Category Archives: Injury
A recent report from the Institute of Medicine found that young athletes in the United States face a "culture of resistance" to reporting when they might have a concussion and to complying with treatment decisions. That culture can result in students heading back to school too quickly—when they should be resting their brains to prevent short- and long-term complications.
"The findings of our report justify the concerns about sports concussions in young people," said Robert Graham, chair of the committee and director of the national program office for Aligning Forces for Quality, at George Washington University, Washington, D.C. (Aligning Forces is a program of the Robert Wood Johnson Foundation.) "However,” says Graham, “there are numerous areas in which we need more and better data. Until we have that information, we urge parents, schools, athletic departments, and the public to examine carefully what we do know, as with any decision regarding risk, so they can make more informed decisions about young athletes playing sports."
Recently, Righttime Medical Care, a chain of urgent care centers in Maryland, opened a number of HeadFirst sports injury and concussion centers in the state, staffed with health professionals who can assess injuries for concussions as well as evaluate students for return to play—in consolation with a team of experts who work with HeadFirst staff. HeadFirst will this year be presenting and publishing data on the more than 10,000 youth it has examined and treated for concussion in just the past two years.
NewPublicHealth recently spoke with Robert Graw, MD, head of Righttime and HeadFirst, about the need for better prevention, evaluation and treatment of concussions to prevent long-term health problems and disability.
NewPublicHealth: Why did Righttime add concussion care to the services provided?
Robert Graw: My son is an orthopedic surgeon and talked to me about the number of injuries he was seeing. We decided a few years ago that we’d learn as much as we could about preventing head injury and the consequences of head injury, and then promote that information through Righttime’s call center and through the visits that people made to our sites.
In the process of learning as much as we could we realized that the knowledge base of how people evaluate and manage concussions had changed drastically in the last five years as people have done more research. So, we then gathered together a group of consultant physicians and neuropsychologists to determine best practices. We met with them frequently, and then had them train our provider staff so that all of them became much more informed about what a concussion really is, the best way to evaluate them and the guidelines for management going forward.
We hate to be the bearers of buzz kill, but folks should think about adding “safety” to their holiday wish lists this year. Researchers at the Consumer Product Safety Commission say there are about 250 injuries a day during the holiday season. Last year the most frequently reported holiday accidents seen in emergency departments involved falls (34%), lacerations (11%) and back strains (10%). And from 2009 through 2011, fire departments nationwide responded to an average of 200 fires in which the Christmas tree was the first item ignited—resulting in 10 deaths, 20 injuries and $16 million in property loss for those years. Candle-related fires during holidays between 2009 and 2011 resulted in an estimated 70 deaths, 680 injuries and $308 million in property loss.
Best tips for avoiding Holiday fires: discard sets of holiday lights with evidence of damage such as broken sockets and bare wires; water Christmas trees frequently; and always extinguish candles before leaving a room.
Here are our top five safety tips for the holidays culled from the websites of the Consumer Product Safety Commission, the American Academy of Pediatrics, the Centers for Disease Control and Prevention and the Food and Drug Administration:
Use of tourniquets—a piece of tightly tied cloth used to keep a victim with an arm or leg wound from bleeding to death—has been discouraged over the last few decades out of concern that the method can save the life, but lose the limb. But a new article in The Wall Street Journal finds that multiple examples of successful use of tourniquets on battle fields in Iraq and Afghanistan, as well as after the bombing at the Boson Marathon earlier this year, has reopened the debate. The pros and cons of tourniquet use is on the agendas of several upcoming medical meetings and preparedness conferences.
Read the full story here.
>>Bonus Link: Read a NewPublicHealth post on new approaches to teaching more people CPR.
Home fires account for 85 percent of fire deaths in the United States, yet the majority of family homes lack fire sprinklers. Since the late 1970s, a grassroots movement has successfully promoted close to 400 local ordinances that mandate fire sprinklers in all new residential construction. In response, the homebuilding industry has sought out state preemption of local authority, a strategy used by other industries as well, in an effort to reduce costs and shield profits. A new study just published in the American Journal of Public Health looks at grassroots public health movements, including the one mobilized to push back against preempting residential fire sprinklers.
To learn more about how preemption can have a negative impact on public health, NewPublicHealth spoke with Marjorie Paloma, MPH, senior policy adviser and senior program officer for the Robert Wood Johnson Foundation’s Health Group, and a co-author of the new AJPH article on preemption, grassroots efforts and public health.
NewPublicHealth: How does the effort to increase installed sprinklers in the U.S. add to the conversation on the grassroots public health movement?
Marjorie Paloma: The residential fire sprinkler story illustrates the power of grassroots movements and the chilling effect preemption can have. I use power very explicitly because when you look at the residential sprinklers movement, over time, you see how much power people have when they come together and act. Families who lost someone to fire, fire officials and others came together first in local communities and then across the nation to advocate sprinklers and save lives. The new article in the American Journal of Public Health shows that over three decades, 34 states passed legislation on this — over 350 local ordinances — and I think that this example shows you the arc of a grassroots movement. This example also shows how powerful preemptive legislation is on a grassroots movement. In those two years between 2009 and 2011, 13 states passed preemptive legislation and that essentially pulled the wind out of the sails of advocates who had been working on this issue. And, it shows you how that tactic, that strategy of preemption can really deflate, thwart, and potentially kill a movement.
NPH: How does the grassroots movement intervene and explain what the impact of preemption is on movements that promote health?
Kids and their parents aren’t the only ones who need to do some back-to-school prep as the fall term starts. A new survey of U.S. school bus drivers released by the National Association of Directors of Pupil Transportation Services (NADPTS) last week found that more than 80,000 vehicles illegally passed a stopped school bus on a single day this past year. That translates to nearly 15 million violations during the 180-day school year, according to the association.
Laws and regulations can vary somewhat by state, but generally drivers must come to a full stop when they are behind or across the street from a school bus when it has its stop sign out and its lights are flashing. The NADPTS maintains a list of state laws regarding what cars must do when they see a stopped school bus.
No one organization keeps tabs on all children injured and killed by drivers who didn’t stop for a school bus, but three children were killed in such accidents in North Carolina alone last year, bringing that state’s total of children killed in such accidents to a dozen since 1998.
“There are nearly a half million school buses on the road each day in the United States,” said Max Christensen, NADPTS president, and, “any driver who passes a stopped school bus illegally is gambling with a child’s life.” According to the association, some states are adopting more stringent safety measures, such as improved motorist education, increased fines, and more law enforcement, including the use of photo evidence in court cases from cameras mounted on the sides of school buses.
>>Recommended Reading: To help reduce the number of injuries and fatalities related to school bus accidents, the National Highway Traffic Safety Administration has a school bus safety website stocked with information.
NewPublicHealth is partnering with Grassroots Change: Connecting for Better Health to share interviews, tools, and other resources on grassroots public health. The project of the Robert Wood Johnson Foundation Health Group supports grassroots leaders as they build and sustain public health movements at the local, state and national levels.
In this excerpted Q&A, conducted by Grassroots Change, California State Fire Marshal Tonya Hoover shared her thoughts on a quiet but highly successful public health movement: fire sprinkler requirements as a cost-effective measure to reduce civilian deaths, injuries, and property damage while protecting fire fighters and the natural environment. Tonya Hoover is a 20-year veteran of the fire service and an experienced advocate for fire prevention. She has promoted residential fire sprinkler ordinances as a local fire marshal in California and a statewide requirement that went into effect on January 1, 2011.
>>Read the full Q&A on GrassrootsChange.net.
Grassroots Change: Tell us about the grassroots movement for residential fire sprinklers.
Tonya Hoover: California has seen the passage of residential sprinkler laws since the first local adoption in San Clemente in 1978. Since that time, over 160 local ordinances have passed [fire sprinkler requirements for all new construction, including 1- and 2-family homes].
Other states have also adopted residential sprinkler ordinances for many years. Residential sprinklers aren’t new. What is new is they’re getting their time in the sun with the public because we already sprinkler apartments and larger buildings. People are used to seeing sprinklers in commercial buildings and office spaces. Most apartments in California – the complexes that have been going up in the past 20-25 years – have sprinklers. We hope to get people to look up and say: “Why isn’t my house sprinklered? This is supposed to be my safe haven.”
The following post originally appeared on the Harvard Law School blog, Bill of Health, launched in September 2012 by Harvard's Petrie-Flom Center. The blog explores news, commentary, and scholarship in the fields of health law policy, biotechnology, and bioethics. This post examines the policies that impact proper use of child car seats and booster seats.
Author Kathleen West is an intern with the Public Health Law Research program. Her summer work has included researching and creating a comprehensive dataset on child restraint systems across the United States using LawAtlas, a gateway database to key laws aimed at improving our health or access to health care. Read more on LawAtlas.
As the world watched Prince William place the new royal baby, reluctantly snug in his car seat, into a vehicle a few weeks ago, my thoughts were not limited to, “Oh, how cute!” After two months researching and collecting a dataset to capture the U.S. laws and regulations for child passenger restraint systems, I also thought, “I wonder if he took a class and knows how to do that correctly?” Perhaps an odd thought, but misuse and faulty installation of child restraint systems is actually a major concern.
According to the CDC, proper restraint use can reduce the risk of death or injury by more than 50 percent. Yet, ongoing studies by the National Highway Traffic Safety Administration (NHTSA) are finding that as many as 20 percent of drivers with child passengers are not reading any of the instructions regarding proper installation, while 90 percent of drivers of child passengers are reporting that they are confident that they are properly installing and using child restraint systems.
>>NewPublicHealth continues a new series to highlight some of the best public health education and outreach campaigns every month. Submit your ideas for Public Health Campaign of the Month to info@newPublichealth.org.
“Oh my gosh, what have I done?” That’s the first question a man asked himself after he looked up from texting “I Love You” to his wife, to find that his car had crashed into a buggy carrying an Amish family and killing three of their children. That story, and three others, make up a new 36-minute video by acclaimed documentary film maker Werner Herzog, “From One Second to the Next.” The video was produced for AT&T and supported by Sprint, T-Mobile and Verizon, to show drivers of all ages what can happen when texting while driving. In the documentary, what happens is that five people die, two have their health ruined and bills pile up into the millions, and one sees his injuries put an end to his career.
Wireless firms hope to distribute the film to tens of thousands of high schools, safety organizations and through government agencies for maximum impact.
According to the National Highway Safety Administration, 3,000 people were killed in distracted driving accidents in 2011 alone. “When you get a message while driving, it’s hard not to pick up your phone,” said Herzog. “With this film, we want to help make people more aware of the potential consequences of that action.”
Britain to Regulate, Improve Quality of E-Cigarettes
The British government plan to regulate electronic cigarettes as non-prescription medicine starting in 201, according to Reuters. E-Cigarettes are battery-operated devices that contain cartridges filled with nicotine, flavor, and other chemicals. They turn nicotine, which is highly addictive, and other chemicals into a vapor that can be inhaled. The U.S. Food and Drug Administration (FDA) has warned that, "As the safety and efficacy of e-cigarettes have not been fully studied, consumers of e-cigarette products currently have no way of knowing:
- whether e-cigarettes are safe for their intended use,
- how much nicotine or other potentially harmful chemicals are being inhaled during use, or
- if there are any benefits associated with using these products."
The devices do not contain any health warnings comparable to FDA-approved nicotine replacement products or conventional cigarettes. Currently, e-cigarettes that are marketed for therapeutic purposes are regulated by the FDA. According to Reuters, "Under the new British system, manufacturers will have to prove the quality of their products and demonstrate that they deliver the correct amount of nicotine. But they will not need to conduct clinical trials." Read more on tobacco and nicotine.
Even Hands-Free Devices Create Unsafe, Distracted Driving Conditions
A new report from AAA finds that even hands-free mobile devices create mental distractions that can drain attention away from focusing on the road and safe driving. The study found that mentally-distracted drivers—those who may not have even taken their eyes off the road but were distracted by speaking with someone through a hands-free device—missed visual cues, had slower reaction times, and even exhibited a sort of "tunnel vision" by not checking side- and rear-view mirrors or actively scanning the full roadway for potential hazards. Activities like listening to the radio or an audio book was mildly distracting (but likely not enough to effect driving safety); conversing with others (whether with fellow passengers, with someone via hand-held device or with some via hands-free device) was moderately but significantly distracting; and using a device with speech-to-text technology to send text messages or e-mails was highly distracting. Researchers hope these findings can be used to help craft science-based policies on driver distraction. Read more on safety.
CDC Partners with 104 Businesses to Improve Employee Health
The Centers for Disease Control and Prevention (CDC), through its partner Viridian Health Management, has identified 104 employers in eight counties across the nation that have voluntarily chosen to participate in the National Healthy Worksite Program, a new initiative aimed at reducing chronic disease and building a healthier, more productive U.S. workforce—while also cutting health care costs. The initiative primarily focuses on small and mid-sized employers. a national evaluation will document best practices and models on how to successfully implement workplace health programs in small worksites more broadly. Read more on what businesses are doing to create healthier communities.
As school winds down and camps and sports prepare for the summer season, a new study funded by the Robert Wood Johnson Foundation and published in the American Journal of Public Health on sports-related traumatic brain injuries in youth sports, is generating deserved attention.
The study, by Hosea Harvey, JD, PhD, Assistant Professor of Law at the Temple University Beasley School of Law, found that while forty four states and Washington, D.C., passed youth sport TBI laws between 2009 and 2012, none of the laws focus on preventing the injuries in the first place. The laws on the books deal primarily with increasing coaches’ and parents’ ability to identify and respond to traumatic brain injuries and reducing the immediate risk of multiple brain injuries.
>>Read more in a Q&A with the Babe Ruth League Inc. about how youth sports leagues are making strides to prevent injuries.
Harvey’s conclusion is that continued research and evaluation is needed to develop a more comprehensive reduction in youth sport traumatic brain injuries.
NewPublicHealth: What did your study address?
Hosea Harvey: I looked at traumatic brain injury (TBI) laws that were passed at the state level that purported to deal with the problem of youth TBIs in sports statewide. I looked at every related state law passed between 2009 through the end of 2012, though most states only had one law that they passed that dealt with youth sports TBIs during that period.
NPH: And your study found that no state that right now has a law that says this is what you have to do in order to prevent these concussions in the first place?