Abstract
Background
Reports from the U.S. suggest increases in the proportion and rate of head and neck injuries in skiers and snowboarders. It is important to determine if the same is true in Canada.
Methods
Skiers and snowboarders (<18 years) presenting to 16 selected emergency departments from 1991 to 1999 were assigned one body region of injury in the following order: i) brain and spine-spinal cord, ii) head and neck, iii) face, iv) other body region (i.e., controls). Crude and adjusted (age, gender, helmet use and hospital admission) odds ratios indicating the proportion of head, brain, face, and neck injury relative to controls by calendar year were estimated. Injury rates were examined for 12 to 17 year olds over the last 4 years of the study.
Results
Compared with 1997–1999, there was a lower proportion of skier head injuries from 1991–93 (adjusted odds ratio (AOR)=0.16; 95% Confidence Interval (CI)=0.09-0.30) and from 1995–97 (AOR=0.71; 95% CI=0.49-1.04). The proportion of skier brain injuries was lower from 1993–95 (AOR=0.69; 95% CI=0.44-1.07) and from 1995–97 (AOR=0.56; 95% CI: 0.35-0.91). In snowboarders, however, compared with 1997–99, there was evidence that although the proportion of head injuries was lower from 1991–93 (AOR=0.19; 95% CI=0.05-0.80), the opposite was true for facial injuries. For 12 to 17 year olds, skier brain and snowboarder head and neck injury rates increased from 1995–99.
Conclusions
The results suggest that head and brain injuries in skiers and head and neck injuries in snowboarders may be increasing, particularly in adolescents.
Résumé
Contexte
Des études américaines ont relaté une augmentation du taux de blessures à la tête et au cou chez les skieurs ainsi que chez les surfeurs des neiges. La présente étude tente de savoir s’il en est de même au Canada.
Méthode
Des skieurs et des surfeurs des neiges (<18 ans) provenant d’une des 16 urgences sélectionnées pour la période allant de 1991 à 1999 ont été classés d’après les blessures corporelles suivantes: i) au cerveau et à la colonne vertébrale, ii) à la tête et à la nuque, iii) au visage et iv) à d’autres parties du corps (population témoin). Les rapports de cotes bruts et ajustés (âge, sexe, port du casque, hospitalisation) indiquant la proportion de blessures à la tête, au cerveau, au visage et à la nuque en comparaison de la population témoin ont été estimés par année civile. Les taux de blessures ont été suivis pendant les quatre dernières années de l’étude pour le segment des 12 à 17 ans.
Résultats
Par rapport à la période 1997–1999, on retrouvait une moindre proportion de blessures à la tête chez les skieurs en 1991–1993 (rapport de cote (RDC) = 0,16; intervalle de confiance [IC] de 95 % = 0,09-0,30) et en 1995–1997 (RDC = 0,71; IC de 95 % = 0,49-1,04). La proportion de blessures au cerveau chez les skieurs était la plus faible pour les périodes de 1993–1995 (RDC = 0,69; IC de 95 % = 0,44-1,07) et de 1995–1997 (RDC = 0,56; IC de 95 % = 0,35-0,91). Pour le groupe des surfeurs des neiges, par contre, en comparaison de la période 1997–1999, malgré qu’une proportion plus faible de blessures à la tête ait été observée en 1991–1993 (RDC = 0,19; IC de 95 % = 0,05-0,80), on constate les résultats inverses quant aux blessures faciales. Chez les 12–17 ans, les taux de blessures au cerveau chez les skieurs, et à la tête et la nuque chez les surfeurs des neiges, ont augmenté de 1995 à 1999.
Conclusions
Ces résultats suggèrent que le nombre de blessures à la tête et au cerveau chez les skieurs, de même que les blessures à la tête et à la nuque chez les surfeurs des neiges, sont en hausse, particulièrement chez les adolescents.
Footnotes
Acknowledgement of Support: At the time of this study, Brent E. Hagel was supported by a Health Research Studentship from the Alberta Heritage Foundation for Medical Research.
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