Deaths of older Australians related to their use of motorised mobility scooters.

This study describes motorized mobility scooter (MMS) rider-related fatalities in the older Australian population during the years 2000-2011, identified from the National Coronial Information System. Seventy-seven fatalities were identified, most aged 80 years or older (74.1%) and males predominated (76.6%). Most deaths (88.3%) resulted from collisions with motor vehicles or falling from the MMS. These findings are consistent with the reported morbidity data. Challenges to MMS case identification included lack of specification in reports to Coroners and inadequate codes. Improved specificity and coding are necessary to fully describe the extent of MMS-related injury. This study raises the issue of emerging largely unregulated consumer products. Further research is required to understand the uptake and use of MMS in the ageing population. Strategies are needed to decrease rider injuries whilst meeting community mobility needs.

Did compulsory wear regulations increase personal flotation device (PFD) use by boaters in small power recreational vessels? A before-after observational study conducted in Victoria, Australia.

OBJECTIVE: To estimate the effect of the 2005 Victorian mandatory personal flotation device (PFD) wearing regulations on PFD use by occupants of small (hull length ≤4.8 m) power recreational vessels. DESIGN: Before-after observational study investigating the probability of PFD use among occupants of small vessels before and after the regulations were introduced compared with the probability of use by their counterparts on large power vessels (hull length >4.8-12 m) who were not required to wear PFDs before or after the regulations were introduced in the low-risk conditions in which observations occurred. METHODS: Statewide observation surveys of boaters were conducted in peak boating periods between January and March 2005 (prelegislation) and 2007 (postlegislation). Data collection included size of vessel, age and sex of boaters, life jacket use, boat type, activity of boaters, type of waterway and weather and water conditions. Logistic regression modelling tested whether there were statistically significant differences in the change in the relative odds of occupants wearing PFDs from the preintervention to the postintervention period in small compared with large power recreational vessels. RESULTS: The probability of PFD use increased from 22% to 63% on small power vessels compared with 12% to 13% on large vessels. Regression analysis showed a high statistically significant increase in the odds of PFD use on small vessels relative to large vessels (OR 6.2, 95% CI 4.2 to 9.3, p<0.001). No statistically significant effect on use on large vessels was associated with the regulation (OR 1.27, 95% CI 0.94 to 1.70, p=0.15). Relative to large vessels, on small vessels the odds of PFD use increased significantly in both sexes, all age groups, all vessel types and activity groupings except for towed water sports where the increase was only marginally statistically significant. CONCLUSIONS: The legislative intervention was successful in increasing PFD wearing in small vessels. However, visible enforcement and tougher penalties are needed to optimise compliance.

Effectiveness of the 2005 compulsory personal flotation device (PFD) wearing regulations in reducing drowning deaths among recreational boaters in Victoria, Australia.

OBJECTIVE: To investigate whether the Victorian mandatory personal flotation device wearing regulations that came into effect on 1 December 2005 reduced drowning deaths among recreational boaters in Victoria, Australia. DESIGN: A retrospective population-based 'before and after' study using Victorian coronial data on drowning deaths of occupants of recreational vessels operating in Victorian waters. METHODS: The annual numbers of deaths in the 5 years after the transition year of the regulations (2005) was compared with the annual numbers of deaths in the 6 years prior to the transition year, using the Mann-Whitney U test. RESULTS: There were 59 recreational boating drowning deaths in the 6-year preintervention period (1 December 1998 to 30 November 2004) compared with 16 in the 5-year postintervention period (1 December 2005 to 30 November 2010). The analysis showed a significant decrease in drowning deaths among all recreational boaters (U=30.0, p=0.01) and among these strata: vessel occupants aged 0-29 years (U=28.0, p=0.02) and 30-59 years (U=27.5, p=0.02), vessel occupants engaged in pleasure cruising (U=29.0, p=0.01) and in 'other' boating activities (U=25.0, p=0.04), boaters on small powerboats ≤4.8 m in length (U=29.5; p=0.01), boaters on motorised (U=29.5; p=0.01) and sail-powered vessels (U=26.0; p=0.04), and occupants of vessels operating in inland waterways (U=30.0; p=0.01). CONCLUSIONS: These findings provide further support for the adoption of a regulatory approach to personal flotation device wearing to reduce drowning among recreational boaters.

Injury causation in the great outdoors: A systems analysis of led outdoor activity injury incidents.

Despite calls for a systems approach to assessing and preventing injurious incidents within the led outdoor activity domain, applications of systems analysis frameworks to the analysis of incident data have been sparse. This article presents an analysis of 1014 led outdoor activity injury and near miss incidents whereby a systems-based risk management framework was used to classify the contributing factors involved across six levels of the led outdoor activity 'system'. The analysis identified causal factors across all levels of the led outdoor activity system, demonstrating the framework's utility for accident analysis efforts in the led outdoor activity injury domain. In addition, issues associated with the current data collection framework that potentially limited the identification of contributing factors outside of the individuals, equipment, and environment involved were identified. In closing, the requirement for new and improved data systems to be underpinned by the systems philosophy and new models of led outdoor activity accident causation is discussed.

Traumatic orodental injuries and the development of an orodental injury surveillance system: a pilot study in Victoria, Australia.

Traumatic orodental injuries are common dental public health problems that have complex aetiology and significant impact on those affected. It is important to understand the frequency, pattern and causes of traumatic orodental injuries so that appropriate and effective treatment services are made available and injury prevention interventions are designed and implemented. The aims of this study were to measure the frequency, causes and patterns of traumatic orodental injuries in patients of all ages treated at the Royal Dental Hospital of Melbourne in Victoria, Australia, over a 12-month period and to investigate the feasibility of establishing an orodental injury surveillance system. For which, a retrospective audit of 304 patient records was undertaken and injury surveillance data were extracted and analysed. Males represented 67% of cases. Three-quarters of all cases were aged less than 24 years. The most frequent cause of orodental injury was falls from less than 1 m or being struck by or colliding with a person or object. Injuries occurred most commonly around the home, on the road, street or footpath, the sports ground and places for recreation and were most often associated with leisure and sports activities. Orodental injuries sustained in one traumatic incident were often multiple and serious. Many severe orodental trauma injury cases present at this public dental hospital are expensive to treat, require long-term management and may be preventable. The findings from this study have led to the development and planned implementation of an enhanced electronic orodental injury structured history form that incorporates the collection of key injury surveillance data. These prospective data are to be combined with injury surveillance data that are routinely collected by all Victorian public hospital emergency departments in order to improve understanding of the nature of orodental injuries impacting Victorian communities and assist with appropriate service planning and the design of orodental injury prevention interventions.

The public health impact of injury during sport and active recreation.

Injuries can be an adverse outcome of participation in sport and recreational activities. The aim of this study was to determine the public health impact of injury during sports and active recreation injury in a select population in Australia. A random household telephone survey was conducted quarterly over a 12-month period in a well-defined geographic region, the Latrobe Valley, Australia. Information was collected on participation in sport and active recreation and associated injuries over the previous 2 weeks for all household members aged over 4 years. Injury rates were calculated per 10,000 population and per 1000 sports participants. Data were collected on 1084 persons from 417 households. Overall, 648 people reported participating in at least one sport or active recreation and 34 (5.2%, 95% CI: 4.8, 5.6%) of these sustained an injury during this activity. Overall, 51.4% of injured cases had a significant impact: 26.5% sought treatment, 34.4% had their activities of daily living adversely affected and 36.0% had their performance/participation limited. Cricket (51 injuries/10,000 population), horse riding (29/10,000 population) and basketball (25/10,000 population) had the highest injury rates. After adjusting for participation, cricket (242 injuries/1000 participants), horse riding (122/1000 participants) and soccer (107/1000 participants) had the highest injury rates. Cricket and soccer were the sports most associated with 'significant' injuries. Injury prevention efforts should be aimed at team ball sports (especially cricket, soccer and netball) because of their comparatively high rate of both overall and 'significant' injury.

Victorian Emergency Minimum Dataset: factors that impact upon the data quality.

OBJECTIVE: The Victorian Emergency Minimum Dataset (VEMD) records details of approximately 80% of Victoria's ED presentations. Its usefulness for quality assurance and research relies on the data being both complete and accurate. We aimed to determine the factors that impact adversely on the collection of high-quality VEMD data. METHODS: The study was a voluntary, anonymous, cross-sectional survey of a range of ED staff (medical, nursing, clerical) who collect and enter data into the VEMD. Nine of the 28 hospitals that contribute to the VEMD were surveyed. The questionnaire was purpose-designed and self-administered. RESULTS: A total of 218 staff participated (response rate 95%). Six different software types were used, with 40% of respondents using the Pickware (MCAT) system. There was no consistency of ED personnel for the completion of specific data fields. One hundred and twenty-six (56%) respondents had heard of the VEMD, 67 (29%) had had its structure and purpose explained and 65 (30%) had been trained to enter data. Ninety-seven (45%) respondents knew what the VEMD data was used for, 38 (17%) knew they could request VEMD data for their own use and 17 (7.8%) had done so. Time constraints, software problems and lack of formal orientation and training in data entry were reported as the most important factors impacting adversely upon quality data entry. CONCLUSION: Staff knowledge of the VEMD system and its uses are poor. Numerous factors impact on the quality of data entered and interventions aimed at improving staff education, training and feedback and software are indicated.