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Cittadini F, Aulino G, Petrucci M, Valentini S, Covino M. Electric scooter-related accidents: a possible protective effect of helmet use on the head injury severity. Forensic Sci Med Pathol 2023; 19:319-324. [PMID: 36331707 PMCID: PMC9638347 DOI: 10.1007/s12024-022-00546-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
Abstract
Despite electric scooter use has proliferated in Italy since 2019, actionable data regarding injury incidence and patterns associated with electric scooter accidents are limited. This study aims at analyzing the rate, clinical, and demographic features of electric scooter accidents accessed to the Emergency Department (ED) of Fondazione Policlinico Universitario A. Gemelli IRCSS (Rome, Italy). This retrospective study included all patients older than 18 years riding an electric scooter in the ED from June 2019 to April 2022. Personal data, injury circumstances, helmet use, and health data were collected. Abbreviated Injury Scale (AIS) codes of all diagnoses were recorded, and the Injury Severity Score (ISS) was calculated for each patient. The analysis includes 92 patients admitted to the ED due to an e-scooter accident during the study period, with an increase in years. Thirty-two patients presented bone fractures especially concerning the extremities and the face districts. The median Injury Severity Score in the study cohort was 3, with the highest AIS represented by AIS Pelvic-Extremity and AIS External. Moreover, statistical significance was found between AIS Head-Neck and severity of trauma. E-scooters have become a familiar sight in cities worldwide recently, with many new companies renting them for use. But their arrival has also brought new safety concerns. Although most injuries reported are minor, the meager rate of helmet use is critical. Implementing compulsory helmet use for electric scooters for all ages could be a protective factor for being patient with head trauma on urban streets.
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Affiliation(s)
- Francesca Cittadini
- Department of Health Surveillance and Bioethics, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo F. Vito, 00168, Rome, Italy
| | - Giovanni Aulino
- Department of Health Surveillance and Bioethics, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo F. Vito, 00168, Rome, Italy.
| | - Martina Petrucci
- Emergency Medicine Department, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Università Cattolica del Sacro Cuore Di Roma, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Silvia Valentini
- Department of Health Surveillance and Bioethics, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo F. Vito, 00168, Rome, Italy
| | - Marcello Covino
- Emergency Medicine Department, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Università Cattolica del Sacro Cuore Di Roma, Largo A. Gemelli 8, 00168, Rome, Italy
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Warren A, Dea M, Barron IG, Zapata I. Ski and snowboard injury patterns in the United States from 2010 to 2020 in pediatric patients. Injury 2023; 54:110899. [PMID: 37330404 DOI: 10.1016/j.injury.2023.110899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 05/19/2023] [Accepted: 06/12/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Children and adolescents are at higher risk of injuries from winter sports like skiing and snowboarding which can cause severe lifelong debilitation and death. PURPOSE The objective of this study is to perform a nationwide analysis of pediatric skiing and snowboarding injuries to identify patterns regarding patient demographics, type of injuries, outcomes, and admission rates. STUDY DESIGN Descriptive Epidemiological Study. METHODS This was a retrospective cohort study of publicly available data. Cases were sourced from the National Electronic Injury Surveillance System (NEISS) from 2010 to 2020 and included 6421 incidents. RESULTS Even when the highest percentage of injuries was the head at 19.30%; the diagnosis of concussion was placed third while fractures were the most common diagnosis at 38.20%. The proportion of pediatric incidents by hospital type is changing with children's hospitals currently managing the majority of cases. CONCLUSIONS These findings can assist clinicians in the ED across different hospital types in understanding the patterns of injury to be better prepared for new cases.
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Affiliation(s)
- Andrew Warren
- Department of Biomedical Sciences, Rocky Vista University College of Osteopathic Medicine, Parker, CO 80134, United States of America
| | - Michael Dea
- Department of Biomedical Sciences, Rocky Vista University College of Osteopathic Medicine, Parker, CO 80134, United States of America
| | - Ileana G Barron
- Department of Epidemiology, University of Alabama Birmingham School of Public Health, Birmingham, AL 35233, United States of America
| | - Isain Zapata
- Department of Biomedical Sciences, Rocky Vista University College of Osteopathic Medicine, Parker, CO 80134, United States of America.
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Yoshimura G, Kamidani R, Yasuda R, Miura T, Yamaji F, Mizuno Y, Kitagawa Y, Fukuta T, Ishihara T, Suzuki K, Miyake T, Nagaya S, Kanda N, Doi T, Okada H, Yoshida T, Yoshida S, Ogura S. Clinical characteristics of patients with snow sports trauma transported to a trauma care center: A retrospective observational study. Injury 2022; 54:1379-1385. [PMID: 36639253 DOI: 10.1016/j.injury.2022.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/08/2022] [Accepted: 12/29/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Snow sports are a popular recreational activity; however, the incidence of injury of snow sports can be high for skiers and snowboarders. Our hospital receives severe trauma cases from snow resorts and hospitals throughout the region. This study aimed to determine whether the risk of snow sports-related major trauma that requires emergency surgery under general anesthesia varies by the equipment and injury mechanism. METHODS This retrospective cohort study included patients with snow sports trauma referred to Gifu University Hospital, Japan between November 2010 and March 2020. We analyzed the need for emergency operation under general anesthesia within 24 h using Fisher's exact test. We identified 106 patients: (1) 90 in the snowboarders' group and 16 in the skiers' group or (2) 46 in the fall after jumping group (jumping group), 27 in the collide with other people and obstacle group (collision group), and 33 in the fall during gliding group (gliding group). RESULTS Snowboarders were nearly twice as likely as skiers to require emergency surgery under general anesthesia (44% vs. 25%; p = 0.236]. No significant associations were found between emergency surgery under general anesthesia and injury mechanism, but half of the patients in the jumping group required emergency surgery. CONCLUSIONS Snowboard as equipment and falls after jumping as a mechanism of injury tended to be associated with emergency surgery under general anesthesia, with no significant differences. In order to provide adequate resources for snow sports trauma, the cause of the patient's injury is strongly related to the urgency of the condition, and transport to a trauma center should be actively considered. Further studies are warranted with respect to the effects of personal protective equipment and skill level.
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Affiliation(s)
- Genki Yoshimura
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Ryo Kamidani
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan; Abuse Prevention Center, Gifu University Graduate School of Medicine, Gifu, Japan.
| | - Ryu Yasuda
- Department of Emergency, Gifu Municipal Hospital, Gifu, Japan
| | - Tomotaka Miura
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Fuminori Yamaji
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Yosuke Mizuno
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Yuichiro Kitagawa
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Tetsuya Fukuta
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan
| | - Kodai Suzuki
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Takahito Miyake
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Soichiro Nagaya
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Norihide Kanda
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Tomoaki Doi
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Hideshi Okada
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Takahiro Yoshida
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Shozo Yoshida
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan; Abuse Prevention Center, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shinji Ogura
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
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Tuckel P. Incidence and factors related to nonmotorized scooter injuries in New York State and New York City, 2005-2020. BMC Public Health 2022; 22:1974. [PMID: 36303131 DOI: 10.1186/s12889-022-14302-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 10/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study provides an analysis of contemporary trends and demographics of patients treated for injuries from nonmotorized scooters in emergency departments in New York state excluding New York City (NYS) and New York City (NYC). METHODS The study tracks the incidence of nonmotorized scooter injuries in NYS and NYC from 2005 to 2020 and furnishes a detailed profile of the injured patients using patient-level records from the Statewide Planning and Research Cooperative System (SPARCS). A negative binomial regression analysis is performed on the SPARCS data to measure the simultaneous effects of demographic variables on scooter injuries for NYS and NYC. The study also examines the demographic correlates of the rate of injuries at the neighborhood level in NYC. A thematically shaded map of the injury rates in New York City neighborhoods is created to locate neighborhoods with greater concentrations of injuries and to identify the reasons which might account for their higher rate of injuries, such as street infrastructure. RESULTS In NYS and NYC injuries from unpowered scooters underwent an overall decline in the past decade. However, both NYS and NYC are now evidencing an increase in their rates. The upswing in the rate in NYC in 2020 is particularly noticeable. Males and children in the age group 5 to 9 were found to be most susceptible to injury. Injuries were more prevalent in more affluent New York City neighborhoods. A map of the injury rates in the City's neighborhoods revealed a clustering of neighborhoods with higher than average injury rates. CONCLUSIONS Injuries from nonmotorized scooters number approximately 40,000 annually in the US and can be prevented by greater use of protective equipment. Street infrastructure is a critical factor contributing to injuries from the use of nonmotorized scooters. Thematically shaded maps can be used to identify and target areas for purposes of intervention.
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Affiliation(s)
- Peter Tuckel
- Department of Sociology, Hunter College, City University of New York, 695 Park Avenue, New York, NY, 10065, USA.
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Slow and Steady Wins the Race: A Comparative Analysis of Standing Electric Scooters’ European Regulations Integrated with the Aspect of Forensic Traumatology. SUSTAINABILITY 2022. [DOI: 10.3390/su14106160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fuel-driven cars are widely considered unsustainable and contrary to the new paradigm of smart growth planning. The need to reform transport behavior, policies, and infrastructure is among the priorities in urban policies around the world. Electric vehicles are an emerging technology that could advance sustainability programs. In the past year, there has been a rapid increase in the diffusion of electric scooters in several European cities, but various states have been unprepared for the rapid spread of green micro-mobility from a regulatory point of view. In addition, in parallel with the spread, there have been numerous road collisions involving standing electric scooters. The aim of this study was to obtain a detailed view of this phenomenon. We focused on the current legislation on electric micro-mobility at the European level to study and summarize the different attitudes adopted by various states whose regulations are present on the web. (It was not possible to evaluate the regulations of all European countries because they are not all available on online platforms.) The elements assessed in the various regulation were age limits, speed limits, compulsory use of helmets, administrative penalties, and the obligation to insure the new e-vehicle (standing scooter). In this study, we analyze the state of the art in electric micro-mobility, highlight the current situation’s limits, and propose new strategies to adequately integrate this new smart vehicle into the urban transport network.
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Tuckel P. Injuries from nonmotorized scooters treated in emergency departments in the United States, 2005–2020. Am J Emerg Med 2022; 54:30-35. [DOI: 10.1016/j.ajem.2022.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 10/19/2022] Open
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Fu XL, Du L, Song YP, Chen HL, Shen WQ. Incidence of injuries in professional snow sports: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:6-13. [PMID: 33130094 PMCID: PMC8847944 DOI: 10.1016/j.jshs.2020.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/11/2020] [Accepted: 08/24/2020] [Indexed: 06/01/2023]
Abstract
PURPOSE The study aimed to conduct a comprehensive systematic review and meta-analysis of injury incidence in professional skiers and snowboarders. METHODS We systematically searched PubMed, Web of Science, and MEDLINE for studies on injury incidence published from inception to April 2020. Injury data were extracted, alongside information on injury location, severity, type, cause, and sport discipline. Incidence of injuries was presented per 1000 athlete-days, with 95% confidence intervals (95%CIs). RESULTS The search identified 462 articles, and 22 were included in our review. The overall incidence of injuries among professional skiers and snowboarders was 3.49 per 1000 athlete-days (95%CI: 2.97-4.01). Lower extremity had the highest injury incidence (1.54 per 1000 athlete-days, 95%CI: 1.24-1.84). Incidence rates of slight, mild, moderate, and severe injuries were 0.26, 0.31, 0.57, and 0.59 per 1000 athlete-days, respectively. Contusion had the highest incidence rate (1.82 per 1000 athlete-days, 95%CI: 1.01-2.63). The most common cause of injury was contact trauma (3.20 per 1000 athlete-days, 95%CI: 1.32-5.08). Freestyle skiing had the highest incidence rate (6.83 per 1000 athlete-days, 95%CI: 4.00-9.66), and Nordic skiing had the lowest rate (2.70 per 1000 athlete-days, 95%CI: 1.94-3.46). CONCLUSION Professional skiers and snowboarders have a substantial risk of sustaining injuries. Our findings can be used to inform the planning and provision of healthcare for elite participants in different snow sports.
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Affiliation(s)
- Xue-Lei Fu
- School of Medicine, Nantong University, Nantong 226001, China
| | - Lin Du
- School of Medicine, Nantong University, Nantong 226001, China
| | - Yi-Ping Song
- School of Medicine, Nantong University, Nantong 226001, China
| | - Hong-Lin Chen
- School of Public Health, Nantong University, Nantong 226019, China.
| | - Wang-Qin Shen
- School of Medicine, Nantong University, Nantong 226001, China.
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8
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Aulino G, Polacco M, Fattoruso V, Cittadini F. A cranio-encephalic trauma due to electric-scooter accident: could the wearing of a helmet reduce this risk? Forensic Sci Med Pathol 2022; 18:264-268. [PMID: 35556216 PMCID: PMC9587086 DOI: 10.1007/s12024-022-00477-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 12/14/2022]
Abstract
Nowadays, one of the most important health and social policy issues concerning all countries is the problem of road accident rates. Traffic is one of the most important risk factors. For this reason, ridesharing companies have been launching electric scooters in Rome since June 2019 with the aim of reducing car traffic. In the absence of relevant legislations, the risk is that of facing an increase in deaths due to electric scooter crashes. We report the case of an electric scooter accident victim with cranio-encephalic trauma associated with limb injuries that caused immediate death. This case report emphasizes how the obligation of using helmets must be extended to all ages, in order to reduce the risk of increasing the number of deaths. Compulsory helmet use can reduce fatalities in all cases where high-speed crashes are not involved.
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Affiliation(s)
- Giovanni Aulino
- Department of Health Surveillance and Bioethics, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore Largo F. Vito, 00168, Rome, Italy.
| | - Matteo Polacco
- Department of Health Surveillance and Bioethics, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore Largo F. Vito, 00168, Rome, Italy
| | - Vincenzo Fattoruso
- Department of Health Surveillance and Bioethics, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore Largo F. Vito, 00168, Rome, Italy
| | - Francesca Cittadini
- Department of Health Surveillance and Bioethics, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore Largo F. Vito, 00168, Rome, Italy
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9
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Rod JE, Oviedo-Trespalacios O, King M. A retrospective registry analysis of the transport-related health burden of wheeled recreational devices in Queensland, Australia. Aust N Z J Public Health 2021; 46:208-215. [PMID: 34648211 DOI: 10.1111/1753-6405.13162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/01/2021] [Accepted: 08/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Evaluate injury patterns from wheeled recreational devices (WRD) in the public space and explore risk factors for hospital admission. METHOD A cross-sectional analysis of WRD injury prevalence and risk factors for hospital admissions was conducted using data from the Queensland Injury Surveillance Unit (QISU) database for 2007 to 2017. Descriptive statistics and a log-binomial regression model were used to calculate adjusted relative risk for hospital admission. RESULTS Most WRD injury in the public space was related to stand-alone WRD injury events such as falls, with few reported WRD users being hit by vehicles from 2007 to 2017. Stand-alone WRD injury events had a higher independent risk of hospital admissions when injured in the head/neck/face (RR 2.08, 95%CI 1.6 to 2.8, p<0.001), and when the injury was a fracture (RR 2.57, 95%CI 2.1 to 3.3, p<0.001) or a brain injury (RR 3.19, 95%CI 2.5 to 4.1, p<0.001). CONCLUSION Head, brain and facial injuries and fractures are leading preventable factors for hospital admissions due to WRD injury. These types of injuries generate a preventable burden to the health system. Implications for public health: The results support the need to consider legislation regarding mandatory helmet use for non-motorised WRD when used on public roads and footpaths, while further research is conducted. This strategy could reduce the long-term health outcomes associated with head, face and brain injury in young commuters.
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Affiliation(s)
- J E Rod
- Centre for Accident Research and Road Safety Queensland (CARRS-Q), Queensland University of Technology.,Centre for Future Mobility, Queensland University of Technology
| | - Oscar Oviedo-Trespalacios
- Centre for Accident Research and Road Safety Queensland (CARRS-Q), Queensland University of Technology.,Centre for Future Mobility, Queensland University of Technology
| | - Mark King
- Centre for Accident Research and Road Safety Queensland (CARRS-Q), Queensland University of Technology.,Centre for Future Mobility, Queensland University of Technology
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Toofany M, Mohsenian S, Shum LK, Chan H, Brubacher JR. Injury patterns and circumstances associated with electric scooter collisions: a scoping review. Inj Prev 2021; 27:490-499. [PMID: 33707220 PMCID: PMC8461400 DOI: 10.1136/injuryprev-2020-044085] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Electric scooters are personal mobility devices that have risen in popularity worldwide since 2017. Emerging reports suggest that both riders and other road users, such as pedestrians and cyclists, have been injured in electric scooter-associated incidents. We undertook a scoping review of the current literature to evaluate the injury patterns and circumstances of electric scooter-associated injuries. METHODS A scoping review of literature published from 2010 to 2020 was undertaken following accepted guidelines. Relevant articles were identified in Medline, Embase, SafetyLit and Transport Research International Documentation using terms related to electric scooters, injuries and incident circumstances. Supplemental searches were conducted to identify relevant grey literature (non-peer-reviewed reports). RESULTS Twenty-eight peer-reviewed studies and nine grey literature records were included in the review. The current literature surrounding electric scooter-associated injuries mainly comprises retrospective case series reporting clinical variables. Factors relating to injury circumstances are inconsistently reported. Findings suggest that the head, upper extremities and lower extremities are particularly vulnerable in electric scooter falls or collisions, while injuries to the chest and abdomen are less common. Injury severity was inconsistently reported, but most reported injuries were minor. Low rates of helmet use among electric scooter users were noted in several studies. CONCLUSION Electric scooters leave riders vulnerable to traumatic injuries of varying severity. Future work should prospectively collect standardised data that include information on the context of the injury event and key clinical variables. Research on interventions to prevent electric scooter injuries is also needed to address this growing area of concern.
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Affiliation(s)
- Manish Toofany
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sasha Mohsenian
- Faculty of Science, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Leona K Shum
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Herbert Chan
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Clinical Epidemiology & Evaluation (C2E2), Vancouver, British Columbia, Canada
| | - Jeffrey R Brubacher
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Clinical Epidemiology & Evaluation (C2E2), Vancouver, British Columbia, Canada
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11
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Porter ED, Goldwag JL, Wilcox AR, Li Z, Tosteson TD, Mancini DJ, Wolffing AB, Martin E, Crockett AO, Scott JW, Briggs A. Geriatric Skiers: Active But Still at Risk, a National Trauma Data Bank Study. J Surg Res 2020; 259:121-129. [PMID: 33279837 DOI: 10.1016/j.jss.2020.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/05/2020] [Accepted: 11/01/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Downhill skiing accounts for a large portion of geriatric sport-related trauma. We assessed the national burden of geriatric versus nongeriatric ski trauma. MATERIALS AND METHODS Adults presenting to level 1/2 trauma centers after ski-associated injuries from 2011 to 2015 were identified from the National Trauma Data Bank by ICD-9 code. We compared demographics, injury patterns, and outcomes between geriatric (age ≥65 y) and nongeriatric adult skiers (age 18-64 y). A multiple regression analysis assessed for risk factors associated with severe injury (Injury Severity Score >15). RESULTS We identified 3255 adult ski trauma patients, and 16.7% (543) were geriatric. Mean ages for nongeriatric versus geriatric skiers were 40.8 and 72.1 y, respectively. Geriatric skiers more often suffered head (36.7 versus 24.3%, P < 0.0001), severe head (abbreviated injury scale score >3, 49.0 versus 31.5%, P < 0.0001) and thorax injuries (22.2 versus 18.1%, P = 0.03) as compared with nongeriatric skiers. Geriatric skiers were also more often admitted to the ICU (26.5 versus 14.9%, P < 0.0001), discharged to a facility (26.7 versus 11.6%, P < 0.0001), and suffered higher mortality rates (1.3 versus 0.4%, P = 0.004). Independent risk factors for severe injury included being male (OR: 1.68, CI: 1.22-2.31), helmeted (OR: 1.41, CI: 1.07-1.85), and having comorbidities (OR: 1.37, CI: 1.05-1.80). Geriatric age was not independently associated with severe injury. CONCLUSIONS At level 1/2 trauma centers, geriatric age in ski trauma victims was associated with unique injury patterns, higher acuity, increased rates of facility care at discharge, and higher mortality as compared with nongeriatric skiers. Our findings indicate the need for specialized care after high impact geriatric ski trauma.
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Affiliation(s)
- Eleah D Porter
- Department of Surgery, Dartmouth Hitchcock Medical Center, Hanover, New Hampshire
| | - Jenaya L Goldwag
- Department of Surgery, Dartmouth Hitchcock Medical Center, Hanover, New Hampshire
| | - Allison R Wilcox
- Department of Surgery, Dartmouth Hitchcock Medical Center, Hanover, New Hampshire
| | - Zhongze Li
- Biomedical Data Science Department, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire
| | - Tor D Tosteson
- Biomedical Data Science Department, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire
| | - D Joshua Mancini
- Department of Surgery, Dartmouth Hitchcock Medical Center, Hanover, New Hampshire; Geisel School of Medicine, Hanover, New Hampshire
| | - Andrea B Wolffing
- Department of Surgery, Dartmouth Hitchcock Medical Center, Hanover, New Hampshire; Geisel School of Medicine, Hanover, New Hampshire
| | - Eric Martin
- Department of Surgery, Dartmouth Hitchcock Medical Center, Hanover, New Hampshire; Geisel School of Medicine, Hanover, New Hampshire
| | - Andrew O Crockett
- Department of Surgery, Dartmouth Hitchcock Medical Center, Hanover, New Hampshire; Geisel School of Medicine, Hanover, New Hampshire
| | - John W Scott
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Alexandra Briggs
- Department of Surgery, Dartmouth Hitchcock Medical Center, Hanover, New Hampshire; Geisel School of Medicine, Hanover, New Hampshire.
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12
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Rodríguez-Rivadulla A, Saavedra-García MÁ, Arriaza-Loureda R. Skateboarding Injuries in Spain: A Web-Based Survey Approach. Orthop J Sports Med 2020; 8:2325967119884907. [PMID: 32232064 PMCID: PMC7082873 DOI: 10.1177/2325967119884907] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: The inclusion of skateboarding in the Tokyo 2020 Olympic Games reinforces this activity as a sport. As the number of skateboarders around the world and the difficulty of skateboarding maneuvers continue to increase, the number of skateboarding injuries may also rise. Thus, there is a need for more comprehensive investigations into the practice habits and injuries of skateboarders. Purpose: To describe the sports habits and skateboarding injuries of a sample of skateboarders in Spain. Study Design: Descriptive epidemiology study. Methods: A web-based survey was shared among skateboarders in Spain. The survey collected data related to sports habits, skateboarding practice habits, and injury history. Comparisons between subgroups of sex, age, and experience were also conducted. Results: The survey was completed by 197 participants (89.3% male) with a mean age of 24.4 ± 7.1 years and a mean experience of 9.7 ± 7.2 years. Most respondents (87.8%) reported not participating in any type of skateboarding-specific physical training program. Only 27.4% took part in skateboarding competitions, with a larger number of respondents younger than 18 years participating in competitive events. The mean number of sessions per week was 3.3 ± 1.7, and the mean length of sessions was 3.3 ± 1.5 hours. The majority of participants (87.8%) reported having suffered injuries (n = 323) as a result of skateboarding, mainly affecting the lower limbs (69.7%). The most common injury type was a ligament sprain (39.6%), especially of the ankle (39.3%). This injury was also reported as the most likely to recur (70.1%). A large number of injuries (54.2%) were considered severe (ie, >21 days to recover). Most injuries occurred while skateboarding gaps or stairs, including any type of a jump that involved a difference in height between the take-off and landing surfaces (25.7%). Female participants accounted for a larger number of ligament sprains than expected, and experienced skateboarders were more likely to suffer more severe injuries and head/trunk injuries. Conclusion: Respondents to this survey were mainly young male adults who practiced skateboarding recreationally. Respondents of different sexes, ages, and experiences demonstrated different habits and injury patterns. The greater number of severe injuries highlights the need for injury surveillance in skateboarding to inform better prevention and rehabilitation practices.
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Affiliation(s)
- Adrián Rodríguez-Rivadulla
- Department of Physical Education and Sports, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Miguel Ángel Saavedra-García
- Department of Physical Education and Sports, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Rafael Arriaza-Loureda
- Department of Physical Education and Sports, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
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13
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Helmet use is associated with higher Injury Severity Scores in alpine skiers and snowboarders evaluated at a Level I trauma center. J Trauma Acute Care Surg 2019; 87:1205-1213. [DOI: 10.1097/ta.0000000000002447] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Tuckel PS, Milczarski W, Silverman DG. Changing Incidence and Nature of Injuries Caused by Falls From Skateboards in the United States. Clin Pediatr (Phila) 2019; 58:417-427. [PMID: 30596266 DOI: 10.1177/0009922818821872] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Since 2000, the number of emergency department visits and hospital admissions for children who have sustained a fall from a skateboard has undergone a noticeable decline. One possible explanation for this decline is that children today lead a more sedentary lifestyle and are not as engaged in outdoor physical activities as were children in previous generations. The profile of patients injured in skateboarding-related accidents has also changed since 2000. The percent minority, percent residents of large metropolitan areas, and percent who incur an injury on a street or highway have all increased during this time period. Data based on observations of riders in skateboard parks indicate that the overwhelming majority do not wear protective gear such as helmets, elbow/knee pads, or wrist guards, and that a sizable segment of riders compound their risk of injury by using headphones or earbuds when performing maneuvers.
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Affiliation(s)
- Peter S Tuckel
- 1 Hunter College-City University of New York, New York, NY, USA
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15
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Weber CD, Horst K, Nguyen AR, Lefering R, Pape HC, Hildebrand F. Evaluation of severe and fatal injuries in extreme and contact sports: an international multicenter analysis. Arch Orthop Trauma Surg 2018; 138:963-970. [PMID: 29675749 DOI: 10.1007/s00402-018-2935-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Indexed: 01/21/2023]
Abstract
PURPOSE The participation in extreme and contact sports has grown internationally, despite the significant risk for major and multiple injuries. We conducted this multicenter study to evaluate sport-specific injury patterns and mechanisms, to characterize individuals at risk and to identify possible approaches for prevention. METHODS We compared demographic data, severity and patterns of injuries; and the pre- and in-hospital management from an international population-based prospective trauma database (TraumaRegister DGU®). The registry was screened for sport-related injuries, and only patients with major injuries [Injury Severity Score (ISS) ≥ 9 points] related to extreme or contact sports activities were included (January 1, 2002, to December 31, 2012). Parameters were compared for different types of sports activities: (1) Airborne sports, (2) Climbing, (3) Skateboarding/Skating, (4) Contact sports. The following countries participated: Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands. Statistical analyses were performed with SPSS (Version 22, IBM Inc., Armonk, New York). RESULTS A total of 278 athletes were identified within the study period and classified into four groups: Airborne sports (n = 105) were associated with the highest injury severity (ISS 22.4 ± 14.6), followed by climbing (n = 35, ISS 16.5 ± 12), skating (n = 67, ISS 15.2 ± 10.3) and contact sports (n = 71, ISS 10.4 ± 9.2). Especially high falls resulted in a significant rate of spinal injuries in airborne activities (68.6%, p < 0.001) and in climbing accidents (45.7%). Skating was associated with the highest rate of loss of consciousness (LOC) at scene (27.1%), the highest pre-hospital intubation rate (33.3%), and also the highest in-hospital mortality (15.2%, p < 0.001), related to major head injuries. CONCLUSIONS Extreme and contact sports related major injuries predominantly affect young male athletes. Especially skaters are at risk for debilitating and lethal head injuries. Individuals recognizing sport-specific hazards might modify their risk behavior. LEVEL OF EVIDENCE Descriptive Epidemiologic Study, Level II.
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Affiliation(s)
- Christian D Weber
- Department of Orthopaedics and Trauma, RWTH Aachen University, Pauwels street 30, 52074, Aachen, Germany. .,Olympic Center Rhineland, Aachen, Germany.
| | - Klemens Horst
- Department of Orthopaedics and Trauma, RWTH Aachen University, Pauwels street 30, 52074, Aachen, Germany
| | - Anthony R Nguyen
- Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, Australia
| | - Rolf Lefering
- Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU), Cologne, Germany
| | | | - Frank Hildebrand
- Department of Orthopaedics and Trauma, RWTH Aachen University, Pauwels street 30, 52074, Aachen, Germany
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16
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Provance AJ, Daoud AK, Tagawa A, Rhodes J. Pediatric and adolescent injury in skiing. Res Sports Med 2018; 26:150-165. [DOI: 10.1080/15438627.2018.1438282] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Aaron J. Provance
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Ariel K. Daoud
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Alex Tagawa
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jason Rhodes
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
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17
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Pourmand A, Liao J, Pines JM, Mazer-Amirshahi M. Segway® Personal Transporter-Related Injuries: A Systematic Literature Review and Implications for Acute and Emergency Care. J Emerg Med 2018; 54:630-635. [PMID: 29321106 DOI: 10.1016/j.jemermed.2017.12.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/12/2017] [Accepted: 12/01/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND The Segway® Personal Transporter™ (SPT) is used widely as a means of transport for city sightseeing tours, law enforcement, and professionals working in large facilities and factories. METHODS We conducted a systematic review of the literature to assess SPT-related injuries. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, we queried PubMed from 1990 to 2017. The search terms Segway, personal transporter, and injury were used. Only English-language studies were included. Data were extracted from each article, specifically the sample size, study setting, and design, as well as the prevalence of specific injuries. RESULTS A total of six articles were included that included data on 135 patients. Sample size per study varied from 1 to 41 patients. Studies occurred in both the emergency department and inpatient settings, including medical-surgical wards, and intensive care units. The most commonly reported injuries were orthopedic cases (n = 45), maxillofacial cases (n = 13), neurologic cases (n = 8), and thoracic cases (n = 10). CONCLUSIONS The SPT is an innovative transportation method; however, its use is associated with a wide range of injuries. Many of these injuries require hospital admission and surgical intervention, incurring significant morbidity and high costs.
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Affiliation(s)
- Ali Pourmand
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Jen Liao
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Jesse M Pines
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia; Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - Maryann Mazer-Amirshahi
- Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC, United States; Georgetown University School of Medicine, Washington, District of Columbia
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18
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Ho M, Horn BD, Lin IC, Chang B, Carrigan RB, Shah A. Musculoskeletal Injuries Resulting from Use of Hoverboards: Safety Concerns With an Unregulated Consumer Product. Clin Pediatr (Phila) 2018; 57:31-35. [PMID: 28110548 DOI: 10.1177/0009922816687327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hoverboards were recently introduced to the US consumer market and experienced rapid popularity. Given the high frequency of musculoskeletal injury with other wheeled recreation devices, we sought to analyze hoverboard injuries in children. A retrospective review of patients with musculoskeletal injury related to hoverboard use was performed at a tertiary care children's hospital. From November 2015 to January 2016, 2.3% of all fractures were related to hoverboards. Common injury mechanisms were fall (79%) and finger entrapment between wheel and wheel-well (10%). The most frequently fractured sites included the distal radius (43%) and phalanx (17%). Common surgical procedures were nailbed repair and pinning for Seymour fracture and percutaneous pinning for distal radius fracture. There exists high risk for distal radius fractures from falls and phalanx fractures from finger entrapment between the wheel and wheel-well. Hoverboard safety can be improved with regular use of wrist guards and improved wheel-well design.
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Affiliation(s)
- Michelle Ho
- 1 Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - B David Horn
- 1 Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ines C Lin
- 1 Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Benjamin Chang
- 1 Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Apurva Shah
- 1 Children's Hospital of Philadelphia, Philadelphia, PA, USA
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19
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McKenzie LB, Fletcher E, Nelson NG, Roberts KJ, Klein EG. Epidemiology of skateboarding-related injuries sustained by children and adolescents 5-19 years of age and treated in US emergency departments: 1990 through 2008. Inj Epidemiol 2016; 3:10. [PMID: 27747547 PMCID: PMC4824795 DOI: 10.1186/s40621-016-0075-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 03/08/2016] [Indexed: 11/22/2022] Open
Abstract
Background The goal was to examine the patterns and trends of skateboarding-related injuries sustained by children and adolescents in the United States. Methods A retrospective analysis was conducted using data from the National Electronic Injury Surveillance System for children and adolescents 5-19 years of age treated in emergency departments for injuries associated with skateboards from 1990 through 2008. Results An estimated 1 226 868 children/adolescents (95 % CI: 948 733—1 505 003) were treated in emergency departments for skateboarding-related injuries from 1990 through 2008, an average of 64,572 cases per year. From 1990 through 1994, the annual rate of injuries per 10,000 children/adolescents significantly decreased overall and for males (overall: 72.9 %, P = 0.014; males: 73.9 %, P = 0.011; females: 63.6 %, P = 0.062). From 1994 to 2008, annual rates of injuries per 10,000 children/adolescents significantly increased overall and for both males and females (overall: 378.9 %, P < 0.001; males: 393.4 %, P < 0.001; females: 283.3 % P < 0.001). From 1990 to 1994 the annual rate of injuries per 10,000 children/adolescents significantly decreased for all age groups (5-10 years: 69.9 %, P = 0.043; 11-14 years: 80.6 %, P = 0.017; 15-19 years: 64.2 %, P = 0.024), and then significantly increased from 1994 to 2008 (5-10 years: 164.5 %, P < 0.001; 11-14 years: 587.0 %, P < 0.001; 15-19 years: 407.9 %, P < 0.001). Most patients were male (89.0 %), injured at home (37.3 %) or in the street and/or highway (29.3 %), and were not hospitalized (96.9 %). Patients 11-14 years of age constituted 44.9 % of cases. The most commonly injured body regions were the upper (44.1 %) and lower (31.7 %) extremities. Fractures and dislocations were the most common diagnoses (32.1 %). Children/adolescents 11-14 years of age were hospitalized more often than younger or older children/adolescents. Lower extremity injuries increased with age, while face and head or neck injuries decreased with age. Conclusions Skateboarding continues to be an important source of injury for children and adolescents. Further research, using more rigorous study designs, is required develop a broad perspective of the incidence and determinants of injury, and to further identify risk factors and viable injury countermeasures while simultaneously promoting participation in skateboarding.
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Affiliation(s)
- Lara B McKenzie
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, 43205, OH, USA. .,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA. .,Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA.
| | - Erica Fletcher
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, 43205, OH, USA
| | - Nicolas G Nelson
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, 43205, OH, USA
| | - Kristin J Roberts
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, 43205, OH, USA
| | - Elizabeth G Klein
- Division of Health Behavior & Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
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