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Mulligan CS, Adams S, Moeller H, Whyte T, Soundappan SSV, Brown J. Comparative analysis of off-road vehicle crashes in children: motorcycles versus quad bikes. Inj Prev 2022; 28:526-532. [PMID: 35831029 DOI: 10.1136/ip-2022-044573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/10/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To characterise and compare off-road motorcycle and quad bike crashes in children in New South Wales (NSW), Australia. METHODS A retrospective, cross-sectional study was performed of children aged 0-16 years, admitted to hospitals in NSW, from 2001 to 2018 following an injury sustained in an off-road motorcycle or quad bike crash, using linked hospital admissions, mortality and census data.Motorcycle and quad bike injuries were compared regarding: demographics; incidence; body region injured and type of injury; injury severity based on the survival risk ratio; length of stay and mortality. RESULTS There were 6624 crashes resulting in hospitalisation; 5156 involving motorcycles (77.8%) and 1468 involving quad bikes (22.2%). There were 10 fatalities (6 from motorcycles and 4 from quad bikes). The rates of injury declined over the study period for motorcycles, but not for quad bikes.Motorcycle riders were more likely than quad bike riders to have lower limb injuries (OR 1.49, p<0.001) but less likely to have head/neck (OR 0.616, p<0.001), abdominal (OR 0.778, p=0.007) and thoracic (OR 0.745, p=0.003) injuries. Quad bike crashes resulted in higher injury severity (mean International Classification Injury Severity Score 0.975 vs 0.977, p=0.03) and longer hospital stay (mean 2.42 days vs 2.09 days, p=0.01). CONCLUSIONS There are significant differences between quad bike and motorcycle crashes in injury type and affected body region. While quad bike injuries in children were more severe, there were almost four times more hospitalisations from motorcycles overall. The overall larger burden of motorcycle crashes suggests a greater focus of injury prevention countermeasures for two-wheeled riders is needed.
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Affiliation(s)
| | - Susan Adams
- Paediatric Surgery, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - Holger Moeller
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Tom Whyte
- Injury Group, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | | | - Julie Brown
- Injury Group, The George Institute for Global Health, Newtown, New South Wales, Australia
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Mulligan CS, Adams S, Soundappan SSV, Albanese B, Brown J. Paediatric off-road vehicle injury in rural and regional Australia. Aust J Rural Health 2021; 29:417-428. [PMID: 34148260 DOI: 10.1111/ajr.12735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 02/11/2021] [Accepted: 02/14/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Off-road riding of quad bikes and motorcycles is common among children across rural and remote Australia, but is a significant source of injury and hospitalisation. An in-depth analysis of paediatric off-road vehicle crashes was undertaken to inform injury prevention countermeasures by characterising injury patterns and sources of injury. DESIGN This is a prospective in-depth case series. PARTICIPANTS Participants are children aged 16 and under who have been hospitalised due to injury sustained from the use of an off-road motorcycle or quad bike in New South Wales, Australia. INTERVENTIONS Crash investigation techniques (medical data, structured interview, vehicle and crash site inspection) were used to ascertain details of the crash event, protective gear, injury information and contributory factors. RESULTS Thirty children were recruited, 27 boys and 3 girls, ranging in age from 4 to 16 years, having crashed on off-road motorcycles (n = 27) or quads (n = 3). Most (73.3%) were participating in unstructured social riding. A total of 67 separate injuries were observed, with overall Injury Severity Scores between 1 and 35. There were high rates of wearing helmets and motorcycle-specific garments. The most commonly injured areas were the upper and lower extremities. The most common sources of injury were from impacting the ground, obstacles/other riders or the vehicle. CONCLUSION This study demonstrates the patterns of riding and injury in rural paediatric off-road vehicle riders, occurring despite high rates of helmet/protective gear use. This underscores the need for investigation into the injury mitigation and fit properties of protective gear and the inherent risks for physically and developmentally maturing children.
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Affiliation(s)
| | - Susan Adams
- Department of Paediatric Surgery, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Soundappan S V Soundappan
- Douglas Cohen Department of Paediatric Surgery, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Bianca Albanese
- The George Institute for Global Health, Newtown, NSW, Australia
| | - Julie Brown
- The George Institute for Global Health, Newtown, NSW, Australia
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Weichelt B, Gorucu S, Jennissen C, Denning G, Oesch S. Assessing the Emergent Public Health Concern of All-Terrain Vehicle Injuries in Rural and Agricultural Environments: Initial Review of Available National Datasets in the United States. JMIR Public Health Surveill 2020; 6:e15477. [PMID: 32469319 PMCID: PMC7293057 DOI: 10.2196/15477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 01/17/2020] [Accepted: 02/15/2020] [Indexed: 02/03/2023] Open
Abstract
Background Injuries related to the operation of off-road vehicles (ORVs), including all-terrain vehicles (ATVs), continue to be a significant public health concern, especially in rural and agricultural environments. In the United States alone, ATVs have played a role in thousands of fatalities and millions of injuries in the recent decades. However, no known centralized federal surveillance system consistently captures these data. Traditional injury data sources include surveys, police reports, trauma registries, emergency department data, newspaper and online media reports, and state and federal agency databases. Objective The objectives of this study paper were to (1) identify published articles on ORV-related injuries and deaths that used large databases and determine the types of datasets that were used, (2) examine and describe several national US-based surveillance systems that capture ORV-related injuries and fatalities, and (3) promote and provide support for the establishment of a federally-funded agricultural injury surveillance system. Methods In this study, we examined several national United States–based injury datasets, including the web-based AgInjuryNews, the Fatality Analysis Reporting System, databases compiled by the US Consumer Product Safety Commission, and the National Fatality Review Case Reporting System. Results Our review found that these data sources cannot provide a complete picture of the incidents or the circumstantial details needed to effectively inform ORV injury prevention efforts. This is particularly true with regard to ORV-related injuries in agricultural production. Conclusions We encourage the establishment of a federally funded national agricultural injury surveillance system. However, in lieu of this, use of multiple data sources will be necessary to provide a more complete picture of ORV- and other agriculture-related injuries and fatalities.
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Affiliation(s)
- Bryan Weichelt
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI, United States
| | - Serap Gorucu
- Department of Agricultural and Biological Engineering, Penn State University, University Park, PA, United States
| | - Charles Jennissen
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Gerene Denning
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, United States
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Ramgopal S, Cramer N, Gaines BA, Conti KA. Risk Factors and Outcomes From All-Terrain Vehicle Injuries Compared With Motor Vehicle Collisions in Children. Clin Pediatr (Phila) 2019; 58:1255-1261. [PMID: 31189332 DOI: 10.1177/0009922819855808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We compared risk factors and outcomes of children injured from all-terrain vehicle (ATV) injuries to those injured from motor vehicle collisions (MVC). We reviewed records of patients ≤18 years of age admitted to a trauma center with ATV- or MVC-related injuries between January 1, 2000, and December 31, 2015. Demographics were compared using logistic regression. Rates of injuries were compared using χ2 tests. Of 6293 patients, 1140 (18%) ATV and 5153 (82%) MVC events were identified. In multivariable analysis (adjusted odds ratio [aOR], 95% confidence interval [CI]), patients with ATV-related injuries occurred more at older age (≥12 years; aOR = 4.29, 95% CI = 3.20-5.77), in rural counties (aOR = 3.72, 95% CI = 2.62-5.28), in regions with lower median household income (aOR = 1.37, 95% CI = 1.03-1.83), and in the spring (aOR = 2.44, 95% CI = 1.87-3.18), and summer (aOR = 2.50, 95% CI = 1.93-3.25) compared with winter. ATV-related injuries occurred less frequently among females (aOR = 0.76, 95% CI = 0.65-0.89). Upper extremity injuries were associated with ATV-related injuries (P ≤ .001). Findings may facilitate identification of at-risk groups for targeted interventions.
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Affiliation(s)
- Sriram Ramgopal
- University of Pittsburgh, Pittsburgh, PA, USA.,Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Natan Cramer
- University of Pittsburgh, Pittsburgh, PA, USA.,Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Barbara A Gaines
- University of Pittsburgh, Pittsburgh, PA, USA.,Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Kavitha A Conti
- University of Pittsburgh, Pittsburgh, PA, USA.,Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
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Epidemiology of Finger Amputations in the United States From 1997 to 2016. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2019. [DOI: 10.1016/j.jhsg.2019.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Aizpuru M, Farley KX, Rojas JC, Crawford RS, Moore TJ, Wagner ER. Motorized scooter injuries in the era of scooter-shares: A review of the national electronic surveillance system. Am J Emerg Med 2019; 37:1133-1138. [PMID: 30952603 DOI: 10.1016/j.ajem.2019.03.049] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 03/25/2019] [Accepted: 03/28/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION There has been a spike in recent news regarding motorized scooter injuries due to the expansion of scooter sharing companies. Given the paucity of literature on this topic, the purpose of our study was to describe and quantify emergency department encounters associated with motorized scooter related injuries. METHODS The National Electronic Injury Surveillance System (NEISS) was queried for motorized scooter related injuries from 2013 to 2017. Patient demographics, diagnosis, injury location, narrative description of incident, and disposition data were collected from emergency department encounters. RESULTS There were an estimated 32,400 motorized scooter injuries from 2013 to 2017. The estimated incidence did not change significantly over time with 1.9 cases per 100,000 in 2013 and 2.6 cases per 100,000 in 2017. A 77.0% increase in scooter injuries was noted for millennials from 2016 to 2017. Head injuries were the most common body area injured (27.6%). Fractures or dislocations (25.9%) were the most common diagnosis. The most common site of fracture was the wrist and lower arm (35.4%). There were no deaths. Major orthopaedic injury and concussion were the strongest independent predictors of hospital admission. CONCLUSIONS Head injuries were the most commonly injured body part, while fractures or dislocations were the most common diagnosis. These results highlight the importance of using protective equipment while riding motorized scooters, and lay a foundation for future policies requiring helmet use.
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Affiliation(s)
- Matthew Aizpuru
- Emory University School of Medicine, Atlanta, GA, United States of America
| | - Kevin X Farley
- Emory University School of Medicine, Department of Orthopaedics, Atlanta, GA, United States of America
| | - Jaimie C Rojas
- New York Medical College, Valhalla, NY, United States of America
| | - Robert S Crawford
- Emory University School of Medicine, Department of Surgery, Vascular Division, Atlanta, GA, United States of America
| | - Thomas J Moore
- Emory University School of Medicine, Department of Orthopaedics, Atlanta, GA, United States of America
| | - Eric R Wagner
- Emory University School of Medicine, Department of Orthopaedics, Atlanta, GA, United States of America.
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