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Age gradient in the cost-effectiveness of bicycle helmets.

https://arctichealth.org/en/permalink/ahliterature32744
Source
Prev Med. 2000 May;30(5):401-6
Publication Type
Article
Date
May-2000
Author
B. Kopjar
T M Wickizer
Author Affiliation
Department of Population Health Sciences, National Institute of Public Health, Oslo, Norway. branko.kopjar@samfunnsmed.uio.no
Source
Prev Med. 2000 May;30(5):401-6
Date
May-2000
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Bicycling - economics
Child
Child, Preschool
Cost-Benefit Analysis
Craniocerebral Trauma - economics - epidemiology - prevention & control
Head Protective Devices - economics - standards
Humans
Incidence
Middle Aged
Risk assessment
Sensitivity and specificity
Abstract
OBJECTIVES: This study analyzed the reduction in risk of head injuries associated with use of bicycle helmets among persons ages 3 to 70 and the cost-effectiveness of helmet use based on this estimated risk reduction. METHODS: To derive our cost-effectiveness estimates, we combined injury incidence data gathered through a detailed and comprehensive injury registration system in Norway, acute medical treatment cost information for the Norwegian health service, and information reported in the scientific literature regarding the health protective effects of helmet use. The analysis included all cases of head injuries reported through the registration system from 1990 through 1996. We performed an age-stratified analysis to determine the incidence of bicycle-related head injuries, the 5-year reduction in absolute risk of injury, the number needed to treat, and the cost-effectiveness of helmet use. To test the robustness of the findings to parameter assumptions, we performed sensitivity analysis. RESULTS: The risk of head injury was highest among children aged 5 to 16. The greatest reduction in absolute risk of head injury, 1.0 to 1.4% over 5 years estimated helmet lifetime, occurred among children who started using a helmet between the ages of 3 and 13. Estimates indicate that it would cost approximately U.S. $2,200 in bicycle helmet expenses to prevent any one upper head injury in children ages 3-13. In contrast, it would cost U.S. $10,000-25,000 to avoid a single injury among adults. CONCLUSIONS: Bicycle safety helmets appear to be several times more cost-effective for children than adults, primarily because of the higher risk of head injury among children. Programs aiming to increase helmet use should consider the differences in injury risk and cost-effectiveness among different age groups and target their efforts accordingly.
PubMed ID
10845749 View in PubMed
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[A potential for prevention of bicycling-related head injuries]

https://arctichealth.org/en/permalink/ahliterature32567
Source
Tidsskr Nor Laegeforen. 2000 Jun 30;120(17):1955-9
Publication Type
Article
Date
Jun-30-2000
Author
K. Alvaer
B. Kopjar
Author Affiliation
Statens institutt for folkehelse Avdeling for samfunnsmedisin, Oslo.
Source
Tidsskr Nor Laegeforen. 2000 Jun 30;120(17):1955-9
Date
Jun-30-2000
Language
Norwegian
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Bicycling - injuries
Child
Child, Preschool
Craniocerebral Trauma - epidemiology - etiology - prevention & control
English Abstract
Evaluation Studies
Head Protective Devices
Humans
Incidence
Middle Aged
Norway - epidemiology
Registries
Abstract
BACKGROUND: Bicycle helmets prevent head injury in bicycle riders. Still, only a portion of bicycle riders in Norway use bicycle helmets. The aim of this study was to estimate the number of head injuries among bicycle riders that might be prevented by increased helmet use in Norway. MATERIAL AND METHODS: We used data from the Norwegian National Injury Register for the years 1995 and 1996 to estimate the number of bicycle injuries in Norway. In order to estimate the number of bicycle users and helmet users in different age groups, we used data from earlier surveys of bicycle use. Data on the effectiveness of helmet promotion interventions have been obtained from a systematic review of the literature. RESULTS: The overall annual incidence rate was 92 injuries per 100,000 bicycle users. The incidence varied with age and was highest among children. If every rider used a helmet, about 1,600 head injuries would be avoided every year, of these, 800 among children aged 0-14. Currently available helmet promotion interventions may improve the use among children by about 40%, thus preventing about 1,500 head injuries over a period of three years. Successful helmet promotion interventions use a combination of health education and helmet distribution strategies. INTERPRETATIONS: There is a significant health improvement potential in promoting bicycle helmets in Norway by implementation of evaluated modes of intervention.
Notes
Comment In: Tidsskr Nor Laegeforen. 2000 Aug 20;120(19):233110997099
PubMed ID
11008524 View in PubMed
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[Costs of medical treatment of injuries in Norway].

https://arctichealth.org/en/permalink/ahliterature212656
Source
Tidsskr Nor Laegeforen. 1996 Feb 10;116(4):512-6
Publication Type
Article
Date
Feb-10-1996
Author
B. Kopjar
B. Guldvog
J. Wiik
Author Affiliation
Avdeling for samfunnsmedisin, Statens institutt for folkehelse, Oslo.
Source
Tidsskr Nor Laegeforen. 1996 Feb 10;116(4):512-6
Date
Feb-10-1996
Language
Norwegian
Publication Type
Article
Keywords
Accidents - economics
Cost of Illness
Health Care Costs
Hospital Costs
Humans
Norway
Patient Admission - economics
Wounds and Injuries - economics - therapy
Abstract
The objective of this study was to estimate the cost of medical treatment of injuries in Norway. We analysed aggregated data from two sources, the National Hospital Discharge Register and the National Injury Register, in order to calculate such costs in 1994. Approximately 400,000 injuries treated in hospitals and emergency departments in 1994 cost NOK 1.7 billion in terms of medical treatment. Unintentional injuries accounted for 91%, self-inflicted injuries for 3%, and injuries stemming from violence for 6% of the costs. Injuries requiring hospitalisation accounted for 71% of the total costs. Persons aged 65 years or more constituted 14% of the cases but accounted for 46% of the cost of treating unintentional injuries. Injuries at home or during leisure time accounted for 75% of the costs of the unintentional injuries, while traffic injuries accounted for 7%, occupational injuries for 8%, and 10% of the costs could not be classified. Hip fractures alone accounted for 27% of the total costs. Traffic and occupational injuries remain important targets for prevention, but greater efforts are required to reduce risk of injuries in the home and during leisure time, injuries to elderly people, hip fractures, and injuries that stem from violence.
PubMed ID
8644058 View in PubMed
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Cycling to school--a significant health risk?

https://arctichealth.org/en/permalink/ahliterature35064
Source
Inj Prev. 1995 Dec;1(4):238-41
Publication Type
Article
Date
Dec-1995
Author
B. Kopjar
T M Wickizer
Author Affiliation
Department of Population Health Sciences, National Institute of Public Health, Oslo, Norway.
Source
Inj Prev. 1995 Dec;1(4):238-41
Date
Dec-1995
Language
English
Publication Type
Article
Keywords
Accidents, Traffic - statistics & numerical data
Adolescent
Athletic Injuries - epidemiology - etiology
Bicycling - injuries
Child
Female
Head Protective Devices
Humans
Incidence
Injury Severity Score
Male
Norway - epidemiology
Prospective Studies
Registries
Reproducibility of Results
Research Support, Non-U.S. Gov't
Risk assessment
Schools
Survival Rate
Transportation - methods
Abstract
OBJECTIVES: The risk of injury to children riding bicycles has been previously documented. However, the specific risk arising from the use of bicycles as a mode of transportation to and from school is unknown. This study examines the incidence of bicycle related injuries among school age children. METHODS: A comprehensive prospective injury registration system was established in Stavanger, Norway. Data were obtained from this system to identify bicycle related injuries occurring from 1990-3 to children aged 10-15. The incidence of injuries was computed for two groups of children: (1) children cycling to school and (2) children cycling for other purposes. RESULTS: 352 children received medical treatment for bicycle related injuries, 12.6/1000 bicycle riders; 108 (30%) of the 352 children were injured while cycling to or from school. The incidence of bicycle related injuries was significantly higher for boys than girls. Seventy seven per cent of the injuries occurred in a non-collision accident, 9% in a collision with another bicycle, and 14% in a collision with a motor vehicle. Twenty per cent of the injured children sustained upper head injuries and 13% required inpatient treatment. Average maximum abbreviated injury severity (MAIS) score was similar for the injuries sustained during travel to/from school and other injuries. CONCLUSIONS: Bicycle related injuries occurring during travel to or from school are a significant contributor to the total incidence of bicycle related injuries. Increased attention among parents, school officials, public health officials, and medical professionals should be paid to this health risk.
PubMed ID
9346038 View in PubMed
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[Fall-related injuries among elderly at home].

https://arctichealth.org/en/permalink/ahliterature215534
Source
Tidsskr Nor Laegeforen. 1995 Mar 30;115(9):1060-2
Publication Type
Article
Date
Mar-30-1995
Author
B. Kopjar
M. Bulajic-Kopjar
J. Wiik
R. Nordhagen
Author Affiliation
Avdeling for Samfunnsmedisin, Statens Institutt for Folkehelse, Oslo.
Source
Tidsskr Nor Laegeforen. 1995 Mar 30;115(9):1060-2
Date
Mar-30-1995
Language
Norwegian
Publication Type
Article
Keywords
Accidental Falls - statistics & numerical data
Accidents, Home - statistics & numerical data
Aged
Female
Humans
Incidence
Male
Norway - epidemiology
Registries
Wounds and Injuries - epidemiology - etiology
Abstract
The aim of this study was to describe the extent of the problem of injuries from falling among elderly people at home. The study is based on data from the National Injury Register, which contains information on all inpatients and outpatients treated for injuries by hospitals and emergency clinics in four Norwegian towns. This study included 594 cases of accidental fall-related injuries which occurred at home in 1992 among a total population of 23,942 persons aged 65 years and over living in two towns, Drammen and Stavanger. The incidence of fall-related injuries at home was 25 per 1,000. The incidence was higher among women than men (32 and 13 per 1,000 respectively). The ratio between falls to the same level and falls to lower levels was 2:1 in the age group 65-79 year and 4:1 in the age group over 80 years. The most common mechanisms causing injuries were loss of balance (46%), stumbling (19%) and sliding (12%). 60% of all patients sustained fractures (15 per 1,000). 50% of all patients were hospitalised. The findings show that possibilities exist for preventing these injuries. The strategies must be directed both at the home environment and at individual factors among the elderly population.
PubMed ID
7725285 View in PubMed
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Fractures among children: incidence and impact on daily activities.

https://arctichealth.org/en/permalink/ahliterature33661
Source
Inj Prev. 1998 Sep;4(3):194-7
Publication Type
Article
Date
Sep-1998
Author
B. Kopjar
T M Wickizer
Author Affiliation
Department of Population Health Sciences, National Institute of Public Health, Oslo, Norway. branko.kopjar@samfunnsmed.uio.no
Source
Inj Prev. 1998 Sep;4(3):194-7
Date
Sep-1998
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Age Distribution
Child
Child, Preschool
Cohort Studies
Confidence Intervals
Female
Fractures, Bone - diagnosis - epidemiology - prevention & control - rehabilitation
Human Activities
Humans
Incidence
Infant
Male
Norway - epidemiology
Prospective Studies
Questionnaires
Research Support, Non-U.S. Gov't
Risk factors
Sex Distribution
Abstract
OBJECTIVES: The study's objective was to examine incidence of fractures and associated activity restriction among children aged 0-12 years. DESIGN: Injuries were prospectively recorded over the four year period from 1992-95 in a cohort of children aged 0-12 years, representing 193,540 children years. Information about length and extent of activity restriction was collected from parents by a mailed questionnaire for a subsample of 192 children with a fracture. RESULTS: A total of 2477 fractures occurred in the study population (128 per 10,000 children annually). The incidence increased linearly with age, by 14 cases per 10,000 children year for each year of age. Boys and girls showed similar patterns of fracture occurrence. There was a significant difference in length of activity restrictions for different types of fractures. The mean and 95% confidence interval (CI) of activity restricted days for leg fractures were 26 (95% CI 7 to 45) days, for arm fractures, 14 (95% CI 8 to 20) days, and for other fractures, 5 (95% CI 1 to 8) days. Arm fractures represented 66% of the cases and 62% of the activity restricted days; leg fractures 19% of cases and 33% of all activity restricted days; and other fractures 16% of the cases but only 5% of the activity restricted days in this population. CONCLUSION: The incidence of fractures increases in childhood. Different types of fractures among children cause different amounts of activity restriction.
PubMed ID
9788089 View in PubMed
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How safe are day care centers? Day care versus home injuries among children in Norway.

https://arctichealth.org/en/permalink/ahliterature35058
Source
Pediatrics. 1996 Jan;97(1):43-7
Publication Type
Article
Date
Jan-1996
Author
B. Kopjar
T. Wickizer
Author Affiliation
Department of Population Health Sciences, National Institute of Public Health, Oslo, Norway.
Source
Pediatrics. 1996 Jan;97(1):43-7
Date
Jan-1996
Language
English
Publication Type
Article
Keywords
Accidents, Home - statistics & numerical data
Child
Child Day Care Centers - statistics & numerical data
Child, Preschool
Comparative Study
Female
Health Services - economics - utilization
Humans
Incidence
Infant
Male
Norway - epidemiology
Population Surveillance
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Safety - statistics & numerical data
Wounds and Injuries - epidemiology - etiology
Abstract
OBJECTIVES. The study's objective was to examine and compare injury rates of children ages 6 months to 6 years in day care centers and homes. More specifically, we tested the hypothesis that the injury rate is lower in day care centers than at homes, as suggested by previous studies. METHODS. A comprehensive prospective injury registration was carried out in Stavanger, Norway, during 1992. We obtained data from this system to identify injuries occurring in day care centers, homes, and other places during 1992. Exposure-adjusted incidence rates were calculated to compare the risk of injury at day care centers, homes, and other places. We also obtained data from medical records on use and costs of medical care. In addition, a parent questionnaire was developed and used to gather data on the amount of injury-related restricted activity. RESULTS. Among 9454 children ages 6 months to 6 years in Stavanger, 770 injuries occurred during 1992: 96 in day care centers, 472 at home, and 202 at other places. For children ages 6 months to 2 years, the rate of injuries was significantly lower in day care centers than at home (1.2 and 2.5, respectively, per 100,000 children-hours), but for children ages 3 to 6, the rates of injuries were similar in day care centers and at home (1.3 and 1.5, respectively, per 100,000 children-hours). The great majority of children attending day care centers were from 3 to 6 years of age. No significant differences were found in the severity of the injuries. CONCLUSIONS. For children ages 3 to 6 years, which included most of the children attending day care centers in Stavanger, Norway, day care centers were not found to be safer than homes. We think continuing attention should be paid to injury control in day care centers.
Notes
Comment In: Pediatrics. 1996 Nov;98(5):10058909509
PubMed ID
8545222 View in PubMed
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[Injuries among children treated at emergency medical centers and in hospitals 1990-97]

https://arctichealth.org/en/permalink/ahliterature33411
Source
Tidsskr Nor Laegeforen. 1999 Feb 28;119(6):784-7
Publication Type
Article
Date
Feb-28-1999
Author
A. Engeland
B. Kopjar
Author Affiliation
Avdeling for samfunnsmedisin, Statens institutt for folkehelse, Oslo.
Source
Tidsskr Nor Laegeforen. 1999 Feb 28;119(6):784-7
Date
Feb-28-1999
Language
Norwegian
Publication Type
Article
Keywords
Abbreviated Injury Scale
Accident prevention
Accidents, Home - prevention & control - statistics & numerical data
Accidents, Traffic - prevention & control - statistics & numerical data
Adolescent
Age Factors
Child
Child, Preschool
English Abstract
Female
Humans
Incidence
Infant
Male
Norway - epidemiology
Patient Admission
Registries
Sex Factors
Wounds and injuries - epidemiology - prevention & control
Abstract
The Norwegian National Injury Sample Registry is a prospective case register of injuries occurring in the defined population of four cities. All injuries treated in hospitals and emergency wards are recorded in the registry. We used data from this registry to provide an epidemiologic overview of the incidence of injuries among children aged 0-14 in Norway. The study population consisted of approximately 61,500 children annually or approximately 492,000 children-years over the 1990-97 period. A total of 57,000 injuries were registered, or 116 injuries per 1,000 children-years. Approximately 2% of the injuries were classified as severe. 36% of all injuries occurred at home, 13% during sport activities and 13% were caused by accidents at school. Incidence was higher among boys than girls in all age groups. During their first 15 years of life, boys sustained on average 2.0 injuries and girls 1.5 injuries. Data from the Norwegian National Sample Injury Registry may provide useful information for prevention of and research on injuries among children.
Notes
Comment In: Tidsskr Nor Laegeforen. 1999 Apr 20;119(10):150710354767
PubMed ID
10101939 View in PubMed
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[Injuries connected to violence--an analysis of data from the injury registry]

https://arctichealth.org/en/permalink/ahliterature32809
Source
Tidsskr Nor Laegeforen. 2000 Feb 28;120(6):714-7
Publication Type
Article
Date
Feb-28-2000
Author
A. Engeland
B. Kopjar
Author Affiliation
Avdeling for samfunnsmedisin, Statens institutt for folkehelse, Oslo.
Source
Tidsskr Nor Laegeforen. 2000 Feb 28;120(6):714-7
Date
Feb-28-2000
Language
Norwegian
Publication Type
Article
Keywords
Accidents, Home - statistics & numerical data
Accidents, Traffic - statistics & numerical data
Adolescent
Adult
Aged
Athletic Injuries - diagnosis - epidemiology - etiology
Child
Domestic Violence
English Abstract
Female
Humans
Injury Severity Score
Male
Middle Aged
Norway - epidemiology
Registries
Violence
Wounds and Injuries - diagnosis - epidemiology - etiology
Abstract
BACKGROUND: Injury purposely inflicted by other persons is a potentially significant public health problem in Norway, and the size of the problem has received little attention. MATERIAL AND METHODS: We used data from the Norwegian National Injury Sample Registry from 1990-1997 and investigated occurrence of such injuries. RESULTS: A total of 9,649 injuries were included in this study, or 3.8 injuries per 1,000 person-years. Of these, 16% (0.6 per 1,000 person-years) required inpatient treatment. Injuries due to violence represented 2.4% of all injuries among women and 5.5% of all injuries among men. The incidence rate for men and women was highest in the age group 15-24 years. The incidence rate among men in this age group was 4-5 times the rate among women. Domestic violence caused at least 39% of injuries among women. Weekend injuries were overrepresented; about 64% of the injuries occurred from Friday to Sunday. INTERPRETATION: Figures represented in this study reveal only a portion of the problem of violent injuries. Spouse abuse, mental abuse, maltreatment, and sexual abuse without a physical injury are not represented in our data.
PubMed ID
10806886 View in PubMed
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Moped injuries among adolescents: a significant forgotten problem?

https://arctichealth.org/en/permalink/ahliterature33216
Source
Accid Anal Prev. 1999 Sep;31(5):473-8
Publication Type
Article
Date
Sep-1999
Author
B. Kopjar
Author Affiliation
Department of Population Health Sciences, National Institute of Public Health, Torshov, Oslo, Norway. branko.kopjar@samfunnsmed.uio.no
Source
Accid Anal Prev. 1999 Sep;31(5):473-8
Date
Sep-1999
Language
English
Publication Type
Article
Keywords
Accidents, Traffic - prevention & control - statistics & numerical data
Adolescent
Adult
Child
Child, Preschool
Cross-Sectional Studies
Female
Humans
Incidence
Infant
Male
Motorcycles - statistics & numerical data
Norway - epidemiology
Wounds and injuries - epidemiology - prevention & control
Abstract
OBJECTIVES: The study's objective is to investigate the size of the problem of moped injuries among children and young adults. DESIGN: A comprehensive prospective injury registration has been carried out at the Central Hospital and Emergency Clinic in Rogaland county in Norway. Out of this system we selected cases of traffic injuries occurring from 1990 to 1996 among a defined population aged 0-24 years and analyzed incidence of traffic injury by the type of transport of the victim. RESULTS: Moped injuries represented 9% (85 per 100,000 person-years) of all (hospitalized and non-hospitalized) traffic related injuries among people under 25 years and 44% of all cases among persons aged 16 and 17 years. Moped injuries represented 13% of hospitalized cases altogether and 50% of hospitalized traffic injuries among persons aged 16 and 17 years. The overall male:female moped injury incidence rate ratio was 2.7 (95% CI 2.0-3.7). Police records captured only 40% of the moped injuries overall. 43% of moped injuries were lone accidents and 40% occurred in a moped-car collision. CONCLUSION: Moped injuries represent a major source of serious traffic injury among older children. This risk seems to be partially overlooked. Significantly higher attention seems to be warranted to reduce the risk of moped injury in populations where the moped is a popular means of transport among older children.
PubMed ID
10440544 View in PubMed
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20 records – page 1 of 2.