Glenn Welander

Bicycle injuries in Western Sweden: a comparison between counties

The objectives of the study were to investigate whether there are differences in the incidence of bicycle-related injuries by geographic district (county), age, and gender in Swedens Western Road Administration Region, and to utilize any detected differences to suggest priorities for intervention and prevention. Injury data come from the Swedish national hospital-discharge registry and a specialized national register of occupational injuries. Both bodily injuries in general and head injuries in particular show intra-regional differences. The rural part of Skaraborg County was shown to have a significantly higher injury incidence than other parts of the Western Region. Females generally show a lower incidence than males, but older women are more likely to be seriously injured than younger (age-related differences being greater than for males). Some striking findings were found with regard to occupational differences. Females sustain more work-related bicycle injuries than males. Head injuries account for more than half of the bicycle injuries in the Western Region that require hospitalization. All this indicates that targeted measures are required. Some studies have shown that the use of bicycle helmets reduces the incidence of head injuries, the degree of their severity, and the number of bicycle-related fatalities. There is a need for mandatory helmet-wearing legislation, which must go hand-in-hand with special efforts to reach groups with a low rate of helmet wearing, in particular those in the middle age range. Although the grown-up/older cycling population has been the subject of targeted action in some countries, the focus of preventive activity has generally been on children. The results of the study suggest the need for further injury-related research into adult cycling.

Differences in child injury hospitalizations in Sweden : The use of time-trend analysis to compare various community injury-prevention approaches

Aim: Swedens child injury fatality rates are among the lowest in the world. The country has engaged in a number of community injury-prevention programmes. The purpose of this study was to compare child injury hospitalization rates from the Skaraborg District with the rest of Sweden. Our study hypothesis was that municipalities that offered comprehensive child injury-prevention programmes would see significant decreases in their child injury hospitalization rates, compared with other areas. Methods: The study areas comprised three groups, consisting of municipalities in Skaraborg that had adapted the Safe Communities approach to injury prevention programmes, other municipalities in the District, and the rest of Sweden. The aim of the analysis was twofold: (1) to fit time trends for childrens injuries in various areas in an integrated manner; and (2) to compare time trends across locations between community safety-promotion programmes as well as with the control areas. Panel data models and parametric splines were used. Results: There were differences between incidence rates in the study areas and with regard to gender. There was a steep decrease in injury rates in one of the Safe Communities study areas for both genders. Conclusions: The methods applied in this analysis reveal more detailed and sophisticated time trends than the usual simple linear regression approach. The model provided a clearer view of the interactions of gender, area, and time as they impacted on childrens injuries, and allowed for better insight into the impact of safety programmes.

The results of 10 years' experience with the Skaraborg bicycle helmet program in Sweden

Abstract The aim of the study was to utilize the Skaraborg Bicycle Helmet Program (SBIHP)to describe processes and methods contributing to attitudinal and behavioral change favorable to bicycle-helmet wearing. A subsidiary aim was to demonstrate how a helmet-wearing program can be built up. The background to the study lies in the fact that the SBIHP has been evaluated to have produced a significant average annual reduction, of 3·1%, in all bicycle-related injuries in Skaraborg County in Sweden over the period 1978–1993. Increased helmet use contributed to a 59% drop in head injuries in the same period. This reduction makes it interesting to examine factors relevant to the program at municipal and county level, and also the national and international factors that may have contributed to the outcome. The structure of the process is described in time sequence, by means of program documentation, campaigns, information meetings and newspaper articles. A county-wide injury-prevention program designed to utilize...

Area-based differences in injury risks in a small Swedish municipality – Geographic and social differences

The current study investigates the geographic and social differences in injury risks across living areas in a small semi-urban Swedish municipality. The study population consisted of all people living in the municipality during the years 1992–1996 (31,820, December 1996). Area comparisons were made based on data related to the municipality’s 15 census districts and grouped according to the geographic location and three different social characteristics (proportion of unemployed, of low educated, or of people born outside Sweden). Injury data was gathered for the period 1992–1996 from two data sources: Sweden’s National Hospital Discharge Register, and the local outpatient register. Three diagnosis groups were used: all injuries aggregated, traffic injuries and other unintentional injuries. Odds-ratios were calculated for males and females separately. There were no remarkable differences in injury risks between areas, whether compared on the basis of their geographic location or some of their socio-economic characteristics. These findings could be attributed to either a lack of sensitivity of the measures employed or the existence of a well-functioning safety promotion program in the municipality that impacts on injury risk distribution between areas. This, in turn, does not imply that members of underprivileged social groups are not in need of special support regardless of the area to which they belong.