| Drowning |
n = 1 (84)
- Canada and United States based study
- Beach drownings in the Great Lakes region significantly higher in 2020 than pre-COVID
- Statistically significant increase in drownings for young males (< 20 years) during 2020 than pre-COVID |
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n = 5 (85–89)
- Reports of increased drownings in open-water and an increase in pediatric drownings
- Water Safety New Zealand report found that no fatal drownings had occurred during the first 4 weeks of the lockdown period. |
| Poisoning |
n = 2 (65, 90)
One study reported 61% decrease in pediatric poisonings during the COVID-19 pandemic Another study reported 40% increase in poisonings related to hand sanitizers and disinfectants shortly following the declaration of a pandemic
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n = 8 (20, 33, 37, 77, 80, 91–93)
Seven studies indicated increases in poisoning occurrences during the lockdown compared to previous periods. Reports of exposures to sanitizer, cleaners/disinfectants, algaecides, bleaches, chloride vapors, fertilizers, glues, silica gel, paints/varnish, batteries, household products, and essential oils increased. One study indicated a decrease in calls concerning exposures to medications, but an increase in exposures to household/cleaning products. United States-based study noted the increase of methanol ingestions, associated with swallowing alcohol-based hand sanitizers – in the United States, hand sanitizers are approved to only contain ethanol or isopropanol suggesting that methanol-based products may have been imported into the country. One study reported no change in poisonings.
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n = 15 (94–107)
Increases in calls to poison centers regarding hand sanitizers, cleaning products, inhalations, bleaches, disinfectants, mushroom exposures, youth, and older adults. A news article from United States outlined two case studies, one in which an individual cleaned her produce with a 10% bleach solution after buying her groceries, and the other about reported on a preschool child who ingested an unknown amount of hand sanitizer causing them to spend two nights in the hospital. Another news article from the United Kingdom stated that 5,800 people were admitted to the hospital as a result of false information they received on social media, and approximately 800 may have died from ingesting methanol or alcohol-based cleaning products. One article identified the harms of turning to homemade remedies that were not proven to protect against COVID-19.
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| Foreign body ingestion |
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n = 2 (32, 57)
Reports of significant increases in foreign body ingestions among children, such as swallowing magnets, beads, plastic, marbles, coins, screws, and batteries from toys.
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| Trampoline |
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n = 6 (16, 26, 45, 108–110)
Four studies observed increases (three of which were significant) in trampoline injuries. One indicated a non-significant decrease, and one saw no significant differences between the time periods.
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n = 4 (111–114)
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| Lacerations |
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n = 18 (27)
Studies reported on lacerations and/or animal/human bites during the COVID-19 pandemic lockdowns. Ten indicated increases in lacerations from sharp objects or animal bites (e.g., snakes and dogs). Five studies noted decreases in lacerations or bites. India-based study reporting a decrease in bull-gore injuries. One United Kingdom-based study noted no significant differences in animal bites during the lockdown period. Three studies that only investigated injuries during the pandemic period (without comparing to previous years) based in the United States, United Kingdom, and Iran noted that animal bites and injuries caused by sharp objects occurred during lockdown.
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| Crush/Trap |
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n = 6 (27, 42, 76, 115–117)
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| Occupational |
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n = 25 (13, 23, 25, 29, 30, 35, 36, 41, 46, 50, 52–54, 58, 62, 118–127)
14 indicated decreases, five of which decreased significantly. Of the studies that noted type of work (n = 3), decreases were found in work including labor, mining, carpentry, and agricultural fieldwork. Another study explained that the decrease in worksite injuries resulted from a reduction in falls. One study noted an increase, on a relative scale, in violence-related injuries at work. Four studies reported increases in work-related injuries; however, this change was non-significant in two of the studies. Of the studies that noted type of work (n = 2), increases were noted in machine-related work and non-machine related work, and one industrial accident. One study also observed an increase in injuries in young workers in 2020 compared to 2019. An additional four studies reported no significant differences in occupational injuries between pre-pandemic and pandemic periods; however, one did note a decrease in injuries sustained while traveling to work. Type of work in these studies, where specified (n = 1) were physical labor related. Three cross-sectional studies described injury rates during the COVID-19 period. One study, based in India, noted that farm work-related injuries were most common during this time (106), and another described sharp and blunt injuries as a result of labor trauma were the most common mechanism of occupational injury.
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| Burns |
n = 1 (65)
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n = 16 (19, 26, 29, 32, 57, 59, 76, 91, 128–135)
Five reported significant increases in burn-related injuries with four reporting non-significant increases. Four studies observed a significant reduction in burn injuries during lockdown. One study, conducted in Israel, indicated that the number of burns among children ages 2–5 increased significantly, and resulted from scalds and one case of electrical burn and burn-related injuries among adults decreased, with the most common cause being fire. A study conducted in Turkey saw an increase in third-degree burns and a reduction in second degree burns during the initial lockdown period in 2020, compared to cases in the same period in 2018 and 2019. Five studies indicated no significant changes in burns across both time periods. Cross-sectional survey with adults in the United States (n = 2011); 26% of households reported having experienced an injury, and 15% experienced an ingestion; 28% experienced either, and 13% experienced both. Of these injuries, burns from hot objects were reported by 5% of respondents and scalds by 4%.
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n = 2 (136, 137)
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| Sports and recreation |
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n = 65 (13, 14, 16, 21, 23–25, 27, 29, 30, 34–36, 38–41, 43, 45, 48, 50–52, 54, 58, 59, 62, 63, 65, 70, 75, 108–110, 115, 118–121, 123–126, 133, 138–158)
Majority (n = 54) indicated decreases in injuries resulting from sport, recreation, or leisure – including playing sports, running, and playground injuries – 28 of these reductions were significant. Four indicated increases in sport-related injuries during the pandemic, though none were significant, and three reported no significant changes over the two time periods. Two USA-based studies investigated running behaviors and injuries during the COVID-19 pandemic; one noted running-related injury risk was higher during the pandemic for lower extremity overuse injuries; the other noted prior history or injury was associated with new running-related injuries but there were no significant changes related to the running-related injuries and the pandemic. One study indicated an increase in indoor recreation injuries but a decrease in gym-related and soccer injuries. Another noted an increase in personal exercise injuries and decrease in injuries resulting from sports. One study in Iran studied emergency department admissions during their lockdown period and indicated that sports-related injuries occurred in 2% of patients (n = 13).
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| Pedestrian |
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n = 20 (18, 19, 29, 50, 54, 66, 67, 71, 74, 116, 133, 140, 159–166)
Decreases in injury incidence (n = 17); 10 were significant. One study indicated reduction was due to fewer individuals utilizing transit during the lockdown period. One study in Australia indicated an increase during the pandemic, acknowledging that numbers were small before and during restrictions. Another study analyzed data during the lockdown compared to two weeks before, and noted five injuries were pedestrian-related out of the 195 total patients seen during study period. One study saw no significant change in pedestrian injuries.
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| Non-Motorized Vehicles (i.e., cycling, two-wheelers, rollerblades, skateboards, and hoverboards) |
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n = 31 (16–19, 26, 29, 31, 34, 35, 39, 49, 50, 54, 65, 70, 108, 110, 116, 123, 133, 139, 153, 159, 162, 163, 167–172)
Nine studies indicated decreases in non-motorized vehicle injuries, three of which were significant. Overall, 18 studies indicated increases in non-motorized vehicle injuries, of which 12 were significant. Four research teams noted that injuries resulting from non-motorized vehicles were main causes of injuries during the pandemic.
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n = 1 (173)
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| Falls |
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n = 105 (14, 15, 18, 19, 21, 24, 27, 29–31, 34, 38–40, 42, 44, 47, 49–55, 57–59, 62, 63, 66, 69, 70, 74, 75, 79, 91, 108–110, 115, 117, 119–122, 124–128, 133, 139–142, 144, 146, 148, 151, 153–159, 161–163, 165, 168, 170, 171, 174–204)
n = 26 studies reported falls were most common mechanism of injury, regardless of whether the proportion or absolute number of fall cases increased or decreased. Forty articles reported increases in falls compared to previous periods, and 43 studies reported that falls decreased. Nine studies indicated that proportion of falls remained relatively consistent over the study periods. Five studies indicated that falls from height decreased and falls from ground-level increased. Two studies reported falls from ground level decreased and falls from height increased. Two studies, based in the UK and Ireland, indicated that falls reduced at the beginning of the lockdown but began to increase as restrictions eased from May–August, 2020.
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n = 1 (205)
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| Motor Vehicle Collisions (i.e., vehicles and motorcycles) |
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n = 134 (13–19, 23, 24, 27–29, 34, 35, 38, 41–45, 47–50, 53–56, 59, 60, 62–71, 74–76, 78, 79, 108–110, 117, 118, 121–128, 133, 139–142, 144–148, 151–154, 156–166, 168, 170, 171, 174, 176, 178–183, 185–194, 196–199, 201, 204, 206–229)
Regardless of whether MVCs increased or decreased, they remained one of the most common mechanisms of injury throughout the pandemic. Total of n = 114 indicated that MVCs decreased during lockdown periods compared to pre-pandemic periods. Interestingly, five of these studies – based in Russia, Israel, Turkey, the United States, and Nepal – observed that while MVCs decreased, the severity of the collisions worsened. Sedain and Pant (224): burden of MVCs remained high during the lockdown period, and although reduction in MVCs, the fatalities and injuries resulting from MVCs remained high. Qureshi et al. (222): significant reduction in MVCs resulting in minor to no injuries, but no reduction in MVCs resulting in serious or fatal injuries during statewide lockdowns; and increase in MVCs resulting in minor or no injuries when mandatory lockdown policies expired but no change in those resulting in serious or fatal injuries. Iran-based study: analyzed emergency department referrals in two trauma centers from February 20–April 3, 2020 and found that 21.3% (n = 136) of the trauma cases during this period resulted from MVCs. Eleven studies reported no significant changes between periods. Total of n = 10 studies noted increases in MVCs during the COVID-19 period, two of which also reported an increase in severity of MVCs.
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n = 9 (230–240)
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