Diana Rus

Epidemiology of assault and self-harm injuries treated in a large Romanian Emergency Department.

Objectives Intentional injury, including interpersonal violence and self-harm, is one of the world’s leading causes of preventable injury. In Europe alone, nearly 1.5 million individuals receive medical treatment each year for a violence-related injury. We examined violent injuries treated in the largest Emergency Department (ED) in Tîrgu Mures County, Romania, with a catchment area of approximately 580 000 residents to describe the epidemiology of assault and self-harm injuries. Methods Data were collected as part of the European Injury Database project, from a sample of patients who presented with a violence-related injury and received care from the ED of the Mures County Emergency Hospital, Romania. The data were collected for 9 months by two trained emergency physicians. Information about individual demographics; mechanism, nature, place, and activity of injury; injury types, and body regions affected; and discharge state were compared for assault and self-harm injuries. Results Of the 380 patients treated for violence-related injuries, 88.7% were for assault and 11.3% were for self-harm. For both types of injuries, the majority of patients were between the ages of 15 and 44. Assaults frequently occurred in the home, on streets and highways, or in public places; and men (80.4%) were far more likely than women (19.6%) to be treated for this type of injury; a slightly higher proportion of men (55.8%) than women (44.2%) were treated for self-harm, most of which occurred in homes. Discussion Of all injuries treated in the Tîrgu Mures ED, one out of five was violence related. One out of 10 patients that suffered an injury as a consequence of a violent event and treated in the ED required admission to a hospital for further medical care, leading to a significant health care burden. These data suggest that prevention strategies should focus on young adults, and particularly men. Interventions that focus on detection and treatment of psychological illness, reduction of alcohol use and associated aggression, and family and intimate partner violence are suggested as priorities.

Epidemiology of pedestrian–MVCs by road type in Cluj, Romania

Objective Pedestrian–motor vehicle (PMV) crash rates in Romania are among the highest in all of Europe. The purpose of this study was to examine the characteristics of pedestrian–MVCs in Cluj County, Romania, on the two major types of roadways: national or local. Methods Cluj County police crash report data from 2010 were used to identify pedestrian, driver and crash characteristics of pedestrian–MVCs. Crashes with available location data were geocoded and road type (national or local) for each crash was determined. Distributions of crash characteristics were examined by road type and multivariable logistic regression models were built to determine predictors of crash road type. Results Crashes occurring on national roads involved more teenagers and adults, while those on local roads involved more young children (0–12) and older adults (65+) (p<0.01). Crashes on national roads were more likely to have marked pedestrian crossings and shoulders compared with local crashes. Pedestrian–MVCs that involved a moving violation by the motorist were more likely to occur on national roadways (adjusted OR=1.93, 95% CI 1.07 to 3.49). Conclusions Pedestrian–MVCs pose a considerable health burden in Romania. Results from this study suggest that factors leading to PMV crashes on national roads are more likely to involve driver-related causes compared with local roads. Intervention priorities to reduce pedestrian crashes on national roads should be directed towards driver behaviour on national roads. Further examination of driver and pedestrian behaviours related to crash risk on both national and local roads, such as distraction and speeding, is warranted.

Paediatric head injuries treated in a children's emergency department from Cluj-Napoca, Romania

The aim of the study was to describe paediatric head injuries and identify factors that led to advanced care. Incident cases of head injuries that sought care from December 2008 to October 2010 at Childrens Emergency Hospital Cluj-Napoca were evaluated. The main outcome was transfer or admission to advanced care. From a total of 3053 children treated for an injury, 1541 (50.4%) presented with head injury. A total of 960 (62.3%) of the children with a head injury required advanced care treatment. Young children were more likely to suffer a head injury than older children, but a higher proportion of older children required advanced care (70.3%). Children who suffered a head injury as a consequence of road traffic were almost five times more likely to require advanced care (OR: 4.97; 3.09-8.06) than being released. Our results suggest that data on injuries provide evidence-based information on the nature of injuries children are prone to, and what activity, type, and mechanism of injury impact Romanian children.

936 Parent’s experience with child safety restraint in Romania

Background Child safety restrains are known as the most effective measures in protecting children from severe injuries and death while travelling in a car. Little is known about the Romanian rates of child safety restrains as the legal requirements are new and there is little enforcement. Methods An observational study on child safety restraint use was conducted in Cluj-Napoca, Romania, between 2013 and 2014. Child restraint and parent surveys were conducted at 38 schools and kindergartens and 3 commercial areas, to explore the use of safety restraints. Drivers were asked about their knowledge and attitudes towards restraint legislation and safety behaviour. A total of 892 children were observed and 533 (69.4%) drivers approached responded to our survey. Results Of the total number of observed children, 67.4% were travelling in some type of restraint. One third of the children were registered as being properly fitted (38.3%). More than two thirds of the drivers approached (n = 348, 68.4%) had knowledge about the existence of child safety restraint legislation. Among parents who did not use a child safety restraint, low use was attributed to lack of awareness and knowledge (49.4%) followed by being aware but choosing not to (27.9%), financial reasons (12.7%) and the seat being in the other car (10.1%). They were also asked to give examples of what would motivate them to use child restraints for their children and 26.6% indicated that a better law would increase the use, while 11.4% acknowledged that free availability will determine them to use restraints. Conclusions Parent drivers could benefit from proper knowledge on the importance of and how to correctly use child safety restraints, as few children were properly restraint in our sample population. The majority of parents had some information on child safety restraint use and were aware that they are important, yet a large proportion of parents were not using restraints, therefore raising awareness actions are much needed.

Paediatric trauma registries are valuable: preliminary results from a Romanian IDB pilot

Traumatic injuries greatly affect childrens physical and psychological well-being, affecting their school performance, and often leave children with life-long disabilities. A surveillance system has been pilot tested in the Emergency Department of the Cluj-Napoca Hospital as part of the EU Injury Data Base (IDB). Data collection were conducted according to the common IDB standard established in the Member States. The scope of the project was to identify the frequency and characteristics of childhood injuries with the goal of providing information to support prevention efforts and provide comparable data among Member States. Relying on a database in progress (N=1000), preliminary descriptive results indicate that over one third of injured children treated in the Children Hospital of Cluj-Napoca occur between 0 and 4 years of age. Children in this age group suffer twice as many injuries as in any other age group. As a result, every 6 months in Cluj County, one out of every 100 children younger than 4 years old receives emergency healthcare treatment for an injury. Furthermore, over two thirds of children sustained injuries to the head region, 40% of which affected the brain and/or the skull. These injuries have a strong potential for life-long disability, and increase the risk for future injuries. This pilot data provided a baseline for evidence-based prevention strategies with substantial return on investment; while further investigation is needed the pilot demonstrated that there is capability to collect EU quality level data in Romania.

Backyard farm injuries assessment in rural area of Cluj County, Romania

Although 46% of the Romanian population lives in rural areas, little is known about injuries and violence rural residents experience. Research worldwide consistently shows that farm related activities are a major cause of rural injuries. While such injuries can result in considerable suffering and financial losses, little data are available on the prevalence and potential causes of injuries, especially among small farming operations. In Romania, the majority of farming operations are backyard farms, which are a method of survival agriculture, and also provide a place for work and recreation. This project assessed the burden of farm injuries, populations at risk and injury risk factors among backyard family farms in Cluj-Napoca, Romania. 150 backyard farms were targeted, with data collected on injury occurrence, defined as an injury that restricted rural inhabitants from normal activities for at least 4 h, or resulted in loss of consciousness, loss of awareness, or loss of memory for any length of time, or required professional care including backyard farm workers, non-working rural residents and visitors. At the time of abstract submission, data is being collected. Data will include the prevalence and risk factors for injury. The project is unique because it is the first to address backyard farm injuries in Romania. This data will provide the first public health information about backyard farm injuries, which will provide a baseline for future research projects on rural injuries as well as frame backyard farm injury prevention strategies and policies.