Shannon Gray

Epidemiology of Hospital-Treated Injuries Sustained by Fitness Participants.

Purpose: The purpose of this study was to provide an epidemiological profile of injuries sustained by participants in fitness activities in Victoria, Australia, based on hospital admissions and emergency department (ED) presentations and to identify the most common types, causes, and sites of these injuries. Method: Hospital-treated fitness activity-related injury cases were identified from International Classification of Disease activity codes (for admissions) and from text narratives of injury events (for ED presentations) from 2003 to 2010, inclusive. Cases were categorized as being associated with aerobics/group exercise (n = 252), resistance/weight training (n = 830) or “other equipment” (motorized and general gym equipment; n = 1,156). Participation information was taken from the Exercise, Recreation and Sport Survey. Results: Overall, 2,238 cases were identified and 11.6% of all patients with ED presentations were subsequently hospitalized. Those participants with aerobics cases were generally female (76.6%) and aged 25 to 34 years old (35.3%), with injuries to the lower limbs (59.1%) and due to falls (57.9%). Resistance-training injuries increased significantly during the 8-year period (by 215.7%; 95% CI [133.5, 326.9]) and generally occurred in male participants (78.0%), in people aged 15 to 24 years old (36.4%), and with injuries to the upper limbs (45.1%) caused by being hit, struck, or crushed by weights or fellow exercisers (71.4%). The “other equipment” cases were equally distributed by gender; they occurred most commonly in people aged 15 to 24 years old (27.8%), with injuries to the lower limbs (41.5%) and due to falls (57.6%). Across all categories, dislocations, sprains, and strains were the most common injury types. Conclusions: Fitness activity-related injury prevention strategies should be targeted at different subgroups according to the type of fitness activity being undertaken.

The causes of injuries sustained at fitness facilities presenting to Victorian emergency departments - identifying the main culprits

BackgroundFitness facilities provide an avenue to engage in physical activity, which is widely encouraged to improve health. However, there is risk of injury. This study aimed to identify the specific causes of injuries sustained at fitness facilities and the activity being participated in, to aid in the development of injury prevention strategies.MethodsAnalysis of routinely collected emergency department case-series data were obtained from July 1999 to June 2013. Fitness activity-related injury cases were identified from narratives of injury events, with narrative information recoded into cause of injury and activity at time of injury categories. Recoded data were then analysed.ResultsOverall, 2,873 cases were identified that specified the exact cause of injury associated with injuries that occurred at fitness facilities. Injuries due to overexertion were most common overall (36.2% of all cases), as well as the main cause of injuries related to general free weight activities (52.6% of this activity) and group exercise classes (35.9%). Crush injuries due to falling weights were common for all free weight activities. Falls and awkward landings were common causes of injuries during group exercise classes (28.5% and 25.8%, respectively). Trips and falls were common throughout facilities, as well as from cardiovascular equipment more specifically.ConclusionsDetailed information on the causes of injuries allows the development of injury prevention strategies for fitness facilities and fitness activities. Facilities should implement risk management strategies to reduce the risk of injuries in their clientele, based on the identified major causes of injury in this study.

EQUIPMENT AND ENVIRONMENT OF FITNESS FACILITIES: THE PERSPECTIVE OF FITNESS INDUSTRY EMPLOYEES

Background Fitness facilities provide an avenue for people to engage in physical activity, however it is important that these facilities do all in their power to reduce the likelihood of injuries occurring. The attitudes and practices of those employed in the fitness industry with respect to risk management are important for implementation of injury prevention measures, as are risk management procedures currently in place. Objective To identify views of the fitness industry employees about injury risks and hazards associated with equipment and training environments within fitness facilities and their risk management and hazard identification practices in relation to them. Design A 6-week nationwide online survey. Setting Australia-wide fitness industry. Participants 1 178 adults across Australia who own, manage or work in the fitness industry. Main outcome measurements Responses to 6-point Likert scale questions. Results 79.1% of survey respondents held the safety of the fitness premises in high importance, and 80.2% stated that the location and condition of their facility (access, lighting, floor surfaces etc.) was very/extremely safe. The layout of equipment in the facility was very/extremely good in 61.9% of cases, and fitness equipment maintenance was reported to have been conducted frequently by 68.5% of the respondents. Fitness employees frequently observed hazardous conditions of the exercise areas with respect to objects lying around (43.8% of cases), equipment misuse (41.9% of cases), and facility users lifting weights that were considered too heavy (47.8% of cases). Conclusion The findings suggest that facility users should be provided with further education regarding their physical activity programs and behaviours that could reduce injury risk, and that guidelines for using the facility should be made more obvious. The findings also indicate that fitness industry employees should be given risk management training, and that in facilities where hazards were observed and hazardous practices are engaged in, that risk analysis and management protocols need to be implemented.

Comparing time off work after work-related mental health conditions across Australian workers’ compensation systems: a retrospective cohort study

Workers’ compensation claims (WCC) due to mental health conditions (MHC) are the most expensive due to often lengthy periods off work. This retrospective cohort study aims to determine the factors associated with work time loss in Australian workers with accepted WCCs for MHCs, and investigate whether jurisdiction in which a claim is made affects work time loss, using administrative claims data between January 2010 and June 2011. Cox regression analysis showed that worker age, industry, occupation and type of MHC were associated with work time loss. Workers with depressive disorders had longer time loss than those with stress-related conditions. Workers from South Australia, Comcare and Victoria had the longest durations of work time loss, while Australian Capital Territory and Tasmania had shorter durations. Future research should investigate policy variations that could explain the differences in time spent on compensation between jurisdictions.

Controlled ecological evaluation of an implemented exercise-training programme to prevent lower limb injuries in sport: population-level trends in hospital-treated injuries

Objective Exercise-training programmes have reduced lower limb injuries in trials, but their population-level effectiveness has not been reported in implementation trials. This study aimed to demonstrate that routinely collected hospital data can be used to evaluate population-level programme effectiveness. Method A controlled ecological design was used to evaluate the effect of FootyFirst, an exercise-training programme, on the number of hospital-treated lower limb injuries sustained by males aged 16–50 years while participating in community-level Australian Football. FootyFirst was implemented with ‘support’ (FootyFirst+S) or ‘without support’ (FootyFirst+NS) in different geographic regions of Victoria, Australia: 22 clubs in region 1: FootyFirst+S in 2012/2013; 25 clubs in region 2: FootyFirst+NS in 2012/2013; 31 clubs region 3: control in 2012, FootyFirst+S in 2013. Interrupted time-series analysis compared injury counts across regions and against trends in the rest of Victoria. Results After 1 year of FootyFirst+S, there was a non-statistically significant decline in the number of lower limb injuries in region 1 (2012) and region 3 (2013); this was not maintained after 2 years in region 1. Compared with before FootyFirst in 2006–2011, injury count changes at the end of 2013 were: region 1: 20.0% reduction (after 2 years support); region 2: 21.5% increase (after 2 years without support); region 3: 21.8% increase (after first year no programme, second year programme with support); rest of Victoria: 12.6% increase. Conclusion Ecological analyses using routinely collected hospital data show promise as the basis of population-level programme evaluation. The implementation and sustainability of sports injury prevention programmes at the population-level remains challenging.

A comprehensive observational audit tool for use in Australian fitness facilities

ABSTRACT A purposely designed observational audit tool (OAT) was developed following review of literature and international standards/guidelines for fitness facilities. The OAT was trialled to assess the physical environment of a sample of fitness facilities and determine its inter-rater reliability. Ten Victorian fitness facilities were visited to test the tools inter-rater reliability, then 22 metropolitan and regional facilities in Victoria ranging in size and type were audited. A high degree of reliability was found (inter-rater reliability κ = 0.659 (p < 0.005); 95% CI (0.633, 0.685)); intra-class correlation = 0.985 (F474,948 = 67.226, p < 0.005, 95% CI (0.983, 0.987)). On average, facilities were colder and darker than international standards/guidelines specified. Distances around cardiovascular equipment varied between facilities. Free equipment was observed lying on floors in 66% (n = 21) of facilities. Twenty-seven facilities had signs instructing users to replace weights after use (66%). Only 19 (59%) facilities enforced towel use; however, 94% (n = 30) had disinfectant stations. The auditing of fitness facilities indicates more should be done at facilities to reduce injury risk.

0164 Early reporting incentives to reduce time between injury and claim: a multiple baseline interrupted time series analysis of two australian workers’ compensation jurisdictions

Background Early access to healthcare and work rehabilitation services provided by workers’ compensation is associated with faster return to work and reduced claim costs. Incentivising employers to report claims early following injury may reduce time to service access and improve injured worker outcomes. We investigated the impact of legislated early reporting incentives on claim processing time in two Australian workers’ compensation jurisdictions. Methods A multiple baseline interrupted time series (ITS) design was used to evaluate incentive impact on claim processing time using Australian administrative workers’ compensation data. We compared median days between injury and lodgement (lodgement time), lodgement and claim acceptance (decision time), and total processing time in South Australia (SA) and Tasmania (TAS). Results Total time was not immediately affected by incentives, though there was a significant downward trend of one-third a day per month in both jurisdictions relative to the comparator. Lodgement time decreased significantly in both jurisdictions, though the magnitude of impacts differed. A concurrent increase in decision time was observed in TAS but not in SA. Conclusions Our findings suggest that employer focused early reporting incentives may have long-term impacts on claim processing time. However, we also observed unanticipated effects such as increases to insurer decision making time, as well as differential impacts between jurisdictions despite identical policy intent. While co-occurring events such as other legislative changes limit causal inferences, ITS analyses provide a useful approach for investigating the impact of legislative change on policy relevant outcomes in workers’ compensation systems.