury risks ranked in the top 33% included 4 lower extremity fractures (femur, fibula, metatarsal/tarsal, patella), 2 head injuries with less than one hour or unspecified prior unconsciousness, and a lung contusion (4

Inability to Perform the Repeated Chair Stand Task Predicts Fall-Related Injury in Older Primary Care Patients.

PubMed

Shea, Cristina A; Ward, Rachel E; Welch, Sarah A; Kiely, Dan K; Goldstein, Richard; Bean, Jonathan F

2018-06-01

The aim of the study was to examine whether the chair stand component of the Short Physical Performance Battery predicts fall-related injury among older adult primary care patients. A 2-yr longitudinal cohort study of 430 Boston-area primary care patients aged ≥65 yrs screened to be at risk for mobility decline was conducted. The three components of the Short Physical Performance Battery (balance time, gait speed, and chair stand time) were measured at baseline. Participants reported incidence of fall-related injuries quarterly for 2 yrs. Complementary log-log discrete time hazard models were constructed to examine the hazard of fall-related injury across Short Physical Performance Battery scores, adjusting for age, sex, race, Digit Symbol Substitution Test score, and fall history. Participants were 68% female and 83% white, with a mean (SD) age of 76.6 (7.0). A total of 137 (32%) reported a fall-related injury during the follow-up period. Overall, inability to perform the chair stand task was a significant predictor of fall-related injury (hazard ratio = 2.11, 95% confidence interval = 1.23-3.62, P = 0.01). Total Short Physical Performance Battery score, gait component score, and balance component score were not predictive of fall-related injury. Inability to perform the repeated chair stand task was associated with increased hazard of an injurious fall for 2 yrs among a cohort of older adult primary care patients.

Utilization of ACL Injury Biomechanical and Neuromuscular Risk Profile Analysis to Determine the Effectiveness of Neuromuscular Training.

PubMed

Hewett, Timothy E; Ford, Kevin R; Xu, Yingying Y; Khoury, Jane; Myer, Gregory D

2016-12-01

The widespread use of anterior cruciate ligament (ACL) injury prevention interventions has not been effective in reducing the injury incidence among female athletes who participate in high-risk sports. The purpose of this study was to determine if biomechanical and neuromuscular factors that contribute to the knee abduction moment (KAM), a predictor of future ACL injuries, could be used to characterize athletes by a distinct factor. Specifically, we hypothesized that a priori selected biomechanical and neuromuscular factors would characterize participants into distinct at-risk profiles. Controlled laboratory study. A total of 624 female athletes who participated in jumping, cutting, and pivoting sports underwent testing before their competitive season. During testing, athletes performed drop-jump tasks from which biomechanical measures were captured. Using data from these tasks, latent profile analysis (LPA) was conducted to identify distinct profiles based on preintervention biomechanical and neuromuscular measures. As a validation, we examined whether the profile membership was a significant predictor of the KAM. LPA using 6 preintervention biomechanical measures selected a priori resulted in 3 distinct profiles, including a low (profile 1), moderate (profile 2), and high (profile 3) risk for ACL injuries. Athletes with profiles 2 and 3 had a significantly higher KAM compared with those with profile 1 (P < .05). This is the first study to use LPA of biomechanical landing data to create ACL injury risk profiles. Three distinct risk groups were identified based on differences in the peak KAM. These findings demonstrate the existence of discernable groups of athletes that may benefit from injury prevention interventions. ClinicalTrials.gov NCT identifier: NCT01034527. © 2016 The Author(s).

The Effects of Injury Prevention Programs on the Biomechanics of Landing Tasks: A Systematic Review With Meta-analysis.

PubMed

Lopes, Thiago Jambo Alves; Simic, Milena; Myer, Gregory D; Ford, Kevin R; Hewett, Timothy E; Pappas, Evangelos

2018-05-01

Anterior cruciate ligament (ACL) tear is a common injury in sports and often occurs during landing from a jump. To synthesize the evidence on the effects of injury prevention programs (IPPs) on landing biomechanics as they relate to the ligament, quadriceps, trunk, and leg dominance theories associated with ACL injury risk. Meta-analysis. Six electronic databases were searched for studies that investigated the effect of IPPs on landing task biomechanics. Prospective studies that reported landing biomechanics at baseline and post-IPP were included. Results from trunk, hip, and knee kinematics and kinetics related to the ACL injury theories were extracted, and meta-analyses were performed when possible. The criteria were met by 28 studies with a total of 466 participants. Most studies evaluated young females, bilateral landing tasks, and recreational athletes, while most variables were related to the ligament and quadriceps dominance theories. An important predictor of ACL injury, peak knee abduction moment, decreased ( P = .01) after the IPPs while other variables related to the ligament dominance theory did not change. Regarding the quadriceps dominance theory, after the IPPs, angles of hip flexion at initial contact ( P = .009), peak hip flexion ( P = .002), and peak knee flexion ( P = .007) increased, while knee flexion at initial contact did not change ( P = .18). Moreover, peak knee flexion moment decreased ( P = .005) and peak vertical ground-reaction force did not change ( P = .10). The exercises used in IPPs might have the potential to improve landing task biomechanics related to the quadriceps dominance theory, especially increasing peak knee and hip flexion angles. Importantly, peak knee abduction moment decreased, which indicates that IPPs influence a desired movement strategy to help athletes overcome dangerous ligament dominance loads arising from lack of frontal plane control during dynamic tasks. The lack of findings for some biomechanical variables

Expanding pedestrian injury risk to the body region level: how to model passive safety systems in pedestrian injury risk functions.

PubMed

Niebuhr, Tobias; Junge, Mirko; Achmus, Stefanie

2015-01-01

Assessment of the effectiveness of advanced driver assistance systems (ADAS) plays a crucial role in accident research. A common way to evaluate the effectiveness of new systems is to determine the potentials for injury severity reduction. Because injury risk functions describe the probability of an injury of a given severity conditional on a technical accident severity (closing speed, delta V, barrier equivalent speed, etc.), they are predestined for such evaluations. Recent work has stated an approach on how to model the pedestrian injury risk in pedestrian-to-passenger car accidents as a family of functions. This approach gave explicit and easily interpretable formulae for the injury risk conditional on the closing speed of the car. These results are extended to injury risk functions for pedestrian body regions. Starting with a double-checked German In-depth Accident Study (GIDAS) pedestrian-to-car accident data set (N = 444) and a functional-anatomical definition of the body regions, investigations on the influence of specific body regions on the overall injury severity will be presented. As the measure of injury severity, the ISSx, a rescaled version of the well-known Injury Severity Score (ISS), was used. Though traditional ISS is computed by summation of the squares of the 3 most severe injured body regions, ISSx is computed by the summation of the exponentials of the Abbreviated Injury Scale (AIS) severities of the 3 most severely injured body regions. The exponentials used are scaled to fit the ISS range of values between 0 and 75. Three body regions (head/face/neck, thorax, hip/legs) clearly dominated abdominal and upper extremity injuries; that is, the latter 2 body regions had no influence at all on the overall injury risk over the range of technical accident severities. Thus, the ISSx is well described by use of the injury codes from the same body regions for any pedestrian injury severity. As a mathematical consequence, the ISSx becomes explicitly

Injury risk curves for the WorldSID 50th male dummy.

PubMed

Petitjean, Audrey; Trosseille, Xavier; Petit, Philippe; Irwin, Annette; Hassan, Joe; Praxl, Norbert

2009-11-01

The development of the WorldSID 50th percentile male dummy was initiated in 1997 by the International Organisation for Standardisation (ISO/SC12/TC22/WG5) with the objective of developing a more biofidelic side impact dummy and supporting the adoption of a harmonised dummy into regulations. More than 45 organizations from all around the world have contributed to this effort including governmental agencies, research institutes, car manufacturers and dummy manufacturers. The first production version of the WorldSID 50th male dummy was released in March 2004 and demonstrated an improved biofidelity over existing side impact dummies. Full scale vehicle tests covering a wide range of side impact test procedures were performed worldwide with the WorldSID dummy. However, the vehicle safety performance could not be assessed due to lack of injury risk curves for this dummy. The development of these curves was initiated in 2004 within the framework of ISO/SC12/TC22/WG6 (Injury criteria). In 2008, the ACEA- Dummy Task Force (TFD) decided to contribute to this work and offered resources for a project manager to coordinate of the effort of a group of volunteer biomechanical experts from international institutions (ISO, EEVC, VRTC/NHTSA, JARI, Transport Canada), car manufacturers (ACEA, Ford, General Motors, Honda, Toyota, Chrysler) and universities (Wayne State University, Ohio State University, John Hopkins University, Medical College of Wisconsin) to develop harmonized injury risk curves. An in-depth literature review was conducted. All the available PMHS datasets were identified, the test configurations and the quality of the results were checked. Criteria were developed for inclusion or exclusion of PMHS tests in the development of the injury risk curves. Data were processed to account for differences in mass and age of the subjects. Finally, injury risk curves were developed using the following statistical techniques, the certainty method, the Mertz/Weber method, the

A case-crossover study on transient risk factors of work-related eye injuries.

PubMed

Chen, S-Y; Fong, P-C; Lin, S-F; Chang, C-H; Chan, C-C

2009-08-01

To investigate modifiable risk and preventive factors of work-related eye injuries. A case-crossover study conducted to explore the associations between transient risk factors and work-related eye injuries. Patients seen at seven medical centres in Taiwan with work-related eye injuries over a 4-year period were enrolled in the study. Clinical information was collected from medical charts and detailed information on exposure to eight potentially modifiable factors during the 60 minutes prior to the occurrence of each injury, as well as during the same time interval on the last work day prior to the injury, were obtained using questionnaire surveys. Matched-pair interval analysis was adopted to assess the odds ratios (ORs) for work-related eye injuries given exposure to the eight modifiable factors. A total of 283 subjects were interviewed. Most of these injured workers were young, male, and self-employed or small enterprise workers. The most common injury type was photokeratitis (33.2%), mainly caused by welding (30.4%). The OR for a work-related eye injury was increased with the performance of an unfamiliar task (57.0), operation of a faulty tool or piece of equipment (48.5), distractions (24.0), being rushed (13.0), or fatigued (10.0), and a poor work environment (4.3). Wearing eye protection devices was found to have a significant protective effect on workers who might otherwise have been exposed to eye injuries (OR = 0.4; 95% CI 0.2 to 0.7). Potential modifiable risk and preventive factors for work-related eye injuries were identified using a case-crossover study. This information should be helpful in the development of preventive strategies.

Achilles tendon injury risk factors associated with running.

PubMed

Lorimer, Anna V; Hume, Patria A

2014-10-01

Research into the nature of overuse Achilles tendon injuries is extensive, yet uncertainty remains around how to identify athletes susceptible to Achilles tendon injury. To identify the strength of evidence for biomechanical risk factors associated with Achilles tendon injuries. SPORTDiscus, CINAHL, Web of Science and PubMed were searched for Achilles tendon injury risk factors and biomechanical measures which are altered in runners with Achilles tendon injuries, excluding ruptures. Fifteen articles were included in the analysis. Two variables, high vertical forces and high arch, showed strong evidence for reduced injury risk. High propulsive forces and running on stiffer surfaces may also be protective. Only one biomechanical variable, high braking force, showed clear evidence for increasing Achilles injury risk. Gait retraining to direct the centre of mass further forward to reduce high braking force could be useful in decreasing the risk of Achilles injury. The majority of biomechanical risk factors examined showed unclear results, which is likely due to the multifactorial nature of Achilles overuse injuries. Many risk factors are related to how the athlete's body interacts with the environment during gait, including ground reaction forces, muscle activity both prior to landing and immediately post ground contact, and joint motion throughout stance. Multiple risk factors have been associated with the development of Achilles tendon injuries in running athletes but most effects remain unclear. Advice for athletes recovering from Achilles tendon injuries could include avoiding soft surfaces and reducing the pace of recovery runs. Orthotic intervention could assist athletes with low arches but modification of pronation should be viewed with caution. Strength training and gait retraining could be beneficial for reducing injury risk.

Polo pony injuries: player-owner reported risk, perception, mitigation and risk factors.

PubMed

Inness, C M; Morgan, K L

2015-07-01

Polo, one of the world's oldest sports, is unique in merging human skill and balance with animal agility and performance in a contact sport. These modern-day 'centaurs' offer medical, dental and veterinary scientists an unrivalled, if quirky, opportunity to collaborate. Collection of epidemiological data on injuries to UK polo riders and ponies is the first step. To measure the reported risk and risk factors for injuries to UK polo ponies, their perception and mitigation by player-owners. A retrospective cohort design and telephone interviews were used. Data on equine injuries, preseason training and risk perception were collected from a random sample of player-owners using a structured questionnaire. Injuries were defined as requiring veterinary treatment. Frequencies were represented as percentages and 95% confidence intervals (CIs). Risk factors for injuries were identified by univariable and multivariable analyses. The cumulative incidence of player-owner-reported injury was 10.6% (95% CI 8.4-12.7). Tendon injuries were most common (4.3%; 95% CI 2.9-5.7), followed by wounds and splints. The only risk factor was stabling all season (odds ratio 4.79; 95% CI 1.46-15.73). Tendon injuries were perceived as the major risk and hard ground the most important risk factor. Risk mitigation practices were bandaging before exercise (45.7%; 95% CI 34.8-56.5), checking tendons (84.0%; 95% CI 76.0-91.9), cold hosing (40.7%; 95% CI 30.0-51.4), bandaging (38.3%; 95% CI 27.7-48.9) and using clays and coolants after exercise (24.7%; 15.3-34.1). Cuts and wounds were considered most frequent by only 2.5% (95% CI 0.0-3.6) of players but were the second most common injury, accounting for 21.6% of veterinary treatments. Splints accounted for 12.5% of injuries. The risk of injury to polo ponies is similar to that in the general horse population; musculoskeletal injuries, particularly tendon injuries, are most common, followed by wounds and splints. The association between stabling and

Training loads and injury risk in Australian football—differing acute: chronic workload ratios influence match injury risk

PubMed Central

Carey, David L; Blanch, Peter; Ong, Kok-Leong; Crossley, Kay M; Crow, Justin; Morris, Meg E

2017-01-01

Aims (1) To investigate whether a daily acute:chronic workload ratio informs injury risk in Australian football players; (2) to identify which combination of workload variable, acute and chronic time window best explains injury likelihood. Methods Workload and injury data were collected from 53 athletes over 2 seasons in a professional Australian football club. Acute:chronic workload ratios were calculated daily for each athlete, and modelled against non-contact injury likelihood using a quadratic relationship. 6 workload variables, 8 acute time windows (2–9 days) and 7 chronic time windows (14–35 days) were considered (336 combinations). Each parameter combination was compared for injury likelihood fit (using R2). Results The ratio of moderate speed running workload (18–24 km/h) in the previous 3 days (acute time window) compared with the previous 21 days (chronic time window) best explained the injury likelihood in matches (R2=0.79) and in the immediate 2 or 5 days following matches (R2=0.76–0.82). The 3:21 acute:chronic workload ratio discriminated between high-risk and low-risk athletes (relative risk=1.98–2.43). Using the previous 6 days to calculate the acute workload time window yielded similar results. The choice of acute time window significantly influenced model performance and appeared to reflect the competition and training schedule. Conclusions Daily workload ratios can inform injury risk in Australian football. Clinicians and conditioning coaches should consider the sport-specific schedule of competition and training when choosing acute and chronic time windows. For Australian football, the ratio of moderate speed running in a 3-day or 6-day acute time window and a 21-day chronic time window best explained injury risk. PMID:27789430

Transient risk factors for acute traumatic hand injuries: a case‐crossover study in Hong Kong

PubMed Central

Chow, C Y; Lee, H; Lau, J; Yu, I T S

2007-01-01

Objectives To identify the remediable transient risk factors of occupational hand injuries in Hong Kong in order to guide the development of prevention strategies. Methods The case‐crossover study design was adopted. Study subjects were workers with acute hand injuries presenting to the government Occupational Medicine Unit for compensation claims within 90 days from the date of injury. Detailed information on exposures to specific transient factors during the 60 minutes prior to the occurrence of the injury, during the same time interval on the day prior to the injury, as well as the usual exposure during the past work‐month was obtained through telephone interviews. Both matched‐pair interval approach and usual frequency approach were adopted to assess the associations between transient exposures in the workplace and the short‐term risk of sustaining a hand injury. Results A total of 196 injured workers were interviewed. The results of the matched‐pair interval analysis matched well with the results obtained using the usual frequency analysis. Seven significant transient risk factors were identified: using malfunctioning equipment/materials, using a different work method, performing an unusual work task, working overtime, feeling ill, being distracted and rushing, with odds ratios ranging from 10.5 to 26.0 in the matched‐pair interval analysis and relative risks ranging between 8.0 and 28.3 with the usual frequency analysis. Wearing gloves was found to have an insignificant protective effect on the occurrence of hand injury in both analyses. Conclusions Using the case‐crossover study design for acute occupational hand injuries, seven transient risk factors that were mostly modifiable were identified. It is suggested that workers and their employers should increase their awareness of these risk factors, and efforts should be made to avoid exposures to these factors by means of engineering and administrative controls supplemented by safety

Field-expedient screening and injury risk algorithm categories as predictors of noncontact lower extremity injury.

PubMed

Lehr, M E; Plisky, P J; Butler, R J; Fink, M L; Kiesel, K B; Underwood, F B

2013-08-01

In athletics, efficient screening tools are sought to curb the rising number of noncontact injuries and associated health care costs. The authors hypothesized that an injury prediction algorithm that incorporates movement screening performance, demographic information, and injury history can accurately categorize risk of noncontact lower extremity (LE) injury. One hundred eighty-three collegiate athletes were screened during the preseason. The test scores and demographic information were entered into an injury prediction algorithm that weighted the evidence-based risk factors. Athletes were then prospectively followed for noncontact LE injury. Subsequent analysis collapsed the groupings into two risk categories: Low (normal and slight) and High (moderate and substantial). Using these groups and noncontact LE injuries, relative risk (RR), sensitivity, specificity, and likelihood ratios were calculated. Forty-two subjects sustained a noncontact LE injury over the course of the study. Athletes identified as High Risk (n = 63) were at a greater risk of noncontact LE injury (27/63) during the season [RR: 3.4 95% confidence interval 2.0 to 6.0]. These results suggest that an injury prediction algorithm composed of performance on efficient, low-cost, field-ready tests can help identify individuals at elevated risk of noncontact LE injury. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Injury rates and injury risk factors among Federal Bureau of Investigation new agent trainees.

PubMed

Knapik, Joseph J; Grier, Tyson; Spiess, Anita; Swedler, David I; Hauret, Keith G; Graham, Bria; Yoder, James; Jones, Bruce H

2011-12-13

A one-year prospective examination of injury rates and injury risk factors was conducted in Federal Bureau of Investigation (FBI) new agent training. Injury incidents were obtained from medical records and injury compensation forms. Potential injury risk factors were acquired from a lifestyle questionnaire and existing data at the FBI Academy. A total of 426 men and 105 women participated in the project. Thirty-five percent of men and 42% of women experienced one or more injuries during training. The injury incidence rate was 2.5 and 3.2 injuries/1,000 person-days for men and women, respectively (risk ratio (women/men) = 1.3, 95% confidence interval = 0.9-1.7). The activities most commonly associated with injuries (% of total) were defensive tactics training (58%), physical fitness training (20%), physical fitness testing (5%), and firearms training (3%). Among the men, higher injury risk was associated with older age, slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the physical fitness test (PFT), lower self-rated physical activity, lower frequency of aerobic exercise, a prior upper or lower limb injury, and prior foot or knee pain that limited activity. Among the women higher injury risk was associated with slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the PFT, and prior back pain that limited activity. The results of this investigation supported those of a previous retrospective investigation emphasizing that lower fitness and self-reported pain limiting activity were associated with higher injury risk among FBI new agents.

Injury surveillance in construction: eye injuries.

PubMed

Welch, L S; Hunting, K L; Mawudeku, A

2001-07-01

Occupational eye injuries are both common and preventable. About 20% of occupational eye injuries occur in construction. To investigate the nature of eye injuries among construction workers, we analyzed a large data set of construction worker injuries. In addition, we interviewed 62 workers with eye injuries to further explore circumstances of eye injury and workers' attitudes and behavior toward the use of eye protection. Eleven percent (363 cases) of the 3,390 construction workers in our data set were treated for eye injuries. Welders, plumbers, insulators, painters/glaziers, supervisors, and electricians had a higher proportion of all injuries due to eye injuries than other trades. Nearly half of the diagnoses were abrasions (46%) followed by foreign objects or splash in the eye (29%), conjunctivitis (10%), and burns (5%). In the interviews with 62 workers, we found that employers very frequently required eye protection for all tasks or for high-risk tasks, and workers report wearing eye protection regularly. However, most did not wear eye protection with top and side shields; if we believe the injuries occurred because a particle or liquid passed between the glasses and the workers' faces, increased use of goggles or full shields would have prevented two-thirds of this group of injuries.

Task difficulty, risk, effort and comfort in a simulated driving task--Implications for Risk Allostasis Theory.

PubMed

Lewis-Evans, Ben; Rothengatter, Talib

2009-09-01

Risk Allostasis Theory states that drivers seek to maintain a feeling of risk within a preferred range [Fuller, R., 2008. What drives the driver? Surface tensions and hidden consensus. In: Keynote at the 4th International Conference on Traffic and Transport Psychology, Washington, DC, August 31-September 4, 2008]. Risk Allostasis Theory is the latest version of Task-Difficulty Homeostasis theory, and is in part based on the findings of experiments where participants were asked to rate the task difficulty, feeling of risk and chance of collision of scenes shown in digitally altered video clips [Fuller, R., McHugh, C., Pender, S., 2008b. Task difficulty and risk in the determination of driver behaviour. Revue européenne de psychologie appliqée 58, 13-21]. The focus of the current research was to expand upon the previous video based experiments using a driving simulator. This allowed participants to be in control of the vehicle rather than acting as passive observers, as well as providing additional speed cues. The results support previous findings that ratings of task difficulty and feeling of risk are related, and that they are also highly related to ratings of effort and moderately related to ratings of comfort and habit. However, the linearly increasing trend for task difficulty and feeling of risk described by the previous research was not observed: instead the findings of this experiment support a threshold effect where ratings of risk (feeling of and chance of loss of control/collision), difficulty, effort, and comfort go through a period of stability and only start to increase once a certain threshold has been crossed. It is within the period of stability where subjective experience of risk and difficulty is low, or absent, that drivers generally prefer to operate.

Risk factors for serious injury in Finnish agriculture.

PubMed

Rautiainen, Risto H; Ledolter, Johannes; Donham, Kelley J; Ohsfeldt, Robert L; Zwerling, Craig

2009-05-01

Previous studies indicate 20% of injuries represent 80% of injury costs in agriculture. To help prevent the most costly injuries, we aimed to identify characteristics and risk factors associated with serious injuries. We analyzed insurance records of 93,550 self-employed Finnish farmers. We ranked injury causes by claim cost and used multiple logistic regressions to identify risk factors for (any) injury and serious injury (injuries exceeding claim costs of 2000 euros). A total of 5,507 compensated injuries occurred in 2002 (rate 5.9/100 person-years), and 1,167 or 21% of them (rate 1.25/100 person-years) were serious. The causes/sources resulting in highest average claim costs were motor vehicles; stairs, scaffoldings, and ladders; trailers and wagons; floors, walkways, and steps; other structures and obstacles; augers, mills, and grain handling equipment; horses; combines and harvesting equipment; tractor steps; and uneven and slippery terrain. Older age, male gender, higher income level, greater field size, residing on the farm, Finnish language (vs. Swedish), occupational health service (OHS) membership, and animal production were risk factors for injury. The risk factors for serious injury were similar; however, the effects of age, income level, and the raising of horses were more prominent. Language, residence, ownership status, and OHS membership were not risk factors for serious injury. Cost-effective prevention efforts should address the following risk factors: older age, male gender, larger income and operation size, livestock production (particularly dairy, swine, and horses), motor vehicle incidents, falls from elevation, and slips, trips and falls. Copyright 2009 Wiley-Liss, Inc.

Risk factors for injury associated with low, moderate, and high mileage road marching in a U.S. Army infantry brigade.

PubMed

Schuh-Renner, Anna; Grier, Tyson L; Canham-Chervak, Michelle; Hauschild, Veronique D; Roy, Tanja C; Fletcher, Jeremy; Jones, Bruce H

2017-11-01

Road marching is an important physical training activity that prepares soldiers for a common occupational task. Continued exploration of risk factors for road marching-related injuries is needed. This analysis has assessed the association between modifiable characteristics of physical training and injury risk. Injuries in the previous 6 months were captured by survey from 831 U.S. Army infantry soldiers. Road marching-related injuries were reported as those attributed to road marching on foot for specified distances while carrying equipment. Frequencies, means, and relative risk ratios (RR) for road marching-related injury with 95% confidence intervals (CI) were calculated. Adjusted odds ratios (OR) and 95% CI were calculated for leading risk factors using multivariable logistic regression. Retrospective cohort study. Half (50%) of reported injuries were attributed to road marching or running. When miles of exposure were considered, injury risk during road marching was higher than during running (RR road marching/running =1.8, 95% CI: 1.38-2.37). A higher product of road marching distance and weight worn (pound-miles per month) resulted in greater injury risk (RR ≥1473 pound-miles/<1472 =1.92, 95% CI: 1.17-2.41). Road marching-related injuries were associated with carrying a load >25% of one's body weight (OR >25%/1-20% =2.09, 95% CI: 1.08-4.05), having high occupational lifting demands (OR 50-100+lbs/25-50lbs =3.43, 95% CI: 1.50-7.85), road marching ≥5 times per month (OR ≥5 times/4 times =2.11, 95% CI: 1.14-3.91), and running <4 miles per week during personal physical training (OR 0/≥10 miles/week =3.56, 95% CI: 1.49-8.54, OR 1-4/≥10 miles/week =4.14, 95% CI: 1.85-9.25). Ideally, attempts should be made to decrease the percentage of body weight carried to reduce road marching-related injuries. Since this is not always operationally feasible, reducing the cumulative overloading from both physical training and occupational tasks may help prevent injury

[Injuries in France: trends and risk factors].

PubMed

Richard, J-B; Thélot, B; Beck, F

2013-06-01

Whatever the type of injury considered, prevention requires an improvement in health services' awareness of risk factors. The Health Barometer is a general population survey conducted in France since 1992 to contribute to surveillance in this field. The survey's statistical power and the numerous health topics included in the questionnaire provide accurate information for healthcare professionals and decision-makers. The Health Barometer 2010 was a nationwide telephone survey of 9110 persons representative of the 15-85-year-old population. One part of the questionnaire detailed injuries which had occurred during the past year. The numerous variables recorded enabled application of logistic regression models to explore risk factors related to different types of injury by age group. The findings were compared with the Health Barometer 2005 data to search for temporal trends of injury prevalence. The data analysis showed that 10.3% of the 15-85-year-olds reported an injury during the past year. This rate was higher than recorded in 2005; the increase was mainly due to domestic accidents and injuries occurring during recreational activities. Both type of injury and risk factors exhibited age-related variability. Domestic accidents and injuries occurring during recreational activities predominated in the older population and were associated with physical or mental health problems (chronic disease, diability, sleep disorders). For younger people, injuries were related to cannabis use, drunkedness, and insufficient sleep. Risk factors were also depended on type of injury: occupational accident-related injuries were linked with social disadvantage (manual worker population) whereas sports injuries were more common in the socially advantaged population. This survey confirms established knowledge and highlights, at different stages of life, new risk factors that contribute to injuries in France. These findings should be helpful for the development of adapted injury

Injury rates and injury risk factors among federal bureau of investigation new agent trainees

PubMed Central

2011-01-01

Background A one-year prospective examination of injury rates and injury risk factors was conducted in Federal Bureau of Investigation (FBI) new agent training. Methods Injury incidents were obtained from medical records and injury compensation forms. Potential injury risk factors were acquired from a lifestyle questionnaire and existing data at the FBI Academy. Results A total of 426 men and 105 women participated in the project. Thirty-five percent of men and 42% of women experienced one or more injuries during training. The injury incidence rate was 2.5 and 3.2 injuries/1,000 person-days for men and women, respectively (risk ratio (women/men) = 1.3, 95% confidence interval = 0.9-1.7). The activities most commonly associated with injuries (% of total) were defensive tactics training (58%), physical fitness training (20%), physical fitness testing (5%), and firearms training (3%). Among the men, higher injury risk was associated with older age, slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the physical fitness test (PFT), lower self-rated physical activity, lower frequency of aerobic exercise, a prior upper or lower limb injury, and prior foot or knee pain that limited activity. Among the women higher injury risk was associated with slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the PFT, and prior back pain that limited activity. Conclusion The results of this investigation supported those of a previous retrospective investigation emphasizing that lower fitness and self-reported pain limiting activity were associated with higher injury risk among FBI new agents. PMID:22166096

Nocturnal awakenings and pediatric injury risk.

PubMed

Schwebel, David C; Brezausek, Carl M

2008-04-01

This study was designed to examine relations between nocturnal awakenings and unintentional injury risk among toddlers. A nationally representative sample of 799 children was followed longitudinally from birth through 36 months. Patterns of nocturnal awakening were assessed by parent-report at ages 6, 15, 24 and 36 months, and injury events were reported at quarterly intervals over the same time period. A range of external covariates, including positive and negative affect and externalizing behavior; maternal stress, maternal depression, and parenting style; and family socioeconomic status were measured. A persistent pattern of very mild nocturnal awakening was related to increased risk of injury during the toddler years, and that relation held after controlling for a range of potential covariates. A pattern of persistent nocturnal awakening appears to be related to unintentional injury risk in toddlers.

Retrospective Injury Epidemiology and Risk Factors for Injury in CrossFit.

PubMed

Montalvo, Alicia M; Shaefer, Hilary; Rodriguez, Belinda; Li, Tan; Epnere, Katrina; Myer, Gregory D

2017-03-01

The objective of the study is to examine injury epidemiology and risk factors for injury in CrossFit athletes. A survey was administered to athletes at four owner-operated facilities in South Florida. Respondents reported number, location of injury, and training exposure from the preceding six months and answered questions regarding potential risk factors for injury. Fifty out of 191 athletes sustained 62 injuries during CrossFit participation in the preceding six months. The most frequently injured locations were the shoulder, knee, and lower back. Injury incidence was 2.3/1000 athlete training hours. Competitors were more likely to be injured (40% v 19%, p = 0.002) and had greater weekly athlete training hours (7.3 ± 7.0 v 4.9 ± 2.9, p < 0.001) than non-competitors. Athletes who reported injury also reported significantly higher values for the following risk factors: years of participation (2.7 ± 1.8 v 1.8 ± 1.5, p = 0.001), weekly athlete training hours (7.3 ± 3.8 v 4.9 ± 2.1, p = 0.020), weekly athlete-exposures (6.4 ± 3.8 v 4.7 ± 2.1, p = 0.003), height (1.72 ± 0.09 m v 1.68 ± 0.01 m, p = 0.011), and body mass (78.24 ± 16.86 kg v 72.91 ± 14.77 kg, p = 0.037). Injury rates during CrossFit and location of injuries were similar to those previously reported. Injury incidence was similar to related sports, including gymnastics and powerlifting. While being a competitor was related to injury, increased exposure and length of participation in CrossFit likely underlied this association. Specifically, increased exposure to training in the form of greater weekly athlete training hours and weekly participations may contribute to injury. Increased height and body mass were also related to injury which is likely reflective of increased load utilized during training. Further research is warranted to determine if biomechanical factors associated with greater height and ability to lift greater loads are modifiable factors that can be adapted to reduce the increase

Training loads and injury risk in Australian football-differing acute: chronic workload ratios influence match injury risk.

PubMed

Carey, David L; Blanch, Peter; Ong, Kok-Leong; Crossley, Kay M; Crow, Justin; Morris, Meg E

2017-08-01

(1) To investigate whether a daily acute:chronic workload ratio informs injury risk in Australian football players; (2) to identify which combination of workload variable, acute and chronic time window best explains injury likelihood. Workload and injury data were collected from 53 athletes over 2 seasons in a professional Australian football club. Acute:chronic workload ratios were calculated daily for each athlete, and modelled against non-contact injury likelihood using a quadratic relationship. 6 workload variables, 8 acute time windows (2-9 days) and 7 chronic time windows (14-35 days) were considered (336 combinations). Each parameter combination was compared for injury likelihood fit (using R 2 ). The ratio of moderate speed running workload (18-24 km/h) in the previous 3 days (acute time window) compared with the previous 21 days (chronic time window) best explained the injury likelihood in matches (R 2 =0.79) and in the immediate 2 or 5 days following matches (R 2 =0.76-0.82). The 3:21 acute:chronic workload ratio discriminated between high-risk and low-risk athletes (relative risk=1.98-2.43). Using the previous 6 days to calculate the acute workload time window yielded similar results. The choice of acute time window significantly influenced model performance and appeared to reflect the competition and training schedule. Daily workload ratios can inform injury risk in Australian football. Clinicians and conditioning coaches should consider the sport-specific schedule of competition and training when choosing acute and chronic time windows. For Australian football, the ratio of moderate speed running in a 3-day or 6-day acute time window and a 21-day chronic time window best explained injury risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Effect of Neurocognition and Concussion on Musculoskeletal Injury Risk

PubMed Central

Herman, Daniel C.; Zaremski, Jason L.; Vincent, Heather K.; Vincent, Kevin R.

2015-01-01

Research regarding musculoskeletal injury risk has focused primarily on anatomical, neuromuscular, hormonal, and environmental risk factors; however, subsequent injury risk screening and intervention programs have been largely limited to neuromuscular factors and have faced challenges in both implementation and efficacy. Recent studies indicate that poor neurocognitive performance, either at baseline or in the aftermath of a concussion, is associated with elevated risk of musculoskeletal injury. Despite the relatively limited current understanding regarding the nature of the relationship between different aspects of neurocognitive performance and musculoskeletal injury risk, this is a promising area of research that may yield significant advances in musculoskeletal injury risk stratification, rehabilitation, and prevention. PMID:25968852

Risk Factors for Injuries in Professional Football Players.

PubMed

Haxhiu, Bekim; Murtezani, Ardiana; Zahiti, Bedri; Shalaj, Ismet; Sllamniku, Sabit

2015-01-01

The aim of this study was to identify risk factors related to the occurrence of injuries in football players. The study included 216 football players from 12 teams in the elite football league. Football-related injury data were collected prospectively during the 2012/2013 competitive season. At baseline the following information was collected for the players: anthropometric measurements (weight, height, BMI, subcutaneous skinfolds), playing experience, injury history, physical fitness performance test (agility run), peak oxygen uptake. The incidence, type and severity of injuries and training and game exposure times were prospectively documented for each player. Most of the players (n = 155, 71.7%) sustained the injures during the study period. The overall injury incidence during the regular season was 6.3 injuries per 1000 athlete-exposures (95% confidence interval, 4.31-9.67). Multivariate logistic regression analysis showed that playing experience (odds ratio [OR] = 0.44; 95% CI = 0.32-0.61, p < 0.01), age (OR = 2.05; 95% CI = 1.49-2.81, p < 0.01) and a previous injury (OR = 4.4; 95% CI = 2.14-9.07, p < 0.01) were significantly correlated to increased risk of injuries. Body mass index was not associated with risk of injury. Strains (34.19%) and sprains (25.81%) were the major injury types. Twenty-seven percent of injured players were absent from football for more than 1 month, with knee injuries (25.42%) being the most severe type. The risk factors that increase injury rates in football players were previous injury, higher age and years of playing. Future research should include adequate rehabilitation program to reduce the risk of injuries.

Occupational injury risk by sex in a manufacturing cohort.

PubMed

Tessier-Sherman, Baylah; Cantley, Linda F; Galusha, Deron; Slade, Martin D; Taiwo, Oyebode A; Cullen, Mark R

2014-09-01

This study expands previous research comparing injury risk for women and men in a cohort of 24,000 US aluminium manufacturing workers in 15 facilities from 2001 to 2010. We compared injury rates (all injury, first aid, medical treatment, restricted work and lost work time) by sex and by job and sex. Using a mixed effect modelling approach, we calculated ORs and 95% CIs adjusting for age, job tenure, ethnicity and year as fixed effects and person, job and plant as random effects. Additionally, we modelled the data stratified by plant type to examine potential differences in injury risk between smelter (generally recognised as more hazardous) and fabrication production environments. Risk of injury was higher for women in four out of the five injury outcomes: all injuries combined (OR: 1.58, CI 1.48 to 1.67), injuries requiring first aid (OR: 1.61, CI 1.54 to 1.70), injuries requiring medical treatment (OR: 1.18, CI 1.03 to 1.36) and injuries requiring restricted work (OR: 1.65, CI 1.46 to 1.87). No difference in the risk of lost time injury by sex was found in this cohort. Analyses stratified by plant type showed similarly elevated injury risk for women, although the risk estimates were higher in smelters than fabrication plants. To our knowledge, this is the largest single-firm study examining injury risk by sex with sufficient data to appropriately adjust for job. We show a consistently higher injury risk for women compared with men in the smelting and fabrication environments. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Injury risk-workload associations in NCAA American college football.

PubMed

Sampson, J A; Murray, A; Williams, S; Halseth, T; Hanisch, J; Golden, G; Fullagar, H H K

2018-05-22

To determine injury risk-workload associations in collegiate American Football. Retrospective analysis. Workload and injury data was recorded from 52 players during a full NCAA football season. Acute, chronic, and a range of acute:chronic workload ratios (ACWR: 7:14, 7:21 and 7:28 day) calculated using rolling and exponentially weighted moving averages (EWMA) were plotted against non-contact injuries (regardless of time lost or not) sustained within 3- and 7-days. Injury risks were also determined relative to position and experience. 105 non-contact injuries (18 game- and 87 training-related) were observed with almost 40% sustained during the pre-season. 7-21 day EWMA ACWR's with a 3-day injury lag were most closely associated with injury (R 2 =0.54). Relative injury risks were >3× greater with high compared to moderate and low ratios and magnified when combined with low 21-day chronic workloads (injury probability=92.1%). Injury risks were similar across positions. 'Juniors' presented likely and possibly increased overall injury risk compared to 'Freshman' (RR: 1.94, CI 1.07-3.52) and 'Seniors' (RR: 1.7, CI 0.92-3.14), yet no specific ACWR - experience or - position interactions were identified. High injury rates during college football pre-season training may be associated with high acute loads. In-season injury risks were greatest with high ACWR and evident even when including (more common and less serious) non-time loss injuries. Substantially increased injury risks when low 21-day chronic workloads and concurrently high EWMA ACWR highlights the importance of load management for individuals with chronic game- (non-involved on game day) and or training (following injury) absences. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Risk of cervical injuries in mixed martial arts.

PubMed

Kochhar, T; Back, D L; Mann, B; Skinner, J

2005-07-01

Mixed martial arts have rapidly succeeded boxing as the world's most popular full contact sport, and the incidence of injury is recognised to be high. To assess qualitatively and quantitatively the potential risk for participants to sustain cervical spine and associated soft tissue injuries. Four commonly performed manoeuvres with possible risks to the cervical spine were analysed with respect to their kinematics, and biomechanical models were constructed. Motion analysis of two manoeuvres revealed strong correlations with rear end motor vehicle impact injuries, and kinematics of the remaining two suggested a strong risk of injury. Mathematical models of the biomechanics showed that the forces involved are of the same order as those involved in whiplash injuries and of the same magnitude as compression injuries of the cervical spine. This study shows that there is a significant risk of whiplash injuries in this sport, and there are no safety regulations to address these concerns.

Risk of cervical injuries in mixed martial arts

PubMed Central

Kochhar, T; Back, D; Mann, B; Skinner, J

2005-01-01

Background: Mixed martial arts have rapidly succeeded boxing as the world's most popular full contact sport, and the incidence of injury is recognised to be high. Objective: To assess qualitatively and quantitatively the potential risk for participants to sustain cervical spine and associated soft tissue injuries. Methods: Four commonly performed manoeuvres with possible risks to the cervical spine were analysed with respect to their kinematics, and biomechanical models were constructed. Results: Motion analysis of two manoeuvres revealed strong correlations with rear end motor vehicle impact injuries, and kinematics of the remaining two suggested a strong risk of injury. Mathematical models of the biomechanics showed that the forces involved are of the same order as those involved in whiplash injuries and of the same magnitude as compression injuries of the cervical spine. Conclusions: This study shows that there is a significant risk of whiplash injuries in this sport, and there are no safety regulations to address these concerns. PMID:15976168

Retrospective Injury Epidemiology and Risk Factors for Injury in CrossFit

PubMed Central

Montalvo, Alicia M.; Shaefer, Hilary; Rodriguez, Belinda; Li, Tan; Epnere, Katrina; Myer, Gregory D.

2017-01-01

The objective of the study is to examine injury epidemiology and risk factors for injury in CrossFit athletes. A survey was administered to athletes at four owner-operated facilities in South Florida. Respondents reported number, location of injury, and training exposure from the preceding six months and answered questions regarding potential risk factors for injury. Fifty out of 191 athletes sustained 62 injuries during CrossFit participation in the preceding six months. The most frequently injured locations were the shoulder, knee, and lower back. Injury incidence was 2.3/1000 athlete training hours. Competitors were more likely to be injured (40% v 19%, p = 0.002) and had greater weekly athlete training hours (7.3 ± 7.0 v 4.9 ± 2.9, p < 0.001) than non-competitors. Athletes who reported injury also reported significantly higher values for the following risk factors: years of participation (2.7 ± 1.8 v 1.8 ± 1.5, p = 0.001), weekly athlete training hours (7.3 ± 3.8 v 4.9 ± 2.1, p = 0.020), weekly athlete-exposures (6.4 ± 3.8 v 4.7 ± 2.1, p = 0.003), height (1.72 ± 0.09 m v 1.68 ± 0.01 m, p = 0.011), and body mass (78.24 ± 16.86 kg v 72.91 ± 14.77 kg, p = 0.037). Injury rates during CrossFit and location of injuries were similar to those previously reported. Injury incidence was similar to related sports, including gymnastics and powerlifting. While being a competitor was related to injury, increased exposure and length of participation in CrossFit likely underlied this association. Specifically, increased exposure to training in the form of greater weekly athlete training hours and weekly participations may contribute to injury. Increased height and body mass were also related to injury which is likely reflective of increased load utilized during training. Further research is warranted to determine if biomechanical factors associated with greater height and ability to lift greater loads are modifiable factors that can be adapted to reduce the increase

Statistical considerations in the development of injury risk functions.

PubMed

McMurry, Timothy L; Poplin, Gerald S

2015-01-01

We address 4 frequently misunderstood and important statistical ideas in the construction of injury risk functions. These include the similarities of survival analysis and logistic regression, the correct scale on which to construct pointwise confidence intervals for injury risk, the ability to discern which form of injury risk function is optimal, and the handling of repeated tests on the same subject. The statistical models are explored through simulation and examination of the underlying mathematics. We provide recommendations for the statistically valid construction and correct interpretation of single-predictor injury risk functions. This article aims to provide useful and understandable statistical guidance to improve the practice in constructing injury risk functions.

Modular control of varied locomotor tasks in children with incomplete spinal cord injuries

PubMed Central

Tester, Nicole J.; Kautz, Steven A.; Howland, Dena R.; Clark, David J.; Garvan, Cyndi; Behrman, Andrea L.

2013-01-01

A module is a functional unit of the nervous system that specifies functionally relevant patterns of muscle activation. In adults, four to five modules account for muscle activation during walking. Neurological injury alters modular control and is associated with walking impairments. The effect of neurological injury on modular control in children is unknown and may differ from adults due to their immature and developing nervous systems. We examined modular control of locomotor tasks in children with incomplete spinal cord injuries (ISCIs) and control children. Five controls (8.6 ± 2.7 yr of age) and five children with ISCIs (8.6 ± 3.7 yr of age performed treadmill walking, overground walking, pedaling, supine lower extremity flexion/extension, stair climbing, and crawling. Electromyograms (EMGs) were recorded in bilateral leg muscles. Nonnegative matrix factorization was applied, and the minimum number of modules required to achieve 90% of the “variance accounted for” (VAF) was calculated. On average, 3.5 modules explained muscle activation in the controls, whereas 2.4 modules were required in the children with ISCIs. To determine if control is similar across tasks, the module weightings identified from treadmill walking were used to reconstruct the EMGs from each of the other tasks. This resulted in VAF values exceeding 86% for each child and each locomotor task. Our results suggest that 1) modularity is constrained in children with ISCIs and 2) for each child, similar neural control mechanisms are used across locomotor tasks. These findings suggest that interventions that activate the neuromuscular system to enhance walking also may influence the control of other locomotor tasks. PMID:23761702

Frequency of musculoskeletal injuries and risk factors associated with injuries incurred in Quarter Horses during races.

PubMed

Cohen, N D; Dresser, B T; Peloso, J G; Mundy, G D; Woods, A M

1999-09-01

To determine the frequency and anatomic location of musculoskeletal injuries incurred by Quarter Horses during races and to compare data from injured horses and matched control horses. Matched case-control study. 97 Quarter Horses that sustained a musculoskeletal injury during races and 291 horses from the same races that were not injured. Data examined included racing history, race-entrant characteristics, racing events determined by analysis of videotapes of races, and, when performed, results of prerace physical inspections. Data for injured horses were compared with data for control horses, using conditional logistic regression. Incidence of a catastrophic injury among Quarter Horses during races was approximately 0.8/1,000 race starts, whereas incidence of musculoskeletal injury during racing was approximately 2.2/1,000 race starts. Odds of musculoskeletal injury were approximately 8 times greater among horses assessed to be at increased risk of injury on the basis of results of prerace physical inspection than for horses not considered to be at increased risk of injury. Evidence was lacking that 2-year-old horses were at increased risk of injury or that sex influenced the risk of injury among Quarter Horses during races. Incidence of racing injury among Quarter Horses appears to be lower than that observed among Thoroughbreds. Regulatory veterinarians can identify horses at increased risk of injury on the basis of prerace physical inspection, indicating that these inspections could be used to reduce the risk of injury during races.

Biomechanical Factors and Injury Risk in High-Severity Rollovers

PubMed Central

Moore, Tara L. A.; Vijayakumar, Vinod; Steffey, Duane L.; Ramachandran, Karuna; Corrigan, Catherine Ford

2005-01-01

The number of rolls, as well as other factors, has been associated with increased injury risk in rollovers. Data from NASS-CDS from 1995–2003 were used to evaluate the biomechanical implications of vehicle kinematics during multiple rolls and to evaluate the risk of injuries to different body regions during rollovers. The data showed that the risk of injury increased with increasing number of rolls. The rate of increase in risk varied by the region of the body affected and injury severity. The increased risk was particularly great when a vehicle rolled more than two complete rolls. PMID:16179145

Functional Movement Screen: Pain versus composite score and injury risk.

PubMed

Alemany, Joseph A; Bushman, Timothy T; Grier, Tyson; Anderson, Morgan K; Canham-Chervak, Michelle; North, William J; Jones, Bruce H

2017-11-01

The Functional Movement Screen (FMS™) has been used as a screening tool to determine musculoskeletal injury risk using composite scores based on movement quality and/or pain. However, no direct comparisons between movement quality and pain have been quantified. Retrospective injury data analysis. Male Soldiers (n=2154, 25.0±1.3years; 26.2±.7kg/m 2 ) completed the FMS (scored from 0 points (pain) to 3 points (no pain and perfect movement quality)) with injury data over the following six months. The FMS is seven movements. Injury data were collected six months after FMS completion. Sensitivity, specificity, receiver operator characteristics and positive and negative predictive values were calculated for pain occurrence and low (≤14 points) composite score. Risk, risk ratios (RR) and 95% confidence intervals were calculated for injury risk. Pain was associated with slightly higher injury risk (RR=1.62) than a composite score of ≤14 points (RR=1.58). When comparing injury risk between those who scored a 1, 2 or 3 on each individual movement, no differences were found (except deep squat). However, Soldiers who experienced pain on any movement had a greater injury risk than those who scored 3 points for that movement (p<0.05). A progressive increase in the relative risk occurred as the number of movements in which pain occurrence increased, so did injury risk (p<0.01). Pain occurrence may be a stronger indicator of injury risk than a low composite score and provides a simpler method of evaluating injury risk compared to the full FMS. Published by Elsevier Ltd.

Closed head injury and perceptual processing in dual-task situations.

PubMed

Hein, G; Schubert, T; von Cramon, D Y

2005-01-01

Using a classical psychological refractory period (PRP) paradigm we investigated whether increased interference between dual-task input processes is one possible source of dual-task deficits in patients with closed-head injury (CHI). Patients and age-matched controls were asked to give speeded motor reactions to an auditory and a visual stimulus. The perceptual difficulty of the visual stimulus was manipulated by varying its intensity. The results of Experiment 1 showed that CHI patients suffer from increased interference between dual-task input processes, which is related to the salience of the visual stimulus. A second experiment indicated that this input interference may be specific to brain damage following CHI. It is not evident in other groups of neurological patients like Parkinson's disease patients. We conclude that the non-interfering processing of input stages in dual-tasks requires cognitive control. A decline in the control of input processes should be considered as one source of dual-task deficits in CHI patients.

Accounting for sampling variability, injury under-reporting, and sensor error in concussion injury risk curves.

PubMed

Elliott, Michael R; Margulies, Susan S; Maltese, Matthew R; Arbogast, Kristy B

2015-09-18

There has been recent dramatic increase in the use of sensors affixed to the heads or helmets of athletes to measure the biomechanics of head impacts that lead to concussion. The relationship between injury and linear or rotational head acceleration measured by such sensors can be quantified with an injury risk curve. The utility of the injury risk curve relies on the accuracy of both the clinical diagnosis and the biomechanical measure. The focus of our analysis was to demonstrate the influence of three sources of error on the shape and interpretation of concussion injury risk curves: sampling variability associated with a rare event, concussion under-reporting, and sensor measurement error. We utilized Bayesian statistical methods to generate synthetic data from previously published concussion injury risk curves developed using data from helmet-based sensors on collegiate football players and assessed the effect of the three sources of error on the risk relationship. Accounting for sampling variability adds uncertainty or width to the injury risk curve. Assuming a variety of rates of unreported concussions in the non-concussed group, we found that accounting for under-reporting lowers the rotational acceleration required for a given concussion risk. Lastly, after accounting for sensor error, we find strengthened relationships between rotational acceleration and injury risk, further lowering the magnitude of rotational acceleration needed for a given risk of concussion. As more accurate sensors are designed and more sensitive and specific clinical diagnostic tools are introduced, our analysis provides guidance for the future development of comprehensive concussion risk curves. Copyright © 2015 Elsevier Ltd. All rights reserved.

Injury risk associated with playing actions during competitive soccer

PubMed Central

Rahnama, N; Reilly, T; Lees, A

2002-01-01

Objective: To assess the exposure of players to injury risk during English Premier League soccer matches in relation to selected factors. Methods: Injury risk was assessed by rating the injury potential of playing actions during competition with respect to (a) type of playing action, (b) period of the game, (c) zone of the pitch, and (d) playing either at home or away. In all, 10 games from the English Premier League 1999–2000 were chosen for analysis. A notation system was used whereby 16 soccer specific playing actions were classified into three categories: those inducing actual injury, those with a potential for injury (graded as mild, moderate, or high), and those deemed to have no potential for injury. The pitch was divided into 18 zones, and the position of each event was recorded along with time elapsed in the game, enabling six 15 minute periods to be defined. Results: Close to 18 000 actions were notated. On average (mean (SD)), 1788 (73) events (one every three seconds), 767 (99) events with injury potential (one every six seconds), and 2 (1) injuries (one every 45 minutes) per game were recorded. An overall injury incidence of 53 per 1000 playing hours was calculated. Receiving a tackle, receiving a "charge", and making a tackle were categorised as having a substantial injury risk, and goal catch, goal punch, kicking the ball, shot on goal, set kick, and heading the ball were all categorised as having a significant injury risk. All other actions were deemed low in risk. The first 15 minutes of each half contained the highest number of actions with mild injury potential, the last 15 minutes having the highest number of actions with moderate injury potential (p<0.01). The first and last 15 minutes of the game had the highest number of actions with high injury potential, although not significant. More actions with mild injury potential occurred in the goal area, and more actions with moderate and high injury potential occurred in the zone adjacent to the

Evaluation of the field relevance of several injury risk functions.

PubMed

Prasad, Priya; Mertz, Harold J; Dalmotas, Danius J; Augenstein, Jeffrey S; Diggs, Kennerly

2010-11-01

An evaluation of the four injury risk curves proposed in the NHTSA NCAP for estimating the risk of AIS>= 3 injuries to the head, neck, chest and AIS>=2 injury to the Knee-Thigh-Hip (KTH) complex has been conducted. The predicted injury risk to the four body regions based on driver dummy responses in over 300 frontal NCAP tests were compared against those to drivers involved in real-world crashes of similar severity as represented in the NASS. The results of the study show that the predicted injury risks to the head and chest were slightly below those in NASS, and the predicted risk for the knee-thigh-hip complex was substantially below that observed in the NASS. The predicted risk for the neck by the Nij curve was greater than the observed risk in NASS by an order of magnitude due to the Nij risk curve predicting a non-zero risk when Nij = 0. An alternative and published Nte risk curve produced a risk estimate consistent with the NASS estimate of neck injury. Similarly, an alternative and published chest injury risk curve produced a risk estimate that was within the bounds of the NASS estimates. No published risk curve for femur compressive load could be found that would give risk estimates consistent with the range of the NASS estimates. Additional work on developing a femur compressive load risk curve is recommended.

Youth Participation and Injury Risk in Martial Arts.

PubMed

Demorest, Rebecca A; Koutures, Chris

2016-12-01

The martial arts can provide children and adolescents with vigorous levels of physical exercise that can improve overall physical fitness. The various types of martial arts encompass noncontact basic forms and techniques that may have a lower relative risk of injury. Contact-based sparring with competitive training and bouts have a higher risk of injury. This clinical report describes important techniques and movement patterns in several types of martial arts and reviews frequently reported injuries encountered in each discipline, with focused discussions of higher risk activities. Some of these higher risk activities include blows to the head and choking or submission movements that may cause concussions or significant head injuries. The roles of rule changes, documented benefits of protective equipment, and changes in training recommendations in attempts to reduce injury are critically assessed. This information is intended to help pediatric health care providers counsel patients and families in encouraging safe participation in martial arts. Copyright © 2016 by the American Academy of Pediatrics.

Self-reported previous knee injury and low knee function increase knee injury risk in adolescent female football.

PubMed

Clausen, M B; Tang, L; Zebis, M K; Krustrup, P; Hölmich, P; Wedderkopp, N; Andersen, L L; Christensen, K B; Møller, M; Thorborg, K

2016-08-01

Knee injuries are common in adolescent female football. Self-reported previous knee injury and low Knee injury and Osteoarthritis Outcome Score (KOOS) are proposed to predict future knee injuries, but evidence regarding this in adolescent female football is scarce. The aim of this study was to investigate self-reported previous knee injury and low KOOS subscale score as risk factors for future knee injuries in adolescent female football. A sample of 326 adolescent female football players, aged 15-18, without knee injury at baseline, were included. Data on self-reported previous knee injury and KOOS questionnaires were collected at baseline. Time-loss knee injuries and football exposures were reported weekly by answers to standardized text-message questions, followed by injury telephone interviews. A priori, self-reported previous knee injury and low KOOS subscale scores (< 80 points) were chosen as independent variables in the risk factor analyses. The study showed that self-reported previous knee injury significantly increased the risk of time-loss knee injury [relative risk (RR): 3.65, 95% confidence (CI) 1.73-7.68; P < 0.001]. Risk of time-loss knee injury was also significantly increased in players with low KOOS subscale scores (< 80 points) in Activities of Daily Living (RR: 5.0), Sport/Recreational (RR: 2.2) and Quality of Life (RR: 3.0) (P < 0.05). In conclusion, self-reported previous knee injury and low scores in three KOOS subscales significantly increase the risk of future time-loss knee injury in adolescent female football. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Extreme conditioning programs and injury risk in a US Army Brigade Combat Team.

PubMed

Grier, Tyson; Canham-Chervak, Michelle; McNulty, Vancil; Jones, Bruce H

2013-01-01

Brigades and battalions throughout the US Army are currently implementing a variety of exercise and conditioning programs with greater focus on preparation for mission-specific tasks. An Army physical therapy clinic working with a light infantry brigade developed the Advanced Tactical Athlete Conditioning (ATAC) program. The ATAC program is a unique physical training program consisting of high-intensity aquatic exercises, tactical agility circuits, combat core conditioning, and interval speed training. Along with ATAC, battalions have also incorporated components of fitness programs such as the Ranger Athlete Warrior program and CrossFit (Crossfit, Inc, Santa Monica, CA) an extreme conditioning program (ECP). To determine if these new programs (ATAC, ECP) had an effect on injury rates and physical fitness. Surveys were administered to collect personal characteristics, tobacco use, personal physical fitness training, Army physical fitness test results, and self-reported injuries. Medical record injury data were obtained 6 months before and 6 months after the implementation of the new program. Predictors of injury risk were assessed using multivariate logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were reported. Injury incidence among Soldiers increased 12% for overall injuries and 16% for overuse injuries after the implementation of the ATAC/ECPs. However, injury incidence among Soldiers not participating in ATAC/ECPs also increased 14% for overall injuries and 10% for overuse injuries. Risk factors associated with higher injury risk for Soldiers participating in ATAC/ECPs included: greater mileage run per week during unit physical training (OR (>16 miles per week÷≤7 miles per week)=2.24, 95% CI, 1.33-3.80); higher body mass index (BMI) (OR (BMI 25-29.9÷BMI<25)=1.77, 95% CI, 1.29-2.44), (OR (BMI =30÷BMI<25)=2.72, 95% CI, 1.67-4.43); cigarette use (OR (smoker÷nonsmoker)=1.80, 95% CI, 1.34-2.42); poor performance on the 2-mile run during

Injury Risk in International Rugby Union

PubMed Central

Moore, Isabel S.; Ranson, Craig; Mathema, Prabhat

2015-01-01

Background: Within international Rugby Union, only injury rates during the Rugby World Cup have been reported. Therefore, injury rates and types during other international tournaments are unknown. Purpose: To assess the 3-year incidence, severity, nature, and causes of match and training injuries sustained during different international tournaments played by the Welsh national Rugby Union team. Study Design: Descriptive epidemiology study. Methods: Injury data for all players (n = 78) selected for 1 national Rugby Union team over a 3-year period were analyzed using the international consensus statement methods. Player height (cm) and mass (kg) were recorded. Tournaments were grouped for comparisons as: autumn tournaments (2012 and 2013), Rugby World Cup (RWC; 2011), Six Nations (2012, 2013, and 2014), and summer tournaments (2012, 2013, and 2014). Injury incidence (injuries/1000 hours), prevalence (% of players unavailable), and severity (days lost) were calculated for each tournament. Injury location, type, and cause of match and training injuries were analyzed. Results: Match injury incidence was highest during autumn tournaments (262.5/1000 match-hours) and lowest during the RWC (178.6/1000 match-hours). Summer tournaments had the highest training incidence (5.5 injuries/1000 training-hours). Mild injuries were most likely during the RWC (risk ratio [RR], 2.02; 95% CI, 1.26-3.24), while severe injuries were most likely during autumn tournaments (RR, 3.27; 95% CI, 1.70-6.29). Quadriceps hematomas (18.8/1000 match-hours; 95% CI, 11.3-31.1) and concussions (13.8/1000 match-hours; 95% CI, 7.6-24.8) were the most common match injuries, with shoulder dislocations being the most severe (111 mean days lost per injury). Conclusion: Injury rates were considerably higher than those previously reported for multiple teams during RWC tournaments. Further investigation of injury rates and risk factors is recommended to accurately gauge their impact within international Rugby

Neck injury criteria formulation and injury risk curves for the ejection environment: a pilot study.

PubMed

Parr, Jeffrey C; Miller, Michael E; Pellettiere, Joseph A; Erich, Roger A

2013-12-01

Helmet mounted displays provide increased pilot capability, but can also increase the risk of injury during ejection. The National Highway Transportation Safety Administration's (NHTSA's) neck injury criteria (Nij) metric is evaluated for understanding the impact of helmet mass on the risk of injury and modified risk curves are developed which are compatible with the needs of the aviation community. Existent human subject data collected under various accelerative and head loading conditions were applied to understand the sensitivity of the Nij construct to changes in acceleration and helmet mass, as well as its stability with respect to gender, body mass, neck circumference, and sitting height. A portion of this data was combined with data from an earlier postmortem human subject study to create pilot study modified risk curves. These curves were compared and contrasted with the NHTSA risk curves. A statistically significant difference in the peak mean Nij was observed when seat acceleration increased by 2 G, but not when helmet mass was varied from 1.6 kg to 2 kg at a constant seat acceleration of 8 G. Although NHTSA risk curves predict a 13% risk of AIS 2+ injury for the 8-G, 2-kg helmet condition mean Nij of 0.138, no AIS 2+ injuries were observed. Modified risk curves were produced which predict a 0.91% risk of AIS 2+ injury under these conditions. The Nij was shown to be sensitive to changes in acceleration and generally robust to anthropometric differences between individuals. Modified risk curves are proposed which improve risk prediction at lower Nij values.

Scrum injury risk in English professional rugby union.

PubMed

Taylor, Aileen E; Kemp, Simon; Trewartha, Grant; Stokes, Keith A

2014-07-01

To assess and evaluate the injury risk associated with the scrum in English professional rugby union in the 2011-2012 season. Prospective, cohort. Players at English Premiership rugby union clubs. Frequency of team scrum-events per match; incidence (injuries per 1000 player-hours; propensity (injuries/1000 events); risk (days absence per 1000 player-hours and days absence per 1000 events). 31% of scrums in competitive matches resulted in collapse. Injury incidence associated with collapsed scrum-events (incidence: 8.6 injuries/1000 scrum-events) was significantly higher than those scrums that did not collapse (incidence: 4.1/1000 scrum-events). The injury risk associated with collapsed scrum supports the continued focus on reducing scrum collapse through changes in, and strict application of, the laws surrounding the scrum. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Risk Factors for Brachial Plexus Birth Injury

PubMed Central

Louden, Emily; Marcotte, Michael; Mehlman, Charles; Lippert, William; Huang, Bin; Paulson, Andrea

2018-01-01

Over the course of decades, the incidence of brachial plexus birth injury (BPBI) has increased despite advances in healthcare which would seem to assist in decreasing the rate. The aim of this study is to identify previously unknown risk factors for BPBI and the risk factors with potential to guide preventative measures. A case control study of 52 mothers who had delivered a child with a BPBI injury and 132 mothers who had delivered without BPBI injury was conducted. Univariate, multivariable and logistic regressions identified risk factors and their combinations. The odds of BPBI were 2.5 times higher when oxytocin was used and 3.7 times higher when tachysystole occurred. The odds of BPBI injury are increased when tachysystole and oxytocin occur during the mother’s labor. Logistic regression identified a higher risk for BPBI when more than three of the following variables (>30 lbs gained during the pregnancy, stage 2 labor >61.5 min, mother’s age >26.4 years, tachysystole, or fetal malpresentation) were present in any combination. PMID:29596309

Ergonomic assessment of airport shuttle driver tasks using an ergonomic analysis toolset.

PubMed

Çakıt, Erman

2018-06-01

This study aimed to (a) evaluate strength requirements and lower back stresses during lifting and baggage handling tasks with the 3D Static Strength Prediction Program (3DSSPP) and (b) provide additional analyses using rapid entire body assessment (REBA) and the NASA task load index (TLX) to assess the risks associated with the tasks. Four healthy female shuttle drivers of good health aged between 55 and 60 years were observed and interviewed in an effort to determine the tasks required of their occupations. The results indicated that lifting bags and placing them in a shuttle were high risk for injury and possible changes should be further investigated. The study concluded there was a potential for injury associated with baggage storing and retrieval tasks of a shuttle driver.

Injury risk functions for frontal oblique collisions.

PubMed

Andricevic, Nino; Junge, Mirko; Krampe, Jonas

2018-03-09

The objective of this article was the construction of injury risk functions (IRFs) for front row occupants in oblique frontal crashes and a comparison to IRF of nonoblique frontal crashes from the same data set. Crashes of modern vehicles from GIDAS (German In-Depth Accident Study) were used as the basis for the construction of a logistic injury risk model. Static deformation, measured via displaced voxels on the postcrash vehicles, was used to calculate the energy dissipated in the crash. This measure of accident severity was termed objective equivalent speed (oEES) because it does not depend on the accident reconstruction and thus eliminates reconstruction biases like impact direction and vehicle model year. Imputation from property damage cases was used to describe underrepresented low-severity crashes-a known shortcoming of GIDAS. Binary logistic regression was used to relate the stimuli (oEES) to the binary outcome variable (injured or not injured). IRFs for the oblique frontal impact and nonoblique frontal impact were computed for the Maximum Abbreviated Injury Scale (MAIS) 2+ and 3+ levels for adults (18-64 years). For a given stimulus, the probability of injury for a belted driver was higher in oblique crashes than in nonoblique frontal crashes. For the 25% injury risk at MAIS 2+ level, the corresponding stimulus for oblique crashes was 40 km/h but it was 64 km/h for nonoblique frontal crashes. The risk of obtaining MAIS 2+ injuries is significantly higher in oblique crashes than in nonoblique crashes. In the real world, most MAIS 2+ injuries occur in an oEES range from 30 to 60 km/h.

Eye injury risk associated with remote control toy helicopter blades.

PubMed

Alphonse, Vanessa D; Kemper, Andrew R; Rowson, Steven; Duma, Stefan M

2012-01-01

Eye injuries can be caused by a variety of consumer products and toys. Recently, indoor remote controlled (RC) toy helicopters have become very popular. The purpose of this study is to quantify eye injury risk associated with five commercially available RC toy helicopter blades. An experimental matrix of 25 tests was developed to test five different RC toy helicopter blades at full battery power on six postmortem human eyes. A pressure sensor inserted through the optic nerve measured intraocular pressure. Corneal abrasion was assessed post-impact using fluorescein dye. Intraocular pressure was correlated to injury risk for hyphema, lens damage, retinal damage, and globe rupture using published risk functions. All tests resulted in corneal abrasions; however, no other injuries were observed. The 25 tests produced an increase intraocular pressure between 15.2 kPa and 99.3 kPa (114.3 mmHg and 744.7 mmHg). Calculated blade velocities ranged between 16.0 m/s and 25.4 m/s. Injury risk for hyphema was a maximum of 0.2%. Injury risk for lens damage, retinal damage, and globe rupture was 0.0% for all tests. Blade design parameters such as length and mass did not affect the risk of eye injury. This is the first study to quantify the risk of eye injury from RC toy helicopter blades. While corneal abrasions were observed, more serious eye injuries were neither observed nor predicted to have occurred. Results from this study are critical for establishing safe design thresholds for RC toy helicopter blades so that more serious injuries can be prevented.

Acrobatic gymnastics injury: occurrence, site and training risk factors.

PubMed

Purnell, Melinda; Shirley, Debra; Nicholson, Leslie; Adams, Roger

2010-05-01

To determine the incidence and risk factors for injury associated with the performance of acrobatic gymnastics. Retrospective injury and training survey. New South Wales acrobatic gymnastics clubs. Surveys were completed by 73 acrobatic gymnasts (69 female) aged 8-26 years. Data on injury incidence and frequency for injury site were collected. Multiple-regression and ROC curve analysis were used to evaluate training-associated injury risk factors. Half (50.7%) of the participants had sustained an injury associated with acrobatic gymnastics in the past 12 months, with 28.8% of participants affected by chronic injury at the time of the study. Age of onset for acute and chronic acrobatics-related injury averaged 13.9 (SD +/- 3.03) and 14.7 (SD +/- 3.85) years, respectively. Injury sites were predominately the knee, ankle and wrist. Risk factors for injury were having an age of >or=13 years and training for >or=8 h per week at age 11 years. The results suggest that the 11-15 years age period is critical for the occurrence of injury in acrobatic gymnasts. This is possibly due to the adolescent growth spurt which may create an increased vulnerability to injury if training volume during this time is above a certain threshold.

Gender differences in injury severity risks in crashes at signalized intersections.

PubMed

Obeng, K

2011-07-01

This paper analyzes gender differences in crash risk severities using data for signalized intersections. It estimates gender models for injury severity risks and finds that driver condition, type of crash, type of vehicle driven and vehicle safety features have different effects on females' and males' injury severity risks. Also, it finds some variables which are significantly related to females' injury severity risks but not males' and others which affect males' injury severity risks but not females'. It concludes that better and more in-depth information about gender differences in injury severity risks is gained by estimating separate models for females and males. Copyright © 2011 Elsevier Ltd. All rights reserved.

A prospective investigation of injury incidence and injury risk factors among Army recruits in military police training.

PubMed

Knapik, Joseph J; Graham, Bria; Cobbs, Jacketta; Thompson, Diane; Steelman, Ryan; Jones, Bruce H

2013-01-17

United States Army military police (MP) training is a 19-week course designed to introduce new recruits to basic soldiering skills, Army values and lifestyle, and law enforcement skills and knowledge. The present investigation examined injury rates and injury risk factors in MP training. At the start of training, 1,838 male and 553 female MP recruits were administered a questionnaire containing items on date of birth, height, weight, tobacco use, prior physical activity, injury history, and menstrual history. Injuries during training were obtained from electronic medical records and the training units provided data on student graduation and attrition. Successfully graduating from the course were 94.3% of the men and 83.7% of the women. Experiencing at least one injury during training were 34.2% of the men and 66.7% of the women (risk ratio (women/men) = 1.95, 95% confidence interval = 1.79-2.13). Recruits were at higher injury risk if they reported that they were older, had smoked in the past, or had performed less frequent exercise or sports prior to MP training. Men were at higher injury risk if they reported a prior injury and women were at higher risk if they reported missing at least six menstrual cycles in the last year or had previously been pregnant. The present investigation was the first to identify injury rates and identify specific factors increasing injury risk during MP training.

A prospective investigation of injury incidence and injury risk factors among army recruits in military police training

PubMed Central

2013-01-01

Background United States Army military police (MP) training is a 19-week course designed to introduce new recruits to basic soldiering skills, Army values and lifestyle, and law enforcement skills and knowledge. The present investigation examined injury rates and injury risk factors in MP training. Methods At the start of training, 1,838 male and 553 female MP recruits were administered a questionnaire containing items on date of birth, height, weight, tobacco use, prior physical activity, injury history, and menstrual history. Injuries during training were obtained from electronic medical records and the training units provided data on student graduation and attrition. Results Successfully graduating from the course were 94.3% of the men and 83.7% of the women. Experiencing at least one injury during training were 34.2% of the men and 66.7% of the women (risk ratio (women/men) = 1.95, 95% confidence interval = 1.79-2.13). Recruits were at higher injury risk if they reported that they were older, had smoked in the past, or had performed less frequent exercise or sports prior to MP training. Men were at higher injury risk if they reported a prior injury and women were at higher risk if they reported missing at least six menstrual cycles in the last year or had previously been pregnant. Conclusion The present investigation was the first to identify injury rates and identify specific factors increasing injury risk during MP training. PMID:23327563

Functional Movement ScreenTM and history of injury in assessment of potential risk of injury among team handball players.

PubMed

Slodownik, Robert; Ogonowska-Slodownik, Anna; Morgulec-Adamowicz, Natalia

2017-09-29

Handball is known to be one of the team sports representing the highest risk of injury. Several investigators have tried to identify injury risk factors in team sports including handball and suggested the need to develop an optimal tool to capture and quantify the potential risk of injury. The aim of the study was to evaluate potential risk of injury among handball players. It was a mixed design study. Handball players from 1st and 2nd division were evaluated (n = 30) using the Functional Movement ScreenTM (FMSTM). Additionally, self-reported history of injury was collected during FMSTM evaluation and after 6 months. Competitive level, training experience, playing position, anthropometric features, symmetry of movement patterns and history of previous injury were analysed while assessing the potential risk of injury. Significant difference between the right and left side (upper limb) was revealed for Shoulder Mobility Test (U = 308.5, p = 0.014). Odds Ratio analysis revealed that having previous injury in the last 12 months is the only statistically significant injury risk factor (OR = 13.71, p = 0.02). Based on this study we can assume that previous injury history reports are crucial in predicting injuries. FMSTM can help in identifying a typical adaptation in throwing shoulder among handball players, but should not be used alone to assess injury risk.

Risk factors for closed-head injuries during military airborne operations.

PubMed

Knapik, Joseph J; Steelman, Ryan; Hoedebecke, Kyle; Klug, Kevin L; Rankin, Shawn; Proctor, Stanley; Graham, Bria; Jones, Bruce H

2014-02-01

One of the more serious adverse outcomes of military airborne operations is closed-head injuries. This investigation examined risk factors for closed-head injuries in an Army airborne infantry unit. Closed-head injuries were defined as energy exchanges in which the head contacted the ground or an object and the soldier sought medical care for external trauma, headache, loss of consciousness, or altered mental state. Injury data were obtained by investigators in the drop zone and diagnoses were confirmed by a physician. Operational data on potential injury risk factors were obtained from routine reports published by the infantry unit. Weather data were obtained using a pocket weather tracker. There were 96,132 jumps resulting in 310 closed-head injuries for a crude incidence of 3.22/1000 jumps. In 98% of known cases the injury was associated with parachute landings. Multivariate logistic regression revealed that independent risk factors for closed-head injuries included night jumps, combat loads, higher wind speeds, higher temperatures, enlisted rank, and entanglements. This study identifies the current incidence and extrinsic risk factors for closed-head injuries during military airborne operations. Although it is necessary to conduct airborne training under realistic conditions, trainers and commanders should be aware of these risks and plan airborne operations accordingly.

Rate and Risk of Anterior Cruciate Ligament Injury Among Sportswomen in Slovenia

PubMed Central

Vauhnik, Renata; Morrissey, Matthew C.; Rutherford, Olga M.; Turk, Zmago; Pilih, Iztok A.; Perme, Maja Pohar

2011-01-01

Abstract Context: Anterior cruciate ligament (ACL)-injury rate is greater among female athletes than among male athletes. Objective: To investigate the rate and risk of ACL injury among Slovenian sportswomen playing professional basketball, team handball, or volleyball. Design: Prospective cohort study. Setting: The Slovenian National Organizations of basketball, team handball, and volleyball. Patients or Other Participants: During the 2003–2004 season, we prospectively followed 585 Slovenian sportswomen registered in the Slovenian National Organizations of basketball, team handball, and volleyball. Main Outcome Measure(s): We asked sportswomen and coaches to document the occurrence of every significant traumatic knee injury requiring medical attention. Injury rate and injury risk were calculated for sportswomen in each sport group. To calculate injury rate, we estimated the average exposure of each sportswoman during the research period. Results: During the 2003–2004 season, 585 Slovenian sportswomen sustained 12 ACL injuries. The ACL-injury risk was different in athletes participating in the various sports, with basketball players having the greatest ACL-injury risk and volleyball players having the lowest ACL-injury risk (P  =  .04). The risk of ACL injury among Slovenian sportswomen was 2.1 per 100 athletes (95% confidence interval  =  0.9, 3.2), whereas the rate of ACL injury was 0.037 per 1000 exposure hours (95% confidence interval  =  0.016, 0.06). Conclusions: Overall differences in injury risk were found among sports, but no differences were noted among divisions within sports. No differences for injury rate were observed between or within sports. The rate and risk of ACL injury among Slovenian sportswomen are high, with basketball players having the greatest ACL-injury risk. PMID:21214356

Pedestrian injury risk functions based on contour lines of equal injury severity using real world pedestrian/passenger-car accident data

PubMed Central

Niebuhr, Tobias; Junge, Mirko; Achmus, Stefanie

2013-01-01

Injury risk assessment plays a pivotal role in the assessment of the effectiveness of Advanced Driver Assistance Systems (ADAS) as they specify the injury reduction potential of the system. The usual way to describe injury risks is by use of injury risk functions, i.e. specifying the probability of an injury of a given severity occurring at a specific technical accident severity (collision speed). A method for the generation of a family of risk functions for different levels of injury severity is developed. The injury severity levels are determined by use of a rescaled version of the Injury Severity Score (ISS) namely the ISSx. The injury risk curves for each collision speed is then obtained by fixing the boundary conditions and use of a case-by-case validated GIDAS subset of pedestrian-car accidents (N=852). The resultant functions are of exponential form as opposed to the frequently used logistic regression form. The exponential approach in combination with the critical speed value creates a new injury risk pattern better fitting for high speed/high energy crashes. Presented is a family of pedestrian injury risk functions for an arbitrary injury severity. Thus, the effectiveness of an ADAS can be assessed for mitigation of different injury severities using the same injury risk function and relying on the internal soundness of the risk function with regard to different injury severity levels. For the assessment of emergency braking ADAS, a Zone of Effective Endangerment Increase (ZEEI), the speed interval in which a one percent speed increase results at least in a one percent of injury risk increase, is defined. The methodology presented is kept in such general terms that a direct adaption to other accident configurations is easily done. PMID:24406954

Incidence and player risk factors for injury in youth football.

PubMed

Malina, Robert M; Morano, Peter J; Barron, Mary; Miller, Susan J; Cumming, Sean P; Kontos, Anthony P

2006-05-01

To estimate the incidence of injuries in youth football and to assess the relationship between player-related risk factors (age, body size, biological maturity status) and the occurrence of injury in youth football. Prospective over two seasons. Two communities in central Michigan. Subjects were 678 youth, 9-14 years of age, who were members of 33 youth football teams in two central Michigan communities in the 2000 and 2001 seasons. Certified athletic trainers (ATCs) were on site to record the number of players at all practices and home games (exposures) and injuries as they occurred. A reportable injury (RI) was defined by the criteria used in the National Athletic Trainers' Association (NATA) survey of several high school sports. Estimated injury rates (95% confidence intervals) per athlete exposures (AE) and per number of athletes were calculated for practices and games by grade. Player risk factors included age, height, weight, BMI and estimated maturity status. Estimated injury rates and relative risks of injury during practices and games by grade; logistic regression to evaluate relationships between player-related risk factors and risk of injury. A total of 259 RIs, 178 in practice and 81 in games, were recorded during the two seasons. Practice injury rates increased with grade level, while game injury rates were similar among fourth through fifth grade and sixth grade players and about twice as high among seventh and eighth grade players. The majority of RIs during the two seasons was minor (64%); the remainder was moderate (18%) and major (13%). Injured fourth through fifth grade players were significantly lighter in weight and had a lower BMI; otherwise, injured and non-injured players within each grade did not differ in age, body size and estimated biological maturity status. Logistic regressions within grade revealed no significant associations between injury and age, height, BMI, and maturity status. Game injury rates are higher than practice injury

Predicting injury risk with "New Car Assessment Program" crashworthiness ratings.

PubMed

Jones, I S; Whitfield, R A

1988-12-01

The relationship between crashworthiness ratings produced by the National Highway Traffic Safety Administration's (NHTSA's) New Car Assessment Program (NCAP) and the risk of incapacitating injury or death for drivers who are involved in single-car, fixed-object, frontal collisions was examined. The results are based on 6,405 such crashes from the Motor Vehicle Traffic Accident file of the Texas Department of Highways and Public Transportation. The risk of injury was modeled using logistic regression taking into account the NCAP test results for each individual model of car and the intervening effects of car mass, age of the driver, restraint use, and crash severity. Three measures of anthropometric dummy response, Head Injury Criterion (HIC), Chest Deceleration (CD), and femur load were used to indicate vehicle crash test performance. The results show that there is a significant relationship between the results of the NCAP tests and the risk of serious injury or death in actual single-car frontal accidents. In terms of overall injury, chest deceleration was a better predictor than the Head Injury Criterion. For restrained drivers, crash severity, driver age, and chest deceleration were significant parameters for predicting risk of serious injury or death; the risk of injury decreased as chest deceleration decreased. The results were similar for unrestrained drivers although vehicle mass and femur load were also significant factors in the model. The risk of overall injury decreased as chest deceleration decreased but appeared to decrease as femur load increased.

Independent risk factors of morbidity in penetrating colon injuries.

PubMed

Girgin, Sadullah; Gedik, Ercan; Uysal, Ersin; Taçyildiz, Ibrahim Halil

2009-05-01

The present study explored the factors effective on colon-related morbidity in patients with penetrating injury of the colon. The medical records of 196 patients were reviewed for variables including age, gender, factor of trauma, time between injury and operation, shock, duration of operation, Penetrating Abdominal Trauma Index (PATI), Injury Severity Score (ISS), site of colon injury, Colon Injury Score, fecal contamination, number of associated intra- and extraabdominal organ injuries, units of transfused blood within the first 24 hours, and type of surgery. In order to determine the independent risk factors, multivariate logistic regression analysis was performed. Gunshot wounds, interval between injury and operation > or =6 hours, shock, duration of the operation > or =6 hours, PATI > or =25, ISS > or =20, Colon Injury Score > or = grade 3, major fecal contamination, number of associated intraabdominal organ injuries >2, number of associated extraabdominal organ injuries >2, multiple blood transfusions, and diversion were significantly associated with morbidity. Multivariate logistic regression analysis showed diversion and transfusion of > or =4 units in the first 24 hours as independent risk factors affecting colon-related morbidity. Diversion and transfusion of > or =4 units in the first 24 hours were determined to be independent risk factors for colon-related morbidity.

ANOTHER "LETHAL TRIAD"-RISK FACTORS FOR VIOLENT INJURY AND LONG-TERM MORTALITY AMONG ADULT VICTIMS OF VIOLENT INJURY.

PubMed

Laytin, Adam D; Shumway, Martha; Boccellari, Alicia; Juillard, Catherine J; Dicker, Rochelle A

2018-05-01

Mental illness, substance abuse, and poverty are risk factors for violent injury, and violent injury is a risk factor for early mortality that can be attenuated through hospital-based violence intervention programs. Most of these programs focus on victims under the age of 30 years. Little is known about risk factors or long-term mortality among older victims of violent injury. To explore the prevalence of risk factors for violent injury among younger (age < 30 years) and older (age 30 ≥ years) victims of violent injury, to determine the long-term mortality rates in these age groups, and to explore the association between risk factors for violent injury and long-term mortality. Adults with violent injuries were enrolled between 2001 and 2004. Demographic and injury data were recorded on enrollment. Ten-year mortality rates were measured. Descriptive analysis and logistic regression were used to compare older and younger subjects. Among 541 subjects, 70% were over age 30. The overall 10-year mortality rate was 15%, and was much higher than in the age-matched general population in both age groups. Risk factors for violent injury including mental illness, substance abuse, and poverty were prevalent, especially among older subjects, and were each independently associated with increased risk of long-term mortality. Mental illness, substance abuse, and poverty constitute a "lethal triad" that is associated with an increased risk of long-term mortality among victims of violent injury, including both younger adults and those over age 30 years. Both groups may benefit from targeted risk-reduction efforts. Emergency department visits offer an invaluable opportunity to engage these vulnerable patients. Copyright © 2018 Elsevier Inc. All rights reserved.

Risk of Lower Extremity Injury in a Military Cadet Population After a Supervised Injury-Prevention Program.

PubMed

Carow, Scott D; Haniuk, Eric M; Cameron, Kenneth L; Padua, Darin A; Marshall, Stephen W; DiStefano, Lindsay J; de la Motte, Sarah J; Beutler, Anthony I; Gerber, John P

2016-11-01

 Specific movement patterns have been identified as possible risk factors for noncontact lower extremity injuries. The Dynamic Integrated Movement Enhancement (DIME) was developed to modify these movement patterns to decrease injury risk.  To determine if the DIME is effective for preventing lower extremity injuries in US Military Academy (USMA) cadets.  Cluster-randomized controlled trial.  Cadet Basic Training at USMA.  Participants were 1313 cadets (1070 men, 243 women).  Participants were cluster randomized to 3 groups. The active warm-up (AWU) group performed standard Army warm-up exercises. The DIME groups were assigned to a DIME cadre-supervised (DCS) group or a DIME expert-supervised (DES) group; the former consisted of cadet supervision and the latter combined cadet and health professional supervision. Groups performed exercises 3 times weekly for 6 weeks.  Cumulative risk of lower extremity injury was the primary outcome. We gathered data during Cadet Basic Training and for 9 months during the subsequent academic year. Risk ratios and 95% confidence intervals (CIs) were calculated to compare groups.  No differences were seen between the AWU and the combined DIME (DCS and DES) groups during Cadet Basic Training or the academic year. During the academic year, lower extremity injury risk in the DES group decreased 41% (relative risk [RR] = 0.59; 95% CI = 0.38, 0.93; P = .02) compared with the DCS group; a nonsignificant 25% (RR = 0.75; 95% CI = 0.49, 1.14; P = .18) decrease occurred in the DES group compared with the AWU group. Finally, there was a nonsignificant 27% (RR = 1.27; 95% CI = 0.90, 1.78; P = .17) increase in injury risk during the academic year in the DCS group compared with the AWU group.  We observed no differences in lower extremity injury risk between the AWU and combined DIME groups. However, the magnitude and direction of the risk ratios in the DES group compared with the AWU group, although not statistically significant

Task performance in virtual environments used for cognitive rehabilitation after traumatic brain injury.

PubMed

Christiansen, C; Abreu, B; Ottenbacher, K; Huffman, K; Masel, B; Culpepper, R

1998-08-01

This report describes a reliability study using a prototype computer-simulated virtual environment to assess basic daily living skills in a sample of persons with traumatic brain injury (TBI). The benefits of using virtual reality in training for situations where safety is a factor have been established in defense and industry, but have not been demonstrated in rehabilitation. Thirty subjects with TBI receiving comprehensive rehabilitation services at a residential facility. An immersive virtual kitchen was developed in which a meal preparation task involving multiple steps could be performed. The prototype was tested using subjects who completed the task twice within 7 days. The stability of performance was estimated using intraclass correlation coefficients (ICCs). The ICC value for total performance based on all steps involved in the meal preparation task was .73. When three items with low variance were removed the ICC improved to .81. Little evidence of vestibular optical side-effects was noted in the subjects tested. Adequate initial reliability exists to continue development of the environment as an assessment and training prototype for persons with brain injury.

Risk factors for injuries in the U.S. Army Ordnance School.

PubMed

Grier, Tyson L; Morrison, Stephanie; Knapik, Joseph J; Canham-Chervak, Michelle; Jones, Bruce H

2011-11-01

To investigate risk factors for time-loss injuries among soldiers attending U.S. Army Ordnance School Advanced Individual Training. Injuries were obtained from an injury surveillance system. A health questionnaire provided data on age, race, rank, current self-reported injury and illness, and tobacco use. Fitness data was obtained from operations office. Cumulative time-loss injury incidence was 31% for men and 54% for women. For men, higher risk of injury was associated with race, a current self-reported injury, smoking before entering the Army, lower sit-up performance, and slower 2-mile run times. For women, higher risk of injury was associated with race, a current self-reported injury, and slower 2-mile run times. Smoking cessation and fitness training before entry are potential strategies to reduce injuries among soldiers in the Ordnance School.

Risk factors for acute knee injury in female youth football.

PubMed

Hägglund, Martin; Waldén, Markus

2016-03-01

To prospectively evaluate risk factors for acute time-loss knee injury, in particular ACL injury, in female youth football players. Risk factors were studied in 4556 players aged 12-17 years from a randomised controlled trial during the 2009 season. Covariates were both intrinsic (body mass index, age, relative age effect, onset of menarche, previous acute knee injury or ACL injury, current knee complaints, and familial disposition of ACL injury) and extrinsic (no. of training sessions/week, no. of matches/week, match exposure ratio, match play with other teams, and artificial turf exposure). Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated from individual variable and multiple Cox regression analyses. Ninety-six acute knee injuries were recorded, 21 of them ACL injuries. Multiple Cox regression showed a fourfold higher ACL injury rate for players with familial disposition of ACL injury (HR 3.57; 95% CI 1.48-8.62). Significant predictor variables for acute knee injury were age >14 years (HR 1.97; 95% CI 1.30-2.97), knee complaints at the start of the season (HR 1.98; 95% CI 1.30-3.02), and familial disposition of ACL injury (HR 1.96; 95% CI 1.22-3.16). No differences in injury rates were seen when playing on artificial turf compared with natural grass. Female youth football players with a familial disposition of ACL injury had an increased risk of ACL injury and acute knee injury. Older players and those with knee complaints at pre-season were more at risk of acute knee injury. Although the predictive values were low, these factors could be used in athlete screening to target preventive interventions. II.

Parachute ankle brace and extrinsic injury risk factors during parachuting.

PubMed

Knapik, Joseph J; Darakjy, Salima; Swedler, David; Amoroso, Paul; Jones, Bruce H

2008-04-01

This study examined the injury prevention effectiveness of the parachute ankle brace (PAB) while controlling for known extrinsic risk factors. Injuries among airborne students who wore the PAB during parachute descents were compared with injuries among those who did not. Injury risk factors from administrative records included wind speed, combat loads, and time of day (day/night). Injuries were collected in the drop zone. A total of 596 injuries occurred in 102,784 parachute descents. In univariate analysis, students not wearing the PAB (Controls) were 2.00 [95% confidence interval (95% CI) = 1.32-3.02] times more likely to experience an ankle sprain, 1.83 (95% CI = 1.04-3.24) times more likely to experience an ankle fracture, and 1.92 (95% CI = 1.38-2.67) times more likely to experience an ankle injury of any type. PAB wearers and Controls had a similar incidence of lower body injuries exclusive of the ankle [risk ratio (Control/PAB) = 0.92, 95% CI = 0.65-1.30]. After accounting for known extrinsic injury risk factors, Controls were 1.90 (95% CI = 1.24-2.90) times more likely than PAB wearers to experience an ankle sprain, 1.47 (95% CI = 0.82- 2.63) times more likely to experience an ankle fracture, and 1.75 (95% CI = 1.25-2.48) times more likely to experience an ankle injury of any type. The incidence of parachute entanglements that persisted until the jumpers reached the ground were similar among PAB wearers and Controls IRR (Control/PAB) = 1.17, 95% CI = 0.61-2.29]. After controlling for known injury risk factors, the PAB protected against ankle injuries, and especially ankle sprains, while not influencing parachute entanglements or lower body injuries exclusive of the ankle.

Group training programs and self-reported injury risk in female marathoners.

PubMed

Parker, Daniel T; Weitzenberg, Todd W; Amey, Annette L; Nied, Robert J

2011-11-01

To investigate the association of group training program (GTP) participation and other known risk factors with training and intrarace injury rates in female marathoners. Multivariate analysis of a self-reported questionnaire. Nike Women's Marathon, San Francisco, CA. Three hundred seventy-eight female marathoners. Training and intrarace injury rates, severity of these injuries, and satisfaction rates. Participants of GTPs were 2.36 times more likely to experience intrarace injury than non-GTP participants (P = 0.02). Runners with mild and severe injuries in the past 12 months preceding training were 3.54 and 5.08 times more likely to be injured during training (P < 0.0001 and P < 0.0001), respectively, and those with previous severe injury were 6.43 times more likely to experience severe training injury (P < 0.0001). Similarly, the risk for intrarace marathon injury was 3.79 and 7.09 times greater among those with mild and severe injuries during training (P = 0.003 and P < 0.0001), and the risk of severe intrarace injury was 5.63 times greater for those reporting a severe training injury (P < 0.001). Runners with previous marathon experience had a 0.53 risk of severe training injury compared with inexperienced runners (P = 0.04). Participants of GTPs were more likely to be injured during the marathon in multivariate analysis but were also more satisfied with training in bivariate analysis. Female runners with previous injury had a greater risk of future training and race injury, and severe previous injury was associated with severe training and intrarace injury. Previous marathon experience was protective of severe training injury.

Relationship between Adolescent Risk Preferences on a Laboratory Task and Behavioral Measures of Risk-taking

PubMed Central

Rao, Uma; Sidhartha, Tanuj; Harker, Karen R.; Bidesi, Anup S.; Chen, Li-Ann; Ernst, Monique

2010-01-01

Purpose The goal of the study was to assess individual differences in risk-taking behavior among adolescents in the laboratory. A second aim was to evaluate whether the laboratory-based risk-taking behavior is associated with other behavioral and psychological measures associated with risk-taking behavior. Methods Eighty-two adolescents with no personal history of psychiatric disorder completed a computerized decision-making task, the Wheel of Fortune (WOF). By offering choices between clearly defined probabilities and real monetary outcomes, this task assesses risk preferences when participants are confronted with potential rewards and losses. The participants also completed a variety of behavioral and psychological measures associated with risk-taking behavior. Results Performance on the task varied based on the probability and anticipated outcomes. In the winning sub-task, participants selected low probability-high magnitude reward (high-risk choice) less frequently than high probability-low magnitude reward (low-risk choice). In the losing sub-task, participants selected low probability-high magnitude loss more often than high probability-low magnitude loss. On average, the selection of probabilistic rewards was optimal and similar to performance in adults. There were, however, individual differences in performance, and one-third of the adolescents made high-risk choice more frequently than low-risk choice while selecting a reward. After controlling for sociodemographic and psychological variables, high-risk choice on the winning task predicted “real-world” risk-taking behavior and substance-related problems. Conclusions These findings highlight individual differences in risk-taking behavior. Preliminary data on face validity of the WOF task suggest that it might be a valuable laboratory tool for studying behavioral and neurobiological processes associated with risk-taking behavior in adolescents. PMID:21257113

Material-specific difficulties in episodic memory tasks in mild traumatic brain injury.

PubMed

Tsirka, Vassiliki; Simos, Panagiotis; Vakis, Antonios; Vourkas, Michael; Arzoglou, Vasileios; Syrmos, Nikolaos; Stavropoulos, Stavros; Micheloyannis, Sifis

2010-03-01

The study examines acute, material-specific secondary memory performance in 26 patients with mild traumatic brain injury (MTBI) and 26 healthy controls, matched on demographic variables and indexes of crystallized intelligence. Neuropsychological tests were used to evaluate primary and secondary memory, executive functions, and verbal fluency. Participants were also tested on episodic memory tasks involving words, pseudowords, pictures of common objects, and abstract kaleidoscopic images. Patients showed reduced performance on episodic memory measures, and on tasks associated with visuospatial processing and executive function (Trail Making Test part B, semantic fluency). Significant differences between groups were also noted for correct rejections and response bias on the kaleidoscope task. MTBI patients' reduced performance on memory tasks for complex, abstract stimuli can be attributed to a dysfunction in the strategic component of memory process.

Parents' Attitudes to Risk and Injury to Children and Young People on Farms.

PubMed

Nilsson, Kerstin

2016-01-01

Children and young people growing up in a farm environment run a greater risk of being injured or dying in an accident than their non-farming counterparts. This study examines farming parents' attitudes and experiences of having their children grow up on farms, one of the most dangerous work environments as their home, everyday environment and playground. Data were collected using two ethnological methods, a question list and interviews, with a study population of 20 parents. The data were analysed phenomenologically. The analysis pursued four themes: i) the most dangerous places and situations on the farm; ii) children's tasks on the farm; iii) children as a safety risk on the farm; and iv) farm risk education for children. Most parents know the risks on their farm, but are sometimes careless when working under stress or exhaustion. Some parents wanted more information and some wanted compulsory preventative or safety measures by manufacturers, e.g. a safety belt as standard on the extra seat in tractors. Children's friends were described as one of the greatest risks for injury due to peer pressure. Some parents mentioned that people who grow up on farms are sometimes 'blind' to the dangers. Other parents seemed to overlook the risks and had their children carrying out tasks for which they were not mentally or physically equipped. Some of the tasks the children reportedly carried out on farms contravened Swedish legislation. It is thus important for farming parents to be repeatedly reminded of the risks to their children and to increase their awareness of how to prevent and eliminate risks in order to avoid accidents on the farm. The situation for farm children is highlighted in a critical discussion.

Parents' Attitudes to Risk and Injury to Children and Young People on Farms

PubMed Central

2016-01-01

Objectives Children and young people growing up in a farm environment run a greater risk of being injured or dying in an accident than their non-farming counterparts. This study examines farming parents’ attitudes and experiences of having their children grow up on farms, one of the most dangerous work environments as their home, everyday environment and playground. Method Data were collected using two ethnological methods, a question list and interviews, with a study population of 20 parents. The data were analysed phenomenologically. Results The analysis pursued four themes: i) the most dangerous places and situations on the farm; ii) children’s tasks on the farm; iii) children as a safety risk on the farm; and iv) farm risk education for children. Conclusions Most parents know the risks on their farm, but are sometimes careless when working under stress or exhaustion. Some parents wanted more information and some wanted compulsory preventative or safety measures by manufacturers, e.g. a safety belt as standard on the extra seat in tractors. Children’s friends were described as one of the greatest risks for injury due to peer pressure. Some parents mentioned that people who grow up on farms are sometimes ‘blind’ to the dangers. Other parents seemed to overlook the risks and had their children carrying out tasks for which they were not mentally or physically equipped. Some of the tasks the children reportedly carried out on farms contravened Swedish legislation. It is thus important for farming parents to be repeatedly reminded of the risks to their children and to increase their awareness of how to prevent and eliminate risks in order to avoid accidents on the farm. The situation for farm children is highlighted in a critical discussion. PMID:27362751

Arterial injuries after penetrating brain injury in civilians: risk factors on admission head computed tomography.

PubMed

Bodanapally, Uttam K; Saksobhavivat, Nitima; Shanmuganathan, Kathirkamanathan; Aarabi, Bizhan; Roy, Ashis K

2015-01-01

The object of this study was to determine the specific CT findings of the injury profile in penetrating brain injury (PBI) that are risk factors related to intracranial arterial injuries. The authors retrospectively evaluated admission head CTs and accompanying digital subtraction angiography (DSA) studies from patients with penetrating trauma to the head in the period between January 2005 and December 2012. Two authors reviewed the CT images to determine the presence or absence of 30 injury profile variables and quantified selected variables. The CT characteristics in patients with and without arterial injuries were compared using univariate analysis, multivariate analysis, and receiver operating characteristic (ROC) curve analysis to determine the respective risk factors, independent predictors, and optimal threshold values for the continuous variables. Fifty-five patients were eligible for study inclusion. The risk factors for an intracranial arterial injury on univariate analysis were an entry wound over the frontobasal-temporal regions, a bihemispheric wound trajectory, a wound trajectory in proximity to the circle of Willis (COW), a subarachnoid hemorrhage (SAH), a higher SAH score, an intraventricular hemorrhage (IVH), and a higher IVH score. A trajectory in proximity to the COW was the best predictor of injury (OR 6.8 and p = 0.005 for all penetrating brain injuries [PBIs]; OR 13.3 and p = 0.001 for gunshot wounds [GSWs]). Significant quantitative variables were higher SAH and IVH scores. An SAH score of 3 (area under the ROC curve [AUC] for all PBIs 0.72; AUC for GSWs 0.71) and an IVH score of 3 (AUC for all PBIs 0.65; AUC for GSWs 0.65) could be used as threshold values to suggest an arterial injury. The risk factors identified may help radiologists suggest the possibility of arterial injury and prioritize neurointerventional consultation and potential DSA studies.

Factors Influencing Running-Related Musculoskeletal Injury Risk Among U.S. Military Recruits.

PubMed

Molloy, Joseph M

2016-06-01

Running-related musculoskeletal injuries among U.S. military recruits negatively impact military readiness. Low aerobic fitness, prior injury, and weekly running distance are known risk factors. Physical fitness screening and remedial physical training (or discharging the most poorly fit recruits) before entry-level military training have tended to reduce injury rates while decreasing attrition, training, and medical costs. Incorporating anaerobic running sessions into training programs can offset decreased weekly running distance and decrease injury risk. Varying lower extremity loading patterns, stride length or cadence manipulation, and hip stability/strengthening programming may further decrease injury risk. No footstrike pattern is ideal for all runners; transitioning to forefoot striking may reduce risk for hip, knee, or tibial injuries, but increase risk for calf, Achilles, foot or ankle injuries. Minimal evidence associates running surfaces with injury risk. Footwear interventions should focus on proper fit and comfort; the evidence does not support running shoe prescription per foot type to reduce injury risk among recruits. Primary injury mitigation efforts should focus on physical fitness screening, remedial physical training (or discharge for unfit recruits), and continued inclusion of anaerobic running sessions to offset decreased weekly running distance. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Evaluation of injury and fatality risk in rock and ice climbing.

PubMed

Schöffl, Volker; Morrison, Audry; Schwarz, Ulrich; Schöffl, Isabelle; Küpper, Thomas

2010-08-01

Rock and ice climbing are widely considered to be 'high-risk' sporting activities that are associated with a high incidence of severe injury and even death, compared with more mainstream sports. However, objective scientific data to support this perception are questionable. Accordingly, >400 sport-specific injury studies were analysed and compared by quantifying the injury incidence and objectively grading the injury severity (using the National Advisory Committee for Aeronautics score) per 1000 hours of sporting participation. Fatalities were also analysed. The analysis revealed that fatalities occurred in all sports, but it was not always clear whether the sport itself or pre-existing health conditions contributed or caused the deaths. Bouldering (ropeless climbing to low heights), sport climbing (mostly bolt protected lead climbing with little objective danger) and indoor climbing (climbing indoors on artificial rock structures), showed a small injury rate, minor injury severity and few fatalities. As more objective/external dangers exist for alpine and ice climbing, the injury rate, injury severity and fatality were all higher. Overall, climbing sports had a lower injury incidence and severity score than many popular sports, including basketball, sailing or soccer; indoor climbing ranked the lowest in terms of injuries of all sports assessed. Nevertheless, a fatality risk remains, especially in alpine and ice climbing. In the absence of a standard definition for a 'high-risk' sport, categorizing climbing as a high-risk sport was found to be either subjective or dependent on the definition used. In conclusion, this analysis showed that retrospective data on sport-specific injuries and fatalities are not reported in a standardized manner. To improve preventative injury measures for climbing sports, it is recommended that a standardized, robust and comprehensive sport-specific scoring model should be developed to report and fully evaluate the injury risk, severity

Reliability of the Cooking Task in adults with acquired brain injury.

PubMed

Poncet, Frédérique; Swaine, Bonnie; Taillefer, Chantal; Lamoureux, Julie; Pradat-Diehl, Pascale; Chevignard, Mathilde

2015-01-01

Acquired brain injury (ABI) often leads to deficits in executive functioning (EF) responsible for severe and long-standing disabilities in daily life activities. The Cooking Task is an ecological and valid test of EF involving multi-tasking in a real environment. Given its complex scoring system, it is important to establish the tool's reliability. The objective of the study was to examine the reliability of the Cooking Task (internal consistency, inter-rater and test-retest reliability). A total of 160 patients with ABI (113 men, mean age 37 years, SD = 14.3) were tested using the Cooking Task. For test-retest reliability, patients were assessed by the same rater on two occasions (mean interval 11 days) while two raters independently and simultaneously observed and scored patients' performances to estimate inter-rater reliability. Internal consistency was high for the global scale (Cronbach α = .74). Inter-rater reliability (n = 66) for total errors was also high (ICC = .93), however the test-retest reliability (n = 11) was poor (ICC = .36). In general the Cooking Task appears to be a reliable tool. The low test-retest results were expected given the importance of EF in the performance of novel tasks.

Fall Risk Assessment Predicts Fall-Related Injury, Hip Fracture, and Head Injury in Older Adults.

PubMed

Nilsson, Martin; Eriksson, Joel; Larsson, Berit; Odén, Anders; Johansson, Helena; Lorentzon, Mattias

2016-11-01

To investigate the role of a fall risk assessment, using the Downton Fall Risk Index (DFRI), in predicting fall-related injury, fall-related head injury and hip fracture, and death, in a large cohort of older women and men residing in Sweden. Cross sectional observational study. Sweden. Older adults (mean age 82.4 ± 7.8) who had a fall risk assessment using the DFRI at baseline (N = 128,596). Information on all fall-related injuries, all fall-related head injuries and hip fractures, and all-cause mortality was collected from the Swedish Patient Register and Cause of Death Register. The predictive role of DFRI was calculated using Poisson regression models with age, sex, height, weight, and comorbidities as covariates, taking time to outcome or end of study into account. During a median follow-up of 253 days (interquartile range 90-402 days) (>80,000 patient-years), 15,299 participants had a fall-related injury, 2,864 a head injury, and 2,557 a hip fracture, and 23,307 died. High fall risk (DFRI ≥3) independently predicted fall-related injury (hazard ratio (HR) = 1.43, 95% confidence interval (CI) = 1.39-1.49), hip fracture (HR = 1.51, 95% CI =1.38-1.66), head injury (HR = 1.12, 95% CI = 1.03-1.22), and all-cause mortality (HR = 1.39, 95% CI = 1.35-1.43). DFRI more strongly predicted head injury (HR = 1.29, 95% CI = 1.21-1.36 vs HR = 1.08, 95% CI = 1.04-1.11) and hip fracture (HR = 1.41, 95% CI = 1.30-1.53 vs HR = 1.08, 95% CI = 1.05-1.11) in 70-year old men than in 90-year old women (P < .001). Fall risk assessment using DFRI independently predicts fall-related injury, fall-related head injury and hip fracture, and all-cause mortality in older men and women, indicating its clinical usefulness to identify individuals who would benefit from interventions. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

Associations between employee and manager gender: impacts on gender-specific risk of acute occupational injury in metal manufacturing.

PubMed

Kubo, Jessica T; Cullen, Mark R; Desai, Manisha; Modrek, Sepideh

2013-11-08

Prior research has shown increased risk of injury for female employees compared to male employees after controlling for job and tasks, but have not explored whether this increased risk might be moderated by manager gender. The gender of one's manager could in theory affect injury rates among male and female employees through their managers' response to an employee's psychosocial stress or through how employees differentially report injuries. Other explanations for the gender disparity in injury experience, such as ergonomic factors or differential training, are unlikely to be impacted by supervisor gender. This study seeks to explore whether an employee's manager's gender modifies the effect of employee gender with regards to risk of acute injury. A cohort of employees and managers were identified using human resources and injury management data between January 1, 2002 and December 31, 2007 for six facilities of a large US aluminum manufacturing company. Cox proportional hazards models were employed to examine the interaction between employee gender and whether the employee had female only manager(s), male only manager(s), or both male and female managers on injury risk. Manager gender category was included as a time varying covariate and reassessed for each employee at the midpoint of each year. The percentage of departments with both female and male managers increased dramatically during the study period due to corporate efforts to increase female representation in management. After adjustment for fixed effects at the facility level and shared frailty by department, manager gender category does not appear to moderate the effect of employee gender (p = 0.717). Manager category was not a significant predictor (p = 0.093) of time to first acute injury. Similarly, having at least one female manager did not modify the hazard of injury for female employees compared to males (p = 0.899) and was not a significant predictor of time to first acute injury (p�

Associations between employee and manager gender: impacts on gender-specific risk of acute occupational injury in metal manufacturing

PubMed Central

2013-01-01

Background Prior research has shown increased risk of injury for female employees compared to male employees after controlling for job and tasks, but have not explored whether this increased risk might be moderated by manager gender. The gender of one’s manager could in theory affect injury rates among male and female employees through their managers’ response to an employee’s psychosocial stress or through how employees differentially report injuries. Other explanations for the gender disparity in injury experience, such as ergonomic factors or differential training, are unlikely to be impacted by supervisor gender. This study seeks to explore whether an employee’s manager’s gender modifies the effect of employee gender with regards to risk of acute injury. Methods A cohort of employees and managers were identified using human resources and injury management data between January 1, 2002 and December 31, 2007 for six facilities of a large US aluminum manufacturing company. Cox proportional hazards models were employed to examine the interaction between employee gender and whether the employee had female only manager(s), male only manager(s), or both male and female managers on injury risk. Manager gender category was included as a time varying covariate and reassessed for each employee at the midpoint of each year. Results The percentage of departments with both female and male managers increased dramatically during the study period due to corporate efforts to increase female representation in management. After adjustment for fixed effects at the facility level and shared frailty by department, manager gender category does not appear to moderate the effect of employee gender (p = 0.717). Manager category was not a significant predictor (p = 0.093) of time to first acute injury. Similarly, having at least one female manager did not modify the hazard of injury for female employees compared to males (p = 0.899) and was not a significant predictor

Modeling the risk: innovative approaches to understand and quantify the risk of severe FB injury.

PubMed

Berchialla, Paola; Bellussi, Luisa; Castella, Annalisa; Snidero, Silvia; Passali, Desiderio; Gregori, Dario

2012-05-14

The entry of a small item into the respiratory or digestive tract is still one of the leading causes of injuries in children up to 14 years old. The aim of the paper is to provide a quantitative risk assessment analysis for identifying consumer product features which contribute to increase the risk of sustaining a severe injury. Data on foreign body injuries were collected in 28 European countries and one Pakistani hospital. A total of 7296 cases were classified according to ICD-9CM 931-935. Information about injuries included age and gender of the injured child, circumstances of the accident and foreign body features. A classification tree was set up in order to analyze the impact of the item features like volume shape and rigidity on the severity of the injury. Males are involved in severe injuries more often than females. Most severe injuries when the foreign body is localized in the ears were due to objects with volume lesser than 49 mm(3). Volume cut-off is slightly higher for foreign bodies that have been found in the nose (55 mm(3)). Objects with conforming rigidity pose children to higher risk of severe injury. The presence and supervision of an adult is crucial in reducing the risk for severe injuries both in pharynx and laryhnx and in mouth. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Risk factors for water sports-related cervical spine injuries.

PubMed

Chang, Spencer K Y; Tominaga, Gail T; Wong, Jan H; Weldon, Edward J; Kaan, Kenneth T

2006-05-01

To examine risk factors associated with water sports-related cervical spine injuries (WSCSI). A retrospective analysis of all patients admitted for WSCSI from 1993 to 1997 was performed. The severity of cervical spine injury was assessed by review of medical records and imaging studies. Mechanisms of injury and activities at the time of injury were noted to determine risk factors for cervical spine injuries caused by wave forced impacts (WFI) from activities such as bodysurfing and body boarding. These risks were compared with injuries incurred by shallow water dives (SWD). One hundred patients were analyzed (mean age, 36 years old); 89% were male, 62% were nonresidents of Hawaii, and 75% had a large build. Patients without radiographic evidence of fractures, subluxations, and/or dislocations (n = 26) were significantly older (48 versus 32 years old, p < 0.0001) with a higher rate of pre-existing cervical spine abnormalities (65% versus 15%, p < 0.0001) compared with the remainder of patients (n = 74). Seventy-seven percent of WFI involved nonresidents. The mean age of WFI patients was significantly older than patients involved in SWD (42 versus 25 years). Ninety-six percent of wave-related accidents occurred at moderately to severely rated shorebreak beaches. Wave forced impacts of the head with the ocean bottom typically occurred at moderate to severe shorebreaks, and involved inexperienced, large-build males in their 40s. Spinal stenosis and degenerative spondylosis may increase the risk of cervical spine injury associated with WFI due to the increased risk of neck hyperextension and hyperflexion impacts inherent to this activity.

Risk factors for clavicle fracture concurrent with brachial plexus injury.

PubMed

Karahanoglu, Ertugrul; Kasapoglu, Taner; Ozdemirci, Safak; Fadıloglu, Erdem; Akyol, Aysegul; Demirdag, Erhan; Yalvac, E Serdar; Kandemir, N Omer

2016-04-01

The aim of this study was to evaluate the risk factors for clavicle fracture concurrent with brachial plexus injuries. A retrospective study was conducted at a tertiary centre. The hospital records of 62,288 vaginal deliveries were evaluated retrospectively. There were 35 cases of brachial plexus injury. Of these patients, nine had brachial plexus injuries with clavicle fracture and 26 without clavicle fracture. The analysed risk factors for clavicle fracture concurrent with brachial plexus injury were gestational diabetes, labour induction and augmentation, prolonged second stage of labour, estimated foetal weight above 4000 g, birth weight above 4000 g, risky working hours, and the requirement of manoeuvres to free the impacted shoulder from behind the symphysis pubis. Labour augmentation with oxytocin increased the risk of clavicle fracture in cases of brachial plexus injury (OR 6.67; 95% CI 1.26-35.03). A birth weight higher than 4000 g also increased the risk of clavicle fracture. Risky working hours, gestational diabetes, estimated foetal weight higher than 4000 g, and requirement of shoulder dystocia manoeuvres did not increase the risk of clavicle fracture. Labour augmentation and actual birth weight higher than 4000 g were identified as risk factors for clavicle fracture in cases of brachial plexus injury.

What are the main risk factors for running-related injuries?

PubMed

Saragiotto, Bruno Tirotti; Yamato, Tiê Parma; Hespanhol Junior, Luiz Carlos; Rainbow, Michael J; Davis, Irene S; Lopes, Alexandre Dias

2014-08-01

Despite several studies that have been conducted on running injuries, the risk factors for running-related injuries are still not clear in the literature. The aim of this study was to systematically review prospective cohort studies that investigated the risk factors for running injuries in general. We conducted electronic searches without restriction of language on EMBASE (1980 to Dec 2012), PUBMED (1946 to Dec 2012), CINAHL (1988 to Dec 2012) SPORTDiscus (1977 to Dec 2012), Latin American and Caribbean Centre on Health Sciences Information (1985 to Dec 2012) and Scientific Electronic Library Online (1998 to Dec 2012) databases, using subject headings, synonyms, relevant terms and variant spellings for each database. Only prospective cohort studies investigating the risk factors for running-related musculoskeletal injuries were included in this review. Two independent reviewers screened each article and, if they did not reach a consensus, a third reviewer decided whether or not the article should be included. Year of publication, type of runners, sample size, definition of running-related musculoskeletal injury, baseline characteristics, reported risk factors and the statistical measurement of risk or protection association were extracted from the articles. A scale adapted by the authors evaluated the risk of bias of the articles. A total of 11 articles were considered eligible in this systematic review. A total of 4,671 pooled participants were analysed and 60 different predictive factors were investigated. The main risk factor reported was previous injury (last 12 months), reported in 5 of the 8 studies that investigated previous injuries as a risk factor. Only one article met the criteria for random selection of the sample and only six articles included a follow-up of 6 months or more. There was no association between gender and running injuries in most of the studies. It is possible that eligible articles for this review were published in journals that were

Risk factors for musculoskeletal injury in preprofessional dancers: a systematic review.

PubMed

Kenny, Sarah J; Whittaker, Jackie L; Emery, Carolyn A

2016-08-01

Preprofessional dancers partake in rigorous training and have high injury prevalence. Attempts to identify risk factors for dance injuries have focused on a diversity of intrinsic and extrinsic factors. To identify and evaluate the evidence examining risk factors for musculoskeletal injury in preprofessional ballet and modern dancers. Fifteen electronic databases were systematically searched to October 2015. Studies selected met a priori inclusion criteria and investigated musculoskeletal injury risk factors in preprofessional (elite adolescent, student, young adult) ballet and modern dancers. Two reviewers independently assessed the quality and level of evidence using the Downs and Black (DB) criteria and a modified Oxford Centre of Evidence-Based Medicine 2009 model, respectively. Of 1364 potentially relevant studies, 47 were included and scored. Inconsistent injury definition and methodology precluded meta-analysis. The most common modifiable risk factors investigated were anthropometrics (ie, body mass index, adiposity), joint range of motion (ie, lower extremity), dance exposure (ie, years training, exposure hours) and age. The median DB score across studies was 8/33 (range 2-16). The majority of studies were classified as level 3 evidence and few considered risk factor inter-relationships. There is some level 2 evidence that previous injury and poor psychological coping skills are associated with increased injury risk. Because of the lack of high-quality studies, consensus regarding risk factors for musculoskeletal injury in preprofessional dancers remains difficult. There is a need for injury definition consensus and high-quality prospective studies examining the multifactorial relationship between risk factors and injury in preprofessional dance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Risk of Lower Extremity Injury in a Military Cadet Population After a Supervised Injury-Prevention Program

PubMed Central

Carow, Scott D.; Haniuk, Eric M.; Cameron, Kenneth L.; Padua, Darin A.; Marshall, Stephen W.; DiStefano, Lindsay J.; de la Motte, Sarah J.; Beutler, Anthony I.; Gerber, John P.

2016-01-01

Context: Specific movement patterns have been identified as possible risk factors for noncontact lower extremity injuries. The Dynamic Integrated Movement Enhancement (DIME) was developed to modify these movement patterns to decrease injury risk. Objective: To determine if the DIME is effective for preventing lower extremity injuries in US Military Academy (USMA) cadets. Design: Cluster-randomized controlled trial. Setting: Cadet Basic Training at USMA. Patients or Other Participants: Participants were 1313 cadets (1070 men, 243 women). Intervention(s): Participants were cluster randomized to 3 groups. The active warm-up (AWU) group performed standard Army warm-up exercises. The DIME groups were assigned to a DIME cadre-supervised (DCS) group or a DIME expert-supervised (DES) group; the former consisted of cadet supervision and the latter combined cadet and health professional supervision. Groups performed exercises 3 times weekly for 6 weeks. Main Outcome Measure(s): Cumulative risk of lower extremity injury was the primary outcome. We gathered data during Cadet Basic Training and for 9 months during the subsequent academic year. Risk ratios and 95% confidence intervals (CIs) were calculated to compare groups. Results: No differences were seen between the AWU and the combined DIME (DCS and DES) groups during Cadet Basic Training or the academic year. During the academic year, lower extremity injury risk in the DES group decreased 41% (relative risk [RR] = 0.59; 95% CI = 0.38, 0.93; P = .02) compared with the DCS group; a nonsignificant 25% (RR = 0.75; 95% CI = 0.49, 1.14; P = .18) decrease occurred in the DES group compared with the AWU group. Finally, there was a nonsignificant 27% (RR = 1.27; 95% CI = 0.90, 1.78; P = .17) increase in injury risk during the academic year in the DCS group compared with the AWU group. Conclusions: We observed no differences in lower extremity injury risk between the AWU and combined DIME groups. However, the magnitude and direction

Risk Factors for Lower-Extremity Injuries Among Contemporary Dance Students.

PubMed

van Seters, Christine; van Rijn, Rogier M; van Middelkoop, Marienke; Stubbe, Janine H

2017-10-10

To determine whether student characteristics, lower-extremity kinematics, and strength are risk factors for sustaining lower-extremity injuries in preprofessional contemporary dancers. Prospective cohort study. Codarts University of the Arts. Forty-five first-year students of Bachelor Dance and Bachelor Dance Teacher. At the beginning of the academic year, the injury history (only lower-extremity) and student characteristics (age, sex, educational program) were assessed using a questionnaire. Besides, lower-extremity kinematics [single-leg squat (SLS)], strength (countermovement jump) and height and weight (body mass index) were measured during a physical performance test. Substantial lower-extremity injuries during the academic year were defined as any problems leading to moderate or severe reductions in training volume or in performance, or complete inability to participate in dance at least once during follow-up as measured with the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on Health Problems. Injuries were recorded on a monthly basis using a questionnaire. Analyses on leg-level were performed using generalized estimating equations to test the associations between substantial lower-extremity injuries and potential risk factors. The 1-year incidence of lower-extremity injuries was 82.2%. Of these, 51.4% was a substantial lower-extremity injury. Multivariate analyses identified that ankle dorsiflexion during the SLS (OR 1.25; 95% confidence interval, 1.03-1.52) was a risk factor for a substantial lower-extremity injury. The findings indicate that contemporary dance students are at high risk for lower-extremity injuries. Therefore, the identified risk factor (ankle dorsiflexion) should be considered for prevention purposes.

Do motor vehicle airbags increase risk of ocular injuries in adults?

PubMed

Lehto, Kirsti S; Sulander, Pekka O; Tervo, Timo M T

2003-06-01

This study was undertaken to evaluate the risk of eye injury in motor vehicle accidents in which airbags deploy. An attempt was made to assess the possible associations between eye injuries and eyewear in these accidents. Retrospective observational case series and literature review with analysis. We conducted a literature review of 62 case reports and articles describing 110 adult cases of eye injury after deployment of an airbag and examined two Finnish accident cohorts. The fatal accident series (FAS; fatal injuries with one or more cars involved) included 121 individuals sitting behind an airbag that deployed (65 survivors), and the Airbag study (AB; nonfatal, relatively serious accidents) included 210 individuals (survivors). The type of eye injury, eyewear, and crash dynamics were studied in each of the reviewed case reports. The fatal accident series and AB studies were analyzed to disclose the eye injuries and use of eyewear and to estimate their possible relation to deployment of airbags. Analysis of the published reports revealed that airbag-induced eye injuries were not more frequently reported among wearers of eyeglasses than among nonwearers. However, open-eye injuries were reported three times more often among eyeglass wearers (P = 0.04), whereas all injuries from airbag chemicals occurred among nonwearers. With the exception of one orbital fracture with hyphema, all eye traumas (n = 7) in the FAS and AB cohorts were mild (eyebrow laceration, lid contusion, bruising). The risk of airbag-related eye injury was 2.5% for any eye injury and 0.4% for severe eye injury. In single accidents when seat belts were used, the risks were 2.0% and 0.5%, respectively. In the accidents from the FAS data no difference was observed in the risk for eye injury between survivors in incidents involving airbag deployment and incidents not involving airbags. This risk was not found to be greater among eyeglass wearers. Despite reported cases in the literature, we found that

Methodological issues and research recommendations for mild traumatic brain injury: the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury.

PubMed

Carroll, Linda J; Cassidy, J David; Holm, Lena; Kraus, Jess; Coronado, Victor G

2004-02-01

The WHO Collaborating Centre for Neurotrauma Task Force on Mild Traumatic Brain Injury performed a comprehensive search and critical review of the literature published between 1980 and 2002 to assemble the best evidence on the epidemiology, diagnosis, prognosis and treatment of mild traumatic brain injury. Of 743 relevant studies, 313 were accepted on scientific merit and comprise our best-evidence synthesis. The current literature on mild traumatic brain injury is of variable quality and we report the most common methodological flaws. We make recommendations for avoiding the shortcomings evident in much of the current literature and identify topic areas in urgent need of further research. This includes the need for large, well-designed studies to support evidence-based guidelines for emergency room triage of children with mild traumatic brain injury and to explore more fully the issue of prognosis after mild traumatic brain injury in the elderly population. We also advocate use of standard criteria for defining mild traumatic brain injury and propose a definition.

Risk factors that predict severe injuries in university rugby sevens players.

PubMed

Mirsafaei Rizi, Rezvan; Yeung, Simon S; Stewart, Nathan J; Yeung, Ella W

2017-07-01

To investigate injury incidence and the influence of physical fitness parameters on the risk of severe injuries in players on rugby sevens university teams. Prospective cohort study. Rugby players from three universities (N=104; 90M:14F; 20.6±1.9years) were recruited before the beginning of the season. Players underwent pre-season assessments of power, strength, speed, agility, endurance, stability, and flexibility. Throughout the season, rugby-related injury and exposure data were collected. Potential predictor variables were analyzed using Cox proportional regression model to identify risk factors associated with severe injuries (time loss>28days). Thirty-one injuries occurred during the rugby season. The match and training injury incidence rates were 59.3 injuries and 3.3 injuries per 1000 player-hours, respectively. Lower limb injuries were most common and most severe. The ankle joint was the most prevalent site of injury, and ligamentous injury was most common (48.4%). Nine severe injuries were sustained resulting in an average time loss of 51.3±14.6days. Female (hazard ratio [HR]=8.35; 95% confidence intervals [CI]=2.01-34.8), slower (HR=3.51; 95% CI=1.17-10.5), and less agile (HR=2.22; 95% CI=1.26-3.92) players as well as those with hip flexors tightness (HR=1.12; 95% CI=1.00-1.25) were at significantly greater risk for sustaining severe injuries. Limited studies are available on risk factors associated with amateur rugby players in the Sevens version. The development of gender-specific injury prevention measures that emphasize speed and agility training, and improve hip flexor extensibility may be important to reduce the risk of severe injuries. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Influence of Injury Risk Thresholds on the Performance of an Algorithm to Predict Crashes with Serious Injuries

PubMed Central

Bahouth, George; Digges, Kennerly; Schulman, Carl

2012-01-01

This paper presents methods to estimate crash injury risk based on crash characteristics captured by some passenger vehicles equipped with Advanced Automatic Crash Notification technology. The resulting injury risk estimates could be used within an algorithm to optimize rescue care. Regression analysis was applied to the National Automotive Sampling System / Crashworthiness Data System (NASS/CDS) to determine how variations in a specific injury risk threshold would influence the accuracy of predicting crashes with serious injuries. The recommended thresholds for classifying crashes with severe injuries are 0.10 for frontal crashes and 0.05 for side crashes. The regression analysis of NASS/CDS indicates that these thresholds will provide sensitivity above 0.67 while maintaining a positive predictive value in the range of 0.20. PMID:23169132

Risk of injury for occupants of motor vehicle collisions from unbelted occupants.

PubMed

MacLennan, P A; McGwin, G; Metzger, J; Moran, S G; Rue, L W

2004-12-01

Unbelted occupants may increase the risk of injury for other occupants in a motor vehicle collision (MVC). This study evaluated the association between occupant restraint use and the risk of injury (including death) to other vehicle occupants. A population based cohort study. United States. MVC occupants (n = 152 191 unweighted, n = 18 426 684 weighted) seated between a belted or unbelted occupant and the line of the principal direction of force in frontal, lateral, and rear MVCs were sampled from the 1991-2002 National Automotive Sampling System General Estimates System. Offset MVCs were not included in the study. Risk ratios and 95% confidence intervals for injury (including death) for occupants seated contiguous to unbelted occupants compared to occupants seated contiguous to belted occupants. Risk ratios were adjusted for at risk occupant's sex, age, seating position, vehicle type, collision type, travel speed, crash severity, and at risk occupants' own seat belt use. Exposure to unbelted occupants was associated with a 40% increased risk of any injury. Belted at risk occupants were at a 90% increased risk of injury but unbelted occupants were not at increased risk. Risks were similar for non-incapacitating and capacitating injuries. There was a 4.8-fold increased risk of death for exposed belted occupants but no increased risk of death for unbelted occupants. Belted occupants are at an increased risk of injury and death in the event of a MVC from unbelted occupants.

Risk factors for acute nerve injury after total knee arthroplasty.

PubMed

Shetty, Teena; Nguyen, Joseph T; Sasaki, Mayu; Wu, Anita; Bogner, Eric; Burge, Alissa; Cogsil, Taylor; Dalal, Aashka; Halvorsen, Kristin; Cummings, Kelianne; Su, Edwin P; Lyman, Stephen

2018-06-01

In this we study identified potential risk factors for post-total knee arthroplasty (TKA) nerve injury, a catastrophic complication with a reported incidence of 0.3%-1.3%. Patients who developed post-TKA nerve injury from 1998 to 2013 were identified, and each was matched with 2 controls. A multivariable logistic regression model was built to calculate odds ratios (ORs). Sixty-five nerve injury cases were identified in 39,990 TKAs (0.16%). Females (OR 3.28, P = 0.003) and patients with history of lumbar pathology (OR 6.12, P = 0.026) were associated with increased risk of nerve injury. Tourniquet pressure < 300 mm Hg and longer duration of anesthesia may also be risk factors. Surgical planning for females and patients with lumbar pathology should be modified to mitigate their higher risk of neurologic complications after TKA. Our finding that lower tourniquet pressure was associated with higher risk of nerve injury was unexpected and requires further investigation. Muscle Nerve 57: 946-950, 2018. © 2017 Wiley Periodicals, Inc.

Civil engineering airman at increased risk for injuries and injury-related musculoskeletal disorders.

PubMed

Webb, Timothy S; Wells, Timothy S

2011-03-01

With the advent of electronic records, the opportunity to conduct research on workplace-related injuries and musculoskeletal disorders has increased dramatically. The purpose of this study was to examine the United States Air Force Civil Engineering career field to determine if they are negatively impacted by their work environment. Specifically, the objective of this study was to determine if enlisted Civil Engineering Airmen (n = 25,385) were at increased risk for injury or injury-related musculoskeletal disorders compared to enlisted Information Management/Communications Airmen (n = 28,947). Using an historical prospective design, electronic data were assembled and analyzed using Cox's proportional hazards modeling. Models were stratified by gender and adjusted for race/ethnicity, marital status, birth year, and deployment status. Male Civil Engineers were observed to be at greater risk for both inpatient injury-related musculoskeletal disorders (HR = 1.86; 95% CI = 1.54-2.26) and injuries (HR = 1.77; 95% CI = 1.48-2.11), while female Civil Engineers were more than double the risk for both inpatient injury-related musculoskeletal disorders (HR = 2.18; 95% CI = 1.28-3.73) and injuries (HR = 2.22; 95% CI = 1.27-3.88) compared to Information Management/Communications Airmen. Although analyses do not allow exploration of specific causes, they highlight the utility of using electronic data to identify occupations for further evaluation. Based on these results, additional resources were allocated to survey Civil Engineers on their physical work demands and job requirements to identify key problem areas for further study and mitigation. Copyright © 2010 Wiley-Liss, Inc.

Cortical Thickness Changes and Their Relationship to Dual-Task Performance following Mild Traumatic Brain Injury in Youth.

PubMed

Urban, Karolina J; Riggs, Lily; Wells, Greg D; Keightley, Michelle; Chen, Jen-Kai; Ptito, Alain; Fait, Philippe; Taha, Tim; Sinopoli, Katia J

2017-02-15

Mild traumatic brain injury (mTBI) is common in youth, especially in those who participate in sport. Recent investigations from our group have shown that asymptomatic children and adolescents with mTBI continue to exhibit alterations in neural activity and cognitive performance compared with those without a history of mTBI. This is an intriguing finding, given that current return-to-learn and return-to-play protocols rely predominately on subjective symptom reports, which may not be sensitive enough to detect subtle injury-related changes. As a result, youth may be at greater risk for re-injury and long-term consequences if they are cleared for activity while their brains continue to be compromised. It is currently unknown whether mTBI also affects brain microstructure in the developing brain, particularly cortical thickness, and whether such changes are also related to cognitive performance. The present study examined cortical thickness in 13 asymptomatic youth (10-14 years old) who had sustained an mTBI 3-8 months prior to testing compared with 14 age-matched typically developing controls. Cortical thickness was also examined in relation to working memory performance during single and dual task paradigms. The results show that youth who had sustained an mTBI had thinner cortices in the left dorsolateral prefrontal region and right anterior and posterior inferior parietal lobes. Additionally, cortical thinning was associated with slower reaction time during the dual-task condition in the injured youth only. The results also point to a possible relationship between functional and structural alterations as a result of mTBI in youth, and lend evidence for neural changes beyond symptom resolution.

Lateral automobile impacts and the risk of traumatic brain injury.

PubMed

Bazarian, Jeffrey J; Fisher, Susan Gross; Flesher, William; Lillis, Robert; Knox, Kerry L; Pearson, Thomas A

2004-08-01

We determine the relative risk and severity of traumatic brain injury among occupants of lateral impacts compared with occupants of nonlateral impacts. This was a secondary analysis of the National Highway Traffic Safety Administration's National Automotive Sampling System, Crashworthiness Data Systems for 2000. Analysis was restricted to occupants of vehicles in which at least 1 person experienced an injury with Abbreviated Injury Scale score greater than 2. Traumatic brain injury was defined as an injury to the head or skull with an Abbreviated Injury Scale score greater than 2. Outcomes were analyzed using the chi2 test and multivariate logistic regression, with adjustment of variance to account for weighted probability sampling. Of the 1,115 occupants available for analysis, impact direction was lateral for 230 (18.42%) occupants and nonlateral for 885 (81.58%) occupants. One hundred eighty-seven (16.07%) occupants experienced a traumatic brain injury, 14.63% after lateral and 16.39% after nonlateral impact. The unadjusted relative risk of traumatic brain injury after lateral impact was 0.89 (95% confidence interval [CI] 0.51 to 1.56). After adjusting for several important crash-related variables, the relative risk of traumatic brain injury was 2.60 (95% CI 1.1 to 6.0). Traumatic brain injuries were more severe after lateral impact according to Abbreviated Injury Scale and Glasgow Coma Scale scores. The proportion of fatal or critical crash-related traumatic brain injuries attributable to lateral impact was 23.5%. Lateral impact is an important independent risk factor for the development of traumatic brain injury after a serious motor vehicle crash. Traumatic brain injuries incurred after lateral impact are more severe than those resulting from nonlateral impact. Vehicle modifications that increase head protection could reduce crash-related severe traumatic brain injuries by up to 61% and prevent up to 2,230 fatal or critical traumatic brain injuries each year

Blunt cerebrovascular injuries in severe traumatic brain injury: incidence, risk factors, and evolution.

PubMed

Esnault, Pierre; Cardinale, Mickaël; Boret, Henry; D'Aranda, Erwan; Montcriol, Ambroise; Bordes, Julien; Prunet, Bertrand; Joubert, Christophe; Dagain, Arnaud; Goutorbe, Philippe; Kaiser, Eric; Meaudre, Eric

2017-07-01

OBJECTIVE Blunt cerebrovascular injuries (BCVIs) affect approximately 1% of patients with blunt trauma. An antithrombotic or anticoagulation therapy is recommended to prevent the occurrence or recurrence of neurovascular events. This treatment has to be carefully considered after severe traumatic brain injury (TBI), due to the risk of intracranial hemorrhage expansion. Thus, the physician in charge of the patient is confronted with a hemorrhagic and ischemic risk. The main objective of this study was to determine the incidence of BCVI after severe TBI. METHODS The authors conducted a prospective, observational, single-center study including all patients with severe TBI admitted in the trauma center. Diagnosis of BCVI was performed using a 64-channel multidetector CT. Characteristics of the patients, CT scan results, and outcomes were collected. A multivariate logistic regression model was developed to determine the risk factors of BCVI. Patients in whom BCVI was diagnosed were treated with systemic anticoagulation. RESULTS In total, 228 patients with severe TBI who were treated over a period of 7 years were included. The incidence of BCVI was 9.2%. The main risk factors were as follows: motorcycle crash (OR 8.2, 95% CI 1.9-34.8), fracture involving the carotid canal (OR 11.7, 95% CI 1.7-80.9), cervical spine injury (OR 13.5, 95% CI 3.1-59.4), thoracic trauma (OR 7.3, 95% CI 1.1-51.2), and hepatic lesion (OR 13.3, 95% CI 2.1-84.5). Among survivors, 82% of patients with BCVI received systemic anticoagulation therapy, beginning at a median of Day 1.5. The overall stroke rate was 19%. One patient had an intracranial hemorrhagic complication. CONCLUSIONS Blunt cerebrovascular injuries are frequent after severe TBI (incidence 9.2%). The main risk factors are high-velocity lesions and injuries near cervical arteries.

Does employee resistance during a robbery increase the risk of customer injury?

PubMed

Yau, Rebecca K; Casteel, Carri; Nocera, Maryalice; Bishop, Stephanie F; Peek-Asa, Corinne

2015-04-01

Retail business robberies can lead to employee and customer injury. Previous work demonstrates that employee resistance increases employee injury risk; limited research has investigated customer injuries. This study examines associations between employee resistance against perpetrators and the risk of customer injury. Retail and service robbery reports were obtained from a metropolitan police department. Generalized estimating equations estimated risk ratios and 95% confidence intervals (CIs). Customers were injured in 75 out of 697 robberies. Employees resisted the perpetrator in 32 out of 697 robberies. Customers had higher injury risk when employees resisted the perpetrator, compared with robberies where employees did not resist (adjusted risk ratio [95% CI], 2.6 [1.5 to 4.5]). Employee resistance against a perpetrator during a robbery increased customer injury risk. Businesses can train employees to not resist during a robbery, providing benefits for both customers and the business itself.

Adult Reconstructive Surgery: A High-Risk Profession for Work-Related Injuries.

PubMed

Alqahtani, Saad M; Alzahrani, Mohammad M; Tanzer, Michael

2016-06-01

Adult reconstructive surgery is an orthopedic subspecialty characterized by surgical tasks that are physical, repetitive, and require some degree of stamina from the surgeon. This can result strain and/or injury of the surgeon's musculoskeletal system. This study investigates the prevalence of work-related injuries among arthroplasty surgeons. A modified version of the physical discomfort survey was sent to surgeon members of the Hip Society, the International Hip Society, and the Canadian Orthopedic Arthroplasty via email. One hundred and eighty-three surgeons completed the survey. Overall, 66.1% of the arthroplasty surgeons reported that they had experienced a work-related injury. The most common injuries that occurred were low back pain (28%), lateral epicondylitis of the elbow (14%), shoulder tendonitis (14%), lumbar disc herniation (13%), and wrist arthritis (12%). Overall, 27% of surgeons took time off from work because of the injury. As the number of disorders diagnosed increased, there was a significant increase in the incidence of requiring time off work because of the disorder (P < .001) and also exacerbation of a previously diagnosed disorder (P < .01). Factors that significantly increased the risk of the surgeon requiring time off because of the disorder were age >55 years, practicing for more than >20 years, and performing >100 total hip arthroplasty procedures per year (P < .05). In addition, 31% of the orthopedic surgeons surveyed required surgery for their injury. Although most studies concentrate on the importance of patient safety and thus the quality of the health care system, the surgeon's safety is also considered an integral part of this system's quality. This study highlights a high prevalence of musculoskeletal work-related injuries among arthroplasty surgeons and indicates the need for the identification of preventive measures directed toward improving the operative surgical environment and work ergonomics for the surgeons. Copyright �

Risk Factors for Anterior Cruciate Ligament Injury in Competitive Adolescent Alpine Skiers

PubMed Central

Westin, Maria; Harringe, Marita L.; Engström, Björn; Alricsson, Marie; Werner, Suzanne

2018-01-01

Background: There is a high risk for anterior cruciate ligament (ACL) injuries in alpine skiers. To reduce or try to prevent these injuries, intrinsic and extrinsic risk factors need to be identified. Purpose: To identify possible intrinsic and extrinsic ACL injury risk factors among competitive adolescent alpine skiers. Study Design: Case-control study; Level of evidence, 3. Methods: Between 2006 and 2009, a cohort of 339 alpine ski students (176 male, 163 female) from Swedish ski high schools were prospectively observed in terms of ACL injuries. First-time ACL injuries were recorded. In September, prior to each ski season, the skiers were clinically examined according to a specific knee protocol. Results: Overall, 11 male and 14 female skiers sustained a total of 25 first-episode ACL injuries. The majority of injuries occurred in the left knee (P < .05). Skiers who had participated in alpine skiing for >13 years (hazard ratio, 0.83; 95% CI, 0.68-1.00; P < .05) had a reduced risk of sustaining an ACL injury. Eighteen ACL injuries occurred during training, 12 in the technical discipline of giant slalom, and 8 in slalom. Fourteen skiers reported not to be fatigued at all at the time of injury, and 8 skiers reported that they were somewhat fatigued. Conclusion: ACL injuries occurred more often in the left knee than the right. This should be taken into consideration in the design of ACL injury prevention programs. Those who reported a higher number of active years in alpine skiing showed a reduced risk of sustaining an ACL injury. No other factor among those studied could be identified as an independent risk factor for ACL injury. PMID:29780835

Brief report: Behavioral risk factors for youth soccer (football) injury.

PubMed

Schwebel, David C; Banaszek, Mark M; McDaniel, McCall

2007-05-01

By most reports, soccer (football) is among the most played and most popular sports in the world. This study prospectively examined behavioral risk factors for youth soccer injury. Sixty 11- and 12-year-old boys who played on six teams in a suburban recreational soccer league were followed over the course of a season. Six predictors were assessed prior to the start of the season via self-report measures from coaches, parents, and the players themselves: inhibition, aggression, risk-taking, skill, experience playing soccer, and physical size. All games were videotaped, and tapes were reviewed to record players' collisions with other players, fouls, falls during the course of play, and injuries. Greater skill and less experience playing soccer best predicted injury risk. Inhibition, aggression, and risk-taking did not emerge as predictors. Results are discussed with respect to previous research in youth sport and general pediatric injury risk.

Mitigating Sports Injury Risks Using Internet of Things and Analytics Approaches.

PubMed

Wilkerson, Gary B; Gupta, Ashish; Colston, Marisa A

2018-03-12

Sport injuries restrict participation, impose a substantial economic burden, and can have persisting adverse effects on health-related quality of life. The effective use of Internet of Things (IoT), when combined with analytics approaches, can improve player safety through identification of injury risk factors that can be addressed by targeted risk reduction training activities. Use of IoT devices can facilitate highly efficient quantification of relevant functional capabilities prior to sport participation, which could substantially advance the prevailing sport injury management paradigm. This study introduces a framework for using sensor-derived IoT data to supplement other data for objective estimation of each individual college football player's level of injury risk, which is an approach to injury prevention that has not been previously reported. A cohort of 45 NCAA Division I-FCS college players provided data in the form of self-ratings of persisting effects of previous injuries and single-leg postural stability test. Instantaneous change in body mass acceleration (jerk) during the test was quantified by a smartphone accelerometer, with data wirelessly transmitted to a secure cloud server. Injuries sustained from the beginning of practice sessions until the end of the 13-game season were documented, along with the number of games played by each athlete over the course of a 13-game season. Results demonstrate a strong prediction model. Our approach may have strong relevance to the estimation of injury risk for other physically demanding activities. Clearly, there is great potential for improvement of injury prevention initiatives through identification of individual athletes who possess elevated injury risk and targeted interventions. © 2018 Society for Risk Analysis.

Injury Risk for Rear-Seated Occupants in Small Overlap Crashes

PubMed Central

Arbogast, Kristy B.; Locey, Caitlin M.; Hammond, Rachel; Belwadi, Aditya

2013-01-01

Small overlap crashes, where the primary crash engagement is outboard from the longitudinal energy absorbing structures of the vehicle, have received recent interest as a crash dynamic that results in high likelihood of injury. Previous analyses of good performing vehicles showed that 24% of crashes with AIS 3+ injuries to front seat occupants were small overlap crashes. However, similar evaluations have not been conducted for those rear seated. Vehicle dynamics suggest that rear seat occupants may be at greater risk due to lack of lateral seating support and a steering wheel to hold, making them more sensitive to lateral movement seen in these crashes. Thus, the objective was to calculate injury risk for rear-seated occupants in small overlap collisions. AIS 2+ and AIS 3+ injury risk was calculated from NASS-CDS data from 2000–2011. Inclusion criteria were vehicles of model year 2000 or later, with CDC codes of “FL” or “FR”, and an occupant in the second or third row. AIS2+ injury risk was 5.1%, and AIS3+ injury risk was 2.4%. Of note, half of the occupants were <15 years of age indicating rear seat protection should emphasize the young. Occupants seated near side were nearly three times as likely to sustain an AIS2+ injury than occupants seated far side. Particular attention should be paid to the prominence of head injuries in this crash dynamic and consideration given to their mitigation. Additional research should determine whether countermeasures being implemented for front seat occupants can be beneficial to rear seat occupants. PMID:24406964

Association between ambient noise exposure, hearing acuity, and risk of acute occupational injury

PubMed Central

Cantley, Linda F; Galusha, Deron; Cullen, Mark R; Dixon-Ernst, Christine; Rabinowitz, Peter M; Neitzel, Richard L

2015-01-01

Objective This study aimed to examine the associations between acute workplace injury risk, ambient noise exposure, and hearing acuity, adjusting for reported hearing protection use. Methods In a cohort of 9220 aluminum manufacturing workers studied over six years (33 300 person-years, 13 323 person-jobs), multivariate mixed effects models were used to estimate relative risk (RR) of all injuries as well as serious injuries by noise exposure category and hearing threshold level (HTL) adjusting for recognized and potential confounders. Results Compared to noise <82 dBA, higher exposure was associated with elevated risk in a monotonic and statistically significant exposure–response pattern for all injuries and serious injuries with higher risk estimates observed for serious injuries [82–84.99 dBA: RR 1.26, 95% confidence interval (95% CI) 0.96–1.64; 85–87.99 dBA: RR 1.39, 95% CI 1.05–1.85; ≥88 dBA: RR 2.29, 95% CI 1.52–3.47]. Hearing loss was associated with increased risk for all injuries, but was not a significant predictor of risk for the subset of more serious injuries. Compared to those without hearing loss, workers with HTL ≥25 dB had 21% increased all injury risk (RR 1.21, 95% CI 1.09–1.33) while those with HTL 10–24.99 dB had 6% increased risk (RR 1.06, 95% CI 1.00–1.13). Reported hearing protection type did not predict injury risk. Conclusion Noise exposure levels as low as 85 dBA may increase workplace injury risk. HTL was associated with increased risk for all, but not the subset of serious, injuries. Additional study is needed both to confirm the observed associations and explore causal pathways. PMID:25137556

Real-time biofeedback to target risk of anterior cruciate ligament injury: a technical report for injury prevention and rehabilitation.

PubMed

Ford, Kevin R; DiCesare, Christopher A; Myer, Gregory D; Hewett, Timothy E

2015-05-20

Biofeedback training enables an athlete to alter biomechanical and physiological function by receiving biomechanical and physiological data concurrent with or immediately after a task. To compare the effects of 2 different modes of real-time biofeedback focused on reducing risk factors related to anterior cruciate ligament injury. Randomized crossover study design. Biomechanics laboratory and sports medicine center. Female high school soccer players (age 14.8 ± 1.0 y, height 162.6 ± 6.8 cm, mass 55.9 ± 7.0 kg; n = 4). A battery of kinetic- or kinematic-based real-time biofeedback during repetitive double-leg squats. Baseline and posttraining drop vertical jumps were collected to determine if either feedback method improved high injury risk landing mechanics. Maximum knee abduction moment and angle during the landing was significantly decreased after kinetic-focused biofeedback (P = .04). The reduced knee abduction moment during the drop vertical jumps after kinematic-focused biofeedback was not different (P = .2). Maximum knee abduction angle was significantly decreased after kinetic biofeedback (P < .01) but only showed a trend toward reduction after kinematic biofeedback (P = .08). The innovative biofeedback employed in the current study reduced knee abduction load and posture from baseline to posttraining during a drop vertical jump.

[Occupational injury risk in the shoe industry: frequency, types of injuries and equipment involved, improvement interventions].

PubMed

Tognon, Ilaria Desirée

2012-01-01

The aim of the work has been to evaluate the risk of injuries connected to the use of machinery and work tools in the footwear industry. The analysis of the data related to injuries in the footwear industry, deduced from the registers of injuries collected in the investigated factories, shows that most accidents arise from the contact of the operator's hands with tools and machinery parts during their use. Risk factors generally include the inherent specific danger of some work tools and machines, the lack or inadequacy of safety devices, the obsolescence of the equipment, the imprudence and underestimation of risk.

Examining Measures of Weight as Risk Factors for Sport-Related Injury in Adolescents

PubMed Central

Nettel-Aguirre, Alberto; Doyle-Baker, Patricia K.; Macpherson, Alison; Emery, Carolyn A.

2016-01-01

Objectives. To examine body mass index (BMI) and waist circumference (WC) as risk factors for sport injury in adolescents. Design. A secondary analysis of prospectively collected data from a pilot cluster randomized controlled trial. Methods. Adolescents (n = 1,040) at the ages of 11–15 years from two Calgary junior high schools were included. BMI (kg/m2) and WC (cm) were measured from direct measures at baseline assessment. Categories (overweight/obese) were created using validated international (BMI) and national (WC) cut-off points. A Poisson regression analysis controlling for relevant covariates (sex, previous injury, sport participation, intervention group, and aerobic fitness level) estimated the risk of sport injury [incidence rate ratios (IRR) with 95% confidence intervals (CI)]. Results. There was an increased risk of time loss injury (IRR = 2.82, 95% CI: 1.01–8.04) and knee injury (IRR = 2.07, 95% CI: 1.00–6.94) in adolescents that were overweight/obese; however, increases in injury risk for all injury and lower extremity injury were not statistically significant. Estimates suggested a greater risk of time loss injury [IRR = 1.63 (95% CI: 0.93–2.47)] in adolescents with high measures of WC. Conclusions. There is an increased risk of time loss injury and knee injury in overweight/obese adolescents. Sport injury prevention training programs should include strategies that target all known risk factors for injury. PMID:27525304

Injury Risk Functions in Frontal Impacts Using Data from Crash Pulse Recorders

PubMed Central

Stigson, Helena; Kullgren, Anders; Rosén, Erik

2012-01-01

Knowledge of how crash severity influences injury risk in car crashes is essential in order to create a safe road transport system. Analyses of real-world crashes increase the ability to obtain such knowledge. The aim of this study was to present injury risk functions based on real-world frontal crashes where crash severity was measured with on-board crash pulse recorders. Results from 489 frontal car crashes (26 models of four car makes) with recorded acceleration-time history were analysed. Injury risk functions for restrained front seat occupants were generated for maximum AIS value of two or greater (MAIS2+) using multiple logistic regression. Analytical as well as empirical injury risk was plotted for several crash severity parameters; change of velocity, mean acceleration and peak acceleration. In addition to crash severity, the influence of occupant age and gender was investigated. A strong dependence between injury risk and crash severity was found. The risk curves reflect that small changes in crash severity may have a considerable influence on the risk of injury. Mean acceleration, followed by change of velocity, was found to be the single variable that best explained the risk of being injured (MAIS2+) in a crash. Furthermore, all three crash severity parameters were found to predict injury better than age and gender. However, age was an important factor. The very best model describing MAIS2+ injury risk included delta V supplemented by an interaction term of peak acceleration and age. PMID:23169136

Risk of injury for occupants of motor vehicle collisions from unbelted occupants

PubMed Central

MacLennan, P; McGwin, G; Metzger, J; Moran, S; Rue, L

2004-01-01

Objective: Unbelted occupants may increase the risk of injury for other occupants in a motor vehicle collision (MVC). This study evaluated the association between occupant restraint use and the risk of injury (including death) to other vehicle occupants. Design: A population based cohort study. Setting: United States. Subjects: MVC occupants (n = 152 191 unweighted, n = 18 426 684 weighted) seated between a belted or unbelted occupant and the line of the principal direction of force in frontal, lateral, and rear MVCs were sampled from the 1991–2002 National Automotive Sampling System General Estimates System. Offset MVCs were not included in the study. Main outcome measure: Risk ratios and 95% confidence intervals for injury (including death) for occupants seated contiguous to unbelted occupants compared to occupants seated contiguous to belted occupants. Risk ratios were adjusted for at risk occupant's sex, age, seating position, vehicle type, collision type, travel speed, crash severity, and at risk occupants' own seat belt use. Results: Exposure to unbelted occupants was associated with a 40% increased risk of any injury. Belted at risk occupants were at a 90% increased risk of injury but unbelted occupants were not at increased risk. Risks were similar for non-incapacitating and capacitating injuries. There was a 4.8-fold increased risk of death for exposed belted occupants but no increased risk of death for unbelted occupants. Conclusions: Belted occupants are at an increased risk of injury and death in the event of a MVC from unbelted occupants. PMID:15583258

Injuries in Runners; A Systematic Review on Risk Factors and Sex Differences

PubMed Central

van der Worp, Maarten P.; ten Haaf, Dominique S. M.; van Cingel, Robert; de Wijer, Anton; Nijhuis-van der Sanden, Maria W. G.; Staal, J. Bart

2015-01-01

Background The popularity of running continues to increase, which means that the incidence of running-related injuries will probably also continue to increase. Little is known about risk factors for running injuries and whether they are sex-specific. Objectives The aim of this study was to review information about risk factors and sex-specific differences for running-induced injuries in adults. Search Strategy The databases PubMed, EMBASE, CINAHL and Psych-INFO were searched for relevant articles. Selection Criteria Longitudinal cohort studies with a minimal follow-up of 1 month that investigated the association between risk factors (personal factors, running/training factors and/or health and lifestyle factors) and the occurrence of lower limb injuries in runners were included. Data Collection and Analysis Two reviewers’ independently selected relevant articles from those identified by the systematic search and assessed the risk of bias of the included studies. The strength of the evidence was determined using a best-evidence rating system. Sex differences in risk were determined by calculating the sex ratio for risk factors (the risk factor for women divided by the risk factor for men). Main Results Of 400 articles retrieved, 15 longitudinal studies were included, of which 11 were considered high-quality studies and 4 moderate-quality studies. Overall, women were at lower risk than men for sustaining running-related injuries. Strong and moderate evidence was found that a history of previous injury and of having used orthotics/inserts was associated with an increased risk of running injuries. Age, previous sports activity, running on a concrete surface, participating in a marathon, weekly running distance (30–39 miles) and wearing running shoes for 4 to 6 months were associated with a greater risk of injury in women than in men. A history of previous injuries, having a running experience of 0–2 years, restarting running, weekly running distance (20–29

Risk factors for injury among construction workers at Denver International Airport.

PubMed

Lowery, J T; Borgerding, J A; Zhen, B; Glazner, J E; Bondy, J; Kreiss, K

1998-08-01

The Denver International Airport construction project provided a rare opportunity to identify risk factors for injury on a large construction project for which 769 contractors were hired to complete 2,843 construction contracts. Workers' compensation claims and payroll data for individual contracts were recorded in an administrative database developed by the project's Owner-Controlled Insurance Program. From claims andy payroll data linked with employee demographic information, we calculated injury rates per 200,000 person-hours by contract and over contract characteristics of interest. We used Poisson regression models to examine contract-specific risk factors in relation to total injuries, lost-work-time (LWT), and non-LWT injuries. We included contract-specific expected loss rates (ELRs) in the model to control for prevailing risk of work and used logistic regression methods to determine the association between LWT and non-LWT injuries on contracts. Injury rates were highest during the first year of construction, at the beginning of contracts, and among older workers. Risk for total and non-LWT injuries was elevated for building construction contracts, contract for special trades companies (SIC 17), contracts with payrolls over $1 million, and those with overtime payrolls greater than 20%. Risk for LWT injuries only was increased for site development contracts and contract starting in the first year of construction. Contracts experiencing one or more minor injuries were four times as likely to have at least one major injury (OR = 4.0, 95% CI (2.9, 5.5)). Enhancement of DIA's safety infrastructure during the second year of construction appears to have been effective in reducing serious (LWT) injures. The absence of correlation between injury rates among contracts belonging to the same company suggest that targeting of safety resources at the level of the contract may be an effective approach to injury prevention. Interventions focused on high-risk contracts

Injury, illness, and disability risk in American seafarers.

PubMed

Lefkowitz, Rafael Y; Slade, Martin D; Redlich, Carrie A

2018-02-01

Seafarers are an understudied and essential workforce, isolated from medical care. This study describes injuries, illness, and risk factors for resultant disability in one shipping company with a majority of American seafarers. The study used a telemedicine database of injury and illness incidence in seafarers, and applied descriptive statistical methods and logistic regression modeling. Illnesses were more frequently reported than injuries (860 vs 479). The overall injury rate was 113 per 1000 person-years, and the overall illness rate was 211 per 1000 person-years. Seafarer ratings had higher risk for disability compared to officers (OR = 1.60; 95%CI 1.17, 2.18), and incidents on dry cargo ships (OR = 2.70; 95%CI 1.49, 4.91) and articulated tug-barges (ATBs) (OR = 2.21; 95%CI 1.26, 3.86) had higher disability risk compared to container vessels. Additional research in this vital American workforce may be useful to confirm these findings forming a basis for preventive interventions. © 2017 Wiley Periodicals, Inc.

Crash injury risks for obese occupants using a matched-pair analysis.

PubMed

Viano, David C; Parenteau, Chantal S; Edwards, Mark L

2008-03-01

The automotive safety community is questioning the impact of obesity on the performance and assessment of occupant protection systems. This study investigates fatality and serious injury risks for front-seat occupants by body mass index (BMI) using a matched-pair analysis. It also develops a simple model for the change in injury risk with obesity. A simple model was developed for the change in injury risk with obesity. It included the normal mass (m) and stiffness (k) of the body resisting compression during a blunt impact. Stiffness is assumed constant as weight is gained (Delta m). For a given impact severity, the risk of injury was assumed proportional to compression. Energy balance was used to determine injury risks with increasing mass. NASS-CDS field data were analyzed for calendar years 1993-2004. Occupant injury was divided into normal (18.5 kg/m2 < or = BMI < 25.0 kg/m2) and obese (BMI > o= 30 kg/m2) categories. A matched-pair analysis was carried out. Driver and front-right passenger fatalities or serious injuries (MAIS 3+) were analyzed in the same crash to determine the effect of obesity. This also allowed the determination of the relative risk of younger (age < or = 55 years), older (age >55 years), male, and female drivers that were obese compared to normal BMI. The family of Hybrid III crash test dummies was evaluated for BMI and the amount of ballast was determined so they could represent an obese or morbidly obese occupant. Based on the simple model, the relative injury risk (r) for an increase in body mass is given by: r = (1 + Delta m / m)(0.5). For a given stature, an obese occupant (BMI = 30-35 kg/m2) has 54-61% higher risk of injury than a normal BMI occupant (22 kg/m2). Matched pairs showed that obese drivers have a 97% higher risk of fatality and 17% higher risk of serious injury (MAIS 3+) than normal BMI drivers. Obese passengers have a 32% higher fatality risk and a 40% higher MAIS 3+ risk than normal passengers. Obese female drivers have

The Functional Movement Screen and Injury Risk: Association and Predictive Value in Active Men.

PubMed

Bushman, Timothy T; Grier, Tyson L; Canham-Chervak, Michelle; Anderson, Morgan K; North, William J; Jones, Bruce H

2016-02-01

The Functional Movement Screen (FMS) is a series of 7 tests used to assess the injury risk in active populations. To determine the association of the FMS with the injury risk, assess predictive values, and identify optimal cut points using 3 injury types. Cohort study; Level of evidence, 2. Physically active male soldiers aged 18 to 57 years (N = 2476) completed the FMS. Demographic and fitness data were collected by survey. Medical record data for overuse injuries, traumatic injuries, and any injury 6 months after the FMS assessment were obtained. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated along with the receiver operating characteristic (ROC) to determine the area under the curve (AUC) and identify optimal cut points for the risk assessment. Risks, risk ratios (RRs), odds ratios (ORs), and 95% CIs were calculated to assess injury risks. Soldiers who scored ≤14 were at a greater risk for injuries compared with those who scored >14 using the composite score for overuse injuries (RR, 1.84; 95% CI, 1.63-2.09), traumatic injuries (RR, 1.26; 95% CI, 1.03-1.54), and any injury (RR, 1.60; 95% CI, 1.45-1.77). When controlling for other known injury risk factors, multivariate logistic regression analysis identified poor FMS performance (OR [score ≤14/19-21], 2.00; 95% CI, 1.42-2.81) as an independent risk factor for injuries. A cut point of ≤14 registered low measures of predictive value for all 3 injury types (sensitivity, 28%-37%; PPV, 19%-52%; AUC, 54%-61%). Shifting the injury risk cut point of ≤14 to the optimal cut points indicated by the ROC did not appreciably improve sensitivity or the PPV. Although poor FMS performance was associated with a higher risk of injuries, it displayed low sensitivity, PPV, and AUC. On the basis of these findings, the use of the FMS to screen for the injury risk is not recommended in this population because of the low predictive value and misclassification of the

Bleeding injuries in professional football: estimating the risk for HIV transmission.

PubMed

Brown, L S; Drotman, D P; Chu, A; Brown, C L; Knowlan, D

1995-02-15

To determine the risk for bleeding injuries in professional football and to estimate the risk for transmission of the human immunodeficiency virus (HIV) through such injuries. A prospective, observational study. Professional football players from 11 teams of the National Football League were observed during 155 regular season games from September through December 1992. The frequencies of bleeding injuries were calculated in association with environmental and athletic factors. Using this information, HIV prevalence, and data on transmission of HIV in other circumstances, the risk for transmission of HIV during football games was estimated. 575 bleeding injuries (average, 3.7 per game for each team) involving 538 players (average, 3.5 players on each team per game) were observed. Approximately 88% of the bleeding injuries were abrasions; the remainder were lacerations. Bleeding injuries were markedly more frequent during games played on artificial surfaces, during games played in domed stadiums, and on teams with a final win/loss percentage of 0.500 or lower. Using data on the prevalence of HIV among college men and rates of HIV transmission in the health care setting, the risk for HIV transmission to each player was estimated to be less than 1 per 85 million game contacts. Although injuries occur in professional football competitions, bleeding injuries, especially lacerations, occur infrequently. We estimate that the risk for HIV transmission during such competition is extremely remote. The role of artificial playing surfaces on the incidence or severity of bleeding injuries should be investigated.

Does additional cone beam computed tomography decrease the risk of inferior alveolar nerve injury in high-risk cases undergoing third molar surgery?Does CBCT decrease the risk of IAN injury?

PubMed

Korkmaz, Y T; Kayıpmaz, S; Senel, F C; Atasoy, K T; Gumrukcu, Z

2017-05-01

The objectives of this study were to evaluate the efficacy of additional cone beam computed tomography (CBCT) imaging on decreasing the risk of inferior alveolar nerve (IAN) injury during third molar removal in patients at high risk and to assess the surgical outcomes. The study sample included patients considered at high risk for IAN injury based on panoramic radiography (PAN) evaluation. The primary predictor was the type of imaging method (PAN only or with additional CBCT). The other variables were demographic and anatomical/radiographic factors. The primary outcome variable was IAN injury. The secondary outcome variables were the preoperative surgical plan and surgical results including IAN exposure and duration of surgery. The sample comprised 122 patients (139 teeth) aged 18-48 years. Postoperative temporary IAN injury was present in three (4.2%) cases in the CBCT group and 11 (16.4%) in the PAN group at 7 days after surgery. However, none of the patients had a permanent IAN injury at the 6-month follow-up. Additional CBCT imaging was not superior to PAN in reducing IAN injury after third molar surgery during long-term follow-up. Nonetheless, CBCT may decrease the prevalence of temporary IAN injury and improve the surgical outcomes in high-risk patients. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Physical training risk factors for musculoskeletal injury in female soldiers.

PubMed

Roy, Tanja C; Songer, Thomas; Ye, Feifei; LaPorte, Ronald; Grier, Tyson; Anderson, Morgan; Chervak, Michelle

2014-12-01

Musculoskeletal injuries (MSIs) result in the most medical encounters, lost duty days, and permanent disability. Women are at greater risk of injury than men and physical training is the leading cause of injury. The purpose of this study was to investigate the demographic, body composition, fitness, and physical training risk factors for injuries in female Soldiers serving in garrison Army units over the past 12 months. Self-report survey was collected from 625 women. The ankle was the most frequently injured body region, 13%. Running was the activity most often associated with injury, 34%. In univariate analysis lower rank, older age, history of deployment, no unit runs, weekly frequency of personal resistance training, and history of injury were all associated with injury. In multivariate analysis rank, history of injury, weekly frequency of unit runs, and weekly frequency of personal resistance training were the best combination of predictors of injury. Running once or twice a week with the unit protected against MSIs, whereas participating in personal resistance training sessions once or twice a week increased the risk of MSIs. With more emphasis on running and resistance training, the U.S. Army could reduce injuries and save billions of dollars in training and health care costs. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

A Nurse-Initiated Perioperative Pressure Injury Risk Assessment and Prevention Protocol.

PubMed

Meehan, Anita J; Beinlich, Nancy R; Hammonds, Tracy L

2016-12-01

Pressure injuries negatively affect patients physically, emotionally, and economically. Studies report that pressure injuries occur in 69% of inpatients who have undergone a surgical procedure while hospitalized. In 2012, we created a nurse-initiated, perioperative pressure injury risk assessment measure for our midwestern, urban, adult teaching hospital. We retrospectively applied the risk assessment to a random sample of 350 surgical patients which validated the measure. The prospective use of the risk assessment and prevention measures in 350 surgical patients resulted in a 60% reduction in pressure injuries compared with the retrospective group. Our findings support the use of a multipronged approach for the prevention of health care-associated pressure injuries in the surgical population, which includes assessment of risk, implementation of evidence-based prevention interventions for at-risk patients, and continuation of prevention beyond the perioperative setting to the nursing care unit. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Risk of Early Childhood Injuries in Twins and Singletons

ERIC Educational Resources Information Center

Roudsari, Bahman S.; Utter, Garth H.; Kernic, Mary A.; Mueller, Beth A.

2006-01-01

The incidence of twin births in the United States (US) has increased more than 65 per cent since 1980. However, the risk of injury to multiple-birth children is unknown. We sought to compare the risk of injury-related hospitalization and death between multiples and singletons. We conducted a retrospective cohort study using linked birth…

Risk factors for lower extremity injury: a review of the literature

PubMed Central

Murphy, D; Connolly, D; Beynnon, B

2003-01-01

Prospective studies on risk factors for lower extremity injury are reviewed. Many intrinsic and extrinsic risk factors have been implicated; however, there is little agreement with respect to the findings. Future prospective studies are needed using sufficient sample sizes of males and females, including collection of exposure data, and using established methods for identifying and classifying injury severity to conclusively determine addtional risk factors for lower extremity injury. PMID:12547739

Vehicle year and the risk of car crash injury.

PubMed

Blows, S; Ivers, R Q; Woodward, M; Connor, J; Ameratunga, S; Norton, R

2003-12-01

To quantify the association between vehicle age and risk of car crash injury. Data from a population based case-control study conducted in the Auckland region in 1998/99 was used to examine the adjusted risk of car crash injury or death due to vehicle age, after controlling for a range of known confounders. Cases were all cars involved in crashes in which at least one occupant was hospitalized or killed anywhere in the Auckland region, and controls were randomly selected cars on Auckland roads. The drivers of the 571 case vehicles and 588 control vehicles completed a structured interview. Hospitalisation or death of a vehicle occupant due to car crash injury. Vehicles constructed before 1984 had significantly greater chance of being involved in an injury crash than those constructed after 1994 (odds ratio 2.88, 95% confidence interval (CI) 1.20 to 6.91), after adjustment for potential confounders. There was also a trend for increasing crash risk with each one year increase in vehicle age after adjustment for potential confounders (odds ratio 1.05, 95% CI 0.99 to 1.11; p = 0.09). This study quantifies the increased risk of car crash injury associated with older vehicle year and confirms this as an important public health issue.

Challenges of animal models in SCI research: Effects of pre-injury task-specific training in adult rats before lesion.

PubMed

May, Zacnicte; Fouad, Karim; Shum-Siu, Alice; Magnuson, David S K

2015-09-15

A rarely explored subject in animal research is the effect of pre-injury variables on behavioral outcome post-SCI. Low reporting of such variables may underlie some discrepancies in findings between laboratories. Particularly, intensive task-specific training before a SCI might be important, considering that sports injuries are one of the leading causes of SCI. Thus, individuals with SCI often underwent rigorous training before their injuries. In the present study, we asked whether training before SCI on a grasping task or a swimming task would influence motor recovery in rats. Swim pre-training impaired recovery of swimming 2 and 4 weeks post-injury. This result fits with the idea of motor learning interference, which posits that learning something new may disrupt learning of a new task; in this case, learning strategies to compensate for functional loss after SCI. In contrast to swimming, grasp pre-training did not influence grasping ability after SCI at any time point. However, grasp pre-trained rats attempted to grasp more times than untrained rats in the first 4 weeks post-injury. Also, lesion volume of grasp pre-trained rats was greater than that of untrained rats, a finding which may be related to stress or activity. The increased participation in rehabilitative training of the pre-trained rats in the early weeks post-injury may have potentiated spontaneous plasticity in the spinal cord and counteracted the deleterious effect of interference and bigger lesions. Thus, our findings suggest that pre-training plays a significant role in recovery after CNS damage and needs to be carefully controlled for. Copyright © 2015 Elsevier B.V. All rights reserved.

Walking in School-Aged Children in a Dual-Task Paradigm Is Related to Age But Not to Cognition, Motor Behavior, Injuries, or Psychosocial Functioning

PubMed Central

Hagmann-von Arx, Priska; Manicolo, Olivia; Lemola, Sakari; Grob, Alexander

2016-01-01

Age-dependent gait characteristics and associations with cognition, motor behavior, injuries, and psychosocial functioning were investigated in 138 typically developing children aged 6.7–13.2 years (M = 10.0 years). Gait velocity, normalized velocity, and variability were measured using the walkway system GAITRite without an additional task (single task) and while performing a motor or cognitive task (dual task). Assessment of children’s cognition included tests for intelligence and executive functions; parents reported on their child’s motor behavior, injuries, and psychosocial functioning. Gait variability (an index of gait regularity) decreased with increasing age in both single- and dual-task walking. Dual-task gait decrements were stronger when children walked in the motor compared to the cognitive dual-task condition and decreased with increasing age in both dual-task conditions. Gait alterations from single- to dual-task conditions were not related to children’s cognition, motor behavior, injuries, or psychosocial functioning. PMID:27014158

Frontal plane comparison between drop jump and vertical jump: implications for the assessment of ACL risk of injury.

PubMed

Cesar, Guilherme M; Tomasevicz, Curtis L; Burnfield, Judith M

2016-11-01

The potential to use the vertical jump (VJ) to assess both athletic performance and risk of anterior cruciate ligament (ACL) injury could have widespread clinical implications since VJ is broadly used in high school, university, and professional sport settings. Although drop jump (DJ) and VJ observationally exhibit similar lower extremity mechanics, the extent to which VJ can also be used as screening tool for ACL injury risk has not been assessed. This study evaluated whether individuals exhibit similar knee joint frontal plane kinematic and kinetic patterns when performing VJs compared with DJs. Twenty-eight female collegiate athletes performed DJs and VJs. Paired t-tests indicated that peak knee valgus angles did not differ significantly between tasks (p = 0.419); however, peak knee internal adductor moments were significantly larger during the DJ vs. VJ (p < 0.001). Pearson correlations between the DJ and VJ revealed strong correlations for knee valgus angles (r = 0.93, p < 0.001) and for internal knee adductor moments (r = 0.82, p < 0.001). Our results provide grounds for investigating whether frontal plane knee mechanics during VJ can predict ACL injuries and thus can be used as an effective tool for the assessment of risk of ACL injury in female athletes.

Risk Factors for Knee Injury in Golf: A Systematic Review.

PubMed

Baker, Matthew L; Epari, Devakar R; Lorenzetti, Silvio; Sayers, Mark; Boutellier, Urs; Taylor, William R

2017-12-01

Golf is commonly considered a low-impact sport that carries little risk of injury to the knee and is generally allowed following total knee arthroplasty (TKA). Kinematic and kinetic studies of the golf swing have reported results relevant to the knee, but consensus as to the loads experienced during a swing and how the biomechanics of an individual's technique may expose the knee to risk of injury is lacking. Our objective was to establish (1) the prevalence of knee injury resulting from participation in golf and (2) the risk factors for knee injury from a biomechanical perspective, based on an improved understanding of the internal loading conditions and kinematics that occur in the knee from the time of addressing the ball to the end of the follow-through. A systematic literature search was conducted to determine the injury rate, kinematic patterns, loading, and muscle activity of the knee during golf. A knee injury prevalence of 3-18% was established among both professional and amateur players, with no clear dependence on skill level or sex; however, older players appear at greater risk of injury. Studies reporting kinematics indicate that the lead knee is exposed to a complex series of motions involving rapid extension and large magnitudes of tibial internal rotation, conditions that may pose risks to the structures of a natural knee or TKA. To date, the loads experienced by the lead knee during a golf swing have been reported inconsistently in the literature. Compressive loads ranging from 100 to 440% bodyweight have been calculated and measured using methods including inverse dynamics analysis and instrumented knee implants. Additionally, the magnitude of loading appears to be independent of the club used. This review is the first to highlight the lack of consensus regarding knee loading during the golf swing and the associated risks of injury. Results from the literature suggest the lead knee is subject to a higher magnitude of stress and more demanding

Risks and injuries in laser and high-frequency applications

NASA Astrophysics Data System (ADS)

Giering, K.; Philipp, Carsten M.; Berlien, Hans-Peter

1995-01-01

An analysis of injuries and risks using high frequency (HF) and lasers in medicine based on a literature search with MEDLINE was performed. The cases reported in the literature were classified according to the following criteria: (1) Avoidable in an optimal operational procedure. These kind of injuries are caused by a chain of unfortunate incidents. They are in principle avoidable by the 'right action at the right time' which presupposes an appropriate training of the operating team, selection of the optimal parameters for procedure and consideration of all safety instructions. (2) Avoidable, caused by malfunction of the equipment and/or accessories. The injuries classified into this group are avoidable if all safety regulations were fulfilled. This includes a pre-operational check-up and the use of medical lasers and high frequency devices only which meet the international safety standards. (3) Avoidable, caused by misuse/mistake. Injuries of this group were caused by an inappropriate selection of the procedure, wrong medical indication or mistakes during application. (4) Unavoidable, fateful. These injuries can be caused by risks inherent to the type of energy used, malfunction of the equipment and/or accessories though a pre-operational check-up was done. Some risks and complications are common to high frequency and laser application. But whereas these risks can be excluded easily in laser surgery there is often a great expenditure necessary or they are not avoidable if high frequency if used. No unavoidable risks due to laser energy occur.

Injury risk and severity in a sample of Maryland residents with serious mental illness

PubMed Central

Daumit, Gail L.; McGinty, Emma Elizabeth; Baker, Susan; Steinwachs, Donald

2013-01-01

Adults with serious mental illness experience premature mortality and heightened risk for medical disease, but little is known about the burden of injuries in this population. We conducted a retrospective cohort study of 6234 Maryland Medicaid recipients with serious mental illness from 1994–2001. Injuries were classified using the Barell Matrix. Relative risks were calculated to compare injury rates among the study cohort with injury rates in the United States population. Cox proportional hazards modeling with time dependent covariates was used to assess factors related to risk of injury and injury-related death. Forty-three percent of the Maryland Medicaid cohort had any injury diagnosis. Of the 7298 injuries incurred, the most common categories were systemic injuries due to poisoning (10.4%), open wounds to the head/face (8.9%), and superficial injuries, fractures, and sprains of the extremities (8.6%, 8.5%, and 8.4%, respectively). Injury incidence was 80% higher and risk for fatal injury was more than four and a half times higher among the cohort with serious mental illness compared to the general population. Alcohol and drug abuse were associated with both risk of injury and risk of injury-related death with hazard ratios of 1.87 and 4.76 at the P<.05 significance level, respectively. The superficial, minor nature of the majority of injuries is consistent with acts of minor victimization and violence or falls. High risk of fatal and non-fatal injury among this group indicates need for increased injury prevention efforts targeting persons with serious mental illness and their caregivers. PMID:22661205

Work environment risk factors for injuries in wood processing.

PubMed

Holcroft, Christina A; Punnett, Laura

2009-01-01

The reported injury rate for wood product manufacturing in Maine, 1987-2004, was almost twice the state-wide average for all jobs. A case-control study was conducted in wood processing plants to determine preventable risk factors for injury. A total of 157 cases with injuries reported to workers' compensation and 251 controls were interviewed. In multivariable analyses, variables associated with injury risk were high physical workload, machine-paced work or inability to take a break, lack of training, absence of a lockout/tagout program, low seniority, and male gender. Different subsets of these variables were significant when acute incidents and overexertions were analyzed separately and when all injuries were stratified by industry sub-sector. Generalizability may be limited somewhat by non-representative participation of workplaces and individuals. Nevertheless, these findings provide evidence that many workplace injuries occurring in wood processing could be prevented by application of ergonomics principles and improved work organization.

The effect of previous traumatic injury on homicide risk.

PubMed

Griffin, Russell L; Davis, Gregory G; Levitan, Emily B; MacLennan, Paul A; Redden, David T; McGwin, Gerald

2014-07-01

Research has reported that a strong risk factor for traumatic injury is having a previous injury (i.e., recidivism). To date, the only study examining the relationship between recidivism and homicide reported strong associations, but was limited by possible selection bias. The current matched case-control study utilized coroner's data from 2004 to 2008. Subjects were linked to trauma registry data to determine whether the person had a previous traumatic injury. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between homicide and recidivism. Homicide risk was increased for those having a previous traumatic injury (OR 1.81, 95% CI 1.09-2.99) or a previous intentional injury (OR 2.53, 95% CI 1.24-5.17). These results suggest an association between homicide and injury recidivism, and that trauma centers may be an effective setting for screening individuals for secondary prevention efforts of homicide through violence prevention programs. © 2014 American Academy of Forensic Sciences.

Work environment risk factors for injuries in wood processing

PubMed Central

Holcroft, Christina A.; Punnett, Laura

2018-01-01

Problem The reported injury rate for wood product manufacturing in Maine, 1987–2004, was almost twice the state-wide average for all jobs. Method A case-control study was conducted in wood processing plants to determine preventable risk factors for injury. A total of 157 cases with injuries reported to workers’ compensation and 251 controls were interviewed. Results In multivariable analyses, variables associated with injury risk were high physical workload, machine-paced work or inability to take a break, lack of training, absence of a lockout/tagout program, low seniority, and male gender. Different subsets of these variables were significant when acute incidents and overexertions were analyzed separately and when all injuries were stratified by industry sub-sector. Impact on industry Generalizability may be limited somewhat by non-representative participation of workplaces and individuals. Nevertheless, these findings provide evidence that many workplace injuries occurring in wood processing could be prevented by application of ergonomics principles and improved work organization. PMID:19778648

The effects of padded surfaces on the risk for cervical spine injury.

PubMed

Nightingale, R W; Richardson, W J; Myers, B S

1997-10-15

This is an in vitro study comparing cervical spine injuries produced in rigid head impacts and in padded head impacts. To test the hypothesis that deformable impact surfaces pose a greater risk for cervical spine injury than rigid surfaces using a cadaver-based model that includes the effects of the head and torso masses. It is widely assumed that energy-absorbing devices that protect the head from injury also reduce the risk for neck injury. However, this has not been demonstrated in any experimental or epidemiologic study. On the contrary, some studies have shown that padded surfaces have no effect on neck injury risk, and others have suggested that they can increase risk. Experiments were performed on 18 cadaveric cervical spines to test 6 combinations of impact angle and impact surface padding. The impact surface was oriented at -15 degrees (posterior impact), 0 degree (vertex impact), or +15 degrees (anterior impact). The impact surface was either a 3-mm sheet of lubricated Teflon or 5 cm of polyurethane foam. Impacts onto padded surfaces produced significantly larger neck impulses (P = 0.00023) and a significantly greater frequency of cervical spine injuries than rigid impacts (P = 0.0375). The impact angle was also correlated with injury risk (P < 0.00001). These experiments suggest that highly deformable, padded contact surfaces should be used carefully in environments where there is the risk for cervical spine injury. The results also suggest that the orientation of the head, neck, and torso relative to the impact surface is of equal if not greater importance in neck injury risk.

Risk factors for lower extremity injuries among male marathon runners.

PubMed

Van Middelkoop, M; Kolkman, J; Van Ochten, J; Bierma-Zeinstra, S M A; Koes, B W

2008-12-01

The aim of this study is to identify risk factors for lower extremity injuries in male marathon runners. A random sample of 1500 recreational male marathon runners was drawn. Possible risk factors were obtained from a baseline questionnaire 1 month before the start of the marathon. Information on injuries sustained shortly before or during the marathon was obtained using a post-race questionnaire. Of the 694 male runners who responded to the baseline and post-race questionnaire, 28% suffered a self-reported running injury on the lower extremities in the month before or during the marathon run. More than six times race participation in the previous 12 months [odds ratio (OR) 1.66; confidence interval (CI) 1.08-2.56], a history of running injuries (OR 2.62; CI 1.82-3.78), high education level (OR 0.73; CI 0.51-1.04) and daily smoking (OR 0.23; CI 0.05-1.01) were associated with the occurrence of lower extremity injuries. Among the modifiable risk factor studies, a training distance <40 km a week is a strong protective factor of future calf injuries, and regular interval training is a strong protective factor for knee injuries. Other training characteristics appear to have little or no effect on future injuries.

Monitoring of sport participation and injury risk in young athletes.

PubMed

Malisoux, Laurent; Frisch, Anne; Urhausen, Axel; Seil, Romain; Theisen, Daniel

2013-11-01

Careful modulation of training characteristics in high-level sports optimizes performance and avoids inappropriate workloads and associated sports injury risk. The aims of this study were to compare sport participation characteristics in different youth sport categories and to investigate their relationship with injury. Prospective cohort follow-up. Young (12-19 years) high-level athletes (n=154) from a regional sport school were followed during 41 weeks regarding sport participation characteristics and traumatic and overuse sports injuries (time-loss definition). All data were self-recorded by the athletes in an electronic system "TIPPS" (Training and Injury Prevention Platform for Sports) and subject to a systematic data quality control. Volume and intensity (self-rated perceived exertion) of each sport session were used to compute weekly load, monotony and strain. Sport categories were defined as team, racket, and individual sports. All sport participation characteristics were dependent on sport category (p<0.05). Weekly intensity, load and strain were dependent on age (p<0.05). Racket and individual sports were associated with lower injury risk (HR=0.37 and 0.34, p=0.001 and p<0.001, respectively) compared to team sports. Average sport participation characteristics were not related to injury according to the survival analysis. However, intensity during the week prior to injury was significantly higher (p<0.01) compared to that of the 4 preceding weeks. This study investigated for the first time the relationship between sport participation pattern and injury risk in young athletes. The monitoring method was sensitive to variations according to pertinent variables and might help identify athletes with increased sports injury risk. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Pedestrians injured by automobiles: risk factors for cervical spine injuries.

PubMed

Yanar, Hakan; Demetriades, Demetrios; Hadjizacharia, Pantelis; Hatzizacharia, Pantelis; Nomoto, Shirley; Salim, Ali; Inaba, Kenji; Rhee, Peter; Chan, Linda S

2007-12-01

Diagnosis of cervical spine injuries (CSI) in multitrauma patients, especially in the presence of head trauma, can be difficult. Identification of risk factors associated with CSI can help avoid missed or delayed diagnosis. Trauma registry study of pedestrian injuries caused by being hit by an automobile. Data abstracted for each patient included age, gender, Glasgow Coma Score on admission, Injury Severity Score, Abbreviated Injury Scale (AIS) for each body area, level of cervical spine injuries, and associated injuries. The incidence of spine injuries was derived for 4 age groups (14 years and younger, 15 to 55 years, 56 to 65 years, and older than 65 years). Logistic regression analysis was performed to identify risk factors associated with CSI. There were 8,401 pedestrian injuries caused by automobiles, and 178 patients (2.1%) had CSI. Incidence of CSI increased with age (0.3% in the age group 14 years and younger, 2.2% in the group 15 to 55 years, 3.7% in the group 56 to 65 years, and 4.4% in the group older than 65 years). Using the youngest age group (14 years and younger) as reference, relative risk of CSI in the other groups was 7.0, 12.1, and 14.2, respectively (p < 0.0001). Patients with severe head trauma (AIS > 3) were significantly more likely to have CSI than patients with less severe head injuries (AIS injuries with no head trauma, there was not even a single case of CSI. Stepwise logistic regression analysis identified age, severe head injury (AIS > 3), severe chest trauma (AIS > 3), pelvic fracture, and femur fracture as independent risk factors for CSI. Incidence of CSI after injuries to pedestrians hit by automobiles increases with age and severity of head trauma. Age, severe head trauma, severe chest trauma, pelvic fracture, and femur fractures are independent predictors of CSI.

Injury rates and injury risk factors among U.S. Army wheel vehicle mechanics.

PubMed

Knapik, Joseph J; Jones, Sarah B; Darakjy, Salima; Hauret, Keith G; Bullock, Steven H; Sharp, Marilyn A; Jones, Bruce H

2007-09-01

This study describes injury rates, injury diagnoses, anatomical locations of injuries, limited duty days, and activities associated with injuries in a sample of Army mechanics. Medical records of 518 male and 43 female Army mechanics were screened for injuries during 1 year at a large U.S. Army installation. Weight, height, age, and ethnicity were also extracted from the medical records. Body mass index was calculated as weight/height2. Overall injury rates for men and women were 124 and 156 injuries/100 person-years, respectively, with a rate of 127 injuries/100 person-years for all soldiers combined. Women had higher overuse injury rates while men had higher traumatic injury rates. Limited duty days for men and women were 2,076 and 1,966 days/100 person-years, respectively. The lower back, knee, ankle, foot, and shoulder involved 61% of the injuries. Activities associated with injury included (in order of incidence) physical training, mechanical work, sports, airborne-related activities, road marching, garrison/home activities, and chronic conditions. Among the men, elevated injury risk was associated with higher body weight and higher body mass index. It may be possible to prevent many injuries by implementation of evidenced-based interventions currently available in the literature.

Is ethnic density associated with risk of child pedestrian injury? A comparison of inter-census changes in ethnic populations and injury rates.

PubMed

Steinbach, Rebecca; Green, Judith; Kenward, Michael G; Edwards, Phil

2016-01-01

Research on inequalities in child pedestrian injury risk has identified some puzzling trends: although, in general, living in more affluent areas protects children from injury, this is not true for those in some minority ethnic groups. This study aimed to identify whether 'group density' effects are associated with injury risk, and whether taking these into account alters the relationship between area deprivation and injury risk. 'Group density' effects exist when ethnic minorities living in an area with a higher proportion of people from a similar ethnic group enjoy better health than those who live in areas with a lower proportion, even though areas with dense minority ethnic populations can be relatively more materially disadvantaged. This study utilised variation in minority ethnic densities in London between two census periods to identify any associations between group density and injury risk. Using police data on road traffic injury and population census data from 2001 to 2011, the numbers of 'White,' 'Asian' and 'Black' child pedestrian injuries in an area were modelled as a function of the percentage of the population in that area that are 'White,' 'Asian' and 'Black,' controlling for socio-economic disadvantage and characteristics of the road environment. There was strong evidence (p < 0.001) of a negative association between 'Black' population density and 'Black' child pedestrian injury risk [incidence (of injury) rate ratios (IRR) 0.575, 95% CI 0.515-0.642]. There was weak evidence (p = 0.083) of a negative association between 'Asian' density and 'Asian' child pedestrian injury risk (IRR 0.901, 95% CI 0.801-1.014) and no evidence (p = 0.412) of an association between 'White' density and 'White' child pedestrian injury risk (IRR 1.075, 95% CI 0.904-1.279). When group density effects are taken into account, area deprivation is associated with injury risk of all ethnic groups. Group density appears to protect 'Black' children living in London against

Risk factors for recurrent violent injury among black men.

PubMed

Richardson, Joseph B; St Vil, Christopher; Sharpe, Tanya; Wagner, Michael; Cooper, Carnell

2016-07-01

Black men are disproportionately overrepresented among victims of repeat violent injury. However, little is known about the risk factors that influence violent trauma recidivism among black men. We hypothesize that the following risk factors would be significant among black male victims of repeat violent injury: disrespect; being under the influence; being in a fight and using a weapon in the past year; and previous incarceration when comparing trauma recidivists versus nonrecidivists. Using secondary data analysis, we identified a sample of 191 (n = 191) urban low-income black men treated by a level I trauma unit in Baltimore for violent injury (e.g., gunshot wound, stabbing, or assault) who participated in a hospital-based violence intervention program from 1998 to 2011. Participants in the program completed a risk factor for violent injury questionnaire to assess: exposure to chronic violence, criminal justice involvement, substance abuse, and disrespect (code of the street). We found that 58% of the sample is characterized as trauma recidivists (defined as hospitalization two or more times for violent injury). Black male patients of violent injury who engage in the following: substance abuse; had previously been in a fight or used a weapon in the past year; perceived disrespect as a precursor to violence; and experienced a previous incarceration were more likely to have multiple hospitalizations for violent injury. Trauma recidivism among urban black male victims of violent injury is a major public health issue. Hospital-based violence intervention programs should be engaged in reducing trauma recidivism among this population. Copyright © 2016 Elsevier Inc. All rights reserved.

Vehicle year and the risk of car crash injury

PubMed Central

Blows, S; Ivers, R; Woodward, M; Connor, J; Ameratunga, S; Norton, R

2003-01-01

Objective: To quantify the association between vehicle age and risk of car crash injury. Design and setting: Data from a population based case-control study conducted in the Auckland region in 1998/99 was used to examine the adjusted risk of car crash injury or death due to vehicle age, after controlling for a range of known confounders. Cases were all cars involved in crashes in which at least one occupant was hospitalized or killed anywhere in the Auckland region, and controls were randomly selected cars on Auckland roads. The drivers of the 571 case vehicles and 588 control vehicles completed a structured interview. Main outcome measure: Hospitalisation or death of a vehicle occupant due to car crash injury. Results: Vehicles constructed before 1984 had significantly greater chance of being involved in an injury crash than those constructed after 1994 (odds ratio 2.88, 95% confidence interval (CI) 1.20 to 6.91), after adjustment for potential confounders. There was also a trend for increasing crash risk with each one year increase in vehicle age after adjustment for potential confounders (odds ratio 1.05, 95% CI 0.99 to 1.11; p = 0.09). Conclusion: This study quantifies the increased risk of car crash injury associated with older vehicle year and confirms this as an important public health issue. PMID:14693899

A Systematic Evaluation of Field-Based Screening Methods for the Assessment of Anterior Cruciate Ligament (ACL) Injury Risk.

PubMed

Fox, Aaron S; Bonacci, Jason; McLean, Scott G; Spittle, Michael; Saunders, Natalie

2016-05-01

further studies met all criteria, resulting in 20 studies being included for review. Five ACL-screening methods-the Landing Error Scoring System (LESS), Clinic-Based Algorithm, Observational Screening of Dynamic Knee Valgus (OSDKV), 2D-Cam Method, and Tuck Jump Assessment-were identified. There was limited evidence supporting the use of field-based screening methods in predicting ACL injuries across a range of populations. Differences relating to the equipment and time required to complete screening methods were identified. Only screening methods for ACL injury risk were included for review. Field-based screening methods developed for lower-limb injury risk in general may also incorporate, and be useful in, screening for ACL injury risk. Limited studies were available relating to the OSDKV and 2D-Cam Method. The LESS showed predictive validity in identifying ACL injuries, however only in a youth athlete population. The LESS also appears practical for community-wide use due to the minimal equipment and set-up/analysis time required. The Clinic-Based Algorithm may have predictive value for ACL injury risk as it identifies athletes who exhibit high frontal plane knee loads during a landing task, but requires extensive additional equipment and time, which may limit its application to wider community settings.

Social environments, risk-taking and injury in farm adolescents

PubMed Central

Pickett, William; Berg, Richard L; Marlenga, Barbara

2017-01-01

Background Farm environments are especially hazardous for young people. While much is known about acute physical causes of traumatic farm injury, little is known about social factors that may underlie their aetiology. Objectives In a nationally representative sample of young Canadians aged 11–15 years, we described and compared farm and non-farm adolescents in terms of the qualities of their social environments, engagement in overt multiple risk-taking as well as how such exposures relate aetiologically to their reported injury experiences. Methods Cross-sectional analysis of survey reports from the 2014 (Cycle 7) Canadian Health Behaviour in School-Aged Children study was conducted. Children (n=2567; 2534 weighted) who reported living or working on farms were matched within schools in a 1:1 ratio with children not living or working on farms. Scales examining quality of social environments and overt risk-taking were compared between the two groups, stratified by gender. We then related the occurrence of any serious injury to these social exposures in direct and interactive models. Results Farm and non-farm children reported social environments that were quite similar, with the exception of overt multiple risk-taking, which was demonstrably higher in farm children of both genders. Engagement in overt risk-taking, but not the other social environmental factors, was strongly and consistently associated with risks for serious injury in farm as well as non-farm children, particularly among males. Conclusions Study findings highlight the strength of associations between overt multiple risk-taking and injury among farm children. This appears to be a normative aspect of adolescent farm culture. PMID:28137978

Some risk factors in trampolining illustrated by six serious injuries.

PubMed Central

Hammer, A.; Schwartzbach, A. L.; Paulev, P. E.

1982-01-01

Four case histories out of 75 significant trampoline injuries (from a total of 198 injuries re-examined) plus two recent accidents (1979) are presented, illustrating that the trampoline is posing an undue risk of serious injury. It is argued that the only single factor capable of preventing trampoline injuries is a trampoline ban. This is imperative in schools. Trampoline clubs are advised to reconsider the risk factors involved. Images p27-a p27-b p27-c Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 PMID:7066612

Racial/ethnic and gender differences in individual workplace injury risk trajectories: 1988-1998.

PubMed

Berdahl, Terceira A

2008-12-01

I examined workplace injury risk over time and across racial/ethnic and gender groups to observe patterns of change and to understand how occupational characteristics and job mobility influence these changes. I used hierarchical generalized linear models to estimate individual workplace injury and illness risk over time ("trajectories") for a cohort of American workers who participated in the National Longitudinal Survey of Youth (1988-1998). Significant temporal variation in injury risk was observed across racial/ethnic and gender groups. At baseline, White men had a high risk of injury relative to the other groups and experienced the greatest decline over time. Latino men demonstrated a pattern of lower injury risk across time compared with White men. Among both Latinos and non-Latino Whites, women had lower odds of injury than did men. Non-Latino Black women's injury risk was similar to Black men's and greater than that for both Latino and non-Latino White women. Occupational characteristics and job mobility partly explained these differences. Disparities between racial/ethnic and gender groups were dynamic and changed over time. Workplace injury risk was associated with job dimensions such as work schedule, union representation, health insurance, job hours, occupational racial segregation, and occupational environmental hazards.

Injury risks between first- and second-generation airbags in frontal motor vehicle collisions.

PubMed

MacLennan, Paul A; Ashwander, William S; Griffin, Russell; McGwin, Gerald; Rue, Loring W

2008-07-01

Airbags in vehicles manufactured after 1997 were depowered to decrease injury risks for infants/children and small adults. It is possible that compared to earlier airbags second-generation airbags provide less injury protection due to their depowered nature. A cohort study was conducted using 1995-2004 national data. Risk ratios (RRs) and 95% confidence intervals (CIs) compared injury risks for occupants involved in frontal collisions in vehicles wherein a first- or second-generation airbag deployed by body region and injury severity using the Abbreviated Injury Scale (AIS). Associations were adjusted for crash severity, seatbelt use, seat position, occupant location, and vehicle curb weight. For upper extremity injuries reduced RRs were observed for AIS 1 or greater (RR=0.76, CI 0.67-0.86), AIS 2 or greater (RR=0.76, CI 0.58-1.00) and AIS 3 (RR=0.81, CI 0.64-1.03). Elevated risks were observed for AIS 5 thoracic injuries (RR=1.46, CI 1.04-2.07) but were made null when differences in age and gender were adjusted for. Vehicles equipped with first- and second-generation airbags appear to offer similar protection for front-seated occupants. The observed decreased risks for upper extremity injury and increased risks for severe thoracic injuries warrant further attention.

Injury Risk and Noise Exposure in Firefighter Training Operations.

PubMed

Neitzel, Richard L; Long, Rachel N; Sun, Kan; Sayler, Stephanie; von Thaden, Terry L

2016-05-01

Firefighters have high rate of injuries and illnesses, as well as exposures to high levels of noise. This study explored the relationship between noise exposure and injury among firefighters. We recruited firefighters undergoing vehicle extrication and structural collapse emergency response training at a highly realistic training facility. Demographics, health status, body mass index (BMI), and history of serious injuries (i.e. injuries requiring first aid treatment, treatment in a medical clinic or office, or treatment at a hospital) were assessed at baseline, and daily activities, injury events, and near misses were assessed daily via surveys. Participants' noise exposures were monitored for one 24-h period using noise dosimeters. We used a mixed-effects logistic regression model to estimate the odds of injury events and near misses associated with noise exposure as an independent variable. Of 56 subjects, 20 (36%) reported that they had ever suffered a serious injury during firefighting activities, and 9 (16%) reported a serious injury within the past year. We estimated rates of 6.6 lifetime serious injuries per 100 FTE 16.1 serious injuries per 100 FTE within the past year. Our models indicated a significant increase in injury events and near misses among those with higher BMI, and as well as a dose-response relationship between near misses/injuries and increasing noise levels. Noise levels >90 dBA in the 30 min prior to time of injury or near miss were associated with substantially increased odds ratios for injury or near miss. Our models further indicated that perceived job demands were significantly associated with increased risk of injury or near miss. Our results suggest that noise exposures may need to be incorporated into injury prevention programs for firefighters to reduce injuries among this high-risk occupational group. © The Author 2015. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Injury risk and noise exposure in firefighter training operations

PubMed Central

Neitzel, Richard L.; Long, Rachel; Sun, Kan; Sayler, Stephanie; von Thaden, Terry L.

2016-01-01

Introduction Firefighters have high rate of injuries and illnesses, as well as exposures to high levels of noise. This study explored the relationship between noise exposure and injury among firefighters. Methods We recruited firefighters undergoing vehicle extrication and structural collapse emergency response training at a highly realistic training facility. Demographics, health status, body mass index, and history of serious injuries (i.e., injuries requiring first aid treatment, treatment in a medical clinic or office, or treatment at a hospital) were assessed at baseline, and daily activities, injury events, and near-misses were assessed daily using surveys. Participants' noise exposures were monitored for one 24-hour period using noise dosimeters. We used a mixed-effects logistic regression model to estimate the odds of injury events and near-misses associated with noise exposure as an independent variable. Results Of 56 subjects, twenty (36%) reported that they had ever suffered a serious injury during firefighting activities, and nine (16%) reported a serious injury within the past year. We estimated rates of 6.6 lifetime serious injuries per 100 FTE 16.1 serious injuries per 100 FTE within the past year. Our models indicated a significant increase in injury events and near misses among those with higher BMI, and as well as a dose-response relationship between near-misses/injuries and increasing noise levels. Noise levels >90 dBA in the 30 min prior to time of injury or near-miss were associated with substantially increased odds ratios for injury or near-miss. Our models further indicated that perceived job demands were significantly associated with increased risk of injury or near-miss. Conclusion Our results suggest that noise exposures may need to be incorporated into injury prevention programs for firefighters to reduce injuries among this high-risk occupational group. PMID:26712895

The Lower Extremity Biomechanics of Single- and Double-Leg Stop-Jump Tasks

PubMed Central

2011-01-01

The anterior cruciate ligament (ACL) injury is a common occurrence in sports requiring stop-jump tasks. Single- and double-leg stop-jump techniques are frequently executed in sports. The higher risk of ACL injury in single-leg drop landing task compared to a double-leg drop landing task has been identified. However the injury bias between single- and double-leg landing techniques has not been investigated for stop-jump tasks. The purpose of this study was to determine the differences between single- and double-leg stop-jump tasks in knee kinetics that were influenced by the lower extremity kinematics during the landing phase. Ground reaction force, lower extremity kinematics, and knee kinetics data during the landing phase were obtained from 10 subjects performing single- and double-leg stop-jump tasks, using motion-capture system and force palates. Greater peak posterior and vertical ground reaction forces, and peak proximal tibia anterior and lateral shear forces (p < 0.05) during landing phase were observed of single-leg stop-jump. Single-leg stop-jump exhibited smaller hip and knee flexion angle, and knee flexion angular velocity at initial foot contact with the ground (p < 0.05). We found smaller peak hip and knee flexion angles (p < 0.05) during the landing phase of single-leg stop-jump. These results indicate that single-leg landing may have higher ACL injury risk than double-leg landing in stop-jump tasks that may be influenced by the lower extremity kinematics during the landing phase. Key points Non-contact ACL injuries are more likely to occur during the single-leg stop-jump task than during the double-leg stop-jump task. Single-leg stop-jump exhibited greater peak proximal tibia anterior and lateral shear forces, and peak posterior and vertical ground reaction forces during the landing phase than the double-leg stop-jump task. Single-leg stop-jump exhibited smaller hip flexion angle, knee flexion angle, and knee flexion angular velocity at initial foot

Driver Injury Risk Variability in Finite Element Reconstructions of Crash Injury Research and Engineering Network (CIREN) Frontal Motor Vehicle Crashes.

PubMed

Gaewsky, James P; Weaver, Ashley A; Koya, Bharath; Stitzel, Joel D

2015-01-01

A 3-phase real-world motor vehicle crash (MVC) reconstruction method was developed to analyze injury variability as a function of precrash occupant position for 2 full-frontal Crash Injury Research and Engineering Network (CIREN) cases. Phase I: A finite element (FE) simplified vehicle model (SVM) was developed and tuned to mimic the frontal crash characteristics of the CIREN case vehicle (Camry or Cobalt) using frontal New Car Assessment Program (NCAP) crash test data. Phase II: The Toyota HUman Model for Safety (THUMS) v4.01 was positioned in 120 precrash configurations per case within the SVM. Five occupant positioning variables were varied using a Latin hypercube design of experiments: seat track position, seat back angle, D-ring height, steering column angle, and steering column telescoping position. An additional baseline simulation was performed that aimed to match the precrash occupant position documented in CIREN for each case. Phase III: FE simulations were then performed using kinematic boundary conditions from each vehicle's event data recorder (EDR). HIC15, combined thoracic index (CTI), femur forces, and strain-based injury metrics in the lung and lumbar vertebrae were evaluated to predict injury. Tuning the SVM to specific vehicle models resulted in close matches between simulated and test injury metric data, allowing the tuned SVM to be used in each case reconstruction with EDR-derived boundary conditions. Simulations with the most rearward seats and reclined seat backs had the greatest HIC15, head injury risk, CTI, and chest injury risk. Calculated injury risks for the head, chest, and femur closely correlated to the CIREN occupant injury patterns. CTI in the Camry case yielded a 54% probability of Abbreviated Injury Scale (AIS) 2+ chest injury in the baseline case simulation and ranged from 34 to 88% (mean = 61%) risk in the least and most dangerous occupant positions. The greater than 50% probability was consistent with the case occupant's AIS 2

Risk factors for lower extremity injuries in elite female soccer players.

PubMed

Nilstad, Agnethe; Andersen, Thor Einar; Bahr, Roald; Holme, Ingar; Steffen, Kathrin

2014-04-01

The incidence of lower extremity injuries in female soccer players is high, but the risk factors for injuries are unknown. To investigate risk factors for lower extremity injuries in elite female soccer players. Cohort study; Level of evidence, 3. Players in the Norwegian elite female soccer league (N = 12 teams) participated in baseline screening tests before the 2009 competitive soccer season. The screening included tests assessing maximal lower extremity strength, dynamic balance, knee valgus angles in a drop-jump landing, knee joint laxity, generalized joint laxity, and foot pronation. Also included was a questionnaire to collect information on demographic data, elite-level experience, and injury history. Time-loss injuries and exposure in training and matches were recorded prospectively in the subsequent soccer season using weekly text messaging. Players reporting an injury were contacted to collect data regarding injury circumstances. Univariate and multivariate regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for ±1 standard deviation of change. In total, 173 players underwent complete screening tests and registration of injuries and exposure throughout the season. A total of 171 injuries in 107 players (62%) were recorded; ligament and muscle injuries were the most frequent. Multivariate analyses showed that a greater body mass index (BMI) (OR, 1.51; 95% CI, 1.21-1.90; P = .001) was the only factor significantly associated with new lower extremity injuries. A greater BMI was associated with new thigh injuries (OR, 1.51; 95% CI, 1.08-2.11; P = .01), a lower knee valgus angle in a drop-jump landing was associated with new ankle injuries (OR, 0.64; 95% CI, 0.41-1.00; P = .04), and a previous knee injury was associated with new lower leg and foot injuries (OR, 3.57; 95% CI, 1.27-9.99; P = .02), whereas none of the factors investigated influenced the risk of new knee injuries. A greater BMI was associated with

Injury Prevention in Physical Education: Scenarios and Solutions

ERIC Educational Resources Information Center

Merrie, Michael D.; Shewmake, Cole; Calleja, Paul

2016-01-01

The purpose of this article is to provide physical educators with practical strategies that can assist in preventing injuries in the classroom. The dynamic nature of physical education and the numerous tasks physical educators must complete daily can be challenging. Embedded in these challenges is the constant risk of student injury. Fortunately,…

Does tinnitus, hearing asymmetry, or hearing loss predispose to occupational injury risk?

PubMed

Cantley, Linda F; Galusha, Deron; Cullen, Mark R; Dixon-Ernst, Christine; Tessier-Sherman, Baylah; Slade, Martin D; Rabinowitz, Peter M; Neitzel, Richard L

2015-02-01

To determine the relative contributions of tinnitus, asymmetrical hearing loss, low frequency hearing loss (pure tone average of 0.5, 1, 2, 3 kHz; PTA.5123), or high frequency hearing loss (pure tone average of 4, 6 kHz; PTA46), to acute injury risk among a cohort of production and maintenance workers at six aluminum manufacturing plants, adjusting for ambient noise exposure and other recognized predictors of injury risk. Retrospective analysis. The study considered 9920 workers employed during 2003 to 2008. The cohort consisted of 8818 workers (89%) whose complete records were available. Adjusting for noise exposure and other recognized injury predictors, a 25% increased acute injury risk was observed among workers with a history of tinnitus in conjunction with high-frequency hearing loss (PTA46). Low frequency hearing loss may be associated with minor, yet less serious, injury risk. We did not find evidence that asymmetry contributes to injury risk. These results provide evidence that tinnitus, combined with high-frequency hearing loss, may pose an important safety threat to workers, especially those who work in high-noise exposed environments. These at risk workers may require careful examination of their communication and hearing protection needs.

[Risk factors for road traffic injury in agricultural vehicle drivers].

PubMed

Cui, M J; Chen, Y; Li, Y; Hu, J; Zhang, X J

2017-08-20

Objective: To examine the risk factors for road traffic injury in agricultural vehicle drivers. Methods: A total of 103 drivers (who had suffered agricultural vehicle road traffic injury within the past year based on the road traffic injury registrar from the Traffic Management Bureau) who were involved in the annual agricultural vehicle inspection from December 2014 to January 2015 were randomly sampled from the Yixing Agricultural Vehicle Station as the case group for this study. Based on a 1∶2 assignment ratio and matched for sex, age, and education, a total of 206 drivers who had not suffered any agricultural vehicle road traffic injury within the past year were selected as the control group. The general information, vehicle information, driving information, driving behavior, and accident details of the agricultural vehicle drivers were analyzed. Results: The incidence rate of road traffic injury was 7.24% given the 103 agricultural vehicle drivers who had suffered agricultural vehicle road traffic injury in the past year. Univariate logistic regression analysis showed that drinking, debt, pressure, history of car accident, history of drunk driving, smoking and phone use during driving, fatigue driving, and driving with illness were the risk factors for road traffic injury in agricultural vehicle drivers ( OR =2.332, 2.429, 19.778, 5.589, 8.517, 2.125, 3.203, 10.249 and 5.639, respectively) . Multivariate logistic regression analysis also demonstrated that pressure, history of car accident, history of drunk driving, fatigue driving, and driving with illness were the risk factors for road traffic injury in agricultural vehicle drivers ( OR =12.139, 11.184, 6.729, 5.939, and 6.544, respectively) . Conclusion: Pressure, history of car accident, history of drunk driving, fatigue driving, and driving with illness are the major risk factors for road traffic injury in agricultural vehicle drivers.

Can child injury prevention include healthy risk promotion?

PubMed Central

Brussoni, Mariana; Brunelle, Sara; Pike, Ian; Sandseter, Ellen Beate Hansen; Herrington, Susan; Turner, Heather; Belair, Scott; Logan, Louise; Fuselli, Pamela; Ball, David J

2015-01-01

To reflect on the role of risk-taking and risky play in child development and consider recommendations for the injury prevention field, a symposium was held prior to the November 2013 Canadian Injury Prevention and Safety Promotion Conference. Delegates heard from Canadian and international researchers, practitioners and play safety experts on child development, play space design and playground safety, provision of recreation, and legal and societal perceptions of risk and hazard. The presenters provided multidisciplinary evidence and perspectives indicating the potential negative effect on children's development of approaches to injury prevention that prioritise safety and limit children's opportunities for risky play. Delegates considered the state of the field of injury prevention and whether alternative approaches were warranted. Each presenter prepared a discussion paper to provide the opportunity for dialogue beyond attendees at the symposium. The resulting discussion papers provide a unique opportunity to consider and learn from multiple perspectives in order to develop a path forward. PMID:25535208

Perceptions of football players regarding injury risk factors and prevention strategies

PubMed Central

Zech, Astrid; Wellmann, Kai

2017-01-01

Current approaches regarding injury prevention focus on the transfer of evidence into daily practice. One promising approach is to influence attitudes and beliefs of players. The objective of this study was to record player’s perceptions on injury prevention. A survey was performed among players of one German high-level football (soccer) club. 139 professional and youth players between age 13 and 35 years completed a standardized questionnaire (response rate = 98%). It included categories with (1) history of lower extremity injuries, (2) perceptions regarding risk factors and (3) regularly used prevention strategies. The majority of players (84.2%) had a previous injury. 47.5% of respondents believe that contact with other players is a risk factor, followed by fatigue (38.1%) and environmental factors (25.9%). The relevance of previous injuries as a risk factor is differently perceived between injured (25%) and uninjured players (0.0%). Nearly all players (91.5%) perform stretching to prevent injuries, followed by neuromuscular warm up exercises (54.0%). Taping is used by 40.2% of previously injured players and 13.6% of players without a history of injuries. In conclusion, the perception of risk factors and performed preventive strategies are inconsistent with scientific evidence. Future transfer strategies should incorporate the players beliefs and attitudes. PMID:28459845

Relationship between balance ability, training and sports injury risk.

PubMed

Hrysomallis, Con

2007-01-01

Traditionally, balance training has been used as part of the rehabilitation programme for ankle injuries. More recently, balance training has been adopted to try and prevent injuries to the ankle and knee joints during sport. The purpose of this review is to synthesise current knowledge in the area of balance ability, training and injury risk, highlight the findings and identify any future research needs. A number of studies have found that poor balance ability is significantly related to an increased risk of ankle injuries in different activities. This relationship appears to be more common in males than females. Multifaceted intervention studies that have included balance training along with jumping, landing and agility exercises have resulted in a significant decrease in ankle or knee injuries in team handball, volleyball and recreational athletes. It is unknown which component of the multifaceted intervention was most effective and whether the effects are additive. As a single intervention, balance training has been shown to significantly reduce the recurrence of ankle ligament injuries in soccer, volleyball and recreational athletes; however, it has not been clearly shown to reduce ankle injuries in athletes without a prior ankle injury. Balance training on its own has also been shown to significantly reduce anterior cruciate ligament injuries in male soccer players. Surprisingly, it was also found to be significantly associated with an increased risk of major knee injuries in female soccer players and overuse knee injuries in male and female volleyball players. The studies with the contrasting findings differed in aspects of their balance training programmes. It would appear that balance training, as a single intervention, is not as effective as when it is part of a multifaceted intervention. Research is required to determine the relative contribution of balance training to a multifaceted intervention so as to generate an effective and efficient preventative

Assessing the Risk of Crew Injury Due to Dynamic Loads During Spaceflight

NASA Technical Reports Server (NTRS)

Somers, J. T.; Gernhardt, M.; Newby, N.

2014-01-01

Spaceflight requires tremendous amounts of energy to achieve Earth orbit and to attain escape velocity for interplanetary missions. Although the majority of the energy is managed in such a way as to limit the accelerations on the crew, several mission phases may result in crew exposure to dynamic loads. In the automotive industry, risk of serious injury can be tolerated because the probability of a crash is remote each time a person enters a vehicle, resulting in a low total risk of injury. For spaceflight, the level of acceptable injury risk must be lower to achieve a low total risk of injury because the dynamic loads are expected on each flight. To mitigate the risk of injury due to dynamic loads, the NASA Human Research Program has developed a research plan to inform the knowledge gaps and develop relevant tools for assessing injury risk. The risk of injury due to dynamic loads can be further subdivided into extrinsic and intrinsic risk factors. Extrinsic risk factors include the vehicle dynamic profile, seat and restraint design, and spacesuit design. Human tolerance to loads varies considerably depending on the direction, amplitude, and rise-time of acceleration therefore the orientation of the body to the dynamic vector is critical to determining crew risk of injury. Although a particular vehicle dynamic profile may be safe for a particular design, the seat, restraint, and suit designs can affect the risk of injury due to localized effects. In addition, characteristics intrinsic to the crewmember may also contribute to the risk of injury, such as crewmember sex, age, anthropometry, and deconditioning due to spaceflight, and each astronaut may have a different risk profile because of these factors. The purpose of the research plan is to address any knowledge gaps in the risk factors to mitigate injury risk. Methods for assessing injury risk have been well documented in other analogous industries and include human volunteer testing, human exposure to dynamic

The risk assessment score in acute whiplash injury predicts outcome and reflects biopsychosocial factors.

PubMed

Kasch, Helge; Qerama, Erisela; Kongsted, Alice; Bach, Flemming W; Bendix, Tom; Jensen, Troels S

2011-12-01

One-year prospective study of 141 acute whiplash patients (WLP) and 40 acute ankle-injured controls. This study investigates a priori determined potential risk factors to develop a risk assessment tool, for which the expediency was examined. The whiplash-associated disorders (WAD) grading system that emerged from The Quebec Task-Force-on-Whiplash has been of limited value for predicting work-related recovery and for explaining biopsychosocial disability after whiplash and new predictive factors, for example, risk criteria that comprehensively differentiate acute WLP in a biopsychosocial manner are needed. Consecutively, 141 acute WLP and 40 ankle-injured recruited from emergency units were examined after 1 week, 1, 3, 6, and 12 months obtaining neck/head visual analog scale score, number of nonpainful complaints, epidemiological, social, psychological data and neurological examination, active neck mobility, and furthermore muscle tenderness and pain response, and strength and duration of neck muscles. Risk factors derived (reduced cervical range of motion, intense neck pain/headache, multiple nonpain complaints) were applied in a risk assessment score and divided into seven risk strata. A receiver operating characteristics curve for the Risk Assessment Score and 1-year work disability showed an area of 0.90. Risk strata and number of sick days showed a log-linear relationship. In stratum 1 full recovery was encountered, but for high-risk patients in stratum 6 only 50% and 7 only 20% had returned to work after 1 year (P < 5.4 × 10). Strength measures, psychophysical pain measurements, and psychological and social data (reported elsewhere) showed significant relation to risk strata. The Risk Assessment score is suggested as a valuable tool for grading WLP early after injury. It has reasonable screening power for encountering work disability and reflects the biopsychosocial nature of whiplash injuries.

Social environments, risk-taking and injury in farm adolescents.

PubMed

Pickett, William; Berg, Richard L; Marlenga, Barbara

2017-12-01

Farm environments are especially hazardous for young people. While much is known about acute physical causes of traumatic farm injury, little is known about social factors that may underlie their aetiology. In a nationally representative sample of young Canadians aged 11-15 years, we described and compared farm and non-farm adolescents in terms of the qualities of their social environments, engagement in overt multiple risk-taking as well as how such exposures relate aetiologically to their reported injury experiences. Cross-sectional analysis of survey reports from the 2014 (Cycle 7) Canadian Health Behaviour in School-Aged Children study was conducted. Children (n=2567; 2534 weighted) who reported living or working on farms were matched within schools in a 1:1 ratio with children not living or working on farms. Scales examining quality of social environments and overt risk-taking were compared between the two groups, stratified by gender. We then related the occurrence of any serious injury to these social exposures in direct and interactive models. Farm and non-farm children reported social environments that were quite similar, with the exception of overt multiple risk-taking, which was demonstrably higher in farm children of both genders. Engagement in overt risk-taking, but not the other social environmental factors, was strongly and consistently associated with risks for serious injury in farm as well as non-farm children, particularly among males. Study findings highlight the strength of associations between overt multiple risk-taking and injury among farm children. This appears to be a normative aspect of adolescent farm culture. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Changes in Classes of Injury-Related Risks and Consequences of Risk-Level Drinking: a Latent Transition Analysis.

PubMed

Cochran, Gerald; Field, Craig; Caetano, Raul

2015-07-01

Risk-level drinking, drinking and driving, and alcohol-related violence are risk factors that result in injuries. The current study sought to identify which subgroups of patients experience the most behavioral change following a brief intervention. A secondary analysis of data from a brief alcohol intervention study was conducted. The sample (N = 664) includes at-risk drinkers who experienced an injury and were admitted for care to a Level 1 trauma center. Injury-related items from the Short Inventory of Problems+6 were used to perform a latent transition analysis to describe class transitions participants experienced following discharge. Four classes emerged for the year before and after the current injury. Most individuals transitioned from higher-risk classes into those with lower risk. Some participants maintained risky profiles, and others increased risks and consequences. Drinking and driving remained a persistent problem among the study participants. Although a large portion of intervention recipients improved risks and consequences of alcohol use following discharge, more intensive intervention services may be needed for a subset of patients who showed little or no improvement.

Vehicle mass and injury risk in two-car crashes: A novel methodology.

PubMed

Tolouei, Reza; Maher, Mike; Titheridge, Helena

2013-01-01

This paper introduces a novel methodology based on disaggregate analysis of two-car crash data to estimate the partial effects of mass, through the velocity change, on absolute driver injury risk in each of the vehicles involved in the crash when absolute injury risk is defined as the probability of injury when the vehicle is involved in a two-car crash. The novel aspect of the introduced methodology is in providing a solution to the issue of lack of data on the speed of vehicles prior to the crash, which is required to calculate the velocity change, as well as a solution to the issue of lack of information on non-injury two-car crashes in national accident data. These issues have often led to focussing on relative measures of injury risk that are not independent of risk in the colliding cars. Furthermore, the introduced methodology is used to investigate whether there is any effect of vehicle size above and beyond that of mass ratio, and whether there are any effects associated with the gender and age of the drivers. The methodology was used to analyse two-car crashes to investigate the partial effects of vehicle mass and size on absolute driver injury risk. The results confirmed that in a two-car collision, vehicle mass has a protective effect on its own driver injury risk and an aggressive effect on the driver injury risk of the colliding vehicle. The results also confirmed that there is a protective effect of vehicle size above and beyond that of vehicle mass for frontal and front to side collisions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Does Tinnitus, Hearing Asymmetry or Hearing Loss Predispose to Occupational Injury Risk?

PubMed Central

Cantley, Linda F; Galusha, Deron; Cullen, Mark R; Dixon-Ernst, Christine; Tessier-Sherman, Baylah; Slade, Martin D; Rabinowitz, Peter M; Neitzel, Richard L

2015-01-01

Objective To determine the relative contributions of tinnitus, asymmetrical hearing loss, low frequency hearing loss (pure tone average of .5, 1, 2, 3 kHz, PTA.5123), or high frequency hearing loss (pure tone average of 4, 6 kHz, PTA46), to acute injury risk among a cohort of production and maintenance workers at six aluminum manufacturing plants, adjusting for ambient noise exposure and other recognized predictors of injury risk. Design and Study Sample This retrospective analysis considered 9,920 workers employed during 2003 to 2008. The cohort consisted of 8,818 workers (89%) whose complete records were available. Results Adjusting for noise exposure and other recognized injury predictors, a 25% increased acute injury risk was observed among workers with a history of tinnitus in conjunction with high-frequency hearing loss (PTA46). Low frequency hearing loss may be associated with minor, yet less serious, injury risk. We did not find evidence that asymmetry contributes to injury risk. Conclusion These results provide evidence that tinnitus, combined with high-frequency hearing loss, may pose an important safety threat to workers, especially those who work in high-noise exposed environments. These at risk workers may require careful examination of their communication and hearing protection needs. PMID:25549168

Mechanisms, Prediction, and Prevention of ACL Injuries: Cut Risk With Three Sharpened and Validated Tools

PubMed Central

Hewett, Timothy E.; Myer, Gregory D.; Ford, Kevin R.; Paterno, Mark V.; Quatman, Carmen E.

2017-01-01

Economic and societal pressures influence modern medical practice to develop and implement prevention strategies. Anterior cruciate ligament (ACL) injury devastates the knee joint leading to short term disability and long term sequelae. Due to the high risk of long term osteoarthritis in all treatment populations following ACL injury, prevention is the only effective intervention for this life-altering disruption in knee health. The “Sequence of Prevention” Model provides a framework to monitor progress towards the ultimate goal of preventing ACL injuries. Utilizing this model, our multidisciplinary collaborative research team has spent the last decade working to delineate injury mechanisms, identify injury risk factors, predict which athletes are at-risk for injury, and develop ACL injury prevention programs. Within this model of injury prevention, modifiable factors (biomechanical and neuromuscular) related to injury mechanisms likely provide the best opportunity for intervention strategies aimed to decrease the risk of ACL injury, particularly in female athletes. Knowledge advancements have led to the development of potential solutions that allow athletes to compete with lowered risk of ACL injury. Design and integration of personalized clinical assessment tools and targeted prevention strategies for athletes at high risk for ACL injury may transform current prevention practices and ultimately significantly reduce ACL injury incidence. This 2016 OREF Clinical Research Award focuses on the authors' work and contributions to the field. The author's acknowledge the many research groups who have contributed to the current state of knowledge in the fields of ACL injury mechanisms, injury risk screening and injury prevention strategies. PMID:27612195

Validation of the principles of injury risk zones for motorcycle protective clothing.

PubMed

de Rome, Liz; Meredith, Lauren; Ivers, Rebecca; Brown, Julie

2014-09-01

The distributions of motorcycle crash impacts and injuries were compared to the four impact risk zones and protective performance specified in the European Standard for motorcycle clothing (EN 13595). Crashed motorcyclists' (n=117) injuries and clothing damage were categorized by body area into the four risk zones. Three levels of protection were defined: protective clothing with impact protection, protective clothing only and non-protective clothing. The distribution of impact/injury sites corresponded to the predictions of EN 13595, with the proportion of all injuries decreasing from 43.9% in Zone 1, to 18.0%, 16.7%, and 11.5% in Zones 2 to 4, respectively. Protective clothing modified the distribution of injuries with substantially more injuries (OR=2.69, 95% CL: 20.1-3.59) at unprotected impact sites. These findings support an appropriate framework for determining performance specifications for the manufacture of motorcycle clothing that will effectively reduce the risk of injury in crashes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Multiple factors explain injury risk in adolescent elite athletes: Applying a biopsychosocial perspective.

PubMed

von Rosen, P; Frohm, A; Kottorp, A; Fridén, C; Heijne, A

2017-12-01

Many risk factors for injury are presented in the literature, few of those are however consistent and the majority is associated with adult and not adolescent elite athletes. The aim was to identify risk factors for injury in adolescent elite athletes, by applying a biopsychosocial approach. A total of 496 adolescent elite athletes (age range 15-19), participating in 16 different sports, were monitored repeatedly over 52 weeks using a valid questionnaire about injuries, training exposure, sleep, stress, nutrition, and competence-based self-esteem. Univariate and multiple Cox regression analyses were used to calculate hazard ratios (HR) for risk factors for first reported injury. The main finding was that an increase in training load, training intensity, and at the same time decreasing the sleep volume resulted in a higher risk for injury compared to no change in these variables (HR 2.25, 95% CI, 1.46-3.45, P<.01), which was the strongest risk factor identified. In addition, an increase by one score of competence-based self-esteem increased the hazard for injury with 1.02 (HR 95% CI, 1.00-1.04, P=.01). Based on the multiple Cox regression analysis, an athlete having the identified risk factors (Risk Index, competence-based self-esteem), with an average competence-based self-esteem score, had more than a threefold increased risk for injury (HR 3.35), compared to an athlete with a low competence-based self-esteem and no change in sleep or training volume. Our findings confirm injury occurrence as a result of multiple risk factors interacting in complex ways. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Development and evaluation of a multifaceted ergonomics program to prevent injuries associated with patient handling tasks.

PubMed

Nelson, Audrey; Matz, Mary; Chen, Fangfei; Siddharthan, Kris; Lloyd, John; Fragala, Guy

2006-08-01

Nurses have one of the highest rates of work-related musculoskeletal injury of any profession. Over the past 30 years, efforts to reduce work-related musculoskeletal disorders in nurses have been largely unsuccessful. The primary goal of this program was to create safer working environments for nursing staff who provide direct patient care. Our first objective was to design and implement a multifaceted program that successfully integrated evidence-based practice, technology, and safety improvement. The second objective was to evaluate the impact of the program on injury rate, lost and modified work days, job satisfaction, self-reported unsafe patient handling acts, level of support for program, staff and patient acceptance, program effectiveness, costs, and return on investment. The intervention included six program elements: (1) Ergonomic Assessment Protocol, (2) Patient Handling Assessment Criteria and Decision Algorithms, (3) Peer Leader role, "Back Injury Resource Nurses", (4) State-of-the-art Equipment, (5) After Action Reviews, and (6) No Lift Policy. A pre-/post design without a control group was used to evaluate the effectiveness of a patient care ergonomics program on 23 high risk units (19 nursing home care units and 4 spinal cord injury units) in 7 facilities. Injury rates, lost work days, modified work days, job satisfaction, staff , and patient acceptance, program effectiveness, and program costs/savings were compared over two nine month periods: pre-intervention (May 2001-January 2002) and post-intervention (March 2002-November 2002). Data were collected prospectively through surveys, weekly process logs, injury logs, and cost logs. The program elements resulted in a statistically significant decrease in the rate of musculoskeletal injuries as well as the number of modified duty days taken per injury. While the total number of lost workdays decreased by 18% post-intervention, this difference was not statistically significant. There were statistically

Increased risk of injury following red and yellow cards, injuries and goals in FIFA World Cups.

PubMed

Ryynänen, Jaakko; Dvorak, Jiri; Peterson, Lars; Kautiainen, Hannu; Karlsson, Jón; Junge, Astrid; Börjesson, Mats

2013-10-01

To study the relationship between potentially game-disrupting incidents (PGDIs; red and yellow cards, goals and injuries) and the injury incidence in football. Prospective injury surveillance during three FIFA World Cups in 2002, 2006 and 2010. Official match statistics were obtained for all the matches played in the three tournaments. 2002, 2006 and 2010 FIFA World Cups. Team physicians at the 2002, 2006 and 2010 FIFA World Cups. Injury incidences and incidence rate ratios (IRRs). The injury incidence was significantly higher during match periods within the minute of, or during a five-minute period following a yellow card, red card, another injury or a goal (PGDIs) than during other match periods (76.7/1000 match hours; 95% CI (66.6 to 87.9) vs 54.0/1000 match hours (46.9 to 61.9), p<0.001). There were significant differences in injury incidence between different match periods, with the highest injury incidence seen in the last 15 min of the first half (p<0.001). The PGDIs (other than injury) had a tendency to increase towards the end of the game and the most frequent PGDI was a yellow card. There was a risk ratio of 1.17 (95% CI 1.08 to 1.26) for injury, per PGDI (other injuries excluded) (p<0.001), and 1.15 (95% CI 1.06 to 1.24) after adjusted match time (p<0.001). The injury incidence is high within the five minutes following a PGDI. For both team management and players, being aware of the increased risk of injury directly after a PGDI may be of clinical relevance, as it may enable them to take precautions in order to prevent injuries. There are significant differences in injury incidence between different match periods and game-related factors, such as PGDIs, appear partly to contribute to this variation.

Mortality risk after head injury increases at 30 years.

PubMed

Harris, Colin; DiRusso, Stephen; Sullivan, Tom; Benzil, Deborah L

2003-11-01

Age has long been recognized as a critical factor in predicting outcomes after head injury, with individuals older than 60 years predicted to have a worse outcome than those younger than 60. The object of this study was to determine the effect of age by decade of life beginning at birth in patients with head injuries of all levels of severity. The New York State Trauma Registry was searched for head injuries from January 1, 1994 to December 31, 1995; the 13,908 cases found were placed into age groups by decade. Data were sought for each patient on demographics, Glasgow Coma Score, ICD-9 injury code, New Injury Severity Score (NISS), and mechanism of injury. These data were analyzed with chi-square and one-way ANOVA tests, with significance set at p < 0.05. The risk of dying was significantly increased in patients beginning at 30 years of age compared with those in the younger age groups, with the greatest increases occurring after age 60 (p < 0.001). For the population with available Glasgow Coma Score data (n = 12,844), the mortality rate for patients ages 0 to 30 was 10.9%, and for patients ages 31 to 50 was 12.4%. The mean Glasgow Coma Score for nonsurvivors ages 0 to 20 (3.9) and for nonsurvivors ages 31 to 50 (5.1) were significantly different, with a risk ratio of 1.3 (p < 0.001). The risk of dying for patients suffering head injuries increases as early as 30 years of age, making it necessary for health-care providers to consider increased monitoring and treatment for patients in this younger age group.

Analysis of sex-specific injury patterns and risk factors in young high-level athletes.

PubMed

Frisch, A; Seil, R; Urhausen, A; Croisier, J L; Lair, M L; Theisen, D

2009-12-01

This study analyzed sex-specific injury patterns and risk factors in young athletes (n=256) from 12 sport disciplines practicing at the national or the international level in the Grand-Duchy of Luxembourg. Injury occurrence as a result of sport practice was analyzed retrospectively over the year 2006 using a standardized self-administered questionnaire. Overall incidence was not different between girls and boys (1.20 and 1.21 injuries/1000 athlete-hours, respectively), but in the context of team sport competition girls tended to be at a greater risk (rate ratio 2.05, P=0.053). Girls had a higher proportion of injuries in the ankle/foot region compared with boys (34.8% vs 16.8%). No sex-related differences were found regarding injury severity. Multivariate logistic regression (controlling for age and practice volume) revealed that girls' team sports were associated with a greater injury risk compared with individual sports [odds ratio (OR) of 4.76], while in boys this was observed for racket sports (OR=3.31). Furthermore, physical or emotional stress tended to be a specific risk factor in girls. There was a tendency for injury outside sports to be coupled to a higher injury risk in girls and boys. Consideration of sex-specific injury patterns and risk factors could be of importance for effective injury prevention.

Association Between NCAP Ratings and Real-World Rear Seat Occupant Risk of Injury.

PubMed

Metzger, Kristina B; Gruschow, Siobhan; Durbin, Dennis R; Curry, Allison E

2015-01-01

Several studies have evaluated the correlation between U.S. or Euro New Car Assessment Program (NCAP) ratings and injury risk to front seat occupants, in particular driver injuries. Conversely, little is known about whether NCAP 5-star ratings predict real-world risk of injury to restrained rear seat occupants. The NHTSA has identified rear seat occupant protection as a specific area under consideration for improvements to its NCAP. In order to inform NHTSA's efforts, we examined how NCAP's current 5-star rating system predicts risk of moderate or greater injury among restrained rear seat occupants in real-world crashes. We identified crash-involved vehicles, model year 2004-2013, in NASS-CDS (2003-2012) with known make and model and nonmissing occupant information. We manually matched these vehicles to their NCAP star ratings using data on make, model, model year, body type, and other identifying information. The resultant linked NASS-CDS and NCAP database was analyzed to examine associations between vehicle ratings and rear seat occupant injury risk; risk to front seat occupants was also estimated for comparison. Data were limited to restrained occupants and occupant injuries were defined as any injury with a maximum Abbreviated Injury Scale (AIS) score of 2 or greater. We linked 95% of vehicles in NASS-CDS to a specific vehicle in NCAP. The 18,218 vehicles represented an estimated 6 million vehicles with over 9 million occupants. Rear seat passengers accounted for 12.4% of restrained occupants. The risk of injury in all crashes for restrained rear seat occupants was lower in vehicles with a 5-star driver rating in frontal impact tests (1.4%) than with 4 or fewer stars (2.6%, P =.015); results were similar for the frontal impact passenger rating (1.3% vs. 2.4%, P =.024). Conversely, side impact driver and passenger crash tests were not associated with rear seat occupant injury risk (driver test: 1.7% for 5-star vs. 1.8% for 1-4 stars; passenger test: 1.6% for 5

Work-related injury among direct care occupations in British Columbia, Canada.

PubMed

Alamgir, Hasanat; Cvitkovich, Yuri; Yu, Shicheng; Yassi, Annalee

2007-11-01

To examine how injury rates and injury types differ across direct care occupations in relation to the healthcare settings in British Columbia, Canada. Data were derived from a standardised operational database in three BC health regions. Injury rates were defined as the number of injuries per 100 full-time equivalent (FTE) positions. Poisson regression, with Generalised Estimating Equations, was used to determine injury risks associated with direct care occupations (registered nurses [RNs], licensed practical nurses [LPNs) and care aides [CAs]) by healthcare setting (acute care, nursing homes and community care). CAs had higher injury rates in every setting, with the highest rate in nursing homes (37.0 injuries per 100 FTE). LPNs had higher injury rates (30.0) within acute care than within nursing homes. Few LPNs worked in community care. For RNs, the highest injury rates (21.9) occurred in acute care, but their highest (13.0) musculoskeletal injury (MSI) rate occurred in nursing homes. MSIs comprised the largest proportion of total injuries in all occupations. In both acute care and nursing homes, CAs had twice the MSI risk of RNs. Across all settings, puncture injuries were more predominant for RNs (21.3% of their total injuries) compared with LPNs (14.4%) and CAs (3.7%). Skin, eye and respiratory irritation injuries comprised a larger proportion of total injuries for RNs (11.1%) than for LPNs (7.2%) and CAs (5.1%). Direct care occupations have different risks of occupational injuries based on the particular tasks and roles they fulfil within each healthcare setting. CAs are the most vulnerable for sustaining MSIs since their job mostly entails transferring and repositioning tasks during patient/resident/client care. Strategies should focus on prevention of MSIs for all occupations as well as target puncture and irritation injuries for RNs and LPNs.

Self-reported psychological characteristics as risk factors for injuries in female youth football.

PubMed

Steffen, K; Pensgaard, A M; Bahr, R

2009-06-01

Identifying and understanding injury risk factors are necessary to target the injury-prone athlete and develop injury prevention measurements. The influence of psychological factors on injuries in football is poorly documented. The purpose of this 8-month prospective cohort study therefore was to examine whether psychological player characteristics assessed by a self-administered questionnaire represent risk factors for injury. At baseline, female football players (14-16 years) were asked to complete a detailed questionnaire covering player history, previous injuries, perception of success and motivational climate, life stress, anxiety and coping strategies. During the 2005 season, a total of 1430 players were followed up to record injuries. A history of a previous injury [odds ratio (OR)=1.9 (1.4; 2.5), P<0.001] increased the risk of a new injury to the same region. There were significant differences in disfavor for previously injured compared with non-injured players for ego orientation (P=0.007), perception of a performance climate (P=0.003) and experienced stressful life events (P<0.001). However, only high life stress (P=0.001) and perception of a mastery climate (P=0.03) were significant risk factors for new injuries. In conclusion, a perceived mastery climate and a high level of life stress were significant predictors for new injuries in a cohort of young female football players.

Dual task cost of walking is related to fall risk in persons with multiple sclerosis.

PubMed

Wajda, Douglas A; Motl, Robert W; Sosnoff, Jacob J

2013-12-15

Persons with multiple sclerosis (MS) commonly have walking and cognitive impairments. While walking with a simultaneous cognitive task, persons with MS experience a greater decline in walking performance than healthy controls. This change in performance is termed dual task cost or dual task interference and has been associated with fall risk in older adults. We examined whether dual task cost during walking was related to fall risk in persons with MS. Thirty-three ambulatory persons with MS performed walking tasks with and without a concurrent cognitive task (dual task condition) as well as underwent a fall risk assessment. Dual task cost was operationalized as the percent change in velocity from normal walking conditions to dual task walking conditions. Fall risk was quantified using the Physiological Profile Assessment. A Spearman correlation analysis revealed a significant positive correlation between dual task cost of walking velocity and fall risk as well as dual task cost of stride length and fall risk. Overall, the findings indicate that dual task cost is associated with fall risk and may be an important target for falls prevention strategies. © 2013.

Distribution of concussion related symptoms after whiplash injury in risk strata.

PubMed

Kasch, Helge; Jensen, Troels S

2017-12-29

Background/aims The presence and severity of concussion related symptoms after acute whiplash injury are debatable. In this study we examine the distribution and development of the burden of concussion related symptoms in whiplash patients. Methods Consecutively 141 acute whiplash patients and 40 ankle injured controls were recruited from emergency units and were examined after 1 week, 1, 3, 6, 12 months obtaining neck/head VAS score, number-of-non-painful complaints, epidemiological, social, psychological data and neurological examination, active neck mobility, and furthermore muscle tenderness and pain response, strength and duration of neck muscles. Risk factors derived (reduced CROM, intense neckpain/headache, multiple non-pain complaints) were applied in a Risk Assessment Score and divided into 7 risk-strata (refer Kasch et al., Spine 2011). After 1 week and 6 months whiplash patients fulfilled the Rivermead Oxford Head Injury questionnaire (10 items, score from 0 = no change to 4 = very marked change, Danish Version, total score range from 0 to 40). Results 138 acute whiplash patients fulfilled the Rivermead Oxford Head Injury questionnaire after 1 week and 111 after 6 months. The distribution was markedly different in the risk strata, in stratum 7 the sum score was a factor 10 higher than stratum 1 after 1 week (Kruskal-Wallis, p < 1.4 × 10-7) and remained high 6 months after injury (p < 0.05). Conclusion Mild concussion symptoms do not necessarily reflect eventual concussion, but are found after injuries with no direct head trauma and amnesia e.g. whiplash injuries. The Risk Assessment Score fits nicely with the burden of concussion related symptoms after whiplash injury.

Roof strength and injury risk in rollover crashes of passenger cars.

PubMed

Brumbelow, Matthew L; Teoh, Eric R

2009-12-01

A 2009 study by the Insurance Institute for Highway Safety found that midsize SUVs with stronger roofs, as measured in quasi-static tests, had lower risk of ejection and lower risk of injury for nonejected drivers. The objective of the present study was to determine whether a similar association exists for other vehicle groups. Twelve small passenger cars were evaluated according to Federal Motor Vehicle Safety Standard 216 test conditions. Crash databases in 14 states provided more than 20,000 single-vehicle rollover crashes involving these vehicles. Logistic regression analyses were used to evaluate the effect of roof strength on the rate of driver injury while assessing and controlling for the effects of driver age, vehicle stability, state, and other factors where necessary. Small cars with stronger roofs had lower overall rates of serious injury, lower rates of ejection, and lower rates of injury for nonejected drivers. Although the effect on ejection was somewhat smaller for cars than for SUVs, the overall pattern of injury results was consistent. For roof strength-to-weight ratio measured within 5 in. (SWR(5)), a one-unit increase (e.g., from 2.0 to 3.0) was associated with a 22 percent reduction in risk of incapacitating or fatal driver injury in single-vehicle rollovers. This compares with a 24 percent reduction estimated for a similar change in roof strength among midsize SUVs. The association between vehicle roof strength and occupant injury risk in rollover crashes appears robust across different vehicle groups and across roof SWR(5) values, varying from just more than 1.5 to just less than 4.0. If roofs were to increase in strength by one SWR(5), a 20-25 percent reduction in risk of serious injury in rollovers would be expected. Still, even if all vehicle roofs were as strong as the strongest roof measured, many rollover injuries still would occur, indicating the need for additional research and countermeasures.

Roles of safety climate and shift work on perceived injury risk: a multi-level analysis.

PubMed

Huang, Yueng-Hsiang; Chen, Jiu-Chiuan; DeArmond, Sarah; Cigularov, Konstantin; Chen, Peter Y

2007-11-01

This study evaluated the relationship between employees' work shift (i.e., day shift versus night shift) and perceptions of injury risk, and how the relationship is affected by company level safety climate and injury frequency. The results showed that night shift workers perceived a higher level of injury risk compared to day shift workers. Both company level safety climate and injury frequency played critical roles in predicting individual perceived work injury risk. Perception of injury risk of night shift workers was significantly lower when they perceived high-level rather than low-level safety climate. However, this pattern was not noticeable for day shift workers. These findings highlighted the importance of considering company level factors when attempting to understand the differences between day shift and night shift work on an individual's perception of injury risk.

Minimalist Running Shoes and Injury Risk Among United States Army Soldiers.

PubMed

Grier, Tyson; Canham-Chervak, Michelle; Bushman, Timothy; Anderson, Morgan; North, William; Jones, Bruce H

2016-06-01

Minimalist running shoes (MRS) are lightweight, are extremely flexible, and have little to no cushioning. It has been thought that MRS will enhance running performance and decrease injury risk. To compare physical characteristics, fitness performance, and injury risks associated with soldiers wearing MRS and those wearing traditional running shoes (TRS). Case series; Level of evidence, 4. Participants were men in a United States Army brigade (N = 1332). Physical characteristics and Army Physical Fitness Test data were obtained by survey. Fitness performance testing was administered at the brigade, and the types of footwear worn were identified by visual inspection. Shoe types were categorized into 2 groups: TRS (stability, cushioning, and motion control) and MRS. Injuries from the previous 12 months were obtained from the Defense Medical Surveillance System. A t test was used to determine mean differences between personal characteristics, training, and fitness performance metrics by shoe type. Hazard ratios and 95% CIs were calculated to determine injury risk by shoe type, controlling for other risk factors. A majority of soldiers wore cushioning shoes (57%), followed by stability shoes (24%), MRS (17%), and motion control shoes (2%). Soldiers wearing MRS were slightly younger than those wearing TRS (P < .01); performed more push-ups, sit-ups, and pull-ups (P < .01); and ran faster during the 2-mile run (P = .01). When other risk factors were controlled, there was no difference in injury risk for running shoe type between soldiers wearing MRS compared with TRS. Soldiers who chose to wear MRS were younger and had higher physical performance scores compared with soldiers wearing TRS. When these differences are controlled, use of MRS does not appear to be associated with higher or lower injury risk in this population. © 2016 The Author(s).

Alpine ski and snowboarding traumatic injuries: incidence, injury patterns, and risk factors for 10 years.

PubMed

McBeth, Paul B; Ball, Chad G; Mulloy, Robert H; Kirkpatrick, Andrew W

2009-05-01

Alpine skiing and snowboarding are popular winter sports in Canada. Every year participation in these activities results in traumatic injury. The purpose of this study was to identify the incidence and injury patterns, as well as risk factors associated with ski and snowboarding injuries. A comprehensive 10-year retrospective review of Alpine ski and snowboarding injuries from 1996 to 2006 was conducted. The Alberta Trauma Registry was used as the primary source of data. A total of 196 patients (56.6% skiers, 43.4% snowboarders) were identified as having major traumatic injuries (Injury Severity Score, >or=12). Forty-three patients required intensive care unit support. The majority of injuries were related to falls and collisions with natural objects. Head injuries were most common, followed by chest, spinal, and extremity trauma. Seventy-nine patients required emergency surgery. Skiing and snowboarding represent activities with high potential for traumatic injury. Safety initiatives should be developed to target this population.

Association among physical activity level, cardiorespiratory fitness, and risk of musculoskeletal injury.

PubMed

Hootman, J M; Macera, C A; Ainsworth, B E; Martin, M; Addy, C L; Blair, S N

2001-08-01

To help public health practitioners promote physical activities with a low risk of injury, this study determined the relation among type and duration of physical activity, cardiorespiratory fitness, and musculoskeletal injury in a sample of adults enrolled in the Aerobics Center Longitudinal Study. Subjects included 4,034 men and 967 women who underwent a baseline physical examination between 1970 and 1985 and who returned a mailed follow-up survey in 1986. At baseline, a treadmill graded exercise test was used to measure cardiorespiratory fitness. At follow-up, subjects reported injuries and type and duration of physical activity in the preceding 12 months. Polytomous logistic regression was used to estimate the association among physical activity type and duration, cardiorespiratory fitness, and injury. The risk of sustaining an activity-related injury increased with higher duration of physical activity per week and cardiorespiratory fitness levels. Results suggest that cardiorespiratory fitness may be a surrogate for unmeasured components of physical activity, such as exercise intensity. Among walkers, increasing duration of activity per week was not associated with an increased risk of injury. Results suggest that, for most adults, walking is a safe form of physical activity associated with a lower risk of injury than running or sport participation.

Detection of the toughest: Pedestrian injury risk as a smooth function of age.

PubMed

Niebuhr, Tobias; Junge, Mirko

2017-07-04

Though it is common to refer to age-specific groups (e.g., children, adults, elderly), smooth trends conditional on age are mainly ignored in the literature. The present study examines the pedestrian injury risk in full-frontal pedestrian-to-passenger car accidents and incorporates age-in addition to collision speed and injury severity-as a plug-in parameter. Recent work introduced a model for pedestrian injury risk functions using explicit formulae with easily interpretable model parameters. This model is expanded by pedestrian age as another model parameter. Using the German In-Depth Accident Study (GIDAS) to obtain age-specific risk proportions, the model parameters are fitted to the raw data and then smoothed by broken-line regression. The approach supplies explicit probabilities for pedestrian injury risk conditional on pedestrian age, collision speed, and injury severity under investigation. All results yield consistency to each other in the sense that risks for more severe injuries are less probable than those for less severe injuries. As a side product, the approach indicates specific ages at which the risk behavior fundamentally changes. These threshold values can be interpreted as the most robust ages for pedestrians. The obtained age-wise risk functions can be aggregated and adapted to any population. The presented approach is formulated in such general terms that in can be directly used for other data sets or additional parameters; for example, the pedestrian's sex. Thus far, no other study using age as a plug-in parameter can be found.

A case-crossover study of transient risk factors influence on occupational injuries: a study protocol based on a review of previous studies.

PubMed

Oesterlund, Anna H; Lander, Flemming; Lauritsen, Jens

2016-10-01

The occupational injury incident rate remains relatively high in the European Union. The case-crossover study gives a unique opportunity to study transient risk factors that normally would be very difficult to approach. Studies like this have been carried out in both America and Asia, but so far no relevant research has been conducted in Europe. Case-crossover studies of occupational injuries were collected from PubMed and Embase and read through. Previous experiences concerning method, exposure and outcome, time-related measurements and construction of the questionnaire were taken into account in the preparation of a pilot study. Consequently, experiences from the pilot study were used to design the study protocol. Approximately 2000 patients with an occupational injury will be recruited from the emergency departments in Herning and Odense, Denmark. A standardised questionnaire will be used to collect basic demographic data and information on eight transient risk factors. Based on previous studies and knowledge on occupational injuries the transient risk factors we chose to examine were: time pressure, performing a task with a different method/using unaccustomed technique, change in working surroundings, using a phone, disagreement, feeling ill, being distracted and using malfunctioning machinery/tools or work material. Exposure time 'just before the injury' will be compared with two control periods, 'previous day at the same time of the injury' (pair match) and the previous work week (usual frequency). This study protocol describes a unique opportunity to calculate the effect of transient risk factors on occupational injuries in a European setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

New Risk Curves for NHTSA's Brain Injury Criterion (BrIC): Derivations and Assessments.

PubMed

Laituri, Tony R; Henry, Scott; Pline, Kevin; Li, Guosong; Frankstein, Michael; Weerappuli, Para

2016-11-01

The National Highway Traffic Safety Administration (NHTSA) recently published a Request for Comments regarding a potential upgrade to the US New Car Assessment Program (US NCAP) - a star-rating program pertaining to vehicle crashworthiness. Therein, NHTSA (a) cited two metrics for assessing head risk: Head Injury Criterion (HIC15) and Brain Injury Criterion (BrIC), and (b) proposed to conduct risk assessment via its risk curves for those metrics, but did not prescribe a specific method for applying them. Recent studies, however, have indicated that the NHTSA risk curves for BrIC significantly overstate field-based head injury rates. Therefore, in the present three-part study, a new set of BrIC-based risk curves was derived, an overarching head risk equation involving risk curves for both BrIC and HIC15 was assessed, and some additional candidatepredictor- variable assessments were conducted. Part 1 pertained to the derivation. Specifically, data were pooled from various sources: Navy volunteers, amateur boxers, professional football players, simple-fall subjects, and racecar drivers. In total, there were 4,501 cases, with brain injury reported in 63. Injury outcomes were approximated on the Abbreviated Injury Scale (AIS). The statistical analysis was conducted subject to ordinal logistic regression analysis (OLR), such that the various levels of brain injury were cast as a function of BrIC. The resulting risk curves, with Goodman Kruksal Gamma=0.83, were significantly different than those from NHTSA. Part 2 pertained to the assessment relative to field data. Two perspectives were considered: "aggregate" (ΔV=0-56 km/h) and "point" (high-speed, regulatory focus). For the aggregate perspective, the new risk curves for BrIC were applied in field models pertaining to belted, mid-size, adult drivers in 11-1 o'clock, full-engagement frontal crashes in the National Automotive Sampling System (NASS, 1993-2014 calendar years). For the point perspective, BrIC data from tests

Are female healthcare workers at higher risk of occupational injury?

PubMed

Alamgir, Hasanat; Yu, Shicheng; Drebit, Sharla; Fast, Catherine; Kidd, Catherine

2009-05-01

Differential risks of occupational injuries by gender have been examined across various industries. With the number of employees in healthcare rising and an overwhelming proportion of this workforce being female, it is important to address this issue in this growing sector. To determine whether compensated work-related injuries among females are higher than their male colleagues in the British Columbia healthcare sector. Incidents of occupational injury resulting in compensated days lost from work over a 1-year period for all healthcare workers were extracted from a standardized operational database and the numbers of productive hours were obtained from payroll data. Injuries were grouped into all injuries and musculoskeletal injuries (MSIs). Detailed analysis was conducted using Poisson regression modelling. A total of 42 332 employees were included in the study of whom 11% were male and 89% female. When adjusted for age, occupation, sub-sector, employment category, health region and facility, female workers had significantly higher risk of all injuries [rate ratio (95% CI) = 1.58 (1.24-2.01)] and MSIs [1.43 (1.11-1.85)] compared to their male colleagues. Occupational health and safety initiatives should be gender sensitive and developed accordingly.

Effect of type of cue, type of response, time delay and two different ongoing tasks on prospective memory functioning after acquired brain injury.

PubMed

Raskin, Sarah A; Buckheit, Carol A; Waxman, Amanda

2012-01-01

Failures of prospective memory (PM) are one of the most frequent, and least studied, sequelae of brain injury. PM, also referred to as memory for intentions, is the ability to remember to carry out a future task. Successful completion of a PM task requires the ability to monitor time, keep the action to be performed periodically in awareness, remember the task to be performed, and initiate the action. Although PM has been shown to be a common difficulty after brain injury, it remains unknown which aspects of performance are impaired. In this study, the performance of 25 individuals with brain injury and that of 25 healthy participants were measured separately on the following variables: time until completion of the task, difficulty of the ongoing task being performed while waiting, whether the task to be performed is an action or is verbal, and whether the cue to perform the task is the passing of a particular amount of time (e.g., 10 minutes) or is an external cue (e.g., an alarm sounding). Individuals with brain injury demonstrated impairment compared to healthy adults on virtually all variables. PM performance was also compared to a battery of standard neuropsychological measures of attention, memory, and executive functions, and to self-report measures of PM functioning, in order to determine the underlying cognitive deficits responsible for poor PM performance, if any. PM performance was correlated with measures of executive functioning but not to self-report measures of PM functioning. Implications are discussed in terms of cognitive rehabilitation recommendations.

The prognostic value of MRI in determining reinjury risk following acute hamstring injury: a systematic review.

PubMed

van Heumen, Moniek; Tol, Johannes L; de Vos, Robert-Jan; Moen, Maarten H; Weir, Adam; Orchard, John; Reurink, Gustaaf

2017-09-01

A challenge for sports physicians is to estimate the risk of a hamstring re-injury, but the current evidence for MRI variables as a risk factor is unknown. To systematically review the literature on the prognostic value of MRI findings at index injury and/or return to play for acute hamstring re-injuries. Databases of PubMed, Embase, MEDLINE, Scopus, CINAHL, Google Scholar, Web of Science, LILACS, SciELO, ScienceDirect, ProQuest, SPORTDiscus and Cochrane Library were searched until 20 June 2016. Studies evaluating MRI as a prognostic tool for determining the risk of re-injury for athletes with acute hamstring injuries were eligible for inclusion. Two authors independently screened the search results and assessed risk of bias using standardised criteria from a consensus statement. A best-evidence synthesis was used to identify the level of evidence. Post hoc analysis included correction for insufficient sample size. Of the 11 studies included, 7 had a low and 4 had a high risk of bias. No strong evidence for any MRI finding as a risk factor for hamstring re-injury was found. There was moderate evidence that intratendinous injuries were associated with increased re-injury risk. Post hoc analysis showed moderate evidence that injury to the biceps femoris was a moderate to strong risk factor for re-injury. There is currently no strong evidence for any MRI finding in predicting hamstring re-injury risk. Intratendinous injuries and biceps femoris injuries showed moderate evidence for association with a higher re-injury risk. Registration in the PROSPERO International prospective register of systematic reviews was performed prior to study initiation (registration number CRD42015024620). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Recurrent obstetric anal sphincter injury and the risk of long-term anal incontinence.

PubMed

Jangö, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne; Sakse, Abelone

2017-06-01

Women with an obstetric anal sphincter injury are concerned about the risk of recurrent obstetric anal sphincter injury in their second pregnancy. Existing studies have failed to clarify whether the recurrence of obstetric anal sphincter injury affects the risk of anal and fecal incontinence at long-term follow-up. The objective of the study was to evaluate whether recurrent obstetric anal sphincter injury influenced the risk of anal and fecal incontinence more than 5 years after the second vaginal delivery. We performed a secondary analysis of data from a postal questionnaire study in women with obstetric anal sphincter injury in the first delivery and 1 subsequent vaginal delivery. The questionnaire was sent to all Danish women who fulfilled inclusion criteria and had 2 vaginal deliveries 1997-2005. We performed uni- and multivariable analyses to assess how recurrent obstetric anal sphincter injury affects the risk of anal incontinence. In 1490 women with a second vaginal delivery after a first delivery with obstetric anal sphincter injury, 106 had a recurrent obstetric anal sphincter injury. Of these, 50.0% (n = 53) reported anal incontinence compared with 37.9% (n = 525) of women without recurrent obstetric anal sphincter injury. Fecal incontinence was present in 23.6% (n = 25) of women with recurrent obstetric anal sphincter injury and in 13.2% (n = 182) of women without recurrent obstetric anal sphincter injury. After adjustment for third- or fourth-degree obstetric anal sphincter injury in the first delivery, maternal age at answering the questionnaire, birthweight of the first and second child, years since first and second delivery, and whether anal incontinence was present before the second pregnancy, the risk of flatal and fecal incontinence was still increased in patients with recurrent obstetric anal sphincter injury (adjusted odds ratio, 1.68 [95% confidence interval, 1.05-2.70), P = .03, and adjusted odds ratio, 1.98 [95% confidence interval, 1

Sleep quality and the risk of work injury: a Swiss case-control study.

PubMed

Uehli, Katrin; Miedinger, David; Bingisser, Roland; Dürr, Selina; Holsboer-Trachsler, Edith; Maier, Sabrina; Mehta, Amar J; Müller, Roland; Schindler, Christian; Zogg, Stefanie; Künzli, Nino; Leuppi, Jörg D

2014-10-01

Sleep problems are a well-known risk factor for work injuries, but less is known about which vulnerable populations are most at risk. The aims of this study were to investigate the association between sleep quality and the risk of work injury and to identify factors that may modify the association. A case-control study including 180 cases and 551 controls was conducted at the University Hospital in Basel, Switzerland, from 1 December 2009 to 30 June 2011. Data on work injuries and sleep quality were collected. Adjusted odds ratios and 95% confidence intervals of the association between sleep quality and work injury were estimated in multivariable logistic regression analyses and were stratified by hypothesized effect modifiers (age, gender, job risk, shift work, sleep duration and working hours). Poor sleep quality was associated significantly with work injury of any type (P < 0.05) and with being caught in particular (P < 0.05). The association between poor sleep quality and work injury was significantly higher for workers older than 30 years (odds ratio>30 1.30 versus odds ratio≤30 0.91, P < 0.01), sleeping 7 h or less per night (odds ratio≤7 1.17 versus odds ratio>7 0.79, P < 0.05) and working 50 h or more per week (odds ratio≥50 1.79 versus odd ratio<50 1.10, P < 0.01). Work injury risk increased with increasing severity of sleep problems (P < 0.05). Prior work injury frequency increased with decreasing sleep quality (P < 0.05). Older age, short sleep duration and long working hours may enhance the risk of work injuries associated with sleep quality. © 2014 European Sleep Research Society.

Automated Pressure Injury Risk Assessment System Incorporated Into an Electronic Health Record System.

PubMed

Jin, Yinji; Jin, Taixian; Lee, Sun-Mi

Pressure injury risk assessment is the first step toward preventing pressure injuries, but traditional assessment tools are time-consuming, resulting in work overload and fatigue for nurses. The objectives of the study were to build an automated pressure injury risk assessment system (Auto-PIRAS) that can assess pressure injury risk using data, without requiring nurses to collect or input additional data, and to evaluate the validity of this assessment tool. A retrospective case-control study and a system development study were conducted in a 1,355-bed university hospital in Seoul, South Korea. A total of 1,305 pressure injury patients and 5,220 nonpressure injury patients participated for the development of a risk scoring algorithm: 687 and 2,748 for the validation of the algorithm and 237 and 994 for validation after clinical implementation, respectively. A total of 4,211 pressure injury-related clinical variables were extracted from the electronic health record (EHR) systems to develop a risk scoring algorithm, which was validated and incorporated into the EHR. That program was further evaluated for predictive and concurrent validity. Auto-PIRAS, incorporated into the EHR system, assigned a risk assessment score of high, moderate, or low and displayed this on the Kardex nursing record screen. Risk scores were updated nightly according to 10 predetermined risk factors. The predictive validity measures of the algorithm validation stage were as follows: sensitivity = .87, specificity = .90, positive predictive value = .68, negative predictive value = .97, Youden index = .77, and the area under the receiver operating characteristic curve = .95. The predictive validity measures of the Braden Scale were as follows: sensitivity = .77, specificity = .93, positive predictive value = .72, negative predictive value = .95, Youden index = .70, and the area under the receiver operating characteristic curve = .85. The kappa of the Auto-PIRAS and Braden Scale risk

Workplace injuries and risk reduction practices in Malaysia.

PubMed

Ali, Roslinah; Shaharudin, Rafiza; Omar, Azahadi; Yusoff, Fadhli

2012-01-01

This study on workplace injuries and risk reduction practices was part of the Malaysia National Health Morbidity Survey III (NHMS III) conducted in 2006. This cross-sectional population-based survey was conducted to determine the incidence of workplaces injuries and assess the magnitude of some important risk reduction practices among workers. Data were gathered through face-to-face household interviews using a pre-coded questionnaire. Of the 22 880 eligible respondents, 88·2% (20 180) responded. The incidence rate for injuries at the workplace was 4·9 per 100 (95% CI: 4·6-5·2). The overall proportion of workers who had received occupational safety and health (OSH) training before or within 1 month of starting work was 33·6%. Among respondents who perceived that personal protective equipment (PPE) was required at their workplace, only 38·9% (95% CI: 37·8-39·4) were provided with it by their employers. Further studies are urgently needed to identify reasons for and management of the low uptake of risk reduction practices. This issue needs to be addressed to ensure the safety and health of our working population.

Preseason Workload Volume and High-Risk Periods for Noncontact Injury Across Multiple Australian Football League Seasons.

PubMed

Colby, Marcus J; Dawson, Brian; Heasman, Jarryd; Rogalski, Brent; Rosenberg, Michael; Lester, Leanne; Peeling, Peter

2017-07-01

Colby, MJ, Dawson, B, Heasman, J, Rogalski, B, Rosenberg, M, Lester, L, and Peeling, P. Preseason workload volume and high-risk periods for noncontact injury across multiple Australian Football League seasons. J Strength Cond Res 31(7): 1821-1829, 2017-The purpose of this study was to assess the association between preseason workloads and noncontact injury risk in Australian football players. Individual player injury data were recorded over 4 full seasons (2012-15) from one professional club. Noncontact injury incidence (per 1,000 "on legs" field training and game hours) was compared across the preseason, precompetition, and in-season phases to determine relative noncontact injury risk. Preseason workloads (global positioning system-derived total distance run and sprint distance) and individual (fixed) injury risk factors (age, previous injury history) were incorporated into the analysis. A generalized estimating equation with a binary logistic function modeled potential risk factors with noncontact injury for selected periods across the annual cycle. Odds ratios were calculated to determine the relative injury risk. The (preseason) precompetition phase (19.1 injuries per 1,000 hours) and (in-season) rounds 12-17 (16.0 injuries per 1,000 hours) resulted in the highest injury incidence. Low cumulative total distances in late preseason (<108 km) and precompetition (76-88 km) periods were associated with significantly (p ≤ 0.05) greater injury risk during the in-season phase. In conclusion, these results suggest players are at the greatest injury risk during the precompetition period, with low preseason cumulative workloads associated with increased in-season injury risk. Therefore, strength and conditioning staff should place particular emphasis on achieving at least moderate training loads during and leading into this phase, where competitive game play is first introduced.

Rates and risk factors of injury in CrossFitTM: a prospective cohort study.

PubMed

Moran, Sebastian; Booker, Harry; Staines, Jacob; Williams, Sean

2017-09-01

CrossFitTM is a strength and conditioning program that has gained widespread popularity since its inception approximately 15 years ago. However, at present little is known about the level of injury risk associated with this form of training. Movement competency, assessed using the Functional Movement ScreenTM (FMS), has been identified as a risk factor for injury in numerous athletic populations, but its role in CrossFit participants is currently unclear. The aim of this study was to evaluate the level of injury risk associated with CrossFit training, and examine the influence of a number of potential risk factors (including movement competency). A cohort of 117 CrossFit participants were followed prospectively for 12 weeks. Participants' characteristics, previous injury history and training experience were recorded at baseline, and an FMS assessment was conducted. The overall injury incidence rate was 2.10 per 1000 training hours (90% confidence limits: 1.32-3.33). A multivariate Poisson regression model identified males (rate ratio [RR]: 4.44 ×/÷ 3.30, very likely harmful) and those with previous injuries (RR: 2.35 ×/÷ 2.37, likely harmful) as having a higher injury risk. Inferences relating to FMS variables were unclear in the multivariate model, although number of asymmetries was a clear risk factor in a univariate model (RR per two additional asymmetries: 2.62 ×/÷ 1.53, likely harmful). The injury incidence rate associated with CrossFit training was low, and comparable to other forms of recreational fitness activities. Previous injury and gender were identified as risk factors for injury, whilst the role of movement competency in this setting warrants further investigation.

Education-to-job mismatch and the risk of work injury.

PubMed

Premji, Stephanie; Smith, Peter M

2013-04-01

To examine the association between education-to-job mismatch and work injury. Cross-sectional data from the 2003 and 2005 Canadian Community Health Surveys (n=63,462) were used to examine the relationship between having an educational level that is incongruent with occupational skills requirements and the risk of sustaining a work injury requiring medical attention or a work-related repetitive movement injury (RMI). The effect on injury of the interaction of overeducation with recent immigrant status was also examined. Models were stratified by sex and adjusted for possible confounders. Occupational physical demands were conceptualised as a potential mediating variable. After adjustment for covariates, over-education was associated with work injury and RMI for both sexes. Adjustment for occupational demands attenuated the impact on work injury but did not eliminate the effect on RMI among men. The interaction of over-education and recent immigrant status resulted among men in a fourfold increase in the odds of work injury compared with non-recent immigrants who were not over-educated. After adjustment for occupational demands, over-educated recent immigrant men still had more than a twofold increase in the odds of injury. The risk of sustaining a work injury is higher among those whose education exceeds that of job requirements. These findings highlight the need to address barriers to suitable employment, particularly among recent immigrants.

Paraffin-related injury in low-income South African communities: knowledge, practice and perceived risk

PubMed Central

Swart, Dehran; Hui, Siu-kuen Azor; Simpson, Jennifer; Hobe, Phumla

2009-01-01

Abstract Objective To explore what individuals at risk of injury from using paraffin (also known as kerosene) know about paraffin safety, what they do to protect themselves and their families from paraffin-related injury, and how they perceive their risk for such injury. Also, to explore interrelations between these factors and age, sex, education and income. Methods A sample of 238 individuals was randomly recruited from low-income housing districts near Cape Town, South Africa in 2007. Trained research assistants interviewed participants to explore their knowledge about paraffin-related safety and their perceived risk of injury from using paraffin. Researchers inspected participants’ homes to evaluate paraffin safety practices. Descriptive and correlational analyses were conducted. Findings Participants had relatively low levels of knowledge about paraffin-related safety. They had high levels of unsafe practice and their perceived risk of injury was moderate. Knowledge of paraffin safety and safe practices were positively correlated with each other. Greater knowledge showed a negative correlation with the perception of being at risk for injury, but safe practices showed no correlation with perceived risk of injury. Formal education, the number of children in the home and frequency of paraffin use were positively correlated with knowledge but not with safe practices. The only significant correlate to safe practices was greater income, perhaps a reflection of the impact of financial resources on paraffin safety practices. Conclusion To develop successful paraffin safety interventions, it is necessary to understand baseline levels of knowledge, practice and perceived risk of injury among at-risk populations. Our findings could be of value for designing interventions that will increase knowledge, improve safe practices and lead to the accurate perception of the risk of injury from using paraffin. PMID:19784450

Airmen with mild traumatic brain injury (mTBI) at increased risk for subsequent mishaps.

PubMed

Whitehead, Casserly R; Webb, Timothy S; Wells, Timothy S; Hunter, Kari L

2014-02-01

Little is known regarding long-term performance decrements associated with mild Traumatic Brain Injury (mTBI). The goal of this study was to determine if individuals with an mTBI may be at increased risk for subsequent mishaps. Cox proportional hazards modeling was utilized to calculate hazard ratios for 518,958 active duty U.S. Air Force service members (Airmen) while controlling for varying lengths of follow-up and potentially confounding variables. Two non-mTBI comparison groups were used; the second being a subset of the original, both without head injuries two years prior to study entrance. Hazard ratios indicate that the causes of increased risk associated with mTBI do not resolve quickly. Additionally, outpatient mTBI injuries do not differ from other outpatient bodily injuries in terms of subsequent injury risk. These findings suggest that increased risk for subsequent mishaps are likely due to differences shared among individuals with any type of injury, including risk-taking behaviors, occupations, and differential participation in sports activities. Therefore, individuals who sustain an mTBI or injury have a long-term risk of additional mishaps. Differences shared among those who seek medical care for injuries may include risk-taking behaviors (Cherpitel, 1999; Turner & McClure, 2004; Turner, McClure, & Pirozzo, 2004), occupations, and differential participation in sports activities, among others. Individuals with an mTBI should be educated that they are at risk for subsequent injury. Historical data supported no lingering effects of mTBI, but more recent data suggest longer lasting effects. This study further adds that one of the longer term sequelae of mTBI may be an increased risk for subsequent mishap. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

[Occupational injury risk in immigrant workers in Italy: differences in work characteristics and age].

PubMed

Bena, Antonella; Giraudo, Massimiliano

2014-01-01

to describe occupational injury risk, comparing regular foreign workers with Italians, by main work characteristics and age. analysis of incidence and risk of total and severe occupational injury by Country of birth, stratified by economic activity, skill level, geographical area of work, firm size and age. sample of 7% of workers registered in the Italian National Institute of Social Insurance (INPS) database. The workers considered were male private sector employees aged from 16 to 55 years old who worked between 2000 and 2005 as apprentice or blue collar. Two groups were distinguished: immigrants from high migratory pressure Countries (PFPM) and immigrants from high-income Countries (PSA; Italians comprised). The three main nationalities considered were the most relevant in Italy: Moroccans, Albanians, and Romanians. all occupational injuries; severe occupational injuries based on the type of damage. PFPM workers have a higher risk of injury compared to PSA both for total (Relative Risk - RR: 1.45) and severe ones (RR: 1.56), particularly in engineering (RR: 1.64) and trade (RR: 1.61). Moroccans have always the greatest risks (RR: 1.86); Romanians are protected on total injuries (RR: 0.80), but have excess of risk of severe injuries (RR: 1.31). Among young people there aren't differences by Country of birth, but the rate decreases as age increases in PSA, while in PFPM it increases as age increases. In this study, injury risk in regular foreign workers were measured more accurately than official statistics: Whip-Salute database can provide useful information for planning prevention programmes of immigrant work-related injuries.

Social Cognition, Child Neglect, and Child Injury Risk: The Contribution of Maternal Social Information Processing to Maladaptive Injury Prevention Beliefs Within a High-Risk Sample.

PubMed

Azar, Sandra T; Miller, Elizabeth A; Stevenson, Michael T; Johnson, David R

2017-08-01

Inadequate supervision has been linked to children's injuries. Parental injury prevention beliefs may play a role in supervision, yet little theory has examined the origins of such beliefs. This study examined whether mothers who perpetrated child neglect, who as a group provide inadequate supervision, have more maladaptive beliefs. Then, it tested a social information processing (SIP) model for explaining these beliefs. SIP and injury prevention beliefs were assessed in disadvantaged mothers of preschoolers (N  =  145), half with child neglect histories. The neglect group exhibited significantly more maladaptive injury prevention beliefs than comparisons. As predicted, SIP was linked to beliefs that may increase injury risk, even after accounting for relevant sociodemographic variables. Findings support the link of beliefs to injury risk and suggest that specific cognitive problems may underlie these beliefs. Future work should further validate this model, which may inform enhancements to prevention efforts. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Muscle Activation During ACL Injury Risk Movements in Young Female Athletes: A Narrative Review.

PubMed

Bencke, Jesper; Aagaard, Per; Zebis, Mette K

2018-01-01

Young, adolescent female athletes are at particular high risk of sustaining a non-contact anterior cruciate ligament (ACL) injury during sport. Through the last decades much attention has been directed toward various anatomical and biomechanical risk factors for non-contact ACL injury, and important information have been retrieved about the influence of external loading factors on ACL injury risk during given sports-specific movements. However, much less attention has been given to the aspect of neuromuscular control during such movements and only sparse knowledge exists on the specific muscle activation patterns involved during specific risk conditions. Therefore, the aim of this narrative review was (1) to describe anatomical aspects, strength aspects and biomechanical aspects relevant for the understanding of ACL non-contact injury mechanisms in young female athletes, and (2) to review the existing literature on lower limb muscle activation in relation to risk of non-contact ACL-injury and prevention of ACL injury in young female athletes. Studies investigating muscle activity patterns associated with sports-specific risk situations were identified, comprising cohort studies, intervention studies and prospective studies. Based on the retrieved studies, clear gender-specific differences in muscle activation and coordination were identified demonstrating elevated quadriceps activity and reduced hamstring activity in young female athletes compared to their male counterparts, and suggesting young female athletes to be at elevated risk of non-contact ACL injury. Only few studies ( n = 6) examined the effect of preventive exercise-based intervention protocols on lower limb muscle activation during sports-specific movements. A general trend toward enhanced hamstring activation was observed during selected injury risk situations (e.g., sidecutting and drop landings). Only a single study examined the association between muscle activation deficits and ACL injury risk

Risk Factors for Parachute Injuries and Airborne Student Observations on the Parachute Ankle Brace

DTIC Science & Technology

2007-10-03

rate of self -reported injuries in the year prior to jump school was 13.9 injuries/ 100 person-years. The most common injury sites were the legs (22...Report No. 12-MA01Q2-08B ES-2 injury risk factors included older age, Airborne recycling, higher BMI, and less physical activity. b. The self ...the most common injury locations. Univariate analysis showed that greater risk of a self -reported jump week injury was associated with higher rank

Configural approaches to temperament assessment: implications for predicting risk of unintentional injury in children.

PubMed

Berry, Jack W; Schwebel, David C

2009-10-01

This study used two configural approaches to understand how temperament factors (surgency/extraversion, negative affect, and effortful control) might predict child injury risk. In the first approach, clustering procedures were applied to trait dimensions to identify discrete personality prototypes. In the second approach, two- and three-way trait interactions were considered dimensionally in regression models predicting injury outcomes. Injury risk was assessed through four measures: lifetime prevalence of injuries requiring professional medical attention, scores on the Injury Behavior Checklist, and frequency and severity of injuries reported in a 2-week injury diary. In the prototype analysis, three temperament clusters were obtained, which resembled resilient, overcontrolled, and undercontrolled types found in previous research. Undercontrolled children had greater risk of injury than children in the other groups. In the dimensional interaction analyses, an interaction between surgency/extraversion and negative affect tended to predict injury, especially when children lacked capacity for effortful control.

Low fitness, low body mass and prior injury predict injury risk during military recruit training: a prospective cohort study in the British Army

PubMed Central

Robinson, Mark; Siddall, Andrew; Bilzon, James; Thompson, Dylan; Greeves, Julie; Izard, Rachel; Stokes, Keith

2016-01-01

Background Injuries sustained by military recruits during initial training impede training progression and military readiness while increasing financial costs. This study investigated training-related injuries and injury risk factors among British Army infantry recruits. Methods Recruits starting infantry training at the British Army Infantry Training Centre between September 2008 and March 2010 were eligible to take part. Information regarding lifestyle behaviours and injury history was collected using the Military Pre-training Questionnaire. Sociodemographic, anthropometric, physical fitness and injury (lower limb and lower back) data were obtained from Army databases. Univariable and multivariable Cox regression models were used to explore the association between time to first training injury and potential risk factors. Results 58% (95% CI 55% to 60%) of 1810 recruits sustained at least 1 injury during training. Overuse injuries were more common than traumatic injuries (65% and 35%, respectively). The lower leg accounted for 81% of all injuries, and non-specific soft tissue damage was the leading diagnosis (55% of all injuries). Injuries resulted in 122 (118 to 126) training days lost per 1000 person-days. Slower 2.4 km run time, low body mass, past injury and shin pain were independently associated with higher risk of any injury. Conclusions There was a high incidence of overuse injuries in British Army recruits undertaking infantry training. Recruits with lower pretraining fitness levels, low body mass and past injuries were at higher risk. Faster 2.4 km run time performance and minimal body mass standards should be considered for physical entry criteria. PMID:27900170

Cognitive and motor abilities of young children and risk of injuries in the home.

PubMed

Ehrhardt, Jennifer; Xu, Yingying; Khoury, Jane; Yolton, Kimberly; Lanphear, Bruce; Phelan, Kieran

2017-02-01

Residential injury is a leading cause of morbidity and mortality in US children. Rates and types of injury vary by child age but little is known about injury risk based on child cognitive and motor abilities. The objective of this study was to determine whether cognitive or motor development in young children is associated with residential injury. We employed data from Health Outcomes and Measures of the Environment (HOME) Study. Parent report of medically attended injury was obtained at regular intervals from 0 to 42 months. Child development was assessed at 12, 24 and 36 months using Bayley Scales of Infant and Toddler Development, 2nd edition, which generates both mental developmental index (MDI) and a psychomotor developmental index (PDI). Injury risk was modelled using multivariable logistic regression as function of child's MDI or PDI. Effects of MDI and PDI on injury risk were examined separately and jointly, adjusting for important covariates. Children with cognitive delay (MDI <77) were at significantly higher risk of injury than children without cognitive delay (OR=3.7, 95% CI 1.4 to 10.5, p=0.012). There was no significant association of PDI with injury. There was, however, significant interaction of MDI and PDI (p=0.02); children with cognitive delay but normal motor development were at significantly higher risk of injury than children with normal cognitive and motor development (OR=9.6, 95% CI 2.6 to 35.8, p=0.001). Children with cognitive delays, especially those with normal motor development, are at elevated risk for residential injuries. Injury prevention efforts should target children with developmental delays. NCT00129324; post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Identifying Risk for Acute Kidney Injury in Infants and Children Following Cardiac Arrest.

PubMed

Neumayr, Tara M; Gill, Jeff; Fitzgerald, Julie C; Gazit, Avihu Z; Pineda, Jose A; Berg, Robert A; Dean, J Michael; Moler, Frank W; Doctor, Allan

2017-10-01

Our goal was to identify risk factors for acute kidney injury in children surviving cardiac arrest. Retrospective analysis of a public access dataset. Fifteen children's hospitals associated with the Pediatric Emergency Care Applied Research Network. Two hundred ninety-six subjects between 1 day and 18 years old who experienced in-hospital or out-of-hospital cardiac arrest between July 1, 2003, and December 31, 2004. None. Our primary outcome was development of acute kidney injury as defined by the Acute Kidney Injury Network criteria. An ordinal probit model was developed. We found six critical explanatory variables, including total number of epinephrine doses, postcardiac arrest blood pressure, arrest location, presence of a chronic lung condition, pH, and presence of an abnormal baseline creatinine. Total number of epinephrine doses received as well as rate of epinephrine dosing impacted acute kidney injury risk and severity of acute kidney injury. This study is the first to identify risk factors for acute kidney injury in children after cardiac arrest. Our findings regarding the impact of epinephrine dosing are of particular interest and suggest potential for epinephrine toxicity with regard to acute kidney injury. The ability to identify and potentially modify risk factors for acute kidney injury after cardiac arrest may lead to improved morbidity and mortality in this population.

The Effects of Acute Cannabis Use on Nontraffic Injury Risk: Reviewing the Available Literature and Identifying Ways Forward

PubMed Central

Andreuccetti, Gabriel; Ye, Yu; Kang, Jaewook; Korcha, Rachael; Witbrodt, Jane A.; Carvalho, Heraclito B.; Cherpitel, Cheryl J.

2018-01-01

Recent evidence has indicated that cannabis use before driving is associated with a modest but increased risk for traffic-related injuries. However, the question of whether recent cannabis use is associated with a greater risk for other types of injuries remains unanswered. Aiming to understand better how acute cannabis use might affect the risk for all causes of injury, we have summarized the limited data available in the literature on the risk of non-traffic injuries associated with recent cannabis use. Very few studies were able to provide estimate risks for all injuries or injuries other than those related to road traffic injuries, with the limited evidence available showing mixed findings. The only significant risk found (in only one study) suggests an inverse association between all injuries and cannabis use. Study designs are limited, and the majority of studies have neither data on acute cannabis use among injured individuals nor a valid control group for estimating injury risk attributable to cannabis. In conclusion, studies of the association between cannabis and non-traffic injuries present several limitations, particularly regarding sampling strategies, injury risk assessment for different causes of injury, and a dose-response risk relationship with injury. Further studies, incorporating better design for different causes of injury and drug testing, are required to reach firmer conclusions on the association between cannabis use and non-traffic injury risk. PMID:29456273

Pro Free Will Priming Enhances "Risk-Taking" Behavior in the Iowa Gambling Task, but Not in the Balloon Analogue Risk Task: Two Independent Priming Studies.

PubMed

Schrag, Yann; Tremea, Alessandro; Lagger, Cyril; Ohana, Noé; Mohr, Christine

2016-01-01

Studies indicated that people behave less responsibly after exposure to information containing deterministic statements as compared to free will statements or neutral statements. Thus, deterministic primes should lead to enhanced risk-taking behavior. We tested this prediction in two studies with healthy participants. In experiment 1, we tested 144 students (24 men) in the laboratory using the Iowa Gambling Task. In experiment 2, we tested 274 participants (104 men) online using the Balloon Analogue Risk Task. In the Iowa Gambling Task, the free will priming condition resulted in more risky decisions than both the deterministic and neutral priming conditions. We observed no priming effects on risk-taking behavior in the Balloon Analogue Risk Task. To explain these unpredicted findings, we consider the somatic marker hypothesis, a gain frequency approach as well as attention to gains and / or inattention to losses. In addition, we highlight the necessity to consider both pro free will and deterministic priming conditions in future studies. Importantly, our and previous results indicate that the effects of pro free will and deterministic priming do not oppose each other on a frequently assumed continuum.

A Hypothesis: Could Portable Natural Grass be a Risk Factor for Knee Injuries?

PubMed Central

Orchard, John; Rodas, Gil; Til, Lluis; ArdevÒl, Jordi; Chivers, Ian

2008-01-01

Previous study has shown a likely link between increased shoe- surface traction and risk of knee Anterior Cruciate Ligament (ACL) injury. Portable natural grass systems are being used more often in sport, but no study to date has investigated their relative safety. By their nature, they must have high resistance to falling apart and therefore newly laid systems may be at risk of creating excessive shoe-surface traction. This study describes two clusters of knee injuries (particularly non-contact ACL injuries), each occurring to players of one professional football team at single venue, using portable grass, in a short space of time. The first series included two ACL injuries, one posterolateral complex disruption and one lateral ligament tear occurring in two rugby league games on a portable bermudagrass surface in Brisbane, Australia. The second series included four non-contact ACL injuries over a period of ten weeks in professional soccer games on a portable Kentucky bluegrass/perennial ryegrass surface in Barcelona, Spain. Possible intrinsic risk factors are discussed but there was no common risk shared by the players. Although no measures of traction were made at the Brisbane venue, average rotational traction was measured towards the end of the injury cluster at Camp Nou, Barcelona, to be 48 Nm. Chance undoubtedly had a part to play in these clusters, but the only obvious common risk factor was play on a portable natural grass surface soon after it was laid. Further study is required to determine whether portable natural grass systems may exhibit high shoe-surface traction soon after being laid and whether this could be a risk factor for knee injury. Key pointsExcessive shoe-surface traction is a hypothesised risk factor for knee ligament injuries, including anterior cruciate ligament injuries.Portable natural grass systems (by their nature in order to prevent grass rolls or squares from falling apart) will tend to exhibit high resistance to tearing when first

Fire fit: assessing comprehensive fitness and injury risk in the fire service.

PubMed

Poplin, Gerald S; Roe, Denise J; Burgess, Jefferey L; Peate, Wayne F; Harris, Robin B

2016-02-01

This study sought to develop a comprehensive measure of fitness that is predictive of injury risk and can be used in the fire service to assess individual-level health and fit-for-duty status. A retrospective occupational cohort of 799 career fire service employees was observed over the years 2005-2009. An equally weighted score for comprehensive fitness was calculated based on cardiovascular fitness, muscular strength, endurance, flexibility, and body composition. Repeated measures survival analyses were used to estimate the risk of any injury, sprain or strain, and exercise-related injuries in relation to comprehensive fitness. A well-distributed comprehensive fitness score was developed to distinguish three tiers of overall fitness status. Intraclass correlations identified flexibility, total grip strength, percent body fat, and resting heart rate as the most reliable fitness metrics, while push-ups, sit-ups, and aerobic capacity demonstrated poor reliability. In general, individuals with a lower comprehensive fitness status had an increased injury risk of injury as compared to the most fit individuals. The risk of any injury was 1.82 (95% CI 1.06-3.11) times as likely for the least fit individuals, as compared to individuals in the top fire fitness category, increasing to 2.90 (95% CI 1.48-5.66) when restricted to sprains and strains. This 5-year analysis of clinical occupational health assessments enabled the development of a relevant metric for relating comprehensive fitness with the risk of injury. Results were consistent with previous studies focused on cardiorespiratory fitness, but also less susceptible to inter-individual variability of discrete measurements.

Developing predictive models for return to work using the Military Power, Performance and Prevention (MP3) musculoskeletal injury risk algorithm: a study protocol for an injury risk assessment programme.

PubMed

Rhon, Daniel I; Teyhen, Deydre S; Shaffer, Scott W; Goffar, Stephen L; Kiesel, Kyle; Plisky, Phil P

2018-02-01

Musculoskeletal injuries are a primary source of disability in the US Military, and low back pain and lower extremity injuries account for over 44% of limited work days annually. History of prior musculoskeletal injury increases the risk for future injury. This study aims to determine the risk of injury after returning to work from a previous injury. The objective is to identify criteria that can help predict likelihood for future injury or re-injury. There will be 480 active duty soldiers recruited from across four medical centres. These will be patients who have sustained a musculoskeletal injury in the lower extremity or lumbar/thoracic spine, and have now been cleared to return back to work without any limitations. Subjects will undergo a battery of physical performance tests and fill out sociodemographic surveys. They will be followed for a year to identify any musculoskeletal injuries that occur. Prediction algorithms will be derived using regression analysis from performance and sociodemographic variables found to be significantly different between injured and non-injured subjects. Due to the high rates of injuries, injury prevention and prediction initiatives are growing. This is the first study looking at predicting re-injury rates after an initial musculoskeletal injury. In addition, multivariate prediction models appear to have move value than models based on only one variable. This approach aims to validate a multivariate model used in healthy non-injured individuals to help improve variables that best predict the ability to return to work with lower risk of injury, after a recent musculoskeletal injury. NCT02776930. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Farm Work-Related Injuries and Risk Factors in South Korean Agriculture.

PubMed

Kim, Hyocher; Räsänen, Kimmo; Chae, Hyeseon; Kim, Kyungsu; Kim, Kyungran; Lee, Kyungsuk

2016-01-01

Agriculture is known to be a risk-filled industry in South Korea, as it is worldwide. The aims of this study were to identify the magnitude of farm work-related injuries and evaluate the association between injury and possible risk factors. Farmers, including farm members (N = 16,160), were surveyed. After excluding 7 subjects with missing data in questions about injury, 16,153 farmer responses were used for the analysis. Of the 16,153 farmers, 3.6% answered having at least one farm work-related injury requiring outpatient treatment or hospitalization during 2012. The proportion of injured men (4.3%) was 1.5 times higher than women (2.9%). From an age perspective, the proportion was 1.3% of those aged 49 or below, 2.7% of those aged 50-59, 4.2% of those aged 60-69, 4.2% of those aged 70-79, and 3.1% of those aged 80 or above. We used a multivariate logistic regression analysis with a stepwise model (forward) for risk factors (gender, age, farm ownership, farm type, work years in agriculture, work months during 2012, night work experience, and work experience under the influence of alcohol). The increased risk of farm work-related injuries significantly remained associated with age, farm ownership, and experience of night work. Further studies should be conducted to consistently identify injury characteristics, especially for old farmers, considering the crop cultivation in Asian countries.

Effect of Planning on Trunk Motion and Knee Moments During a Side Step Cut Task

NASA Astrophysics Data System (ADS)

Houck, Jeff; Gorniak, Stacey; Nicholson, Kristen

2004-03-01

Recent studies suggest that alterations in knee biomechanics associated with unanticipated cutting tasks place athletes at higher risk of knee injuries. Besier et al observed alterations in knee moments during unanticipated cutting tasks that were consistent with in-vitro ACL injury mechanisms. During similar tasks, Patla et al observed lateral trunk lean and decreased foot placement, suggesting that full body center of mass control is perturbed during such tasks. The purpose of this study was to compare the trunk and knee frontal plane moments and evaluate a relationship between the two during unanticipated cutting tasks. The results of this study suggest that there is a relationship between the trunk and knee frontal plane moments during the first 200-400ms of the stance phase of gait.

Caffeinated Alcohol, Sensation Seeking, and Injury Risk

PubMed Central

McCoy, Thomas P.; Egan, Kathleen L.; Goldin, Shoshanna; Rhodes, Scott D.; Wolfson, Mark

2013-01-01

Background College students who consume caffeinated alcoholic beverages (CaffAlc) are at increased injury risk. This study examines the extent to which a sensation-seeking personality accounts for the relationship between consumption of CaffAlc and negative outcomes. Methods A Web-based survey was administered to stratified random samples of 4907 college students from eight North Carolina universities in Fall 2009. Sensation seeking was assessed using the Brief Sensation-Seeking Scale (BSSS) (α=0.81). Data were analyzed using linear and logistic regression. Results 3390 students (71.2%) reported past 30-day drinking, of whom 786 (23.2%) consumed CaffAlc. CaffAlc past 30-day drinkers had higher BSSS scores (3.8 vs. 3.4; p<0.001), compared to non-CaffAlc drinkers. Consumption of CaffAlc was associated with more frequent binge drinking (p<0.001) and drunken days in a typical week (p<0.001), even after adjusting for the BSSS score. CaffAlc students were more likely to be taken advantage of sexually (adjusted odds ratio [AOR]=1.70, p=0.012), drive under the influence of alcohol (AOR=2.00, p<0.001), and ride with a driver under the influence of alcohol (AOR=1.87, p<0.001). Injury requiring medical treatment was more prevalent among CaffAlc students with higher BSSS-8 scores (interaction p=0.024), even after adjustment for drinking levels and student characteristics. Conclusions Sensation seeking does not fully account for the increase in risky drinking among college students who consume CaffAlc, nor does it moderate the relationship between CaffAlc and drinking behaviors. Sensation seeking moderates the risk of alcohol-associated injury requiring medical treatment among college students who consume CaffAlc. Those with strong sensation-seeking dispositions are at the highest risk of alcohol-associated injury requiring medical treatment. PMID:24761275

Parcellating the neuroanatomical basis of impaired decision-making in traumatic brain injury.

PubMed

Newcombe, Virginia F J; Outtrim, Joanne G; Chatfield, Doris A; Manktelow, Anne; Hutchinson, Peter J; Coles, Jonathan P; Williams, Guy B; Sahakian, Barbara J; Menon, David K

2011-03-01

Cognitive dysfunction is a devastating consequence of traumatic brain injury that affects the majority of those who survive with moderate-to-severe injury, and many patients with mild head injury. Disruption of key monoaminergic neurotransmitter systems, such as the dopaminergic system, may play a key role in the widespread cognitive dysfunction seen after traumatic axonal injury. Manifestations of injury to this system may include impaired decision-making and impulsivity. We used the Cambridge Gambling Task to characterize decision-making and risk-taking behaviour, outside of a learning context, in a cohort of 44 patients at least six months post-traumatic brain injury. These patients were found to have broadly intact processing of risk adjustment and probability judgement, and to bet similar amounts to controls. However, a patient preference for consistently early bets indicated a higher level of impulsiveness. These behavioural measures were compared with imaging findings on diffusion tensor magnetic resonance imaging. Performance in specific domains of the Cambridge Gambling Task correlated inversely and specifically with the severity of diffusion tensor imaging abnormalities in regions that have been implicated in these cognitive processes. Thus, impulsivity was associated with increased apparent diffusion coefficient bilaterally in the orbitofrontal gyrus, insula and caudate; abnormal risk adjustment with increased apparent diffusion coefficient in the right thalamus and dorsal striatum and left caudate; and impaired performance on rational choice with increased apparent diffusion coefficient in the bilateral dorsolateral prefrontal cortices, and the superior frontal gyri, right ventrolateral prefrontal cortex, the dorsal and ventral striatum, and left hippocampus. Importantly, performance in specific cognitive domains of the task did not correlate with diffusion tensor imaging abnormalities in areas not implicated in their performance. The ability to

Parcellating the neuroanatomical basis of impaired decision-making in traumatic brain injury

PubMed Central

Outtrim, Joanne G.; Chatfield, Doris A.; Manktelow, Anne; Hutchinson, Peter J.; Coles, Jonathan P.; Williams, Guy B.; Sahakian, Barbara J.; Menon, David K.

2011-01-01

Cognitive dysfunction is a devastating consequence of traumatic brain injury that affects the majority of those who survive with moderate-to-severe injury, and many patients with mild head injury. Disruption of key monoaminergic neurotransmitter systems, such as the dopaminergic system, may play a key role in the widespread cognitive dysfunction seen after traumatic axonal injury. Manifestations of injury to this system may include impaired decision-making and impulsivity. We used the Cambridge Gambling Task to characterize decision-making and risk-taking behaviour, outside of a learning context, in a cohort of 44 patients at least six months post-traumatic brain injury. These patients were found to have broadly intact processing of risk adjustment and probability judgement, and to bet similar amounts to controls. However, a patient preference for consistently early bets indicated a higher level of impulsiveness. These behavioural measures were compared with imaging findings on diffusion tensor magnetic resonance imaging. Performance in specific domains of the Cambridge Gambling Task correlated inversely and specifically with the severity of diffusion tensor imaging abnormalities in regions that have been implicated in these cognitive processes. Thus, impulsivity was associated with increased apparent diffusion coefficient bilaterally in the orbitofrontal gyrus, insula and caudate; abnormal risk adjustment with increased apparent diffusion coefficient in the right thalamus and dorsal striatum and left caudate; and impaired performance on rational choice with increased apparent diffusion coefficient in the bilateral dorsolateral prefrontal cortices, and the superior frontal gyri, right ventrolateral prefrontal cortex, the dorsal and ventral striatum, and left hippocampus. Importantly, performance in specific cognitive domains of the task did not correlate with diffusion tensor imaging abnormalities in areas not implicated in their performance. The ability to

Impact differences in ground reaction force and center of mass between the first and second landing phases of a drop vertical jump and their implications for injury risk assessment.

PubMed

Bates, Nathaniel A; Ford, Kevin R; Myer, Gregory D; Hewett, Timothy E

2013-04-26

The drop vertical jump (DVJ) task is commonly used to assess biomechanical performance measures that are associated with ACL injury risk in athletes. Previous investigations have solely assessed the first landing phase. We examined the first and second landings of a DVJ for differences in the magnitude of vertical ground reaction force (vGRF) and position of center of mass (CoM). A cohort of 239 adolescent female basketball athletes completed a series of DVJ tasks from an initial box height of 31 cm. Dual force platforms and a three dimensional motion capture system recorded force and positional data for each trial. There was no difference in peak vGRF between landings (p=0.445), but side-to-side differences increased from the first to second landing (p=0.007). Participants demonstrated a lower minimum CoM during stance in the first landing than the second landing (p<0.001). The results have important implications for the future assessment of ACL injury risk behaviors in adolescent female athletes. Greater side-to-side asymmetry in vGRF and higher CoM during impact indicate the second landing of a DVJ may exhibit greater perturbation and better represent in-game mechanics associated with ACL injury risk. Copyright © 2013 Elsevier Ltd. All rights reserved.

Profile and Risk Factor Analysis of Unintentional Injuries in Children.

PubMed

Bhamkar, Rahul; Seth, Bageshree; Setia, Maninder Singh

2016-10-01

To study the profile and various risk factors associated with unintentional injuries in children. The study is a cross sectional analysis of data collected from 351 children presenting with unintentional injury to a tertiary care hospital in Navi Mumbai, India. Data were collected about variables based on Haddon Phase Factor Matrix - host, environment and agent factors. Proportions for categorical variables across various groups were compared using Chi square test or Fisher's exact test. Logistic regression model was used to evaluate the factors. Falls (36 %) were the most common injuries followed by bites (23 %). Majority of children were school going children (38 %) followed by preschool children (29 %). Forty-seven percent were from lower socioeconomic class. Commonest place of injury was home (48 %) and the commonest time was evening (49 %). Though there was male predominance in injuries, the difference across gender did not vary significantly (p = 0.15). Poisonings were significantly more common in infants and toddlers and in rural population (p < 0.001); kerosene being the commonest agent. Rural population is at more risk of bites compared to urban (p < 0.001); dog bites being the commonest followed by scorpion bites. Foreign bodies were significantly more common in upper and middle socioeconomic class and bites, in lower socioeconomic class (p < 0.005). Injuries from rural area and lower socioeconomic class were more serious, requiring hospitalization; they were also more likely to present late to the hospital (p < 0.05). Profile of injuries varies widely as per the variations in agent, host and environmental factors. Socio-environmental, economic conditions and infancy-toddler age groups are predisposing risk factors for bites and poisoning. Although rural areas and lower socioeconomic class population are more vulnerable to serious types of injuries, they still lack essential basic medical care.

Ergonomic and socioeconomic risk factors for hospital workers' compensation injury claims.

PubMed

Boyer, Jon; Galizzi, Monica; Cifuentes, Manuel; d'Errico, Angelo; Gore, Rebecca; Punnett, Laura; Slatin, Craig

2009-07-01

Hospital workers are a diverse population with high rates of musculoskeletal disorders (MSDs). The risk of MSD leading to workers' compensation (WC) claims is likely to show a gradient by socioeconomic status (SES) that may be partly explained by working conditions. A single community hospital provided workforce demographics and WC claim records for 2003-2005. An ergonomic job exposure matrix (JEM) was developed for these healthcare jobs from direct observation of physical workload and extraction of physical and psychosocial job requirements from the O*NET online database. Occupational exposures and SES categories were assigned to workers through their O*NET job titles. Univariate and multivariate Poisson regression analyses were performed to estimate the propensity to file an injury claim in relation to individual factors, occupational exposures, and SES. The jobs with the highest injury rates were nurses, semi-professionals, and semi-skilled. Increased physical work and psychological demands along with low job tenure were associated with an increase in risk, while risk decreased with psychosocial rewards and supervisor support. Both occupational and individual factors mediated the relationship between SES and rate of injury claims. Physical and organizational features of these hospital jobs along with low job tenure predicted WC injury claim risk and explained a substantial proportion of the effects of SES. Further studies that include lifestyle risk factors and control for prior injuries and co-morbidities are warranted to strengthen the current study findings.

Ergonomic and Socioeconomic Risk Factors for Hospital Workers’ Compensation Injury Claims

PubMed Central

Boyer, Jon; Galizzi, Monica; Cifuentes, Manuel; d’Errico, Angelo; Gore, Rebecca; Punnett, Laura; Slatin, Craig

2018-01-01

Background Hospital workers are a diverse population with high rates of musculoskeletal disorders (MSDs). The risk of MSD leading to workers’ compensation (WC) claims is likely to show a gradient by socioeconomic status (SES) that may be partly explained by working conditions. Methods A single community hospital provided workforce demographics and WC claim records for 2003–2005. An ergonomic job exposure matrix (JEM) was developed for these healthcare jobs from direct observation of physical workload and extraction of physical and psychosocial job requirements from the O*NET online database. Occupational exposures and SES categories were assigned to workers through their O*NET job titles. Univariate and multivariate Poisson regression analyses were performed to estimate the propensity to file an injury claim in relation to individual factors, occupational exposures, and SES. Results The jobs with the highest injury rates were nurses, semi-professionals, and semi-skilled. Increased physical work and psychological demands along with low job tenure were associated with an increase in risk, while risk decreased with psychosocial rewards and supervisor support. Both occupational and individual factors mediated the relationship between SES and rate of injury claims. Conclusions Physical and organizational features of these hospital jobs along with low job tenure predicted WC injury claim risk and explained a substantial proportion of the effects of SES. Further studies that include lifestyle risk factors and control for prior injuries and co-morbidities are warranted to strengthen the current study findings. PMID:19479820

Maternal Body Mass Index and Risk of Obstetric Anal Sphincter Injury

PubMed Central

2014-01-01

Objective. To estimate the association between maternal obesity and risk of three different degrees of severity of obstetric anal sphincter injury. Methods. The study population consisted of 436,482 primiparous women with singleton term vaginal cephalic births between 1998 and 2011 identified in the Swedish Medical Birth Registry. Women were grouped into six categories of BMI. BMI 18.5–24.9 was set as reference. Primary outcome was third-degree perineal laceration, partial or total, and fourth-degree perineal laceration. Adjustments were made for year of delivery, maternal age, fetal head position at delivery, infant birth weight and instrumental delivery. Results. The overall prevalence of third- or four-degree anal sphincter injury was 6.6% (partial anal sphincter injury 4.6%, total anal sphincter injury 1.2%, unclassified as either partial and total 0.2%, or fourth degree lacerations 0.6%). The risk for a partial, total, or a fourth-degree anal sphincter injury decreased with increasing maternal BMI most pronounced for total anal sphincter injury where the risk among morbidly obese women was half that of normal weight women, OR 0.47 95% CI 0.28–0.78. Conclusion. Obese women had a favourable outcome compared to normal weight women concerning serious pelvic floor damages at birth. PMID:24839604

Maternal body mass index and risk of obstetric anal sphincter injury.

PubMed

Blomberg, Marie

2014-01-01

To estimate the association between maternal obesity and risk of three different degrees of severity of obstetric anal sphincter injury. The study population consisted of 436,482 primiparous women with singleton term vaginal cephalic births between 1998 and 2011 identified in the Swedish Medical Birth Registry. Women were grouped into six categories of BMI. BMI 18.5-24.9 was set as reference. Primary outcome was third-degree perineal laceration, partial or total, and fourth-degree perineal laceration. Adjustments were made for year of delivery, maternal age, fetal head position at delivery, infant birth weight and instrumental delivery. The overall prevalence of third- or four-degree anal sphincter injury was 6.6% (partial anal sphincter injury 4.6%, total anal sphincter injury 1.2%, unclassified as either partial and total 0.2%, or fourth degree lacerations 0.6%). The risk for a partial, total, or a fourth-degree anal sphincter injury decreased with increasing maternal BMI most pronounced for total anal sphincter injury where the risk among morbidly obese women was half that of normal weight women, OR 0.47 95% CI 0.28-0.78. Obese women had a favourable outcome compared to normal weight women concerning serious pelvic floor damages at birth.

Age, occupational demands and the risk of serious work injury.

PubMed

Smith, P M; Berecki-Gisolf, J

2014-12-01

Interest in the relationship between age and serious work injury is increasing, given the ageing of the workforce in many industrialized economies. To examine if the relationship between age and risk of serious musculoskeletal injury differs when the physical demands of work are higher from those when they are lower. A secondary analysis of workers' compensation claims in the State of Victoria, Australia, combined with estimates of the insured labour force. We focused on musculoskeletal claims, which required 10 days of absence or health care expenditures beyond a pecuniary threshold. Regression models examined the relationship between age and claim-risk across workers with different occupational demands, as well as the relationship between occupational demands and musculoskeletal claim-risk across different age groups. Older age and greater physical demands at work were associated with an increased risk of musculoskeletal claims. In models stratified by occupational demands, we observed the relationship between age and claim-risk was steeper when occupational demands were higher. We also observed that the relationship between occupational demands and risk of work injury claim peaked among workers aged 25-44, attenuating among those aged 45 and older. This study's results suggest that although older workers and occupations with higher demands should be the targets of primary preventive efforts related to serious musculoskeletal injuries, there may also be gains in targeting middle-aged workers in the most physically demanding occupations. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Risks and injuries of go-karting].

PubMed

Bley, T; Gahr, R H

2002-06-01

The demands on leisuretime activities are getting more exacting. So trendy sports just like inline-skating, mountain-biking, paragliding, bungee-jumping or driving go karts become increasing popular. On the other side risks and injuries of this fun sports are not enough represented. We observed in a 16 months period 5 serious accidents with go karts. The injuries included bruise of lower leg, a contusion of the stomach with a pancreatic lesion, an instable fracture of the spinal column, a difficult fracture of the knee and upper tibia and a large sized burnwound. The mean hospitalization time was 32,5 days (17-54 days) and the average age of the patients 27,7 years (9-45 years). The lack of safety devices and the subjective inexperience make go kart driving a dangerous fun. The TUV worked out guidelines for security of indoor kart centres but they don't have any legal liability in case of injury. Therefore everyone carrying out fun sports like go kart driving should be aware of the dangers and should gather information whether the accident insurance will help out in case of injury.

Injury during U.S. Army basic combat training: a systematic review of risk factor studies.

PubMed

Bulzacchelli, Maria T; Sulsky, Sandra I; Rodriguez-Monguio, Rosa; Karlsson, Lee H; Hill, Maj Owen T

2014-12-01

Approximately one quarter of men and half of women in U.S. Army basic combat training experience an injury. Preventing basic combat training-related injuries would reduce associated human and economic costs and discharges from the Army. Identification of risk factors for such injuries is a crucial step toward their prevention. Although some research has begun to address this need, prior studies of risk factors for training-related injury have not been reviewed systematically. This study systematically reviews the literature on risk factors for injury during U.S. Army basic combat training. Original studies of risk factors for injury during U.S. Army basic combat training published since 1990 in peer-reviewed journals were identified using PubMed and manual searches of reference lists. This search was last performed in May 2013. Nineteen studies met the inclusion criteria. Methodologic quality and potential for bias were assessed. The findings of 11 studies deemed to be of high or medium quality were synthesized to determine the level of evidence supporting the association between each risk factor studied and risk of injury during basic combat training. Quality assessment and evidence synthesis were performed from June to September 2013. There is strong or moderate evidence supporting association of older age, history of smoking, and self-rated low physical activity level prior to basic combat training with increased risk of training-related injury among male trainees. There is limited, mixed, or insufficient evidence to identify risk factors for injury among female trainees. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

Risk factors for deep vein thrombosis and pulmonary embolism after traumatic injury: A competing risks analysis.

PubMed

Van Gent, Jan-Michael; Calvo, Richard Yee; Zander, Ashley L; Olson, Erik J; Sise, C Beth; Sise, Michael J; Shackford, Steven R

2017-12-01

Venous thromboembolism, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given that recent data suggesting postinjury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of postinjury DVT and PE are different. We examined all adult trauma patients admitted to our Level I trauma center from July 2006 to December 2011 who received at least one surveillance duplex ultrasound of the lower extremities and who were at high risk or greater for DVT. Outcomes included DVT and PE events, and time-to-event from admission. We used competing risks analysis to evaluate risk factors for DVT while accounting for PE as a competing event, and vice versa. Of 2,370 patients, 265 (11.2%) had at least one venous thromboembolism event, 235 DVT only, 19 PE only, 11 DVT and PE. Within 2 days of admission, 38% of DVT cases had occurred compared with 26% of PE. Competing risks modeling of DVT as primary event identified older age, severe injury (Injury Severity Score, ≥ 15), mechanical ventilation longer than 4 days, active cancer, history of DVT or PE, major venous repair, male sex, and prophylactic enoxaparin and prophylactic heparin as associated risk factors. Modeling of PE as the primary event showed younger age, nonsevere injury (Injury Severity Score, < 15), central line placement, and prophylactic heparin as relevant factors. The risk factors for PE and DVT after injury were different, suggesting that they are clinically distinct events that merit independent consideration. Many DVT events occurred early despite prophylaxis, bringing into question the preventability of postinjury DVT. We recommend trauma center quality reporting program measures be revised to account for DVT and PE as unique events. Epidemiologic

Injury risk factors in parachuting and acceptability of the parachute ankle brace.

PubMed

Knapik, Joseph J; Spiess, Anita; Swedler, David; Grier, Tyson; Darakjy, Salima; Amoroso, Paul; Jones, Bruce H

2008-07-01

This investigation examined risk factors for injuries during military parachute training and solicited attitudes and opinions regarding a parachute ankle brace (PAB) that has been shown to protect against ankle injuries. Male Army airborne students (N = 1677) completed a questionnaire after they had successfully executed 4 of the 5 jumps necessary for qualification as a military paratrooper. The questionnaire asked about injuries during parachute descents, demographics, lifestyle characteristics, physical characteristics, physical fitness, airborne recycling (i.e., repeating airborne training because of failure to qualify on a previous attempt), PAB wear, problems with aircraft exits, and injuries in the year before airborne school. A final section of the questionnaire solicited open-ended comments about the PAB. Increased risk of a parachute-related injury occurred among students who had longer time in service, were older, taller, heavier, performed fewer push-ups, ran slower, were airborne recycles, did not wear the PAB, had an aircraft exit problem, and/or reported an injury in the year prior to jump school. Among students who wore the brace, most negative comments about the PAB had to do with design, comfort, and difficulties during parachute landing falls. This study supported some previously identified injury risk factors (older age, greater body weight, and not using a PAB) and identified a number of new risk factors. To address PAB design and comfort issues, a strap is being added over the dorsum of the foot to better hold the PAB in place.

Aeroallergens, allergic rhinitis, and sedating antihistamines: risk factors for traumatic occupational injury and economic impact.

PubMed

Hanrahan, L P; Paramore, L C

2003-10-01

The U.S. workplace injury burden is significant. Our objective was to assess the particular impact of aeroallergen, allergic rhinitis, and antihistamine exposures and side effects on the risk of traumatic work-related injuries, and the associated economic impact. This is an observational case-control study with 1,223 acute traumatic injury cases that are compared to 1,202 chronic back injury controls. Structured telephone interviews were conducted in 1998 and 1999 on Workers' Compensation applicants injured in 1997. Antihistamine use and pollen levels were measured 2 weeks prior to the injury date. Sedating antihistamine exposures elevated acute injury risk (main effect OR: 2.93). A significant increase in traumatic injury risk was observed for combined sedating antihistamine and high pollen exposures among subjects with physician and self-diagnosed allergic rhinitis (OR: 2.41). Direct medical costs associated with this increased risk were estimated at $143 million in 2001. Workers with physician-diagnosed allergic rhinitis have as high a reliance on sedating antihistamines as do self-diagnosed and self-medicating nasal allergy sufferers. High pollen exposures along with sedating antihistamine use may confer significant additional injury risks among allergic rhinitis sufferers. Medical management "best practices" of diagnosed allergic rhinitis should include avoidance of sedating antihistamines to minimize acute, traumatic injury risks. Copyright 2003 Wiley-Liss, Inc.

Compound risk judgment in tasks with both idiosyncratic and systematic risk: The "Robust Beauty" of additive probability integration.

PubMed

Sundh, Joakim; Juslin, Peter

2018-02-01

In this study, we explore how people integrate risks of assets in a simulated financial market into a judgment of the conjunctive risk that all assets decrease in value, both when assets are independent and when there is a systematic risk present affecting all assets. Simulations indicate that while mental calculation according to naïve application of probability theory is best when the assets are independent, additive or exemplar-based algorithms perform better when systematic risk is high. Considering that people tend to intuitively approach compound probability tasks using additive heuristics, we expected the participants to find it easiest to master tasks with high systematic risk - the most complex tasks from the standpoint of probability theory - while they should shift to probability theory or exemplar memory with independence between the assets. The results from 3 experiments confirm that participants shift between strategies depending on the task, starting off with the default of additive integration. In contrast to results in similar multiple cue judgment tasks, there is little evidence for use of exemplar memory. The additive heuristics also appear to be surprisingly context-sensitive, with limited generalization across formally very similar tasks. Copyright © 2017 Elsevier B.V. All rights reserved.

Identification of risk factors for mucosal injury during laparoscopic Heller myotomy for achalasia.

PubMed

Tsuboi, Kazuto; Omura, Nobuo; Yano, Fumiaki; Hoshino, Masato; Yamamoto, Se-Ryung; Akimoto, Shusuke; Masuda, Takahiro; Kashiwagi, Hideyuki; Yanaga, Katsuhiko

2016-02-01

Mucosal injury during myotomy is the most frequent complication seen with the Heller-Dor procedure for achalasia. The present study aimed to examine risk factors for such mucosal injury during this procedure. This was a retrospective analysis of patients who underwent the laparoscopic Heller-Dor procedure for achalasia at a single facility. Variables for evaluation included patient characteristics, preoperative pathophysiological findings, and surgeon's operative experience. Logistic regression was used to identify risk factors. We also examined surgical outcomes and the degree of patient satisfaction in relation to intraoperative mucosal injury. Four hundred thirty-five patients satisfied study criteria. Intraoperative mucosal injury occurred in 67 patients (15.4%). In univariate analysis, mucosal injury was significantly associated with the patient age ≥60 years, disease history ≥10 years, prior history of cardiac diseases, preoperative esophageal transverse diameter ≥80 mm, and surgeon's operative experience with fewer than five cases. In multivariate analysis involving these factors, the following variables were identified as risk factors: age ≥60 years, esophageal transverse diameter ≥80 mm, and surgeon's operative experience with fewer than five cases. The mucosal injury group had significant extension of the operative time and increased blood loss. However, there were no significant differences between the two groups in the incidence of reflux esophagitis or the degree of symptom alleviation postoperatively. The fragile esophagus caused by advanced patient age and/or dilatation were risk factor for mucosal injury during laparoscopic Heller-Dor procedure. And novice surgeon was also identified as an isolated risk factor for mucosal injury.

High incidence of falls and fall-related injuries in wheelchair users with spinal cord injury: A prospective study of risk indicators.

PubMed

Forslund, Emelie Butler; Jørgensen, Vivien; Franzén, Erika; Opheim, Arve; Seiger, Åke; Ståhle, Agneta; Hultling, Claes; Stanghelle, Johan K; Roaldsen, Kirsti Skavberg; Wahman, Kerstin

2017-01-31

To identify risk indicators for, and incidence of, recurrent falls and fall-related injuries in wheelchair users with traumatic spinal cord injury. Prospective multi-centre study. One hundred and forty-nine wheelchair users with spinal cord injury attending follow-up in Sweden and Norway. Inclusion criteria: wheelchair users ≥ 18 years old with traumatic spinal cord injury ≥ 1 year post-injury. individuals with motor complete injuries above C5. Falls were prospectively reported by text message every second week for one year and were followed-up by telephone interviews. Outcomes were: fall incidence, risk indicators for recurrent (> 2) falls and fall-related injuries. Independent variables were: demographic data, quality of life, risk willingness, functional independence, and exercise habits. Of the total sample (n = 149), 96 (64%) participants fell, 45 (32%) fell recurrently, 50 (34%) were injured, and 7 (5%) severely injured. Multivariate logistic regression analysis showed that reporting recurrent falls the previous year increased the odds ratio (OR) of recurrent falls (OR 10.2, p < 0.001). Higher quality of life reduced the OR of fall-related injuries (OR 0.86, p = 0.037). Previous recurrent falls was a strong predictor of future falls. The incidence of falls, recurrent falls and fall-related injuries was high. Hence, prevention of falls and fall-related injuries is important.

Recovery–stress balance and injury risk in professional football players: a prospective study

PubMed Central

Laux, Philipp; Krumm, Bertram; Diers, Martin; Flor, Herta

2015-01-01

Abstract Professional football is a contact sport with a high risk of injury. This study was designed to examine the contribution of stress and recovery variables as assessed with the Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) to the risk of injury in professional football players. In a prospective, non-experimental cohort design, 22 professional football players in the highest German football league were observed over the course of 16 months. From January 2010 until April 2011, the players completed the RESTQ-Sport a total of 222 times in monthly intervals. In addition, injury data were assessed by the medical staff of the club. Overall, 34 traumatic injuries and 10 overuse injuries occurred. Most of the injuries were located in the lower limb (79.5%), and muscle and tendon injuries (43.2%) were the most frequently occurring injury type. In a generalised linear model, the stress-related scales Fatigue (OR 1.70, P = 0.007), Disturbed Breaks (OR 1.84, P = 0.047) and Injury (OR 1.77, P < 0.001) and the recovery-related scale Sleep Quality (OR 0.53, P = 0.010) significantly predicted injuries in the month after the assessment. These results support the importance of frequent monitoring of recovery and stress parameters to lower the risk of injuries in professional football. PMID:26168148

'System-Risk' Flood Task Force

NASA Astrophysics Data System (ADS)

Schröter, Kai; Ridder, Nina; Tavares da Costa, Ricardo; Diederen, Dirk; Viglione, Alberto

2017-04-01

Current scientific methods and engineering practice in flood risk assessment do not consider the full complexity of flood risk systems. Fundamental spatio-temporal dependencies, interactions and feedbacks need to be addressed to comprehensively quantify the effects of measures at various levels, ranging from local technical to high-level policy options. As each flood is unique, each event offers an unparalleled opportunity to collect data and to gain insights into system's behavior under extreme conditions potentially revealing exceptional circumstances, unexpected failures and cascading effects, and thus a chance to learn and to improve methods and models. To make use of this the Marie-Skłodowska-Curie European Training Network 'System-Risk' (www.system-risk.eu) establishes a Flood Task Force (FTF) that aims to learn about successful practical approaches, but also potential pitfalls and failures in the management of real flood events. The FTF consists of an interdisciplinary group of researchers who will apply in situ their latest methods and knowledge of e.g. how the event developed, how the risk management responded, and what the consequences were. This multi-layered perspective is intended to deepen the understanding of the complexity of flood risk systems as for instance in terms of interactions between hazard, the natural and the built environment, societal institutions and coping capacities. This contribution gives an overview of the conceptual approach to the System-Risk FTF.

Associations between Adolescent Risk Behaviors and Injury: The Modifying Role of Disability

ERIC Educational Resources Information Center

Raman, Sudha R.; Boyce, William F.; Pickett, William

2009-01-01

Background: Adolescents with disabilities are at risk for poor health outcomes including injury. The objective of this study was to examine if disability status modifies the association between risk behavior and injury among adolescents. Methods: The cross-sectional Health Behavior in School-Aged Children Survey was administered to a…

Reliability of the Tuck Jump Injury Risk Screening Assessment in Elite Male Youth Soccer Players.

PubMed

Read, Paul J; Oliver, Jon L; de Ste Croix, Mark B A; Myer, Gregory D; Lloyd, Rhodri S

2016-06-01

Read, PJ, Oliver, JL, de Ste Croix, MBA, Myer, GD, and Lloyd, RS. Reliability of the tuck jump injury risk screening assessment in elite male youth soccer players. J Strength Cond Res 30(6): 1510-1516, 2016-Altered neuromuscular control has been suggested as a mechanism for injury in soccer players. Ligamentous injuries most often occur during dynamic movements, such as decelerations from jump-landing maneuvers where high-risk movement patterns are present. The assessment of kinematic variables during jump-landing tasks as part of a preparticipation screen is useful in the identification of injury risk. An example of a field-based screening tool is the repeated tuck jump assessment. The purpose of this study was to analyze the within-subject variation of the tuck jump screening assessment in elite male youth soccer players. Twenty-five pre-peak height velocity (PHV) and 25 post-PHV elite male youth soccer players from the academy of a professional English soccer club completed the assessment. A test-retest design was used to explore the within-subject intersession reliability. Technique was graded retrospectively against the 10-point criteria set out in the screening protocol using two-dimensional video cameras. The typical error range reported for tuck jump total score (0.90-1.01 in pre-PHV and post-PHV players respectively) was considered acceptable. When each criteria was analyzed individually, kappa coefficient determined that knee valgus was the only criterion to reach substantial agreement across the two test sessions for both groups. The results of this study suggest that although tuck jump total score may be reliably assessed in elite male youth soccer players, caution should be applied in solely interpreting the composite score due to the high within-subject variation in a number of the individual criteria. Knee valgus may be reliably used to screen elite youth male soccer players for this plyometric technique error and for test-retest comparison.

Biomechanical evaluation of nursing tasks in a hospital setting.

PubMed

Jang, R; Karwowski, W; Quesada, P M; Rodrick, D; Sherehiy, B; Cronin, S N; Layer, J K

2007-11-01

A field study was conducted to investigate spinal kinematics and loading in the nursing profession using objective and subjective measurements of selected nursing tasks observed in a hospital setting. Spinal loading was estimated using trunk motion dynamics measured by the lumbar motion monitor (LMM) and lower back compressive and shear forces were estimated using the three-dimensional (3D) Static Strength Prediction Program. Subjective measures included the rate of perceived physical effort and the perceived risk of low back pain. A multiple logistic regression model, reported in the literature for predicting low back injury based on defined risk groups, was tested. The study results concluded that the major risk factors for low back injury in nurses were the weight of patients handled, trunk moment, and trunk axial rotation. The activities that required long time exposure to awkward postures were perceived by nurses as a high physical effort. This study also concluded that self-reported perceived exertion could be used as a tool to identify nursing activities with a high risk of low-back injury.

Assessment scale of risk for surgical positioning injuries 1

PubMed Central

Lopes, Camila Mendonça de Moraes; Haas, Vanderlei José; Dantas, Rosana Aparecida Spadoti; de Oliveira, Cheila Gonçalves; Galvão, Cristina Maria

2016-01-01

ABSTRACT Objective: to build and validate a scale to assess the risk of surgical positioning injuries in adult patients. Method: methodological research, conducted in two phases: construction and face and content validation of the scale and field research, involving 115 patients. Results: the Risk Assessment Scale for the Development of Injuries due to Surgical Positioning contains seven items, each of which presents five subitems. The scale score ranges between seven and 35 points in which, the higher the score, the higher the patient's risk. The Content Validity Index of the scale corresponded to 0.88. The application of Student's t-test for equality of means revealed the concurrent criterion validity between the scores on the Braden scale and the constructed scale. To assess the predictive criterion validity, the association was tested between the presence of pain deriving from surgical positioning and the development of pressure ulcer, using the score on the Risk Assessment Scale for the Development of Injuries due to Surgical Positioning (p<0.001). The interrater reliability was verified using the intraclass correlation coefficient, equal to 0.99 (p<0.001). Conclusion: the scale is a valid and reliable tool, but further research is needed to assess its use in clinical practice. PMID:27579925

RESIDENTIAL BUILDING STAKEHOLDERS’ ATTITUDES AND BELIEFS REGARDING NAIL GUN INJURY RISKS AND PREVENTION

PubMed Central

ALBERS, JAMES T.; HUDOCK, STEPHEN D.; LOWE, BRIAN D.

2015-01-01

Pneumatic nail guns are ubiquitous at residential construction sites across the United States. These tools are noted for the traumatic injuries that can occur from their operation. Different trigger mechanisms on these tools are associated with different levels of risk. Residential building subcontractors and workers, both native-born and immigrant, were brought together in focus groups to discuss their attitudes and beliefs regarding risk factors for nail gun injury as well as barriers to the adoption of safer technology. Participants’ comments are organized first by influences on traumatic injury occurrence or prevention and later by sociotechnical system category. Participants attributed influences on injury risk to personal and external causation factors in all sociotechnical system categories; however, participants more frequently described influences on injury prevention as related to workers’ behaviors, rather than to external factors. A discussion of these influences with respect to attribution theory and sociotechnical models of injury causation is presented. PMID:24704813

Implications of Vehicle Roll Direction on Occupant Ejection and Injury Risk

PubMed Central

Gloeckner, D. Claire; Moore, Tara L. A.; Steffey, Duane; Bare, Cleve; Corrigan, Catherine Ford

2006-01-01

Vehicle roll direction and occupant position have been shown to affect occupant kinematics. Data from NASS-CDS were analyzed for risk of serious or greater injuries and ejection with respect to the position of the occupant (near side or far side). The risk of AIS 3+ injuries was higher for unrestrained occupants, for ejected occupants, for occupants involved in rollovers with higher numbers of quarter turns, and for far side occupants. Near side occupants had an increased risk of partial ejection in rollovers consisting of one complete roll or less. Occupant roll direction did not affect risk of complete ejection. PMID:16968635

Risk Reduction and Resource Pooling on a Cooperation Task

ERIC Educational Resources Information Center

Pietras, Cynthia J.; Cherek, Don R.; Lane, Scott D.; Tcheremissine, Oleg

2006-01-01

Two experiments investigated choice in adult humans on a simulated cooperation task to evaluate a risk-reduction account of sharing based on the energy-budget rule. The energy-budget rule is an optimal foraging model that predicts risk-averse choices when net energy gains exceed energy requirements (positive energy budget) and risk-prone choices…

Trampoline related injuries in children: risk factors and radiographic findings.

PubMed

Klimek, Peter Michael; Juen, David; Stranzinger, Enno; Wolf, Rainer; Slongo, Theddy

2013-05-01

Backyard trampolines are immensely popular among children, but are associated with an increase of trampoline-related injuries. The aim of this study was to evaluate radiographs of children with trampoline related injuries and to determine the risk factors. Between 2003 and 2009, 286 children under the age of 16 with backyard trampoline injuries were included in the study. The number of injuries increased from 13 patients in 2003 to 86 in 2009. The median age of the 286 patients was 7 years (range: 1-15 years). Totally 140 (49%) patients were males, and 146 (51%) females. Medical records and all available diagnostic imaging were reviewed. A questionnaire was sent to the parents to evaluate the circumstances of each injury, the type of trampoline, the protection equipment and the experience of the children using the trampoline. The study was approved by the Institutional Ethics Committee of the University Hospital of Bern. The questionnaires and radiographs of the 104 patients were available for evaluation. A fracture was sustained in 51 of the 104 patients. More than 75% of all patients sustaining injuries and in 90% of patients with fractures were jumping on the trampoline with other children at the time of the accident. The most common fractures were supracondylar humeral fractures (29%) and forearm fractures (25%). Fractures of the proximal tibia occurred especially in younger children between 2-5 years of age. Children younger than 5 years old are at risk for specific proximal tibia fractures ("Trampoline Fracture"). A child jumping simultaneously with other children has a higher risk of suffering from a fracture.

Pro Free Will Priming Enhances “Risk-Taking” Behavior in the Iowa Gambling Task, but Not in the Balloon Analogue Risk Task: Two Independent Priming Studies

PubMed Central

Schrag, Yann; Tremea, Alessandro; Lagger, Cyril; Ohana, Noé; Mohr, Christine

2016-01-01

Studies indicated that people behave less responsibly after exposure to information containing deterministic statements as compared to free will statements or neutral statements. Thus, deterministic primes should lead to enhanced risk-taking behavior. We tested this prediction in two studies with healthy participants. In experiment 1, we tested 144 students (24 men) in the laboratory using the Iowa Gambling Task. In experiment 2, we tested 274 participants (104 men) online using the Balloon Analogue Risk Task. In the Iowa Gambling Task, the free will priming condition resulted in more risky decisions than both the deterministic and neutral priming conditions. We observed no priming effects on risk-taking behavior in the Balloon Analogue Risk Task. To explain these unpredicted findings, we consider the somatic marker hypothesis, a gain frequency approach as well as attention to gains and / or inattention to losses. In addition, we highlight the necessity to consider both pro free will and deterministic priming conditions in future studies. Importantly, our and previous results indicate that the effects of pro free will and deterministic priming do not oppose each other on a frequently assumed continuum. PMID:27018854

Shoulder injury in water polo: A systematic review of incidence and intrinsic risk factors.

PubMed

Miller, Andrea H; Evans, Kerrie; Adams, Roger; Waddington, Gordon; Witchalls, Jeremy

2018-04-01

Water polo is a popular water-based contact sport that involves swimming, throwing and defending. Cumulatively, these repetitive overhead activities are thought to increase the risk of shoulder injury and, subsequently to affect players' physical conditioning as well as team performance. The purpose of this review was to examine available evidence relating to shoulder injury rates and risk factors for shoulder injury in water polo. Systematic review METHODS: CINAHL, AUSPORT, Pubmed, Pedro and SPORTDiscus databases were searched for original research papers using the predefined terms ("water polo") AND (shoulder OR glenohumeral* OR arm OR "upper limb"). Twenty papers were identified as suitable for inclusion. Reported shoulder injury rates varied from 24% - 51%. Shoulder injuries were more likely to become chronic compared to all other reported injuries. Injury data during the last three World Championships indicates an increasing rate of shoulder injuries-per-year with participation in aquatic sports. Risk for shoulder injury in water polo is multi-factorial. Volume of shooting, range of motion, scapular dyskinesis, strength imbalance, proprioceptive deficit and altered throwing kinematics have been proposed to be associated with an increased risk of injury. Although this review showed water polo to have a high propensity for shoulder injury, the descriptive nature of the included papers limited the inferences that could be drawn from the pooled literature. Future directions for research include collecting normative data for shoulder range of motion, strength ratio and proprioception with prospective analysis of these attributes in relation to injury rates and time lost. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Physiological and Medical Aspects That Put Women Soldiers at Increased Risk for Overuse Injuries.

PubMed

Epstein, Yoram; Fleischmann, Chen; Yanovich, Ran; Heled, Yuval

2015-11-01

Anthropometric and physiological factors place female soldiers at a disadvantage relative to male soldiers in most aspects of physical performance. Average aerobic and anaerobic fitness levels are lower in women than in men. Thus, women have a lower overall work capacity and must exert themselves more than men to achieve the same output. The lower weight and fat-free mass and the higher body fat of women are associated with lower muscle strength and endurance, placing them at a disadvantage compared with men in performing military tasks such as lifting and carrying weights, or marching with a load. Working at a higher percentage of their maximal capacity to achieve the same performance levels as men, women tire earlier. Their smaller size, skeletal anatomy, and different bone geometry also predispose women to a higher incidence of exercise-related injuries. Consequently, the attrition rate of female soldiers in combat units is higher than that of their male counterparts. This review summarizes the literature on gender-related physiological and anatomical differences that put female soldiers at an increased risk of exercise-related injuries.

Dual-task and anticipation impact lower limb biomechanics during a single-leg cut with body borne load.

PubMed

Seymore, Kayla D; Cameron, Sarah E; Kaplan, Jonathan T; Ramsay, John W; Brown, Tyler N

2017-12-08

This study quantified how a dual cognitive task impacts lower limb biomechanics during anticipated and unanticipated single-leg cuts with body borne load. Twenty-four males performed anticipated and unanticipated cuts with and without a dual cognitive task with three load conditions: no load (∼6 kg), medium load (15% of BW), and heavy load (30% of BW). Lower limb biomechanics were submitted to a repeated measures linear mixed model to test the main and interaction effects of load, anticipation, and dual task. With body borne load, participants increased peak stance (PS) hip flexion (p = .004) and hip internal rotation (p = .001) angle, and PS hip flexion (p = .001) and internal rotation (p = .018), and knee flexion (p = .016) and abduction (p = .001) moments. With the dual task, participants decreased PS knee flexion angle (p < .001) and hip flexion moment (p = .027), and increased PS knee external rotation angle (p = .034). During the unanticipated cut, participants increased PS hip (p = .040) and knee flexion angle (p < .001), and decreased PS hip adduction (p = .001), and knee abduction (p = .005) and external rotation (p = .026) moments. Adding body borne load produces lower limb biomechanical adaptations thought to increase risk of musculoskeletal injury, but neither anticipation nor dual task exaggerated those biomechanical adaptations. With a dual task, participants adopted biomechanics known to increase injury risk; whereas, participants used lower limb biomechanics thought to decrease injury risk during unanticipated cuts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of BMI on the risk and frequency of AIS 3+ injuries in motor-vehicle crashes.

PubMed

Rupp, Jonathan D; Flannagan, Carol A C; Leslie, Andrew J; Hoff, Carrie N; Reed, Matthew P; Cunningham, Rebecca M

2013-01-01

Determine the effects of BMI on the risk of serious-to-fatal injury (Abbreviated Injury Scale ≥ 3 or AIS 3+) to different body regions for adults in frontal, nearside, farside, and rollover crashes. Multivariate logistic regression analysis was applied to a probability sample of adult occupants involved in crashes generated by combining the National Automotive Sampling System (NASS-CDS) with a pseudoweighted version of the Crash Injury Research and Engineering Network database. Logistic regression models were applied to weighted data to estimate the change in the number of occupants with AIS 3+ injuries if no occupants were obese. Increasing BMI increased risk of lower-extremity injury in frontal crashes, decreased risk of lower-extremity injury in nearside impacts, increased risk of upper-extremity injury in frontal and nearside crashes, and increased risk of spine injury in frontal crashes. Several of these findings were affected by interactions with gender and vehicle type. If no occupants in frontal crashes were obese, 7% fewer occupants would sustain AIS 3+ upper-extremity injuries, 8% fewer occupants would sustain AIS 3+ lower-extremity injuries, and 28% fewer occupants would sustain AIS 3+ spine injuries. Results of this study have implications on the design and evaluation of vehicle safety systems. Copyright © 2013 The Obesity Society.

Effect of systematic ergonomic hazard identification and control implementation on musculoskeletal disorder and injury risk.

PubMed

Cantley, Linda F; Taiwo, Oyebode A; Galusha, Deron; Barbour, Russell; Slade, Martin D; Tessier-Sherman, Baylah; Cullen, Mark R

2014-01-01

This study aimed to examine the effect of an ergonomic hazard control (HC) initiative, undertaken as part of a company ergonomics standard, on worker injury risk. Using the company's ergonomic hazards database to identify jobs with and without ergonomic HC implementation and linking to individual job and injury histories, injury risk among person-jobs with HC implementation (the HC group) was compared to those without HC (NoHC group) using random coefficient models. Further analysis of the HC group was conducted to determine the effect of additional ergonomic hazards controlled on injury risk. Among 123 jobs at 17 plant locations, 347 ergonomic hazards were quantitatively identified during the study period. HC were implemented for 204 quantified ergonomic hazards in 84 jobs, impacting 10 385 persons (12 967 person-jobs). No HC were implemented for quantified ergonomic hazards in the remaining 39 jobs affecting 4155 persons (5046 person-jobs). Adjusting for age, sex, plant origin, and year to control for any temporal trend in injury risk, the relative risk (RR) for musculoskeletal disorder (MSD) was 0.85 and the RR for any injury or MSD was 0.92 in the HC compared to NoHC group. Among the HC group, each ergonomic hazard controlled was associated with risk reduction for MSD and acute injury outcomes (RR 0.93). Systematic ergonomic HC through participatory ergonomics, as part of a mandatory company ergonomics standard, is associated with MSD and injury risk reduction among workers in jobs with HC implemented.

Injury risk is different in team and individual youth sport.

PubMed

Theisen, Daniel; Frisch, Anne; Malisoux, Laurent; Urhausen, Axel; Croisier, Jean-Louis; Seil, Romain

2013-05-01

This study compared sports injury incidence in young high-level athletes from various team and individual sports and investigated if sport participation patterns are linked to injuries. Prospective cohort follow-up. Pupils from a public sports school (12-19 years) were recruited over two separate school years (2008-2009: 42 weeks, n=199 athletes; 2009-2010: 40 weeks, n=89 athletes). Training and competition volume and intensity were recorded via a personal sports diary. Sports injuries (time-loss definition) were registered by medical staff members using a standardized questionnaire. Injury incidence was significantly higher in team compared with individual sports (6.16 versus 2.88 injuries/1000h, respectively), as a result of a higher incidence of both traumatic (RR=2.17; CI95%=1.75-2.70; p<0.001), and overuse injuries (RR=2.06; CI95%=1.46-2.91; p<0.001). A Cox proportional hazards regression revealed that team sports participation had a hazard ratio of 2.00 (CI95%=1.49-2.68; p<0.001) compared to individual sports, with additionally previous injury being a risk and age a protective factor. The number of competitions per 100 days was significantly higher in team sports, whereas the number of intense training sessions per 100 days was significantly lower. In team sports, the number of competitions per 100 days was positively associated with injuries (HR=1.072; CI95% [1.033; 1.113]; p<0.001), while in individual sports the number of competitions per 100 days had a protective effect (HR=0.940; CI95% [0.893; 0.989]; p=0.017). Team sports participation entailed a higher injury risk, whatever the injury category. Further research should elucidate the role of characteristics related to sport participation in injury causation. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

A Prospective Investigation of Biomechanical Risk Factors for Patellofemoral Pain Syndrome. The Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) Cohort

DTIC Science & Technology

2009-09-24

flexion angle, decreased vertical ground-reaction force , and increased hip internal rotation angle during the jump -landing task. Additionally, decreased...was to determine the biomechanical risk factors for PFPS. The specific factors examined were lower extremity kinematics and kinetics during a jump ...ACL Injury [ JUMP -ACL] study) in which baseline data are collected for participants at all 3 service academies (USNA, United States Air Force Academy

Risk factors for ventilator-associated pneumonia: among trauma patients with and without brain injury.

PubMed

Gianakis, Anastasia; McNett, Molly; Belle, Josie; Moran, Cristina; Grimm, Dawn

2015-01-01

Ventilator-associated pneumonia (VAP) rates remain highest among trauma and brain injured patients; yet, no research compares VAP risk factors between the 2 groups. This retrospective, case-controlled study identified risk factors for VAP among critically ill trauma patients with and without brain injury. Data were abstracted on trauma patients with (cases) and without (controls) brain injury. Data gathered on n = 157 subjects. Trauma patients with brain injury had more emergent and field intubations. Age was strongest predictor of VAP in cases, and ventilator days predicted VAP in controls. Trauma patients with brain injury may be at higher risk for VAP.

Evaluation of eye injury risk from projectile shooting toys using the focus headform - biomed 2009.

PubMed

Bisplinghoff, Jill A; Duma, Stefan M

2009-01-01

Half of eye injuries in the United States are caused by a blunt impact and more specifically, eye injuries effecting children often result from projectile shooting toys. The purpose of this study is to evaluate the risk of eye injuries of currently available projectile shooting toys. In order to assess the risk of each toy, a Facial and Ocular Countermeasure Safety (FOCUS) headform was used to measure the force applied to the eye during each hit for a total of 18 tests. The selected toys included a dart gun, a foam launcher, and a ball launcher. The force ranged from 4-93 N and was analyzed using the injury risk function for globe rupture for the FOCUS headform. Projectile characteristics were also examined using normalized energy to determine risk of corneal abrasion, hyphema, lens dislocation, retinal damage and globe rupture. It was found that the three toys tested produced peak loads corresponding with risk of globe rupture between 0% and 17.3%. The normalized energy results show no risk of hyphema, lens dislocation, retinal damage or globe rupture and a maximum risk of corneal abrasion of 5.9%. This study concludes that although there are many eye injuries caused by projectiles, the selected toys show a very low risk of eye injury.

Risk of work injury among adolescent students from single and partnered parent families.

PubMed

Wong, Imelda S; Breslin, F Curtis

2017-03-01

Parental involvement in keeping their children safe at work has been examined in a handful of studies, with mixed results. Evidence has suggested that non-work injury risk is higher among children from single-parent families, but little is known about their risk for work-related injuries. Five survey cycles of the Canadian Community Health Survey were pooled to create a nationally representative sample of employed 15-19-year old students (N = 16,620). Multivariable logistic regression estimated the association between family status and work injury. Risk of work-related repetitive strains (OR:1.24, 95%CI: 0.69-2.22) did not differ by family type. However, children of single parents were less likely to sustain a work injury receiving immediate medical care (OR:0.43, 95%CI: 0.19-0.96). Despite advantages and disadvantages related to family types, there is no evidence that work-related injury risk among adolescents from single parent families is greater than that of partnered-parent families. Am. J. Ind. Med. 60:285-294, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Understanding children's injury-risk behavior: wearing safety gear can lead to increased risk taking.

PubMed

Morrongiello, Barbara A; Walpole, Beverly; Lasenby, Jennifer

2007-05-01

The present study examined whether school-age children show risk compensation and engage in greater risk taking when wearing safety gear compared to when not doing so when running an obstacle course containing hazards that could lead to physical injury. Because sensation seeking has been shown to influence risk taking, this child attribute was also assessed and related to risk compensation. Children 7-12 years of age were videotaped navigating the obstacle course twice, once wearing safety gear and once without safety gear, with reverse directions used to minimize possible practice effects. The time it took the child to run through the course and the number of reckless behaviors (e.g., falls, trips, bumping into things) that the child made while running the course were compared for the gear and no-gear conditions. Results indicated that children went more quickly and behaved more recklessly when wearing safety gear than when not wearing gear, providing evidence of risk compensation. Moreover, those high in sensation seeking showed greater risk compensation compared with other children. Implications for childhood injury prevention are discussed.

Farm work injuries among a cohort of children in Kentucky, USA.

PubMed

Browning, Steven R; Westneat, Susan C; Reed, Deborah B

2016-12-23

Children residing on farms with livestock may be at an increased risk for work-related injuries, compared to children who work on other commodity farms. This study characterizes children's work tasks on Kentucky farms and assesses whether children who work on beef cattle farms are at an increased risk for farm work injuries. The results of a cohort study of children aged 5-18 years (N=999 at baseline) working on family farms in Kentucky, followed for two consecutive years after an initial enumeration five years previously, found that 70% of the children were involved in animal-related chores. Across all age groups, children on beef cattle farms devoted a greater number of hours per week to farm work, compared to children living on other commodity farms, especially during the school year. For all children in the study, working more than 180 days per year, performing farm work independently, and working on a beef cattle farm (compared to other commodity farm), increased the risk of a farm work injury. However, none of these associations were statistically significant. For male children only, the performance of work tasks independently was significantly associated with a 2.4-fold increased risk (OR = 2.41; 95% CI: 1.15-5.06; P=0.02) for a farm work injury, after controlling for days of working, age, period of data collection, and commodity type of the farm.

Neuromuscular Risk Factors for Knee and Ankle Ligament Injuries in Male Youth Soccer Players

PubMed Central

Read, Paul J.; Oliver, Jon L.; De Ste Croix, Mark B. A.; Myer, Gregory D.; Lloyd, Rhodri S.

2017-01-01

Injuries reported in male youth soccer players most commonly occur in the lower extremities, and include a high proportion of ligament sprains at the ankle and knee with a lower proportion of overuse injuries. There is currently a paucity of available literature that examines age- and sex-specific injury risk factors for such injuries within youth soccer players. Epidemiological data have reported movements that lead to non-contact ligament injury include running, twisting and turning, over-reaching and landing. Altered neuromuscular control during these actions has been suggested as a key mechanism in females and adult populations; however, data available in male soccer players is sparse. The focus of this article is to review the available literature and elucidate prevalent risk factors pertaining to male youth soccer players which may contribute to their relative risk of injury. PMID:26856339

Neuromuscular Risk Factors for Knee and Ankle Ligament Injuries in Male Youth Soccer Players.

PubMed

Read, Paul J; Oliver, Jon L; De Ste Croix, Mark B A; Myer, Gregory D; Lloyd, Rhodri S

2016-08-01

Injuries reported in male youth soccer players most commonly occur in the lower extremities, and include a high proportion of ligament sprains at the ankle and knee with a lower proportion of overuse injuries. There is currently a paucity of available literature that examines age- and sex-specific injury risk factors for such injuries within youth soccer players. Epidemiological data have reported movements that lead to non-contact ligament injury include running, twisting and turning, over-reaching and landing. Altered neuromuscular control during these actions has been suggested as a key mechanism in females and adult populations; however, data available in male soccer players is sparse. The focus of this article is to review the available literature and elucidate prevalent risk factors pertaining to male youth soccer players which may contribute to their relative risk of injury.

Predicting Family Burden Following Childhood Traumatic Brain Injury: A Cumulative Risk Approach

PubMed Central

Josie, Katherine Leigh; Peterson, Catherine Cant; Burant, Christopher; Drotar, Dennis; Stancin, Terry; Wade, Shari L.; Yeates, Keith; Taylor, H. Gerry

2015-01-01

Objective To examine the utility of a cumulative risk index (CRI) in predicting the family burden of injury (FBI) over time in families of children with traumatic brain injury (TBI). Participants One hundred eight children with severe or moderate TBI and their families participated in the study. Measures The measures used in the study include the Socioeconomic Composite Index, Life Stressors and Social Resources Inventory—Adult Form, Vineland Adaptive Behavior Scales, Child Behavior Checklist, Children’s Depression Inventory, McMaster Family Assessment Device, Brief Symptom Inventory, and Family Burden of Injury Interview. In addition, information on injury-related risk was obtained via medical charts. Methods Participants were assessed immediately, 6, and 12 months postinjury and at a 4-year extended follow-up. Results Risk variables were dichotomized (ie, high- or low-risk) and summed to create a CRI for each child. The CRI predicted the FBI at all assessments, even after accounting for autocorrelations across repeated assessments. Path coefficients between the outcome measures at each time point were significant, as were all path coefficients from the CRI to family burden at each time point. In addition, all fit indices were above the recommended guidelines, and the χ2 statistic indicated a good fit to the data. Conclusions The current study provides initial support for the utility of a CRI (ie, an index of accumulated risk factors) in predicting family outcomes over time for children with TBI. The time period immediately after injury best predicts the future levels of FBI; however, cumulative risk continues to influence the change across successive postinjury assessments. These results suggest that clinical interventions could be proactive or preventive by intervening with identified “at-risk” subgroups immediately following injury. PMID:19033828

Screening for violence risk factors identifies young adults at risk for return emergency department visit for injury.

PubMed

Hankin, Abigail; Wei, Stanley; Foreman, Juron; Houry, Debra

2014-08-01

Homicide is the second leading cause of death among youth aged 15-24. Prior cross-sectional studies, in non-healthcare settings, have reported exposure to community violence, peer behavior, and delinquency as risk factors for violent injury. However, longitudinal cohort studies have not been performed to evaluate the temporal or predictive relationship between these risk factors and emergency department (ED) visits for injuries among at-risk youth. The objective was to assess whether self-reported exposure to violence risk factors in young adults can be used to predict future ED visits for injuries over a 1-year period. This prospective cohort study was performed in the ED of a Southeastern US Level I trauma center. Eligible participants were patients aged 18-24, presenting for any chief complaint. We excluded patients if they were critically ill, incarcerated, or could not read English. Initial recruitment occurred over a 6-month period, by a research assistant in the ED for 3-5 days per week, with shifts scheduled such that they included weekends and weekdays, over the hours from 8AM-8PM. At the time of initial contact in the ED, patients were asked to complete a written questionnaire, consisting of previously validated instruments measuring the following risk factors: a) aggression, b) perceived likelihood of violence, c) recent violent behavior, d) peer behavior, e) community exposure to violence, and f) positive future outlook. At 12 months following the initial ED visit, the participants' medical records were reviewed to identify any subsequent ED visits for injury-related complaints. We analyzed data with chi-square and logistic regression analyses. Three hundred thirty-two patients were approached, of whom 300 patients consented. Participants' average age was 21.1 years, with 60.1% female, 86.0% African American. After controlling for participant gender, ethnicity, or injury complaint at time of first visit, return visits for injuries were significantly

Injury Surveillance Among NASA Astronauts Using the Barell Injury Diagnosis Matrix

NASA Technical Reports Server (NTRS)

Murray, J. D.; Laughlin, M. S.; Eudy, D. L.; Wear, M. L.; VanBaalen, M. G.

2014-01-01

Astronauts perform physically demanding tasks and risk incurring musculoskeletal injuries during both groundbased training and missions. Increased injury rates throughout the history of the U.S. space program have been attributed to numerous factors, including an aging astronaut corps, increased Weightless Environment Training Facility (WETF) and Neutral Buoyancy Laboratory (NBL) training to construct the International Space Station, and improved clinical operations that promote injury prevention and reporting. With NASA program changes through the years (including retirement of the Shuttle program) and an improved training environment (including a new astronaut gym), there is no surveillance program to systematically track injury rates. A limited number of research projects have been conducted over the past 20 years to evaluate musculoskeletal injuries: (1) to evaluate orthopedic injuries from 1987 to 1995, (2) to describe upper extremity injuries, (3) to evaluate EVA spacesuit training related injuries, and (4) to evaluate in-flight musculoskeletal injuries. Nevertheless, there has been no consistently performed comprehensive assessment of musculoskeletal injuries among astronauts. The Barell Injury Diagnosis Matrix was introduced at the 2001 meeting of the International Collaborative Effort (ICE) on Injury Statistics. The Matrix proposes a standardized method of classifying body region by nature of injury. Diagnoses are coded using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) coding system. The purpose of this study is to assess the usefulness and complexity of the Barell Injury Diagnosis Matrix to classify and track musculoskeletal injuries among NASA astronauts.

Do Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Influence Preschool Unintentional Injury Risk?

PubMed Central

Garzon, Dawn Lee; Huang, Hongyan; Todd, Richard D.

2008-01-01

Purpose This study explores the relationship between preschool attention deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), injury risk-taking behavior, and unintentional injury. Method Emergency department case control study of parent reported child behavior. Findings Children with ODD and ADHD had significantly more injury risk-taking behaviors (OR=7.68, 95% CI 2.25–26.25, OR 4.87, 95% CI 1.17–20.28 respectively) and injured children had a 17-fold increase in high risk-taking behaviors (OR 17.2, 95% CI 2.14–138.0). No significant association existed between ODD or ADHD and ED-treated unintentional injury. Implications Disruptive behavior disorders are not major contributors to ED-treated unintentional injury in preschool children. PMID:18809121

Injury risk curves for the WorldSID 50th male dummy.

PubMed

Petitjean, Audrey; Trosseille, Xavier; Praxl, Norbert; Hynd, David; Irwin, Annette

2012-10-01

The development of the WorldSID 50th percentile male dummy was initiated in 1997 by the International Organisation for Standardisation (ISO/TC22/SC12/WG5) with the objective of developing a more biofidelic side impact dummy and supporting the adoption of a harmonised dummy into regulations. The dummy is currently under evaluation at the Working Party on Passive Safety (GRSP) in order to be included in the pole side impact global technical regulation (GTR). Injury risk curves dedicated to this dummy and built on behalf of ISO/TC22/SC12/WG6 were proposed in order to assess the occupant safety performance (Petitjean et al. 2009). At that time, there was no recommendation yet on the injury criteria and no consensus on the most accurate statistical method to be used. Since 2009, ISO/TC22/SC12/WG6 reached a consensus on the definition of guidelines to build injury risk curves, including the use of the survival analysis, the distribution assessment and quality checks. These guidelines were applied to the WorldSID 50th results published in 2009 in order to be able to provide a final set of injury risk curves recommended by ISO/TC22/SC12/WG6. The paper presents the different steps of the guidelines as well as the recommended injury risk curves dedicated to the WorldSID 50th for lateral shoulder load, thoracic rib deflection, abdomen rib deflection and pubic force.

Risk factors of acute and overuse musculoskeletal injuries among young conscripts: a population-based cohort study.

PubMed

Taanila, Henri; Suni, Jaana H; Kannus, Pekka; Pihlajamäki, Harri; Ruohola, Juha-Petri; Viskari, Jarmo; Parkkari, Jari

2015-05-01

Military service in Finland is compulsory for all male citizens and annually about 80% of 19-year-old men enter into the service. The elevated risk for many chronic diseases and loss of function among those who are inactive and unfit can be often detected already in youth. On the other hand, activity-induced injuries among young are true public health issue. The purpose of the present prospective cohort follow-up study was to evaluate predictive associations between acute or overuse injuries and their various intrinsic risk factors. Four successive cohorts of conscripts who formed a representative sample of Finnish young men were followed for 6 months. At the beginning of the service, the risk factors of injuries were measured and recorded and then the acute and overuse injuries treated at the garrison clinic were identified. Predictive associations between injuries and their risk factors were examined by multivariate Cox's proportional hazard models. Of the 1411 participants, 27% sustained an acute injury and 51% suffered from overuse injury. Concerning acute injuries, highest risk for severe injuries were detected among conscripts with low fitness level in both the standing long-jump and push-up tests (hazard rate, HR=5.9; 95% CI: 1.6‒21.3). A history of good degree in school sports was not a protective factor against acute injuries. High waist circumference and, on the other hand, being underweight according to BMI increased the HR for overuse injuries. Brisk leisure time physical activity before military entry was a protective factor against overuse injuries. Poor result in Cooper's test was a warning signal of elevated risk of overuse injuries. We confirmed previous findings that low level of physical fitness is predictor for musculoskeletal injuries during intensive physical training. The U-shaped relationship between body composition and overuse injuries was noticed indicating that both obesity and underweight are risk factors for overuse injuries. Persons

Low External Workloads Are Related to Higher Injury Risk in Professional Male Basketball Games

PubMed Central

Caparrós, Toni; Casals, Martí; Solana, Álvaro; Peña, Javier

2018-01-01

The primary purpose of this study was to identify potential risk factors for sports injuries in professional basketball. An observational retrospective cohort study involving a male professional basketball team, using game tracking data was conducted during three consecutive seasons. Thirty-three professional basketball players took part in this study. A total of 29 time-loss injuries were recorded during regular season games, accounting for 244 total missed games with a mean of 16.26 ± 15.21 per player and season. The tracking data included the following variables: minutes played, physiological load, physiological intensity, mechanical load, mechanical intensity, distance covered, walking maximal speed, maximal speed, sprinting maximal speed, maximal speed, average offensive speed, average defensive speed, level one acceleration, level two acceleration, level three acceleration, level four acceleration, level one deceleration, level two deceleration, level three deceleration, level four deceleration, player efficiency rating and usage percentage. The influence of demographic characteristics, tracking data and performance factors on the risk of injury was investigated using multivariate analysis with their incidence rate ratios (IRRs). Athletes with less or equal than 3 decelerations per game (IRR, 4.36; 95% CI, 1.78-10.6) and those running less or equal than 1.3 miles per game (lower workload) (IRR, 6.42 ; 95% CI, 2.52-16.3) had a higher risk of injury during games (p < 0.01 in both cases). Therefore, unloaded players have a higher risk of injury. Adequate management of training loads might be a relevant factor to reduce the likelihood of injury according to individual profiles. Key points The number of decelerations and the total distance can be considered risk factors for injuries in professional basketball players. Unloaded players have greater risk of injury compared to players with higher accumulated external workload. Workload management should be

Anterior cruciate ligament injury: Identifying information sources and risk factor awareness among the general population.

PubMed

Nagano, Yasuharu; Yako-Suketomo, Hiroko; Natsui, Hiroaki

2018-01-01

Raising awareness on a disorder is important for its prevention and for promoting public health. However, for sports injuries like the anterior cruciate ligament (ACL) injury no studies have investigated the awareness on risk factors for injury and possible preventative measures in the general population. The sources of information among the population are also unclear. The purpose of the present study was to identify these aspects of public awareness about the ACL injury. A questionnaire was randomly distributed among the general population registered with a web based questionnaire supplier, to recruit 900 participants who were aware about the ACL injury. The questionnaire consisted of two parts: Question 1 asked them about their sources of information regarding the ACL injury; Question 2 asked them about the risk factors for ACL injury. Multivariate logistic regression was used to determine the information sources that provide a good understanding of the risk factors. The leading source of information for ACL injury was television (57.0%). However, the results of logistic regression analysis revealed that television was not an effective medium to create awareness about the risk factors, among the general population. Instead "Lecture by a coach", "Classroom session on Health", and "Newspaper" were significantly more effective in creating a good awareness of the risk factors (p < 0.001).

The effects of military body armour on trunk and hip kinematics during performance of manual handling tasks (.).

PubMed

Lenton, Gavin; Aisbett, Brad; Neesham-Smith, Daniel; Carvajal, Alvaro; Netto, Kevin

2016-06-01

Musculoskeletal injuries are reported as burdening the military. An identified risk factor for injury is carrying heavy loads; however, soldiers are also required to wear their load as body armour. To investigate the effects of body armour on trunk and hip kinematics during military-specific manual handling tasks, 16 males completed 3 tasks while wearing each of 4 body armour conditions plus a control. Three-dimensional motion analysis captured and quantified all kinematic data. Average trunk flexion for the weightiest armour type was higher compared with control during the carry component of the ammunition box lift (p < 0.001) and sandbag lift tasks (p < 0.001). Trunk rotation ROM was lower for all armour types compared with control during the ammunition box place component (p < 0.001). The altered kinematics with body armour occurred independent of armour design. In order to optimise armour design, manufacturers need to work with end-users to explore how armour configurations interact with range of personal and situational factors in operationally relevant environments. Practitioner Summary: Musculoskeletal injuries are reported as burdening the military and may relate to body armour wear. Body armour increased trunk flexion and reduced trunk rotation during military-specific lifting and carrying tasks. The altered kinematics may contribute to injury risk, but more research is required.

Risk and protective factors for obstetric anal sphincter injuries: A retrospective nationwide study.

PubMed

Marschalek, Marie-Louise; Worda, Christof; Kuessel, Lorenz; Koelbl, Heinz; Oberaigner, Willi; Leitner, Hermann; Marschalek, Julian; Husslein, Heinrich

2018-03-14

In view of the reported increase in obstetric anal sphincter injuries, the objective of this study was to evaluate the incidence of such injuries over time and the associated risk and protective factors. This was a retrospective cohort study from a national database of 168 137 primiparous women with term, singleton, cephalic, vaginal delivery between 2008 and 2014. The main outcome measure was obstetric anal sphincter injury. A multivariate regression model was used to identify risk and protective factors. Age >19 years, birthweight >4000 g, and operative vaginal delivery were independent risk factors for obstetric anal sphincter injuries. Mediolateral episiotomy increased the risk for obstetric anal sphincter injuries in spontaneous vaginal birth (number needed to harm 333), whereas it was protective in vacuum delivery (number needed to treat 50). From 2008 to 2014, there was an increase in the rate of obstetric anal sphincter injuries (2.1% vs 3.1%, P < .01), vacuum deliveries (12.1% vs 12.8%, P < .01), and cesarean delivery after labor (17.1% vs 19.4%, P < .01), while forceps deliveries (0.4% vs 0.1%, P < .01) and episiotomy rate decreased (35.9% vs 26.4%, P < .01). Episiotomy may be a risk or protective factor depending on the type of episiotomy and the clinical setting in which it is used. Our study supports a restrictive use of mediolateral episiotomy in spontaneous vaginal deliveries. In vacuum deliveries mediolateral episiotomy may help prevent obstetric anal sphincter injuries. © 2018 the Authors. Birth published by Wiley Periodicals, Inc.

Snowboarding injuries in Australia: investigating risk factors in wrist fractures to enhance injury prevention strategies.

PubMed

Dickson, Tracey J; Terwiel, F Anne

2011-09-01

To investigate risk factors associated with wrist fractures in snowboarders to inform future snowsport safety strategies. A prospective case-control study using a nonprobability convenience sample was conducted with data collected via a respondent-completed questionnaire. Subjects consisted of snowboarders with a snowboard-related injury who presented to one of 10 medical centers and physiotherapy clinics in resort medical centers and gateway communities across the Australian snowsport season in 2007. Those presenting with injuries other than wrist fractures acted as the control. The 611 respondents reported 802 injuries (61.3% were males and 51.5% were aged 16-25 years). Protective equipment was worn by 57.0% of respondents. The main reason for not wearing a wrist guard was that they did not see the need; of these, 12.9% experienced a wrist fracture. Most injuries occurred on-piste, in a terrain park, or in a lesson. The main mechanism of injury was falling. The major risk factors for wrist fractures were being less than 16 years of age (OR 3.97, CI 2.54-6.22), being in the alpine area for a holiday (OR 2.77, CI 1.47-5.21), and being a first-day snowboard participant (OR 2.02, CI 1.15-3.64). A direct logistic regression indicated that 3 variables had a statistically significant contribution to the model (being less than 16 years old, being on holidays in the region, and not wearing a wrist guard). The key risk factors in this Australian study reflect other international studies, providing a clear market segment for targeted snowsport safety messages: those less than 16 years old, visitors to the alpine regions, and those not wearing wrist guards. Copyright © 2011. Published by Elsevier Inc.

Magnitude and risk factors of injuries in a glass bottle manufacturing plant.

PubMed

Bazroy, Joy; Roy, Gautam; Sahai, Ajit; Soudarssanane, M B

2003-01-01

A study was conducted in a glass bottle manufacturing plant in Pondicherry, India, to assess the magnitude and identify the risk factors of work-related injuries between January and December 1998. Three hundred and seventy-seven injuries were reported among 341 permanent workers followed up for one year (incidence=1,105.5/1,000 workers/yr). A higher load of injuries was noted in the first half of the night shifts and the second half of the other three shifts. Injuries were higher in the second half of the week and during the first half of the year. Hands and wrists were the most common sites of injury (40.6%), whereas the eye, foot, ankles and other body parts had 30%, 14.6%, 10.6% and 4.2% of injuries respectively. The commonest type of injury was cuts and lacerations (50.1%); injuries to the eye (due to foreign bodies, chemicals and welding sparks) accounted for 30%, sprains 8% and burns 7.1% of the injuries. A cohort of 75 workers chosen from the 341 permanent workers were followed up for the one year for identification of risk factors. Significant risk factors were age (less than 30 yr) and experience (less than 2 yr). Technical factors responsible for injury were a hazardous worksite in 37 (38.5%) cases, inadequate protection with safety wear in 32 (33%) cases and proximity to machines in 14 (14.6%) cases. Human factors identified were non-use of protective wear in 43 (45%), overconfidence in 18 (18.7%) and timing error while working with machines in 11 (11.4%) episodes.

[Features of dual--postural and calculation--task performance in patients with consequences of traumatic brain injury].

PubMed

Zharikova, A V; Zhavoronkova, L A; Maksakova, O A; Kuptsova, S V

2012-01-01

Dual tasks with voluntary postural control and calculation have been done by 14 patients (25.7 +/- 4.7 yo.) after traumatic brain injury and 40 healthy volunteers (29.8 +/- 2.5 y.o.). Complex clinical (MMSE, FIM, MPAI-3 and Berg scales) and stabilographic evaluation has been performed. According to clinical evaluation 8 patients were included into group 1 with less severe functional deficit and 6 patients formed group 2 with more severe deficit. Parameters of motor and especially cognitive sub-tasks in patients were lower than in healthy subjects in both separate and dual tasks. In group 2 these parameters were lower than in group 1. Certain types of dual task where the quality of sub-tasks, especially of the motor-one increased in healthy subjects and patients of the first group were revealed. The complex of stabilographic parameters which could be used for estimation of quality of sub-tasks performance has been revealed. Dual tasks could be an additional method of evaluation of patients' adaptive possibilities and certain type of dual task could become a promising approach to recovery at late period of rehabilitation.

Effects of osteoporosis on AIS 3+ injury risk in motor-vehicle crashes.

PubMed

Rupp, Jonathan D; Flannagan, Carol A C; Hoff, Carrie N; Cunningham, Rebecca M

2010-11-01

Older occupants in motor-vehicle crashes are more likely to experience injury than younger occupants. One possible reason for this is that increasing age is associated with increased prevalence of osteoporosis, which decreases bone strength. Crash-injury data were used with Bayes' Theorem to estimate the conditional probability of AIS 3+ skeletal injury given that an occupant is osteoporotic for the injury to the head, spine, thorax, lower extremities, and upper extremities. This requires the conditional probabilities of osteoporosis given AIS 3+ injury for each of the body regions, which were determined from analysis of the Crash Injury Research and Engineering Network database. It also requires information on probability of osteoporosis in the crash-involved population and the probabilities of AIS 3+ skeletal injury to different body regions in crashes. The latter probabilities were obtained from the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) database. The former was obtained by modeling the probability of osteoporosis in the US populations using data from the 2006 National Health Examination Nutrition Survey and applying this model to the estimate of the crash-involved population in NASS-CDS. To attempt to account for the effects of age on injury outcome that are independent of osteoporosis, only data from occupants who were 60 years of age or older were used in all analyses. Results indicate that the only body region that experiences a statistically significant change in fracture injury risk with osteoporosis is the spine, for which osteoporosis increases the risk of AIS 3+ fracture by 3.28 times, or from 0.41% to 1.34% (p<0.0001). This finding suggests that the increase in AIS 3+ injury risk with age for non-spine injuries is likely influenced by factors other than osteoporosis. 2010 Elsevier Ltd. All rights reserved.

Injury risk in British Columbia, Canada, 1986 to 2009: are Aboriginal children and youth over-represented?

PubMed

George, M Anne; Jin, Andrew; Brussoni, Mariana; Lalonde, Christopher E; McCormick, Rod

2015-12-01

Children and youth worldwide are at high risk of injury resulting in morbidity, disability or mortality. Disparities in risk exist between and within countries, and by sex and ethnicity. Our aim is to contribute data on disparities of injury rates for Aboriginal children and youth compared with those of the general population in British Columbia (BC), Canada, by examining risks for the two populations, utilizing provincial administrative data over a 24-year period. Hospital discharge records from the provincial health care database for children and youth were used to identify injury for the years 1986 to 2009. Within the total BC population, the Aboriginal population was identified. Crude rates and standardized relative risks (SRR) of hospitalization were calculated, by year and category of injury type and external cause, and compared to the total BC population for males and females under age 25 years. Over the 24-year period, substantive decreases were found in hospitalization injury risks for children and youth in both Aboriginal and total populations, for both sexes, and for most categories and types of injuries. Risk in overall injury dropped by 69% for the Aboriginal population and by 66% for the total BC population, yet in every year, the Aboriginal population had a higher risk than the total BC population. There were over 70% declines in risks among females of intentionally inflicted injury by another, among both the Aboriginal and total BC populations. Risk of injury caused by transport vehicles has decreased by an overwhelming 83% and 72% for the Aboriginal male population and for the total BC male population, respectively. The over 70% declines in risks for females of intentionally inflicted injury by another, among both the Aboriginal and total BC populations is excellent news. Risk of injury caused by transport vehicles for males decreased overwhelmingly for both populations. Disparities in rates between the Aboriginal population and total BC

The association between traumatic brain injury and suicide: are kids at risk?

PubMed

Richard, Yvonne F; Swaine, Bonnie R; Sylvestre, Marie-Pierre; Lesage, Alain; Zhang, Xun; Feldman, Debbie Ehrmann

2015-07-15

Traumatic brain injury (TBI) in late adolescence and adulthood is associated with a higher risk of suicide; however, it is unknown whether this association is also present in people who sustained a TBI during childhood. The purpose of the present study was to determine whether experiencing a TBI during childhood is a risk factor for suicide later in life and to examine whether the risk of suicide differs by sex or injury severity. A cohort of 135,703 children aged 0-17 years was identified from the Quebec population-based physician reimbursement database in 1987, and follow-up was conducted until 2008. Of the children in this cohort, 21,047 had sustained a TBI. Using a survival analysis with time-dependent indicators of TBI, we found a higher risk of suicide for people who sustained a TBI during childhood (hazard ratio (HR) = 1.49, 95% confidence interval (CI): 1.04, 2.14), adolescence (HR = 1.57, 95% CI: 1.09, 2.26), and adulthood (HR = 2.53, 95% CI: 1.79, 3.59). When compared with less severe injuries, such as concussions and cranial fractures, more severe injuries, such as intracranial hemorrhages, were associated with a higher risk of suicide (HR = 2.18 vs. 2.77, respectively). Repeated injuries were associated with higher risks of suicide in all age groups. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Injuries and risk factors in a 100-mile (161-km) infantry road march.

PubMed

Reynolds, K L; White, J S; Knapik, J J; Witt, C E; Amoroso, P J

1999-02-01

Light infantry soldiers (N = 218) completed a 161-km cross-country march over 5 days carrying an average +/- SD load mass (i.e., the weight of all equipment and clothing) of 47 +/- 5 kg. Prior to the march, height, weight, body fat, and physical fitness (3.2-km run, sit-ups, push-ups) were measured. Soldiers completed a demographic questionnaire which included questions on age and tobacco use history. Thirty-six percent (78/218) of the soldiers suffered one or more injuries. Of the total injuries, 48% presented were blisters and 18% were foot pain (not otherwise specified). Eight percent (17/218) of the soldiers were unable to complete the march because of injuries. Thirty-five percent (27/78) of the injured soldiers had 1 or more limited duty days for a total of 69 days. Risk of injury was higher among smokers (risk ratio = 1.8, P = 0.03 compared to nonsmokers) and lower among older soldiers (risk ratio = 3.2, P = 0.02, < 20 years compared to > 24 years). Carrying heavy loads over long distances can result in a high injury incidence to the lower body, since 36% of soldiers were injured during the 161-km march. Smoking and younger age (< 20 years) were independent risk factors for injuries.

Risk of Secondary Injury in Younger Athletes After Anterior Cruciate Ligament Reconstruction

PubMed Central

Wiggins, Amelia J.; Grandhi, Ravi K.; Schneider, Daniel K.; Stanfield, Denver; Webster, Kate E.; Myer, Gregory D.

2017-01-01

Background Injury to the ipsilateral graft used for reconstruction of the anterior cruciate ligament (ACL) or a new injury to the contralateral ACL are disastrous outcomes after successful ACL reconstruction (ACLR), rehabilitation, and return to activity. Studies reporting ACL reinjury rates in younger active populations are emerging in the literature, but these data have not yet been comprehensively synthesized. Purpose To provide a current review of the literature to evaluate age and activity level as the primary risk factors in reinjury after ACLR. Study Design Systematic review and meta-analysis. Methods A systematic review of the literature was conducted via searches in PubMed (1966 to July 2015) and EBSCO host (CINAHL, Medline, SPORTDiscus [1987 to July 2015]). After the search and consultation with experts and rating of study quality, 19 articles met inclusion for review and aggregation. Population demographic data and total reinjury (ipsilateral and contralateral) rate data were recorded from each individual study and combined using random-effects meta-analyses. Separate meta-analyses were conducted for the total population data as well as the following subsets: young age, return to sport, and young age + return to sport. Results Overall, the total second ACL reinjury rate was 15%, with an ipsilateral reinjury rate of 7% and contralateral injury rate of 8%. The secondary ACL injury rate (ipsilateral + contralateral) for patients younger than 25 years was 21%. The secondary ACL injury rate for athletes who return to a sport was also 20%. Combining these risk factors, athletes younger than 25 years who return to sport have a secondary ACL injury rate of 23%. Conclusion This systematic review and meta-analysis demonstrates that younger age and a return to high level of activity are salient factors associated with secondary ACL injury. These combined data indicate that nearly 1 in 4 young athletic patients who sustain an ACL injury and return to high-risk sport

Effect of systematic ergonomic hazard identification and control implementation on musculoskeletal disorder and injury risk

PubMed Central

Cantley, Linda F; Taiwo, Oyebode A; Galusha, Deron; Barbour, Russell; Slade, Martin D; Tessier-Sherman, Baylah; Cullen, Mark R

2014-01-01

Objectives This study aimed to examine the effect of an ergonomic hazard control (HC) initiative, undertaken as part of a company ergonomics standard, on worker injury risk. Methods Using the company's ergonomic hazards database to identify jobs with and without ergonomic HC implementation and linking to individual job and injury histories, injury risk among person-jobs with HC implementation (the HC group) was compared to those without HC (NoHC group) using random coefficient models. Further analysis of the HC group was conducted to determine the effect of additional ergonomic hazards controlled on injury risk. Results Among 123jobs at 17 plant locations, 347 ergonomic hazards were quantitatively identified during the study period. HC were implemented for 204 quantified ergonomic hazards in 84 jobs, impacting 10 385 persons (12 967 person-jobs). No HC were implemented for quantified ergonomic hazards in the remaining 39 jobs affecting 4155 persons (5046 person-jobs). Adjusting for age, sex, plant origin, and year to control for any temporal trend in injury risk, the relative risk (RR) for musculoskeletal disorder (MSD) was 0.85 and the RR for any injury or MSD was 0.92 in the HC compared to NoHC group. Among the HC group, each ergonomic hazard controlled was associated with risk reduction for MSD and acute injury outcomes (RR 0.93). Conclusion Systematic ergonomic HC through participatory ergonomics, as part of a mandatory company ergonomics standard, is associated with MSD and injury risk reduction among workers in jobs with HC implemented. PMID:24142048

Childhood and adolescent injuries in elementary schools in north-western Uganda: extent, risk and associated factors.

PubMed

Mutto, Milton; Lawoko, Stephen; Ovuga, Emilio; Svanstrom, Leif

2012-01-01

Childhood injuries remain understudied in Uganda. The objective of this study was to determine the extent, nature and determinants of school-related childhood injury risk in north-western Uganda. A cohort of 1000 grade fives from 13 elementary schools was followed-up for one term. Survival and multi-level modelling techniques compared the risk rates across gender, schools and locations. Childhood injuries are common in north-western Uganda. Most of them occur during travel, breaks, practical classes and gardening, while walking, playing, learning and digging. Most injuries result from collisions with objects, sports and falls. Two-thirds of children receive first aid and hospital care. Times to injury were 72.1 and 192.9 person days (p = 0.0000). Gender differences in time to event were significant (p = 0.0091). Girls had better survival rates: cumulative prevalence of childhood injury was 36.1%; with significant gender differences (p = 0.007). Injury rate was 12.3/1000 person days, with a hazard ratio of 1.4. Compared to girls, boys had a 37% higher injury rate (p = 0.004). Rates varied among schools. Associated factors include sex and school. Rural-urban location and school differences do influence childhood injury risk. Childhood injuries are common: the risk is high, gender- and school-specific. Determinants include gender and school. Location and school contexts influence injury risk.

Risk assessment of maintenance operations: the analysis of performing task and accident mechanism.

PubMed

Carrillo-Castrillo, Jesús A; Rubio-Romero, Juan Carlos; Guadix, Jose; Onieva, Luis

2015-01-01

Maintenance operations cover a great number of occupations. Most small and medium-sized enterprises lack the appropriate information to conduct risk assessments of maintenance operations. The objective of this research is to provide a method based on the concepts of task and accident mechanisms for an initial risk assessment by taking into consideration the prevalence and severity of the maintenance accidents reported. Data were gathered from 11,190 reported accidents in maintenance operations in the manufacturing sector of Andalusia from 2003 to 2012. By using a semi-quantitative methodology, likelihood and severity were evaluated based on the actual distribution of accident mechanisms in each of the tasks. Accident mechanisms and tasks were identified by using those variables included in the European Statistics of Accidents at Work methodology. As main results, the estimated risk of the most frequent accident mechanisms identified for each of the analysed tasks is low and the only accident mechanisms with medium risk are accidents when lifting or pushing with physical stress on the musculoskeletal system in tasks involving carrying, and impacts against objects after slipping or stumbling for tasks involving movements. The prioritisation of public preventive actions for the accident mechanisms with a higher estimated risk is highly recommended.

Fall-related injuries in a nursing home setting: is polypharmacy a risk factor?

PubMed

Baranzini, Federico; Diurni, Marcello; Ceccon, Francesca; Poloni, Nicola; Cazzamalli, Sara; Costantini, Chiara; Colli, Cristiano; Greco, Laura; Callegari, Camilla

2009-12-11

Polypharmacy is regarded as an important risk factor for fallingand several studies and meta-analyses have shown an increased fall risk in users of diuretics, type 1a antiarrhythmics, digoxin and psychotropic agents. In particular, recent evidence has shown that fall risk is associated with the use of polypharmacy regimens that include at least one established fall risk-increasing drug, rather than with polypharmacy per se. We studied the role of polypharmacy and the role of well-known fall risk-increasing drugs on the incidence of injurious falls. A retrospective observational study was carried out in a population of elderly nursing home residents. An unmatched, post-stratification design for age class, gender and length of stay was adopted. In all, 695 falls were recorded in 293 residents. 221 residents (75.4%) were female and 72 (24.6%) male, and 133 (45.4%) were recurrent fallers. 152 residents sustained no injuries when they fell, whereas injuries were sustained by 141: minor in 95 (67.4%) and major in 46 (32.6%). Only fall dynamics (p = 0.013) and drugs interaction between antiarrhythmic or antiparkinson class and polypharmacy regimen (> or =7 medications) seem to represent a risk association for injuries (p = 0.024; OR = 4.4; CI 95% 1.21 - 15.36). This work reinforces the importance of routine medication reviews, especially in residents exposed to polypharmacy regimens that include antiarrhythmics or antiparkinson drugs, in order to reduce the risk of fall-related injuries during nursing home stays.

A discrimination task used as a novel method of testing decision-making behavior following traumatic brain injury.

PubMed

Martens, Kris M; Vonder Haar, Cole; Hutsell, Blake A; Hoane, Michael R

2012-10-10

Traumatic brain injury (TBI) results in a multitude of deficits following injury. Some of the most pervasive in humans are the changes that affect frontally-mediated cognitive functioning, such as decision making. The assessment of decision-making behavior in rodents has been extensively tested in the field of the experimental analysis of behavior. However, due to the narrow therapeutic window following TBI, time-intensive operant paradigms are rarely incorporated into the battery of tests traditionally used, the majority of which assess motor and sensory functioning. The cognitive measures that are used are frequently limited to memory and do not account for changes in decision-making behavior. The purpose of the present study was to develop a simplified discrimination task that can assess deficits in decision-making behavior in rodents. For the task, rats were required to dig in cocoa-scented sand (versus unscented sand) for a reinforcer. Rats were given 12 sessions per day until a criterion level of 80% accuracy for 3 days straight was reached. Once the criterion was achieved, cortical contusion injuries were induced (frontal, parietal, or sham). Following a recovery period, the rats were re-tested on cocoa versus unscented sand. Upon reaching criterion, a reversal discrimination was evaluated in which the reinforcer was placed in unscented sand. Finally, a novel scent discrimination (basil versus coffee with basil reinforced), and a reversal (coffee) were evaluated. The results indicated that the Dig task is a simple experimental preparation that can be used to assess deficits in decision-making behavior following TBI.

Relationship between interchange usage and risk of hamstring injuries in the Australian Football League.

PubMed

Orchard, John W; Driscoll, Tim; Seward, Hugh; Orchard, Jessica J

2012-05-01

To study risk factors for hamstring injury in the Australian Football League (AFL), in particular the effect of recent changes in match participation (increased use of the interchange bench) on hamstring injury. Analysis of hamstring match injury statistics extracted from an injury database combined with match participation statistics extracted from a player statistics database. 56,320 player matches in the AFL over the period 2003-2010 were analyzed, in which 416 hamstring injuries occurred. In a Generalized Estimating Equation (GEE) analysis accounting for clustering of different teams, significant predictors of hamstring injuries were recent hamstring injury (RR 4.16, 95% CI 3.19-5.43), past history of ACL reconstruction (RR 1.69, 95% CI 1.09-2.60), past history of calf injury (RR 1.58, 95% CI 1.37-1.82), opposition team making 60 or more interchanges during the game (RR 1.38, 95% CI 1.12-1.68) and player having made 7 or more interchanges off the field in the last 3 weeks (protective RR 0.74, 95% CI 0.59-0.93). These findings suggest that regular interchanges protect individual players against hamstring injuries, but increase the risk of hamstring injury for opposition players. These findings can be explained by a model in which both fatigue and average match running speed are risk factors for hamstring injury. A player who returns to the ground after a rest on the interchange bench may himself have some short-term protection against hamstring injury because of the reduced fatigue, but his rested state may contribute to increased average running speed for his direct opponent, increasing the risk of injury for players on the opposition team. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.