A retrospective analysis of mission reports in the national Swedish Police Registry on mountain rescue 2018-2022: here be snowmobiles.

BACKGROUND: Increasing mountain activity and decreasing participant preparedness, as well as climate change, suggest needs to tailor mountain rescue. In Sweden, previous medical research of these services are lacking. The aim of the study is to describe Swedish mountain rescue missions as a basis for future studies, public education, resource allocation, and rescuer training. METHODS: Retrospective analysis of all mission reports in the national Swedish Police Registry on Mountain Rescue 2018-2022 (n = 1543). Outcome measures were frequencies and characteristics of missions, casualties, fatalities, traumatic injuries, medical conditions, and incident mechanisms. RESULTS: Jämtland county had the highest proportion of missions (38%), followed by Norrbotten county (36%). 2% of missions involved ≥ 4 casualties, and 44% involved ≥ 4 mountain rescuers. Helicopter use was recorded in 59% of missions. Non-Swedish citizens were rescued in 12% of missions. 37% of casualties were females. 14% of casualties were ≥ 66 or ≤ 12 years of age. Of a total 39 fatalities, cardiac event (n = 14) was the most frequent cause of death, followed by trauma (n = 10) and drowning (n = 8). There was one avalanche fatality. 8 fatalities were related to snowmobiling, and of the total 1543 missions, 309 (20%) were addressing snowmobiling incidents. Of non-fatal casualties, 431 involved a medical condition, of which 90 (21%) suffered hypothermia and 73 (17%) cardiovascular illness. CONCLUSIONS: These baseline data suggest snowmobiling, cardiac events, drownings, multi-casualty incidents, and backcountry internal medicine merit future study and intervention.

Vehicle-related injuries in and around a medium sized Swedish City - bicyclist injuries caused the heaviest burden on the medical sector.

BACKGROUND: A data acquisition from the medical sector may give one important view of the burden on the society caused by vehicle related injuries. The official police-reported statistics may only reflect a part of all vehicle-related injured seeking medical attention. The aim is to provide a comprehensive picture of the burden of vehicle related injuries on the medical sector (2013), and to compare with official police-reported statistics and the development year 2000-2013. METHODS: The data set includes 1085 injured from the Injury Data Base at Umeå University Hospital's catchment area with 148,500 inhabitants in 2013. RESULTS: Bicyclists were the most frequently injured (54%). One-third had non-minor (MAIS2+) injuries, and bicyclists accounted for 58% of the 1071 hospital bed days for all vehicle-related injuries. Car occupants represented 23% of all injured, and only 9% had MAIS2+ injuries. They accounted for 17% of the hospital bed days. Motorized two wheel vehicle riders represented 11% of the injured and 39% had MAIS2+ injuries and they occupied 11% of the hospital bed days. Of the 1085 medically treated persons, 767 were injured in public traffic areas, and, therefore, should be included in the official police statistics; however, only a third (232) of them were reported by the police. The annual injury rate had not changed during 2000-2013 for bicyclists, motor-cycle riders, pedestrians or snowmobile riders. However, for passenger car occupants a decrease was observed after 2008, and for mopedists the injury rate was halved after 2009 when a licensing regulation was introduced. CONCLUSION: The Swedish traffic injury reducing strategy Vision Zero, may have contributed to the reduction of injured car occupants and moped riders. The official police-reported statistics was a biased data source for vehicle related injuries and the total number medically treated was in total five times higher. Bicyclists caused the heaviest burden on the medical sector; consequently, they need to be prioritized in future safety work, as recently declared in the Government plan Vision Zero 2.0.

Outdoor pedestrian fall-related injuries among Swedish senior citizens--injuries and preventive strategies.

Senior citizens get around, to a large extent, as pedestrians, and safe walking is desirable for senior citizens allowing them to stay mobile, independent and healthy in old age. Senior citizens are over-represented in injury statistics, and fall-related injuries are common. The aim of this study was to investigate fall-related injuries including healthcare costs among senior citizen pedestrians injured when walking in public outdoor environments and to describe their self-reported causes and suggested preventive strategies. The data were based on a combination of information from injury data and a questionnaire. Three hundred senior citizens attended one emergency department after sustaining injuries from pedestrian falls; 60% suffered nonminor injuries, mostly fractures. One-fifth of the pedestrians were hospitalised for an average of 8 days with an indirect hospital cost of 6.2 million EUR (55 million SEK). Environmental factors such as ice were the most commonly described cause of the injury incident. Forty per cent of the respondents indicated that the municipality was responsible for the cause of the injury incident. Fewer respondents mentioned their own responsibility as a preventive strategy. Thirty per cent described a combination of improvements such as better road maintenance, changes in human behaviour and use of safety products as preventive strategies. It is of great importance to highlight general safety, products and preventive strategies to minimise injury risks, so that pedestrians can safely realise the known health benefits of walking and thereby limit healthcare costs.

Car crash fatalities associated with fire in Sweden.

OBJECTIVE: To study the epidemiology and causes of death in fatal car crashes on Swedish roads in which the victim's vehicle caught fire. METHODS: The data set is from the Swedish Transport Administrations in-depth studies of fatal crashes 1998-2008. Autopsies from all cases provided data on injuries, toxicological analyses, and cause of death. RESULTS: In total, 181 people died in 133 burning cars, accounting for 5 percent of all deaths in passenger cars, sport utility vehicles, vans, and minibuses during 1998 to 2008. The cause of death for a third of the victims was fire related, as burns and/or smoke inhalation injuries, with no fatal trauma injuries. Twenty-five of these 55 deaths were persons 19 years or younger and included 15 of 18 rear seat deaths. Over half of the 181 deaths were in vehicles that had collided with another vehicle and, of these cases, half were killed in collisions with heavy vehicles. The percentage of drivers with illegal blood alcohol concentrations (27%) and suicides (5.5%) were not higher than in other fatal crashes on Swedish roads. The ignition point of the fire was indicated in only half of the cases and, of those, half started in the engine compartment and one fourth started around the fuel tank or lines. CONCLUSIONS: Car fires are a deadly postcrash problem. Reducing this risk would be primarily a responsibility for the automotive industry. A multifactor approach could be considered as follows: risk-reducing design, insulation, reduced flammability in motor compartment fluids and plastics, and automatic fire extinguishing equipment. Inspiration could be found in how, for example, the auto racing and aviation industries handle this problem.

Passenger car collision fatalities--with special emphasis on collisions with heavy vehicles.

Between 1995 and 2004, 293 passenger car occupants died in collisions with other vehicles in northern Sweden (annual incidence: 3.3 per 100,000 inhabitants, 6.9 per 100,000 cars, or 4.8 per 10(9)km driven); half of these deaths involved heavy vehicles. The annual number of passenger car occupant deaths per 100,000 cars in car-truck/bus collisions has remained unchanged since the 1980s, but in car-car collisions it has decreased to one third of its former level. As crash objects, trucks and buses killed five times as many car occupants per truck/bus kilometer driven as did cars. The collisions were characterized by crashes in the oncoming vehicle's lane, under icy, snowy, or wet conditions; crashes into heavy vehicles generally occurred in daylight, on workdays, in winter, and on 90 and 70 km/h two-lane roads. Head and chest injuries accounted for most of the fatal injuries. Multiple fatal injuries and critical and deadly head injuries characterized the deaths in collisions with heavy vehicles. An indication of suicide was present in 4% of the deaths; for those who crashed into trucks, this percentage was doubled. Among the driver victims, 4% had blood alcohol levels above the legal limit of 0.2g/L. Frontal collision risks might be reduced by a mid-barrier, by building less injurious fronts on trucks and buses, by efficient skid prevention, and by use of flexible speed limits varying with road and light conditions.

Violent deaths in small children in northern Sweden.

OBJECTIVES: To identify causes and trends of violent deaths among children younger than 4 years in a northern region. STUDY DESIGN: Retrospective analysis of medico-legal autopsy and police data. METHODS: Data from all 72 deaths from "external causes" 1977-2004, in children < 4 years from the northern half of Sweden were analysed. RESULTS: The death rate was 7.1 per 100,000 children and year during the first half of the study period, and 5.2 during the second half. Vehicle- and drowning-related deaths were halved. Fifteen were struck by motor vehicles (in 8 cases by heavy vehicles), 14 car occupants were killed in car crashes, 12 were killed by intentional violence inflicted by an adult, and 9 each were killed by (i) carbon monoxide/smoke inhalation, (ii) asphyxiation, or (iii) drowning. The boy:girl ratio was 1:1 in all groups, except in the groups "drowning" and "run over by motor vehicle", where boys dominated. CONCLUSIONS: Medical professionals have a difficult but important task in identifying and taking action against child abuse and in promoting child safety especially in the traffic and home environments.