Escalators, rubber clogs, and severe foot injuries in children

Contributing Factors Affecting the Severity of Metro Escalator Injuries in the Guangzhou Metro, China

Urban rail transit has become one of the indispensable modes of public transportation in large cities. Escalators are ubiquitous in metro stations, as passengers typically use escalators when entering or leaving a metro station. Thus, escalators have become an accident-prone location. To develop suitable prevention strategies, it is necessary to understand the risk factors that affect the severity of escalator accidents. This study analyzed 967 escalator passenger accidents that occurred in the Guangzhou Metro from 2013 to 2015. The Haddon matrix was used to evaluate the interaction of humans, escalators, and environmental factors before, during, and after accidents. Then, the contributing factors associated with the severity levels were determined based on chi-square tests. Passengers aged 66 years and older are more vulnerable to serious injuries (p < 0.001), and previous health conditions are significantly related to the severity of the passenger’s injuries (p = 0.002). The weather conditions (rainy days) are also significantly related to the severity of escalator accident injuries (p = 0.039), and injured people with head injuries are at greater risk of being severely injured (p < 0.001). The analysis results of these risk factors can provide theoretical support for the metro operators to develop reasonable and effective preventive measures to reduce the escalator risk.

Analysis Factors That Influence Escalator-Related Injuries in Metro Stations Based on Bayesian Networks: A Case Study in China

Escalator-related injuries have become an important issue in daily metro operation. To reduce the probability and severity of escalator-related injuries, this study conducted a probability and severity analysis of escalator-related injuries by using a Bayesian network to identify the risk factors that affect the escalator safety in metro stations. The Bayesian network structure was constructed based on expert knowledge and Dempster–Shafer evidence theory, and further modified based on conditional-independence test. Then, 950 escalator-related injuries were used to estimate the posterior probabilities of the Bayesian network with expectation–maximization (EM) algorithm. The results of probability analysis indicate that the most influential factor in four passenger behaviors is failing to stand firm (p = 0.48), followed by carrying out other tasks (p = 0.32), not holding the handrail (p = 0.23), and another passenger’s movement (p = 0.20). Women (p = 0.64) and elderly people (aged 66 years and above, p = 0.48) are more likely to be involved in escalator-related injuries. Riding an escalator with company (p = 0.63) has a relatively high likelihood of resulting in escalator-related injuries. The results from the severity analysis show that head and neck injuries seem to be more serious and are more likely to require an ambulance for treatment. Passengers who suffer from entrapment injury tend to claim for compensation. Severe injuries, as expected, significantly increase the probability of a claim for compensation. These findings could provide valuable references for metro operation corporations to understand the characteristics of escalator-related injuries and develop effective injury prevention measures.

Escalator-related injuries in one of the deepest subway stations in Europe

BACKGROUND

Escalator-related injuries (ERI) have emerged as a new injury type due to the frequent use of escalators in Metro stations.

OBJECTIVES

Investigate ERI in the stations on the Marmaray metro line.

DESIGN

Retrospective, observational study.

SETTING

Patients admitted to the emergency department of a training and research hospital.

PATIENTS AND METHODS

All patients with ERI were included in the study. We analyzed demographic characteristics, injury type and anatomical location of injury, Glasgow coma score, and body mass index (BMI). Patients were grouped by BMI: underweight (BMI less than 18.5 kg/m2), normal weight (BMI=18.5-24.9 kg/m2), overweight (BMI=25-29.9 kg/ m2) and obese (BMI greater than or equal 30kg/m2).

MAIN OUTCOME MEASURES

Injury characteristics and BMI values of patients with ERI.

SAMPLE SIZE

82 patients.

RESULTS

The mean age was 45.1 (15.5) years (range:14-77 years). Forty-two were women (52.5%). The mean BMI was 26.7 (2.2) kg/m2 (range: 22.1-33.3 kg/m2)]. Most of the patients who were injured due to escalators were older than 50 years (n=39, 47.6%) and 77.5% (n=62) of all patients were overweight. There was a significant relationship between increased BMI and serious ERI (P=.010, OR: 1.85, 95% C.I: 1.132.65). The most frequent mechanism of injuries was a fall (97.6%). The majority of injuries were the head (42%) and extremity injuries (33%). The major type of ERI was soft tissue injuries (41.3%), followed by lacerations (20.7%), closed head injuries (18.5%), fractures (15.2%) and serious injuries (4.4%). Serious injuries were more prevalent in patients aged older than 50 years (P less than .05), and in overweight and obese individuals (P less than .001) CONCLUSION: Novel protective measures against ERI should be developed for crowded subway stations.

LIMITATIONS

The small sample size and retrospective nature.

CONFLICT OF INTEREST

None.

Escalator-related injuries in 30 dogs (2007-2014)

OBJECTIVE

To describe a population of dogs affected by escalator-related injuries, and to characterize the types of injuries sustained and describe treatment administered.

DESIGN

Retrospective study from March 2007 to November 2014.

SETTING

Large urban referral and emergency facility.

ANIMALS

Thirty client-owned dogs presenting with injuries acquired while riding an escalator.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

All injuries in this study occurred secondary to entrapment of 1 or more paws in the moving parts of an escalator; 39 paws were injured in total. The median body weight of the patients in this study was 4.25 kg, with 73.3% of the patients weighing less than 10 kg. Fifteen patients (50.0%) were treated surgically, the remainder were managed conservatively. Eight patients (26.7%) underwent digit or partial-digit amputation. Of the conservatively managed patients, 10 were treated with bandaging of the wounds. Antimicrobials, opiate analgesics, and nonsteroidal anti-inflammatory drugs were administered in both surgically and conservatively managed patients.

CONCLUSIONS

While uncommon, escalator accidents can result in significant injury to dogs. Measures can be taken to prevent these injuries from occurring, whether through client education, dog training, structural modifications in the escalators themselves, or avoidance of escalators. In the present study, the survival rate of dogs injured on escalators was 100%.

Childhood Injuries in Singapore: Can Local Physicians and the Healthcare System Do More to Confront This Public Health Concern?

Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood injuries locally. A search for relevant articles published from 1996–2016 was performed on PubMed, Cochrane Library and Google Scholar using keywords relating to childhood injury in Singapore. The epidemiology, mechanisms of injury, risk factors and recommended prevention strategies of unintentional childhood injuries were reviewed and described. Epidemiological studies have shown that childhood injury is a common, preventable and significant public health concern in Singapore. Home injuries and falls are responsible for majority of the injuries. Injuries related to childcare products, playground and road traffic accidents are also important causes. Healthcare professionals and legislators play an important role in raising awareness and reducing the incidence of childhood injuries in Singapore. For example, despite legislative requirements for many years, the low usage of child restraint seats in Singapore is worrisome. Thus, greater efforts in public health education in understanding childhood injuries, coupled with more research studies to evaluate the effectiveness and deficiencies of current prevention strategies will be necessary.