Tadesse Haileyesus

Trends in Sports- and Recreation-Related Traumatic Brain Injuries Treated in US Emergency Departments: The National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) 2001-2012.

Importance:Sports- and recreation-related traumatic brain injuries (SRR-TBIs) are a growing public health problem affecting persons of all ages in the United States. Objective:To describe the trends of SRR-TBIs treated in US emergency departments (EDs) from 2001 to 2012 and to identify which sports and recreational activities and demographic groups are at higher risk for these injuries. Design:Data on initial ED visits for an SRR-TBI from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) for 2001-2012 were analyzed. Setting:NEISS-AIP data are drawn from a nationally representative sample of hospital-based EDs. Participants:Cases of TBI were identified from approximately 500 000 annual initial visits for all causes and types of injuries treated in EDs captured by NEISS-AIP. Main Outcome Measure(s):Numbers and rates by age group, sex, and year were estimated. Aggregated numbers and percentages by discharge disposition were produced. Results:Approximately 3.42 million ED visits for an SRR-TBI occurred during 2001-2012. During this period, the rates of SRR-TBIs treated in US EDs significantly increased in both males and females regardless of age (all Ps < .001). For males, significant increases ranged from a low of 45.8% (ages 5-9) to a high of 139.8 % (ages 10-14), and for females, from 25.1% (ages 0-4) to 211.5% (ages 15-19) (all Ps < .001). Every year males had about twice the rates of SRR-TBIs than females. Approximately 70% of all SRR-TBIs were reported among persons aged 0 to 19 years. The largest number of SRR-TBIs among males occurred during bicycling, football, and basketball. Among females, the largest number of SRR-TBIs occurred during bicycling, playground activities, and horseback riding. Approximately 89% of males and 91% of females with an SRR-TBI were treated and released from EDs. Conclusion and Relevance:The rates of ED-treated SRR-TBIs increased during 2001-2012, affecting mainly persons aged 0 to 19 years and males in all age groups. Increases began to appear in 2004 for females and 2006 for males. Activities associated with the largest number of TBIs varied by sex and age. Reasons for the reported increases in ED visits are unknown but may be associated with increased awareness of TBI through increased media exposure and from campaigns, such as the Centers for Disease Control and Preventions Heads Up. Prevention efforts should be targeted by sports and recreational activity, age, and sex.

Firearm injuries in the United States.

OBJECTIVE This paper examines the epidemiology of fatal and nonfatal firearm violence in the United States. Trends over two decades in homicide, assault, self-directed and unintentional firearm injuries are described along with current demographic characteristics of victimization and health impact. METHOD Fatal firearm injury data were obtained from the National Vital Statistics System (NVSS). Nonfatal firearm injury data were obtained from the National Electronic Injury Surveillance System (NEISS). Trends were tested using Joinpoint regression analyses. CDC Cost of Injury modules were used to estimate costs associated with firearm deaths and injuries. RESULTS More than 32,000 persons die and over 67,000 persons are injured by firearms each year. Case fatality rates are highest for self-harm related firearm injuries, followed by assault-related injuries. Males, racial/ethnic minority populations, and young Americans (with the exception of firearm suicide) are disproportionately affected. The severity of such injuries is distributed relatively evenly across outcomes from outpatient treatment to hospitalization to death. Firearm injuries result in over

Cyclists injured while sharing the road with motor vehicles

48 billion in medical and work loss costs annually, particularly fatal firearm injuries. From 1993 to 1999, rates of firearm violence declined significantly. Declines were seen in both fatal and nonfatal firearm violence and across all types of intent. While unintentional firearm deaths continued to decline from 2000 to 2012, firearm suicides increased and nonfatal firearm assaults increased to their highest level since 1995. CONCLUSION Firearm injuries are an important public health problem in the United States, contributing substantially each year to premature death, illness, and disability. Understanding the nature and impact of the problem is only a first step toward preventing firearm violence. A science-driven approach to understand risk and protective factors and identify effective solutions is key to achieving measurable reductions in firearm violence.

National Estimates of Outdoor Recreational Injuries Treated in Emergency Departments, United States, 2004–2005

Objective: To provide national estimates of non-fatal cyclist injuries treated in US hospital emergency departments (EDs) resulting from an encounter with a motor vehicle (MV) on the road. Methods: Non-fatal injury data for 2001–4 from the National Electronic Injury Surveillance System All Injury Program were analyzed. Results: An estimated 62 267 persons (21.5 per 100 000 population; 95% CI 14.3 to 28.7) were treated annually in US hospital EDs for unintentional non-fatal cyclist injuries involving an MV on the road. Among these cases, children aged 10–14 years (65.8 per 100 000) and males (35.3 per 100 000) had the highest injury rates. Many injuries involved the extremities (41.9%). The head was the primary body part affected for 38.6% of hospitalized/transferred patients, of which about 84.7% had a principal diagnosis of a concussion or internal head injury. Conclusions: Effective road environmental interventions (eg, bicycle-friendly roadway design, intersections and crossings) along with efforts to promote safe personal behavior (eg, helmet use and following rules of the road) are needed to help reduce injuries among cyclists while sharing the road.

National Estimates of Noncanine Bite and Sting Injuries Treated in US Hospital Emergency Departments, 2001-2010

Abstract Objective.—To provide national estimates of nonfatal outdoor recreational injuries treated in US emergency departments (EDs). Methods.—Outdoor recreational injuries from January 2004 through December 2005 were identified using the National Electronic Injury Surveillance System–All Injury Program, a nationally representative sample of ED visits. National estimates of outdoor recreational injuries were calculated, and activities leading to injury, demographic characteristics, principal diagnoses, and primary body parts affected were described. Results.—From January 2004 through December 2005, an estimated 212 708 (95% CI = 113 808– 311 608) persons were treated each year in US EDs for outdoor recreational injuries. The annual rate of injuries was 72.1 per 100 000 population (95% CI = 38.6–105.6). Males accounted for 68.2% of the injuries. The lower limb (27%), upper limb (25%), and head and neck region (23.3%) were the most commonly injured body regions. Fractures (27.4%) and sprains or strains (23.9%) were the most common diagnoses. Traumatic brain injuries were diagnosed in 6.5% of injuries, and 5% of injuries resulted in hospitalization or transfer to another hospital. Conclusions.—The results of this study provide a starting point for further research into the epidemiology of outdoor and wilderness injury. The results reinforce many common perceptions about the nature of these injuries while highlighting the potential severity and long-term consequences of the injuries. The general recommendations of proper planning, preparation, and problem anticipation for outdoor and wilderness injury prevention should be followed to reduce both the number and severity of injuries.

Fall injuries in older adults from an unusual source: entering and exiting a vehicle.

OBJECTIVE Injuries resulting from contact with animals and insects are a significant public health concern. This study quantifies nonfatal bite and sting injuries by noncanine sources using data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP). METHODS The NEISS-AIP is an ongoing nationally representative surveillance system used to monitor all types and causes of injuries treated in US hospital emergency departments (EDs). Cases were coded by trained hospital coders using information from medical records on animal and insect sources of bite and sting injuries being treated. Data were weighted to produce national annualized estimates, percentages, and rates based on the US population. RESULTS From 2001 to 2010 an estimated 10.1 million people visited EDs for noncanine bite and sting injuries, based on an unweighted case count of 169,010. This translates to a rate of 340.1 per 100,000 people (95% CI, 232.9-447.3). Insects accounted for 67.5% (95% CI, 45.8-89.2) of bite and sting injuries, followed by arachnids 20.8% (95% CI, 13.8-27.9). The estimated number of ED visits for bedbug bite injuries increased more than 7-fold-from 2156 visits in 2007 to 15,945 visits in 2010. CONCLUSIONS This study provides an update of national estimates of noncanine bite and sting injuries and describes the diversity of animal exposures based on a national sample of EDs. Treatment of nonfatal bite and sting injuries are costly to society. Direct medical and work time lost translates to an estimated

Nonfatal Choking on Food Among Children 14 Years or Younger in the United States, 2001–2009

7.5 billion annually.

Dogs and cats as environmental fall hazards

OBJECTIVES: To examine injuries in older adults due to boarding (i.e., entering) and alighting from (i.e., exiting) motor vehicles, with a special emphasis on falls.

Child passenger restraint use and emergency department–reported injuries: A special study using the National Electronic Injury Surveillance System–All Injury Program, 2004

OBJECTIVE: The objective of this study was to investigate the epidemiology of nonfatal choking on food among US children. METHODS: Using a nationally representative sample, nonfatal pediatric choking-related emergency department (ED) visits involving food for 2001 through 2009 were analyzed by using data from the National Electronic Injury Surveillance System–All Injury Program. Narratives abstracted from the medical record were reviewed to identify choking cases and the types of food involved. RESULTS: An estimated 111 914 (95% confidence interval: 83 975–139 854) children ages 0 to 14 years were treated in US hospital EDs from 2001 through 2009 for nonfatal food-related choking, yielding an average of 12 435 children annually and a rate of 20.4 (95% confidence interval: 15.4–25.3) visits per 100 000 population. The mean age of children treated for nonfatal food-related choking was 4.5 years. Children aged ≤1 year accounted for 37.8% of cases, and male children accounted for more than one-half (55.4%) of cases. Of all food types, hard candy was most frequently (15.5% [16 168 cases]) associated with choking, followed by other candy (12.8% [13 324]), meat (12.2% [12 671]), and bone (12.0% [12 496]). Most patients (87.3% [97 509]) were treated and released, but 10.0% (11 218) were hospitalized, and 2.6% (2911) left against medical advice. CONCLUSIONS: This is the first nationally representative study to focus solely on nonfatal pediatric food-related choking treated in US EDs over a multiyear period. Improved surveillance, food labeling and redesign, and public education are strategies that can help reduce pediatric choking on food.

Childhood Firearm Injuries in the United States

PROBLEM Falls are the leading cause of non-fatal injuries in the United States. This study assessed the prevalence of fall injuries associated with cats and dogs in the United States and describes the types of injuries sustained, the location, activity, and circumstances under which they occurred. METHODS Data were from a nationally representative sample of emergency department visits from January 1, 2001 to December 31, 2006, available through the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP). RESULTS Based on 7,456 cases, an estimated 86,629 fall injuries each year were associated with cats and dogs, for an injury rate of 29.7. There were 7.5 times as many injuries involving dogs as cats and females were 2.1 times more likely to be injured than males. Injury rates were highest among people aged >/=75, but pets were a fall hazard for all ages. Fractures and contusions or abrasions were the most common injuries; the highest rates were for injuries to the extremities. About 66.4% of falls associated with cats and 31.3 % of falls associated with dogs were caused by falling or tripping over the pet. An additional 21.2% of falls related to dogs were caused by being pushed or pulled. SUMMARY Although pets were associated with fall injuries, this risk can be reduced by increasing public awareness about situations that can lead to falls, such as dog-walking and chasing pets, and by calling attention to the importance of obedience training for dogs to minimize hazardous behaviors such as pulling and pushing. IMPACT ON INDUSTRY Fall injuries represent a burden to individuals, our society and our health care system. Increasing public awareness and implementing basic prevention strategies can help people of all ages enjoy their pets, reduce their chances of experiencing pet-related falls, and lessen the impact of fall injuries on our health care system.