Bicycle helmet use and bicycling-related injury among young Canadians: an equity analysis.

INTRODUCTION: Cycling is a major activity for adolescents in Canada and potential differences exist in bicycling-related risk and experience of injury by population subgroup. The overall aim of this study was to inform health equity interventions by profiling stratified analytic methods and identifying potential inequities associated with bicycle-related injury and the use of bicycle helmets among Canadian youth. The two objectives of this study were: (1) To examine national patterns in bicycle ridership and also bicycle helmet use among Canadian youth in a stratified analysis by potentially vulnerable population subgroups, and (2) To examine bicycling-related injury in the same population subgroups of Canadian youth in order to identify possible health inequities. METHODS: Data for this study were obtained from the 6th cycle (2009/10) of the Health Behaviour in School-aged Children (HBSC) study, which is a general health survey that was completed by 26,078 students in grades 6-10 from 436 Canadian schools. Based on survey responses, we determined point prevalence for bicycle ridership, bicycle helmet use and relative risks for bicycling-related injury. RESULTS: Three quarters of all respondents were bicycle riders (n=19,410). Independent factors associated with bicycle ridership among students include being male, being a younger student, being more affluent, and being a resident of a small town. Among bicycle riders, 43% (95%CI ± 0.6%) reported never wearing and 32% (± 0.6%) inconsistently wearing a helmet. Only 26% (± 0.5%) of students reported always wearing a bicycle helmet. Helmets were less frequently used among older students and there were also important patterns by sex, geographic location and socioeconomic status. Adjusting for all other demographic characteristics, boys reported 2.02-fold increase (95% CI: 1.61 to 1.90) and new immigrants a 1.35-fold increase (95%CI: 1.00 to1.82) in the relative risk of bicycling-related injury in the past 12 months, as compared to girls and students born in Canada. The relative risk of injury did not vary significantly by levels of socioeconomic status. CONCLUSIONS: Troubling disparities exist in bicycle use, bicycle helmet use and bicycling-related injuries across specific population subgroups. Bicycle safety and injury prevention initiatives should be informed by disaggregated analyses and the context of bicycle-related health differences should be further examined.

Epidemiology of acute soccer injuries in canadian children and youth.

OBJECTIVES: To describe acute injury characteristics in children and youth soccer players and to identify the characteristics of patients who required hospital admission. METHODS: The analysis of the study was based on the Canadian Hospitals Injury Reporting and Prevention Program. A total of 32,149 patients (aged 5-19 years) with soccer-related injuries presenting to 16 participating hospital emergency departments from 1994 to 2004 were included in the analysis. RESULTS: Males had the highest proportion of injuries (62%). The leading injuries were sprains/strains (38%), followed by fractures/dislocations (31%) and superficial injuries (23%). A total of 896 cases (3%) required hospital admission. Based on logistic regression analysis, being a male, playing unorganized soccer, having multiple body injuries, playing soccer outside school premises, and playing during the summer/fall increased the likelihood of hospital admission. Moreover, having a head/face/neck injury (Odds ratio [OR], 1.3; 95% confidence interval [95% CI], 1.1-1.7) and trunk injury (OR, 1.7; 95% CI, 1.2-2.4) as compared with an upper extremity injury and having injuries from contact with structures/surfaces (OR, 3.1; 95% CI, 2.2-4.3) and with other players (OR, 2.5; 95% CI, 1.8-3.5) as compared with ball contact had the highest odds of hospital admission. CONCLUSIONS: Soccer accounted for a significant proportion of injuries presented to Canadian Hospitals Injury Reporting and Prevention Program emergency departments during 1994-2004. Further studies investigating potential interventional programs and techniques among this population are highly warranted.

Epidemiology of acute head injuries in Canadian children and youth soccer players.

BACKGROUND: Limited studies have been done to assess head injury characteristics for children and youth soccer players in Canada. OBJECTIVES: To describe acute head injury characteristics in children and youth soccer players and identify the characteristics of patients who required hospital admission. METHODS: Analysis was based on the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP). Soccer-related head injuries amongst 5-19 year old children presenting at 16 hospital emergency departments during 1994-2004 were selected in the study. All head injury-related variables (nature of injury, mechanism of injury, location of play, soccer type and season of play) were stratified by age and sex. A logistic regression model, consisting of the injury-related variables, sex and age as the independent variables, was performed to examine the characteristics of those head-injured patients who required hospital admission. RESULTS: Overall, there were 4720 head injury cases identified (15% of all soccer-related emergency department visits). The highest proportion of head injuries was amongst males (70%) and children aged 10-14 years (50%). Of head injury cases, 35% were superficial and/or open wounds, 28% minor head injuries, 11% concussions, 9% eye injuries and 5% fractures. The total number of cases that required hospital admission was 164 (3.5%). Based on logistic regression analysis, head-injured youth aged 15-19 years were almost two times more likely to be admitted to hospital than their younger counterparts (OR=2.2, 95% CI: 1.3-3.6). Compared to ball contact injuries, contact with structures/surfaces, other players/persons and other unspecified objects increased the odds of hospital admission at least by two-folds. Moreover, those who played unorganised soccer were significantly more likely to be admitted to the hospital as compared to those who played organised soccer (OR=1.7, 95% CI: 1.2-2.6). Finally, playing in the non-winter seasons had increased likelihood of hospital admissions. CONCLUSIONS: Head injuries constituted a significant proportion of soccer-related injuries presenting to emergency departments. Future studies need to evaluate the nature and safety of the playing surfaces/turf and other structures on or around the field of play.