Acute occupational inhalation injuries-United States, 2011-2022

BACKGROUND

Inhalation injuries due to acute occupational exposures to chemicals are preventable. National surveillance of acute inhalation exposures is limited. This study identified the most common acute inhalation exposure-related incidents by industry sector among US workers.

METHODS

To characterize inhalation-related injuries and their exposures during April 2011-March 2022, state and federal records from the Occupational Safety and Health Administration (OSHA) Occupational Safety and Health Information System (OIS) accident database were analyzed. Industry-specific injury, hospitalization, and fatality rates were calculated.

RESULTS

The most frequent acute inhalation incidents investigated by OSHA were caused by inorganic gases (52.9%) such as carbon monoxide (CO) or acids, bases, and oxidizing chemical agents (12.9%) such as anhydrous ammonia. The largest number of fatal and nonfatal injuries were reported in the manufacturing (28.6%) and construction (17.2%) sectors.

CONCLUSIONS

Workers were affected by acute inhalation exposures in most industries. Using this surveillance, employers can recognize frequently-occurring preventable acute inhalation exposures by industry, such as inorganic gases in the manufacturing sector, and implement prevention measures. Training of workers on exposure characteristics and limits, adverse health effects, and use of protective equipment by exposure agent can prevent inhalation injuries.

Prevalence of dance-related injuries and associated risk factors among children and young Chinese dance practitioners

While Chinese dance is a popular dance genre among Chinese teenagers and adults, little is known regarding the prevalence of dance-related injuries or factors associated with such injuries among Chinese dance practitioners. The current cross-sectional study aimed to determine the prevalence of dance-related injuries and their associated risk factors among young Chinese dance practitioners in Hong Kong. Online surveys were distributed to dancers through local dance associations, while paper-based surveys were distributed to young Chinese dance performers during the 54th School Dance Festival in Hong Kong. Self-reported hours of dancing, injuries in the last 12 months, injury sites, and related factors were collected. The injury rate, 12-month prevalence of dance-related injuries were determined. Risk factors for common dance injuries were analyzed using separate multivariate regression models. A total of 175 children (aged 10-14 years) and 118 young (aged 15-24 years) Chinese dance practitioners provided their dance injury information. Young dancers had a significantly higher injury rate (6.5 injuries vs 4.6 injuries/1000 dance hours) and 12-month prevalence (52.5% vs 19.4%) than their child counterparts. The most commonly injured sites were the knee (children:7.4%; young:15.3%), lower back (children: 4.6%; young: 9.5%), and ankles (children: 5.1%; young: 16.9%). Age was a significant independent risk factor for dance-related injuries to the upper back, lower back, and pelvis/buttock (odds ratios ranging from 1.2 to 1.3/additional years). Additionally, height was a significant independent risk factor for lower limb injury (odds ratios ranging from 1.0-1.1/additional centimeter). Collectively, young Chinese dance practitioners are more vulnerable to dance-related injuries than are child dancers. Older age increases the risk of trunk injuries, whereas taller dancers are more likely to sustain lower-limb injuries. Future research should determine the mechanisms underlying dance-related injuries among these dancers.

Descriptive Epidemiology of Game-Related Youth Flag Football Injuries

CONTEXT

Flag football is promoted as a safer alternative to tackle football. This may be 1 reason why participation rates have risen by 39% over the past 3 years. Despite rising participation, epidemiologic research on sport-specific injuries and associated relative risk is lacking.

OBJECTIVE

To prospectively document the epidemiology of injuries in youth flag football.

DESIGN

Descriptive epidemiology study.

SETTING

Regional and national youth flag football tournaments.

PATIENTS OR OTHER PARTICIPANTS

Athletes (N = 1939; 1744 boys and 195 girls), ages 6 to 12 years. An athletic trainer prospectively monitored the athletes for sport-related injury and exposures.

MAIN OUTCOME MEASURE(S)

Athlete risks of injury and injury rates were calculated overall and by sex. Injury characteristics were reported for the total population and by sex.

RESULTS

Forty-seven injuries to unique individuals were recorded in 1939 athletes with a total of 9228 athlete-exposures (AEs). The overall risk of injury was 2.4% (95% CI = 1.79%, 3.21%), with an overall injury rate of 5.1 per 1000 AEs (95% CI = 3.75, 6.77). Of the 47 injuries, 36 occurred in boys (8365 AEs), and 11 occurred in girls (863 AEs). A higher risk in girls was evidenced by both the injury risk ratio (2.73; 95% CI = 1.41, 5.30) and injury rate ratio of 2.96 (95% CI = 1.51, 5.82). The most common injury sites were the head/face/neck (n = 15, 31.9%), followed by the ankle/foot (n = 9, 19.1%). The most frequent types of injury were contusion (55.3%), sprain/subluxation (14.9%), and general trauma (10.6%); 74.5% of all injuries resulted from direct impact.

CONCLUSIONS

Although the competition injury rate for youth flag football was lower than the values from studies reporting comparable tackle football data, the frequencies by body part, type, and mechanism were similar. Given that most injuries were related to some form of impact and predominantly contusions, adopting minimal protective equipment or padding may reduce the numbers of these injuries.

High rate of muscle injury despite no changes in physical, physiological and psychophysiological parameters in a professional football team during a long-congested fixture period

This study aimed to analyse match availability, participation, and muscle injury incidence and to compare the effect of time intervals between matches (3-4 versus 6-7 days) on physical, physiological, and psychophysiological parameters in a professional football team during a prolonged congested fixture period. Thirteen professional male football players (29.2 ± 4.8 years old; 78.5 ± 8.3 kg; 179.3 ± 8.8 cm;) participated. Data were collected during 17 consecutive weeks for 35 official matches separated by an average interval of ≤ 3.5 days. Results showed a player availability of 84.8 ± 16.1% while match participation was 68.8% ± 6.4%. Muscle injury incidence was 19.0/ 1,000 hours of match exposure. These injuries occurred after individual players participated in sequences of 8.3 ± 3.3 consecutive matches with intervals of 3.8 ± 0.8 days. No differences were observed in physical performance or in fatigue-related parameters irrespective of the time interval between matches. A high player availability rate was observed. No differences were observed in physical, physiological, and psychophysiological indices of performance when comparing shorter and longer time intervals between consecutive matches.Prolonged exposure to fixture congestion resulted in an high risk of incurring muscle injury.

The Injury Rate in NBA Players Did Not Increase Following Return to Play After the COVID-19 Stay-at-Home Order

OBJECTIVE

The purpose of this study was to investigate the injury rate in NBA players following return to play during the post-COVID-19 shutdown 2019-2020 NBA season.

METHODS

This study was a retrospective review of all NBA players who were placed on the injury report during the preseason and first 4 weeks of the regular season as well as playoffs from the 2017-2018 through 2020-2021 NBA seasons. The data were compiled using publicly available injury reports. All injuries were recorded, and injury rates were calculated per 1000 athletic exposures. Risk ratio with 95% confidence intervals compared injury rates between the 2 cohorts.

RESULTS

Over the course of the study period, 399 injuries were reported. The highest injury rate per athletic exposure was observed to have occurred during the first month of the regular season in the 2 seasons prior to the COVID-19 pandemic. There was no significant difference in the average number of games missed before and after the pandemic for the preseason (P = .95), first month of regular season (P = .62), and playoffs (P = .69). There was no significant difference in the rate of injury when comparing injury rates before and after the pandemic for the preseason (P = .25), first month of the regular season (P = .11), and playoffs (P = .3).

CONCLUSION

The rate of injury in NBA players following the COVID-19 pandemic was not significantly higher than 2 recent past NBA seasons.

Trends in pediatric baseball and softball injuries presenting to emergency departments

BACKGROUND

Millions of youth participate in baseball and softball in the United States and these youth account for a large number of pediatric sports injuries. This study sought to characterize annual, seasonal, and age-related trends in pediatric softball and baseball injuries presenting to the Emergency Department (ED).

METHODS

The National Electronic Injury Surveillance System (NEISS) database was retrospectively examined for all softball and baseball injuries from 2010 to 2019 involving pediatric patients aged 7-21 years. Patients were classified by age as children (ages 7-13), adolescents (ages 14-18), or young adults (ages 19-21). Case narratives were used to assign mechanisms of injury. National injury estimates were calculated using statistical weights provided by the Consumer Product Safety Commission.

RESULTS

An estimated 1,372,573 pediatric softball and baseball ED visits occurred from 2010 to 2019. The mean age of the patient population was 13.6 years old (95% CI = 13.5-13.8 years), and baseball athletes were younger than softball athletes (13.2 years and 14.3 years) (p < 0.01). Moreover, baseball athletes hit by the bat were younger than their softball counterparts (11.8 years and 13.4 years). Most baseball and softball injuries were the result of being hit by the ball (52.8% and 54.2%) or sliding into a base (13.1% and 15.8%). The annual number of injuries decreased during the studied time period by 41.1% for baseball injuries and by 38.3% for softball injuries. The annual number of injuries related to all injury mechanisms decreased over the studied time period for both sports, with the exception of baseball throwing injuries, which increased by 8.6%. Baseball and softball injuries were both most likely to be present to the ED on Sunday (16.3% and 17.9%) and during the Spring (53.2% and 55.3%).

CONCLUSION

Safety guidelines should focus on reducing the prevalence of injuries acquired by younger baseball and softball players during practice and educating coaches and players on existing pitch count guidelines.

Do Injury Rates in Position Players Who Convert to Pitchers in Professional Baseball Differ From Players Who Have Always Been Pitchers?

Background:

There are some professional baseball players who begin their career as a position player and later convert to a pitcher; injury rates in these players are unknown.

Purpose:

To compare injury rates of professional baseball players who started their career as position players and converted to pitchers with a control group of pitchers who have been only pitchers throughout their professional career.

Hypothesis:

Injury rates would be lower in the conversion players.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

All players who began their professional baseball career as position players and converted to pitchers between 2011 and 2018 were included. All injuries that occurred after they converted to pitchers were included. The conversion players were matched 1 to 1 with a control group of pitchers who entered professional baseball as pitchers and never changed position. Injury rates were compared between groups. The performance between groups was also compared.

Results:

Overall, 221 players were identified who converted from position players to pitchers. There were significantly more injuries per year in the control pitcher group (0.8 ± 0.9) than in the conversion pitcher group (0.7 ± 0.9; P = .015). Injuries in the control group resulted in 61 ± 112 days missed per injury, while injuries in the conversion player group resulted in 54 ± 102 days missed per injury (P = .894). Injury characteristics differed between groups. However, in both groups, most of the injuries were related to pitching or throwing, were noncontact or gradual overuse injuries, and involved the upper extremity. Converted pitchers had lower pitcher usage, with fewer games and innings pitched (P < .001), with significantly worse statistics for walks plus hits per inning pitched (P = .018).

Conclusion:

Professional baseball players who convert from position players to pitchers are injured at lower rates than control pitchers. Conversion pitchers have lower pitcher usage, which may contribute to their reduced injury rates.

Epidemiology of Sports-Related Injuries and Associated Risk Factors in Adolescent Athletes: An Injury Surveillance

The present study aimed to determine the epidemiology of sport-related injuries in amateur and professional adolescent athletes and the incidence of different risk factors on those injuries. Four hundred ninety-eight athletes aged 14 to 21 voluntarily participated in this prospective injury surveillance, conducted from 1 January 2019 to 31 December 2019. The information collected included: personal data, sports aspects, characteristics of the injuries, and lifestyle. Forty point four percent of the participants suffered an injury in 2019 (39% of them in a previously injured area). The average injury rate was 2.64 per 1000 h. Soccer presented the highest rate (7.21). The most common injuries were: lumbar muscle strains (12.24%), ankle sprains (11.98%), and bone fractures (9.31%). Ankles (36.12%), knees (19.32%), and shoulders (6.47%) concentrated the highest number of injuries. Fifty-nine point twenty-eight percent of the injuries occurred during practices, and 40.72% during competition or peri-competition. Higher injury rates were associated (in this order) with the following factors: (a) Greater number of hours of practice per week. (b) Not performing warm-ups. (c) Using inadequate sports facilities. (d) Being aged 14–17. (e) Not performing physical preparation. (f) Inappropriate training load. (g) Not performing injury-preventive activities. (h) Performing sports technique without the supervision of one sports coach. (i) Inadequate sports equipment. In conclusion, since most injury risk factors are modifiable, it is imperative to implement strategies to reduce amateur and professional adolescent athletes’ injury rates.

Rear-seat occupant demographics in rear impacts: Analysis of NASS-CDS

PURPOSE

This study analyzes field accidents to identify rear-occupant exposure and injury by crash types. Occupant demographics and injury were assessed by body region and crash severity to understand rear-occupant injury mechanisms in rear crashes.

METHODS

The exposure and serious-to-fatal injury was determined by crash type for non-ejected second- and third- row occupants in 1994+ MY vehicles using 1994-2015 NASS-CDS. Selected occupant demographics and serious injury distributions were assessed over a range of delta V for rear crashes.

RESULTS

Rear crashes accounted for 8.7% of exposed and 5.4% of serious-to-fatally injured rear-seat occupants. On average, rear-seat occupants were 14.3 ± 1.5 years old (median 10.3, 90^th CI 0.08-29.6), weighed 44.7 ± 2.6 kg (median 44.4, 90^th CI 7.9-81.7) and were 130.3 ± 4.1 cm tall (median 141.4, 90^th CI 67.3-178.4). With serious injury, the average rear occupant was 18.1 ± 5.8 years old (median 13.1, 90^th CI 0.0-47.2), weighed 42.6 ± 10.7 kg (median 31.4, 90^th CI 7.0-82.4) and was 120.6 ± 15.4 cm tall (median 145.4, 90^th CI 48.8-174.1). More than 72% of rear-seat occupants were in delta V less than 24 km/h. Less than 2% were in delta V 48 km/h or greater. The overall rate of serious-to-fatally injured (MAIS 3 + F) was 0.73% ± 0.37%. For serious-to-fatally injured rear-seat occupants, the average delta V was 37.4 ± 3.1 km/h (median 29.8, 90th CI 28.6-62.1). None were involved in delta Vs less than 24 km/h, about 78% were in a delta V between 24-48 km/h and 22% were in a delta V of 48 km/h or greater. Head and chest were most commonly injured, irrespective of crash severity.

CONCLUSIONS

The height and weight of a 10-year old and 5^th Hybrid III ATD are representative of the average rear-seat occupant involved in rear crashes based on NASS-CDS. Crash tests with a delta V of between 30 and 37 km/h represent the typical collision causing serious-to-fatal injury.

Effect of ABTS and conventional seats on occupant injury in rear impacts: Analysis of field and test data

PURPOSE

This study addressed the potential effect of higher seat stiffness with ABTS (All-Belt-to-Seat) compared to conventional seats in rear impacts. It analyzed field accidents and sled tests over a wide range in delta V and estimated the change in number of injured occupants if front-seats were replaced with stiffer ABTS.

METHODS

The rear-impact exposures and serious-to-fatal injury rates were determined for 15+ year old non-ejected drivers and right-front passengers in 1994+ model year vehicles using 1994-2015 NASS-CDS. More than 50 rear sled tests were analyzed using conventional and ABTS seats. An injury risk was calculated for selected ATD biomechanical responses. The results obtained with the ABTS and conventional seats were compared for matched tests based on head restraint position, ATD size and initial position and delta V. The change in risk was used to estimate the change in injury in the field by adjusting the injury rate by delta V.

RESULTS

On average, front seat occupants were 39 years old, weighed 78 kg and were 171 cm tall. About 29.3% of serious-to-fatally injured (MAIS 3 + F) front seat occupants were involved in delta Vs less than 24 km/h and about 28.4% in a delta V of 48 km/h or greater. The average biomechanical response and injury risk in sled tests were higher with an ABTS seat than with a conventional seat. The average maximum injury risk was assessed by delta V groups for conventional and ABTS seats. The relative risk of ABTS to conventional seats was 1.34 in less than 16 km/h, 1.69 in 16-24 km/h, 1.65 in 24-32 km/h, 1.33 in 32-40 km/h, 5.77 in 40-48 km/h and 48.24 in the 56-64 km/h delta V category. The estimated relative risk was 11.90 in 48-56 km/h and 34.11 in 64+ km/h. The number of serious-to-fatally injured occupants was estimated to increase by up to 6.88-times if stiffer ABTS seats replaced conventional seats.

CONCLUSIONS

The field data indicate that the 50^th percentile male Hybrid III size is representative of an average occupant involved in rear crashes. ABTS seats used in this study are stiffer than conventional seats and increase ATD responses and injury risks over a wide range of crash severities.

Epidemiology of Boys' Club Lacrosse Injuries During the 2018 Summer Lacrosse Season

CONTEXT

In the past 10 years, participation in boys' youth and high school lacrosse has increased by 33%. Among many club teams and tournaments, athletes may not have access to medical coverage. Additionally, these athletes face a higher volume of play than in traditional scholastic sport settings.

OBJECTIVE

To describe the injury characteristics of boys' nonscholastic youth and high school club lacrosse athletes over the course of a summer season.

DESIGN

Descriptive epidemiology study.

PATIENTS OR OTHER PARTICIPANTS

Boys' nonscholastic youth and high school lacrosse athletes, aged 8 to 18 years, who competed in tournaments.

MAIN OUTCOME MEASURE(S)

Athletic trainers at tournaments were given standardized injury report forms to document patient encounters. These reports were then entered into the Datalys Injury Surveillance Tool.

RESULTS

Over the summer tournament season, 233 injuries were reported in 109 342 athlete-exposures (AEs) for an injury rate of 2.13 per 1000 AEs (95% confidence interval = 1.87, 2.42). The most frequently injured body parts were the head and/or face (n = 51, 22%), arm and/or elbow (n = 34, 15%), and hand and/or wrist (n = 29, 12%). The most common diagnoses were contusions (n = 63, 27%), concussions (n = 44, 19%), fractures (n = 39, 17%), and sprains (n = 35, 15%). The most often injured position was midfielder (n = 65, 41%), followed by defense (n = 48, 30%), attack (n = 36, 23%), and goalkeeper (n = 9, 6%). The concussion rate was 0.4 per 1000 AEs (95% confidence interval = 0.28, 0.52).

CONCLUSIONS

The injury rate experienced by boys' nonscholastic club lacrosse athletes was similar to the rates of their high school counterparts as well as school-sponsored football and wrestling athletes. Because of the risk of injury, athletic training services should be available for youth and high school club lacrosse tournaments.

Outcome measures from experimental traumatic brain injury in male rats vary with the complete temporal biomechanical profile of the injury event

Millions suffer a traumatic brain injury (TBI) each year wherein the outcomes associated with injury can vary greatly between individuals. This study postulates that variations in each biomechanical parameter of a head trauma lead to differences in histological and behavioral outcome measures that should be considered collectively in assessing injury. While trauma severity typically scales with the magnitude of injury, much less is known about the effects of rate and duration of the mechanical insult. In this study, a newly developed voice-coil fluid percussion injury system was used to investigate the effects of injury rate and fluid percussion impulse on a collection of post-injury outcomes in male rats. Collectively the data suggest a potential shift in the specificity and progression of neuronal injury and function rather than a general scaling of injury severity. While a faster, shorter fluid percussion first presents as a mild TBI, neuronal loss and some behavioral tasks were similar among the slower and faster fluid percussion injuries. This study concludes that the sequelae of neuronal degeneration and behavioral outcomes are related to the complete temporal profile of the fluid percussion and do not scale only with peak pressure.

An Injury Prevention Program for Professional Ballet: A Randomized Controlled Investigation

BACKGROUND

Few investigations have examined dance-specific injury prevention programs (IPPs), and no published randomized controlled trials are available that evaluate IPPs for dance.

HYPOTHESIS

The implementation of an IPP will significantly reduce the risk of injury in professional ballet dancers.

STUDY DESIGN

Randomized controlled trial; Level of evidence, 2.

METHODS

A randomized controlled trial was designed that entailed a superiority model for the intervention group. All professional dancers from a single ballet company were eligible to participate. Randomization and allocation were performed before the start of the season. The control group practiced and performed without change to preexisting standard operating practice. The IPP group was instructed to perform a 30-minute exercise program 3 times per week over the 52-week study period. Injuries were recorded. Standard continuous and categorical data comparisons and correlations were used. Cox proportional hazards regression models for recurrent failures were used wherein the hazard ratio indicates the relative likelihood of injury in the control versus intervention groups.

RESULTS

Of the 52 eligible dancers, 75% (n = 39) participated. Of these 39 dancers, 19 (9 males, 10 females; mean age, 26.6 ± 4.0 years) were randomized to the control group and 20 (11 males, 9 females; mean age, 25.1 ± 5.1 years) to the IPP group. No significant (P > .05) difference was found in baseline demographics between groups. A total of 116 injuries were recorded for the entire study population (49 IPP; 67 control). Traumatic and chronic injuries accounted for 54% and 46% of injuries, respectively. The injury rate was 82% less (IPP hazard ratio, 0.18; z = -2.29; P = .022) in the IPP group after adjustment for confounding variables, and time between injuries was 45% longer (IPP hazard ratio, 0.55; z = -2.20; P = .028) than for controls.

CONCLUSION

The present study is the first prospective randomized controlled investigation of an IPP for professional ballet. The results showed an 82% decrease in injury rate for the intervention group and an extended period from previous injury to subsequent injury.

REGISTRATION

NCT04110002 (ClinicalTrials.gov identifier).

Injuries in Novice Participants during an Eight-Week Start up CrossFit Program-A Prospective Cohort Study

Background: Previously published studies have reported injury rates ranging from 0.74 to 3.3 per 1000 h of exposure in CrossFit participants. However, the existing body of evidence is mainly based on experienced participants; therefore, the injury incidence and injury rate within novice CrossFit participants remains relatively unknown. The aim of this study wasto investigate the injury incidence and injury rate among novice participants in an eight-week CrossFit program. Methods: This survey-based prospective cohort study included CrossFit Copenhagen’s novice members who began an eight-week, free-of-charge membership period. A questionnaire was distributed at baseline and at eight-week follow-up. Information about exposure was retrieved through the online booking system. Injury incidence, defined as proportion of participants who sustained an injury, and injury rates per 1000 h of exposure were calculated. Results: Among the 168 included participants, a total of 28 injuries (14.9%) were reported. The number of injured participants and total exposure time resulted in an injury rate per 1000 h of exposure of 9.5. Conclusions: Compared to the existing body of evidence, the findings in this study indicate that the risk of injuries is higher among novice participants than among experienced CrossFit participants.

Epidemiology of Cervical Muscle Strains in Collegiate and High School Football Athletes, 2011-2012 Through 2013-2014 Academic Years

CONTEXT

Cervical muscle strains are an often-overlooked injury, with neck- and spine-related research typically focusing on spinal cord and vertebral injuries.

OBJECTIVE

To examine the rates and distributions of cervical muscle strains in collegiate and high school football athletes.

DESIGN

Descriptive epidemiology study.

SETTING

Collegiate and high school football teams.

PATIENTS OR OTHER PARTICIPANTS

The National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) collected data from collegiate football athletes. The High School National Athletic Treatment, Injury and Outcomes Network (HS NATION) and High School Reporting Information Online (HS RIO) collected data from high school football athletes. Data from the 2011-2012 through 2013-2014 academic years were used.

MAIN OUTCOME MEASURE(S)

Athletic trainers collected injury and exposure data for football players. Injury counts, injury rates per 10 000 athlete-exposures (AEs), and injury rate ratios with 95% confidence intervals (CIs) were calculated.

RESULTS

The NCAA-ISP reported 49 cervical muscle strains (rate = 0.96/10 000 AEs), of which 28 (57.1%) were TL (time loss; rate = 0.55/10 000 AEs). High School NATION reported 184 cervical muscle strains (rate = 1.66/10 000 AEs), of which 33 (17.9%) were TL injuries (rate = 0.30/10 000 AEs). The HS RIO, which collects only TL injuries, reported 120 TL cervical muscle strains (rate = 0.51/10 000 AEs). The overall injury rate was lower in the NCAA-ISP than in HS NATION (injury rate ratio = 0.58; 95% CI = 0.42, 0.79); when restricted to TL injuries, the overall injury rate was higher in the NCAA-ISP (injury rate ratio = 1.83; 95% CI = 1.11, 3.03). No differences were found when comparing TL injuries in HS RIO and the NCAA-ISP. Cervical muscle-strain rates were higher during competitions than during practices across all 3 surveillance systems for all injuries. Most cervical muscle strains were due to player contact (NCAA-ISP = 85.7%, HS NATION = 78.8%, HS RIO = 85.8%).

CONCLUSIONS

The incidence of cervical muscle strains in football players was low compared with other injuries. Nonetheless, identifying and implementing interventions, particularly those aimed at reducing unsafe player contact, are essential to further decrease the risk of injury and associated adverse outcomes.

Epidemiology and Impact of Prior Musculoskeletal Injury and Orthopaedic Surgery on Draft Rank, Availability, and Short-term Performance in Major League Baseball: A Summary Analysis and Matched Cohort of 1890 Predraft Players

Background:

Despite the many reports of injury rates in Major League Baseball (MLB), little is known about the epidemiology or impact of prior musculoskeletal injuries and surgical procedures among players entering the MLB draft.

Purpose:

To determine the (1) epidemiology of all musculoskeletal injuries and surgical procedures among players entering the MLB draft, (2) impact of injury or surgery on draft rank, (3) impact of injury or surgery on availability within the first 2 years of play in the MLB, and (4) impact of injury or surgery on performance.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We retrospectively reviewed 1890 medical records that were completed by MLB team physicians as preparticipation physical assessment prior to the draft from 2014 to 2018. Players were divided into 3 groups: noninjured, nonoperative, and operative. Draft status, overall draft rank, missed games, batting average, and earned run average for the first 2 seasons of MLB play were obtained for all available players. Players across all 3 groups were compared with linear, logistic, and beta regression models, controlling for age, position, injury status, and draft rank. Unadjusted differences among groups were assessed with 1-way analysis of variance.

Results:

Overall, 750 position players and 1140 pitchers were included, of whom 22.8% had no reported injury history; 48.8% reported injury treated nonoperatively; and 28.5% were treated operatively. The most common predraft injuries were elbow tendinitis (n = 312), ulnar collateral ligament injury (n = 212), and shoulder labral tear (n = 76). The most common predraft treatments were physical therapy (n = 922), ulnar collateral ligament reconstruction (n = 115), and fracture fixation (n = 69). Of the 1890 players, 719 were drafted and played for at least 2 years. No difference was found among noninjured, nonoperative, and operative groups in terms of draft rank, games missed, or performance. Players with a nonoperative injury had a decreased odds ratio of being drafted (0.738; P = .017).

Conclusion:

More than half of the players entering the MLB reported a history of musculoskeletal injury requiring treatment, and the most commonly affected joints were the shoulder and elbow. Musculoskeletal history did not affect draft rank, short-term availability, or performance for MLB prospects.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Ice Hockey (2008-2009 Through 2013-2014) and National Collegiate Athletic Association Men's and Women's Ice Hockey (2004-2005 Through 2013-2014)

CONTEXT

Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided efforts to collect data on ice hockey injuries.

OBJECTIVE

To describe the epidemiology of injuries sustained in high school boy's ice hockey in the 2008-2009 through 2013-2014 academic years and collegiate men's and women's ice hockey in the 2004-2005 through 2013-2014 academic years using Web-based surveillance.

DESIGN

Descriptive epidemiology study.

SETTING

Online injury surveillance of ice hockey teams of high school boys (annual average = 34), collegiate men (annual average = 20), and collegiate women (annual average = 11).

PATIENTS OR OTHER PARTICIPANTS

Boys', men's, and women's ice hockey players who participated in practices and competitions during the 2008-2009 through 2013-2014 high school academic years or the 2004-2005 through 2013-2014 collegiate academic years.

MAIN OUTCOME MEASURE(S)

Athletic trainers collected time-loss (≥24 hours) injury and exposure data. We calculated injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis.

RESULTS

The High School Reporting Information Online system documented 831 boys' ice hockey time-loss injuries during 356 997 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 2611 men's ice hockey time-loss injuries during 552 642 AEs and 752 women's ice hockey injuries during 232 051 AEs. Injury rates were higher in collegiate men than in high school boys during 2008-2009 through 2013-2014 (4.38 versus 2.33/1000 AEs; IRR = 1.88; 95% CI = 1.73, 2.05) and collegiate women during 2004-2005 through 2013-2014 (IRR = 1.46; 95% CI = 1.34, 1.58). Most injuries occurred during competitions (boys = 80.0%, men = 66.9%, women = 55.3%); injury rates were higher in competitions than in practices for boys (IRR = 8.14; 95% CI = 6.87, 9.65), men (IRR = 6.58; 95% CI = 6.06, 7.13), and women (IRR = 3.63; 95% CI = 3.14, 4.19). At all levels, most injuries occurred to the head/face and shoulder/clavicle and resulted in concussions, contusions, or ligament sprains.

CONCLUSIONS

Injury rates varied across sports but were consistently higher in competitions than in practices. In competitions, concussions were common injuries, highlighting the need for continued development of injury-prevention strategies.

Trends in Workplace Injuries in Slovak Forest Enterprises

The aim of the paper is to analyse the effect of key factors affecting the risk of workplace injuries and to identify the most common workplace accidents regarding injured body parts with respect to anthropometric data measurements of the population. Data associated with workplace accidents over the years 2000⁻2016 were drawn from the records of the state enterprise Forests of the Slovak Republic, situated in Banská Bystrica. Gathered data were processed and entered into the database complemented by the data on accidents of the self-employed working in the forestry industry. A total of 1874 workplace accidents in the state enterprise were recorded and statistically evaluated during the analysis period. A method for contingency table was used to analyse correlation between qualitative (categorical) variables in the dataset. A Poisson regression model was used to determine the injury rate. Forest harvesting is considered the most risky phase of the process of harvesting, processing, and transport. The highest number of workplace accidents (31.8% of all recorded workplace accidents) occurred during the forest harvesting phase during the analysis period. Timber skidding, with 16% of recorded accidents, was the second highest-risk phase. The workplace injury rate in the forest industry in Slovakia decreased over the course of the years 2000⁻2016. Head and facial injuries were those with the highest rate (67.1% injuries of these body parts) during the phase of harvesting and skidding.

A 9-Year Epidemiologic Study (2007-2015) on Race-Day Jockey Fall and Injury Incidence in Amateur Irish Horse Racing

CONTEXT

Point-to-point racing may place jockeys at risk of serious injuries due to the high incidence of falls as previously reported. Despite many advances in health and safety strategies, the incidence of falls and injuries in point-to-point racing has not been reported since 2006.

OBJECTIVES

To provide a longitudinal analysis of the fall and injury incidence in point-to-point horse racing jockeys in Ireland from 2007 to 2015 and compare these findings with the previous literature.

DESIGN

Descriptive epidemiologic study.

SETTING

All injuries that occurred due to a fall at every official point-to-point race meeting from 2007 to 2015 were recorded by a medical doctor using a standardized injury report form.

MAIN OUTCOME MEASURE(S)

Falls and injury rates and their 95% confidence intervals were calculated. Incidence rate ratios (IRRs), 95% confidence intervals and percentage change were compared between point-to-point and professional racing, between previous data and the current results, and from 2007 to 2015.

RESULTS

An average of 67.40 injuries/1000 falls and 9.08 injuries/1000 rides occurred in point-to-point racing, and this was reduced compared with the previous analysis. Amateur jockeys sustained an overall mean of 134.77 falls/1000 rides and the yearly means decreased over the 9 years of the study. Amateur jockeys sustained a higher fall rate than professional jockeys (flat: IRR = 35.47 [31.03, 40.54]; jump: IRR = 2.72 [2.63, 2.82]); however, their injuries/1000 falls rate was lower (flat: IRR = 0.19 [0.15, 0.24]; jump: IRR = 0.33 [0.30, 0.63]). Soft tissue injuries were predominant (43.09%), with 26.06 fractures and 9.98 concussions/1000 falls occurring.

CONCLUSIONS

Although injuries have been reduced since the previous analysis, more serious injuries such as fractures and concussions were more common in point-to-point racing than professional racing, possibly due to their higher fall risk. Thus, identifying strategies to reduce the fall risk in point-to-point racing should be a priority.

Injury Incidence and Patterns Among Dutch CrossFit Athletes

Background:

CrossFit is a strength and conditioning program that has gained widespread recognition, with 11,000 affiliated gyms worldwide. The incidence of injuries during CrossFit training is poorly analyzed.

Purpose:

To investigate the incidence of injuries for persons participating in CrossFit. Risk factors for injury and injury mechanisms were also explored through athlete demographics and characteristics.

Study Design:

Descriptive epidemiology study.

Methods:

A questionnaire that focused on injury incidence in CrossFit in the past year and included data on athlete demographics and characteristics was distributed to all 130 CrossFit gyms in the Netherlands and was also available online in active Facebook groups. Data were collected from July 2015 to January 2016. Inclusion criteria consisted of age ≥18 years and training at a registered CrossFit gym in the Netherlands. A total of 553 participants completed the survey. Univariable and multivariable generalized linear mixed models were used to identify potential risk factors for injury.

Results:

A total of 449 participants met the inclusion criteria. Of all respondents, 252 athletes (56.1%) sustained an injury in the preceding 12 months. The most injured body parts were the shoulder (n = 87, 28.7%), lower back (n = 48, 15.8%), and knee (n = 25, 8.3%). The duration of participation in CrossFit significantly affected the injury incidence rates (<6 months vs ≥24 months; odds ratio, 3.687 [95% CI, 2.091-6.502]; P < .001). The majority of injuries were caused by overuse (n = 148, 58.7%).

Conclusion:

The injury incidence for athletes participating in CrossFit was 56.1%. The most frequent injury locations were the shoulder, lower back, and knee. A short duration of participation (<6 months) was significantly associated with an increased risk for injury.

Epidemiology of Injury Due to Race-Day Jockey Falls in Professional Flat and Jump Horse Racing in Ireland, 2011-2015

CONTEXT

  Professional horse racing is considered a high-risk sport, yet the last analysis of fall and injury incidence in this sport in Ireland was completed between 1999 and 2006.

OBJECTIVE

  To provide an updated analysis of the fall and injury incidence in professional flat and jump horse racing in Ireland from 2011 through 2015, compare it with the previous analysis, and detail the specific types and locations of injuries.

DESIGN

  Descriptive epidemiology study.

SETTING

  A medical doctor recorded all injuries that occurred at every official flat and jump race meeting for the 2011 through 2015 seasons using standardized injury-report forms.

MAIN OUTCOME MEASURE(S)

  Injury and fall rates and their 95% confidence intervals (CIs) were reported for flat and jump racing. Incidence rate ratios and 95% CIs were calculated between flat and jump racing, between the 1999-2006 analysis and the current results, and between 2011 and 2015. The distribution of injuries for type and location of injury was reported.

RESULTS

  Compared with flat racing, jump racing had significantly more falls per 1000 rides (49.5 versus 3.8), injuries per 1000 rides (10.1 versus 1.4), and injuries per 1000 meetings (776.0 versus 94.1). However, the rate of injuries per 1000 falls was significantly higher in flat racing (352.8 versus 203.8). An increase in injuries per 1000 falls between 2011 and 2015 was found in flat racing ( P = .005). Since the previous analysis, a significant increase in injuries per 1000 rides and falls was noted in jump racing. Soft tissue injuries were predominant in flat and jump racing (61.54% and 68.80%, respectively), with fractures the second most common injury (15.38% and 18.06%, respectively). Concussions were more prevalent from flat-racing falls (incidence rate ratio = 0.30; 95% CI = 0.15, 0.61). The lower limb was the most frequent location of injury (32.89%) in flat racing; however, in jump racing, upper limb injuries (34.97%) were predominant.

CONCLUSIONS

  An update on professional flat- and jump-racing fall and injury epidemiology is provided. Further research to identify risk factors for injury, design and investigate the feasibility of injury-prevention strategies, and document their effects on fall and injury incidence is required.

The Epidemiology of Overuse Conditions in Youth Football and High School Football Players

CONTEXT

  High-intensity sport training at the youth level has led to increased concern for overuse conditions. Few researchers have examined overuse conditions in youth sports.

OBJECTIVE

  To examine the rates, risks, and distributions of overuse conditions between youth and high school football players.

DESIGN

  Descriptive epidemiologic study.

SETTING

  Youth and high school football teams.

PATIENTS OR OTHER PARTICIPANTS

  The Youth Football Safety Study (YFSS) investigated youth football athletes from age 5 to 14 years. The National Athletic Treatment, Injury and Outcomes Network (NATION) focused on high school football athletes 14 to 18 years old. The YFSS data consisted of 210 team-seasons, and the NATION data consisted of 138 team-seasons.

MAIN OUTCOME MEASURE(S)

  Athletic trainers collected football injury and exposure data during the 2012 and 2013 seasons. Injury rates, risks, and distributions were calculated, with injury rate ratios, risk ratios, and injury proportion ratios with 95% confidence intervals (CIs) comparing youth and high school football players.

RESULTS

  The YFSS reported 1488 injuries, of which 53 (3.6%) were overuse conditions. The NATION reported 12 013 injuries, of which 339 (2.8%) were overuse conditions. The overuse condition rate did not differ between high school and youth football (3.93 versus 3.72/10 000 athlete-exposures; injury rate ratio = 1.06; 95% CI = 0.79, 1.41). However, the 1-season risk of overuse condition was higher in high school than in youth football players (2.66% versus 1.05%; risk ratio = 2.53; 95% CI = 1.84, 3.47). Compared with high school football players, youth football players had greater proportions of overuse conditions that were nontime loss (ie, <24 hours participation-restriction time; 83.0% versus 67.0%; injury proportion ratio = 1.24; 95% CI = 1.07, 1.43) and affecting the lower extremity (92.5% versus 62.5%; injury proportion ratio = 1.48; 95% CI = 1.32, 1.65).

CONCLUSIONS

  Overuse conditions may not present a primary concern in youth and high school football players. However, differences existed between the 2 levels of competition. Although additional research on the incidence of overuse conditions across all youth and high school sports is needed, these findings may highlight the need for programming that is specific to competition level.

The Latarjet Procedure at the National Football League Scouting Combine: An Imaging and Performance Analysis

Background:

The Latarjet procedure is commonly performed in the setting of glenoid bone loss for treatment of recurrent anterior shoulder instability; however, little is known regarding the outcomes of this procedure in elite American football players.

Purpose:

(1) Determine the prevalence, clinical features, and imaging findings of elite college football athletes who present to the National Football League (NFL) Combine with a previous Latarjet procedure and (2) describe these athletes’ performance in the NFL in terms of draft status and initial playing time.

Study Design:

Case series; Level of evidence, 4.

Methods:

After review of all football players who participated in the NFL Combine from 2009 to 2016, any player with a previous Latarjet procedure was included in this study. Medical records, position on the field, and draft position were recorded for each player. In addition, imaging studies were reviewed to determine fixation type, hardware complications, and status of the bone block. For those players who were ultimately drafted, performance was assessed based on games played and started, total snaps, and percentage of eligible snaps in which the player participated during his rookie season.

Results:

Overall, 13 of 2617 (<1%) players at the combine were identified with a previous Latarjet procedure. Radiographically, 8 of 13 (61%) showed 2-screw fixation, while 5 of 13 (39%) had 1 screw. Of the 13 players, 6 (46%) players demonstrated hardware complications. All players had evidence of degenerative changes on plain radiographs, with 10 (77%) graded as mild, 1 (8%) as moderate, and 2 (15%) as severe according to the Samilson Prieto classification. Six of the 13 (46%) players went undrafted, while the remaining 7 (54%) were drafted; however, no player participated in more than half of the plays for which he was eligible during his rookie season.

Conclusion:

Only a small percentage of players at the NFL Combine (<1%) had undergone a Latarjet procedure. High rates of postoperative complications and radiographically confirmed degenerative change were observed. Athletes who had undergone a Latarjet procedure demonstrated a variable amount of playing time, but none participated in more than half of their eligible plays during their rookie season.

Effect of Changes in Artificial Turf on Sports Injuries in Male University Soccer Players

Background:

Studies comparing the types and severity of trauma and injuries caused by different types of field surfaces have been conducted. However, there have been no studies on sports injuries caused by temporal deterioration of long-pile artificial turf fields and related decreases in the rubber chip and silica sand infill.

Purpose:

To investigate the influence of an artificial turf field on sports injuries in a university soccer team.

Study Design:

Descriptive epidemiological study.

Methods:

A total of 397 male soccer players who were members of a single university soccer team were surveyed over a 12-year period, from April 2003 to March 2015. During this period, the team played for 4 years on a soil field (2003-2006) and 8 years on artificial turf (2007-2014). We analyzed the effect of changes in the artificial turf on the incidence rate of sports injuries (injury rate per 1000 athlete-exposures). We calculated the incidence rate of injuries sustained by the team and compared the results for each year of the study.

Results:

After conversion of the field to artificial turf, there was a significant increase in the incidence of upper extremity trauma (P < .05). There was a significant increase in lower extremity sprains from 2007 to 2008, 1 year after the conversion from soil to artificial turf (P < .05). Analysis of the incidence of lower extremity muscle strain indicated that although the injury rate increased progressively, it decreased significantly after the insertion of additional rubber chips in 2014 (P < .05).

Conclusion:

After conversion to artificial turf, there was a significant increase in the incidence of upper extremity trauma. After the refurbishing with additional rubber chips, the incidence of lower extremity muscle strain significantly declined. When analyzing measures that could prevent sports injuries related to soccer, it is necessary to take into consideration the changes that occur to the artificial turf over time.

Analysis of Injuries and Risk Factors in Taekwondo during the 2014 Italian University Championship

Purpose  This study aims to analyze the risk factors and type of injuries occurring in Taekwondo athletes participating in a national competition.

Methods  Out of the 127 competitors, 18 athletes got injured during a Taekwondo championship who were analyzed for the following parameters: modality of training; age, weight; belt color; and the type of injury.

Results  Around 89% of the injuries were due to bruising and were found mainly on the lower limbs (61%) during the elimination rounds and during the first match of the day. The higher probability of injury was in the second round (56%), and during the first match of the day (72%). Nearly all the athletes were able to complete the game in which they were injured (83%). Comparing the average age of the athletes suffering an injury (23.6 ± 2.06 years) with their average years of training (8.4 ± 7.05 years) it can be noted that these athletes began this discipline rather late. The more is the training age and the weekly hours of training, the more are the numbers of matches completed, even as injured. Beginners with a low-level belt suffered more injuries than the experienced subjects did.

Conclusion  The following risk factors for injury were found: starting to practice in late age, weekly training sessions with a few number of hours, male sex, low-level belt, elimination rounds, the first match of the day, and second round.

Level of Evidence  Level III, observational analytic study without a control group.

Epidemiology of Injuries Identified at the NFL Scouting Combine and Their Impact on Performance in the National Football League: Evaluation of 2203 Athletes From 2009 to 2015

Background:

At the annual National Football League (NFL) Scouting Combine, the medical staff of each NFL franchise performs a comprehensive medical evaluation of all athletes potentially entering the NFL. Currently, little is known regarding the overall epidemiology of injuries identified at the combine and their impact on NFL performance.

Purpose:

To determine the epidemiology of injuries identified at the combine and their impact on initial NFL performance.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

All previous musculoskeletal injuries identified at the NFL Combine from 2009 to 2015 were retrospectively reviewed. Medical records and imaging reports were examined. Game statistics for the first 2 seasons of NFL play were obtained for all players from 2009 to 2013. Analysis of injury prevalence and overall impact on the draft status and position-specific performance metrics of each injury was performed and compared with a position-matched control group with no history of injury or surgery.

Results:

A total of 2203 athletes over 7 years were evaluated, including 1490 (67.6%) drafted athletes and 1040 (47.2%) who ultimately played at least 2 years in the NFL. The most common sites of injury were the ankle (1160, 52.7%), shoulder (1143, 51.9%), knee (1128, 51.2%), spine (785, 35.6%), and hand (739, 33.5%). Odds ratios (ORs) demonstrated that quarterbacks were most at risk of shoulder injury (OR, 2.78; P = .001), while running backs most commonly sustained ankle (OR, 1.39; P = .040) and shoulder injuries (OR, 1.55; P = .020) when compared with all other players. Ultimately, defensive players demonstrated a greater negative impact due to injury than offensive players, with multiple performance metrics significantly affected for each defensive position analyzed, whereas skilled offensive players (eg, quarterbacks, running backs) demonstrated only 1 metric significantly affected at each position.

Conclusion:

The most common sites of injury identified at the combine were (1) ankle, (2) shoulder, (3) knee, (4) spine, and (5) hand. Overall, performance in the NFL tended to worsen with injury history, with a direct correlation found between injury at a certain anatomic location and position of play. Defensive players tended to perform worse compared with offensive players if injury history was present.

Preseason Anxiety and Depressive Symptoms and Prospective Injury Risk in Collegiate Athletes

BACKGROUND

Psychological risk factors are increasingly recognized as important in sport-related injury prevention. Understanding how these psychological factors may affect the risk of injuries could help design effective prevention programs.

PURPOSE

To determine the effect of reported preseason anxiety and depressive symptoms on the risk of injuries during a prospective season in a cohort of collegiate athletes.

STUDY DESIGN

Cohort study; Level of evidence, 2.

METHODS

Collegiate athletes participating in 4 men's sports and 5 women's sports from 2 National Collegiate Athletic Association (NCAA) Division I universities were enrolled and prospectively followed during the 2007-2011 seasons. Preseason anxiety and depressive symptoms were measured at enrollment. Injuries occurring during the season were reported by certified athletic trainers. The injury incidence rate was calculated as the total number of injuries divided by the total number of athlete-exposures (ie, games and practices).

RESULTS

Of 958 enrolled athletes (response rate of 90.3%), 389 (40.6%) athletes sustained a total of 597 injuries. At preseason, 276 (28.8%) athletes reported anxiety symptoms, and 208 (21.7%) reported depressive symptoms. Among athletes reporting any of these symptoms, 48.5% (n = 158) reported having both anxiety and depressive symptoms. Athletes with preseason anxiety symptoms had a significantly higher injury incidence rate compared with athletes without anxiety symptoms (rate ratio [RR], 2.3; 95% CI, 2.0-2.6), adjusting for age, race, body mass index, history of injuries 12 months before baseline, and university attended, and this was observed for both male and female athletes. Only male athletes who reported co-occurring preseason depressive and anxiety symptoms had a significantly increased injury risk (RR, 2.1; 95% CI, 1.6-2.6) compared with male athletes who reported no co-occurring symptoms. However, no such increase in the injury risk was observed among female athletes or male athletes who reported preseason depressive symptoms but no anxiety symptoms.

CONCLUSION

Athletes with anxiety symptoms at preseason were at an increased risk of injuries during the prospective season. Targeted programs could focus on psychological health and injury prevention for athletes, especially for those exhibiting symptoms at preseason.

Shoulder Injuries in Individuals Who Participate in CrossFit Training

Background:

CrossFit, a sport and fitness program, has become increasingly popular both nationally and internationally. Researchers have recently identified significant improvements in health and wellness due to CrossFit. However, some individuals assert that CrossFit poses an inherent risk of injury, specifically to the shoulder, due to the intensity of training. Currently, there is limited evidence to support this assertion.

Hypothesis:

Exercises performed during CrossFit do not place the shoulder at greater risk for injury. Injury rates are comparable to other sports of similar intensity.

Study Design:

Descriptive survey study.

Level of Evidence:

Level 5.

Methods:

An electronic survey was developed and dispersed to approximately 980 individuals who trained in CrossFit gyms. The survey identified demographic data, training characteristics, and the prevalence of injury over a 6-month period in individuals who participated in CrossFit training.

Results:

A total of 187 (19.1%) individuals completed the survey. Forty-four (23.5%) indicated that they had experienced a shoulder injury during CrossFit training over the previous 6 months. Of those who reported injury, 17 (38.6%) stated that this injury was an exacerbation of a previous injury sustained prior to starting CrossFit. There was no significant relationship between several demographic and training variables and shoulder injury. All shoulder injuries occurred at a rate of 1.94 per 1000 hours training, while “new” shoulder injuries occurred at a rate of 1.18 per 1000 hours training. The most commonly attributed causes of injury were improper form (33.3%) and exacerbation of a previous injury (33.3%). Twenty-five (64.1%) of those who experienced injury reported 1 month or less of training reduction due to the injury.

Conclusion:

Shoulder injury rates during CrossFit training are comparable to other methods of recreational exercise.

Clinical Relevance:

Clinicians should be aware of training demands of exercises in CrossFit and modifications for these exercises to safely progress their patients back to participation.

Hired crop worker injuries on farms in the United States: A comparison of two survey periods from the National Agricultural Workers Survey

BACKGROUND

Hired crop workers in the United States are at high risk of occupational injury. Targeted surveillance is important for effective occupational safety efforts.

METHODS

The National Agricultural Workers Survey was utilized to collect injury data during the years 1999, 2002-2004 (period I) and 2008-2010 (period II).

RESULTS

The overall injury rate declined between the two periods from 4.3 to 2.9/100 per full-time week-based equivalents (FTEWB ). Injury rates remained high during both periods for those with greater than 20 years farm experience (3.6 and 3.8/100 FTEWB ) and pesticide handling work (4.9 and 5.0/100 FTEWB ). Overexertion, contact with objects and equipment, and falls from height were common during both periods. Older workers comprised a greater proportion of injury cases in period II.

CONCLUSION

Overexertion that leads to sprains/strains, dangerous ladder use, and pesticide use should be targeted as important risk exposures on the farm.

Safety survey of Iran's mines and comparison to some other countries

The increasing development of mining activities in Iran makes it necessary to have a closer look at the safety issues. Analysis of different incidents and damages in mines can be helpful for the adoption of suitable approaches to prevent the incidents. In this study, safety statistics of Iran's mines in 2011 and 2012 were assessed and important incidents and injuries happening to employees for 12 different groups of minerals were evaluated and eventually compared to the situation of some other countries. According to the obtained results, the average incidence probability in Iran's mines was calculated to be 0.18 for 2011 and the incidence probability of coal, copper and iron ore mines was greater than others. The injury rate of Iran's mines was 106 and 164 out of 10,000 persons for 2011 and 2012, respectively, and the maximum values of injury rate belonged to coal, dimension stone and aggregate mines. Also, it turned out that the fatal rate per 100 tons of production had the highest values in chromite and coal mines. Besides, comparison of injury rate and the fatal rate in Iran and some countries showed that the safety situation in Iran's mines was in a fair condition.

Injury Rate and Patterns Among CrossFit Athletes

Background:

CrossFit is a type of competitive exercise program that has gained widespread recognition. To date, there have been no studies that have formally examined injury rates among CrossFit participants or factors that may contribute to injury rates.

Purpose:

To establish an injury rate among CrossFit participants and to identify trends and associations between injury rates and demographic categories, gym characteristics, and athletic abilities among CrossFit participants.

Study Design:

Descriptive epidemiology study.

Methods:

A survey was conducted, based on validated epidemiologic injury surveillance methods, to identify patterns of injury among CrossFit participants. It was sent to CrossFit gyms in Rochester, New York; New York City, New York; and Philadelphia, Pennsylvania, and made available via a posting on the main CrossFit website. Participants were encouraged to distribute it further, and as such, there were responses from a wide geographical location. Inclusion criteria included participating in CrossFit training at a CrossFit gym in the United States. Data were collected from October 2012 to February 2013. Data analysis was performed using Fisher exact tests and chi-square tests.

Results:

A total of 486 CrossFit participants completed the survey, and 386 met the inclusion criteria. The overall injury rate was determined to be 19.4% (75/386). Males (53/231) were injured more frequently than females (21/150; P = .03). Across all exercises, injury rates were significantly different (P < .001), with shoulder (21/84), low back (12/84), and knee (11/84) being the most commonly injured overall. The shoulder was most commonly injured in gymnastic movements, and the low back was most commonly injured in power lifting movements. Most participants did not report prior injury (72/89; P < .001) or discomfort in the area (58/88; P < .001). Last, the injury rate was significantly decreased with trainer involvement (P = .028).

Conclusion:

The injury rate in CrossFit was approximately 20%. Males were more likely to sustain an injury than females. The involvement of trainers in coaching participants on their form and guiding them through the workout correlates with a decreased injury rate. The shoulder and lower back were the most commonly injured in gymnastic and power lifting movements, respectively. Participants reported primarily acute and fairly mild injuries.

Can anatomical morphomic variables help predict abdominal injury rates in frontal vehicle crashes?

OBJECTIVE

Abdominal injuries resulting from vehicle crashes can be significant, in particular when undetected. In this study, abdominal injuries for occupants involved in frontal impacts were assessed using crash and medical data.

METHODS

Injury rates and patterns were first assessed with respect to thoracic injuries. A statistical analysis was then conducted to predict abdominal injury outcome using 18 covariate variables, including 4 vehicle, 4 demographic, and 10 morphomic, derived from computed tomography (CT) scans. More than 260,000 logistic regression models were fitted using all possible variable combinations. The models were ranked using the Akaike information criterion (AIC) and combined through the model-averaging approach to produce the optimal predictive model. The performance of the models was then assessed using the area under the curve (AUC).

RESULTS

The rate of serious thoracic injury was 2.49 times higher than the rate of abdominal injury. The associated odds ratio was 2.31 (P <.01). These results suggest a strong association between serious abdominal and thoracic injuries. The optimal model AUC was 0.646 when using solely vehicle data, 0.696 when combining vehicle and demographic data, 0.866 when combining vehicle and morphomic data, and 0.879 when combining vehicle, demographic, and morphomic data. These results suggest that morphomic variables better predict abdominal injury outcomes than demographic variables. The most important morphomics variables included visceral fat area, trabecular bone density, and spine angulation.

CONCLUSION

This study is the first to combine vehicle, demographic, and anatomical data to predict abdominal injury rates in frontal crashes.