Stephen W. Marshall

Height and surfacing as risk factors for injury in falls from playground equipment: a case-control study.

OBJECTIVES: Despite the widespread promotion of safety standards no epidemiological studies have adequately evaluated their effectiveness in preventing injury in falls from playground equipment. This study evaluated the effectiveness of the height and surfacing requirements of the New Zealand standard for playgrounds and playground equipment. SETTING: Early childhood education centres and schools in two major cities in the South Island of New Zealand. METHODS: Data were collected on 300 children aged 14 years or less who had fallen from playground equipment. Of these, 110 (cases) had sustained injury and received medical attention, while 190 (controls) had not sustained injury requiring medical attention. RESULTS: Logistic regression models fitted to the data indicated that the risk of injury being sustained in a fall was increased if the equipment failed to comply with the maximum fall height (odds ratio (OR) = 3.0; 95% confidence interval (CI) 0.7 to 13.1), surfacing (OR = 2.3; 95% CI 1.0 to 5.0), or safe fall height (OR = 2.1; 95% CI 1.1 to 4.0) requirements. Falls from heights in excess of 1.5 metres increased the risk of injury 4.1 times that of falls from 1.5 metres or less and it was estimated that a 45% reduction in children attending emergency departments could be achieved if the maximum fall height was lowered to 1.5 metres. CONCLUSIONS: Although the height and surfacing requirements of the New Zealand standard are effective in preventing injury in falls from playground equipment, consideration should be given to lowering the maximum permissible fall height to 1.5 metres.

Factors affecting work-related injury among forestry workers: A review

Forestry workers have previously been identified as an occupational group at high risk of work-related injury. This paper reviews factors affecting injury among forestry workers and draws on international literature in general (New Zealand studies in particular). A major proportion of the literature relates to tasks involving chain saws, such as felling and delimbing, and the operation of forestry machinery. By comparison, less attention has been given to tasks such as tree planting and pruning. And while physical risks have been well documented, comparatively little research has focused on mental workload, particularly in relation to motor-manual logging. Few studies have focused on the effects of work organization (e.g., hours of work, contracting) on injury rates.

Mania and seasonality in the southern hemisphere

Admissions for mania over a 9-year period in New Zealand were analysed, including data from four separate regions spanning nine degrees in latitude. A spring/summer peak of admissions for mania was found. The four regions showed marked, unexpected variability in seasonality. Regression analyses were performed to test the association of admissions for mania, in the month of admission and the previous month, with mean daily temperature, day length, hours of bright sunshine and mean relative humidity plus the rate of change of each of these variables.

The New Zealand Rugby Injury and Performance Project: I. Design and methodology of a prospective follow-up study.

Injury resulting from participation in sporting and physical recreational activities is a major contributor to the overall incidence of injury in the developed world. If sports injuries are to be reduced, a comprehensive approach must be taken to define the nature and magnitude of the problem, to establish models of relationships between risk factors, protective factors and injury experience, and to address injury through well designed intervention and evaluation programmes. The Rugby Injury and Performance Project (RIPP) is a prospective cohort study designed to examine the risk and protective factors for rugby injury. Data were collected on potential risk and protective factors from the RIPP cohort pre-season. Data on exposure to rugby, injury events and medical treatments were collected from the players each week during the season through telephone interviews. Pre-season measures were repeated post-season. A key feature of the design was that data were collected on both injured and non-injured players, allowing a longitudinal comparison of the injury experience of players with and without the factors of interest. A wealth of information was collected on each cohort member during the pre-season interview. A contact rate of 90% was achieved during the weekly follow-up phase. Post-season questionnaires were completed by 76% of the players and 88% of the coaches. Recommendations are made for the use of this methodology by other researchers and future directions for RIPP are described.

Morbidity and death due to child abuse in New Zealand.

The purpose of this study was to explore under-diagnosis and racial bias among child abuse morbidity and mortality data from New Zealand. Computerized files of all intentional injury fatalities among children 16 years of age and under for 1978-87, and all hospital discharges for intentionally injured children 16 and under for 1988, were analyzed for evidence of physical abuse and sexual abuse. Among the 92 fatalities, only 21 of 68 deaths due to physical and/or sexual abuse were so coded. In both the mortality and the morbidity data, there was an association between the diagnosis of child abuse and race. In the case of fatalities, Maori and Samoan abuse victims were more likely to be assigned an E-code of E967 (child battering and other maltreatment) than were others (p = 0.04), controlling for sex. In the case of hospitalizations, the association between E967 and whether or not the victim was European was significant for physical abuse only (p = 0.05). Assignment of N-code = 995.5 (child maltreatment syndrome) as the reason for admission was significantly associated with race for those cases considered by us to have been abused, controlling for age (p = 0.002) or sex (p = 0.004).

Incidence of facial fractures resulting in hospitalisation in New Zealand from 1979 to 1988

The incidence and aetiology of facial fractures resulting in admission to public hospitals in New Zealand in 1987 were investigated retrospectively from data collected by the Health Statistical Services. Data were analysed by the age group, ethnic origin and gender of those affected. During 1987 the overall incidence of facial fractures was 47.9/100,000 of the population. The highest incidence was for Maori males at 152/100,000. A comparison with data for the period 1979 to 1988 showed a decrease for the population as a whole but an increase for those who declared themselves to be Maori. Assault was the most common cause of facial fractures resulting in hospitalisation for both males and females. Sport was the second most common cause of facial fractures with rugby football contributing two-thirds of these. These results indicate where future preventive measures should be targeted.

Child day care and home injuries involving playground equipment

Abstract The increasing number of children attending child day care has led to a corresponding concern for their safety in the absence of parental care. Previous studies have documented that the majority of injuries occurring in child day care involve falls, and that the most common consumer product associated with such falls is playground equipment. This study describes New Zealand children less than 5 years of age admitted to hospital between 1979 and 1988 for injuries associated with playground equipment located at home or a child care facility. There were 528 hospitalized home injuries involving playground equipment, and 145 such day care injuries. Fractures were the most common injury, and the head was the most commonly involved body region. Lower limb injuries were the most severe. Among the differences between home and day care injuries were the type of equipment involved. Swings were disproportionately associated with head injuries.

Inpatient costs of injury due to motor vehicle traffic crashes in New Zealand

The hospital inpatient costs for the treatment of injury were obtained for Dunedin Hospital for a two-year period using the Resource Utilisation System. These data were used as a basis for estimating national inpatient costs for motor vehicle traffic crashes (MVTCs). The results show that injuries were on average more expensive to treat than non-injuries (

The severity of road traffic crashes resulting in hospitalisation in New Zealand

3,115 vs.

Tractor Fatalities and Injury on New Zealand Farms

2,749 per case). At a mean cost of