Leonard Banco

A population-based study of motorcycle injury and costs

STUDY OBJECTIVE To provide a population-based injury and cost profile for motorcycle injury in Connecticut. DESIGN Population-based retrospective epidemiologic review of Connecticut death certificates, hospital discharge data, and police accident reports. RESULTS Connecticut death certificates identified 112 deaths from motorcycle injuries for an annual death rate of 1.2 per 100,000 persons. Death rates were highest among 20- to 24-year-old men. Nonhelmeted motorcyclists were 3.4-fold more likely to die than were helmeted riders (P less than .05). An estimated 2,361 motorcycle-related hospital discharges resulted in an annual hospitalization rate of 24.7 per 100,000 persons. Head, neck, and spinal injuries accounted for 22% of all injuries. Total costs exceeded

Burn injuries among children in an urban emergency department

29 million; 29% of hospitalized patients were uninsured, and 42% of the cost was not reimbursed to the hospitals. CONCLUSION Motorcycle injuries contribute significantly to Connecticuts mortality, morbidity, and medical costs. Our study suggests that a uniform helmet law would save an estimated ten lives and prevent more than 90 nonfatal injuries in Connecticut each year at a cost savings to the state of

Outdoor play: A survey of parent's perceptions of their child's safety

5.1 million. These data are crucial in advocating re-enactment of motorcycle helmet laws.

The safe teen work project: A study to reduce cutting injuries among young and inexperienced workers

To determine the profile of burn injury among an ambulatory population, we conducted a retrospective chart review over a one-year period of all first visits by patients under age 18 receiving burn care in our emergency department. Of the 109 visits, contact burns were most numerous (43.1%) followed by scalds (33.9%), flame/explosion (11.0%), cigarettes (5.5%) and electrical (2.8%). For children under 11 years of age, contact burns caused over half of all burns. Irons accounted for 44.7% of contact burns and 19.1% of all burns. The next most frequent causative agents were beverages (14.7%), food (nonbeverage) (7.3%), tap water/bath (7.3%), and cooking-related (6.4%). Contact burns were more likely to be smaller and more localized when compared with other burns. The cause and causative agents of burns differ in frequency and relative importance depending on the patient population studied and the level of medical care being provided. Specific burn prevention strategies should be directed toward particular patterns of injury within defined patient groups.

Evaluating the impact of a street barrier on urban crime

BACKGROUND Anecdotal reports suggest that parents may be restricting outdoor play in response to a perceived lack of safety and fear of violence and crime in urban environments. The study objective was to determine whether parents who perceived their neighborhood as unsafe would be most likely to restrict their childs outdoor play and report the greatest worries related to neighborhood characteristics. METHODS A convenience sample of primary caregivers of children aged 5 years to 7 years were recruited from a pediatric primary care center based at an urban academic childrens hospital. Study participants completed a 23-question survey available in English and Spanish. RESULTS Two hundred fifty-four parents completed the survey. Most were English speakers (69%), female (89%), and aged between 21 years and 35 years (76%). Sixty-two percent let their child play outside often or sometimes; whereas 19% reported never allowing their child to play outside. Parents were less likely to allow outside play as their degree of worry increased about traffic (p < 0.0001), rundown parks (p < 0.003), crime (p < 0.0001), witnessing violence (p < 0.0001), being a victim of violence (p < 0.0009), drugs (p < 0.0001), gangs (p < 0.004), and weapons (p < 0.003). Frequency of outdoor play was not correlated with the sex or age of the child or number of children in the family. Spanish speakers were less likely to allow outside play (p < 0.008) but more likely to allow unsupervised play (p < 0.03). CONCLUSIONS Decreased frequency of outdoor play correlated with increased parental concerns about safety, however, many parents still report allowing outdoor play at least sometimes.

Pediatrician attitudes, knowledge, and practice behavior regarding teen driving safety

A tool used to cut cardboard containers, known as a case cutter, frequently causes lacerations among adolescent grocery store workers. We evaluated a safety program using a less hazardous case cutter combined with worker education. Nine supermarket stores were divided into three groups. In Group A stores, employees received new safety case cutters with education; in Group B stores, employees received education using old cutters; Group C stores were the control. Case cutting lacerations were tracked 3 years before, and 1 year after, the intervention. There were 199 cutting injuries. Cutting injury rates decreased 3.5/100,000 man-hours in Group A stores, compared to 1.5 in Group B stores and 1.6/100,000 man-hours in control stores, with a marked reduction of compensation-related injuries in A stores. Estimated cost savings for A stores were

Child pedestrian injury: a population-based collision and injury severity profile.

245/year/store and

Intervention improves physician counseling on teen driving safety

29,413/year for the chain. An intervention to decrease case cutting injuries among adolescent grocery store workers can be protective and cost-effective.

Practical applications of injury surveillance: a brief 25-year history of the Connecticut Injury Prevention Center

Objectives—Violence is a major urban public health problem in the United States. The impact of a physical barrier placed across a street in a public housing project to prevent street violence and drug activity was evaluated. Methods—Hartford Police Department data on violent and drug related crime incidence within the housing project containing the barrier were analyzed by use of a computerized geographic information system. Results—Violent crime decreased 33% on the intervention street during the 15 month period after erection of the barrier, compared with the 15 month period before erection of the barrier, but there was no change in drug related crime. On adjoining streets and surrounding blocks, violent crime decreased 30%–50% but drug related crimes roughly doubled. A non-adjacent area of the housing project and the entire city experienced 26% and 15% decreases in violent crimes, and 414% and 25% increases in drug crimes, respectively. Conclusions—The barrier decreased violent crime but displaced drug crimes to surrounding areas of the housing project. These results have important implications for other cities that have erected or are considering erecting similar barriers.

Use of Aspirin and Reye's Syndrome

PROBLEM Each year about 4,000 teens ages 16-19 die on U.S. roads. Injury prevention counseling is recommended as a valuable and cost-effective part of routine health supervision. This study describes pediatrician knowledge and practice regarding teen driving safety. METHODS A 31-item self-administered survey was mailed to pediatricians. RESULTS 160 of 392 pediatricians (41%) completed the survey. During a health supervision visit 93% of pediatricians reported discussing seat belt use, 89% impaired driving, 54% teen licensing laws, and 16% parent teen contract. Half reported having a teen in their practice killed in a crash. CONCLUSIONS A majority surveyed report discussing and counseling teens on first wave teen driver safety issues (seat belts, alcohol use), but most do not discuss graduated driver licensing laws or related issues. IMPACT ON INDUSTRY Broadly adopted, this inexpensive counseling approach, could lead to reductions in teen motorvehicle crash injuries.