Work-related acute injuries from mandatory fitness training in the Swedish Police Force.

Acute injuries in the Swedish Police Force from on-duty fitness training were selected retrospectively from the Information System of Occupational Injuries (ISA) at the National Board of Occupational Safety and Health and, if having caused a sick-leave exceeding 2 weeks, to the Labour Market Insurance (AMF Insurance). The latter included injuries from 1995 only. During the seven-year period 1992 to 1998, 920 injuries (80 % in males) from fitness training involving police officers were reported to the ISA-register. The total incidence was 1.6 for policemen per 10 000 hours of exposure and 2.2 for policewomen, which is 1.4 times higher than in men. Around 50 % of the injuries occurred in team and contact sports, with a slightly higher percentage for males, 54 % versus 49 % in females. The percentage of injuries from self-defense training was twice as high as in women than in men, 29 % versus 15 %. In 1995, 42 of the 72 injuries in males and 6 of the 21 injuries in females caused more than 14 days of sick-leave and were announced to the Occupational No Fault Liability Insurance. The major part, 32 of 48 injuries, came from team or contact sports (mainly floorball and soccer). Six policemen incurred injuries that were classified with a degree of disability ranging from 2 to 5 %. The total cost for medical treatment and production loss for the 48 injuries was Euro 248 448 and 99 336, respectively. Team and contact sports accounted for 89 % of the costs and 77 % of the production loss through sick-leave.

Work-related injuries from mandatory fitness training among Swedish firemen.

A considerable amount of employees incur injuries in professions with mandatory on-duty fitness training. The training is necessary for maintaining a good health status, physical condition and strength in professions requiring such qualities. Injuries in Swedish firemen from on-duty fitness training between 1992 and 1998 were selected retrospectively from the Information System of Occupational Injuries (ISA) at the National Board of Occupational Safety and Health and, if having caused a sick-leave exceeding 2 weeks, to the Labour Market Insurance (AMF Insurance). The latter comprised injuries from 1995 only. During the seven-year period 1,468 injuries from fitness training occurred in male firemen. With an estimated 147 h per man and year the injury incidence was 2.6 per 10,000 h of exposure. The mean number of days of absence from work was 24.1 days (SD 39.8). In 1995, the mean cost per injury for medical treatment was close to 7,000 Euro and for production loss almost 4,500 Euro. By far the major part of the injuries, 75 %, occurred during team and contact sports (primarily floorball and soccer) and this sport category also accounted for 83% of the medical costs and 78% of the costs for production loss. It is suggested that a restriction of team and contact sports as mandatory on-duty fitness training for firemen should be tested and evaluated concerning the injury incidence.

A 7-year study on risks and costs of knee injuries in male and female youth participants in 12 sports.

Knee injuries are common and account in various sports for 15-50% of all sports injuries. The cost of knee injuries is therefore a large part of the cost for medical care of sports injuries. Furthermore, the risk of acquiring a knee injury during sports is considered higher for females than for males. The nationwide organization "Youth and Sports" represents the major source of organized sports and recreation for Swiss youth and engages annually around 370000 participants in the age group of 14 to 20 years. The purpose of this study was to combine data on knee injuries from two sources, the first being data on the exposure to risk found in the activity registration in "Youth and Sports" and the second injuries with their associated costs resulting from the activities and filed at the Swiss Military Insurance. This allowed calculation of knee injury incidences, to compare risks between males and females and to estimate the costs of medical treatment. The study comprises 3864 knee injuries from 12 sports during 7 years. Females were significantly more at risk in six sports: alpinism, downhill skiing, gymnastics, volleyball, basketball and team handball. The incidences of knee injuries and of cruciate ligament injuries in particular, together with the costs per hour of participation, all displayed the same sports as the top five for both females and males: ice hockey, team handball, soccer, downhill skiing and basketball. Female alpinism and gymnastics had also high rankings. Knee injuries comprised 10% of all injuries in males and 13% in females, but their proportional contribution to the costs per hour of participation was 27% and 33%, respectively. From this study it can be concluded that females were significantly more at risk for knee injuries than males in six sports and that knee injuries accounted for a high proportion of the costs of medical treatment.

Exposure data. Why are they needed?

Aspects of different approaches to study design in the epidemiology of sports injuries are presented, identifying 4 major types: (i) the clinical case series; (ii) the community-based survey; (iii) studies on specific sports or diagnoses without exposure data; and (iv) studies on specific sports or diagnoses with exposure data. The advantages and disadvantages of these concepts are discussed. It is concluded that to optimise preventive efforts and improve the comparability of studies in sports injury epidemiology, there is not only a need for consensus on definitional issues, but also for an agreement on the methodology. Attention to exposure issues is a crucial component of this.

Epidemiology of sports injuries in the Swiss organization "Youth and Sports" 1987-1989. Injuries, exposure and risks of main diagnoses.

In the Swiss organization "Youth and Sports" all acute injuries that are attended to by a physician are registered by the Military Insurance, and data on the number of participants in 32 sports together with the time of exposure are collected by the organization. Per year there are close to 350,000 participants (age 14-20 years) during 13.2 million hours causing more than 5,000 injuries. In a descriptive study the data on the activities in "Youth and Sports" from 1987-1989 have been combined with the injuries which occurred during the same time period. The exposure to risk per 10,000 hours (incidence rate) has been calculated and is presented as a mean of the three years. Icehockey, handball and soccer had the highest incidences in males (8.6, 7.2, and 6.6) followed by wrestling, hiking and basketball (6.3, 3.6, and 3.5). In females the ranking order was handball, soccer and basketball (7.6, 6.7, and 4.9) succeeded by alpine skiing, volleyball and alpinism (3.9, 3.8, and 3.0). A comparison between males and females of the incidence rates in eleven analogous sports showed five significantly higher rates, four in female sports: basketball, alpine skiing, volleyball and apparatus gymnastics, and one in a male sport, hiking. The overall rate was significantly higher in males, but the higher risk was explained by the predominance of male soccer (56% of the injuries in males). After standardization for total exposure the results were even reversed and female sports had a higher overall risk.

On the epidemiology of sports injuries in Switzerland.

A review of the current literature and of insurance data sources on sports injuries in Switzerland during the latest decade is presented. Epidemiological denominator data to determine the population-at-risk and the exposure time are scarce and it is therefore recommended that both the quantity and the quality of Swiss research in this field will be enhanced. It is also proposed that at least one academic institution in Switzerland would assemble systematically all available data of standard format on sports and recreational injuries to ensure a continuous analysis of these data.

Risk exposure and incidence of injuries in school physical education at different activity levels.

Pupils in the age range of 14-19 years in the schools of a municipality in Sweden were observed prospectively for one year for acute injuries during school physical education (n = 2089). Pupils registered in the Injury Surveillance System for an acute injury sustained during physical education classes and treated by a physician were interviewed. The number of observed injuries was 53. The incidence rate as a ratio of injury and estimated time of activity has been calculated. Physical activity during leisure time was investigated by a mailed questionnaire to a random sample of 7% of the population in the same age range. Levels of physical activity during leisure time of the injured pupils were related to activity levels in the whole population. An increased risk of injury (7 times) was found in pupils with a low activity level, compared to those with a medium or high level, and the risk of injury in females with a sedentary life style was 10 times as high as in active females.

Medical treatment and costs of sports-related injuries in a total population.

A prospective study of acute injuries from sports and physical exercise was carried out during 1 year in a total population of a municipality with 31,620 inhabitants. The medical treatment and the services required for the injuries have been calculated and related to the total consumption of medical care in the municipality. A total of 571 injuries (17% of all injuries) occurred in 28 different sports: 65% of the injured were males. Sports injuries accounted for 3% of all acute visits and there were altogether 1,083 outpatient visits, which yields a mean of 1.9 visits per injury. Related to the total consumption of outpatient visits to the five clinics in the municipality sports injuries also accounted for 3%. Forty-four patients were hospitalized; the proportion of inpatient care due to sports injuries was 0.7% and the mean length of stay in hospital 3.9 days. The total amount of sick leave compensated for sports injuries (3,477 days) was 1.2% of all days compensated in 1984. The overall mean cost per injury was US$ 335. Individual sports (motorcycling, downhill skiing and equine sport) were by far the most costly in the Falköping survey, the dearest of the team sports ranking only fifth (handball followed by soccer).

Incidence rate of injuries during sport activity and physical exercise in a rural Swedish municipality: incidence rates in 17 sports.

A prospective study of acute injuries from sports and physical exercise was carried out during 1 year in a total population of a municipality with 31,620 inhabitants. Data on exposure were collected: the number of participants in each sport, the hours of participation, and number of weeks in the season per year. The number of injuries was used as numerator and the exposure data as denominator in a formula modified from Chambers for the calculation of population at risk in sports. A total of 571 injuries occurred in 28 different sports: 65% of the injured were males. The majority of the injuries were from soccer: 50% of the males and 27% of the females. Incidence rates in 17 sports are presented. The ranking order differs, when calculating not only the number, but also the exposure. Ice hockey and handball were then found to have the highest risk followed by soccer. Team and contact sports on the whole had the highest rates in both genders. As a group, intercompany players had the highest rate, especially in soccer. The lowest rates were found in individual sports such as downhill skiing, horseback riding, racket sports, and running. Gymnastics, except in school physical education, had no injuries at all. Sprains and strains were diagnosed in nearly half of the cases and the foot and ankle were the most frequent sites. Preventive measures are proposed.

[Evaluation of a school anti-smoking week]. / Evaluation einer Schul-Konzentrationswoche zum Thema "Rauchen".

Week-long anti-smoking campaigns were organised in the schools of an urban area. Telephone interviews were conducted in order to measure the extent to which the community and parents took notice of the campaign and changed their attitude toward smoking. The results show an effect on parents that was dependent on the degree of social integration of the community and the interest in anti-smoking activities prevailing before the campaign.