Epidemiology of Accidental Injuries at Home and Related Risk Factors for Mortality among Older Adults in South Korea: A Retrospective Cohort Study.

Background and Objectives: Accidental home injuries among older adults are increasing globally, but reporting is limited. This study aims to establish foundational data for program development and policies to prevent accidental injuries at home in older adults by using data on the occurrence of accidental injuries at home and analyzing the risk factors of mortality due to accidental injuries among adults aged 65 years and older. Materials and Methods: This retrospective study used data from the community-based Severe Trauma Survey in South Korea. This study identified general, injury-related, and treatment-related characteristics of older adults who were transported to the emergency department with accidental injuries at home. Single-variable and multiple logistic regression analyses were used to identify risk factors for mortality after injury. Results: The majority of older adults in this study who experienced accidental injuries at home were aged 75 to 84 (42.8%) and female (52.8%), with 1465 injured from falls and slips (68.0%). Risk factors for mortality included older age (≥85 years) (ORs 2.25, 95% CI 1.47-3.45), male sex (ORs 1.60, 95% CI 1.15-2.20), mechanism of injury (falls or slips vs. contact injury, ORs 6.76, 95% CI 3.39-13.47; airway obstruction vs. contact injury, ORs 13.96, 95% CI 6.35-30.71), higher severity (moderate vs. mild, ORs 2.56, 95% CI 1.45-4.54; severe vs. mild, ORs 12.24, 95% CI 6.48-23.12; very severe vs. mild, ORs 67.95, 95% CI 38.86-118.81), and receiving a blood transfusion (ORs 2.14, 95% CI 1.24-3.67). Conclusions: Based on these findings, the home and community environments where older adults live should be inspected and monitored, and in-home accidental injury prevention strategies should be developed tailored to the characteristics of older adults' risk factors and their injury-related characteristics.

Epidemiological analysis of burn injuries in children during the first COVID-19 lockdown, and a comparison with the previous five years.

BACKGROUND: Child burns rank among the most frequent domestic accidents in France. COVID-19 lockdown between March 16th and May 11th of 2020 increased time spent at home by children. MATERIAL: This retrospective, observational study described the epidemiological impact of COVID-19 lockdown on child burns in a pediatric surgery department compared with previous five years. Child burns in the previous five years constituted the "before COVID-19 group" as the reference group. Child burns during the first lockdown formed the "COVID-19 group". Demographics characteristics, the delay before first attendance at the surgery department, burns characteristics, the place of the incident, need of skin graft, and child reactions to trauma or isolation were recorded for these two groups. RESULTS: A total of thirty-seven children were included, 16 of them in the COVID-19 group. In the COVID-19 group, burned children were mainly boys, with a median age of 18 months. The median time before first attendance was four days. Main burns characteristics were to be deep partial thickness burns, involved lower limbs, caused by scalding. All burns occurred at home. Half parents reported child reactions to trauma or isolation among their children before burn injury. CONCLUSION: The incidence of child burn injuries in the COVID-19 group was higher compared to the before COVID-19 group, but no increased delay to attendance recorded. Time spent at home and psychosocial impact of lockdown might partially explain this high incidence rate of child burns. LEVEL OF EVIDENCE: IV.

Dog leash-related injuries treated at emergency departments.

BACKGROUND: Although dog ownership may provide health benefits, interactions with dogs and their leashes can result in injuries. The intent of this study was to describe dog leash-related injuries treated at United States (US) emergency departments (EDs). METHODS: Cases were dog leash-related injuries during 2001-2018 reported to the National Electronic Injury Surveillance System (NEISS), from which national estimates of dog leash-related injuries treated at US EDs were calculated. The distribution of the cases and estimated number of dog leash-related injuries was determined for selected variables, such as the circumstances of the injury, patient demographics, and diagnosis. RESULTS: A dog leash was involved in 8189 injuries, resulting in a national estimate of 356,746 injuries and an estimated rate of 63.4 injuries per 1,000,000 population. Of these injuries, 193,483 resulted from a pull, 136,767 from a trip/tangle, and 26,496 from other or unknown circumstances. The total injury rate per 1,000,000 population increased from 25.4 in 2001 to 105.5 in 2018. Adults accounted for 314,712 (88.2%) of the patients; 260,328 (73.0%) of the patients were female. The injury occurred at home in 133,549 (37.4%) cases. The most common injuries were 95,677 (26.8%) fracture, 92,644 (26.0%) strain or sprain, and 62,980 (17.7%) contusions or abrasions. CONCLUSION: The most common type of dog leash-related injuries resulted from a pull followed by a trip/tangle. The number of dog leash-related injuries increased during the time period. The majority of the persons sustaining such injuries were adults and female. Over one-third of the injuries occurred at home.

Varying Effect of a Randomized Toddler Home Safety Promotion Intervention Trial by Initial Home Safety Problems.

OBJECTIVES: Toddlers are vulnerable to unintentional injuries. A safety intervention targeting low-income families of toddlers, was effective at improving home safety. The current study examined whether the effect varies by initial home safety problems. METHODS: 277 mother-toddler dyads recruited in the Mid-Atlantic region of the United States during 2007-2010 were randomized into safety promotion (n = 91) or attention-control groups (n = 186). Observers rated participants' homes with a 9-item safety problem checklist at baseline, and at 6- and 12-months follow-up. Initial home safety problems were categorized as multiple (≥ 4 problems) and none/few (< 4). Linear mixed models assessed the moderating effect with a three-way interaction (time, intervention, and initial safety problems). RESULTS: At 12 months, the intervention effect was stronger among families with multiple initial problems than no/few initial problems, with a reduction of 1.55 more problems among the families with multiple problems, compared to the families with no/few problems (b = - 1.55, SE = 0.62, p = 0.013). CONCLUSIONS: Interventions targeting families with multiple safety problems may be more effective than universal programming.

Characteristics of indoor injuries in hotels compared to home among young children.

BACKGROUND: Although attention has recently been afforded to home injury prevention for young children, we often encounter young children who have experienced indoor injuries at places other than the home. We aimed to identify characteristics of unintentional indoor injuries that occurred when young children were not at home. METHODS: We retrospectively reviewed the medical records of young children (aged <6 years) with indoor injuries from January to June 2017. We classified patients injured in hotel rooms as the "Hotel group" and compared them to patients injured at home ("Home group"). RESULTS: Among 102 patients who met the study criteria, 33 patients (32.4%) were classified as the Hotel group. Falls were the most frequent cause of injury in both groups (Home, 56.5% versus Hotel, 87.9%). Falls from beds were more likely to happen in hotel rooms (1.4% versus 48.5%). In regard to fall-associated injuries, head and / or facial injury was most frequent in both groups (Home, 92.3% versus Hotel, 89.7%). A suture and follow-up were less likely in the Home group than in the Hotel group (18.8% versus 42.4%, 39.1% versus 69.7%, respectively). CONCLUSIONS: In hotel rooms, head and / or facial injuries due to falling from a bed were the most common types of injury, and they often needed more invasive procedures than home injuries. Injuries that tended to occur in hotel rooms are more predictable than home injuries. Modification of the surrounding environment has the potential to prevent unintentional injuries not only in the home environment but also in hotel rooms.

Life stress and uncertainty stress: which is more associated with unintentional injury?

Injury is a serious public health problem with significant social and economic costs. Prior studies reported an association between mental stress and unintentional injury. However, no comparable studies have examined uncertainty stress, along with other types of stress, and their relative impact upon unintentional injury. The purpose of this study was to assess the salience of uncertainty stress as a predictor. Participants were 11,954 students, who were identified through a multistage sampling process that incorporated 50 universities. Stress and unintentional injury status were obtained by self-report. Both unadjusted and adjusted methods were considered in the analyses. Based on a retrospective 12-month reporting window, 12.6% of the respondents had experienced traffic injury, 21.4% home injury, 15.2% work-related injury, and 23.1% sports injury. The multivariable logistic regression model found that uncertainty stress was associated with all categories of unintentional injury, while life stress only was related to traffic injury. These findings underscore the importance of minimizing uncertainty stress and can inform pertinent policies and reinforce the need for uncertainty stress management in China.

[Development and performance test of the environment scale of unintentional injury in the home for children aged 0-6 years old in urban area of China].

Objective: To develop the environment scale of unintentional injury in the home for children aged 0-6 years living in urban area of China, and test its validity and reliability. Methods: The content of the environment scale was established through the literature review, expert consultation and pilot study. A total of 1 104 children aged 0-6 years in urban area of Changsha were enrolled in this study by using a multi-stage stratified cluster random sampling method. The questionnaire was used to collect the basic information of children, the incidence of unintentional injury and the status of home environment. The reliability of the scale was tested by using Cronbach's α coefficient and split-half reliability coefficient. The content validity and construct validity were tested by using Pearson correlation analysis and factor analysis. All children were divided into two groups according to the incidence of unintentional injury in the home and the discrimination validity of the scale was tested by using t-test. Results: The scale had 54 items in 6 dimensions. The number of eligible questionnaires was 1 074, including 554 (51.6%) from boys and 519 (48.3%) from children under 3 years old. The incidence rate of unintentional injury and in-home injury was 18.34% (197 children) and 10.71% (115 children). The internal consistency reliability (Cronbach's α) coefficient for the scale was 0.87 and the split-efficacy reliability coefficient was 0.82, both meeting the standard of reliability above 0.70. The Pearson correlation coefficient between each dimension and the whole scale ranged from 0.53 to 0.84 (all P values <0.001). The common factor cumulative variance contribution rate of the scale was 58.34%. There were 54 items with factor loadings greater than 0.30. The root mean square error of approximation, comparative fit index and goodness-of-fit index were 0.07, 0.61 and 0.71, respectively. The score of scale in children with injury was significantly higher than that in children without injury (P=0.022). Conclusion: The validity and reliability of the environment scale for unintentional injury in the home for children aged 0-6 years old in the urban area of China are good.

Multifactorial falls prevention programmes for older adults presenting to the emergency department with a fall: systematic review and meta-analysis.

OBJECTIVE: To determine whether multifactorial falls prevention interventions are effective in preventing falls, fall injuries, emergency department (ED) re-presentations and hospital admissions in older adults presenting to the ED with a fall. DESIGN: Systematic review and meta-analyses of randomised controlled trials (RCTs). DATA SOURCES: Four health-related electronic databases (Ovid MEDLINE, CINAHL, EMBASE, PEDro and The Cochrane Central Register of Controlled Trials) were searched (inception to June 2018). STUDY SELECTION: RCTs of multifactorial falls prevention interventions targeting community-dwelling older adults ( ≥ 60 years) presenting to the ED with a fall with quantitative data on at least one review outcome. DATA EXTRACTION: Two independent reviewers determined inclusion, assessed study quality and undertook data extraction, discrepancies resolved by a third. DATA SYNTHESIS: 12 studies involving 3986 participants, from six countries, were eligible for inclusion. Studies were of variable methodological quality. Multifactorial interventions were heterogeneous, though the majority included education, referral to healthcare services, home modifications, exercise and medication changes. Meta-analyses demonstrated no reduction in falls (rate ratio = 0.78; 95% CI: 0.58 to 1.05), number of fallers (risk ratio = 1.02; 95% CI: 0.88 to 1.18), rate of fractured neck of femur (risk ratio = 0.82; 95% CI: 0.53 to 1.25), fall-related ED presentations (rate ratio = 0.99; 95% CI: 0.84 to 1.16) or hospitalisations (rate ratio = 1.14; 95% CI: 0.69 to 1.89) with multifactorial falls prevention programmes. CONCLUSIONS: There is insufficient evidence to support the use of multifactorial interventions to prevent falls or hospital utilisation in older people presenting to ED following a fall. Further research targeting this population group is required.

Knowledge of childhood burn risks and burn first aid: Cool Runnings.

AIM: The high incidence of hot beverage scalds among young children has not changed in the past 15 years, but preventive campaigns have been scarce. A novel approach was used to engage mothers of young children in an app-based hot beverage scald prevention campaign 'Cool Runnings'. This paper provides baseline data for this randomised controlled trial (RCT). METHOD: Queensland-based mothers aged 18+ years with at least one child aged 5-12 months were recruited via social media to Cool Runnings, which is a two-group, parallel, single-blinded RCT. RESULTS: In total, 498 participants from across Queensland completed the baseline questionnaire. The most common source of burn first aid information was the internet (79%). One-third (33%) correctly identified hot beverage scalds as the leading cause of childhood burns, 43% knew the age group most at risk. While 94% reported they would cool a burn with water, only 10% reported the recommended 20min duration. After adjusting for all relevant variables, there were two independent predictors of adequate burn first aid knowledge: first aid training in the past year (OR=3.32; 95% CI 1.8 to 6.1) and smoking status (OR=0.17; 95% CI 0.04 to 0.7). CONCLUSION: In this study, mothers of young children were largely unaware how frequently hot beverage scalds occur and the age group most susceptible to them. Inadequate burn first aid knowledge is prevalent across mothers of young children; there is an urgent and compelling need to improve burn first aid knowledge in this group. Given the high incidence of hot beverages scalds in children aged 6-24 months, it is important to target future burn prevention/first aid campaigns at parents of young children. TRIAL REGISTRATION NUMBER: ACTRN12616000019404; Pre-results.

Injury patterns and mechanisms related to refrigerator and freezer utilization in the United States.

INTRODUCTION: Refrigerators and freezers (R/F) are a common household item and injury patterns associated with these appliances are not well characterized. We aimed to characterize the injury patterns, mechanisms, and affected body parts in patients treated in the emergency departments nationally, hypothesizing that injury patterns would differ by age group. METHODS: A retrospective review of the National Electronic Injury Surveillance System for all patients injured using R/F during 2010-2016 was performed. Patient narrative was reviewed for injury mechanism. Comparative and multivariable analyses were performed with effects reported as odds ratios with 95% confidence intervals (CI). RESULTS: During the study period (January 1, 2010-December 31, 2016) there were 6913 R/F related injuries. The study cohort was predominantly male 3734 (55%) and the median [IQR] age was 38 [22-56] years. The annual frequency of R/F related injuries was stable between years. The most common injury mechanism was falling while using R/F (31%) followed up injuries sustained while moving the appliance (25%). Teenaged patients more frequently struck the appliance compared to adults (39% vs 14%, p < 0.001). On regression, pediatric and elderly patients, mechanical fall mechanism, and cranial injury were risk factors independently associated with the need for hospitalization. CONCLUSIONS: Falls in proximity to R/F were the most common injuries sustained and teenagers were more likely to strike/punch the appliance. Injury prevention efforts should support ongoing efforts of fall risk reduction for elderly populations. LEVEL OF EVIDENCE: IV. STUDY TYPE: Retrospective.

Unsafe storage of household medicines: results from a cross-sectional study of four-year-olds from the 2004 Pelotas birth cohort (Brazil).

BACKGROUND: Unintentional child poisoning represents a significant public health problem across the globe, placing a substantial burden on health services emergency departments. Around the world, every year, thousands of children die as a result of physical injuries, most of which involve children under 5 years old. Medicines are the main products involved in poisoning, and children under 5 years old are the most vulnerable age group. The objective of this study was to measure the prevalence of unsafe storage of medicines in households with a 4-year-old child. METHODS: We used data from the follow-up of 4-year-old in the 2004 Pelotas Birth Cohort Study in Brazil (N = 3799). "Unsafe storage" was considered present when medicines were stored unlocked and within reach of children (at a height below the eye level of the average adult). Independent variables included maternal and family socioeconomic and demographic characteristics and the child's health care. All information was collected during household interviews with the mothers using a standardized questionnaire. The overall prevalence rate with a 95% confidence interval (95% CI) and the prevalence associated with various independent variables were determined. RESULTS: The storage of medicines in unlocked areas was reported by 80.9% of the mothers, and, within reach of children for 26.5%. The overall prevalence rate of unsafe storage of medicines was 21.4% (20.1-22.7%). The main storage locations used were the kitchen (57.0%) and bedroom (53.3%). CONCLUSIONS: The results indicate that medicines were unsafely stored in a 21.4% number of homes, which can contribute to the vulnerability of children to poisoning from medicines. To minimize this risk, education about the safe storage of medicines should be reinforced by health professionals.

Accidental Infant Suffocation and Strangulation in Bed: Disparities and Opportunities.

Objectives (a) Update previous descriptions of trends in ASSB; (b) determine if factors previously associated with ASSB are replicated by updated data; and (c) generate new hypotheses about the occurrence of ASSB and racial inequalities in ASSB mortality. Methods National Center for Health Statistics files (International Classification of Diseases, Tenth Edition) Code W75 to describe race-ethnicity-specific ASSB occurrence. Results (a) ASSB mortality continues to increase significantly; for 1999-2016, 4.4-fold for NHB girls (45.8 per 100,000 in 2016), 3.5-fold for NHB boys (53.8), 2.7-fold for NHW girls (15.8) and 4.0-fold for NHW boys (25.9); (b) F actors previously associated with ASSB (unmarried mothers and mothers with low educational attainment, low infant birth weight, low gestational age, lack of prenatal care, male infant, multiple birth, high birth order) continue to be associated with both overall ASSB and inequalities adversely affecting NHB; (c) (1) geographic differences and similarities in ASSB occurrence support hypotheses related to positive deviance; (2) lower ASSB mortality for births attended by midwives as contrasted to physicians generate hypotheses related to both medical infrastructure and maternal engagement; (3) high rates of ASSB among infants born to teenage mothers generate hypotheses related to the possibility that poor maternal health may be a barrier to ASSB prevention based on education, culture and tradition. Conclusions for Practice These descriptive data may generate new hypotheses and targets for interventions for reducing both ASSB mortality and racial inequalities. Analytic epidemiologic studies designed a priori to do so are required to address these hypotheses.

International Epidemiological Differences in Acute Poisonings in Pediatric Emergency Departments.

BACKGROUND AND OBJECTIVE: Identifying international differences in the epidemiology of acute poisonings in children may help in improving prevention. We sought to evaluate the international epidemiological differences in acute poisonings in children presenting to emergency departments (EDs) from 8 different global regions. METHODS: This was an international multicenter cross-sectional prospective study including children younger than 18 years with acute poisonings presenting to 105 EDs in 20 countries was conducted. Data collection started at each ED between January and September 2013, and continued for 1 year. RESULTS: During the study period, we registered 363,245 pediatric ED presentations, of which 1727 were for poisoning (0.47%; 95% confidence interval, 0.45%-0.50%), with a significant variation in incidence between the regions. Full data were obtained for 1688 presentations. Most poisonings (1361 [80.6%]) occurred at home with either ingestion (1504 [89.0%]) or inhalation of the toxin (126 [7.6%]). Nonintentional exposures accounted for 1157 poisonings (68.5%; mainly in South America and Eastern Mediterranean region), with therapeutic drugs (494 [42.7%]), household products (310 [26.8%]), and pesticides (59 [5.1%]) being the most common toxins. Suicide attempts accounted for 233 exposures (13.8%; mainly in the Western Pacific region and North America), with therapeutic drugs (214 [91.8%], mainly psychotropics and acetaminophen) being the most common toxins. Significant differences between regions were found in both types of poisonings. Recreational poisonings were more common in Europe and Western Pacific region. No patient died. CONCLUSIONS: There are substantial epidemiological differences in acute poisonings among children in different countries and regions of the globe. International best practices need to be identified for prevention of acute poisonings in childhood.

Gender, socioeconomic, medical, and environmental factors related to domestic accidents of the elderly in Spain. Findings of a national survey.

Domestic accidents pose serious threats to the independence of the elderly. We explored associations between domestic accidents and gender, socioeconomic, medical, and environmental factors using data from the European Health Survey 2014 for elderly Spanish female and male nationals. Records of 5960 participants (mean age ± SD: 75.9 ± 7.6 years), 59.8% of whom were women, were examined. Domestic accidents occurred in 460 (7.1%) seniors, predominately in women (78.5%). Age (adjusted odds ratio [aOR]: 1.02 [95% confidence interval [CI]: 1.00-1.03, p = .003], female gender (aOR 2.04 [95% CI 1.60-2.60, p < .001]), difficulty managing 12 stairs (reference: none) (some: aOR 2.03 [95% CI 1.53-2.68, p < .001]; much: aOR 2.88 [95% CI 2.15-3.87, p < .001]; inability: aOR 3.09 [95% CI 2.14-4.45, p < .001]), and depressive symptoms severity (reference: absent) (mild: aOR 1.44 [95% CI 1.10-1.89, p = .008]; moderate: aOR 1.91 [95% CI 1.35-2.71, p < .001];. Very severe: aOR 2.53 [95% CI 1.72-3.71, p < .001]; extremely severe: aOR 2.38 [95% CI 1.45-3.93, p = .001]) were independently associated with domestic accidents. Severity of depressive symptoms was the most prominent feature for women, while inability to manage 12 stairs was the most prominent for men. Our results suggest important gender differences in factors associated with domestic accidents that are relevant to intervention and preventive programs.

Patterns of burns and scalds in Mongolian children: a hospital-based prospective study.

OBJECTIVE: To describe the circumstances of burn injury occurrence among Mongolian children and the products involved. METHODS: Study participants were children aged 15 years and younger who were admitted to the Burn Unit of the National Trauma Orthopedic Research Center from August 2015 to July 2016. We collected data on participant demographics and the aetiology and clinical features of their burn injuries, and we analysed the data based on the NOMESCO Classification model. FINDINGS: Of 906 children, 83% were aged 0-3 years, 66% were injured around the cooking area in the traditional tent-like dwelling called a ger or a detached house where no specified kitchen exists, and 28% were injured in a kitchen. Burn injuries resulted mostly from exposure to overflowing hot liquids (93%). Electric pots and electric kettles were the products most frequently involved in causing burn injuries (41% and 14%, respectively). Of 601 major burn injuries, 52% were due to electric pots. Moreover, burn injuries inflicted by electric pots were most likely to be major burn injuries (83%). Children typically fell into electric pots, while electric kettles were often pulled down by children. CONCLUSION: Burn injuries among Mongolian children mainly occurred in cooking area of a ger involving electric pots. The current practice of cooking on the floor should be reconsidered for child burn prevention.

Surveillance of paediatric exposures to liquid laundry detergent pods in Italy.

OBJECTIVE: To analyse paediatric exposures to pod and traditional laundry detergents in Italy and changes in exposure trends. METHODS: Analyses of a series of patients aged <5 years and exposed to laundry detergents between September 2010 and June 2015, identified by the National Poison Control in Milan. RESULTS: In comparison with patients exposed to traditional laundry detergents (n=1150), a higher proportion of those exposed to pods (n=1649) were managed in hospital (68% vs 42%), had clinical effects (75% vs 22%) and moderate/high severity outcomes (13% vs <1%). Exposure rates were stable over time for traditional detergents (average 0.65 cases/day), but an abrupt decline in major company pods was seen in December 2012, 4 months after the introduction of opaque outer packaging (from 1.03 to 0.36 cases/day and from 1.88 to 0.86 cases/million units sold). The odds of clinical effects was higher for exposure to pods than for traditional detergents (OR=10.8; 95% CI 9.0 to 12.9). Among patients exposed to pods, the odds of moderate/high severity outcomes was four times higher for children aged <1 years than for the other age groups (OR=3.9; 95% CI 2.2 to 7.0). Ten children exposed to laundry detergent pods had high severity outcomes while no children exposed to traditional laundry detergents developed high severity effects. CONCLUSIONS: The study confirms that exposure to laundry detergent pods is more dangerous than exposure to traditional detergents. In Italy, 4 months after the introduction of opaque outer packaging by a major company, product-specific exposure rates decreased sharply, suggesting that reducing visibility of laundry detergent pods may be an effective preventive measure. Further efforts are needed to improve safety.

Weekend woodsmen: Overview and comparison of injury patterns associated with power saw and axe utilization in the United States.

INTRODUCTION: Power saw and axe injuries are associated with significant morbidity and are increasingly managed in the emergency department (ED). However, these injuries have not been summarily reported in the literature. We aim to evaluate and compare the common injury patterns seen with use of power saws and axes. MATERIALS AND METHODS: Data from the National Electronic Injury Surveillance System- All Injury Program (NEISS-AIP) database was analyzed during 2006 to 2016. All patients with nonfatal injuries relating to the use of power saws or axes were included. Baseline demographics type and location of injuries were collected. Descriptive statistical analyses were performed using Chi Square or Fisher's exact test. RESULTS: Information on (n = 18,250) patients was retrieved from the NEISS-AIP database. Injuries were caused by power saw n = 16,384 (89%) and axe n = 1866 (11%) use, and mostly involved males (95%). The most frequently encountered injury was laceration axe n = 1166 (62.5%); power saw n = 11,298 (68.9%). Approximately half of all injuries in both groups involved the fingers and hand. Most injuries occurred at home (65%) and were attributed to power saw use (89%). CONCLUSIONS: Power saws and axes can cause significant injuries, the majority of which occurred at home and were primarily associated with power saw use. Lacerations and injuries to the finger and hand were prevalent in both study groups. Further research into power saw and axe injuries should place emphasis on preventative measures and personal protective equipment (PPE). LEVEL OF EVIDENCE: IV Study type: Retrospective review.

Lawn mower injuries presenting to the emergency department: 2005 to 2015.

OBJECTIVE: The objective of this study was to describe recent trends in the epidemiology of lawn mower injuries presenting to the Emergency Department in the United States using nationally representative data for all ages. METHODS: Data for this retrospective analysis were obtained from the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS), for the years 2005-2015. We queried the system using all product codes under "lawn mowers" in the NEISS Coding Manual. We examined body part injured, types of injuries, gender and age distribution, and disposition. RESULTS: There were an estimated 934,394 lawn mower injuries treated in U.S. ED's from 2005 to 2015, with an average of 84,944 injuries annually. The most commonly injured body parts were the hand/finger (22.3%), followed by the lower extremity (16.2%). The most common type of injury was laceration (23.1%), followed by sprain/strain (18.8%). The mean age of individuals injured was 46.5 years, and men were more than three times as likely to be injured as women. Patients presenting to the ED were far more likely to be discharged home after treatment (90.5%) than to be admitted (8.5%). CONCLUSION: Lawn mowers continue to account for a large number of injuries every year in the United States. The incidence of lawn mower injuries showed no decrease during the period of 2005-2015. Preventative measures should take into account the epidemiology of these injuries.

Cognitive functioning, subjective memory complaints and risky behaviour predict minor home injuries in elderly.

INTRODUCTION: Home accidents are one of the major causes of death, particularly in older people, young children and women. AIMS: The first aim of this study was to explore the role of subjective memory complaints, cognitive functioning and risky behaviour as predictors of home injuries occurred in a year in a sample of healthy Italian older adults. The second aim was to investigate the role of risky behaviour as a mediator in the relationship between subjective and objective cognitive functioning and home injuries. METHODS: One hundred thirty-three community-dwelling older people from southern Italy were administered a battery of tests to evaluate cognitive functioning, subjective memory complaints, and risky behaviour during home activities. Risky behaviour was evaluated using the Domestic Behaviour Questionnaire, created specifically for this purpose. The number of home injuries was recorded for a year throughout monthly telephone interviews. A path analysis was performed to test the following model: cognitive functioning and subjective memory complaints directly influence risky behaviour and number of accidents over a year; risky behaviour mediates the impact of cognitive functioning and subjective memory on number of accidents over a year. RESULTS: Path analysis confirmed the model tested except the role of risky behaviour as a mediator between cognitive functioning and home accidents. DISCUSSION: Risky behaviour could represent a further risk factor in cognitively intact older adults with subjective memory complaints. CONCLUSIONS: The assessment of both cognition and behaviour in elderly can make a valuable contribution in preventing home accidents in elderly.

Child understandings of the causation of childhood burn injuries: Child activity, parental domestic demands, and impoverished settings.

BACKGROUND: Burns are a global public health problem. In South Africa, the rate of paediatric burn deaths is 5 times higher than other upper middle-income countries, with concentrations in impoverished settings. Globally, the majority of research focuses on expert and caregiver descriptions of burn occurrence, causation, and prevention, with limited consideration of children's perspectives. This study investigated children's understanding of the causation and prevention of childhood burns. METHODS: Data were collected from eighteen 10- to 11-year-old children living in selected impoverished, fire-affected neighbourhoods in Cape Town, through 3 isiXhosa focus groups. All focus groups were transcribed, coded, and analysed for emerging themes through thematic analysis. RESULTS: Themes regarding burn causation and risks centred around 4 themes: (a) developmental limits in context; (b) domestic chores, child capacity, and inability to say "no"; (c) inadequate supervision and compromised caregiving; and (d) unsafe structures. Child accounts of prevention pertained to (e) burn injury prevention activities in comprised environments and emphasized child agency, and upgrading the physical environment. CONCLUSION: The children in this study ascribed burn injuries as the consequence of their developmental limits in the context of poverty, constraints on parental supervision, and unsafe environments. The children recommended safety education and upgrading their physical environments as part of burns injury prevention. The child accounts offer useful insights to inform safety interventions in impoverished settings.