Ski and snowboard school programs: Injury surveillance and risk factors for grade-specific injury.

The objective of our study was to evaluate incidence rates and profile of school program ski and snowboard-related injuries by school grade group using a historical cohort design. Injuries were identified via Accident Report Forms completed by ski patrollers. Severe injury was defined as those with ambulance evacuation or recommending patient transport to hospital. Poisson regression analysis was used to examine the school grade group-specific injury rates adjusting for risk factors (sex, activity, ability, and socioeconomic status) and accounting for the effect of clustering by school. Forty of 107 (37%) injuries reported were severe. Adolescents (grades 7-12) had higher crude injury rates (91 of 10 000 student-days) than children (grades 1-3: 25 of 10 000 student-days; grades 4-6: 65 of 10 000 student-days). Those in grades 1-3 had no severe injuries. Although the rate of injury was lower in grades 1-3, there were no statistically significant grade group differences in adjusted analyses. Snowboarders had a higher rate of injury compared with skiers, while higher ability level was protective. Participants in grades 1-3 had the lowest crude and adjusted injury rates. Students in grades 7-12 had the highest rate of overall and severe injuries. These results will inform evidence-based guidelines for school ski/snowboard program participation by school-aged children.

Cyclist head and facial injury risk in relation to helmet fit: a case-control study.

INTRODUCTION: We examined the effect of bicycle helmet fit and position on head and facial injuries. METHODS: Cases were helmeted cyclists with a head (n=297) or facial (n=289) injury. Controls were helmeted cyclists with other injuries, excluding the neck. Participants were interviewed in seven Alberta emergency departments or by telephone; injury data were collected from charts. Missing values were imputed using chained equations and custom prediction imputation models. RESULTS: Compared with excellent helmet fit, those with poor fit had increased odds of head injury (odds ratio [OR] = 3.38, 95% confidence interval [CI]: 1.06-10.74). Compared with a helmet that stayed centred, those whose helmet tilted back (OR = 2.90, 95% CI: 1.54-5.47), shifted (OR = 1.91, 95% CI: 1.01-3.63) or came off (OR = 6.72, 95% CI: 2.86-15.82) had higher odds of head injury. A helmet that tilted back (OR = 4.81, 95% CI: 2.74-8.46), shifted (OR = 1.83, 95% CI: 1.04-3.19) or came off (OR = 3.31, 95% CI: 1.24-8.85) also increased the odds of facial injury. CONCLUSION: Our findings have implications for consumer and retail education programs.

TITRE: Risque de blessures à la tête et au visage chez les cyclistes en relation avec l'ajustement du casque : une étude cas-témoins. INTRODUCTION: Nous avons examiné l'effet de l'ajustement et de la position du casque de vélo sur les blessures à la tête et au visage. MÉTHODOLOGIE: Les cas étaient ceux de cyclistes portant un casque qui avaient subi des blessures à la tête (n = 297) ou au visage (n = 289). Les témoins étaient des cyclistes portant un casque qui avaient subi d'autres blessures, à l'exception des blessures au cou. Les participants ont été interrogés dans sept services d'urgence de l'Alberta ou par téléphone. Les données sur les blessures ont été recueillies au moyen des dossiers médicaux. Les valeurs manquantes ont été déduites à l'aide d'équations enchaînées et de modèles personnalisés d'imputation par prédiction. RÉSULTATS: Comparativement aux sujets dont l'ajustement du casque était excellent, ceux dont l'ajustement était mauvais affichaient un plus grand risque de blessures à la tête (rapport de cotes [RC] = 3,38, intervalle de confiance [IC] à 95 % : 1,06 à 10,74). Comparativement aux sujets dont le casque était demeuré bien centré, ceux dont le casque s'était incliné vers l'arrière (RC= 2,90, IC à 95% : 1,54 à 5,47) ou s'était déplacé (RC = 1,91, IC à 95 % : 1,01 à 3,63) et ceux qui avaient perdu leur casque (RC = 6,72, IC à 95 % : 2,86 à 15,82) présentaient un plus grand risque de blessures à la tête. Un casque qui s'était incliné vers l'arrière (RC = 4,81, IC à 95 % : 2,74 à 8,46), s'était déplacé (RC = 1,83, IC à 95 % : 1,04 à 3,19) ou avait été perdu (RC = 3,31, IC à 95% : 1,24 à 8,85) augmentait aussi le risque de blessures au visage. CONCLUSION: Nos observations ont des retombées sur les consommateurs et les programmes d'éducation des détaillants.

The relationship between visibility aid use and motor vehicle related injuries among bicyclists presenting to emergency departments.

BACKGROUND: Little is known about the effectiveness of visibility aids (VAs; e.g., reflectors, lights, fluorescent clothing) in reducing the risk of a bicyclist-motor-vehicle (MV) collision. PURPOSE: To determine if VAs reduce the risk of a bicyclist-MV collision. METHODS: Cases were bicyclists struck by a MV and assessed at Calgary and Edmonton, Alberta, Canada, emergency departments (EDs) from May 2008 to October 2010. Controls were bicyclists with non-MV injuries. Participants were interviewed about their personal and injury characteristics, including use of VAs. Injury information was collected from charts. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for VAs during daylight and dark conditions, and adjusted for confounders using logistic regression. Missing values were imputed using chained equations and adjusted OR estimates from the imputed data were calculated. RESULTS: There were 2403 injured bicyclists including 278 cases. After adjusting for age, sex, type of bicycling (commuting vs. recreational) and bicyclist speed, white compared with black (OR 0.52; 95% CI 0.28, 0.95), and bicyclist self-reported light compared with dark coloured (OR 0.67; 95% CI 0.49, 0.92) upper body clothing reduced the odds of a MV collision during daylight. After imputing missing values, white compared with black (OR 0.57; 95% CI: 0.32, 0.99) and bicyclist self-reported light compared with dark coloured (OR 0.71; 95% CI 0.52, 0.97) upper body clothing remained protective against MV collision in daylight conditions. During dark conditions, crude estimates indicated that reflective clothing or other items, red/orange/yellow front upper body clothing compared with black, fluorescent clothing, headlights and tail lights were estimated to increase the odds of a MV collision. An imputed adjusted analysis revealed that red/orange/yellow front upper body clothing colour (OR 4.11; 95% CI 1.06, 15.99) and tail lights (OR 2.54; 95% CI: 1.06, 6.07) remained the only significant risk factors for MV collisions. One or more visibility aids reduced the odds of a bicyclist MV collision resulting in hospitalization. CONCLUSIONS: Bicyclist clothing choice may be important in reducing the risk of MV collision. The protective effect of visibility aids varies based on light conditions, and non-bicyclist risk factors also need to be considered.