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McNamara M, Barondeau J, Brown J. Mental Health, Climate Change, and Bodily Autonomy: An Analysis of Adolescent Health Policy in the Post-Pandemic Climate. Pediatr Clin North Am 2024; 71:729-744. [PMID: 39003013 DOI: 10.1016/j.pcl.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/15/2024]
Abstract
The COVID-19 pandemic exacerbated the vulnerability of adolescents and young adults (AYAs) who face economic disadvantage, depend on social safety net resources, have politically targeted identities, are geopolitically displaced, and/or are racially or ethnically marginalized. A rapid change in social safety net policies has impacts that reverberate throughout interrelated domains of AYA health, especially for vulnerable AYAs. The authors analyze policy-related changes in mental health, climate change, and bodily autonomy to offer a paradigm for an equitable path forward.
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Affiliation(s)
| | - Jesse Barondeau
- University of Nebraska Medical Center, Children's Nebraska, 8200 Dodge Street, Omaha, NE 68114, USA
| | - Joanna Brown
- Boston Children's Hospital, 333 Longwood Avenue, Boston, MA 02115, USA
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Donnelly R, Remani B, Erving CL. Dual pandemics? Assessing associations between area racism, COVID-19 case rates, and mental health among U.S. adults. SSM - MENTAL HEALTH 2023; 4:100248. [PMID: 38125912 PMCID: PMC10732532 DOI: 10.1016/j.ssmmh.2023.100248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Mental health worsened during the COVID-19 pandemic, especially among racially minoritized adults. Population-level racial attitudes, or area racism, may be associated with mental health, particularly during this historical moment, but this possibility has not been tested in prior research. In the present study, we use nationally representative data from the Household Pulse Survey (April-October 2020) to document associations between area racism and depression/anxiety in the United States among non-Hispanic Black, non-Hispanic Asian, Hispanic, non-Hispanic White, and other racial/ethnic minority adults. We further consider the national COVID-19 case rate to examine an additional macro-level stressor. Findings indicate that area racism was positively associated with depression and/or anxiety for Black, Hispanic, White, and other racial/ethnic minority adults. Moreover, COVID-19 cases posed an additional, independent mental health threat for most groups. This study points to area racism as a macro-level stressor and an antecedent of mental health for racially diverse groups of Americans.
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Hassan A, Ojanen-Goldsmith A, Hing AK, Mahoney M, Traxler S, Boraas CM. More than tears: associations between exposure to chemical agents used by law enforcement and adverse reproductive health outcomes. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1177874. [PMID: 38516336 PMCID: PMC10956352 DOI: 10.3389/fepid.2023.1177874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/17/2023] [Indexed: 03/23/2024]
Abstract
Despite routine law enforcement use of chemical agents for crowd control, the reproductive health safety profiles of these products are unknown. Moreover, limited evidence has documented a link between such exposures and adverse reproductive health outcomes including abnormal uterine bleeding and potential pregnancy disruption. This cross-sectional study examined reproductive outcomes in adults with uteri exposed to chemical agents used by law enforcement, more commonly known as "tear gas". Participants were recruited through social media in the wake of police violence protests. Of the 1,276 participants included in analysis, 83% reported experiencing at least one of the outcomes of interest, included uterine cramping (69%), early menstrual bleeding (55%), breast tenderness (30%), and delayed menstrual bleeding (19%). Chemical agent exposure was significantly associated with higher odds of an adverse reproductive health outcome, those with 5 days or more of exposure have 2.6 times the odds (CI: 1.61, 4.22) of adverse outcomes and having a perception that one's menstruation may fluctuate according to psychosocial stressors was associated (OR = 1.94, CI: 1.36, 2.79) with a higher odds of an adverse reproductive health experience. These findings suggest a potential relationship between exposure to chemical agents and adverse reproductive health outcomes. Given the pervasive use of these chemical agents and their potential for reproductive health harm, further investigation into the safety of these products and their impacts on individual and community health is warranted urgently.
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Affiliation(s)
- Asha Hassan
- Research Division, Planned Parenthood North Central States, Minneapolis, MN, United States
- Center for Antiracism Research for Health Equity, University of Minnesota School of Public Health, Minneapolis, MN, United States
| | | | - Anna K. Hing
- Center for Antiracism Research for Health Equity, University of Minnesota School of Public Health, Minneapolis, MN, United States
| | - Madeline Mahoney
- Research Division, Planned Parenthood North Central States, Minneapolis, MN, United States
| | - Sarah Traxler
- Research Division, Planned Parenthood North Central States, Minneapolis, MN, United States
| | - Christy M. Boraas
- Research Division, Planned Parenthood North Central States, Minneapolis, MN, United States
- Department of Obstetrics, Gynecology, and Women’s Health, University of Minnesota Medical School, Minneapolis, MN, United States
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LEE HEDWIG, LARIMORE SAVANNAH, ESPOSITO MICHAEL. Policing and Population Health: Past, Present, and Future. Milbank Q 2023; 101:444-459. [PMID: 37096626 PMCID: PMC10126959 DOI: 10.1111/1468-0009.12628] [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: 04/16/2022] [Revised: 10/26/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points A growing body of research suggests that policing, as a form of state-sanctioned racial violence, operates as a social determinant of population health and racial or ethnic health disparities. A lack of compulsory, comprehensive data on interactions with police has greatly limited our ability to calculate the true prevalence and nature of police violence. While innovative unofficial data sources have been able to fill these data gaps, compulsory and comprehensive data reporting on interactions with police, as well as considerable investments in research on policing and health, are required to further our understanding of this public health issue.
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Affiliation(s)
- HEDWIG LEE
- Duke University
- Washington University in St. Louis
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Jimenez T, Helm PJ, Arndt J. Racial Prejudice Predicts Police Militarization. Psychol Sci 2022; 33:2009-2026. [PMID: 36260362 DOI: 10.1177/09567976221112936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In the United States, police are becoming increasingly militarized. Whereas the racialized nature of police militarization has been documented, the relationship between racial prejudice and police militarization is less understood. We assessed the link between racial prejudice against Black and Native Americans and police militarization at individual and regional levels. Study 1 (N = 765) recruited a nationally representative sample of White Americans and found a positive association between racial prejudice and support for police militarization. Study 2 (N = 3,129,343) sourced regional aggregates of prejudice among White Americans from Project Implicit and policing data from the Defense Logistics Agency and found that police departments in states higher in prejudice acquired greater amounts of militarized equipment. Together, these studies demonstrate that, in terms of attitudes and policies, racial prejudice predicts police militarization.
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Affiliation(s)
| | - Peter J Helm
- Department of Psychological Sciences, University of Missouri
| | - Jamie Arndt
- Department of Psychological Sciences, University of Missouri
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Chaudhary MJ, Richardson J. Violence Against Black Lives Matter Protestors: a Review. CURRENT TRAUMA REPORTS 2022; 8:96-104. [PMID: 35669314 PMCID: PMC9136198 DOI: 10.1007/s40719-022-00228-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 11/24/2022]
Abstract
Purpose of Review The Black Lives Matter (BLM) protests against racialized police violence represents the most prolific mass social movement in modern times. It has been met by sustained and repressive violence by state authorities and right-wing groups. This review seeks to synthesize existing scholarly, journalistic, case report, and crowd sourced data on violence directed against BLM protestors. Recent Findings Data from various sources suggests that police disproportionately target BLM protests for violent intervention. There is also mounting evidence of organized and vigilante right-wing violence targeting BLM protestors. While police frequently use chemical irritants and projectiles, right-wing protestors often use car ramming to bluntly injure protestors. The true scale and nature of injuries affecting BLM protestors remains unknown though injuries resulting in the need for intensive care, operative intervention, permanent morbidity, and mortality have been reported. Summary State and conservative civilian violence against BLM protestors represents an ongoing threat to the right to organize and publicly dissent. The use of force manifested by police and right-wing groups against BLM protestors resulted in significant injury and mortality.
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Affiliation(s)
- Mihir J. Chaudhary
- Department of Surgery, University of California San Francisco – East Bay, 1411 E 31st Street, Oakland, CA 94602 USA
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The language of less-lethal weapons. Proc Natl Acad Sci U S A 2022; 119:e2117779119. [PMID: 35412863 PMCID: PMC9169936 DOI: 10.1073/pnas.2117779119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
It has been over 1 year since we observed the policing of the George Floyd protests in the United States [R. R. Hardeman, E. M. Medina, R. W. Boyd, N. Engl. J. Med. 383, 197-199 (2020)]. Multiple injury reports emerged in medical journals, and the scientific community called for law enforcement to discontinue the use of less-lethal weapons [E. A. Kaske et al., N. Engl. J. Med. 384, 774-775 (2021) and K. A. Olson et al., N. Engl. J. Med. 383, 1081-1083 (2020)]. Despite progress in research, policy change has not followed a similar pace. Although the reasoning for this discrepancy is multifactorial, failure to use appropriate language may be one contributing factor to the challenges faced in updating policies and practices. Here, we detail how language has the potential to influence thinking and decision-making, we discuss how the language of less-lethal weapons minimizes harm, and we provide a framework for naming conventions that acknowledges harm.
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Chemical Agents Encountered in Protests. Emerg Med Clin North Am 2022; 40:365-379. [DOI: 10.1016/j.emc.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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PECULIARITIES OF THE PROJECTILE PENETRATION DEPTH WHEN FIRED WITH “FORT 9R” AND “FORT 17R” PISTOLS WHILE USING DIFFERENT CLOTHING FABRIC. WORLD OF MEDICINE AND BIOLOGY 2022. [DOI: 10.26724/2079-8334-2022-4-82-230-235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Bir C, Sherman D, MacDonald R, Esquivel A. Assessment of Less Lethal Impact Munitions Using the Facial and Ocular CountermeasUre for Safety (FOCUS) Headform. HUMAN FACTORS AND MECHANICAL ENGINEERING FOR DEFENSE AND SAFETY 2022; 6:2. [PMCID: PMC9792641 DOI: 10.1007/s41314-022-00045-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 10/20/2023]
Abstract
Recent social protests and gatherings in the USA have prompted law enforcement agencies to increase their use of less lethal impact munitions (LLIMs) for crowd control. Media reports and firsthand accounts have indicated that many of the LLIMs are impacting individuals in the head and neck regions. There is very little data available on the risk of injury (ROI) from LLIM impacts to these body regions. The Facial and Ocular CountermeasUre for Safety (FOCUS) surrogate headform was used to assess the ROI (fracture) from LLIM impacts. LLIMs were fired at the FOCUS headform to determine the ROI to the frontal and maxilla bones. Sixteen different LLIMs were assessed which included 12-gauge, 37-mm, and 40-mm caliber projectiles from five manufacturers. The LLIMs included bean bag style, rubber, and foam/sponge projectiles. Each LLIM was tested multiple times to determine the average ROI. The average peak resultant frontal bone force ranged from 2.0 to 7.6 kN which represented ROIs from ~ 30% up to 95%. The average peak resultant maxilla bone force ranged from 1.0 to 4.4 kN which represented ROIs from ~ 30% up to 99%. In general, 12-gauge LLIMs had a lower ROI than the larger caliber LLIMs and the rubber projectiles had a lower ROI than the bean bag style projectiles. Due to the relative thickness, the maxilla has a much lower fracture force than the frontal bone, and this was borne out in the ROIs from the maxilla impacts. Impacts to both bones showed a positive correlation between normalized energy and resultant force (p < 0.01). The slope of the plotted resultant force against the normalized energy for the 12-gauge munitions was significantly smaller compared to larger calibers for both impact sites, frontal (p = 0.031), and maxilla (p < 0.001).
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Affiliation(s)
- Cynthia Bir
- Department of Biomedical Engineering, Wayne State University, Detroit, MI USA
| | - Donald Sherman
- Department of Biomedical Engineering, Wayne State University, Detroit, MI USA
| | - Robert MacDonald
- Department of Biomedical Engineering, Wayne State University, Detroit, MI USA
| | - Amanda Esquivel
- Department of Mechanical Engineering, University of Michigan - Dearborn, Dearborn, MI USA
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Pearl RC, Torbati S, Geiderman JM. Kinetic Projectile Injuries Treated During Civil Protests in Los Angeles: A Case Series. Clin Pract Cases Emerg Med 2021; 5:385-389. [PMID: 34813425 PMCID: PMC8610479 DOI: 10.5811/cpcem.2021.7.52885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/27/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction During protests following the death of George Floyd, kinetic impact projectiles (KIP) were used by law enforcement as a method of crowd control. We describe the injuries seen at a single Level 1 trauma center in Los Angeles over a two-day period of protests to add to the collective understanding of the public health ramifications of crowd-control weapons used in the setting of protests. Case Series We reviewed the emergency department visits of 14 patients who presented to our facility due to injuries sustained from KIPs over a 48-hour period during civil protests after the death of George Floyd. Conclusion Less lethal weapons can cause significant injuries and may not be appropriate for the purposes of crowd control, especially when used outside of established guidelines.
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Affiliation(s)
- Rachel C Pearl
- Cedars-Sinai Medical Center, Department of Emergency Medicine, Los Angeles, California
| | - Sam Torbati
- Cedars-Sinai Medical Center, Department of Emergency Medicine, Los Angeles, California
| | - Joel M Geiderman
- Cedars-Sinai Medical Center, Department of Emergency Medicine, Los Angeles, California
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Kahle ME, Hamann KM, Sakher AA, Kaske EA, Pagliara T, Pariser JJ. Testicular rupture following rubber bullet trauma case report. Transl Androl Urol 2021; 10:3529-3531. [PMID: 34532277 PMCID: PMC8421836 DOI: 10.21037/tau-21-213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/25/2021] [Indexed: 11/06/2022] Open
Abstract
Following civil unrest during 2020, physicians began to notice a variety of injuries resulting from crowd control weapons. While prior research emphasized ocular trauma, genitourinary complications of injuries have yet to be investigated. A previously healthy 27-year-old male presented to the emergency department due to sudden onset of severe left testicular pain following rubber bullet trauma. Physical exam showed extreme tenderness, abrasion, contusion, and edema of the left testicle with normal right testicle. Doppler ultrasound showed minimal blood flow to the superior pole with irregularity of the tunica albuginea. Surgery confirmed testicular rupture with a large tunical violation and extruded spermatic tubules. The testicle was thoroughly irrigated, non-viable tubules were debrided, and intraoperative ultrasound confirmed restoration of blood flow. Patient was discharged and instructed to follow-up should he face any fertility concerns in the future. Current crowd control guidelines state projectiles should be aimed at the lower abdomen or extremities; however, projectiles can cause testicular trauma which may lead to hypogonadism, infection, and psychological impact. Until there are changes to methods of crowd control, attendees should consider the use of athletic cups.
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Affiliation(s)
- Madison E Kahle
- Department of Urology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Kayla M Hamann
- Department of Urology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Aliya A Sakher
- Department of Urology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Erika A Kaske
- Department of Urology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Travis Pagliara
- Department of Urology, Hennepin Healthcare, Minneapolis, MN, USA
| | - Joseph J Pariser
- Department of Urology, University of Minnesota Medical School, Minneapolis, MN, USA
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Abstract
Tear gases, or chemical demonstration control agents (DCA), were originally created as weapons that could severely disable or kill enemy troops. Though banned in war, these chemicals are still used in domestic policing. Here we review the available scientific literature on tear gas, summarizing findings from animal and environmental studies as well describing data from new human studies. We find a lack of scientific evidence supporting the safety of tear gas, especially regarding its long-term impacts on human health and the environment. Many of the available studies were published decades ago, and do not parse data by variables such as chemical type and exposure time, nor do they account for the diversity of individuals who are exposed to tear gas in real-life situations. Due to the dearth of scientific research and the misinterpretation of some of the available studies, we conclude that a serious reevaluation of chemical DCA safety and more comprehensive exposure follow-up studies are necessary.
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Affiliation(s)
- Jennifer L Brown
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA
| | - Carey E Lyons
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA
| | - Carlee Toddes
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA
| | - Timothy Monko
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA
| | - Roman Tyshynsky
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA
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Kaltiso SAO, Seitz RM, Zdradzinski MJ, Moran TP, Heron S, Robertson J, Lall MD. The impact of racism on emergency health care workers. Acad Emerg Med 2021; 28:974-981. [PMID: 34358387 DOI: 10.1111/acem.14347] [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: 02/27/2021] [Revised: 07/03/2021] [Accepted: 07/05/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Discrimination based on race is a known source of stress in individuals and is a contributor to poor health outcomes in patients. However, less is known about how the experiences of racism impact the stress levels of emergency health care workers (EHCWs). OBJECTIVES The goal of this study was to assess the impact that racism has on the stress of EHCWs. METHODS An anonymous electronic cross-sectional survey of EHCWs including attending physicians, resident physicians, advanced practice providers, nurses, and staff at three large metropolitan hospitals was administered in the summer of 2020. The survey evaluated the stress related to systemic racism and the COVID-19 pandemic in addition to the wellness measures utilized to cope with these stressors. The focus of this article is the impact of systemic racism on EHCWs. RESULTS Of the 576 eligible participants, the total number of respondents utilized for analysis was 260. Overall, 64% of participants were very concerned about the state of racism in the United States, and 30% reported moderate-high or high stress resulting from racism. When stratified by race, 46% of Black participants reported moderate-high or high stress resulting from racism, compared to 31% of other participants of color and 23% of White participants (p = 0.002). CONCLUSION Systemic racism is a significant concern and source of stress for EHCWs. Additional research about systemic racism, its impact on medical providers, and more importantly, active strategies to reduce and ultimately eliminate it in health care is needed.
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Affiliation(s)
- Sheri-Ann O Kaltiso
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Roslyn M Seitz
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael J Zdradzinski
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Timothy P Moran
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Sheryl Heron
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jennifer Robertson
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michelle D Lall
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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Schenck CS, Lokeshwar SD, Riedel MD, Davis KA. Penetrating deep pelvic injury due to "less-lethal" beanbag munitions: a case report and policy implications. Trauma Surg Acute Care Open 2021; 6:e000754. [PMID: 34041366 PMCID: PMC8112415 DOI: 10.1136/tsaco-2021-000754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 12/01/2022] Open
Abstract
“Less-lethal” munitions are designed to cause incapacitation and are often used by law enforcement officers. Although these munitions are not designed to cause severe injury, recent reports have demonstrated that they can cause severe injury, permanent disability, and death. The long-term consequences of injury due to less-lethal munitions are not well understood. We present a case of osteomyelitis and pelvic abscess secondary to a retained beanbag munition following penetrating injury in the setting of a patient with delayed presentation for care. The patient underwent surgical removal of the retained beanbag munition and irrigation and debridement of the osteomyelitis and pelvic abscess with an excellent functional outcome. We discuss the public health and policy implications of serious injury due to less-lethal munitions.
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Affiliation(s)
| | - Soum D Lokeshwar
- Yale School of Medicine, New Haven, Connecticut, USA.,Department of Urology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Matthew D Riedel
- Yale School of Medicine, New Haven, Connecticut, USA.,Division of Orthopaedic Trauma, Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Kimberly A Davis
- Yale School of Medicine, New Haven, Connecticut, USA.,Division of Trauma, Surgical Critical Care and Surgical Emergencies, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
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