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OIPRC - Fundamentals for Injury Prevention Practitioners - for personal educational use only

A presentation of

Ontario Injury Prevention Resource Centre

Supporting practitioners to reduce injury in Ontario

www.oninjuryresources.ca


Fundamentals for Injury Prevention Practitioners

Module 2 Common Types of Injuries

and their Risk Factors


Common Causes of Injury Identified by looking at:

• emergency department (ED) visits

• hospitalizations

• fatalities


Common Causes of Injury These include:

Falls

Motor vehicle crashes

Pedestrian incidents

Sport & recreation

Suffocation/breathing incidents

Poisoning

Off-road vehicles

Unintentional Injuries Intentional Injuries

Violence

Self-harm and suicide

*based on 2007-2009 Ontario data


Identifying Risk Factors

Risk factors help identify high risk groups and individuals, so resources can be directed appropriately.

Research sheds light on risk factors for each type of injury.


Age as a Risk FactorAge is an important consideration for discussing risk factors.

Individual, social and environmental changes occur as we age, affecting exposure to risk.

Some practitioners work according to life stage rather than

cause of injury (e.g. child injury prevention vs. road safety)


Falls


Each age group has unique risk factors:

Falls

Children

Teens

Adults

Older Adults


Falls in Children Risk Factor Description

Natural CuriosityNatural curiosity about the environment. Inexperience assessing risks.

Young Age Greater risk for younger children aged 0 - 6.

Low Socioeconomic Status (SES)

Greater risk for children coming from a lower SES.

Play EquipmentRisk impacted by level of maintenance, height, surfaces, and level of active supervision.

Home Environment Risk impacted by furniture placed near windows, the appropriate use of stair and window guards, and level of active supervision.

Sex Greater risk for boys than girls.


Falls in TeensRisk Factor Description

Increase in Risk Taking Behaviour

Teens show an increase in risk-taking behaviour.

Substance Use Teens may begin using alcohol or other drugs.

Work ConditionsBeginning of working years. Workplace risks include tripping hazards and heights.

Sport and RecreationParticipation in sports and recreational activities, particularly involving skates, skis, rollerblades, etc.


Falls in AdultsRisk Factor Description

Risk Taking Behaviour Varying levels of risk-taking behaviour among adults.

Substance Use Alcohol and other drug use can contribute to fall risk.

Unsafe Work Conditions Work conditions include using heavy or tall equipment.

Environmental Hazards Outdoor hazards include ice, snow, and poorly maintained public spaces. Indoor hazards include clutter and stairs.


Falls in Older Adults❖ High prevalence of falls in this age group (65 & over).

❖ High risk of injury after a fall in frail older adults.

❖ Risk factors and prevention strategies have been extensively researched.

Four categories of risk factors:

Biological

Behavioural

Social/economic

Environmental


Falls in Older Adults

Biological • Mobility (balance, gait, weakness) • Chronic disease (diabetes, arthritis) • Visual impairment • Acute illness

Behavioural • History of falling • Fear of falling • Taking multiple medications • Lack of exercise • Poor nutrition

Social/Economic • Living alone • Lack of social support • Lack of appropriate transportation

Environmental • Building maintenance • Home hazards (loose rugs, pets) • Uneven surfaces


Motor Vehicle Crashes


Risk factors can be grouped in

categories4




1Factors influencing

exposure




involvement in a crash




crash severity




post-crash injury severity



Factors influencing

post-crash injury severity

crash severity

involvement in a crash

exposure


ExposureFactors influencing exposure to on-road risk:

Risk Factor Description

Age Younger drivers are at higher risk.

Motorization More cars on the road correlate to more injuries.

Urban Planning Mixture of heavy traffic in highly populated areas. Lack of space for pedestrians and cyclists.


InvolvementFactors influencing involvement in a road crash:


Speed Driving at high speeds increases risk.

Driver Impairment Impaired driving includes alcohol, drug use, and fatigue.

Distraction Driver inattention.

Weather Conditions Poor weather contributes to increased likelihood of a crash.


Crash severityFactors influencing road crash severity:


In-car Protection Availability and appropriate use of air bags, seatbelts and child restraints.

Excessive Speed Higher speeds correlate to more severe incidents.

Roadside Objects The presence or absence of roadside objects (e.g. trees, poles, signs).


Post-crash injury severityFactors influencing post-crash injury severity and recovery (injury outcome):


Emergency Response Time Time and quality of response (e.g. access to EMS, pre-hospital care, access to trauma care).

Vehicle factors Design of the vehicle (e.g. type and size)


Pedestrian Injuries


Pedestrian Injuries Risk Factor Description

Alcohol Use Alcohol use by either pedestrian or driver.

High Speeds Driving at high speeds increases the chance of pedestrian injuries.

Urban Areas Traffic-heavy urban areas increase risk.

Age - Children Children are at higher risk.

Age - Older Adults Older adults are at higher risk.


Sports & Recreation


Risk factors for sport and recreation injuries are usually described as

or

intrinsic

extrinsic

Sports & Recreation


Sports & Recreation

intrinsic

extrinsic

factors relate to the individual

factors relate to the environment


Sports & Recreation

Intrinsic Risk Factor Description

Previous Injury Those with previous injuries are more likely to be re-injured.

Physical Growth Characteristics

Physiological factors related to growth (e.g. muscle and bone development processes).

Fitness Level Level of fitness (cardiovascular, muscular, balance) and type of activity.


Sports & Recreation

Extrinsic Risk Factor Description

Protective Equipment Proper use of protective equipment, including its condition and compliance with safety regulations.

Rules The rules of a game or activity can impact risk.

Culture The culture of a game or activity can impact risk.

Coaching Impact through the culture of the team, direction of practice and play, and tolerance to injury.


Breathing IncidentsSuffocation &



Age Young children and adults over 65 are at higher risk.

Sleep Environment

Children: Characteristics include loose blanketing, pillows and unsafe sleep positions.

Older adults in hospitals or nursing home may be exposed to risk of entrapment in bedrails.

Breathing IncidentsSuffocation &


Poisoning



AgeChildren are at higher risk, mainly due to curiosity and inexperience with harmful substances.

EnvironmentFactors include storage of medication and other harmful household substances.

Poisoning


Off-Road Vehicles


Off-Road Vehicles

Risk Factors Description

Sex Males are more likely to experience an injury than females.

Age Children under age 16 experience a high risk.

ATV Use on Roadways The majority of ATV injuries occur on roadways, and involve collision with another vehicle.

❖ Off-road vehicles include ATVs, boats and aircrafts.

❖ Most ED visits and hospital admissions for off-road incidents

are due to ATV use.

Risk factors for ATV-related injuries:


Suicide and Self-Harm


Suicide and Self-HarmResearch has allowed us to gain a better understanding of this issue.

This research is correlational; no one factor or combination of factors causes this behaviour.

There are important distinctions between suicide and self-harm. For more information: OIPRC’s Ontario Regional Injury Data Report (linked below the module).

The risk factors included here pertain to suicide.

Suicide and Self-Harm



Mental Illness Presence of a mental illness, particularly mood disorders.

Previous Suicide Attempt Having made a previous suicide attempt is a strong risk factor.

Substance Abuse Using alcohol and other drugs increases risk.

Hopelessness Experiencing a feeling of hopelessness increases risk.

Access to Lethal Means Lethal means include firearms, medications, and structures (buildings, railways, bridges).

Suicide


Violence


Ecological model of factors leading to violence (World Health Organization).

Cannot be attributed to one risk factor or particular combination of factors.

Violence


Ecological Model of Violence Risk Factors

Individual


Relationship Individual



Community Relationship Individual



Societal Community

Source: WHO, 2002.




Societal Community Relationship Individual


Societal Community Relationship

Individual

witnessing violenceuse of alcohol or drugs

presence of mental illnessage

gender


Societal Community

Relationship

Individual

alcohol / drug usefriends that engage in violence


Societal

Community


housingunemployment

availability of drugs / alcohol


Societal

Community Relationship Individual

social normsavailability of weapons


Violence

For more information: WHO’s World Report on Violence and Health (linked below the module).

Risk factors for violence are complex.


The Ontario Injury Prevention Resource Centre is supported by Public Health Ontario, the Ministry of Health and Long-Term Care

and the Province of Ontario.

The views expressed in this publication are the views of the OIPRC and do not necessarily reflect the views of Public Health Ontario, the Ministry of Health and Long-Term Care or the Province of Ontario.

www.oninjuryresources.ca

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Ontario Injury Prevention Resource Centre · Motor vehicle crashes ... Fundamentals for Injury Prevention Practitioners ... The Ontario Injury Prevention Resource Centre is supported