Cycling-Related Injuries During COVID-19 Lockdown: A North London Experience

Cycling safely: Examining the factors associated with bicycle accidents in Seoul, South Korea

This study investigates the factors contributing to bicycle accidents, focusing on four types of bicycle lanes and other exposure and built environment characteristics of census blocks. Using Seoul as a case study, three years of bicycle accident spot data from 2018 to 2020 was collected, resulting in 1,330 bicycle accident spots and a total of 2,072 accidents. The geographically weighted Poisson regression (GWPR) model was used as a methodological approach to investigate the spatially varying relationships between the accident frequency and explanatory variables across the space, as opposed to the Poisson regression model. The results indicated that the GWPR model outperforms the global Poisson regression model in capturing unobserved spatial heterogeneity. For example, the value of deviance that determines the goodness of fit for a model was 0.244 for the Poisson regression model and 0.500 for the far better-fitting GWPR model. Further findings revealed that the factors affecting bicycle accidents have varying impacts depending on the location and distribution of accidents. For example, despite the presence of bicycle lanes, some census blocks, particularly in the northeast part of the city, still pose a risk for bicycle accidents. These findings can provide valuable insights for urban planners and policymakers in developing bicycle safety measures and regulations.

Impact of the COVID-19 pandemic on maxillofacial trauma surgery in Germany - implications from the national DRG database

PURPOSE

The COVID-19 pandemic has affected the personal and social lives of millions of people and also impacted the etiological factors of midfacial trauma such as falls, interpersonal violence or traffic accidents. The aim of this study was to analyze the influence of the COVID-19 pandemic on maxillofacial trauma surgery in the German healthcare system.

METHODS

Nationwide data regarding the national diagnosis-related-group (DRG) inpatient billing system used in all German hospitals was received from the German Federal Statistical Office. Various trauma-associated procedures of the Operation and Procedure Classification System (OPS), a German modification of the International Classification of Medical Procedures (ICPM), were statistically associated with different epidemiological factors between 2012 and 2021.

RESULTS

A statistically significant decrease (p < 0.05) in surgeries regarding maxillofacial fractures was registered during the years 2020 and 2021. Young male patients had the largest decline in maxillofacial trauma surgeries during this period (p < 0.05). In contrast. elderly patients 80 years and older showed a dramatic increase in the frequency of fractures in both the midface and the mandible (p < 0.05).

CONCLUSIONS

During the COVID 19 pandemic there has been a shift in the number, composition and etiology of maxillofacial fracture surgeries. Measures of social distancing and personal risk avoidance had a societal positive effect on the frequency of facial injuries. This stands in contrast to the drastic increase in fractures of elderly people who should be protected primarily by the measures taken. These results can help to understand these influences better in future pandemics.

TRIAL REGISTRATION

German Clinical Trials Register No: DRKS00032778.

What was the impact of COVID-19 restrictions on unintentional injuries, in Canada and globally? A scoping review investigating how lockdown measures impacted the global burden of unintentional injury

Background

Injuries are among the leading causes for hospitalizations and emergency department (ED) visits. COVID-19 restrictions ensured safety to Canadians, but also negatively impacted health outcomes, including increasing rates of certain injuries. These differences in trends have been reported internationally however the evidence is scattered and needs to be better understood to identify opportunities for public education and to prepare for future outbreaks.

Objective

A scoping review was conducted to synthesize evidence regarding the impact of COVID-19 restrictions on unintentional injuries in Canada, compared to other countries.

Methods

Studies investigating unintentional injuries among all ages during COVID-19 from any country, published in English between December 2019 and July 2021, were included. Intentional injuries and/or previous pandemics were excluded. Four databases were searched (MEDLINE, Embase, Web of Science, SPORTDiscus), and a gray literature search was also conducted.

Results

The search yielded 3,041 results, and 189 articles were selected for extraction. A total of 41 reports were included from the gray literature search. Final studies included research from: Europe (n = 85); North America (n = 44); Asia (n = 32); Oceania (n = 12); Africa (n = 8); South America (n = 4); and multi-country (n = 4). Most studies reported higher occurrence of injuries/trauma among males, and the average age across studies was 46 years. The following mechanisms of injury were reported on most frequently: motor vehicle collisions (MVCs; n = 134), falls (n = 104), sports/recreation (n = 65), non-motorized vehicle (n = 31), and occupational (n = 24). Injuries occurring at home (e.g., gardening, home improvement projects) increased, and injuries occurring at schools, workplaces, and public spaces decreased. Overall, decreases were observed in occupational injuries and those resulting from sport/recreation, pedestrian-related, and crush/trap incidents. Decreases were also seen in MVCs and burns, however the severity of injury from these causes increased during the pandemic period. Increases were observed in poisonings, non-motorized vehicle collisions, lacerations, drownings, trampoline injuries; and, foreign body ingestions.

Implications

Findings from this review can inform interventions and policies to identify gaps in public education, promote safety within the home, and decrease the negative impact of future stay-at-home measures on unintentional injury among Canadians and populations worldwide.

Characteristics of injuries related to traffic crashes in Israel before and during the COVID-19 pandemic

OBJECTIVES

This study explored differences in patient characteristics, injury characteristics, treatment modalities, and treatment outcomes among patients who presented to the Emergency Department (ED) following traffic crashes during the COVID-19 period (from March 15, 2020 to March 15, 2022) in comparison to the previous corresponding period between 2017 and 2019.

METHODS

The study is a retrospective chart review study. The study included a random sample of 610 patients who presented to the ED of a major hospital located in northern-central Israel following traffic crashes: 305 patients who presented during the COVID-19 period (from March 15, 2020 to March 15, 2022) and 305 patients who presented during the previous corresponding period (from March 15, 2017 to March 15, 2019). Socio-demographic data, data regarding the traffic crashes, and medical data of the patients were collected from their medical records, and the data were compared.

RESULTS

In the context of the COVID-19 period, a notable surge in the percentage of cyclist victims was evident, marking an increase from 7.5% to 19% compared to the corresponding period. Conversely, the incidence of pedestrian victims during the COVID-19 period dropped to 19.7%, in contrast to 30.8% in the corresponding period. Notably, patients involved in pedestrian crashes amid the COVID-19 period exhibited a shorter hospital stay (M = 2.8 days, SD = 3.3) compared to the corresponding period (M = 4.3 days, SD = 7.1) [t = 1.8 (df = 141), p < 0.05]. However, a higher fatality rate was observed among these patients during the COVID-19 period compared to the corresponding period (6.7% vs. 0%) [χ2 = 6.4 (df = 1), p < 0.05].

CONCLUSIONS

The study reveals significant changes in traffic crashes characteristics during the pandemic period, including a notable increase in cyclist victims and a decrease in pedestrian incidents. These shifts may be attributed to factors such as changes in transportation patterns, increased use of bicycles for essential travel. Despite these changes, the proportion of severe crashes remained relatively consistent. These findings underscore the importance of understanding the underlying causes behind these shifts and highlight the ongoing need for public education and awareness initiatives to promote traffic safety, particularly for vulnerable road users, during pandemic periods.

Bicycle-related traumatic injuries: a retrospective study during COVID-19 pandemic

BACKGROUND

This study aimed to review bicycle-related injuries during the COVID-19 pandemic to assist with reinforcement or implementation of new policies for injury prevention.

METHODS

This is a retrospective descriptive analysis of injuries sustained during cycling for patients 18 years old and above who presented to Singapore General Hospital from January to June 2021. Medical records were reviewed and consolidated. Descriptive analyses were used to summarize patient characteristics, and differences in characteristics subgrouped by triage acuity and discharge status were analyzed.

RESULTS

The study included 272 patients with a mean age of 43 years and a male predominance (71.7%). Most presented without referrals (88.2%) and were not conveyed by ambulances (70.6%). Based on acuity category, there were 24 (8.8%) Priority 1 (P1) patients with 7 trauma activations, 174 (64.0%) and 74 (27.2%) P2 and P3 patients respectively. The most common injuries were fractures (34.2%), followed by superficial abrasion/contusion (29.4%) and laceration/wound (19.1%). Thirteen (4.8%) patients experienced head injury and 85 patients (31.3%) were documented to be wearing a helmet. The majority occurred on the roads as traffic accidents (32.7%). Forty-two patients (15.4%) were admitted with a mean length of stay of 4.1 d and 17 (6.3%) undergone surgical procedures. Out of 214 (78.7%) discharged patients, no re-attendances or mortality were observed. In the subgroup analysis, higher acuity patients were generally older, with higher proportions of head injuries leading to admission.

CONCLUSION

Our study highlights significant morbidities in bicycle-related injuries. There is also a high proportion of fractures in the young healthy male population. Injury prevention is paramount and we propose emphasizing helmet use and road user safety.