Category Archives: Injury Prevention
Faces of Public Health: Q&A with Andrea Gielen, the Johns Hopkins Center for Injury Research and Policy
The U.S. Centers for Disease Control and Prevention (CDC) recently awarded $4 million to the Johns Hopkins Center for Injury Research and Policy at the Bloomberg School of Public Health to further fund its work on injury prevention research and policy development. According to the CDC, injuries are the leading cause of death in the United States among people ages 1 to 44, costing the country $406 billion each year. And across the globe, 16,000 people die from largely preventable injuries every day.
“This funding will allow us to advance our work in closing the gap between research and practice in new and innovative ways,” said Andrea Gielen, ScD, ScM, the center’s director. “Whether fatal or non-fatal, injuries take an enormous toll on communities. Our faculty, staff and students are dedicated to preventing injuries and ameliorating their effects through better design of products and environments, more effective policies, increased education and improved treatment.”
The five-year grant will support several innovative research projects on key issues, including evaluating motor vehicle ignition interlock laws, studying universal bicycle helmet policies, testing m-Health tools to reduce prescription drug overdose and evaluating programs to prevent falls among older adults. The center will also continue to offer training and education to public health students and practitioners, as well as to new audiences that can contribute to injury prevention.
NewPublicHealth recently spoke with Gielen about the CDC grant
NewPublicHealth: What are the goals for each of the four research areas for which you’ve received funding?
Andrea Gielen: Each of the four is a full research projects with specific aims. For example, with ignition interlock laws—which are car ignitions that can’t start unless a breathalyzer confirms that a driver is sober—there’s been a little bit of evidence that they reduce alcohol-related motor vehicle crash injuries and deaths, but there are two gaps. There has never been a national study of the impact of these laws, and we don’t know a whole lot about how they’re implemented. What is it about ignition interlock policies and how they’re implemented that’s really related to their impact on reducing fatal crashes?
We want to look at all four projects in the same way: We’ll be looking at barriers and facilitators to how policies that we think are effective are adopted and implemented, and what it is about that adoption and implementation of the processes that make these policies effective.
The start of the school year also means a return to team sports. There’s no question that playing a team sport provides clear benefits for kids, including the opportunity to develop physical fitness and other healthy habits, good sportsmanship, self-esteem and self-discipline. Kids who play sports are also less likely to engage in risky behaviors such as smoking or substance abuse.
But there is a potential dark side: An increased risk of sports-related injuries, with concussions at the top of the list of current concerns. Each year nearly 250,000 kids go to emergency departments for suspected sports-related concussions and there’s growing recognition that continuing to play with a concussion can lead to long-term effects on the brain, especially for kids. Girls also now have a higher rate of sports-related concussions than do boys, according to the Children’s Safety Network.
Because of all of these reasons there’s a major push underway to prevent concussions in all youth sports, not just in football, since concussions also commonly occur in girls’ and boys’ soccer, lacrosse, basketball and other sports, according to the American Academy of Pediatrics. In May, the White House hosted the first-ever Healthy Kids & Safe Sports Concussion Summit to promote and expand research on sports-related concussions among kids and raise awareness of steps that can be taken to help prevent, identify and respond to concussions in young athletes.
Meanwhile, the U.S. Centers for Disease Control and Prevention (CDC) launched the Heads Up: Concussion in High School Sports initiative to help coaches, athletes and parents take steps to prevent concussions and respond appropriately if they occur. Among the prevention measures being introduced are modifications to protective gear (including new helmet technology for various sports), rule changes (such as limits on heading drills in soccer practices and tackling drills in football), identifying athletes who are at risk (by looking for genetic markers of risk) and educating everyone involved with youth sports about the dangers of concussions.
There are also stricter guidelines about when it’s appropriate for athletes to return to play after a concussion, based on their physical and cognitive symptoms; concussion history; and adherence to a step-by-step process for returning to the field or court. The CDC now recommends that coaches and parents consider whether their league or school should conduct baseline testing—a pre-season exam to assess an athlete’s balance and brain function—so that if a concussion is suspected to have occurred, the baseline results can help establish the extent of the head injury.
“Players, coaches and parents are demanding that we find a way to reduce concussion risk in sports,” said Michael Sims, head athletic trainer for football at Baylor University and a board member of the National Operating Committee on Standards for Athletic Equipment. “But equipment can’t do it alone. It’s critical that safe play and return to play practices are enforced.”
Sexual assaults on college campuses have grabbed headlines in recent months and for good reason: One in five U.S. women are raped or otherwise sexually assaulted during their college years, often during their freshman or sophomore year and often by someone they know. Last winter, President Obama established the White House Task Force to Protect Students from Sexual Assault. This marked a call to action to help prevent sexual assaults on campuses; to help schools respond effectively when an assault does occur; and strengthen federal enforcement efforts, including the launch of a website to make with various resources for students and schools.
Meanwhile, various colleges and universities have stepped up their own sexual assault prevention efforts. The Indiana Campus Sexual Assault Primary Prevention Project guides Indiana colleges and universities in the prevention of sexual violence through education and technical assistance; as well as the promotion of bystander intervention skills and healthy, respectful relationships.
Earlier this year, the University of Massachusetts Amherst launched a program called UMatter at UMass, which promotes “active bystander intervention” to prevent sexual assaults. The program uses “Three Ds” to help someone who witnesses a situation where a sexual assault is threatened know what to do:
- “Direct": Stepping in and confronting dangerous behavior in a direct and clear—but non-confrontational—way
- “Distract”: Using tactics that will divert behavior before it becomes violent or harmful
- “Delegate”: Enlisting help from acquaintances or law enforcement professionals to help prevent an assault
“Our simple starting point was our determination to build a more caring community, cementing the idea that we care about each other at UMass and that we demonstrate that care without first having a crisis or tragedy,” said Enku Gelaye, vice chancellor for student affairs and campus life at UMass. “With active bystanders, we want to reinforce a culture of active engagement. This is a very specific concept. The idea is that students have to take an active role in monitoring their environment and being engaged and caring about each other.”
This week, NewPublicHealth will run a series on new and creative public health campaigns that aim to improve the health of communities across the country through the use of public service announcements, infographics and more. Stay tuned to learn more about a new campaign each day.
Each day in 2010 approximately two children ages 12 and younger were killed in car crashes and another 325 were injured. If the correct child safety seats were used and installed properly, that death rate could be cut by more than 50 percent. Proper use of car seats reduces the risk of death by 71 percent in infants and by 54 percent among toddlers ages one to four, according to the U.S. Centers for Disease Control and Prevention. Use of booster seats decreases the risk of serious injury by 45 percent among kids ages four to eight, compared to just using seatbelts in this age group.
The U.S. National Highway Traffic Safety Administration’s (NHTSA) and the Ad Council’s Child Passenger Safety campaign urges parents and caregivers of children under age 12 to secure their kids in the best possible car restraint system for their age and size.
Through a series of television, radio, print, outdoor and digital PSAs, the campaign aims to raise awareness of the importance of using the correct restraints for children, whether it’s a rear-facing car seat (for babies up to age one), a forward-facing car seat (for kids up to age five), a booster seat (for ages five to 12) or a seatbelt for older kids. The PSAs direct viewers to the Parents Central website, where they can find out whether their children are in age- and size-appropriate car seats and learn how to install the car seats properly.
Child Passenger Safety Week, from September 14-20, will also feature free car seat inspection events throughout the country to help people learn how to install and use them properly.
>>Bonus Links: Read previous NewPublicHealth coverage on child car seat safety:
EBOLA UPDATE: Spanish Priest Receives Experimental U.S. Drug
(NewPublicHealth is monitoring the public health crisis in West Africa.)
As the World Health Organization (WHO) and other public health agencies continue to debate the ethics and intricacies of using experimental treatments in response to the ongoing Ebola outbreak in West Africa, Spain has imported the U.S.-made ZMapp drug to treat a 75-year-old Spanish missionary priest who was evacuated from Liberia last week. The experimental drug, produced by Mapp Biopharmaceutical Inc. of San Diego, Calif., was previously used on two American health workers who are now being treated at an Atlanta, Ga., hospital. More than 1,000 people have been killed so far in the outbreak which began last March. Read more on Ebola.
Study: Concussions Similar No Matter their Locations
One concussion should be treated just as seriously as any other concussion no matter where on the head it occurs, according to a new study in the journal Pediatrics. Researchers determined that no matter the location, the symptoms and time away from the field were similar for high-school football players who received a concussion. Approximately 44.7 percent of concussions from player-to-player collisions occurred from front-of-the-head impacts and 22.3 percent were from side-of-the-head impacts. The researchers recommended improved education on safer “head up” tackling techniques in order to reduce student athlete concussions. Read more on injury prevention.
Pregnant Women, Fetuses Exposed to Unnecessary Antibacterial Compounds
Children of pregnant women who are exposed to certain antibacterial compounds may experience developmental and reproductive issues, according to new data presented this weekend at the American Chemical Society annual meeting in San Francisco, Calif. Researchers looked at triclosan and triclocarbon levels in the urine of 184 pregnant women, finding that all tested positive for the former and 85 percent tested positive for the latter. Triclosan was also found in more than half of the samples of umbilical cord blood. The two chemicals are found in more than 2,000 everyday consumer products, including toothpastes, soaps, detergents, carpets, paints, school supplies and toys. Researchers also found butyl paraben in more than half of the urine and cord samples; the chemical has been linked to shorter length in newborns. All three can and should be removed from household goods, according to Andrea Gore, a spokeswoman for The Endocrine Society and a professor of pharmacology and toxicology at the University of Texas at Austin. "The efficacy of these products as being helpful to human health has not been proven, but companies are adding them to products anyway," she said, according to HealthDay. "There's no downside to removing chemicals that have no proven benefit." Read more on maternal and infant health.
NCAA Reaches Preliminary Concussion Settlement, Including $70M Monitoring Program
The NCAA has reached a preliminary settlement in response to a class-action push to revise its head injury policies. The settlement includes a $70 million medical monitoring fund that would provide all former college athletes with the opportunity to receive neurological screenings, as well as a new national protocol which would require assessments by trained professionals and keep athletes from returning to games or practices the same day they suffer a head injury. “This offers college athletes another level of protection, which is vitally important to their health,” said the lead plaintiffs’ lawyer, Steve Berman, according to The New York Times. “Student-athletes—not just football players—have dropped out of school and suffered huge long-term symptoms because of brain injuries. Anything we can do to enhance concussion management is a very important day for student-athletes.” Read more on injury prevention.
Marijuana Legalization Not Linked to Rise in Teen Use
The gradual increase in marijuana use by U.S. teens over the past two decades is not linked to the legalization of medical marijuana in various states, according to a new research paper based on data from the U.S. Centers for Disease Control and Prevention. Researchers determined that the probability that a high school student had used marijuana in the previous 30 days was only 0.8 percent higher in states where use was legal. While marijuana is illegal under federal law, it has been legalized for medical purposes in 21 states and the District of Columbia, and legalized for recreational use in Colorado and Washington. "Our results are not consistent with the hypothesis that the legalization of medical marijuana caused an increase in the use of marijuana among high school students," wrote D. Mark Anderson of Montana State University, Daniel Rees of the University of Colorado and Benjamin Hansen of the University of Oregon, in the paper. Read more on substance abuse.
Study: 5-10 Minutes of Daily Running Can Add Three Years to Life Expectancy
As little as five to ten minutes of slow running every day can add up to an additional three years of life expectancy, according to a new study in the Journal of the American College of Cardiology. Researchers examined data on 55,137 adults 18-100 years of age (with a media age of 44 years), finding that running for the length of time at six miles an hour or slower was associated with markedly reduced risk of death from all causes, including heart disease. Researchers said the results should help drive inactive individuals to take up exercise programs. Read more on physical activity.
Earlier this month, following the heatstroke death of a Georgia toddler who was left in a sweltering car for hours, Tennessee became the first state in the nation to pass a law that specifically protects people from liability for forcibly breaking into cars and rescuing kids they think are at risk of heatstroke. The law requires those individuals to call 911 first and follow instructions.
Many states have Good Samaritan laws that may protect people in such instances, but the specifics vary from state to state, according to Cristina M. Meneses, JD, MS, a staff attorney with the Network for Public Health Law’s Eastern Region. A recent Today show poll found that 88 percent of the 44,000 people asked would break into a car to rescue a child they thought was in danger, but specific laws can increase the response—and potentially remove penalties—while raising awareness of the issue. More such laws could soon follow. Janette Fennell, founder and head of KidsAndCars, a nonprofit based in Kansas City, Mo., which advocates for laws that will protect kids from heat in vehicles, said she’s received inquiries from two states about those laws since Tennessee’s law was passed. Another set of laws that KidsAndCars tracks are those that penalize adults for leaving kids in cars. Nineteen states currently have such laws on the books.
“It’s a good deterrent for anyone who might think, ‘Oh, I’ll just leave them in the car for a minute,’” said Fennell, “because it’s often that minute that turns into much longer and results in injury or death.”
According to the National Highway Traffic Safety Administration (NHTSA), more than 40 kids—often under age 2—die each year of “vehicular heatstroke.” Seventeen U.S. kids have died after being left or trapped in car since the beginning of 2014. Fennell and other experts say many people just don’t realize how quickly temperatures can climb in a car, even if the window is cracked open a bit—when outside temperatures are in the low 80's, the temperature inside a vehicle can reach deadly levels in only 10 minutes, even with a window rolled down two inches. Children's bodies, in particular, overheat easily; and infants and children under four years old are at the greatest risk for heat-related illness.
NHTSA research shows that heatstroke deaths and injuries often occur after a child gets into an unlocked vehicle to play without a parent or caregiver's knowledge. Other incidents can occur when a parent or caregiver who is not used to transporting a child as part of their daily routine inadvertently forgets a child sleeping in the back.
Last week, KidsAndCars launched a petition drive to encourage NHTSA to require technology in all cars that would remind a driver that there is a child in the back. There are devices parents can install, but a 2012 study by NHTSA found that none that the agency studied were consistently effective.
“You get a warning if you don't buckle your seatbelt, leave a car door open, your gas is low or you leave your headlights on,” said Fennell. “If a child is left behind then you absolutely need a warning.”
Guidelines from NHTSA and other safety experts aimed at never leaving a child unattended in a car include:
- Make a habit of looking in the vehicle—front and back—before locking the door and walking away
- Ask childcare providers to call if a child doesn't show up for care as expected
- Put items in the back seat you’ll have to retrieve such as a purse or briefcase, or put a stuffed animal in sight of the driver to indicate there’s a child in the car.
HHS, DOJ Release ‘Roadmap’ to Prevent Elder Abuse
The U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services (HHS) have announced a new Elder Justice Roadmap to enhance elder abuse prevention and prosecution, while also highlighting the issue of elder abuse. An estimated one in 10 Americans over the age of 60 have experienced elder abuse or neglect. The Roadmap includes the DOJ’s development of an interactive, online curriculum to teach legal aid and other civil attorneys to identify and respond to elder abuse, as well as the HHS’ development of a voluntary national adult protective services data system. “Elder abuse is a problem that has gone on too long, but the Roadmap Report released today can change this trajectory by offering comprehensive and concrete action items for all of the stakeholders dedicated to combating the multi-faceted dimensions of elder abuse and financial exploitation,” said Associate Attorney General Tony West, in a release. “While we have taken some important steps in the right direction, we must do more to prevent elder abuse from occurring in the first place and face it head on when it occurs.” Read more on aging.
Study: Health Care Providers Must Do More to Ensure Pregnant Women Receive the Flu Vaccine
A new study finds that health care providers (HCPs) must do more to ensure pregnant women are vaccinated against influenza. After a review of 45 research papers, researchers determined that HCP influenza vaccine recommendations and on-site services would both help increase the current suboptimal vaccination rate. The study pointed to inadequate knowledge of the risks of influenza; doubts about vaccine safety, efficacy and benefits; and fear of adverse reactions for both the pregnant women and their unborn fetuses as barriers to vaccination. Many of the women in the review were also unaware that their pregnancies placed them at higher risk of complications from influenza. Read more on maternal and infant health.
Study: Younger Pro Pitchers at Higher Risk of Needing ‘Tommy John’ Surgery
Stephen Strasburg. Matt Harvey. Kerry Wood. All were or are hard-throwing Major League Baseball (MLB) pitchers who underwent “Tommy John” surgery early in their careers. Now, a new study from researchers at the American Orthopaedic Society for Sports Medicine indicates that entering the MLB at a younger age increases the risk of needing Tommy John surgery—which is a reconstruction of the ulnar collateral ligament in the elbow—at some point in a career. In a study of 168 pitchers who had Tommy John surgery and 178 age-matched pitchers who did not, approximately 60 percent of those who needed the surgery had it in the first five years of their career. They also had statistically more Major League experience, indicating that arm stress at a younger age heightens the risk of damage. “Having athletic trainers and team physicians closely look at when players’ pitching performance stats start to decrease may allow for steps to be taken before a surgery is needed. Our study also further highlights the need for kids not to overuse their arms early in their pitching careers,” said lead author Robert Keller, MD, of Henry Ford Hospital in Detroit, in a release. Read more on injury prevention.
HHS: $83.4M to Improve Community Access to Primary Health Care
The U.S. Department of Health and Human Services (HHS) is awarding $83.4 million to 60 Teaching Health Centers as part of the Affordable Care Act. The funds will go toward training more than 550 residents during the 2014-15 academic year, with the goal of strengthening primary care and improving access to health care in U.S. communities. Areas covered will include family medicine, internal medicine, pediatrics, obstetrics, gynecology, psychiatry, geriatrics and general dentistry. “This program not only provides training to primary care medical and dental residents, but also galvanizes communities,” said Health Resources and Services Administration Administrator Mary K. Wakefield, PhD, RN. “It brings hospitals, academic centers, health centers, and community organizations together to provide top-notch medical education and services in areas of the country that need them most.” Read more on access to care.
Community Preventive Services Task Force Recommends Universal Motorcycle Helmet Laws
Universal motorcycle helmet laws can prevent injuries and save lives while also saving communities the high health care costs associated with collisions, according to a new review of 69 studies and a separate economic review of 22 studies by the Community Preventive Services Task Force. Based on the conclusions, the task force—an independent, nonfederal, unpaid panel of public health and prevention experts—recommends all U.S. communities adopt universal helmet laws, with are more effective than no law or partial helmet laws at preventing severe injuries. The study found that the United States and other high-income communities saw substantial decreases in motorcycle-related deaths and injuries after enacting universal helmet laws, but the inverse when universal laws were repealed or replaced with other laws. Read more on injury prevention.
Study: Fungus Behind 2013 Yogurt Recall a Larger Threat than Previously Believed
The fungus behind an outbreak that led to the September 2013 recall of Chobani brand Greek yogurt is more dangerous than first believed, according to a new study in mBio, the online journal of the American Society for Microbiology. Initially the company believed that the Murcor circinelloides fungus was only a potential danger to people with compromised immune systems. However, as additional gastrointestinal were reported researchers continued their study, concluding that the “harmless” fungus was actually a strain with the ability to cause disease. “When people think about food-borne pathogens, normally they list bacteria, viruses, and maybe parasites. Fungal pathogens are not considered as food-borne pathogens. However, this incidence indicates that we need to pay more attention to fungi. Fungal pathogens can threaten our health systems as food-borne pathogens” said Soo Chan Lee of Duke University, an author on the study. Read more on food safety.
OECD: Economic Crisis Contributed to Global Obesity Crisis
More people than not in the member countries of the Organization for Economic Co-operation and Development (OECD) are obese, with the economic crisis that began in 2008 contributing even more to the overall increase in body weight and obesity, according to a new OECD report. The analysis found that many of the people and families in the countries hit hardest by the economic crisis were forced to turn to less expensive—but also less healthy—food. For example, from 2008-2009 households in the United Kingdom decreased their food expenditure by 8.5 percent in real terms, while also increasing the average calorie density of purchased foods by 4.8 percent.
Among the other findings:
- One in 5 OECD children are overweight or obese
- The obesity epidemic has spread further in the past five years, but rates have been increasing at a slower pace than before
- People with less education and lower socio-economic status are more likely to be obese, and the gap is generally larger in women
- A growing number of countries have adopted policies to prevent obesity from spreading further
Read more on obesity.
Study: 1 in 5 Medicare Patients Experience Medical Injuries
Approximately 20 percent of Medicare patients experience medical injuries, which are often not linked to any underlying disease or condition, according to a new study in the journal Injury Prevention. Typical injuries include being given the wrong medication, having an allergic reaction to a medication, or receiving any treatment that led to more complications of an existing medical problem. Using data on more than 12,500 Medicare patients who made claims between 1998 and 2005, researchers found that 19 percent experienced at least one adverse medical event and 62 percent of the injuries took place during outpatient care. The highest risks were scene in older people, men and those from lower-income backgrounds. "These injuries are caused by the medical care or management rather than any underlying disease," said lead researcher Mary Carter, director of the Gerontology Program at Towson University in Maryland. "To really improve our ability to prevent these types of adverse events, we have to focus at least as much on outpatient care as we do on inpatient care." Read more on injury prevention.
Salmonella Outbreak Causes an Additional 50 Cases; Total Now at 574
With an additional 50 cases, the salmonella outbreak linked to Foster Farms chicken that began in March 2013 now has sickened a total of 574 people, according to the U.S. Centers for Disease Control and Prevention (CDC). The CDC estimates there have been an average of eight new cases per week since an April report on the drug-resistant Salmonella Heidelberg. Thirty-seven percent of the cases have led to hospitalization and about 13 percent have developed blood infections, which is three times higher than what’s seen with typical salmonella infections. Read more on food safety.