Możliwości zmniejszenia liczby śmiertelnych obrażeń w szwedzkim rolnictwie dzięki programowi prewencyjnemu Opportunities to reduce fatal injuries in Swedish agriculture using a prevention program

Z globalnego punktu widzenia rolnictwo jest jednym z najbardziej niebezpiecznych sektorów gospodarki. Podobna sytuacja ma miejsce również w Szwecji, gdzie występuje wiele wypadków – zarówno ze skutkiem śmiertelnym, jak i zakończone obrażeniami ciała. Celem niniejszego artykułu jest próba dokonania całościowej oceny krajowego programu interwencyjnego na rzecz zapobiegania urazom (2009–2013). Aby osiągnąć ten cel, zbadano rozwój wypadków śmiertelnych przy pracy w szwedzkim rolnictwie w okresie 15 lat: pięć lat przed wdrożeniem programu prewencyjnego, podczas jego trwania i pięć lat po zakończeniu programu. W artykule wykorzystano zarówno statystyki oficjalne, jak i nieoficjalne, oparte na publikacjach prasowych. Wyniki analizy wykazały spadek liczby ofiar śmiertelnych o około 45% w ciągu pięciu lat trwania programu prewencyjnego (według oficjalnych statystyk). Efekt ten jednak prawie zanikł w okresie pięciu lat po zakończeniu ww. programu. Po dodaniu informacji z publikacji prasowych ukazuje się szerszy obraz wypadków śmiertelnych w rolnictwie z uwzględnieniem dzieci, osób odwiedzających, a także wypadków niezwiązanych z pracą. W artykule omówiono rekomendacje dotyczące znaczenia długoterminowych programów, możliwości zdigitalizowanego systemu BHP dla rolników, współpracy międzynarodowej oraz wartości strategii „Wizja Zero” stworzonej przez Międzynarodową Sekcję ISSA ds. Prewencji w Rolnictwie.

Availability of population-level data sources for tracking the incidence of deaths and injuries from road traffic crashes in low-income and middle-income countries

IntroductionTracking progress towards Sustainable Development Goal (SDG) 3·6 of reducing traffic deaths and serious injuries poses a measurement challenge in most low-income and middle-income countries (LMICs) due to large discrepancies between reported official statistics and estimates from global health measurement studies. We assess the extent to which national population censuses and health surveys can fill the information gaps.MethodsWe reviewed questionnaires for nationally representative surveys and censuses conducted since 2000 in LMICs. We identified sources that provide estimates of household ownership of vehicles, incidence of traffic deaths and non-fatal injuries, and prevalence of disability.ResultsWe identified 802 data sources from 132 LMICs. Sub-Saharan African countries accounted for 43% of all measurements. The number of measurements since 2000 was high, with 97% of the current global LMIC population having at least one measurement for vehicle ownership, 77% for deaths, 90% for non-fatal injuries and 50% for disability due to traffic injuries. Recent data (since 2010) on traffic injuries were available from far fewer countries (deaths: 21 countries; non-fatal injuries: 62 and disability: 12). However, there were many more countries with recent data on less-specific questions about unintentional or all injuries (deaths: 41 countries, non-fatal: 87, disability: 32).ConclusionTraffic injuries are substantially underreported in official statistics of most LMICs. National surveys and censuses provide a viable alternative information source, but despite a large increase in their use to monitor SDGs, traffic injury measurements have not increased. We show that relatively small modifications and additions to questions in forthcoming surveys can provide countries with a way to benchmark their existing surveillance systems and result in a substantial increase in data for tracking road traffic injuries globally.

Gender differences in snowboarding accidents in Austria: a 2005–2018 registry analysis

ObjectivesTo elucidate gender differences in snowboarding accidents.DesignRetrospective registry analysis within the Austrian National Registry of Mountain Accidents.SettingSnowboard-related emergencies between November 2005 and October 2018.ParticipantsAll injured snowboarders with documented injury severity and gender (3536 men; 2155 women).Primary and secondary outcome measuresGender-specific analysis of emergency characteristics and injury patterns.ResultsOver time, the number of mild, severe and fatal injuries per season decreased in men but not in women. Accidents most frequently were interindividual collisions (>80%) and occurred when heading downhill on a slope. Men more often suffered injuries to the shoulder (15.1% vs 9.2%) and chest (6.8% vs 4.4%), were involved in accidents caused by falling (12.9% vs 9.6%) or obstacle impact (4.3% vs 1.5%), while on slopes with higher difficulty levels (red: 42.6% vs 39.9%; black: 4.2% vs 2.5%), while snowboarding in a park (4.8% vs 2.1%) and under the influence of alcohol (1.6% vs 0.5%). Women more often sustained injuries to the back (10.2% vs 13.1%) and pelvis (2.9% vs 4.2%), on easier slopes (blue: 46.1% vs 52.4%) and while standing or sitting (11.0% vs 15.8%). Mild injuries were more frequent in women (48.6% vs 56.4%), severe and fatal injuries in men (36.0% vs 29.7% and 0.9% vs 0.4%). Male gender, age and the use of a helmet were risk factors for the combined outcome of severe or fatal injuries (OR (99% CI): 1.22 (1.00 to 1.48), 1.02 (1.02 to 1.03) and 1.31 (1.05 to 1.63)). When wearing a helmet, the relative risk (RR) for severe injuries increased while that for mild injuries decreased in male snowboarders only (RR (95% CI): 1.21 (1.09 to 1.34) and 0.88 (0.83 to 0.95)).ConclusionsSnowboard injuries are proportionally increasing in women and the observed injury patterns and emergency characteristics differ substantially from those of men. Further gender-specific research in snowboard-related injuries should be encouraged.Trial registration numberNCT03755050.

Social segregation and lethal police violence in the city of São Paulo, Brazil (2014-2015)

We aimed to investigate how lethal police violence (LPV) in the City of São Paulo (CSP), Brazil, is associated with socioeconomic development when we consider the victims’ place of residence and the locations of the fatal injuries. The spatial distribution of lethal police violence rate (LPVR) and its association with the human development index (HDI) was investigated using the Moran’s I (Global and Bivariate Local). Between 2014 and 2015 we found 403 police victims in the Health database and 794 victims in the Security Department. We found a non-random spatial distribution of the LPV considering the victim’s place of residence (I=+0.12; p<0.001) and the locations where the fatal injuries were inflicted (I=+0.07; p<0.001). We found a negative association between LPVR and the HDI of the place of residence (I=-0.10; p<0.001) and a positive association between LPVR and the HDI of the locations of the fatal injuries (I=+0.02; p<0.001). The results point to different dynamics of LPV in CSP. High mortality clusters are found in areas with lower HDI, when considering the victim’s address, and in areas with higher HDI, when considering the address of the violent events. LPV impacts young blacks, poorly educated residents of outskirts informing us about patterns of social segregation.

982Injury fatalities in Australian sport: lessons from cases in the National Coronial Information System

Background Quantifying adverse outcomes of sport participation is critical if we are to address risk and continue to promote safe physical activity. This study addresses the tip of the iceberg in sports injury - fatalities. We aimed to identify the number and trends for fatal injuries in Australian sport. Methods This case-series draws on data from closed cases in the Australian National Coronial Information System. A search strategy was developed to include all unintentional deaths with an external cause, where the Level One Activity code was “sport and exercise during leisure time”. Drowning and transport related cases (e.g. cycling) were excluded. Descriptive analyses are presented (number and %). The injury incidence rate (IIR) was computed for each State/Territory and a negative binomial regression model used to assess changes in deaths over time. Results There were 1010 unintentional injury deaths included. Most cases were males (85.2%), with the largest proportion aged 15 to 24 years (24.2%). The IIR varied from a high in 2001 at 0.49/100,000 population (95%CI: 0.34; 0.59) to a low of 0.17/100,000 people (95%CI: 0.12; 0.22) in 2014. There was a significant reduction (5% annually) in deaths from 2001 to 2015. Conclusions This study presents new knowledge on the scope of fatal injuries in Australian sport, providing an important benchmark for future prevention-oriented work. Key messages Although the rate appears to be decreasing, there is still a concerning number of fatalities from injuries sustained in sport.

Work-Related Injuries Reported to Workers Compensation Fund in Tanzania from 2016 to 2019

Quality data on the magnitude and determinants of work-related injuries is an important element in the development of appropriate preventative strategies. However, there have been many challenges in obtaining quality information on work-related injuries in the developing countries. This archival study based on the data from workers’ compensation registry from the year 2016 to 2019 aimed at determining trends and factors associated with work-related injuries (WRI). Data from 4578 WRI claims reported to Workers Compensation Fund (WCF) in Tanzania were analyzed. As expected, this new workers’ compensation system had increasing participation from inception in 2016 through 2019, resulting in increasing numbers of fatal and non-fatal work-related claims. Motor traffic accidents, machine faults and falls were the most reported causes of WRI. Males had more than 2-fold increased odds of sustaining fatal injuries compared to females. More than 6-fold increased odds of fatal injuries were observed for injuries occurring during conveyance. Explosions, motor traffic accidents, and falls were more likely to result into fatal injuries. Increased odds of fatal injuries were observed in workers from transportation and storage sector; information and technology; construction and building; and electricity, gas, and steam sectors, as well as among teachers, drivers, office workers, and security guards. The current study offers some insights regarding trends and associated factors that are vital in planning and implementation of appropriate preventative strategies for work-related injuries in Tanzania.

50 Years of Mass-Fatality Terrorist Attacks: A Retrospective Study of Target Demographics, Modalities, and Injury Patterns to Better Inform Future Counter-Terrorism Medicine Preparedness and Response

Background: Terrorism-related deaths have fallen year after year since peaking in 2014, and whilst the coronavirus disease 2019 (COVID-19) pandemic has disrupted terrorist organizations capacity to conduct attacks and limited their potential targets, counter-terrorism experts believe this is a short-term phenomenon with serious concerns of an escalation of violence and events in the near future. This study aims to provide an epidemiological analysis of all terrorism-related mass-fatality events (>100 fatalities) sustained between 1970-2019, including historical attack strategies, modalities used, and target selection, to better inform health care responders on the injury types they are likely to encounter. Methods: The Global Terrorism Database (GTD) was searched for all attacks between the years 1970-2019. Attacks met inclusion criteria if they fulfilled the three terrorism-related criteria as set by the GTD codebook. Ambiguous events were excluded. State-sponsored terrorist events do not meet the codebook’s definition, and as such, are excluded from the study. Data analysis and subsequent discussions were focused on events causing 100+ fatal injuries (FI). Results: In total, 168,003 events were recorded between the years 1970-2019. Of these, 85,225 (50.73%) events recorded no FI; 67,356 (40.10%) events recorded 1-10 FI; 5,791 (3.45%) events recorded 11-50 FI; 405 (0.24%) events recorded 51-100 FI; 149 (0.09%) events recorded over 100 FI; and 9,077 (5.40%) events recorded unknown number of FI. Also, 96,905 events recorded no non-fatal injuries (NFI); 47,425 events recorded 1-10 NFI; 8,313 events recorded 11-50 NFI; 867 events recorded 51-100 NFI; 360 events recorded over 100 NFI; and 14,130 events recorded unknown number of NFI. Private citizens and property were the primary targets in 67 of the 149 high-FI events (100+ FI). Of the 149 events recording 100+ FI, 46 (30.87%) were attributed to bombings/explosions as the primary attack modality, 43 (28.86%) were armed assaults, 23 (15.44%) hostage incidents, two (1.34%) were facility/infrastructure attacks (incendiary), one (0.67%) was an unarmed assault, seven (4.70%) had unknown modalities, and 27 (18.12%) were mixed modality attacks. Conclusions: The most common attack modality causing 100+ FI was the use of bombs and explosions (30.87%), followed by armed assaults (28.86%). Private citizens and properties (44.97%) were most commonly targeted, followed by government (6.04%), businesses (5.37%), police (4.70%), and airports and aircrafts (4.70%). These data will be useful for the development of training programs in Counter-Terrorism Medicine (CTM), a rapidly emerging Disaster Medicine sub-specialty.