This study investigated the epidemiology of traumatic brain injuries (TBIs) occurring to young children, associated with consumer products at home in the United States. Data from the National Electronic Injury Surveillance System were analyzed. There were an estimated 2 292 896 (95% CI = 1 707 891-2 877 900) children <5 years of age treated in US emergency departments for a TBI associated with a consumer product at home during 1991-2012, which equals an annual average of 104 223 (95% CI = 77 631-130 814) children. During the 22-year study period, the number and rate of TBIs increased significantly by 283.3% (estimated annual rate of change, m = 7182.6; P <.001) and 266.5% (m = 0.35; P <.001), respectively. The number of TBIs decreased with increasing age of the child. Falls from household products were the leading mechanism of injury (53.7%). To our knowledge, this is the first nationally representative study of TBIs associated with consumer products at home among young children. These findings underscore the need for increased prevention efforts.

Traumatic brain injury (TBI) remains a major public health problem in the United States. Identifying and modifying vehicle designs associated with TBI will have a significant impact on the frequency and severity of TBI in motor vehicle crashes (MVCs). The objective, therefore, was to identify interior vehicle contact points associated with severe TBI (head Abbreviated Injury Scale score > 3) among drivers and determine the extent to which modifications of these contact points impact the likelihood of severe TBI. The authors analyzed drivers in MVCs from the 1993 to 2001 National Automotive Sampling System database. The odds of severe TBI with respect to various vehicle contact points were estimated using multivariate logistic regression. Using computer simulation software, the magnitude of driver head deceleration was modeled while manipulating vehicle design features. The potential impact of this design modification on the frequency and hospital charges of TBI cases was estimated. Results showed that there were 18,313 drivers involved who were victims of TBI, equating to a national sample size of 3,275,472 cases. The most frequent contact point associated with severe TBI was the roof rail. Increasing roof rail padding thickness to 5.0 cm reduced the peak acceleration from 700 g to 218 g, which would potentially reduce the attributable number of severe TBI cases per year from 2,730 to 210, thereby reducing annual acute care charges from $136.5 million to $10.5 million. In conclusion, contact with the roof rail significantly increases the likelihood of TBI in MVCs. Minor increases in padding at these points may reduce the frequency of severe TBI, which would have a substantial effect on health care costs.

Aims Previous research has suggested there are ethnic disparities in the incidence of traumatic brain injury (TBI). This study aimed to: identify the incidence of TBI for Pacific people; describe the injury profile in this population; and determine if there were disparities in healthcare service use. Methods: All TBI cases that occurred within a 1-year period in the Hamilton and Waikato regions of New Zealand were identified using multiple case ascertainment methods as part of a population-based incidence study. Demographic and injury data from people who self-identified as a Pacific person (N=76) were extracted and compared to New Zealand (NZ) Europeans (N=794). Differences in injury severity, mechanism of injury and acute healthcare service use were explored between the two ethnic groups. Results: The total crude incidence of TBI in Pacific people was 1242 cases per 100,000 person-years, significantly higher than NZ Europeans (842 per 100,000). Peaks in incidence for Pacific people and NZ Europeans were observed between 0–4 and 15–24 years of age, with males at greater risk of injury than females. There were no statistically significant differences in TBI severity, mechanism of injury and acute healthcare use between the two groups. Conclusion: Pacific people are at a significantly higher risk of experiencing a TBI than NZ Europeans and targeted prevention efforts are needed.

This publication fro ACC: "... provides evidence-based recommendations for best practice in the diagnosis, acute management and rehabilitation of children, young people and adults after traumatic brain injury (TBI). It is intended to support informed decision-making about acute management, care and rehabilitative approaches by practitioners working with people who have a TBI, their families/whanau and carers. ... The guideline will also be a resource for the Accident Compensation Corporation (ACC) and District Health Board (DHB) funders and planners as it identifies the necessary aspects of care and services that should be provided. In addition, it identifies where there is a need for targeted research to improve the evidence base."

The causes of traumatic deaths of children under 14 in the US are presented. Available prevention strategies to decrease injury fatalities due to various causes are described, and the number of preventable deaths is calculated. With the implementation of only 12 currently available prevention strategies, childhood deaths from trauma could be reduced by 29% in the US. The implications of these strategies are discussed, as well as the areas for which no effective countermeasures exist and which require further epidemiologic and investigative research.

BACKGROUND: With a reported incidence of up to 10% compared to all spinal trauma, spinal injuries in children are less common than in adults. Children can have spine fractures with or without myelopathy, or spinal cord injuries without radiological abnormalities (SCIWORA). METHODS: We retrospectively reviewed the cases of children with spinal injuries treated at a level 1 pediatric trauma centre between 1990 and 2013. RESULTS: A total of 275 children were treated during the study period. The mean age at admission was 12 ± 4.5 years, and the male:female ratio was 1.4:1. Spinal injuries were more common in children of ages 12-16 years, with most injuries among ages 15-16 years. The top 3 mechanisms of spinal injury were motor vehicle-related trauma (53%), sports (28%) and falls (13%). Myelopathy occurred in 12% and SCIWORA occurred in 6%. The most common spine levels injured were L2-sacrum, followed by O-C2. Associated injuries, including head injuries (29%), and fractures/dislocations (27%) occurred in 55% of children. Overall mortality was 3%. Surgical intervention was required in 14%. CONCLUSION: The creation of a pediatric spinal injury database using this 23-year retrospective review helped identify important clinical concepts; we found that active adolescent boys had the highest risk of spine injury, that noncontiguous spine injuries occured at a rate higher than reported previously and that nonaccidental spine injuries in children are underreported. Our findings also emphasize the importance of maintaining a higher index of suspicion with trauma patients with multiple injuries and of conducting detailed clinical and radiographic examinations of the entire spine in children with a known spinal injury.

This highlights booklet presents results from the large number of tables and graphs which appear in the principal document, the 'New Zealand Travel Survey Report'. It provides information on recent travel patterens as well as showing how travel behaviour has changed over the eight years since the 1989/1990 survey. When road crash statistics are combined with this travel information, it is possible to show which demograpohic groups are at (and which driving situations present) the greatest risk and how, influenced by changing travel patterens and road safety programmes, risk has changed over time.

The NZ Travel Survey was a project initiated and funded by the New Zealand Road Safety Trust. Its aim was to update information on road crash and injury risk to allow accurate targeting of road safety strategy and initiatives. This report provides a detailed description of the survey methodology together with tables of survey results including changes over the last eight years since the last travel survey of 1989/90.

This is a an ideas page for teachers to be able to discuss safe school travel and pedestrian behaviour with their pupils. The two headings are: (1) Travelling on the school bus, and (2) Walking home

The main aim of this project was to quantify the relationship between free travelling speed and the risk of involvement in a casualty crash, for sober drivers of cars in 60 km/h speed limit zones in the Adelaide metropolitan area. The secondary aims of the project were to examine the effect of hypothetical speed reductions on the crashes in this study and to explore the relationship between travelling speed and driver blood alcohol concentration. Using a case-control study design, the speeds of cars involved in casualty crashes were compared with the speeds of cars not involved in crashes but travelling in the same direction, at the same location, time of day, day of week, and time of year. Additional information about the effects of travelling speed was obtained by calculating what the results of the crash would have been if the case vehicle had been travelling at a different speed. A separate study was set up to measure the relationship between blood alcohol concentration and travelling speed. The speed of an approaching car was measured 200-300 metres before a signalised intersection using a laser speed meter. When the car stopped at this intersection for a red light, the driver was approached and asked to blow into a breath alcohol meter. Results showed that cars involved in casualty crashes were generally travelling faster than cars that were not involved in a crash: 68 per cent of casualty crash involved cars were exceeding 60 km/h compared to 42 per cent of those not involved in a crash etc. None of the travelling speeds below 60 km/h was shown to be associated with a risk of involvement in a casualty crash that was statistically significantly different from the risk at 60 km/h. Above 60 km/h there is an exponential increase in risk of involvement in a casualty crash with increasing travelling speed such that the risk approximately doubles with each 5 km/h increase in travelling speed. By working back from the risk estimates we have concluded that nearly half (46 per cent) of these free travelling speed casualty crashes probably would have been avoided, or reduced to non-casualty crashes, if none of the case vehicles had been travelling above the speed limit. The study of the relationship between free travelling speed and the driver's blood alcohol concentration (BAC) showed that higher BAC levels are associated with slightly higher travelling speeds although the average difference in speed is less than three kilometres per hour. Conclusions and Recommendations: In a 60 km/h speed limit area, the risk of involvement in a casualty crash doubles with each 5 km/h increase in travelling speed above 60 km/h. Speeding in an urban area is as dangerous as driving with an illegal blood alcohol concentration. Even travelling at 5 km/h above the 60 km/h limit increases the risk of crash involvement as much as driving with a blood alcohol concentration of 0.05. In this study the free speed casualty crashes occurred almost entirely on main roads. There is a compelling case for a lower speed limit throughout urban areas, particularly on arterial roads. Most motorised countries have an urban area speed limit of 50 km/h, as did Victoria and NSW until the early 1960s.

Each day during the school term millions of pupils and their parents travel from home to school in the morning, and make the return trip in the afternoon. Many pupils living close to school walk, with those living further away travelling mainly by bus or by car. The school journey affects public transport patterns, causes localised congestion around schools and contributes to the sharp road traffic peak around nine o'clock each morning. Over the past 20 years the proportion of children travelling to school by car has almost doubled, yet many live close enough to school to walk. Many older children would like to cycle, but are worried about safety, or their school may lack secure cycle storage facilities. Other pupils would like to travel by bus, but there may not be a service available at the right time. If one is available it may be too expensive, particularly for families with two or more children, or else children may feel intimidated by bullying or other anti-social behaviour. This good practice guide for local transport and education authorities is one of two documents we are publishing. Its companion document Travelling to School: an action plan (see rec # 8064) describes what we think needs to be done to change the way children travel to school. We want to bring about a step change in home to school travel patterns to cut congestion and pollution, but also to allow many more pupils to take regular exercise. This document describes what schools, local authorities and bus operators around the country have been doing to promote walking, cycling and public transport and combat increasing car use. There are already 2,000 schools that have adopted this agenda and many have found that it is surprisingly easy to engage their local transport authority in setting up walking buses and changing road layouts. We want all schools to follow this example. So we will fund more school travel advisers to help schools put together travel plans, and work in partnership with road safety, highways engineering and local education authorities. We will also make funding available for schools – to provide secure cycle parking, lockers and bus bays – to support sustainable travel. We are also considering whether to invite a small number of local authorities to pilot innovative school transport arrangements which would focus on better school bus provision for more pupils. Above all, we want every school, local authority and bus operator to work together to make it safe and cost effective for many more children to walk, cycle or take the bus to school.

Each day during the school term millions of pupils and their parents travel from home to school in the morning, and make the return trip in the afternoon. Many pupils living close to school walk, with those living further away travelling mainly by bus or by car. The school journey affects public transport patterns, causes localised congestion around schools and contributes to the sharp road traffic peak around nine o'clock each morning. Over the past 20 years the proportion of children travelling to school by car has almost doubled, yet many live close enough to school to walk. Many older children would like to cycle, but are worried about safety, or their school may lack secure cycle storage facilities. Other pupils would like to travel by bus, but there may not be a service available at the right time. If one is available it may be too expensive, particularly for families with two or more children, or else children may feel intimidated by bullying or other anti-social behaviour. This action plan for schools, local authorities and DfES is one of two documents we are publishing. Its companion document ‘Travelling to School: a good practice guide’ describes what schools, local authorities and bus operators around the country have been doing to promote walking, cycling and public transport and combat increasing car use. We want to bring about a step change in home to school travel patterns to cut congestion and pollution, but also to allow many more pupils to take regular exercise. This document sets out how we want to help and reward schools that commit themselves to increasing the proportion of pupils walking and cycling or – for those living some distance from school – catching the bus. There are already 2,000 schools that have adopted this agenda and many have found that it is surprisingly easy to engage their local transport authority in setting up walking buses and changing road layouts. We want all schools to follow this example. So we will fund more school travel advisers to help schools put together travel plans, and work in partnership with road safety, highways engineering and local authority services. We will also make funding available for schools – to provide secure cycle parking, lockers and bus bays – to support sustainable travel. We are also considering whether to invite a small number of local authorities to pilot innovative new school transport arrangements which would focus on better school bus provision for more pupils.

This poster warns that 'Treadmills and kids don't mix!' Treadmills are great for adult fitness but can be dangerous to toddlers and young children. Even parents who carefully child-proof their home may not fully realise the risks associated with treadmills. In the last few years more than 100 Australian children have been seriously injured by treadmills at home. Most injuries happen when a baby or toddler moves to the back of the treadmill (where they are out of sight) and either touches the moving belt or gets their hand caught under it. This can result in severe friction burns that can take many months to heal, possibly requiring skin graft operations and even plastic surgery when the child is older. Unfortunately the number of accidents in New South Wales is growing as the sales of domestic treadmills continue to increase. This poster features the safety tips: 'If you can, use your treadmill in a room away from young children. If this is not possible: use safety barriers to protect children from getting hurt, do not use your treadmill when young children are around. When not in use always keep your treadmill unplugged.' PDF available at: http://www.fairtrading.nsw.gov.au/Consumers/Product_and_service_safety/General_products/Treadmills.html

Treadmills are a burn risk for children. A child's hand can get trapped in the conveyor belt, causing friction burns to the underlying tissue. The purpose of this retrospective study was to review the characteristics and treatment of treadmill-related burns in children from 1998 to 2002. Ten patients, at a mean age of 3.4 years, sustained injuries associated with treadmill use. Trapping of the hand between the conveyor belt and the base was the most frequent injury mechanism. Burn location was predominantly on fingers and palms. Four patients required operative intervention. All patients required specialized wound care as well as scar management and occupational therapy. Treadmills pose a danger to children. Current safety devices are ineffective for preventing serious hand injuries in children. New design modifications and public awareness are needed to improve child safety.

This article discusses the use of copper, chromium, and arsenic treated timber in early childhood education centres and outlines best practice for minimising children's contact with timber treated chemicals.

This resource kit answers many often posed questions about the Treaty of Waitangi. It aims to inform New Zealanders about the Treaty, its history and application today.

In the UK, overall, there is a widening socioeconomic differential in mortality from injury.

The Commission for Children Young People and Child Guardian - Queensland publishes a 'Trends and issues paper' series to publish data about different types of preventable deaths and injury. This paper focuses on bicycle safety for children and young people and examines the incidence of children who died in bicycle incidents between 2004 and 2011 in Queensland and outlines areas of concern to the Commission such as the need for child cyclists under the age of ten to be accompanied on the road and the importance of correctly fitting and secured helmets. Available at: http://www.ccypcg.qld.gov.au/about/news/2011/november/Trends-and-Issues-Paper-released-Child-deaths-suicide-intent.html

`The objective of this study was to determine the prevalence, trends, and severity of injuries attributable to playround falls relative to other common unintentional mechanisms that resulted in an emergency department (ED) visit in the USA. Results from this study showed that playground falls were twice as prevalent as pedestrian mechanisms, but they were less prevalent than visits for motor vehicle and bicycle-related injuries. A larger proportion of playground falls resulted in "moderate-to-severe" injury than did bicycle or motor vehicle injuries. Children aged 5-9 years had the highest number of playground falls and these were more likely to occur at school compared to home, public, and other locations. In conclusion, playground injury emergency visits have not significantly declined and remain a common unintentinal mechanism of injury. Injury visits for playground falls were proportionally more severe than injury visits attributable to other common unintentional mechanisms. Interventions targeting schools and 5-9 year old children may have the greatest impact in reducing ED visits for playground injuries.

BACKGROUND: The number of children admitted to hospital is increasing year on year, with very short-stay admissions doubling in the last decade. Childhood head injury accounts for half a million emergency department attendances in the UK every year. The National Institute for Health and Care Excellence (NICE) has issued three iterations of evidence-based national guidance for head injury since 2003. OBJECTIVES: To assess if any changes in the rates of admission, death or causes of head injury could be temporally associated with the introduction of sequential national guidelines by longitudinal analysis of the epidemiology of paediatric head injury admissions in England from 2000 to 2011. METHODS: Retrospective analysis of English Hospital Episode Statistics data of children under the age of 16 years old admitted to hospital with the discharge diagnosis of head injury. RESULTS: The number of hospital admissions with paediatric head injury in England rose by 10% from 34 150 in 2000 to 37 430 in 2011, with the proportion admitted for less than 1 day rising from 38% to 57%. The main cause of head injury was falls (42-47%). Deaths due to head injury decreased by 52% from 76 in 2000 to 40 in 2011. Road traffic accidents were the main cause of death in the year 2000 (67%) but fell to 40% by 2011. In 2000, children who were admitted or died from head injuries were more than twice as likely to come from the most deprived homes compared with least deprived homes. By 2011, the disparity for risk of admission had narrowed, but no change was seen for risk of death. CONCLUSIONS: Temporal relationships exist between implementation of NICE head injury guidance and increased admissions, shorter hospital stay and reduced mortality. The underlying cause of this association is likely to be multifactorial.

The objective of this study was to characterize national trends in non-fatal BB/pellet gun related injury rates for persons aged 19 years or younger in relation to trends in non-fatal and fatal firearm related injury rates and discuss these trends in light of injury prevention and violence prevention efforts. The National Electronic Injury Surveillance System (NEISS) includes approximately 100 hospitals with at least six beds that provide emergency services. These hospitals comprise a stratified probability sample of all US hospitals with emergency departments. The National Vital Statistics System (NVSS) is a complete census of all death certificates filed by states and is compiled annually. National data on BB/pellet gun related injuries and injury rates were examined along with fatal and non-fatal firearm related injuries and injury rates. Non-fatal injury data for all BB/pellet gun related injury cases from 1985 through 1999, and firearm related injury cases from 1993 through 1999 were obtained from hospital emergency department records using the NEISS. Firearm related deaths from 1985 through 1999 were obtained from the NVSS. Results showed that BB/pellet gun related injury rates increased from age 3 years to a peak at age 13 years and declined thereafter. In contrast, firearm related injury and death rates increased gradually until age 13 and then increased sharply until age 18 years. For persons aged 19 years and younger, BB/pellet gun related injury rates increased from the late 1980s until the early 1990s and then declined until 1999; these injury rates per 100 000 population were 24.0 in 1988, 32.8 in 1992, and 18.3 in 1999. This trend was similar to those for fatal and non-fatal firearm related injury rates per 100 000 which were 4.5 in 1985, 7.8 in 1993, and 4.3 in 1999 (fatal) and 38.6 in 1993 and 16.3 in 1999 (non-fatal). In 1999, an estimated 14 313 cases with non-fatal BB/pellet gun injuries and an estimated 12 748 cases with non-fatal firearm related injuries among persons aged 19 years and younger were treated in US hospital emergency departments. In conclusion, BB/pellet gun related and firearm related injury rates show similar declines since the early 1990s. These declines coincide with a growing number of prevention efforts aimed at reducing injuries to children from unsupervised access to guns and from youth violence. Evaluations at the state and local level are needed to determine true associations.

Booster seat use in the United States is extremely low among 4- to 8-year-old children, the group targeted for their use. However, more recent attention has been paid to the role of booster seats for children who have outgrown their forward-facing child safety seat. In particular, several states are currently considering upgrades to their child restraint laws to include the use of booster seats for children over 4 years of age. The objective of this study was to examine recent trends in booster seat use among children involved in automobile crashes in 3 large regions of the United States. This study was performed as part of the Partners for Child Passenger Safety project, an ongoing, child-specific crash surveillance system that links insurance claims data to telephone survey and crash investigation data. All crashes occurring between December 1, 1998, and November 30, 2000, involving a child occupant between 2 to 8 years of age riding in a model year 1990 or newer vehicle reported to State Farm Insurance Companies from 15 states and Washington, DC, were eligible for this study. A probability sample of eligible crashes was selected for a telephone survey with the driver of the vehicle using a previously validated instrument. The study sample was weighted according to each subject’s probability of selection, with analyses conducted on the weighted sample. The weighted study sample consisted of 53 834 children between 2 to 8 years old, 11.5% of whom were using a booster seat at the time of the crash. Booster seat use peaked at age 3 and dropped dramatically after age 4. Over the period of study, booster seat use among 4- to 8-year-olds increased from 4% to 13%. Among 4- year olds specifically, booster use increased from 14% to 34%. Among children using booster seats, approximately half used shield boosters and half used belt-positioning boosters. In conclusion, although overall booster seat use among the targeted population of 4- to 8-year-old children remains low, significant increases have been noted among specific age groups of children over the past 2 years. These data may be useful to pediatricians, legislators, and educators in efforts to target interventions designed to increase appropriate booster seat use in these children.

Motor vehicle crashes on a public road are a major cause of death and hospitalisation in New Zealand. This factsheet is a summary of injuries to occupants of motor vehicles, other than motorcyclists, involved in traffic crashes in New Zealand.

Computerised mortality data files from the national Center for Health Statistics were analysed to describe childhood farm drowning from 1986 through 1997. Farm drowning rates were compared to the U.S. unintentional youth drowning rates for the same period. The denominator for the calculation of rates was derived from a series of farm youth estimates published by the Bureau of Census. There were 378 childhood farm drowning cases during the study period, for an average annual rate of 2.3 deaths per 100,000 farm youth resident years. This rate is comparable to unintentional drowning rates for U.S. youth (2.2/100,000 population). Fatality rates declined 28% from 1986 through 1997 for farm youth and 41% for U.S. youth. An average 32 farm drowning incidents occur to youth annually, making drowning a legitimate concern for farm residents and visitors.

This articles examines trends in children's attendance at hospital Accident and Emergency Departments for unintentional poisoning from 1990-1999 in the UK and finds declines in cases. Although poisoning attendance and admission rates have declined, continued efforts are still needed to prevent poisoning in childhood. While child-resistant containers and use of blister packs for medication play an important preventative role, it is important to remember that such measures are not 'child proof.' The safe storage of hazardous substances remains essential and strategies to increase safe storage require evaluation.

Serious injury trends for 3 age groups of cyclists were examined. The age groups were children from 5-12 years, from 13-18 years and over 18 years, and "serious injury" was defined as necessitating hospitalisation. Results have revealed that although larger percentages of all cyclists are now wearing helmets there was little association with rates of serious head injuries.

This fact sheet details trends in cyclist injury from 1989 to 1998.

To clarify trends and urban-rural differences in the early death rate (deaths within 24 h divided by the deaths within 1 year after motor vehicle accident X 100 [%]) due to motor vehicle accidents (MVAs) in Japan. Mortality data were collected from the annual statistics of traffic accident research and vital statistics in Japan from 1980 through 1998 and analyzed. Early death rates were nearly constant (73.9–78.0%) from 1980 through 1998. Early death rates were lower in younger and elderly groups. As regards to geographic variations, early death rates and 1-year death rates per 100,000 vehicles were significantly higher in rural areas (population density <1000/km2) than in urban areas. To investigate MVA deaths, both early and late deaths should be examined. Decreasing the early death rate, a new index for MVA death, which reflects the reduction of injury severity is important for preventing MVA deaths.

A factsheet which presents graphs and tables to show the trends in rates and percentages for fatal injury for major categories for New Zealand 1977-1997.

The objective of this study was to examine the trends in childhood head injury mortality in Scotland between 1986 and 1995. A total of 290 children in Scotland died as a result of a head injury between 1986 and 1995. While there was a significant decline in the head injury mortality rate, head injury as a proportion of all injury fatalities remained relatively stable. Boys, and children residing in relatively less affluent areas had the highest head injury mortality rates. Although both these groups experienced a significant decline over the study period, the mortality diffrerences between children in deprivation categories 1-2 and 6-7 persisted among 0-9 year olds, and increased in the 10-14 years age group. Pedestrian accidents were the leading cause of mortality. In conclusion, children residing in less affluent areas seem to be at a relatively graeter risk of sustianing a fatal head injury than their more affluent counterparts. While the difference between the most and least affluent have decreased overall, they have widened among 10-14 year olds. The decline in head injury mortality as a result of pedestrian accidents may be partly attributable to injury prevention measures.

BACKGROUND: Use of potentially hazardous bedding, as defined by the American Academy of Pediatrics (eg, pillows, quilts, comforters, loose bedding), is a modifiable risk factor for sudden infant death syndrome and unintentional sleep-related suffocation. The proportion of US infants sleeping with these types of bedding is unknown. METHODS: To investigate the US prevalence of and trends in bedding use, we analyzed 1993–2010 data from the National Infant Sleep Position study. Infants reported as being usually placed to sleep with blankets, quilts, pillows, and other similar materials under or covering them in the last 2 weeks were classified as bedding users. Logistic regression was used to describe characteristics associated with bedding use. RESULTS: From 1993 to 2010, bedding use declined but remained a widespread practice (moving average of 85.9% in 1993–1995 to 54.7% in 2008–2010). Prevalence was highest for infants of teen-aged mothers (83.5%) and lowest for infants born at term 55.6%). Bedding use was also frequently reported among infants sleeping in adult beds, on their sides, and on a shared surface. The rate of decline in bedding use was markedly less from 2001–2010 compared with 1993–2000. For 2007 to 2010, the strongest predictors (adjusted odds ratio: $1.5) of bedding use were young maternal age, non-white race and ethnicity, and not being college educated. CONCLUSIONS: Bedding use for infant sleep remains common despite recommendations against this practice. Understanding trends in bedding use is important for tailoring safe sleep interventions

This factsheet presents information on rates of motorcycle crashes on a public road in New Zealand in relation to trends, age and distance travelled from 1989 to 1998.

A factsheet which presents graphs and tables showing trends in rates and percentages for non-fatal injury resulting in inpatient treatment in New Zealand public hospitals, 1978-1998.

Objective: The primary aim of this study was to develop a method of calculating paediatric injury rate from Emergency Department injury surveillance data and use this to describe trends in paediatric injury. This study also aimed to establish whether triage category could be used as an indicator of severity. Methods: Prospective observational study of paediatric injury in Brisbane, Australia from 1998 to 2005 using Emergency Department injury surveillance data. Injury incidence was calculated using postcode restriction, census data and analysis of injury surveillance data quality and alternative hospital presentations. Conclusion: Injury incidence can be determined using Emergency Department injury surveillance data and triage category is a useful indicator of injury severity. Paediatric emergency department injury presentations, including serious injury, increased significantly between 1998 and 2005. Implications: The methodology used in this study is easily repeatable and could be used to evaluate injury prevention interventions. The prevention and management of injury should be directed by accurate injury incidence data.

OBJECTIVES: The purpose of this study was to review the epidemiology, aetiology and management of maxillofacial injuries in the paediatric population seen in Dunedin, New Zealand from 2006 to 2012. MATERIALS AND METHODS: A retrospective descriptive analysis was conducted over a 7 year period. Data concerning demographics, injuries and management of patients between the ages of 0-17 years who presented to the oral and maxillofacial service in Dunedin were gathered and analysed. RESULTS: 340 incidents that excluded pure dental trauma were recorded. Falls were found to be the most common cause of injury; followed by contact with animate objects (other individuals and animals), contact with inanimate objects and road traffic accidents. Injuries in younger age groups were found to be caused by falls and contact with inanimate objects more often, receiving predominantly soft tissue injuries. In the older age group, a higher number of facial fractures were seen with a change in the most common causes to road traffic accidents and contact with animate objects. An increase in alcohol-related road traffic accidents was noted among females. For all injuries the male to female ratio was 2:1 which is similar to previous reports from New Zealand and overseas. For the sub group of facial fractures a much higher ratio of males were seen at a ratio of 8.5:1. CONCLUSIONS: Causes of injury and anatomical location followed similar patterns to reports worldwide, along with a similar male to female ratio. Although the incidence of road traffic accident related facial injuries is relatively low, the high proportion of these accidents involving paediatric patients and alcohol is of concern.

This factsheet presents an overview of pedestrian injury in New Zealand

The objective of this study was to examine trends in road injury hospitalisation rates for Aboriginal and non-Aboriginal people in Western Australia. Data from the Western Australian Hospital Morbidity Data System for the years between 1971 and 1997 were analysed. Poisson regression models were fitted to determine whether the trends were significant. Results showed that the rate of hospitalisation due to road injury for Aboriginal people (719.1 per 100 000 population per year) over the time period examined was almost twice as high as that for non-Aboriginal people (363.4 per 100 000 population per year). Overall, the results showed that while hospitalisations from road injury involving non-Aboriginal people have been decreasing by 6.7% per three year period since 1971, the rates of hospitalisation for Aboriginal people have been increasing by 2.6% per three year period. Both of these trends were statistically significant. The alarming increasing trend observed for Aboriginal people was more pronounced in males, those aged 0–14 years and over 45 years, and for those living in rural areas. In conclusions, as the rates of road injury for Aboriginal people are higher than for non-Aboriginal people, and are also following an increasing trend, road safety issues involving Aboriginal people need to be addressed urgently by health and transport authorities.

In England the use of bicycle helmets remains low as debate continues about their effectiveness. Time trend studies have previously shown an inverse association between helmet wearing rates and hospital admissions for head injury, but data on helmet wearing are often sparse and admission rates vary for numerous reasons. For the period of this study comprehensive data on helmet wearing are available, and pedestrians are used as a control to monitor trends in admission. Among cyclists admitted to hospital, the percentage with head injury reduced from 27.9% (n = 3070) to 20.4% (n = 2154), as helmet wearing rose from 16.0% to 21.8%. Pedestrian head injury admissions also declined but by a significantly smaller amount. The wearing of a cycle helmet is estimated to prevent 60% of head injuries.

As the health and environmental benefits of cycling have become better appreciated, successive governments in the United Kingdom have encouraged cycle use. Cyclists, however, face considerable risk of injury, of which head injuries most commonly result in serious adverse outcomes. Despite evidence from case control and time trend studies, questions remain about the effectiveness of helmets, particularly for adults. The authors examined trends in emergency admissions for cycle injuries to English hospitals between 1991 and 1995, during which time the wearing of helmets increased. The findings indicate that cycle helmets are of benefit both to children and, contrary to popular belief, to adults. The reason that people most frequently cite for not cycling is risk of injury; measures to increase cycle use must therefore address safety. Local publicity campaigns encouraging the voluntary wearing of helmets have been effective and should accompany national drives to promote cycling.

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 Prevention's Heads Up. Prevention efforts should be targeted by sports and recreational activity, age, and sex.

OBJECTIVE: To evaluate the epidemiology of sudden unexpected infant death (SUID) over a 20-year period in the US, to assess the potential frequency of sudden unexpected postnatal collapse in the early days of life, and to determine if SUID rates in the neonatal period (0-27 days) have changed in parallel with rates in the postneonatal periods, including the percentages attributed to codes that include accidental suffocation. STUDY DESIGN: Data from the US Centers for Disease Control and Prevention Linked Birth/Infant Death Records for 1995-2014 were analyzed for the first hour, day, week, and month of life. A comparison of neonatal and postneonatal data related to SUID, including accidental suffocation, was carried out. RESULTS: Death records for 1995-2014 indicate that, although SUID rates in the postneonatal period have declined subsequent to the 1992 American Academy of Pediatrics sleep position policy change, newborn SUIDs have failed to decrease, and the percentage of SUIDs attributed to unsafe sleep conditions has increased significantly in both periods; 29.2% of the neonatal cases occurred within the first 6 days of life. CONCLUSIONS: The frequency of SUIDs during the neonatal period warrants ongoing attention to all circumstances contributing to this category of deaths. The development of a standardized definition of sudden unexpected postnatal collapse and a national registry of these events is recommended. Ongoing research on the effects of early neonatal practices on postneonatal SUID should also be encouraged.

CDC released a new study that looks at trends in injury deaths in the United States, Canada, and Australia from 2000 – 2014. The study, published in the Canadian Journal of Public Health, compared trends for five major causes of injury-related deaths (falls, motor vehicle traffic, homicides, suicides and unintentional poisoning). Researchers found significant differences and similarities, in injury-related deaths between the three countries and within each country over time. These trends differed across the five causes of injury-related deaths the researchers examined. Key Findings; Overall trends in four major causes of injury-related deaths differed across the United States, Canada, and Australia. o Rates of motor vehicle traffic deaths and homicides in the United States fell from 2000-2014 but remained higher than in Canada and Australia. o The suicide rate in the United States was the lowest of the three countries in 2000 but rose 24% between 2000 and 2014. By 2012, the rate was 14% higher than Australia and Canada. o Rates of unintentional poisoning deaths in the United States rose nearly 190% from 2000-2014, while rates in Canada and Australia rose modestly or remained the same. o Death rates from falls rose across all three countries from 2000-2014.; Societal level factors may be driving the differences in injury-related death rates across the three countries.; More research is needed to identify these underlying and contributing factors, as well as potential strategies to address them.

This fact sheet provides information on the trends over 20 years in injury from these causes for all ages.

This factsheet from the National Safe Kids Campaign provides information under the following two headings; 1) Unintentional injury-related death rates 2) Injury prevention efforts (this section discusses injury prevention efforts and programmes within these areas; child restraints, bicycle helmets, and fire and burns).

OBJECTIVES: To examine unintentional injury mortality rates in children (0-19 years) in Canada from 1950 to 2009 against national population-level injury prevention interventions. METHODS: Injury mortality rates were age and sex adjusted. Changes in trend and level of mortality rates were assessed at pre-specified intervention periods using segmented linear regression analyses for interrupted time series. Maximum likelihood estimation was used with a second order autoregressive error process. RESULTS: From 1950 to 2009, the overall unintentional injury mortality rate decreased by 86%. Males had consistently higher mortality rates compared to females; however, the standardized rate ratio decreased from 2.37:1 in 1950 to 1.97:1 in 2009. Substantial declines in choking/suffocation deaths were noted in children less than 1 year of age, predominantly during the period 1970-1988 when the Hazardous Products Act and Crib Regulations were implemented. For burns, significant changes in slope were noted comparing 1972-1994 to pre-1971 (introduction of the Hazardous Products Act - Flammability Regulations), where the greatest decline was noted in children ages 1-4 years (Est. = -0.03, 95% CI = -0.02, -0.04). For 15-19 year olds, there was a 408% increase in motor vehicle collision-related mortality rates between 1950 and 1971; however a significant change in slope was noted during the period 1978-1985, compared to 1972-1977 (Est. = -0.10, 95% CI = -0.20, -0.007) across all age groups. CONCLUSION: While this study is not a cause and effect analysis, there is a strong association with implementation of safety campaigns and legislative changes related to child safety and a dramatic decline in childhood fatalities related to injury.

A factsheet showing injury hospitalisation trends in Waitakere City 1993-1999. Also see rec # 7198.

Written by Associate Professor Cindy Kiro, Martin von Randow and Andrew Sporle the report “Trends in Wellbeing for Maori households/families, 1981–2006” uses data from the Family Whanau and Wellbeing project based at COMPASS and was commissioned by Nga Pae o Maramatanga. This report is the first to specifically concentrate on Maori whanau and households providing a framework for monitoring whanau wellbeing through the use and analyses of Census data. Given the wide and current interest in whanau ora, the report is a timely contribution allowing more informed public policy development around Maori whanau/households wellbeing. Available at: http://www.maramatanga.ac.nz/Publications/TrendsinWellbeingforMaorihouseholdsfamilies/tabid/1119/Default.aspx

OBJECTIVE: To determine the trends of acute poisoning in terms of frequency, nature of poisoning agent, clinical presentation and its outcome. METHODS: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of patients who presented with poisoning between January 1989 and December 2010.The patients were randomly selected , and demographic, chemical information, clinical feature, treatment and outcome were analysed using SPSS 16. RESULTS: Of the total hospital admissions during the period, 3,189(0.3%) were cases of poisoning. Of them, medical records of 705(22%) cases were reviewed; 462(65.5%) adult and 243(34.5%) paediatric cases below 16 years of age. The overall median age was 21 years (interquartile range: 4-32 years)Moreover, 544(87%) were critical at the time of presentation. In 647(92%) cases, the poisoning occurred at home. Psychiatric drugs were found involved in 205(29%) cases, followed by prescription drugs 172(24.4%), pesticides 108(15.3%), hydrocarbons 71(10%), analgesics 59(8.7%), household toxins 59(8.7%), alcohol and drug abuse 21(2.97%) and others 47(6.67%). CONCLUSIONS: Poisoning was a serious cause of morbidity in children and young adults. Medications were the leading cause and home was the most common place of incident.

BACKGROUND AND OBJECTIVES: Ingestion of rare earth magnets is a serious ongoing hazard for pediatric patients. Our study aims to investigate whether 2012 Consumer Product Safety Commission (CPSC) policy action, in coordination with efforts from consumer and physician advocacy groups, decreased the incidence of magnet ingestions in children in US since 2012. METHODS: Data from the National Electronic Injury Surveillance System (NEISS) was used to evaluate trends in emergency department (ED) encounters with pediatric patients (<18 years) who presented with suspected magnet ingestions (SMI) from 2010-2015. National estimates of SMI were made using the NEISS-supplied weights and variance variables. RESULTS: An estimated 14586 children (59% male, 50% age <5 years) presented to the ED for SMI from 2010-2015. A significant upward trend in magnet-related ED visits preceded the CPSC action, with the peak ingestions of 3167 (95% CI, 1612-4723) recorded in 2012. This was followed by a steady decrease in the rate of SMI to 1907 (95% CI, 1062-2752) in 2015, an average annual decrease of 13.3%. Most importantly, post-federal action estimates demonstrated a downward trend in overall SMI ED visits (P = 0.03). CONCLUSIONS: The frequency of magnet ingestions continued to rise from 2010 and then peak in 2012, followed by a decline in magnet ingestion ED visits during the post-federal action years. This down trend emphasizes the importance of advocacy on decreasing magnet ingestions in children. Further study will be required to determine the impact of the court decision to lift the magnet ban in 2016.

A survey of the types of child restraints available in New Zealand, their ease of use and how to choose the right one for your child.