To examine the annual incidence of acute whiplash injuries after road traffic crashes in a geographic catchment area in Northern Sweden during the period 2000-2009.
Descriptive epidemiology determined by prospectively collected data from a defined population.
The study was conducted at a public hospital in Sweden.
The population of the hospital's catchment area (136,600 inhabitants in 1999 and 144,500 in 2009).
At the emergency department, all injured persons (approximately 11,000 per year) were asked to answer a questionnaire about the injury incident. Data from the medical records also were analyzed. From 2000-2009, 15,506 persons were injured in vehicle crashes. Persons who were subject to an acute neck injury within whiplash-associated disorder grades 1-3 were included. The overall and annual incidences were calculated as incidence. Age, gender, type of injury event, and direction of impact were described. The incidences were compared with national statistics on insurance claims from 2003, 2007, and 2008 to detect changes in the proportions of claims.
The annual incidence of acute whiplash injuries. Secondary outcome measures were types of injury events, age and gender distribution, changes in the proportion of rear-end crashes during 2000-2009, and changes in the proportion of insurance claims during 2003-2008.
During 2000-2009, 3297 cases of acute whiplash injury were encountered. The overall incidence was 235/100,000/year. The average yearly increase in incidence was 1.0%. Women comprised 51.9% and men 48.1% of the injured. Car occupants (86.4%) and bicycle riders (6.1%) were most frequently injured. The proportion of rear-end crashes decreased from 55% to 45% from 2000-2009. The proportion of insurance claims significantly decreased between 2003 and 2008 (P
Abdominal injuries occur relatively infrequently during trauma, and they rarely require surgical intervention. In this era of non-operative management of abdominal injuries, surgeons are seldom exposed to these patients. Consequently, surgeons may misinterpret the mechanism of injury, underestimate symptoms and radiologic findings, and delay definite treatment. Here, we determined the incidence, diagnosis, and treatment of traumatic abdominal injuries at our hospital to provide a basis for identifying potential hazards in non-operative management of patients with these injuries in a low trauma volume hospital.
This retrospective study included prehospital and in-hospital assessments of 110 patients that received 147 abdominal injuries from an isolated abdominal trauma (n = 70 patients) or during multiple trauma (n = 40 patients). Patients were primarily treated at the University Hospital of Umeå from January 2000 to December 2009.
The median New Injury Severity Score was 9 (range: 1-57) for 147 abdominal injuries. Most patients (94%) received computed tomography (CT), but only 38% of patients with multiple trauma were diagnosed with CT
The aim of this paper is to analyse and compare injuries and injury sources in pedestrian and bicyclist non-fatal real-life frontal passengercar crashes, considering in what way pedestrian injury mitigation systems also might be adequate for bicyclists. Data from 203 non-fatal vehicle-to-pedestrian and vehicle-to-bicyclist crashes from 1997 through 2006 in a city in northern Sweden were analysed by use of the hospitals injury data base in addition to interviews with the injured. In vehicle-to-pedestrian crashes (n = 103) head and neck injuries were in general due to hitting the windscreen frame, while in vehicle-to-bicycle crashes (n = 100) head and neck injuries were typically sustained by ground impact. Abdominal, pelvic and thoracic injuries in pedestrians and thoracic injuries in bicyclists were in general caused by impacting the bonnet. In vehicle-to-pedestrian crashes, energy reducing airbags at critical impact points with low yielding ability on the car, as the bonnet and the windscreen frame, might reduce injuries. As vehicle-to-bicyclist crashes occurred mostly in good lighting conditions and visibility and the ground impact causing almost four times as many injuries as an impact to the different regions of the car, crash avoidance systems as well as separating bicyclists from motor traffic, may contribute to mitigate these injuries.
Bicycles are a common mode of transportation and injured bicyclists cause a substantial burden on the medical sector. In Sweden, about half of fatally injured bicyclists are 65 years or older. This study analyzes the injury mechanisms, injuries, and consequences among bicyclists 65 years or older and compare with younger bicyclists (
The purpose of this study was to investigate if teenagers visiting an emergency room because of injury have an increased risk of premature death ahead and, if so, identify possible risk factors and suggest preventive measures.
In January 2010, the personal identity numbers of 12,812 teenagers who had visited the emergency room at the University Hospital in Umeå, Sweden, during 1993 through 2006 because of injury were checked against the National Cause of Death Register in Sweden. Standardised mortality ratio and confidence intervals were calculated. For the unnatural deaths that took place in Sweden, the police report, autopsy protocol, and hospital records, if present, were studied.
Thirty-eight fatalities were included giving a standardised mortality ratio of 1.44 (95% CI: 1.02-1.98). A majority of the decedents were males (n=32, 84%) and the median age at the time of death was 21 years. Twenty-three deaths were caused by unintentional injuries and ten by intentional injuries (all suicides), while five deaths were categorised as undetermined whether intentional or not. Seventy-four percent tested positive for either alcohol or drugs or a combination at the post mortem examination. Nine males and one female committed suicide, five tested positive for alcohol (one also for drugs), while four tested negative at the post mortem examination. One died abroad and in this case we lack information on alcohol and drugs.
Teenagers visiting an emergency room due to injury experience an increased risk of premature death by unnatural cause and those at risk are especially males. The use of alcohol and drugs often seems to contribute to their untimely deaths. Identifying those at risk when they visit the emergency room for an injury and to take preventive actions at this stage could be a way to reduce the number of fatalities.
Designing effective vehicle-based countermeasures for vulnerable road users demands an understanding of the relationship between injury and injury source. The aim of this study was to explore this association for bicyclists in fatal real-life-crashes. All fatal crashes in Sweden where a bicyclist was killed when hit by the front of a passenger car between 2002 and 2008 were studied in detail using on-scene data. An analysis was performed to determine the body region containing the injury causing death, and the point of the car accountable for the fatal injury. These crashes were then compared to a previous study with the same selection criteria for vehicle-to-pedestrian fatal crashes.A combined analysis revealed that the dominating injury mechanism was head/neck injury from the windshield area. The most frequent injurious windshield parts were structural; the frame and lower parts of the glass area with instrument panel situated within the head's line of motion. This study indicates that bicyclists' injury sources were located more rearwardly on the car (e.g. windshield relative to hood), in comparison to injury sources in fatal vehicle-to-pedestrian crashes.If countermeasures to prevent fatal bicyclist injury in vehicle impacts were to be concentrated on mitigating head and thorax impact to the structural parts of the windshield, a dominant share of fatal bicyclist crashes could be prevented. This study shows that pedestrian countermeasures also have a potential for reducing injury in bicyclist crashes, but indicating that these countermeasures should be extended to address higher areas of the windshield.
Clearing snow from roofs causes serious injuries annually. The aim of this study was to describe injury mechanisms, injury panorama, and injury incidence in connection to this activity. A specific aim was to study the association between snow depth and injury incidence. A total of 95 people were injured during four study periods. The risk of injury is strongly associated with snow depth, and the incidence varied up to 10-fold between the studied winter seasons. The majority of injuries (91; 96%) occurred during leisure time and only four people were injured in the occupational setting. The most common injury mechanism was falling off roofs or ladders of residential homes. Nearly 60% sustained moderate or serious injuries (Maximum Abbreviated Injury Scale [MAIS] 2-3), and fractures accounted for almost half of all injuries. Because roofs of single-family homes in Sweden usually do not require snow removal for heavy snow loads, these injuries may have been both unnecessary and avoidable. Further education is required to advise the public on the risks associated with snow removal from roofs.
Previous research has pointed out that non-collision injuries occur among wheelchair users in Special Transportation Services (STS - a demand-responsive transport mode). The organization of such modes is also quite complex, involving both stakeholders and key personnel at different levels. Our objective was therefore to qualitatively explore the state of safety, as perceived and discussed within a workplace context. Focus groups were held with drivers of both taxi companies and bus companies. The results indicated that passengers run the risk of being injured without being involved in a vehicle collision. The pertinent organizational and corporate culture did not prioritize safety. The drivers identified some relatively clear-cut safety threats, primarily before and after a ride, at vehicle standstill. The driver's work place seemed to be surrounded with a reactive instead of proactive structure. We conclude that not only vehicle and wheelchair technical safety must be considered in STS, but also system safety. Instead of viewing drivers' error as a cause, it should be seen as a symptom of systems failure. Human error is connected to aspects of tools, tasks, and operating environment. Enhanced understanding and influence of these connections within STS and accessible public transport systems will promote safety for wheelchair users.
Injuries due to interaction with dogs and cats are not uncommon, and constituted 1.4% of all injuries in an unselected policlinical and inpatient material. This material was collected from a population of 135,000 people in Northern Sweden, and during 2 years 280 patients with injuries related to these domestic animals were found (Ndogs = 212, Ncats = 68). The injuries were in most cases caused by bites and by falls. The former were more common among men, the latter more common among women and related to fractures and dislocations. In contrast to many previous investigations, bite injuries were more common among adults than among children, possibly related to national differences in the keeping of dogs. Most dog related injuries were caused by the owner's dog. Walking the dog was the activity most often related to personal injury. The cost for inpatient cases (treated at the University Hospital, UmeÃ¥) caused by dogs and cats is of the same magnitude as the cost due to motorcycling in traffic, but less than the cost for injuries sustained during horseback riding and other horse related activities, for soccer, snowmobiling and for assaults.