R. S. Thompson

Population-based study of unintentional injury incidence and impact during childhood.

We report a prospective study of medically treated unintentional injuries ascertained in an HMO population of children and adolescents 19 years of age and younger over a one-year period. The overall rate of medically treated injuries was 247 per 1,000, 147/1,000 for those treated in the clinic, and 100/1,000 for those treated in the emergency room (ER). Overall, 2.5 percent of patients were hospitalized. The highest rates of injury were for falls (60 per 1,000), recreational activities (57 per 1,000) and competitive sports (49 per 1,000). The site of care varied little by injury diagnosis or etiology, with the exception that sprains/strains, fractures, and injuries due to play and sports were more commonly treated in the clinic. The impact of trauma on activity was considerable, with 55.9 percent of injuries resulting in restricted activity, 10.6 percent in greater than or equal to 2 days of school missed, and 6.7 percent in greater than or equal to 2 days spent in bed.

A case-control study of the effectiveness of bicycle safety helmets in preventing facial injury.

In a case-control study we sought to assess the potential effectiveness of helmets in preventing facial injuries. Our study included 212 bicyclists with facial injuries and 319 controls with injuries to other body areas, who were treated in emergency rooms of five Seattle area hospitals over a one-year period. Using regression analyses to control for age, sex, education and income, accident severity, and cycling experience we found no definite effect of helmets on the risk of serious facial injury (odds ratio 0.81; 95 percent confidence interval = 0.45, 1.5), but protection against serious injuries to the upper face (odds ratio 0.27; 95% CI = 0.1, 0.8). No protection was found against serious injuries to the lower face. The independent effect of helmet use on facial injury was difficult to isolate due to the association of head and facial injuries. Our results suggest that bicycle helmets as presently designed may have some protective effect against serious upper facial injuries.

Ability of parents to recall the injuries of their young children

Objective: To estimate the ability of parents to recall the injuries of their children. Design: Comparison of parent recall with computerized medical records. Setting: A health maintenance organization in Washington State during 2003. Subjects: Parents of children younger than 6 years. Main outcome measures: The ratio of recalled injuries to injuries in computerized data. Results: Telephone interviews were completed with a parent of 1672 young children who had computerized medical data for at least one injury in the last year. Counting the three most recent treated injuries, the 1672 children had 1896 separate new injuries in the year before interview and parents recalled 1150 of these: recall ratio 0.61 (95% confidence interval (CI) 0.58 to 0.63). The recall ratio decreased from 0.82 (95% CI 0.79 to 0.85) for injuries one day before interview to 0.37 (95% CI 0.32 to 0.40) at 365 days before interview. For 341 major injuries the recall ratio was 0.80 (95% CI 0.76 to 0.84), for 202 minor injuries treated in an emergency department or hospital it was 0.77 (95% CI 0.71 to 0.82), for 597 minor injuries treated in urgent care it was 0.70 (95% CI 0.65 to 0.73), and for 756 minor injuries treated in a clinic it was 0.43 (95% CI 0.39 to 0.47). Conclusions: Recall decreased with time. Recall was best for major injuries, intermediate for minor injuries treated in a hospital, emergency department, or urgent care center, and worst for minor injuries treated in a clinic.

Incidence of bicycle-related injuries in a defined population

Population-based incidence rates for head injuries and total injuries resulting from bicycle crashes were calculated in a Seattle, Washington health maintenance organization population. Overall rates were 163 per 100,000 for all injuries and 42/100,000 for head injuries. Individuals between 5 and 14 years of age are at highest risk for bicycle-related injuries. The data are presented for their potential utility in program planning.

Ascertainment of intimate partner violence using two abuse measurement frameworks

Objective: To estimate prevalence of intimate partner violence (IPV) according to two abuse ascertainment tools, and agreement between the tools. Methods: 2504 women randomly selected from a health maintenance organization were asked about IPV exposure in their most recent intimate relationship using five questions on physical and sexual abuse, and fear due to partner’s threats and controlling behavior from the Behavioral Risk Factor Surveillance Survey (BRFSS) and 10 questions from the Women’s Experience with Battering (WEB) scale. IPV prevalence was estimated according to the BRFSS and WEB, and the proportion of women who were WEB+/BRFSS+, WEB−/BRFSS−, WEB−/BRFSS+, and WEB+/BRFSS−. Results: In their most recent relationship, 14.7% of women reported abuse of any type on the BRFSS versus 7.0% on the WEB scale. In direct comparisons of the WEB and BRFSS questions, a higher percentage of abused women reported any IPV on the five BRFSS questions (88.4%) compared to the 10 WEB questions (42.0%). However, both the BRFSS and WEB identified some women as abused that would have been missed by the other instrument. Conclusions: Intimate partner violence prevalence depends on how women are asked about abuse. Resources permitting, more than one abuse ascertainment strategy (for example, both the BRFSS and WEB questions) should be tried in order to broadly identify as many women as possible who interpret themselves as abused.

Effectiveness of bicycle safety helmets in preventing head injuries. A case-control study

The objective of this study is to examine the protective effectiveness of bicycle helmets in 4 different age groups of bicyclists, in crashes involving motor vehicles, and by helmet type and certification standards. Places studied were emergency departments in 7 Seattle, Washington area hospitals between March 1, 1992 and August 31, 1994. There were 3,390 injured bicyclists in the study; 29% of cases and 56% of controls were helmeted. It was concluded that bicycle helmets, regardless of type, provide substantial protection against head injuries for cyclists of all ages involved in crashes, including crashes involving motor vehicles.