Epidemiology of snow sports injuries amongst children, the importance of prevention

7th EFSMA European Sports Medicine Congress 3rd Central European Congress of Physical Medicine and Rehabilitation

Annual Assembly of the Austrian and German Society of Physical Medicine and

Rehabilitation

http://www.sportsmedpmr2011.at/Salzburg, October 26th to October 29th. 2011

http://www.sportsmed-pmr-2011.at/

EPIDEMIOLOGY OF SNOW SPORTS INJURIES AMONGST CHILDREN

THE IMPORTANCE OF PREVENTION

Dr Bernat ESCODA ALEGRETDr Bernat ESCODA ALEGRETSITEMSH National Secretary for AndorraSITEMSH National Secretary for Andorra

Centre Medic Pas de la Casa-Grau RoigCentre Medic Pas de la Casa-Grau Roig

GRANDVALIRA SKI AREA ANDORRAGRANDVALIRA SKI AREA ANDORRA

www.cmpas.comwww.cmpas.com

[email protected]@cmpas.com

http://www.cmpas.com/

INTRODUCTION

many studies have been published on injuries in snow sports, but few deal specifically on children

epidemiologic studies must rely on a rigorous data collecting system

understanding of injury epidemiology is the first step towards injury prevention

EPIDEMIOLOGY OF SNOW SPORTS INJURIES AMONGST CHILDRENTHE IMPORTANCE OF PREVENTION


PUBLISHED STUDIES

snow sports injuries = snow sports injuries = 1746 publications1746 publications

snow sports injuries + children = snow sports injuries + children = 368368

snow sports injuries + prevention = 419snow sports injuries + prevention = 419

snow sports injuries + children +prevention = 132snow sports injuries + children +prevention = 132


PUBLISHED STUDIES

In a previous presentation we found that:

on 210 works published between 1998 and 2008:

1 work on 4 talks about general epidemiology

1 work on 10 talks about children

1 work on 10 talks about prevention


PUBLISHED STUDIES

Comparison between studies is difficult because of the lack of a common design.


SNOW SPORTS INJURIES EPIDEMIOLOGY IN ANDORRA

-462 square km-80000 inhabitants

- 2,000,000 skierdays/season


ANDORRA SNOW SPORTS INJURIES DATABASE

For the last 9 seasons, data collected by the ski patrols, the ski resorts medical centers, and the unique hospital in Andorra, wich where previously kept separate are integrated in a single national

database.


FIGURES ON SNOW SNOW SPORT INJURIES

EPIDEMIOLOGY OF SNOW SPORTS INJURIES AMONGST CHILDRENEPIDEMIOLOGY OF SNOW SPORTS INJURIES AMONGST CHILDRENTHE IMPORTANCE OF PREVENTIONTHE IMPORTANCE OF PREVENTION

SNOW SPORTS INJURIES IN CHILDREN

Andorra Snow Sports Injuries Database:

is consistent in number of recorded injuries (more than 120000)

for some of the seasons ski resorts have performed in site interviews to have a control

group



BUT:

subjectivity in some of the recorded items

(ski or sport level, precise cause of the injury...)

the population at risk is not well kown

(Children are under represented in the interviews)



9 seasons >120000 Injuries

Under 11 years old

12 - 17 year old

Over 18 year old

% total customers

6 14 80

% total injuried

7 18 75


SNOW SPORT INJURIES IN CHILDREN

Hand/wrist Arm/forearm Shoulder Head /Th/Abd /Spine

pelvis/Thigh Knee Leg Ankle/foot 0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

Injured Region

Under 11 years old

12 - 17 year old

18 year old and over


SNOW SNOW SPORT INJURIES IN CHILDREN

Casual falling Collision Other0,0

10,0

20,0

30,0

40,0

50,0

60,0

70,0

80,0

90,0

100,0

Injury cause

Under 11 years old12 - 17 year old18 year old and over



AIS I AIS II AIS III-IV-V0,0

10,0

20,0

30,0

40,0

50,0

60,0

70,0

80,0

90,0 Injury SeverityAIS code




A - < 1 weekB – 1 to 4 weeks

C – 1 to 3 monthsD - > 3months

0,0

10,0

20,0

30,0

40,0

50,0

60,0

70,0


Injury Severity

healing estimated time



Treated at the ski resort medical centerFirst assistance in Andorra Hospital

0

10

20

30

40

50

60

70

80

90

100

Under 11 years old12 - 17 year oldOver 18 year old

In resort treatment vs hospital



Our epidemiological data show that:

children are more prone to head injuries

children suffer more collisions than adults

wrist injuries are common in the group aged 1217 (more snowboarders)



Our epidemiological data show that:

Snow sports injuries in children are less severe than in adults

but the incidence is higher


SNOW SPORTS INJURIES PREVENTION IN CHILDREN

THERE ARE ACTUALLY SOME CONSISTENT EPIDEMIOLOGICAL EVIDENCES ABOUT SNOW SPORTS INJURIES WICH HAVE LEAD TO PREVENTION MEASURES



HELMET USE

IT IS WELL ESTABLISHED THAT IT DECREASES INCIDENCE AND SEVERITY OF HEAD INJURIES

CHILDREN ARE MORE PRONE TO COLLISIONS AND HEAD INJURIES, HELMET USE IS SPECIALLY USEFULL IN THIS GROUP



HELMET USECAN BE:

DEVELOPPED BY MAKING IT MANDATORY ENCOURAGED BY DISCOUNTS IN SKIPASS PRICES ENCOURAGED IN RENTAL PACKS ENCOURAGED BY MIMETIC EFFECT (USE BY

SNOWSPORTS PROFESSIONALS)



WRIST PROTECTIONS

WRIST INJURIES ARE VERY COMMON IN BEGINNER SNOWBOARDERS

PROTECTIONS REDUCE THE NUMBER OF WRIST INJURIES

WRIST PROTECTIONS USE SHOULD BE DEVELOPED



CHILDREN AND TEENAGERS

ARE ACCESSIBLE TO BEHAVIOURAL MEASURES:

EDUCATIONAL TALKS OR VIDEO PROJECTIONS ABOUT SNOWSPORTS SAFETY ARE BENEFICAL ON INJURY RATES



School workshops

Dressing

Nutrition

Ski area signals

Lifts



BOOTS, SKI BINDINGS

NEED FOR PERFECT FITTING AND PROPER ADJUSTMENT

POSES A PROBLEM WITH GROWTH THE BEST SOLUTION: RENTING WITH GOOD

PROFESSIONALS



There are many oder measures of prevention that need to be validated...



WE HAVE MANY EPIDEMIOLOGICAL EVIDENCES ABOUT SNOW SPORT INJURIES IN CHILDREN AND THE WAY THEY CAN BE PREVENTED.

CHILDREN ARE VERY ACCESSIBLE TO PREVENTION MEASURES MAY IT BE THRU MATERIAL IMPROVEMENTS, OR THRU BEHAVIOURAL MESSAGES

WE CAN GO FURTHER BY IMPROVING OUR KNOWLEDGE OF SNOW SPORTS INJURIES RISK FACTORS

