Deepa P. Rao

At-a-glance - The Physical Activity, Sedentary Behaviour and Sleep (PASS) Indicator Framework

Physical activity surveillance in Canada has traditionally focussed on measuring and reporting on the most active end of the activity spectrum. Emerging research suggests that in addition to insufficient moderate-to-vigorous physical activity (MVPA), sedentary behaviour and inadequate sleep are also important risk factors for chronic disease. In order to create effective public health policy and program initiatives to target all levels of activity (MVPA, light physical activity, sedentary behaviour and sleep), the demand for reliable, nationally representative data and information on the patterns of all of these behaviours among Canadians has increased. As a result, the need for a broader, modernized approach to national physical activity surveillance, with the inclusion of sedentary behaviour, sleep and the proximal and distal factors that impact all of these behaviours, was identified as a priority for the Public Health Agency of Canada (PHAC) in 2014.

Tooth ‘aches’: Injuries related to toothbrush use

Abstract Objectives A toothbrush is a medical device that is widely used for oral hygiene practices at almost all ages. Descriptive studies of toothbrush-related injuries (TRI) are fairly limited, with existing studies mainly focusing on case reports. The present study sought to describe TRIs in Canada, including the contexts within which they occur. Methods The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database, years 1990 to 2016, was queried for cases of TRI. The circumstance, mechanism and type of injury are described based on an examination of narrative text, using data mining techniques and corresponding variable codes. Average annual percent change estimates are presented to describe trends over time. Results The rate of TRIs is low (16.9 of 100,000 CHIRPP cases among ages 14 years and below [0.02%], and 2.4 of 100,000 CHIRPP cases among ages 15 years and above [0.002%]) and has been relatively stable over the past quarter century. A majority of cases occurred among individuals aged 14 years and below; falls were the most common circumstance (50.0%) and mechanism (39.8%) of injury and laceration to the internal mouth was the most frequent type of injury (51.9%). Intentional injuries due to a toothbrush were only observed among individuals aged 15 years and older, such as in cases of inducing vomiting. Conclusions Although rare, TRIs are occurring in Canada and risk can be mitigated. Behaviours associated with routine habits of toothbrushing are an area that might assist with injury prevention efforts. The safe and appropriate use of toothbrushes should be considered at all ages.

The ups and downs of trampolines: Injuries associated with backyard trampolines and trampoline parks

Abstract Objective To compare characteristics associated with backyard trampoline injuries (BTI) and trampoline park injuries (TPI) using records from the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP). Methods eCHIRPP records for trampoline injuries (2012 to 2016) were extracted using variable codes and narratives, and injuries were examined among individuals 17 years and younger. Descriptive estimates for BTI and TPI, as well as age and sex adjusted odds ratios (OR) for the mechanism, source, body part and type of injury associated with TPIs relative to BTIs, are presented. Results Trampoline injuries are increasing in Canada (P<0.01). Patients with TPIs were older than those with BTIs. Relative to BTIs, TPIs were more associated with impact as the mechanism (OR 2.6, 95% CI: 2.2 to 3.1), trampoline beds as the source (OR 1.7, 95% CI: 1.4 to 2.1), lower extremity as the body part (OR 3.7, 95% CI: 3.0 to 4.4) and sprains as the type of injury (OR 2.0, 95% CI: 1.6 to 2.4). In contrast, another jumper (OR 0.5, 95% CI: 0.4 to 0.6) or fall (OR 0.4, 95% CI: 0.4 to 0.6) as the mechanism, surface (OR 0.7, 95% CI: 0.5 to 0.9) or another jumper (OR 0.5, 95% CI: 0.4 to 0.7) as the source, face or neck (OR 0.6, 95% CI: 0.4 to 0.7) as the body part, and lacerations (OR 0.6, 95% CI: 0.3 to 0.9) or soft tissue injury (OR 0.7, 95% CI: 0.6 to 0.9) as the type of injury were more associated with BTIs relative to TPIs. Conclusion Trampoline parks result in injuries different than those from backyard trampolines. This examination into the distinct injury characteristics can help to inform future prevention measures.

At-a-glance - Traumatic brain injury management in Canada: changing patterns of care

INTRODUCTION With growing awareness about traumatic brain injuries (TBI), there is limited information about population level patterns of TBI care in Canada. METHODS We examined data from the Canadian Community Health Survey (years 2004, 2009, and 2014) among all respondents ages 12 years and older. TBI management characteristics examined included access to care within 48 hours of injury, point of care, hospital admission, and follow-up. RESULTS We observed that many Canadians sought care within 48 hours of their injury, with no changes over time. We found a significant decline in the proportion of Canadians opting to visit an emergency department (p = 0.03, all ages), and a significant increase in youth opting to visit a doctors office (p < 0.01). CONCLUSION TBIs are an important and growing health concern in Canada. Care for such injuries appears to have shifted towards the use of health care professionals outside the hospital environment, including primary care doctors.

The lows of getting high: sentinel surveillance of injuries associated with cannabis and other substance use

ObjectivesCannabis is a widely used illicit substance that has been associated with acute injuries. This study seeks to provide near real-time injury estimates related to cannabis and other substance use from the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) database.MethodsData from the eCHIRPP database, years 2011 to 2016, were analyzed via data mining, descriptive, logistic regression, and sensitivity analyses. Drug use trends over time for cannabis and/or other substances (alcohol, illicit drugs, and medications) were assessed. Descriptive statistics (intent, external cause, and nature of injury) and proportionate injury ratios (PIR) associated with cannabis use are presented.ResultsCannabis use was observed in 184 cases/100,000 eCHIRPP cases, and related injuries were mostly identified as unintentional (66.8%). Poisoning (68.5%) and intoxication (69.4%) were the external cause and nature of injury most associated with these events, and hospitalization was recorded for 14.3% of cases. Per 100,000 eCHIRPP cases, cannabis was used alone in 72.4 cases, and in combination with alcohol, illicit drugs, or medications in 74.6 cases, 11.3 cases, and 7.9 cases, respectively. Relative to non-use, the PIR of hospitalization was not significant for cannabis-only users of either sex (males: PIR 1.0, 95% CI 0.6–1.7, females: PIR 0.9, 95% CI: 0.5–1.7).ConclusionCannabis use injuries are rare, but can occur when cannabis is used with or without other substances. As Canada considers legislative changes, our finding of cases related to unintentional injury, poisoning, and intoxication suggests areas that might benefit from health literacy efforts.RésuméObjectifsLe cannabis, une substance illicite largement consommée, est associé à des blessures aiguës. Notre étude vise à présenter en quasi temps réel les blessures estimatives liées à la consommation de cannabis et d’autres substances d’après la base de données de la plateforme électronique du Système canadien hospitalier d’information et de recherche en prévention des traumatismes (eSCHIRPT).MéthodeNous avons analysé les données de la base eSCHIRPT pour les années 2011 à 2016 au moyen de techniques de forage de données et d’analyses descriptives, de sensibilité et de régression logistique. Nous avons estimé les tendances de la consommation de cannabis avec ou sans autres substances (alcool, drogues et médicaments) au fil du temps. Nous présentons les statistiques descriptives (intention, cause externe et nature de la blessure) et les rapports proportionnels de blessures (RPB) associés à la consommation de cannabis.RésultatsLa consommation de cannabis a été observée dans 184 pour 100,000 cas dans eSCHIRPT, et les blessures associées étaient principalement non intentionnelles (66,8%). L’empoisonnement (68,5%) et l’intoxication (69,4%) étaient la cause externe et la nature de la blessure les plus souvent associées à ces épisodes, et une hospitalization a été enregistrée dans 14,3% des cas. Pour 100,000 cas dans eSCHIRPT, le cannabis avait été consommé seul dans 72,4 cas, et en combinaison avec de l’alcool, de la drogue ou des médicaments dans 74,6, 11,3 et 7,9 cas, respectivement. Par rapport à la non-consommation, les RPB de l’hospitalization n’étaient pas significatifs pour les consommateurs et consommatrices de cannabis seul (hommes: RPB 1,0, IC de 95%: 0,6–1,7; femmes: RPB 0,9, IC de 95%: 0,5–1,7).ConclusionLes blessures dues à la consommation de cannabis sont rares, mais elles peuvent se produire, que le cannabis soit consommé seul ou avec d’autres substances. Étant donné les modifications législatives envisagées au Canada, nos constatations sur les cas de blessures, d’empoisonnements et d’intoxications involontaires indiquent que des efforts pour renforcer l’information en matière de santé sur ces aspects pourraient être bénéfiques.

PW 2578 Sentinel surveillance of injuries related to substance use and abuse among the canadian pediatric population

Substance use is an individual behaviour that is also embedded in sociocultural context. The use of such psychoactive agents has been associated with injuries, most notably poisoning. This study seeks to identify and describe injuries related to substance use in the Canadian pediatric population that were captured within the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) database. Records in the eCHIRPP system, years 2011 to 2016, were extracted for ages below 18 years old. Existing variable codes and narrative text were used to identify injuries related to substance use (depressants, stimulants, opioids, cannabis, and alcohol). Descriptive statistics (intent, type of injury, and hospitalization) were calculated using SAS Enterprise Guide version 5.1 and are presented. A total of 3363 cases of injury related to substance use were identified, with a frequency of 627 per 1 00 000 eCHIRPP cases. Among cases where substance use was identified, poly-substance use was observed in 14.9% of cases, and the use of depressants only in 2.4% of cases, stimulants only in 1.0% of cases, opioids in 3.2% of cases, cannabis in 12.7% of cases, and alcohol in 65.9% of cases. Poisoning accounted for most injuries (72.0%), and the majority of injuries were unintentional in nature (67.1%), although cases of physical assault (12.8%), self-harm (11.3%), and sexual assault (0.8%) were observed. Injuries severe enough to warrant hospitalization occurred in 12.1% of cases. Injuries related to the use of different categories of substances have been identified in pediatric populations presenting to eCHIRPP centres. Given the possibility of physical and psychological dependence on psychoactive agents, continued surveillance and awareness health literacy efforts are warranted. Continued surveillance and monitoring of injuries related to substance use should help to inform future injury prevention efforts.

At-a-glance - Sentinel surveillance of emergency department presentations for barbecue brush-related injuries: the electronic Canadian Hospitals Injury Reporting and Prevention Program, 2011 to 2017

A barbecue (BBQ) brush is a common household item designed for cleaning grills used for barbecuing. Data from the electronic Canadian Hospitals Injury Reporting and Prevention Program database were analysed to estimate the frequency of injuries related to BBQ brushes as a proportion of all injuries, as well as to describe characteristics associated with such injury events. Between April 1, 2011 and July 17, 2017, BBQ brush injuries were observed at a frequency of 1.5 cases per 100 000 eCHIRPP cases (N = 12). Findings suggest that in addition to risks associated with the ingestion of loose BBQ brush bristles attached to foods, loose bristles could also result in injury via other mechanisms.

Tendances en matière d’embonpoint et d’obésité chez les enfants au Canada

L’obésité étant un facteur de risque important de maladie chronique1, elle pèse sur le réseau de soins de santé, l’économie et la qualité de vie des Canadiens2. En 40 ans, la prévalence de l’obésité chez les enfants et les jeunes au Canada a connu une hausse considérable3. Ces derniers sont ainsi de plus en plus nombreux à recevoir un diagnostic de troubles de la santé liés à l’obésité, troubles auparavant presque exclusivement observés chez les adultes, Cet article a fait l’objet d’une évaluation par les pairs.