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Hazel SJ, Iankov I. A public health campaign to increase awareness of the risk of dog bites in South Australia. Prev Vet Med 2024; 231:106298. [PMID: 39116764 DOI: 10.1016/j.prevetmed.2024.106298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 07/23/2024] [Accepted: 07/28/2024] [Indexed: 08/10/2024]
Abstract
Dog bites are a serious public health problem. A campaign by the Dog and Cat Management Board of South Australia was launched to increase awareness that any dog can bite as a first step in reducing the incidence of dog bites. The aims of this study were to 1) evaluate changes in attitudes to dog bites following the media campaign, and 2) provide baseline data on dog bites and attitudes to interactions with dogs to help target future campaigns. The media campaign 'Good Dogs Have Bad Days' was run from July to October, 2023, using TV, radio, billboards and social media. A cross-sectional survey was conducted pre- and post-campaign, including demographics and questions relating to interactions and attitudes to dogs. A total of n = 402 to the pre- and n = 404 responses to the post-campaign surveys were received, with most having owned a dog, living in metropolitan areas, and an equal split of males and females. Over one third (36-37 %) of dog owners and 25-29 % of non-dog owners had been previously bitten by a dog, although most did not require medical attention. Respondents were more likely to agree that any dog can bite if they recalled seeing the campaign, and less likely if they were male and had poor knowledge of the scenarios in which a dog might bite. Older respondents and those from lower socioeconomic areas believed dog bites were a more serious community issue than younger respondents from higher socioeconomic areas. Approximately 70 % of dog owners believed it was safe for strangers to approach their dog, 34-37 % allowed children or other people to pat their dog without permission and less than half separated their dog from visitors or delivery people. In contrast few of the non-dog owners allowed their children to pat a dog without the owner's permission and only 2 % allowed them to play with dogs without supervision. The results demonstrate a relatively short campaign was associated with increased agreement any dog can bite. The proportion of respondents who had been bitten by a dog affirms the importance of public health campaigns targeting dog attacks. Some behaviours, such as supervising dogs around children and keeping dogs separate from delivery people, had relatively low agreement from dog owners and may be targeted in future campaigns. Public awareness campaigns and ongoing education will help to increase safer interactions with dogs, but it will take time and commitment to achieve a result.
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Affiliation(s)
- Susan J Hazel
- School of Animal & Veterinary Sciences, Faculty of Science, Engineering and Technology, University of Adelaide, South Australia, Australia.
| | - Ivan Iankov
- Dog and Cat Management Board of South Australia, Level 9, 81-95 Waymouth Street, Adelaide, SA 5000, Australia.
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2
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Finn E. Role of prophylactic antibiotics in treating patients presenting to emergency care with dog bites. Emerg Nurse 2024:e2208. [PMID: 39206503 DOI: 10.7748/en.2024.e2208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2024] [Indexed: 09/04/2024]
Abstract
Dog bites account for 250,000 attendances for urgent and emergency care each year. They pose risks including infections with potentially life-threatening complications. This article scrutinises the evidence underpinning the use of prophylactic antibiotics in dog bite wounds. A focused literature review involving four databases specialising in peer-reviewed healthcare literature was conducted to identify the highest quality evidence, which was then systematically appraised. The use of antibiotics in treating dog bite wounds to reduce the risk of infection is largely supported by the evidence. However, significant limitations exist in the research, with patient-specific criteria for administering prophylactic antibiotics and the associated risks and financial costs not addressed. Further research into antibiotic treatment for dog bites would help to support clinicians, nurse practitioners and the wider nursing and allied health professional team in urgent and emergency care by informing safe practice and in turn improving patient care, cost-effectiveness and antimicrobial stewardship.
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Affiliation(s)
- Emma Finn
- emergency department, St George's Hospital, Tooting, London, England
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3
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Meek E, Lewis K, Hulbert J, Mustafa S. Who let the dogs out? A 10-year review of maxillofacial dog bite injuries. Br J Oral Maxillofac Surg 2024:S0266-4356(24)00207-9. [PMID: 39214815 DOI: 10.1016/j.bjoms.2024.07.012] [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: 05/29/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024]
Abstract
Dog bites are common within the United Kingdom, with their incidence increasing over recent years. Bites to the head and neck region can have substantial and multifactorial implications for victims, and can provide a challenge to maxillofacial departments. This study is a 10-year retrospective review of head and neck dog bites that required input from the maxillofacial team within the Cwm Taf Morgannwg University Health Board. Data collected included demographics of the patients involved, relationship with and breed of dog, nature of the injury, treatment received, and nature of any complications. In total, 168 records matched our inclusion criteria. The median age of our cohort was 12 years, with 57.1% of patients being younger than 15. Of the patients, 52.4% were female. Eighty-three per cent of cases involved a known dog, with Jack Russells being the breed most commonly involved. The upper lip was the most commonly affected area (30.3%), followed by the cheek (24.5%). Twenty-eight per cent of patients were admitted for management in theatre, with 8% of the total patients experiencing a complication. In conclusion, head and neck dog bites most commonly affect children and the upper lip.
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Affiliation(s)
- E Meek
- Oral and Maxillofacial department, Morriston Hospital, Heol Maes Eglwys, Treforys, Cwmrhydyceirw, Swansea SA6 6NL, United Kingdom.
| | - K Lewis
- Oral and Maxillofacial department, Prince Charles Hospital, Gurnos Rd, Merthyr Tydfil, CF47 9DT, United Kingdom
| | - J Hulbert
- Oral and Maxillofacial department, Prince Charles Hospital, Gurnos Rd, Merthyr Tydfil, CF47 9DT, United Kingdom
| | - S Mustafa
- Oral and Maxillofacial department, Prince Charles Hospital, Gurnos Rd, Merthyr Tydfil, CF47 9DT, United Kingdom
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Owczarczak-Garstecka SC, Oxley JA, Tulloch JSP. Welsh hospital admissions due to dog bites and strikes (2014-2022). Public Health 2024; 233:83-89. [PMID: 38861778 DOI: 10.1016/j.puhe.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 06/13/2024]
Abstract
OBJECTIVE To describe the incidence and victim demographics of Welsh hospital admissions due to dog bites and strikes from 2014 to 2022. STUDY DESIGN Descriptive analysis of Welsh hospital admissions data. METHODS Residents of Wales admitted to a Welsh National Health Service (NHS) hospital for a dog bite or strike, were identified using ICD-10 codes. The annual incidence of dog bite and strike admissions between 2014 and 2022 was calculated and stratified by child-adult status, sex, and Local Health Boards. Trends over time were analysed using the Chi-square test for trends. RESULTS Hospital admissions due to dog bites and strikes have significantly increased from 16.3 per 100,000 to 23.7 per 100,000 population in 2022. This was driven by an increase in non-geriatric adults and an increase in three Local Health Boards. The Swansea Bay area has the highest incidence in Wales (56.1 admissions per 100,000). CONCLUSIONS Wales has a higher incidence of dog bites and strikes than England or the Republic of Ireland. Work in the communities where incidence is exceptionally high is needed to understand the reasons behind having the highest incidence of dog bites in the British Isles and to establish the most efficacious methods for bite prevention.
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Affiliation(s)
| | - J A Oxley
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, CH64 7TE, UK
| | - J S P Tulloch
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, CH64 7TE, UK.
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5
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Westgarth C, Provazza S, Nicholas J, Gray V. Review of psychological effects of dog bites in children. BMJ Paediatr Open 2024; 8:e000922. [PMID: 38844383 PMCID: PMC11163822 DOI: 10.1136/bmjpo-2020-000922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 05/20/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Dog bites are a concerning health problem in children and one of the leading causes of non-fatal injuries in this population. Dog attacks not only cause physical injuries but can also lead to long-term psychological problems. A review was performed to investigate the scope of literature on the psychological effects of dog bites on a paediatric population. METHODS A literature search was performed on Web of Knowledge database between 1982 to June 2023, returning 249 results. 14 primary studies reporting the psychological consequences of dog bites in children or adolescents were classed as eligible and 9 further studies were added from prior knowledge and bibliographical searches. 23 studies involving 1894 participants met the criteria and were included in this review. RESULTS Of these 23 studies, 8 were case studies or small case series reports (up to n=4), 14 larger descriptive studies and 1 analytical cross-sectional study. There was a mixture of retrospective and prospective data-gathering. The most common psychological consequences of dog bites in children were post-traumatic stress disorder, dog phobia, nightmares and symptoms of anxiety and avoidance behaviours. CONCLUSIONS Studies on dog bites in a paediatric population with a specific focus on the psychological consequences associated with dog bites and their management are sparse. Future research and practice should more greatly consider the psychological impact on child victims of dog bites and their family members, as well as their management to avoid the development of mental health issues and improve their quality of life. Future research also needs to ascertain the efficacy of using virtual reality in treating children with dog phobia.
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Affiliation(s)
- Carri Westgarth
- Department of Livestock and One Health, Faculty of Health and Life Sciences, University of Liverpool, Neston, Cheshire, UK
| | - Serena Provazza
- Department of Clinical Health Psychology, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
| | | | - Victoria Gray
- Department of Clinical Health Psychology, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
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Haq II, Manku B, Mahon A, Langley C, Samson D. Ambulatory Management of Bite Injuries to the Hand: A Safe and Cost-Effective Option. Cureus 2024; 16:e62399. [PMID: 39006662 PMCID: PMC11246729 DOI: 10.7759/cureus.62399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2024] [Indexed: 07/16/2024] Open
Abstract
Introduction Animal or human hand bites are a common presentation to the emergency department. If hand bites are not treated adequately, they can give rise to significant local and systemic complications, potentially leading to functional deficits that impact patients' lives. Traditionally, hand bites require hospital admission for the administration of intravenous antibiotics and, in some cases, surgical intervention. A combination of the increasing incidence, hospital admission rates, and in-patient bed pressures prompted a change in our bite management protocol and a move toward ambulatory management of bite injuries. We found this new protocol to be safe, efficient, and cost-effective with a scope for wider implementation. Aim The primary outcome is to assess the feasibility of safely managing hand bites on an outpatient basis, by reviewing the local data before and after the change in practice. The secondary outcome is to compare the financial implications of treating hand bites with an outpatient approach. Material and methods All first-presentation adult consultations referred to Trauma and Orthopaedics from the emergency department over a three-month snapshot period were reviewed in 2017. This was repeated after the implementation of the updated handbite guidelines in 2023. Initial admission documentation as well as operation notes and clinic follow-up letters were each reviewed retrospectively. Results In 2017, 36 patients were identified over three months. The average time to surgery was 1.19 days with an average inpatient stay of 2.36 days. There were two re-operations and follow-up of two cases of osteomyelitis. In 2023, 63 patients were identified over three months. The average time to surgery was 1.03 days with an average inpatient stay of 0.56 days. Thirty-seven surgeries were performed for 33 patients with 32% (20/63) of patients admitted directly from the emergency department. There were no documented cases of osteomyelitis on follow-up. The cost per patient episode decreased by 40% from 2017 to 2023, without accounting for inflation. Conclusions With the implementation of the new departmental guidelines, there has been a reduced average inpatient stay and reduced time to surgery without an increase in documented osteomyelitis. There is also a significant decrease in the average patient cost. This data suggests that without compromising patient safety it is possible to cost-effectively manage hand bites without the need for long inpatient stays. However, it is imperative that there is close patient follow-up as well as prompt time to surgery to ensure patient safety. Our findings suggest a need for further research to strengthen the evidence supporting our conclusions.
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Affiliation(s)
- Ibrahim I Haq
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR
| | - Bhagat Manku
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR
| | - Andrew Mahon
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR
| | - Clare Langley
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR
| | - Deepak Samson
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR
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Oxley JA, Meyer G, Butcher M, Bellantuono G, Levers A, Westgarth C. Veterinary students' proximity to and interpretation of a simulated "aggressive" dog before and after training. Sci Rep 2024; 14:3209. [PMID: 38332166 PMCID: PMC10853229 DOI: 10.1038/s41598-024-53551-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 02/01/2024] [Indexed: 02/10/2024] Open
Abstract
Dog "aggression" in the veterinary practice is commonplace. Therefore, student knowledge and education about dog behaviour and the ability to interpret "aggressive" behaviour is important from a human injury prevention and dog welfare perspective. The study aimed to compare first-year veterinary students' perceived safest proximity to both an "aggressive" and non-reactive simulated dog, both before and after a teaching intervention about canine behaviour and a handling practical. It also examined student confidence and their ability to identify "aggressive" behaviours. Forty first year veterinary students took part in two surveys. Each survey included two videos: one of a simulated dog displaying "aggressive" behaviour, based on the 'Canine Ladder of Aggression'; and another displaying non-reactive (passive behaviours without reaction to the participants) behaviours. Each video depicted the slow and consistent approach towards the virtual dog within a virtual indoor environment, and participants were asked to press stop if or when they would stop approaching the dog. In the "aggressive" scenario, there was a reduction in the approach-stop time from survey 1 (median = 17.8 s) to survey 2 (median = 15.2 s) in the intervention group (p = 0.018) but not in the control group (p = 0.147). Regarding confidence, there was a significant increase in the self-reported confidence rating relating to a participant's ability to interpret canine behaviour in both the control (p = 0.011) and intervention (p = 0.003). In conclusion, these results indicate that students using approach-stop videos stayed further away from an "aggressive" virtual dog model if they had undertaken a canine behaviour educational intervention. This novel approach has the potential for further use in teaching and assessment of student knowledge and behaviour which may otherwise be difficult to demonstrate.
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Affiliation(s)
- James A Oxley
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, Cheshire, UK
| | - Georg Meyer
- Institute of Digital Engineering and Autonomous Systems, University of Liverpool, Liverpool, UK
| | - Matthew Butcher
- Institute of Digital Engineering and Autonomous Systems, University of Liverpool, Liverpool, UK
| | - Giuseppe Bellantuono
- Institute of Digital Engineering and Autonomous Systems, University of Liverpool, Liverpool, UK
| | - Andrew Levers
- Institute of Digital Engineering and Autonomous Systems, University of Liverpool, Liverpool, UK
| | - Carri Westgarth
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, Cheshire, UK.
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Malkani R, Paramasivam S, Wolfensohn S. A Multidimensional Evaluation of the Factors in the Animal Welfare Assessment Grid (AWAG) That Are Associated with, and Predictive of, Behaviour Disorders in Dogs. Animals (Basel) 2024; 14:528. [PMID: 38396496 PMCID: PMC10886356 DOI: 10.3390/ani14040528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
Behavioural disorders in dogs are common and have severe welfare consequences for dogs. This study aimed to assess the factors that are significant and predictive of behaviour problems in dogs using the animal welfare assessment grid (AWAG) to further understand what factors influence their welfare. 177 AWAG assessments were undertaken across 129 dogs that clinicians deemed to have a behavioural disorder. Wilcoxon rank-sum tests were used to assess the difference in scores between dogs with behaviour disorders and a cohort of healthy dogs (n = 117). This analysis showed that all physical factors besides body condition, all procedural factors besides procedure pain, and all psychological, and environmental factors were significantly different between healthy dogs and dogs with behaviour disorders. Spearman rank correlation coefficient (RS) revealed several significant strong positive correlations including the procedural impact on the dog's daily routine with aggression towards unfamiliar people and procedure pain, as well as other correlations between the dog's behaviour during assessment with the frequency at which they encounter fears and anxieties, clinical assessment and procedure pain, and reaction to stressors and social interactions. These findings highlight the interdependent nature of the various influences of welfare. Logistic regression analysis identified that aggression towards the caregiver, fears and anxieties frequency, and choice, control, and predictability were all significant predictors of behaviour disorders. The findings have important implications for veterinary, behaviour, and animal welfare professionals as any changes across these factors may indicate poor welfare linked to emotional disorders in dogs.
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Affiliation(s)
- Rachel Malkani
- School of Veterinary Medicine, University of Surrey, Guildford GU2 7AL, UK; (S.P.); (S.W.)
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9
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Tulloch JSP, Fleming KM, Pinchbeck G, Forster J, Lowe W, Westgarth C. Audit of animal-related injuries at UK veterinary schools between 2009 and 2018. Vet Rec 2023; 193:e3171. [PMID: 37310022 DOI: 10.1002/vetr.3171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/02/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Animal-related injuries pose a significant risk to the veterinary profession. This study aimed to describe the incidence, demographics, context and consequences of animal-related injuries at UK veterinary schools. METHODS A multicentre audit of accident records (2009-2018) across five UK veterinary schools was performed. Injury rates were stratified by school, demographics and species. The context and cause of the injury were described. Multivariable logistic models explored factors associated with medical treatment, hospital visits and time off work. RESULTS An annual rate of 2.60 (95% confidence interval 2.48-2.72) injuries per 100 graduating students was calculated, varying between veterinary schools. Injuries were more frequently recorded in staff than students, and there were significant differences between staff and students in the activities performed preceding injury. Cats and dogs were associated with the highest number of reported injuries. However, injuries associated with cattle and horses were the most severe, with significantly higher hospital attendances and more time off work taken. LIMITATIONS Data were based on reported injuries and likely underestimate the true injury rate. The population at risk was hard to quantify as population size and exposure were variable. CONCLUSION Further research is recommended to explore the clinical and workplace management, including recording culture, of animal-related injuries among veterinary professionals.
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Affiliation(s)
- John S P Tulloch
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Kate M Fleming
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Gina Pinchbeck
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | | | - Walter Lowe
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, UK
| | - Carri Westgarth
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
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Baslington-Davies A, Howell H, Hogue TE, Mills DS. An Assessment of Scientific Evidence Relating to the Effect of Early Experience on the Risk of Human-Directed Aggression by Adult Dogs. Animals (Basel) 2023; 13:2329. [PMID: 37508106 PMCID: PMC10376210 DOI: 10.3390/ani13142329] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/06/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Human-directed aggression by domestic dogs is a major worldwide public health problem. The causes of aggression are complex, and research in this area often has to balance ecological validity with pragmatic controls; accordingly, it often does not meet the thresholds for quality typically used in reviews applying a classical "evidence-based" approach. Here, we propose a method of literature assessment that makes the "best use" of available evidence to identify and synthesise evidence relating to the most likely risk factors reported in the scientific literature. We used a systematic review process to initially identify relevant literature relating to potential early life experience (i.e., in the first six months of life) risk factors in the dog for human-directed aggression in the adult animal. Fourteen papers met our initial screening process and were subsequently analysed in detail, with data extracted and effect sizes calculated where possible. This highlighted the potential importance of the source of the animal, the age at which it was rehomed, the reason for the acquisition, the experience level of the owner, the animal's socialisation experiences, the consistent husbandry and management practices, the training, the sex ratio of the litter and the history of dogs that display aggression in the pedigree as risk factors. Taken together, it seems that early experiences which limit the ability to develop effective coping strategies and routines may be particularly important. We provide guidance for the future standardised reporting of risk related to human-directed aggression by dogs to allow greater synthesis of the literature in the future.
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Affiliation(s)
| | - Helen Howell
- School of Psychology, University of Lincoln, Lincoln LN6 7TS, UK
| | - Todd E Hogue
- School of Psychology, University of Lincoln, Lincoln LN6 7TS, UK
| | - Daniel S Mills
- Department of Life Sciences, University of Lincoln, Lincoln LN6 7DL, UK
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Sawhney S, Kwaskowski T, Promod P, Mumtaz S. RE: Pediatric Dog Bites to the Face May Have Been Less Severe During COVID 19 Pandemic: A Retrospective Cohort Study. J Oral Maxillofac Surg 2023; 81:660. [PMID: 37270282 DOI: 10.1016/j.joms.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/15/2023] [Accepted: 01/15/2023] [Indexed: 06/05/2023]
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12
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Waters A. Rising fatalities, injuries, and NHS costs: dog bites as a public health problem. BMJ 2023; 381:879. [PMID: 37105591 DOI: 10.1136/bmj.p879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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13
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Caneschi A, Bardhi A, Barbarossa A, Zaghini A. The Use of Antibiotics and Antimicrobial Resistance in Veterinary Medicine, a Complex Phenomenon: A Narrative Review. Antibiotics (Basel) 2023; 12:antibiotics12030487. [PMID: 36978354 PMCID: PMC10044628 DOI: 10.3390/antibiotics12030487] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
As warned by Sir Alexander Fleming in his Nobel Prize address: “the use of antimicrobials can, and will, lead to resistance”. Antimicrobial resistance (AMR) has recently increased due to the overuse and misuse of antibiotics, and their use in animals (food-producing and companion) has also resulted in the selection and transmission of resistant bacteria. The epidemiology of resistance is complex, and factors other than the overall quantity of antibiotics consumed may influence it. Nowadays, AMR has a serious impact on society, both economically and in terms of healthcare. This narrative review aimed to provide a scenario of the state of the AMR phenomenon in veterinary medicine related to the use of antibiotics in different animal species; the impact that it can have on animals, as well as humans and the environment, was considered. Providing some particular instances, the authors tried to explain the vastness of the phenomenon of AMR in veterinary medicine due to many and diverse aspects that cannot always be controlled. The veterinarian is the main reference point here and has a high responsibility towards the human–animal–environment triad. Sharing such a burden with human medicine and cooperating together for the same purpose (fighting and containing AMR) represents an effective example of the application of the One Health approach.
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Affiliation(s)
| | - Anisa Bardhi
- Correspondence: (A.B.); (A.B.); Tel.: +39-051-2097-500 (Andrea Barbarossa)
| | - Andrea Barbarossa
- Correspondence: (A.B.); (A.B.); Tel.: +39-051-2097-500 (Andrea Barbarossa)
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14
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Colmers-Gray IN, Tulloch JS, Dostaler G, Bai AD. Management of mammalian bites. BMJ 2023; 380:e071921. [PMID: 36731914 DOI: 10.1136/bmj-2022-071921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
| | - John Sp Tulloch
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Geneviève Dostaler
- Department of Plastic Surgery, Hand and Upper Limb Clinic, University of Western Ontario, London, Ontario, Canada
| | - Anthony D Bai
- Division of Infectious Diseases, Department of Medicine, Queen's University, Kingston, Ontario, Canada
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15
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Tulloch JSP, Oxley JA, Christley RM, Westgarth C. Dog-related deaths registered in England and Wales from 2001 to 2021. Public Health 2023; 215:91-93. [PMID: 36652787 DOI: 10.1016/j.puhe.2022.12.005] [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: 10/26/2022] [Revised: 12/05/2022] [Accepted: 12/11/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE This study aimed to describe the incidence and demographics of fatal dog bites or strikes, as defined in English and Welsh mortality data (2001-2021). STUDY DESIGN A descriptive analysis of the Office for National Statistics registered deaths data set. METHODS Individuals whose cause of death was defined as 'bitten or struck by a dog' were identified. The average annual number of dog-related deaths and trends in incidence were calculated. Age and sex demographics of victims were described. RESULTS In total, there were 69 registered deaths, a mean of 3.3 (95% confidence interval 0.3-6.3) dog-related deaths per year, and a mean annual incidence of 0.59 (95% confidence interval 0.06-1.11) deaths per 10 million population. There was no year-on-year change in incidence. Of victims, 59% were male, 10% were <5 years, and 30% were ≥75 years. CONCLUSIONS Dog-related deaths are rare in England and Wales and have not increased between 2001 and 2021. Further contextual information about the incidents is needed to be able to develop public health strategies and interventions.
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Affiliation(s)
- J S P Tulloch
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences (IVES), The University of Liverpool, CH64 7TE, UK.
| | - J A Oxley
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences (IVES), The University of Liverpool, CH64 7TE, UK; PDSA, Telford, UK
| | - R M Christley
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences (IVES), The University of Liverpool, CH64 7TE, UK; Dogs Trust, London, UK
| | - C Westgarth
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences (IVES), The University of Liverpool, CH64 7TE, UK
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16
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Murphy RN, de Schoulepnikoff C, Chen JH, Columb MO, Bedford J, Wong JK, Reid AJ. The incidence and management of peripheral nerve injury in England (2005-2020). J Plast Reconstr Aesthet Surg 2023; 80:75-85. [PMID: 36996504 DOI: 10.1016/j.bjps.2023.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023]
Abstract
Peripheral nerve injury (PNI) is a significant health problem that confers lifelong impact on those injured. Current interventions are purely surgical; however, outcomes remain poor. There is a lack of high-quality epidemiological data that is needed to identify populations involved, current healthcare demands, and ensure resources are distributed to the greatest effect, to reduce the injury burden. METHODS Anonymized hospital episode statistical (HES) data on admitted patient care was obtained from NHS Digital for all National Health Service (NHS) patients sustaining PNI of all body regions between 2005 and 2020. Total numbers of finished consultant episodes (FCEs) or FCEs/100,000 population were used to demonstrate changes in demographic variables, anatomical locations of injury, mechanisms of injury, speciality, and main operation. RESULTS There was a mean national incidence of 11.2 (95% CI 10.9, 11.6) events per 100,000 population per year. Males were at least twice as likely (p < 0.0001) to sustain a PNI. Upper limb nerves at or distal to the wrist were most commonly injured. Knife injuries increased (p < 0.0001), whereas glass injuries decreased (p < 0.0001). Plastic surgeons increasingly managed PNI (p = 0.002) as opposed to orthopaedic surgeons (p = 0.006) or neurosurgeons (p = 0.001). There was an increase in neurosynthesis (p = 0.022) and graft procedures (p < 0.0001) during the study period. DISCUSSION PNI is a significant national healthcare problem predominantly affecting distal, upper limb nerves of men of working age. Injury prevention strategies, improved targeted funding and rehabilitation pathways are needed to reduce the injury burden and improve patient care.
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Alberghina D, Virga A, Sottile G, Buffa SP, Panzera M. A 10-year retrospective analysis (2012-2021) of hospitalizations resulting from dog bites in Southern Italy. Front Vet Sci 2023; 10:1104477. [PMID: 36896292 PMCID: PMC9988904 DOI: 10.3389/fvets.2023.1104477] [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: 11/21/2022] [Accepted: 01/30/2023] [Indexed: 02/23/2023] Open
Abstract
This study aimed to describe the incidence and characteristics of dog-bite injury hospitalizations (DBIH) in the largest administrative region of Italy (Sicily) over the 10-year period: 2012-2021. Four hundred and forty-nine cases were analyzed. Patients were divided into seven age groups: preschoolers (0-5 years), school-age children (6-12 years), teenagers (13-19 years), young adults (20-39 years), middle-aged adults (40-59 years), old adults (60-74 years), and the elderly (≥75 years). Association among categorical variables (age, gender, principal injury location) was evaluated using chi-square tests, and mean differences for normally distributed variables were assessed using one-way analysis of variance. Finally, a Poisson regression general linear model (GLM) analysis was used to model incidence data. The results revealed that the incidence of DBIH per 100,000 population increased from 0.648 in 2012 (95%CI 0.565-0.731) to 1.162 in 2021 (95%CI 1.078-1.247, P < 0.01). Incidence for both male and female victims also increased over the studied period (P < 0.05). We found an increasing trend of incidence in young and middle-aged adults (P < 0.05 and P < 0.005 respectively). Moreover, the most frequently injured age group by dogs was the preschooler group and, whilst we found a lower risk of being injured for males older than 20 years, no difference with females was observed. The location of lesions depended on the age group (P < 0.001). The number of days of DBIH increased significantly with age (P < 0.01). The increase of DBIH represents a public health problem that requires the development of preventive approaches.
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Affiliation(s)
- Daniela Alberghina
- Dipartimento di Scienze Veterinarie, Università degli Studi di Messina, Messina, Italy
| | - Antonino Virga
- Dipartimento di Scienze Agrarie, Alimentari e Forestali, Università degli Studi di Palermo, Palermo, Italy
| | - Gianluca Sottile
- Dipartimento di Scienze Economiche, Aziendali e Statistiche, Università degli Studi di Palermo, Palermo, Italy
| | - Sergio Pio Buffa
- Assessorato Regionale della Salute - Regione Sicilia, Palermo, Italy
| | - Michele Panzera
- Dipartimento di Scienze Veterinarie, Università degli Studi di Messina, Messina, Italy
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18
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Duncan-Sutherland N, Hunt M, Alatini M, Shepherd M, Kool B. Study of dog control strategies. Inj Prev 2022; 29:219-226. [PMID: 36600525 DOI: 10.1136/ip-2022-044686] [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: 06/17/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES (1) To explore the relationship between regionally implemented dog control strategies and dog bite injuries (DBIs) and (2) to evaluate current implementation of dog control strategies. METHODS Observational study using a nationwide online survey of territorial authorities (TAs). Domains of interest included complaints for attacks on people, dog population, primary and secondary prevention strategies, resourcing and perspectives of current strategies. Quantitative variables were compared with DBI Accident Compensation Corporation (ACC) claims by region from 2014 to 2018. RESULTS Two-thirds of TAs (70%; n=47/67) responded to the survey. No clear relationship was observed between DBIs and: registered dog population, proportion sterilisations or microchipping, classifications due to dog behaviour, or existing limited resourcing. Legislated breeds and infringements for failure to control a dog or non-registration were higher in areas with greater DBIs. Educational messages varied widely and were predominantly victim directed (67%; n=71/106). Complaints for dog attacks on people were lower than DBIs in most areas, with no formal cross-agency notification policies. Few prosecutions or dog destruction orders were made. CONCLUSIONS Regional inequity in DBIs could not be explained by differences in the registered dog population or dog control strategies. Minimal and inequitable resourcing exists to implement current dog control strategies and provide owner-directed education. Gaps in legislation include environmental barrier requirements for all dogs (leash/muzzle use, adequate fencing), notification of incidents and child protection. Partnership with the Indigenous community (Māori) and other community groups will be required to implement these measures successfully.
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Affiliation(s)
| | - Mareta Hunt
- Safekids Aotearoa, Starship Foundation, Auckland, New Zealand
| | - Moses Alatini
- Safekids Aotearoa, Starship Foundation, Auckland, New Zealand
| | - Michael Shepherd
- Children's Emergency Department, Starship Foundation, Auckland, New Zealand.,Department of Paediatrics: Child Youth and Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Bridget Kool
- Section of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
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19
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Canine Saliva as a Possible Source of Antimicrobial Resistance Genes. Antibiotics (Basel) 2022; 11:antibiotics11111490. [DOI: 10.3390/antibiotics11111490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
While the One Health issues of intensive animal farming are commonly discussed, keeping companion animals is less associated with the interspecies headway of antimicrobial resistance. With the constant advance in veterinary standards, antibiotics are regularly applied in companion animal medicine. Due to the close coexistence of dogs and humans, dog bites and other casual encounters with dog saliva (e.g., licking the owner) are common. According to our metagenome study, based on 26 new generation sequencing canine saliva datasets from 2020 and 2021 reposited in NCBI SRA by The 10,000 Dog Genome Consortium and the Broad Institute within Darwin’s Ark project, canine saliva is rich in bacteria with predictably transferable antimicrobial resistance genes (ARGs). In the genome of potentially pathogenic Bacteroides, Capnocytophaga, Corynebacterium, Fusobacterium, Pasteurella, Porphyromonas, Staphylococcus and Streptococcus species, which are some of the most relevant bacteria in dog bite infections, ARGs against aminoglycosides, carbapenems, cephalosporins, glycylcyclines, lincosamides, macrolides, oxazolidinone, penams, phenicols, pleuromutilins, streptogramins, sulfonamides and tetracyclines could be identified. Several ARGs, including ones against amoxicillin–clavulanate, the most commonly applied antimicrobial agent for dog bites, were predicted to be potentially transferable based on their association with mobile genetic elements (e.g., plasmids, prophages and integrated mobile genetic elements). According to our findings, canine saliva may be a source of transfer for ARG-rich bacteria that can either colonize the human body or transport ARGs to the host bacteriota, and thus can be considered as a risk in the spread of antimicrobial resistance.
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20
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McEvoy V, Espinosa UB, Crump A, Arnott G. Canine Socialisation: A Narrative Systematic Review. Animals (Basel) 2022; 12:2895. [PMID: 36359020 PMCID: PMC9655304 DOI: 10.3390/ani12212895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/16/2022] [Accepted: 10/20/2022] [Indexed: 01/09/2023] Open
Abstract
There are over 10 million pet dogs in the UK alone, and they have become a member of modern human families. If not properly socialised as puppies, dogs have a higher risk of problematic behaviours during adulthood, yet socialisation studies are lacking. Much of the experimental research was carried out at least 50 years ago, and the importance of socialisation was demonstrated so clearly that further studies with unsocialised controls would be deemed unethical. In this review, the aim was to evaluate all literature relevant to canine socialisation. This review used PRISMA-P guidelines to identify 29 studies: 14 were questionnaire-based studies (two of which also had a testing element), 15 included some form of experimental manipulation relating to socialisation, and one was a purely observational study. Based on this literature review, we recommend future research into minimum necessary socialisation levels, as well as breed differences in the timing of effective socialisation. Such studies will help owners and breeders produce well-adjusted adult dogs.
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Affiliation(s)
- Victoria McEvoy
- Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, 19 Chlorine Gardens, Belfast BT9 5DL, UK; (U.B.E.); (G.A.)
| | - Uri Baqueiro Espinosa
- Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, 19 Chlorine Gardens, Belfast BT9 5DL, UK; (U.B.E.); (G.A.)
| | - Andrew Crump
- Centre for Philosophy of Natural and Social Science, London School of Economics and Political Science, Houghton St., Holborn, London WC2A 2AE, UK;
| | - Gareth Arnott
- Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, 19 Chlorine Gardens, Belfast BT9 5DL, UK; (U.B.E.); (G.A.)
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21
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Oxley JA, Meyer G, Cant I, Bellantuono GM, Butcher M, Levers A, Westgarth C. A pilot study investigating human behaviour towards DAVE (Dog Assisted Virtual Environment) and interpretation of non-reactive and aggressive behaviours during a virtual reality exploration task. PLoS One 2022; 17:e0274329. [PMID: 36170291 PMCID: PMC9518854 DOI: 10.1371/journal.pone.0274329] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/12/2022] [Indexed: 12/03/2022] Open
Abstract
Dog aggression is a public health concern because dog bites often lead to physical and psychological trauma in humans. It is also a welfare concern for dogs. To prevent aggressive behaviours, it is important to understand human behaviour towards dogs and our ability to interpret signs of dog aggression. This poses ethical challenges for humans and dogs. The aim of this study was to introduce, describe and pilot test a virtual reality dog model (DAVE (Dog Assisted Virtual Environment)). The Labrador model has two different modes displaying aggressive and non-reactive non-aggressive behaviours. The aggressive behaviours displayed are based on the current understanding of canine ethology and expert feedback. The objective of the study was to test the recognition of dog behaviour and associated human approach and avoidance behaviour. Sixteen university students were recruited via an online survey to participate in a practical study, and randomly allocated to two experimental conditions, an aggressive followed by a non-reactive virtual reality model (group AN) or vice versa (group NA). Participants were instructed to ‘explore the area’ in each condition, followed by a survey. A Wilcoxon and Mann Whitney U test was used to compare the closest distance to the dog within and between groups respectively. Participants moved overall significantly closer to the non-reactive dog compared to the aggressive dog (p≤0.001; r = 0.8). Descriptions of the aggressive dog given by participants often used motivational or emotional terms. There was little evidence of simulator sickness and presence scores were high indicating sufficient immersion in the virtual environment. Participants appeared to perceive the dog as realistic and behaved and interacted with the dog model in a manner that might be expected during an interaction with a live dog. This study also highlights the promising results for the potential future use of virtual reality in behavioural research (i.e., human-dog interactions), education (i.e. safety around dogs) and psychological treatment (e.g. dog phobia treatment).
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Affiliation(s)
- James A. Oxley
- Department of Livestock and One Health, University of Liverpool, Leahurst Campus, Neston, Cheshire, United Kingdom
| | - Georg Meyer
- Institute of Digital Engineering and Autonomous Systems, University of Liverpool, Liverpool, United Kingdom
| | - Iain Cant
- Virtual Engineering Centre, Daresbury, United Kingdom
| | | | | | - Andrew Levers
- Virtual Engineering Centre, Daresbury, United Kingdom
| | - Carri Westgarth
- Department of Livestock and One Health, University of Liverpool, Leahurst Campus, Neston, Cheshire, United Kingdom
- * E-mail:
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22
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Dog Bites in Portugal: Analysis of Incidents, and Consequences for both People and Dogs. J Vet Behav 2022. [DOI: 10.1016/j.jveb.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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23
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Duncan-Sutherland N, Lissaman AC, Shepherd M, Kool B. Systematic review of dog bite prevention strategies. Inj Prev 2022; 28:288-297. [PMID: 35393286 DOI: 10.1136/injuryprev-2021-044477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 03/26/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The prevention of dog bites is an increasingly important public health topic, as the incidence of serious injury continues to rise. OBJECTIVES To evaluate the effectiveness of interventions to prevent dog bites and aggression. METHODS Online databases were searched (PubMed, Cochrane Library, Embase and Google Scholar), using the search terms: dog/s, canine, canis, kuri, bite/s, bitten, aggression, attack, death, fatal, mortality, injury/ies, prevention, intervention, for studies between 1960 and 2021. All study designs were considered. Outcomes of interest were the incidence of dog bites or dog aggression. Non-English studies, and those without full-text access were excluded. RESULTS Forty-three studies met the review criteria, including 15 observational and 27 interventional studies. Fifteen studies investigating dog-control legislation, including leash laws, stray dog control and infringements indicated this can reduce dog bite rates. Breed-specific legislation had less of an effect. Six studies investigating sterilisation, showed while this may reduce dog bites through a reduction in the dog population, the effect on dog aggression was unclear. An alcohol reduction programme showed a significant reduction in dog bite rates in one study. Seven studies assessing educational approaches found that intensive adult-directed education may be effective, with one study showing child-directed education was not effective. Eight studies on dog training (two police-dog related), and six evaluating dog medication or diet were generally low quality and inconclusive. CONCLUSIONS Multiple strategies including effective engagement with indigenous communities and organisations will be required to reduce dog-bites and other incidents involving dog aggression. This review provides some evidence that legislated dog control strategies reduce dog bite rates. Available evidence suggests greater restrictions should be made for all dogs, rather than based on breed alone. Due to a burden of child injury, protection of children should be a focus of legislation and further investigations. Prevention strategies in children require redirection away from a focus on child-directed education and future research should investigate the effectiveness of engineering barriers and reporting strategies.
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Affiliation(s)
| | - Abbey C Lissaman
- Department of Physiology, The University of Auckland, Auckland, New Zealand
| | - Michael Shepherd
- Starship Children's Emergency Department, Starship Foundation, Auckland, New Zealand
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Bridget Kool
- Section of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand
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24
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" If You Don't See the Dog, What Can You Do?" Using Procedures to Negotiate the Risk of Dog Bites in Occupational Contexts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147377. [PMID: 34299828 PMCID: PMC8307013 DOI: 10.3390/ijerph18147377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/20/2021] [Accepted: 06/30/2021] [Indexed: 12/02/2022]
Abstract
Dog bites are a health risk in a number of workplaces such as the delivery, veterinary and dog rescue sectors. This study aimed to explore how workers negotiate the risk of dog bites in daily interactions with dogs and the role of procedures in workplace safety. Participants who encounter dogs at work were recruited using snowball sampling. Ethnographic methods (interviews, focus group discussions, participant-observations) were used for data collection. All data were coded qualitatively into themes. Six themes describing dog bite risk management were identified: ‘Surveillance of dogs’; ‘Communicating risk; ‘Actions taken to manage perceived risk’; ‘Reporting bites and near-misses’, ‘Investigating bites and near-misses’, and; ‘Learning and teaching safety’. While the procedures described dog bite risk as objective, when interacting with dogs, participants drew on experiential knowledge and subjective judgment of risk. There was a discrepancy between risks that the procedures aimed to guard against and the risk participants were experiencing in the course of work. This often led to disregarding procedures. Paradoxically, procedures generated risks to individual wellbeing and sometimes employment, by contributing to blaming employees for bites. Dog bite prevention could be improved by clarifying definitions of bites, involving at risk staff in procedure development, and avoiding blaming the victim for the incident.
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25
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Tulloch JSP, Minford S, Pimblett V, Rotheram M, Christley RM, Westgarth C. Paediatric emergency department dog bite attendance during the COVID-19 pandemic: an audit at a tertiary children's hospital. BMJ Paediatr Open 2021; 5:e001040. [PMID: 33884313 PMCID: PMC8023759 DOI: 10.1136/bmjpo-2021-001040] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/26/2021] [Accepted: 03/20/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Responses to the COVID-19 pandemic include strict public health measures, such as national lockdowns. During these measures, paediatric emergency department attendances have declined and the prevalence of presenting complaints has changed. This study sought to identify whether dog bite attendance and victim demographics changed during COVID-19 public health measures. METHODS An audit was conducted of emergency department attendance data from a UK tertiary paediatric hospital between January 2016 and September 2020. Dog bite attendance and victim demographics were explored using χ2 tests and multivariable Poisson regression. The mean monthly percentage of attendance due to dog bites in 2020 was compared against predicted percentages based on previous years' data. RESULTS Dog bite attendance rose in conjunction with the introduction of COVID-19 public health measures and reached a peak in July 2020 (44 dog bites, 1.3% of all attendances were due to dog bites). This was a threefold increase in dog bite attendance. By September 2020, attendance had returned to normal. The demographic profile of child dog bite victims remained the same. Boys had the highest attendance rates in 7-12 year-olds, girls in 4-6 year-olds. Girls showed higher attendance rates in the summer, while boys' attendance rates were constant throughout the year. COVID-19 public health measures were associated with a 78% increase in attendance for boys and a 66% increase in girls. CONCLUSIONS COVID-19 national public health measures were associated with an increase in paediatric emergency department dog bite attendance, and may be due to increased child exposure to dogs via 'stay at home' orders and school closures. National lockdowns are likely to continue globally throughout the COVID-19 pandemic; this is likely to result in more dog bites. Urgent public health communication and injury prevention strategies are needed to help prevent these avoidable injuries.
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Affiliation(s)
- John S P Tulloch
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, Merseyside, UK
| | - Simon Minford
- Department of Plastic Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Vicky Pimblett
- Department of Plastic Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Matt Rotheram
- Emergency Department, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Robert M Christley
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, Merseyside, UK.,Dogs Trust, London, UK
| | - Carri Westgarth
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, Merseyside, UK
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