Body mass index and injury risk among US children 9-15 years old in motor vehicle crashes.

OBJECTIVE: To determine the relationship between body mass index (BMI) and injury risk among US children in motor vehicle crashes. DESIGN: Cross-sectional study using data from the Partners for Child Passenger Safety study, a child-focused crash surveillance system. PARTICIPANTS: A probability sample of children, 9-15 years of age, involved in crashes in parent-operated vehicles between 1 December 2000 and 31 December 2006. MAIN OUTCOME MEASURE: The odds ratio of Abbreviated Injury Severity (AIS) 2+ injuries (overall and body region specific) by BMI category: underweight, normal, overweight, and obese. RESULTS: The study sample included 3232 children in 2873 vehicles, representing a population estimate of 54 616 children in 49 037 vehicles. Approximately 15% (n = 502) sustained an AIS 2+ injury to any body region; 34% of the children were overweight or obese. There was no overall increase in injury risk by BMI; however, body region differences were found. In multivariate logistic regression, compared with normal weight children, the odds of sustaining an AIS 2+ injury to the extremities for overweight and obese children was 2.64 (95% CI 1.64 to 4.77) and 2.54 (95% CI 1.15 to 5.59), respectively. CONCLUSIONS: Although overweight and obese children are not at increased overall risk of injury, they are at increased risk of injury to the lower and upper extremities. This increased risk may be due to a combination of physiology, biomechanical forces, and vehicle design.

Interventions to prevent softball related injuries: a review of the literature.

OBJECTIVES: To examine the published evidence on interventions to prevent softball related injuries among adults, and to encourage more epidemiologic research as a foundation for future softball injury prevention efforts. METHODS: The authors reviewed literature identified from six electronic databases for studies on softball related injuries. The search was limited to studies written in the English language, published between 1970 and 2002, and involving adult populations. Research was excluded that evaluated baseball ("hard ball") related injuries or was aimed at injury treatment. Identified studies were categorized by study design. Intervention/prevention papers were evaluated further and described in detail. RESULTS: The search strategy identified 39 studies specifically related to softball. Most studies were case reports/case series (n=13) or descriptive studies (n=11); only four were analytic or intervention/prevention studies. Studies collected data in a variety of ways, often without denominator data to permit calculation of injury rates. Studies also did not differentiate between slow or fast pitch softball activities and most did not mention the type of softball that was used. CONCLUSIONS: Surprisingly few studies exist on interventions to reduce injuries during softball, one of the most popular recreational sports in the US. Of the existing literature, much attention has been on sliding related injuries, which comprise only a segment of softball injuries. Basic epidemiologic studies describing the nature, severity, and risk factors for softball injuries in a variety of populations are needed, followed by additional intervention evaluation studies aimed at modifiable risk factors.