[Injuries in France: trends and risk factors]

A web-based prospective cohort study of home, leisure, school and sports injuries in France: a descriptive analysis

Background

Home and leisure injuries (HLIs) are a major public health problem. Cohort studies among general population are needed for targeted preventive actions but remain scarce. We quantify and qualify the HLIs collected prospectively in the MAVIE (Mutualists against Home and Leisure Injuries) observatory, a web-based cohort among volunteers of the French general population.

Methods

Participants reported HLIs from November 2014 to December 2019. We calculated crude and standardized incidence rates (SIRs) on the entire cohort, for each of the selected socio-demographic variables and each of the injury circumstances (place and activity), mechanisms, and injury severity levels. We also described other HLIs characteristics and consequences.

Results

Out of the 29,931 household members enrolled in the cohort, 12,419 participants completed the questionnaires. Among them, 8640 participants provided follow-up data, leading to a follow-up of 6302 persons for 5.2 years and 2483 HLIs were reported. We obtained a SIR of 85.0 HLIs per 1000 persons-years. Most reported injuries did not require emergency department attendance or hospitalization (64%). SIRs were higher in children (< 15 years of age) (109.1 HLIs per 1000 persons-years; 95% CI, 78.2–140.1) and adults aged 70 years and older (123.7 HLIs per 1000 persons-years; 95% CI, 79.2–168.3). Struck or hit by fall was the most frequent injury mechanism (52%) and also among the most severe injuries (73% of Struck or hit by fall HLIs ending with hospitalization). Sport (without contact with nature), and leisure and play activities were the injury circumstances with higher SIRs, 15.2 HLIs per 1000 persons-years (95% CI, 14.6–15.8) and 11.2 HLIs per 1000 persons-years (95% CI, 10.7–11.6), respectively. Outdoor sport activity (in contact with nature) was the circumstance with the highest proportion of hospitalizations (18% of outdoor sports HLIs ending with hospitalization).

Conclusion

The incidences, causes, and consequences of HLI differ by age group and are mainly related to the performance of certain activities. Although the participants in the MAVIE cohort were not representative of the French population. Our study identified potential sub-populations and specific types of HLIs that should be targeted by future studies concerning risk factors and prevention programs.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40621-021-00343-9.

Impact of using immersive virtual reality over time and steps in the Timed Up and Go test in elderly people

Today, falls constitute a substantial health problem, especially in the elderly, and the diagnostic tests used by clinicians present often a low sensitivity and specificity. This is the case for the Timed Up and Go test which lacks contextualization with regard to everyday life limiting the relevance of its diagnosis. Virtual reality enables the creation of immersive, reproducible and secure environments, close to situations encountered in daily life, and as such could improve falling risk assessment. This study aims to evaluate the effect of immersive virtual reality by wearing a virtual reality headset with a non-disturbing virtual environment compared to real world on the Timed Up and Go test completion. Thirty-one elders (73.7 ± 9 years old) volunteered to participate in the study and the mean times and number of steps to complete a Timed Up and Go were compared in two conditions: actual-world clinical and virtual reality conditions. The results showed that the mean completion times and most of the mean number of steps of the Timed Up and Go in virtual reality condition were significantly different to those in clinical condition. These results suggest that there is a virtual reality effect and this effect is significantly correlated to the time taken to complete the Timed Up and Go. This information will be of interest to quantify the potential part of virtual reality effect on the motor control, measured in a virtual task using virtual controlled disturbances.

Occupational and non-occupational factors associated with work-related injuries among construction workers in the USA

BACKGROUND

Many factors contribute to occupational injuries. However, these factors have been compartmentalized and isolated in most studies.

OBJECTIVE

To examine the relationship between work-related injuries and multiple occupational and non-occupational factors among construction workers in the USA.

METHODS

Data from the 1988-2000 National Longitudinal Survey of Youth, 1979 cohort (N = 12,686) were analyzed. Job exposures and health behaviors were examined and used as independent variables in four multivariate logistic regression models to identify associations with occupational injuries.

RESULTS

After controlling for demographic variables, occupational injuries were 18% (95% CI: 1.04-1.34) more likely in construction than in non-construction. Blue-collar occupations, job physical efforts, multiple jobs, and long working hours accounted for the escalated risk in construction. Smoking, obesity/overweight, and cocaine use significantly increased the risk of work-related injury when demographics and occupational factors were held constant.

CONCLUSIONS

Workplace injuries are better explained by simultaneously examining occupational and non-occupational characteristics.

[Facilitators and barriers for older people to take part in fall prevention programs: A review of literature]

BACKGROUND

Falling is the leading cause of accidental death after 65. Fall prevention programs are effective, but they involve few seniors. This article reviewed the literature on facilitators and barriers to participate in such programs.

METHODS

A literature review was conducted to identify documents in English, German and French published between 1990 and May 2012. Medline database, PsychInfo, Psychological and behavioral sciences and Francis were systematically searched, as were the bibliographies and some journals of public health, gerontology and social sciences. Of 462 documents found, 19 were selected and analyzed.

RESULTS

Of the 19 articles selected, 12 were on qualitative studies and 7 on literature reviews. Among the barriers to participation in falls prevention programs, documents highlighted the perception of fall as an inevitable event, the inadequate timing of prevention intervention and material difficulties. Conversely, being referred to prevention intervention by a professional, being convinced by the social benefits of interventions and the adequacy of interventions to the needs of beneficiaries were factors facilitating the participation and compliance of the elderly.

CONCLUSION

This literature review identified three major issues to consider when implementing sustainable and acceptable fall prevention programs: choice of the referring agent, and social representations of falling.

[Alcohol use in France]

Alcohol consumption has regularly decreased in France since the 1950s, essentially in connection with the decrease of wine consumption, with disaffection for the "table wine", for the benefit of better quality wines that are drunk in lesser quantity. France is still part of the most alcohol drinking countries in the European Union but is no longer situated at the very top of the ranking. General population surveys results tend to confirm the evolution of sale of alcohol: since 1992, among 15-75 years old, alcohol daily users proportion was divided by two, from 24% in 1992 to 11% in 2010, currently replaced by a more occasional use. We indeed observe in the general population a profile of young adults having a strong and punctual consumption, and an older profile of less important but regular consumption. The proportion of problematic alcohol users remains stable, concerning approximately a person on 10 in the adult population. The part of persons who declared they have drunk six glasses or more during the same occasion at least once a month during the last twelve months increased from 15% in 2005 to 18% in 2010. Binge drinking and the frequency of drunkenness have increased among teenagers and young adults these last years. These behaviors can lead to short term risks, such as accidents, undergone violence, unwanted or unprotected sexual intercourse, even coma, whereas chronic alcohol use can lead to numerous hepatic, cardiovascular and neuropsychiatric complications, as well as cancers. With such sanitary consequences, alcohol is a major risk factor of avoidable morbidity and premature mortality. The beneficial effect that seems to have a moderate consumption of alcohol on the risk of death by cardiovascular diseases has brought about recurring scientific controversies. However, its major noxious effects in terms of non-transmitted diseases should remain the major point in public health decisions on alcoholization.

Estimates of home and leisure injuries treated in emergency departments in the adult population living in metropolitan France: a model-assisted approach

BACKGROUND

Home and leisure injuries (HLIs) are currently a major public health concern, because of their frequency, associated consequences, and considerable medical costs. As in many other countries in Europe, in France the population coverage of the surveillance system of HLIs is low. In this study, a model-assisted approach is developed to estimate the incidence rates of HLIs in adults treated in emergency departments (EDs) in metropolitan France between 2004 and 2008.

METHODS

Using a sample of the hospitals participating in the French ED-based surveillance system, a generalized linear mixed model was applied, which describes the relationship between the numbers of ED visits for HLIs and the sex and age of the patients on the basis of the number of injury-related stays recorded by the hospitals. Statistics on hospital stays were provided by the French hospital discharge databases in the participating hospitals. The same statistics were available at the national level, which made it possible to extrapolate national incidence estimates.

RESULTS

Over the 2004-2008 period, the estimated incidence rate of HLIs age-standardized on the European population aged 15 years and over was 48.7 per 1,000 person-years (95% confidence interval: 39.4-58.0), and displayed little variability over time. This rate corresponded to an average of 2.5 million emergency hospital visits each year due to an HLI in people aged over 15 in France.

CONCLUSIONS

The method made it possible to use medico-administrative datasets available nationwide to provide informative estimates despite the small number of participating EDs. The consequences and costs generated by hospital emergency visits can sometimes be onerous, and these estimated rates confirm the scale of the problem and the need to continue investing in preventive actions.