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PubMed2005

The prevalence of driveway back-over injuries in the era of sports utility vehicles.

BACKGROUND: Small children are vulnerable to serious accidents when a motor vehicle is placed in motion in a driveway. We describe a series of such accidents, consider the predisposing factors, and analyze the outcomes. METHODS: We conducted a retrospective review of the trauma database of a large, level I, freestanding children's hospital with specific attention to driveway auto-pedestrian accidents. RESULTS: During an 8-year period, 495 children were treated for injuries sustained in auto-pedestrian accidents, with 128 occurring in the driveway. The children's median age was 2.9 years, with 54% of the injuries sustained by boys. These often serious accidents carried an overall mortality rate of 6%. The most common injuries were abrasions, blunt head injury, and fractures. Chest trauma was associated with the highest mortality (11%), and both chest and abdominal trauma had the highest median Injury Severity Score of 13. Orthopedic injuries were the most common reason for operative intervention. Thirty-one percent of the children required intensive care unit monitoring, with their average unit stay being 3.9 days. Cars, trucks, and sports utility vehicles comprised 55%, 25%, and 12% of the accidents, respectively. Truck accidents carried the highest mortality rate (19%). Accidents were more likely to occur between 3:00 and 8:00 pm, between Thursday and Saturday, and between May and October. An increasing number of accidents occurred during the last 4 years of the study. CONCLUSIONS: Driveway injuries are an underrecognized often severe form of auto-pedestrian accidents. To prevent these family tragedies, drivers of large vehicles with children younger than 12 years old should be extremely attentive and account for children outside the vehicle before moving.

Abdominal Injuries↗
PubMed2001

Carpal tunnel syndrome in female nurse anesthetists versus operating room nurses: prevalence, laterality, and impact of handedness.

UNLABELLED: Nurse anesthesia may be a high-risk occupation for carpal tunnel syndrome (CTS) in the workplace. We designed a cross-sectional investigation to study the prevalence of CTS in nurse anesthetists (NAs) as compared with operating room nurses (ORNs). Two-hundred forty-four female operating room workers were classified by job title as NAs (n = 63) and ORNs (n = 181). The case definition of CTS was established by a history of surgical correction or a combination of four positive historical and physical findings. There were 10 cases of CTS in NAs and 10 cases of CTS in ORNs. The crude odds ratio (OR) for CTS in NAs was 3.23 (95% confidence interval, 1.27-8.17, P = 0.021). The crude OR for left-hand CTS in NAs was also 3.23 and 3.58 for bilateral CTS. When adjusted for nondominant left-hand or bilateral CTS, the OR for CTS in NAs was 3.85. The Yates-corrected chi(2) for CTS in NAs was 5.346 (P = 0.021) and 5.075 (P = 0.024) for nondominant left-hand or bilateral CTS in NAs as compared with ORNs. On the basis of our data analysis, nondominant left-hand CTS and bilateral CTS were significantly more prevalent in NAs than ORNs. IMPLICATIONS: Repetitive stress injuries have now exceeded back injuries as the most commonly reported workplace injuries in the United States. Female nurse anesthetists may face greater occupational risks for developing left hand and bilateral carpal tunnel syndrome than female operating room nurses.

Adult↗
PubMed2005

Injuries among competitive snowboarders at the national elite level.

BACKGROUND: Little is known about injury risk or the pattern of injuries among competitive snowboarders. PURPOSE: To describe the incidence and pattern of injuries among female and male snowboard athletes at the highest national level. STUDY DESIGN: Descriptive epidemiology study. METHODS: This study consists of 2 parts: prospective registration of injuries at snowboarding national cup events and the national championships during the 2002 season, as well as a retrospective interview of the participants during the national championships in March 2002. All injuries that resulted in missed participation were recorded. Exposure was recorded as the number of runs in all disciplines. RESULTS: In the prospective study, the competition incidence was 4.0 +/- 0.7 injuries per 1000 runs (n = 32 injuries). Back (22%), knee (16%), and hand/wrist injuries (9%) were the most common. The incidence for the different disciplines was 14.2 +/- 5.3 per 1000 runs for big jump, 6.1 +/- 1.8 for snowboardcross, 3.1 +/- 0.9 for halfpipe, and 1.9 +/- 1.9 for giant slalom. The retrospective interview (n = 163 athletes, 83% response) revealed 84 acute time-loss injuries during the season; knee (16%), back (13%), head (13%), and hand/wrist injuries (12%) were the 4 most common injury types. The overall competition incidence was 3.4 +/- 0.6 injuries per 1000 runs (6.6 +/- 3.0 for big jump, 5.8 +/- 1.7 for snowboardcross, 2.1 +/- 0.7 for halfpipe, and 6.6 +/- 4.7 for giant slalom). No injury was recorded in parallel slalom in either study. CONCLUSION: The incidence of injuries is high among competitive snowboarders at the elite national level. The injury pattern is different from the panorama seen among less experienced athletes, with fewer wrist injuries and more knee injuries.

Adolescent↗
PubMed2003

The analysis of epidemiological characteristics of road traffic crashes in a mountain city in western China.

OBJECTIVE: To study the epidemiological characteristics and preventive methods of road traffic crashes in a mountain city in western China through sampling investigation of traffic crashes in different regions of Chongqing city in recent years. METHODS: Two police teams of traffic management in downtown, two teams in suburb, one team in county and one freeway team were randomly selected, and road traffic crashes between 1988 and 1997 were investigated and analyzed. RESULTS: A total of 13121 road traffic crashes with 6201 crashes with casualties were analyzed. The incidence of crashes was higher in May, June and July, and on Friday and Wednesday and at 8:00-12:00 and 14:00-18:00 within a day. Casualties were 44.0% in pedestrians and 42.5% in passengers of total casualties. The deaths and severe injuries in pedestrians were 59.1% of total deaths and 56.4% of total severe injuries. The age of drivers and passengers were mainly at 18-30 years, followed by 31-40 years. People over 60 years old accounted for 24.1% of total pedestrian casualty. Head injury was the most common reason for deaths. The main reasons for these crashes were improper driving and violating traffic laws. Violating traffic laws by pedestrian was one of the main reasons for pedestrian casualty. CONCLUSIONS: The crashes are related to the characteristics of geography, climate, society activity of people, and the sense of traffic safety, the basic traffic construction and management in Chongqing. The traffic casualty of pedestrian is a big problem in Chongqing. To prevent and decrease road traffic injuries effective methods should be worked out and propaganda on traffic safety and traffic management should be strengthened according to different characteristics of different regions. To strengthen the first aid and treatment of cranium-brain injury and chest-back injury is also helpful in decreasing traffic deaths.

Accident Prevention↗
PubMed2006

Multi-systemic methicillin resistant Staphylococcus aureus (MRSA) community-acquired infection.

BACKGROUND: An alarming increase of the incidence of community-acquired infections due to methicillin resistant Staphylococcus aureus (MRSA) has been noted in several countries during the recent years. CASE REPORT: We present the case of a 64-year-old male who complained of fever, shortness of breath, productive cough, and mild low back pain. The patient was diagnosed to have severe community-acquired pneumonia caused by methicillin resistant Staphylococcus aureus. Due to the severity of his respiratory symptoms and the history of back injury, the mild low back pain did not receive the appropriate attention. It became clear later that the back pain was caused by an extra-pulmonary focus of the MRSA infection. CONCLUSIONS: Staphylococcus aureus has been reported to be the cause of considerably different proportions of patients with community-acquired pneumonia in studies from various parts of the world. Our case emphasizes the occasionally multi-systemic manifestations of community-acquired MRSA infections and the difficulties in their control.

Acetamides↗
PubMed2004

Handle with care: The American Nurses Association's Campaign to address work-related musculoskeletal disorders.

In response to the significant number and severity of work-related back injuries and other musculoskeletal disorders among nurses, the American Nurses Association (ANA) has launched the Handle With Care campaign. The campaign seeks to build a health care industry-wide effort to prevent back and other musculoskeletal injuries. This is being done through developing partnerships and coalitions, education and training, increasing use of assistive equipment and patient-handling devices, reshaping nursing education to incorporate safe patient handling, and pursuing federal and state ergonomics policy by highlighting technology-oriented safe-patient handling benefits for patients and nurses. In the absence of ergonomics regulations at national or state levels that protect health care workers, ANA has taken on alternative approaches to encourage a movement to control ergonomic hazards in the health care workplace and prevent back injuries among the nation's nursing workforce.

American Nurses' Association↗
PubMed2000

Nontreatment variables affecting return-to-work in Tennessee-based employees with complaints of low back pain.

UNLABELLED: Disability and health care-related costs continue to rise as a result of work-related low back injury. Our investigation examined treatment-independent variables that influenced return-to-work outcome in a sample of workers employed in Northeast Tennessee. METHODS: The review collected 11 variables from two different outpatient physical therapy clinics utilizing a balanced quota sampling design. The patients were enrolled if the documented complaint was low back pain and was an employment-related injury. The patients were grouped according to whether or not they returned to full-time pre-injury work. Twenty-five patients were enrolled in the positive outcome group, those who returned to full-time pre-injury work. Twenty-two patients who did not achieve this goal were enrolled in a separate group. RESULTS: Return-to-work for these patients was not dependent upon age, gender, insurer, number of physical therapy treatments attended, or previously reported low back injury. Those who returned to work had (1) a higher percentage of patients working full-time at their pre-injury position during the rehabilitation process (28% vs. 0%); (2) a higher compliance with the treatment schedule (97% vs. 93%); (3) a lower cancellation rate (0.5 vs. 2.4); (4) a shorter interval in days between reporting the injury and initiation of physical therapy rehabilitation (27 vs. 58); and (5) a lower percentage of previous surgeries resulting from low back injuries (12% vs. 36%), than those who did not. A relationship was also demonstrated between previous surgery and the interval prior to beginning treatments (P < or = 0.0001). However, no relationship was observed between previous surgery and compliance, or between the interval prior to beginning treatments and compliance. DISCUSSION: These results document two variables representing independent factors affecting return-to-work in this population. The first was previous injury influencing the current injury, as documented by both previous surgery and the interval between the current injury and beginning of treatments. The second was compliance with the treatment schedule for the current injury. The psychosocioeconomic aspects of these results are discussed.

Adult↗
PubMed2006

Injuries among elite snowboarders (FIS Snowboard World Cup).

BACKGROUND: Although snowboarding is already established as an Olympic sport, it is still a developing sport, with new disciplines, more demanding snow installations, and spectacular tricks. A recent study on subjects at Norwegian national elite level showed that injury risk is high and that injuries among competitive snowboarders differ from those seen in recreational snowboarders, with fewer wrist injuries and more knee and back injuries. OBJECTIVE: To describe the incidence and type of injuries among female and male snowboarders at international elite level. METHOD: At the last race of the Fédération Internationale de Ski Snowboard World Cup, acute injuries resulting in missed participation and overuse injuries influencing performance, were recorded during a retrospective interview (91% response rate). The registration period was from April 2002 (end of season) until March 2003. Exposure was recorded as the number of runs in all disciplines, and the incidence was calculated as number of injuries per 1000 runs. RESULTS: The 258 athletes interviewed reported 3193 competition days (n = 46 879 runs) in all disciplines. In total, 135 acute injuries were recorded; 62 (46%) during competition in the official disciplines. Of the 135 acute injuries, the most common injury locations were knee (n = 24; 18%), shoulder (n = 18; 13%), back (n = 17; 13%), and wrist (n = 11; 8%). The overall incidence during competition was 1.3 (95% confidence interval 1.0 to 1.7) injuries per 1000 runs; 2.3 (0.9 to 3.8) for big air (n = 10), 1.9 (1.1 to 2.8) for halfpipe (n = 21), 2.1 (1.2 to 3.0) for snowboard cross (n = 20), 0.6 (0.2 to 1.0) for parallel giant slalom (n = 8), and 0.3 (0.0 to 0.7) for parallel slalom (n = 3). The severity of injuries was graded based on time loss (27% lost >21 days) and score on the Abbreviated Injury Scale (AIS) (38% AIS 1, 61% AIS 2 and 1% AIS 3). There were 122 overuse injuries, 38 (31%) of these to the knee. CONCLUSION: The injury risk for big air, snowboard cross, and halfpipe disciplines is high, while that for the snowboard slalom disciplines is lower. The injury pattern is different from recreational athletes, with a greater share of knee injuries and fewer wrist injuries. Compared with national level, the injury risk appears to be lower at World Cup level.

Adult↗
PubMed1995

Sports injuries in footballers related to defects of posture and body mechanics.

The objective of this study was to investigate possible relationships between the incidence of sports injury and the existence of body mechanics defects in players of various codes of football. Injuries were recorded prospectively over a 24 month period. Fifteen aspects of body mechanics were evaluated at the start of the study using a specially developed photogrammetric technique known to have high reliability and sensitivity. It was found that subjects who suffered from ankle injuries had lower mean scores for ankle mechanics than the non-injured players. Knee injuries were found to be associated with lumbar lordosis and sway back. Subjects who suffered from muscle strains had a higher incidence of lumbar lordosis, sway back and abnormal knee inter-space. Back injuries were associated with poor shoulder symmetry, scapulae abduction, back asymmetry, kyphosis, lordosis and scoliosis. Subjects who suffered from two or more injuries had lower overall body mechanics scores than the other subjects. In general, it was found that the incidence of ankle, back, knee and muscle injuries was influenced by the presence of defects of body mechanics. These results suggest that intervention to improve body mechanics would be likely to reduce the incidence of sports injuries in football.

Adolescent↗
PubMed2004

Technique factors related to ball release speed and trunk injuries in high performance cricket fast bowlers.

In this study we analysed technique, ball speed and trunk injury data collected at the Australian Institute of Sport (AIS) from 42 high performance male fast bowlers over a four year period. We found several notable technique inter-relationships, technique and ball speed relationships, and associations between technique and trunk injuries. A more front-on shoulder alignment at back foot contact was significantly related to increased shoulder counter-rotation (p < 0.001). Bowlers who released the ball at greater speeds had an extended front knee, or extended their front knee, during the front foot contact phase (p < 0.05). They also recorded higher braking and vertical impact forces during the front foot contact phase and developed those forces more rapidly (p < or =0.05). A maximum hip-shoulder separation angle occurring later in the delivery stride (p = 0.05) and a larger shoulder rotation to ball release (p = 0.05) were also characteristics of faster bowlers. Bowlers suffering lower back injuries exhibited typical characteristics of the 'mixed' technique. Specifically, the hip to shoulder separation angle at back foot contact was greater in bowlers who reported soft tissue injuries than in non trunk-injured bowlers (p = 0.03), and shoulder counter-rotation was significantly higher in bowlers who reported lumbar spine stress fractures than non trunk-injured bowlers (p = 0.01). The stress fracture group was also characterised by a larger hip angle at front foot contact and ball release, whereas a more flexed front knee at ball release characterised the non trunk-injured group.

Adult↗
PubMed1994

Personal history, training, and worksite as predictors of back pain of nurses.

Back pain among nurses is a common problem. Prior studies of this problem have been based on cross-sectional or retrospective data. This 18-month prospective study involving nurses newly graduated from nursing school investigated personal, worksite, and training factors associated with future risk of back pain. Each nurse underwent a preliminary interview and periodic follow-ups to identify those with back injuries. Contingency tables and logistic regression analyses demonstrated that prior significant back pain episodes (evidenced by previous job changes because of back pain, frequent medication use, etc.) were associated with increased future risk. Training at nursing school or on the job did not have a protective effect. This pilot study therefore suggests factors useful in placement and counseling of new nurses and indicates the need for further implementation of mechanical lift assist device use.

Accidents, Occupational↗
PubMedDate not supplied

Manual handling practices and injuries among ICU nurses.

This paper describes manual handling practices and injuries among Intensive Care Units (ICU) nurses working in a large tertiary referral medical centre in Australia. The objectives of this study were to identify patterns of manual handling activities; the incidence, types of injury and body site injured; and establish the consequences of injuries. The rate of manual handling injuries among ICU nurses was unacceptably high (52.2%), as was back injury (71.4% of all injuries). In order to reduce manual handling injuries, employers should provide lifting assistance devices; design workplaces so as to minimise the need for ICU nurses to twist, bend and/or lift items from the floor; introduce regular equipment maintenance procedures; provide adequate staffing to assist with lifting patients; and implement processes that facilitate more detailed statistics on manual handling activities and outcomes.

Adult↗
PubMed2002

An ergonomic comparison between mechanical and manual patient transfer techniques.

Multiple studies have concluded that manual patient transfer and repositioning techniques are a significant cause of low back injuries. The objective of this study was to compare the low back stresses resulting from the use of two different mechanical patient transfer assist devices with the use of traditional manual transfer techniques. The mechanical transfer systems used were the Barton Patient Transfer System and a Sling-Suspension Lift similar to a "Hoyer Lift". The back compressive forces derived using the Michigan 3D Static Strength Model (Version 4.0) and electromyography (EMG) of the muscles of the low back were compared. This study found that the mechanical assist devices placed less stress on the low back and were more desirable to use than the traditional manual techniques. The Barton System was found to be, in general, less hazardous and more preferred than the Sling Suspension Lift.

Adult↗
PubMed1990

Weight-training injuries in adolescents.

We studied the incidence of injury caused by weight training in junior and senior high school football players. Three hundred fifty-four subjects completed a retrospective injury questionnaire; histories were confirmed for high school athletes. Cumulative incidence and incidence rates were determined for injuries causing more than 7 days of missed participation. The cumulative incidences of injuries were as follows: all athletes, 7.6% (27/354); junior high school athletes, 7.1% (7/98); high school freshman/junior varsity athletes, 9.4% (15/159); and high school varsity athletes, 5.2% (5/97). The total incidence rate was 0.082 injuries per person-year, with 0.11 injuries per person-year in junior high school athletes, 0.091 injuries per person-year in high school freshman/junior varsity players, and 0.051 injuries per person-year in high school varsity players. Differences in the incidence measures among groups were not statistically significant. The most common injury type was a strain (74.1%), and the most common site was the back (59.3%). Certain exercise apparently caused more back injuries in older athletes.

Adolescent↗