Kickball and Its Underappreciated Pediatric Injury Burden: An 18-Year Retrospective Epidemiological Study

Background: Kickball is a popular childhood game most frequently played during gym class or recess at schools throughout the United States (US). Despite this, the national health burden of injuries associated with kickball has never been explored in the US pediatric population. Purpose: To report national estimates and demographic characteristics of pediatric patients presenting to US emergency departments between 2000 and 2017 with kickball-associated injuries. Study Design: Descriptive epidemiology study. Methods: This study retrospectively analyzed the National Electronic Injury Surveillance System (NEISS) database (2000-2017) to identify annual cases of injuries associated with playing kickball presenting to US emergency departments in the pediatric population (age ≤18 years). Results: On average, 10,644 (95% CI, 8671-12,618) pediatric kickball-associated injuries presented to US emergency departments each year. There was no significant change in the number of injuries between the years 2000 (n = 10,331; 95% CI, 7781-12,881) and 2017 (n = 9407; 95% CI, 7233-11,582) ( P = .64). Patients frequently sustained sprains, strains, or muscle tears (34.4%; 95% CI, 32.4%-36.5%) and fractures (24.8%; 95% CI, 23.1%-26.5%); these injuries most commonly affected the ankle (13.7%; 95% CI, 12.2%-15.2%) and the fingers of the hand (17.1%; 95% CI, 15.5%-18.7%). The greatest proportion of injuries occurred in male patients (60.7%; 95% CI, 58.7%-62.7%) who were 10 to 12 years of age (44.8%; 95% CI, 43.0%-46.6%), with over half of kickball-associated injuries occurring at school (54.1%; 95% CI, 50.7%-57.5%). Conclusion: Despite kickball’s ubiquity as a schoolyard game, its associated injuries remain largely underappreciated. This is particularly unjustified when considering that the annual pediatric injury burden associated with playing kickball surpasses that of other sports acknowledged as carrying a high injury risk, such as martial arts or tennis.

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Child Development and Pediatric Sport and Recreational Injuries by Age

Journal of Athletic Training ◽

10.4085/1062-6050-49.3.41 ◽

2014 ◽

Vol 49 (6) ◽

pp. 780-785 ◽

Cited By ~ 21

Author(s):

David C. Schwebel ◽

Carl M. Brezausek

Keyword(s):

United States ◽

Emergency Department ◽

Emergency Departments ◽

Injury Risk ◽

The United States ◽

Emergency Department Visits ◽

Sociocultural Factors ◽

Childhood And Adolescence ◽

Injury Surveillance System ◽

Sport And Recreation

Context: In 2010, 8.6 million children were treated for unintentional injuries in American emergency departments. Child engagement in sports and recreation offers many health benefits but also exposure to injury risks. In this analysis, we consider possible developmental risk factors in a review of age, sex, and incidence of 39 sport and recreational injuries. Objective: To assess (1) how the incidence of 39 sport and recreational injuries changed through each year of child and adolescent development, ages 1 to 18 years, and (2) sex differences. Design Descriptive epidemiology study. Setting: Emergency department visits across the United States, as reported in the 2001–2008 National Electronic Injury Surveillance System database. Patients or Other Participants: Data represent population-wide emergency department visits in the United States. Main Outcome Measure(s) Pediatric sport- and recreation-related injuries requiring treatment in hospital emergency departments. Results: Almost 37 pediatric sport or recreational injuries are treated hourly in the United States. The incidence of sport- and recreation-related injuries peaks at widely different ages. Team-sport injuries tend to peak in the middle teen years, playground injuries peak in the early elementary ages and then drop off slowly, and bicycling injuries peak in the preteen years but are a common cause of injury throughout childhood and adolescence. Bowling injuries peaked at the earliest age (4 years), and injuries linked to camping and personal watercraft peaked at the oldest age (18 years). The 5 most common causes of sport and recreational injuries across development, in order, were basketball, football, bicycling, playgrounds, and soccer. Sex disparities were common in the incidence of pediatric sport and recreational injuries. Conclusions: Both biological and sociocultural factors likely influence the developmental aspects of pediatric sport and recreational injury risk. Biologically, changes in perception, cognition, and motor control might influence injury risk. Socioculturally, decisions must be made about which sport and recreational activities to engage in and how much risk taking occurs while engaging in those activities. Understanding the developmental aspects of injury data trends allows preventionists to target education at specific groups.

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Electronic nicotine delivery system (ENDS) liquid nicotine exposure in young children presenting to US emergency departments, 2018

Injury Epidemiology ◽

10.1186/s40621-019-0219-6 ◽

2019 ◽

Vol 6 (1) ◽

Cited By ~ 4

Author(s):

Joanne T. Chang ◽

Brian L. Rostron

Keyword(s):

Emergency Departments ◽

The United States ◽

Nicotine Exposure ◽

Injury Surveillance System ◽

Nicotine Delivery ◽

National Estimates ◽

System Data ◽

Route Of Exposure ◽

National Emergency ◽

Hospital Emergency Departments

Abstract Background Increased use of electronic nicotine delivery systems (ENDS) in the United States (U.S.) has been related to acute adverse events from liquid nicotine exposure. Previous studies have reported on these events through 2017. Findings We used 2018 National Emergency Injury Surveillance System data to generate national estimates with 95% confidence intervals (CIs) of ENDS liquid nicotine-related poisonings among children under age 5 treated in U.S. hospital emergency departments (EDs). In 2018, an estimated 885 (95% CI: 397–1374) poisoning cases related to liquid nicotine among children under 5 were treated in U.S. EDs, which was a non-statistically signficant increase from 2017 (411 poisoning cases, 95% CI: 84–738). The most common route of exposure was through ingestion (99.4%). The majority of cases were treated and released from the hospital (90.0%), 8.9% of the cases left the hospital without being seen, and 1.1% of the cases were treated and admitted to the hospital. Conclusions This study provides updated national estimates of poisoning events related to liquid nicotine exposure that occurred in 2018 among children under age 5. Updated information from this study may complement public education efforts and prevent liquid nicotine exposure among children.

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49,000 Avocado Cutting Injuries

American Journal of Health Behavior ◽

10.5993/ajhb.44.1.2 ◽

2020 ◽

Vol 44 (1) ◽

pp. 13-17

Author(s):

Matthew E. Rossheim ◽

Eric Q. Ninh ◽

Melvin D. Livingston ◽

Dennis L. Thombs

Keyword(s):

Emergency Departments ◽

The United States ◽

Hospital Emergency ◽

Sampling Weights ◽

Injury Surveillance System ◽

Cross Sectional ◽

The Us ◽

National Estimates ◽

Hospital Emergency Departments ◽

Year 2000

Objectives: In the United States (US), avocado consumption has increased dramatically since the year 2000. Despite media attention concerning injuries resulting from cutting or pitting avocados, such injuries have not been monitored systematically. The current study is the first to estimate the number of people with avocado cutting injuries presenting to US hospital emergency departments. Methods: We utilized cross-sectional data from the US Consumer Product Safety Commission's (CPSC) National Electronic Injury Surveillance System (NEISS). We used keyword searches of case narrative text to identify avocado cutting and pitting injuries from 2000 to 2017. Sampling weights were applied to generate national estimates of avocado cutting injuries. Results: From 2000 to 2017, there were an estimated 49,331 avocado cutting injuries presenting to US emergency departments (95% CI 34,178-64,483). The increase in these injuries appears to coincide with increases in per capita avocado consumption. Avocado cutting injuries now constitute nearly 2% of knife-related injuries presenting to US hospital emergency departments. Conclusions: Due to the increase in avocado cutting injuries and the severity of these injuries, more systematic surveillance is needed as well as improved safety measures.

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Feel the Burn! Fireworks-related Otolaryngologic Trauma

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211008100 ◽

2021 ◽

pp. 000348942110081

Author(s):

Alexander J. Straughan ◽

Luke J. Pasick ◽

Vrinda Gupta ◽

Daniel A. Benito ◽

Joseph F. Goodman ◽

...

Keyword(s):

United States ◽

Head And Neck ◽

Emergency Departments ◽

Closed Head Injury ◽

Penetrating Trauma ◽

The United States ◽

Neck Injuries ◽

Chi Square ◽

Injury Surveillance System ◽

Cross Sectional

Objectives: Fireworks are used commonly for celebrations in the United States, but can lead to severe injury to the head and neck. We aim to assess the incidence, types, and mechanisms of head and neck injuries associated with fireworks use from 2010 to 2019. Methods: A retrospective cross-sectional study, using data from the National Electronic Injury Surveillance System, of individuals presenting to United States Emergency Departments with head and neck injuries caused by fireworks and flares from 2010 to 2019. Incidence, types, and mechanisms of injury related to fireworks use in the US population were assessed. Results: A total of 541 patients (349 [64.5%] male, and 294 [54%] under 18 years of age) presented to emergency departments with fireworks-related head and neck injuries; the estimated national total was 20 584 patients (13 279 male, 9170 white, and 11 186 under 18 years of age). The most common injury diagnoses were burns (44.7% of injuries), laceration/avulsion/penetrating trauma (21.1%), and otologic injury (15.2%), which included hearing loss, otalgia, tinnitus, unspecified acoustic trauma, and tympanic membrane perforation. The remaining 19% of injuries were a mix, including contusion, abrasion, hematoma, fracture, and closed head injury. Associations between fireworks type and injury diagnosis (chi-square P < .001), as well as fireworks type by age group (chi-square P < .001) were found. Similarly, associations were found between age groups and injury diagnoses (chi-square P < .001); these included children 5 years and younger and adults older than 30 years. Conclusions: Fireworks-related head and neck injuries are more likely to occur in young, white, and male individuals. Burns are the most common injury, while otologic injury is a significant contributor. Annual rates of fireworks-related head and neck injuries have not changed or improved significantly in the United States in the past decade, suggesting efforts to identify and prevent these injuries are insufficient.

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Pediatric Playground-Related Injuries Treated in Hospital Emergency Departments in the United States

Clinical Pediatrics ◽

10.1177/0009922817732144 ◽

2017 ◽

Vol 57 (5) ◽

pp. 584-592 ◽

Cited By ~ 8

Author(s):

Sarah L. Adelson ◽

Thitphalak Chounthirath ◽

Nichole L. Hodges ◽

Christy L. Collins ◽

Gary A. Smith

Keyword(s):

Emergency Departments ◽

Closed Head Injury ◽

Injury Rate ◽

The United States ◽

Injury Surveillance System ◽

Safety Standards ◽

Average Patient ◽

Impact Attenuation ◽

Standards And Guidelines ◽

Hospital Emergency Departments

This study analyzed pediatric playground-related injuries data from the National Electronic Injury Surveillance System. An estimated 5 025 440 children <18 years were treated in US emergency departments for playground-related injuries during 1990-2012, averaging 218 497 children annually. The average patient age was 6.5 years. The overall annual injury rate declined during 1990-2007 ( P < .001) and then increased during 2007-2012 ( P < .001). The climbing equipment–related injury rate remained constant during 1990-2009 and then increased during 2007-2012 ( P = .014). The concussion/closed head injury rate increased during 1990-2008 ( P < .002) with the rate almost doubling from 2008-2012 ( P < .001). Falls accounted for 76.7% of all injuries and 87.7% of injuries to the upper extremities. Injuries resulted in hospitalization for 4.3% of patients. Despite current playground safety standards and guidelines, a large number of playground-related injuries continue to occur. Revised impact attenuation criteria for playground surfacing materials should be implemented and evaluated to more adequately prevent fall-related upper extremity fractures.

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Firework-related injuries treated at emergency departments in the United States during the COVID-19 pandemic in 2020 compared to 2018–2019

Injury Epidemiology ◽

10.1186/s40621-021-00358-2 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Nathan Maassel ◽

Abbie Saccary ◽

Daniel Solomon ◽

David Stitelman ◽

Yunshan Xu ◽

...

Keyword(s):

United States ◽

Census Data ◽

The United States ◽

Population Based ◽

Emergency Department Visits ◽

Consumer Product Safety Commission ◽

Injury Surveillance System ◽

Time Period ◽

National Estimates ◽

Us Census

Abstract Background Despite a national decrease in emergency department visits in the United States during the first 10 months of the pandemic, preliminary Consumer Product Safety Commission data indicate increased firework-related injuries. We hypothesized an increase in firework-related injuries during 2020 compared to years prior related to a corresponding increase in consumer firework sales. Methods The National Electronic Injury Surveillance System (NEISS) was queried from 2018 to 2020 for cases with product codes 1313 (firework injury) and narratives containing “fireworks”. Population-based national estimates were calculated using US Census data, then compared across the three years of study inclusion. Patient demographic and available injury information was also tracked and compared across the three years. Firework sales data obtained from the American Pyrotechnics Association were determined for the same time period to examine trends in consumption. Results There were 935 firework-related injuries reported to the NEISS from 2018 to 2020, 47% of which occurred during 2020. National estimates for monthly injuries per million were 1.6 times greater in 2020 compared to 2019 (p < 0.0001) with no difference between 2018 and 2019 (p = 0.38). The same results were found when the month of July was excluded. Firework consumption in 2020 was 1.5 times greater than 2019 or 2018, with a 55% increase in consumer fireworks and 22% decrease in professional fireworks sales. Conclusions Firework-related injures saw a substantial increase in 2020 compared to the two years prior, corroborated by a proportional increase in consumer firework sales. Increased incidence of firework-related injuries was detected even with the exclusion of the month of July, suggesting that the COVID-19 pandemic may have impacted firework epidemiology more broadly than US Independence Day celebrations.

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PEAK LOWER EXTREMITY SOCCER INJURIES OCCUR IMMEDIATELY FOLLOWING GROWTH IN ADOLESCENTS: AN EPIDEMIOLOGIC REVIEW OF EMERGENCY DEPARTMENT VISITS

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00214 ◽

2020 ◽

Vol 8 (4_suppl3) ◽

pp. 2325967120S0021

Author(s):

Aidan P. Wright ◽

Aaron J. Zynda ◽

Jane S. Chung ◽

Philip L. Wilson ◽

Henry B. Ellis ◽

...

Keyword(s):

Emergency Department ◽

Lower Extremity ◽

Emergency Departments ◽

Skeletal Maturity ◽

Epidemiologic Study ◽

The United States ◽

Emergency Department Visits ◽

Injury Surveillance System ◽

Lower Extremity Injuries ◽

Extremity Injuries

BACKGROUND: Soccer has become the most popular youth sport in the world. Within the last decade, there has been limited epidemiologic research on pediatric soccer-related injuries based on sex and age. PURPOSE: To examine trends associated with soccer injuries presenting to emergency departments and to describe differences in injury pattern and location based on sex and age during periods of growth. METHODS: An epidemiologic study was conducted utilizing publicly accessible data from the National Electronic Injury Surveillance System (NEISS). The NEISS compiles Emergency Department (ED) data on all injuries presenting to the approximately 100 participating network hospitals in the United States. Information on all soccer-related injuries occurring in ages 7-19 from January 2009 – December 2018 was extracted and summary statistics were calculated. RESULTS: Approximately 54,287 pediatric soccer-related injuries were identified. The average age for all injuries was 13.3 years, and males (60.50%) presented more often than females (39.50%). Concussions and head injuries (15.57%) were most commonly reported overall, with a greater percentage occurring in females than males (17.44% vs. 14.35%). The ankle (15.3%) was the second most common injury location with females also presenting more commonly than males (18.71% vs. 13.62%). Age and sex-based evaluation noted peaks in lower extremity injuries in females younger than in males. Both ankle (F=13-15 years, M=15-17 years) and knee (F=14 years, M=16 years) injuries peaked at ages coinciding with recognized sex-based lower extremity skeletal maturity (Figure 1). CONCLUSION: Peak pediatric soccer-related ankle and knee injuries presenting to emergency departments occur at different ages in females and males and appear to, on average, coincide with maturation (age 14 in females and 16 in males). Lower extremity injuries significantly increase nearing the completion of lower extremity growth, and may indicate appropriate timing for differential sex-specific injury prevention programs within soccer. [Figure: see text]

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Rising Burden of Alcohol-Associated Foot and Ankle Fractures Presenting to U.S. Emergency Departments: 2000-2017

Foot & Ankle Orthopaedics ◽

10.1177/2473011419s00341 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0034

Author(s):

Kevin Pirruccio ◽

Daniel C. Farber

Keyword(s):

Alcohol Consumption ◽

Emergency Departments ◽

The United States ◽

Ankle Fractures ◽

Foot And Ankle ◽

New Findings ◽

Injury Mechanisms ◽

Simple Regression Model ◽

National Estimates ◽

Simple Regression

Category: Ankle, Trauma, Epidemiology Introduction/Purpose: The most frequent cause of traumatic foot and ankle fractures is a fall to the ground. Alcohol consumption, especially in excess, has the potential to impart a significant fall risk on patients by reducing postural control resulting in imbalance. However, the relationship between the consumption of alcohol and the risk of traumatic foot and ankle fracture is poorly characterized. The purpose of this study was to report national estimates, injury mechanisms, and demographic characteristics of patients presenting to U.S. emergency departments (EDs) with traumatic foot and ankle fractures associated with alcohol consumption. Methods: This cross-sectional, retrospective epidemiological study analyzes case narratives in the National Electronic Injury Surveillance System (NEISS) database to examine national estimates of traumatic foot and ankle fractures associated with alcohol consumption presenting to U.S. emergency departments between 2000 and 2017, sampling in two-year intervals. Data from the Organisation for Economic Co-operation and Development (OECD) on the “Value for Total U.S. Adult Alcohol Consumption in Liters/Capita” was used in a simple regression model to demonstrate how increased alcohol consumption in the United States has predicted changes in the national number of alcohol-associated foot and ankle fractures over time. Results: Nationally, alcohol-associated foot and ankle fractures increased significantly between the 2000-2001 (N=2,878; C.I. 1,869-3,887) and 2016-2017 (N=8,778; C.I. 6,751-10,806) periods (p<0.001). Simple regression (R2 = 0.87; p<0.001) demonstrated that in the U.S., a one-tenth increase in the total liters of alcohol consumed per capita predicted an additional 606 alcohol-associated foot and ankle fractures presenting to U.S. EDs. About two-thirds of patients suffered ankle fractures (65.6%; C.I. 61.1%-70.1%). Fractures were commonly sustained by male patients (58.4%; C.I. 53.9%-62.9%) at home (46.5%; C.I. 40.9%- 52.2%); roughly one-third of patients required admission to the hospital (29.7%; C.I. 24.5%-34.9%). The most common injury mechanisms for alcohol-associated foot and ankle fractures were falls to the ground from standing height (33.0%; C.I. 28.8%- 37.2%), and falls down stairs or steps (31.0%; C.I. 26.1%-35.9%). Conclusion: Falls to the ground mechanistically link alcohol consumption to traumatic fractures of the foot and ankle. These new findings highlight how the negative societal impacts of alcohol – and potentially other substances – may be overlooked. As a result, this information should serve as an impetus to direct national attention towards awareness and preventative measures. Furthermore, our findings may help clinicians identify, educate, and counsel patients with certain demographic risk factors for alcohol-associated foot and ankle fractures.

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Pediatric Cheerleading Injuries Treated in Emergency Departments in the United States

Clinical Pediatrics ◽

10.1177/0009922817702938 ◽

2017 ◽

Vol 56 (11) ◽

pp. 985-992 ◽

Cited By ~ 3

Author(s):

Nada Naiyer ◽

Thiphalak Chounthirath ◽

Gary A. Smith

Keyword(s):

United States ◽

Emergency Departments ◽

Closed Head Injury ◽

Injury Rate ◽

The United States ◽

Common Mechanism ◽

Injury Surveillance System ◽

Injury Mechanisms ◽

States Data ◽

Closed Head

This study investigates the epidemiology of cheerleading injuries to children in the United States. Data were analyzed from the National Electronic Injury Surveillance System for children 5 through 18 years of age treated in US emergency departments for cheerleading injuries from 1990 through 2012. An estimated 497 095 children ages 5 to 18 years were treated in US emergency departments for a cheerleading injury during the 23-year study period, averaging 21 613 injured children per year. From 1990 to 2012, the annual cheerleading injury rate increased significantly by 189.1%; and from 2001 to 2012, the annual rate of cheerleading-related concussion/closed head injury increased significantly by 290.9%. Falls were the most common mechanism of injury (29.4%) and were more likely to lead to hospitalization (relative risk = 2.47; 95% confidence interval = 1.67-3.68) compared with other injury mechanisms. The rising number and rate of pediatric cheerleading injuries underscore the need for increased efforts to prevent these injuries.

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Water Tubing–Related Injuries Treated in US Emergency Departments, 1991−2009

Journal of Physical Activity and Health ◽

10.1123/jpah.10.2.151 ◽

2013 ◽

Vol 10 (2) ◽

pp. 151-159 ◽

Cited By ~ 5

Author(s):

Kevin R. Heinsimer ◽

Nicolas G. Nelson ◽

Kristin J. Roberts ◽

Lara B. McKenzie

Keyword(s):

Children And Adolescents ◽

Emergency Departments ◽

Surveillance System ◽

Body Part ◽

Injury Surveillance ◽

Annual Number ◽

Sprains And Strains ◽

Injury Surveillance System ◽

Sample Weights ◽

National Estimates

Background:The objective was to describe the patterns and mechanisms of water tubing–related injuries treated in U.S. emergency departments.Methods:The National Electronic Injury Surveillance System was used to examine cases of water tubing–related injuries. Sample weights were used to calculate national estimates of water tubing–related injuries. Analyses were conducted in 2010.Results:From 1991−2009 an estimated 69,471 injuries were treated in US emergency departments for water tubing–related injuries. The annual number of cases increased 250% over the 19-year study period (P < .001). Sprains and strains accounted for the largest portion of injuries (27.2%). The head was the most frequently injured body part (27.5%). Children and adolescents ≤ 19 years were more likely to be injured by contact with another person (OR: 2.47; 95% CI = 1.61−3.80) and were more likely to sustain injuries to the head (OR: 2.61; 95% CI = 2.01−3.38) compared with adults. Adults ≥ 20 years, were more likely than individuals ≤ 19 years to sustain sprains and strains (OR: 2.11; 95% CI = 1.64−2.71) and were most commonly injured by impact with the water (54.6%).Conclusions:Patterns of water tubing–related injuries differ for children and adults. Research is needed to determine how best to reduce these injuries.

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