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Ogunmayowa O, Lozano A, Hanlon A, Paige F, Cook N, Baker C. Social vulnerability and traumatic brain injury hospitalizations from sports and recreation among pediatric patients in the United States. Ann Epidemiol 2024; 93:19-26. [PMID: 38508406 DOI: 10.1016/j.annepidem.2024.03.002] [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: 07/01/2023] [Revised: 02/29/2024] [Accepted: 03/13/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE This study examined the associations between individual as well as neighborhood social vulnerability and sports and recreation-related traumatic brain injury (SR-TBI) hospitalizations among pediatric patients in the U.S. METHODS We obtained 2009, 2010 and 2011 hospitalization data in the U.S. from the National Inpatient Sample (NIS) database, linked it to 2010 neighborhood social vulnerability index (SVI) data from the Centers for Disease Prevention and Control (CDC), and assigned U.S. hospitals to one of four SVI quartiles. SR-TBI outcomes studied include: odds of hospitalization, length of stay (LOS), and discharge to post-acute care (DTPAC). RESULTS We found associations between race/ethnicity and all SR-TBI outcomes; however, sex, primary payer, and neighborhood overall SVI were only associated with LOS. Compared to White children, Native American children had almost three times higher odds of hospitalization for SR-TBI (OR: 2.82, 95% CI: 1.30, 6.14), 27% longer LOS (β: 27.06, 95% CI: 16.56, 38.51), but 99.9% lower odds of DTPAC (OR: 0.001, 95% CI: 0.00, 0.01). Compared to children with private insurance, children with public insurance had 11% longer LOS (β: 10.83, 95% CI: 8.65, 13.05). Hospitalization in neighborhood with higher overall SVI was associated with longer LOS (p < 0.0001). CONCLUSIONS These findings suggest that individual and neighborhood social vulnerability can have a significant impact on the health outcomes of children, especially in the context of SR-TBI.
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Affiliation(s)
| | - Alicia Lozano
- Virginia Polytechnic Institute and State University, Blacksburg, VI, USA
| | - Alexandra Hanlon
- Virginia Polytechnic Institute and State University, Blacksburg, VI, USA
| | - Frederick Paige
- Virginia Polytechnic Institute and State University, Blacksburg, VI, USA
| | - Natalie Cook
- Virginia Polytechnic Institute and State University, Blacksburg, VI, USA
| | - Charlotte Baker
- Virginia Polytechnic Institute and State University, Blacksburg, VI, USA
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Foss KDB, Khoury JC, Eisenmann JC, Cappaert TA. Descriptive Epidemiology of Game-Related Youth Flag Football Injuries. J Athl Train 2023; 58:1004-1009. [PMID: 37347143 PMCID: PMC10784883 DOI: 10.4085/1062-6050-0427.22] [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] [Indexed: 06/23/2023]
Abstract
CONTEXT Flag football is promoted as a safer alternative to tackle football. This may be 1 reason why participation rates have risen by 39% over the past 3 years. Despite rising participation, epidemiologic research on sport-specific injuries and associated relative risk is lacking. OBJECTIVE To prospectively document the epidemiology of injuries in youth flag football. DESIGN Descriptive epidemiology study. SETTING Regional and national youth flag football tournaments. PATIENTS OR OTHER PARTICIPANTS Athletes (N = 1939; 1744 boys and 195 girls), ages 6 to 12 years. An athletic trainer prospectively monitored the athletes for sport-related injury and exposures. MAIN OUTCOME MEASURE(S) Athlete risks of injury and injury rates were calculated overall and by sex. Injury characteristics were reported for the total population and by sex. RESULTS Forty-seven injuries to unique individuals were recorded in 1939 athletes with a total of 9228 athlete-exposures (AEs). The overall risk of injury was 2.4% (95% CI = 1.79%, 3.21%), with an overall injury rate of 5.1 per 1000 AEs (95% CI = 3.75, 6.77). Of the 47 injuries, 36 occurred in boys (8365 AEs), and 11 occurred in girls (863 AEs). A higher risk in girls was evidenced by both the injury risk ratio (2.73; 95% CI = 1.41, 5.30) and injury rate ratio of 2.96 (95% CI = 1.51, 5.82). The most common injury sites were the head/face/neck (n = 15, 31.9%), followed by the ankle/foot (n = 9, 19.1%). The most frequent types of injury were contusion (55.3%), sprain/subluxation (14.9%), and general trauma (10.6%); 74.5% of all injuries resulted from direct impact. CONCLUSIONS Although the competition injury rate for youth flag football was lower than the values from studies reporting comparable tackle football data, the frequencies by body part, type, and mechanism were similar. Given that most injuries were related to some form of impact and predominantly contusions, adopting minimal protective equipment or padding may reduce the numbers of these injuries.
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Affiliation(s)
| | - Jane C. Khoury
- Cincinnati Childrens Hospital Medical Center University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, Ohio USA
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Hirschhorn RM, Kerr ZY, Mensch JM, Huggins RA, Dompier TP, Rudisill C, Yeargin SW. Epidemiology of Emergency Medical Services Activations for Sport-Related Injuries in the United States. Cureus 2022; 14:e27403. [PMID: 36046296 PMCID: PMC9419755 DOI: 10.7759/cureus.27403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/29/2022] Open
Abstract
Background Literature examining emergency medical services (EMS) activations for sport-related injuries is limited to the pediatric, high school, and collegiate student-athlete populations, excluding older individuals and recreational athletes. The purpose of this study was to examine EMS activations for sport-related injuries using the National EMS Information System Database from 2017-2018. Methods Data were obtained using the National EMS Information System Database from 2017-2018. EMS activations were limited to 9-1-1 responses for individuals aged 3-99 who sustained a sports-related injury. Independent variables included patient age group: pediatric (<18 years old) vs. adult (≥18 years old). Dependent variables were patient age, gender, and chief complaint anatomic location. Frequencies and proportions were calculated for each variable. Injury proportion ratios (IPRs) with 95% confidence intervals were calculated to compare chief complaint anatomic location by age group. Results There were 71,322 sport-related injuries. Patients were 36.6±22.9 years and most (58.1%, n=41,132) were male. Adults had higher proportions of injuries affecting the abdomen (IPR: 2.05, 95%CI: 1.83, 2.31), chest (IPR: 1.90, 95%CI: 1.75, 2.05), general/global (IPR: 1.54, 95%CI: 1.50, 1.58), and genitalia (IPR: 2.40, 95%CI: 1.39, 4.15), and lower proportions of injuries affecting the back (IPR: 0.55, 95%CI: 0.50, 0.60), lower extremity (IPR: 0.63, 95%CI: 0.60, 0.65), upper extremity (IPR: 0.50, 95%CI: 0.47, 0.53), head (IPR: 0.73, 95%CI: 0.70, 0.77), and neck (IPR: 0.18, 95%CI: 0.16, 0.20) compared to pediatric patients. Conclusion Injuries sustained differed between adult and pediatric patients, indicating sport-related emergencies may change across the lifespan. General/global chief complaints likely indicate sport-related injuries affecting multiple anatomic locations and organ systems. Stakeholders planning large or high-risk athletic events should consider arranging standby or dedicated advanced life support units for their events.
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Baker C, Nottingham Q, Holloway J. Lessons in Linkage: combining administrative data using deterministic linkage for surveillance of sports and recreation injuries in Florida, United States. Int J Popul Data Sci 2022; 7:1749. [PMID: 37650029 PMCID: PMC10464874 DOI: 10.23889/ijpds.v7i1.1749] [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] [Indexed: 10/16/2022] Open
Abstract
Objectives Previous and ongoing epidemiological surveillance of sports and recreation injuries (SRI) has been cross-sectional in nature, utilised a subset of injuries based on athletic trainer availability, or focused on elite and professional athletes. In the United States, surveillance is often prohibitively expensive and not well funded by national organisations or agencies, except for the case of some professional and elite sports. This paper details the methodology, barriers, and successes of using deterministic linkage to combine emergency department and hospitalisation data with a single identifier for use in surveilling sports injuries for persons aged 5 to 18 years. Design Data linkage of a population cohort. Methods We performed deterministic linkage of administrative emergency department and hospitalisation data from the state of Florida in the US. Data was acquired from the Florida Agency for Health Care Administration. With limited identifiers available due to privacy, we combined data across multiple years using a near universal identifier. We identified sport and recreation injuries using a modified External Cause of Injury Morbidity Matrix and ICD codes across all possible diagnoses. Finally, we obtained descriptive statistics of records that were successfully linked and those that were not to assess similarities between the groups. Results We found 384,731 visits for SRI over a seven-year period. We were able to link approximately 70% of the records using a single identifier. There were statistically significant differences by age, sex, payer, and race/ethnicity for the records that were linked compared to the records that were not linked. Conclusions This study is significant because while similar methods have been used to examine other conditions (e.g. asthma), few have linked multiple types of administrative data especially with nearly no identifiers to examine sports and recreation injuries. This method was found useful to identify injuries over time for the same individuals seeking care in emergency departments, or in hospital inpatient settings, though future work will need to address the limitations of this method. If we expect to move health surveillance forward as budgets for it become even more limited, we must develop and improve methods to do it with fewer resources, including using data that has great limitations.
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Affiliation(s)
- Charlotte Baker
- Virginia Polytechnic Institute and State University, Virginia-Maryland College of Veterinary Medicine, Department of Population Health Sciences, 205 Duck Pond Drive (0442), Blacksburg, Virginia, USA 24061-0442
| | - Quinton Nottingham
- Virginia Polytechnic Institute and State University, Pamplin College of Business, Department of Business Information Technology, 880 W Campus Drive (0235), Blacksburg, Virginia, USA 24061-0235
| | - Jonathan Holloway
- Virginia Polytechnic Institute and State University, Virginia-Maryland College of Veterinary Medicine, Department of Population Health Sciences, 205 Duck Pond Drive (0442), Blacksburg, Virginia, USA 24061-0442
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Tang D, Cai W, Yang W, Chen S, Li L. Effectiveness of Health-Related Behavior Interventions on Physical Activity-Related Injuries in Junior Middle School Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4049. [PMID: 35409732 PMCID: PMC8997892 DOI: 10.3390/ijerph19074049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/26/2022] [Accepted: 03/27/2022] [Indexed: 02/05/2023]
Abstract
The objective of this study was to determine the effectiveness of an intervention program based on Health-Related Behavior Theory (HRBT) in reducing physical activity-related injuries (PARIs) occurrence and individual risk-taking behaviors, as well as improving PA-related behaviors. A total of 1044 students from six junior middle schools in Shantou city were included and divided randomly into an intervention group (n = 550) and a control group (n = 494), respectively. The intervention group followed a prescribed PARIs intervention program based on HRBT, and the control group performed a common health education program, consisting of seven sessions and lasting seven months from May to November 2018. After the intervention, both groups showed a significantly lower prevalence of PARIs (intervention group: from 25.45% to 10.91%, control group: from 29.76% to 11.74%, both p < 0.05), but no significant between-group differences could be observed in the post-intervention PARIs prevalence (p > 0.05). Compared with the control group, students in the intervention group had a higher improvement in PA-related behaviors and a lower score of risk-taking behaviors (both p < 0.05). Thus, it could be concluded that the HRBT intervention program had a positive effect on PA-related and risk-taking behaviors in junior middle school students, though its effectiveness in reducing the occurrence of PARIs was not significant.
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Affiliation(s)
- Dongchun Tang
- School of Public Health, Shantou University, Shantou 515041, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China
- Department of Non-communicable Diseases Control, Futian District Institute for Prevention and Control of Chronic Diseases, Shenzhen 518048, China
| | - Weicong Cai
- School of Public Health, Shantou University, Shantou 515041, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China
- The George Institute for Global Health, University of New South Wales, Newtown, NSW 2042, Australia
| | - Wenda Yang
- School of Public Health, Shantou University, Shantou 515041, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China
| | - Shangmin Chen
- School of Public Health, Shantou University, Shantou 515041, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China
| | - Liping Li
- School of Public Health, Shantou University, Shantou 515041, China
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Player age and initial helmet contact among American football players. Am J Emerg Med 2021; 47:115-118. [PMID: 33794473 DOI: 10.1016/j.ajem.2021.03.039] [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: 02/04/2021] [Revised: 03/03/2021] [Accepted: 03/10/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Concussions and chronic traumatic encephalopathy (CTE) related to professional football has received much attention within emergency care and sports medicine. Research suggests that some of this may be due to a greater likelihood of initial helmet contact (IHC), however this association has not been studied across all age groups. This study aims to investigate the association between player age and IHC in American football. METHODS Retrospective review of championship games between 2016 and 2018 at 6 levels of amateur tackle football as well as the National Football League (NFL). Trained raters classified plays as IHC using pre-specified criteria. A priori power analysis established the requisite impacts needed to establish non-inferiority of the incidence rate of IHC across the levels of play. RESULTS Thirty-seven games representing 2912 hits were rated. The overall incidence of IHC was 16% across all groups, ranging from 12.6% to 18.9%. All but 2 of the non-NFL divisions had a statistically reduced risk of IHC when compared with the NFL, with relative risk ratios ranging from 0.55-0.92. IHC initiated by defensive participants were twice as high as offensive participants (RR 2.04, p < 0.01) while 6% [95% CI 5.4-7.2] of all hits were helmet-on-helmet contact. CONCLUSIONS There is a high rate of IHC with a lower relative risk of IHC at most levels of play compared to the NFL. Further research is necessary to determine the impact of IHC; the high rates across all age groups suggests an important role for education and prevention.
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Seah PZ, Chee JNZH, Feng JXY, Ting YS, Chong SL. Risk Stratification of Paediatric Sports Injuries Seen at a Tertiary Hospital. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2020; 49:955-962. [PMID: 33463653 DOI: 10.47102/annals-acadmedsg.2020262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION In this study, we described paediatric sports injuries seen in the paediatric emergency department of a large, tertiary paediatric hospital in Singapore and evaluated risk factors for severe sports injuries. METHODS This is a retrospective review of a paediatric trauma surveillance registry from February 2012 to October 2017, including patient demographics, type of sports, circumstances, type of injuries, and clinical management in the hospital. Patients 5 to 17 years old with a sports-related injury were included. We performed logistic regression to identify predictors of severe sports injuries (defined by Injury Severity Score of ≥9), injuries requiring hospitalisation, trauma team activation, resuscitation, or those that resulted in death. RESULTS Among 10,951 patients analysed, the most common injuries sustained were fractures (4,819, 44.0%), sprains and contusions (3,334, 30.4%). For patients with severe injuries, the median length of hospital stay was 2 days (IQR 1-3 days), and time away from sports was 162 days (IQR 104-182 days). Predictors for severe injuries include transportation by emergency medical service (aOR 6.346, 95% CI 5.147-7.823), involvement in rugby (aOR 2.067, 95% CI 1.446-2.957), neurological injuries (aOR 4.585, 95% CI 2.393-4.365), dislocations (aOR 2.779, 95% CI 1.744-4.427), fractures (aOR 1.438, 95% CI 1.039-1.990), injuries to the head and neck (aOR 2.274, 95% CI 1.184-4.365), and injuries to the abdomen and pelvis (aOR 5.273, 95% CI 3.225-8.623). CONCLUSION Predictors for severe sports injuries identified may aid in risk stratification and resource allocation.
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Affiliation(s)
- Pei Zhen Seah
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
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Anderson DS, Cathcart J, Wilson I, Hides J, Leung F, Kerr D. Lower limb MSK injuries among school-aged rugby and football players: a systematic review. BMJ Open Sport Exerc Med 2020; 6:e000806. [PMID: 33178442 PMCID: PMC7642221 DOI: 10.1136/bmjsem-2020-000806] [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] [Accepted: 10/09/2020] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE The objective of this systematic review was to explore the incidence of lower limb musculoskeletal (MSK) injuries sustained by rugby union, rugby league, soccer, Australian Rules and Gaelic football players under 18 years. The review sought to identify the mechanisms and types of injury sustained and to compare between sports. DESIGN This systematic review focused on the incidence of lower limb injury in adolescent team sports that involved running and kicking a ball. A literature search of studies published prior to January 2020 was conducted using SportDiscus, Medline and PubMed databases. The Standard Quality Assessment Criteria appraisal tool was used to assess the quality of each article included in the review. Two or more authors independently reviewed all papers. RESULTS Sixteen papers met the inclusion criteria; prospective cohort (N=14), retrospective (n=1) and longitudinal (n=1). These studies investigated injuries in rugby union and rugby league (n=10), football (soccer) (n=3), Australian Rules (n=2) and Gaelic football (n=1). There were a total of 55 882 participants, aged 7-19 years old, who reported 6525 injuries. The type, site and mechanisms of injury differed across sports. SUMMARY Lower limb injuries were common in adolescent rugby, soccer, Gaelic football and Australian Rules football players, however these studies may not fully reflect the true injury burden where recurrent and overuse injuries have not been considered. There were differences between sports in the mechanisms, types and severity of injury.
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Affiliation(s)
| | - John Cathcart
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University - Jordanstown Campus, Newtownabbey, UK
| | - Iseult Wilson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - Julie Hides
- School of Allied Health Sciences, Griffith University, Nathan, Australia
| | - Felix Leung
- School of Allied Health Sciences, Griffith University, Nathan, Australia
| | - Daniel Kerr
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University - Jordanstown Campus, Newtownabbey, UK
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Ojifinni K, Motara F, Laher AE. Knowledge, Attitudes and Perceptions Regarding Basic Life Support Among Teachers in Training. Cureus 2019; 11:e6302. [PMID: 31938594 PMCID: PMC6944153 DOI: 10.7759/cureus.6302] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Cardiac arrests may occur anytime, anywhere and to anyone including learners at schools. Teachers have a moral obligation to care for learners while on the school premises. Outcomes after cardiac arrest are better when the first-responder possesses adequate knowledge and skill in basic life support (BLS) and cardiopulmonary resuscitation (CPR). The aim of this study was to assess the knowledge, attitudes and perceptions of student-teachers pertaining to BLS. Methods This was a self-administered, questionnaire based, prospective and cross-sectional study of senior undergraduate student-teachers enrolled at a South African university. The study was conducted between 04 November 2017 and 18 February 2018. Results A total of 316 student-teachers, with a mean age of 21.8 ± 2.6 years completed the survey. Trauma-related emergencies, allergic reactions and breathing difficulties were witnessed during practice teaching sessions at various schools by 52.5% (n = 166), 36.4% (n = 115) and 32.9% (n = 104) of participants, respectively. The mean knowledge score pertaining to BLS was 4.0 ± 1.7 out of 12 points. Previous CPR training was associated with a good knowledge score (p = 0.005) and confidence in responding to an emergency (p = 0.005). Most of the participants (N = 288, 91.1%) had no formal training in CPR with more than three-quarters (76.4%) of them not knowing where to acquire training. Barriers to initiating CPR included fear of litigation (n = 264, 83.5%), injury to the victim (n = 238, 75.3%), presence of blood, vomitus or secretions (n = 206, 65.2%) and fear of contracting a disease (n = 186, 58.8%). Most (n = 255, 80.7%) respondents reported that they would perform CPR on a learner at school. Conclusion Student-teachers surveyed in this study displayed poor knowledge and perceptions but positive attitudes with regards to the practice of CPR and BLS. Consideration should be given to including formal CPR training as part of the curriculum for teachers in training.
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Affiliation(s)
- Kehinde Ojifinni
- Emergency Medicine, University of the Witwatersrand, Johannesburg, ZAF
| | - Feroza Motara
- Emergency Medicine, University of the Witwatersrand, Johannesburg, ZAF
| | - Abdullah E Laher
- Emergency Medicine, University of the Witwatersrand, Johannesburg, ZAF
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Tang D, Cai W, Yang W, Gao Y, Li L. Gender-Specific Risk Factors of Physical Activity-Related Injuries among Middle School Students in Southern China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132359. [PMID: 31277298 PMCID: PMC6650942 DOI: 10.3390/ijerph16132359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/25/2019] [Accepted: 07/01/2019] [Indexed: 02/05/2023]
Abstract
This cross-sectional study was carried out to explore the potential risk factors of physical activity-related injuries (PARI) among middle-school students of different genders. Selected by the random cluster sampling method, students aged from 12 to 16 years old in grades 7-8 from six middle schools in Shantou, southern China, were recruited for this investigation in November 2017. Information about socio-demographics, physical activity (PA) exposure time, individual exercise behaviors, risk-taking behaviors, and PARI experiences in the past 12 months was collected. A multivariate logistic regression model was used to explore the risk factors of PARI. A total of 1270 students completed valid questionnaires, with an overall injury incidence of 33.6% (boys: 42.0%; girls: 25.0%), an injury risk of 0.68 injuries/student/year, and an injury rate of 1.43 injuries per 1000 PA exposure hours. For boys, living in a school dormitory, participating in sports teams, exercising on a wet floor, rebellious behavior, and having longer PA exposure time were the risk factors of PARI. For girls, those who were sports team members, whose parents were divorced or separated, and those with longer PA exposure time were more vulnerable to suffer from PARI. In conclusion, PARI was a health problem among middle school students in southern China. Boys and girls differed in PARI occurrence and were affected by different risk factors, which provides a basis for targeted gender-specific intervention programs to reduce the occurrence of PARI among middle-school students.
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Affiliation(s)
- Dongchun Tang
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China
| | - Weicong Cai
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China
| | - Wenda Yang
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China
| | - Yang Gao
- Department of Sport and Physical Education, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Liping Li
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China.
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Griffiths LJ, Cortina-Borja M, Tingay K, Bandyopadhyay A, Akbari A, DeStavola BL, Bedford H, Lyons RA, Dezateux C. Are active children and young people at increased risk of injuries resulting in hospital admission or accident and emergency department attendance? Analysis of linked cohort and electronic hospital records in Wales and Scotland. PLoS One 2019; 14:e0213435. [PMID: 30969971 PMCID: PMC6457613 DOI: 10.1371/journal.pone.0213435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 02/21/2019] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Children and young people (CYP) are encouraged to increase time spent being physically active, especially in moderate and vigorous intensity pursuits. However, there is limited evidence on the prospective association of activity levels with injuries resulting in use of hospital services. We examined the relationship between objectively-measured physical activity (PA) and subsequent injuries resulting in hospital admissions or accident and emergency department (A&E) attendances, using linked electronic hospital records (EHR) from a nationally representative prospective cohort of CYP in Wales and Scotland. METHODS We analysed accelerometer-based estimates of moderate to vigorous (MVPA) and vigorous PA (VPA) from 1,585 (777 [46%] boys) seven-year-old Millennium Cohort Study members, living in Wales or Scotland, whose parents consented to linkage of cohort records to EHRs up until their 14th birthday. Negative binomial regression models adjusted by potential individual, household and area-level confounders, were fitted to estimate associations between average daily minutes of MVPA, and VPA (in 10-minute increments), and number of injury-related hospital admissions and/or A&E attendances from age nine to 14 years. RESULTS CYP spent a median of 59.5 and 18.1 minutes in MVPA and VPA/day respectively, with boys significantly more active than girls; 47.3% of children experienced at least one injury-related admission or A&E attendance during the study period. Rates of injury-related hospital admission and/or A&E attendance were positively associated with MVPA and VPA in boys but not in girls: respective adjusted incidence rate ratios (95% CI) for boys: 1.09 (1.01, 1.17) and 1.16 (1.00, 1.34), and for girls: 0.94 (0.86, 1.03) and 0.85 (0.69, 1.04). CONCLUSION Boys but not girls who engage in more intense PA at age seven years are at higher risk of injury-related hospital admission or A&E attendance when aged nine to 14 years than their less active peers. This may reflect gender differences in the type and associated risks of activities undertaken. EHRs can make a useful contribution to injury surveillance and prevention if routinely augmented with information on context and setting of the injuries sustained. Injury prevention initiatives should not discourage engagement in PA and outdoor play given their over-riding health and social benefits.
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Affiliation(s)
- Lucy J. Griffiths
- Health Data Research UK, Wales and Northern Ireland, Swansea University Medical School, Swansea, United Kingdom
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Mario Cortina-Borja
- Clinical Epidemiology, Nutrition and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Karen Tingay
- Administrative Data Research Centre Wales, Swansea University Medical School, Swansea, United Kingdom
| | - Amrita Bandyopadhyay
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, United Kingdom
| | - Ashley Akbari
- Health Data Research UK, Wales and Northern Ireland, Swansea University Medical School, Swansea, United Kingdom
- Administrative Data Research Centre Wales, Swansea University Medical School, Swansea, United Kingdom
| | - Bianca L. DeStavola
- Clinical Epidemiology, Nutrition and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Helen Bedford
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Ronan A. Lyons
- Health Data Research UK, Wales and Northern Ireland, Swansea University Medical School, Swansea, United Kingdom
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, United Kingdom
| | - Carol Dezateux
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- Health Data Research UK London, Queen Mary University London, London, United Kingdom
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Schneuer FJ, Bell JC, Adams SE, Brown J, Finch C, Nassar N. The burden of hospitalized sports-related injuries in children: an Australian population-based study, 2005-2013. Inj Epidemiol 2018; 5:45. [PMID: 30556103 PMCID: PMC6295440 DOI: 10.1186/s40621-018-0175-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 11/04/2018] [Indexed: 11/10/2022] Open
Abstract
Background There is concern about recent increase and severity of sports-related injuries in children. Despite the benefits of sports participation, injuries may carry long-term health consequences. We aimed to evaluate the prevalence, characteristics and types of hospitalized sports-related injuries in children. Methods Population-based study of all acute sports-related injuries requiring hospitalization in children 5 to 15 years of age in New South Wales (NSW), Australia, 2005–2013. Health information was obtained from the NSW Admitted Patient Data Collection, a census of all hospital admissions from public and private hospitals. Children with a recorded ICD10-AM injury code (S00-T79) and sport-related activity code (U50-U70) were included. Prevalence and trend in injuries by age group, sporting code, body region affected and type of injury were assessed. Results There was a total of 20,034 hospitalizations for sports-related injuries (2.7% of all hospitalizations in children aged 5–15 years), involving 21,346 recorded injuries in 19,576 children. The overall population hospitalization period prevalence was 227 per 100,000 children aged 5–15 years in 2005–2013, remaining stable over time (RR 0.99; 95% CI 0.98–1.00). Football codes such as rugby league/union and soccer combined represented nearly two thirds of the total (60%). The most common body regions affected were the forearm (31%) head (15%) and hand injuries (13%). Fractures accounted for 65% of injuries followed by dislocations (10%) and traumatic brain injury (10%). Compared to other age groups, children aged 5–8 years had double the proportion of shoulder (15% vs. 7%) while 13–15 year olds had higher proportion of lower-leg (14% vs. 8%) and knee (6% vs.2%) injuries. One in seven injuries sustained while playing rugby league/union, baseball and hockey were traumatic brain injuries. A total of 444 (2.2%) of children had more than one hospitalization for sports-related injuries. Conclusion On average, six children were hospitalized every day for sports-related injuries in the last decade with trends remaining stable. The most common sports involved were football codes, one in three injuries involved the forearm and two thirds were fractures. These findings can be used to inform health policy and sporting governing bodies to target preventive interventions and promote safe sports participation in children. Electronic supplementary material The online version of this article (10.1186/s40621-018-0175-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Francisco J Schneuer
- Child Population and Translational Health Research, The Children's Hospital at Westmead Clinical School, Level 2 The Hub, Charles Perkins Centre D17, The University of Sydney, Westmead, NSW, 2006, Australia.
| | - Jane C Bell
- Child Population and Translational Health Research, The Children's Hospital at Westmead Clinical School, Level 2 The Hub, Charles Perkins Centre D17, The University of Sydney, Westmead, NSW, 2006, Australia
| | - Susan E Adams
- Injury Prevention, Neuroscience Research Australia, Randwick, NSW, Australia.,Department Paediatric Surgery, Sydney Children's Hospital, Randwick, NSW, Australia.,School of Women's and Children's Health, University of New South Wales, Kensington, NSW, Australia
| | - Julie Brown
- Injury Prevention, Neuroscience Research Australia, Randwick, NSW, Australia
| | - Caroline Finch
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Edith Cowan University, Perth, WA, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, The Children's Hospital at Westmead Clinical School, Level 2 The Hub, Charles Perkins Centre D17, The University of Sydney, Westmead, NSW, 2006, Australia
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