|
Abstract
|
Injury is an important cause of deaths and hospitalisations of Eastern Sydney children'. More than one-third of hospital admissions for injury in 1989-90 were due to falls. We investigated one cause of an epidemic of falls in children in Eastern Sydney in the early 1990s: the in-line skating 'craze'. In-line skates or rollerblades were invented in the United States in the early 1980s and consist of a boot attached to a single row of wheels, usually four. They became popu]ar in Australia in the early 1990s. In Eastern Sydney, the Prince of Wales Children's Hospital (POWCH) contributes to the national Injury Surveillance and Information System (ISIS) database. We consulted the hospital's ISIS database for information about presentations of children to the Emergency Department for in-line skating injuries. Our aim was to quantify and describe the injuries, identify factors for preventive action and recommend and implement measures locally to prevent or reduce injuries.
METHODS Data were collected for all children (0- <16 years) who were recorded by ISIS as presenting to the Emergency Department with in-line skating injuries between June 30, 1991 and June 30, 1993. Audits have shown that about 70 per cent of all injury presentations and 100 per cent of injury admissions are captured by ISIS at POWCH. Data were analysed using Epi-Info.
Information on in-line skate design and safety issues was sought from the literature, the Trade Practices Commission, the Australian Consumers' Association, the Australian Standards Association, the In-line Skaters' Association and retail and hire outlets. Information on the regulation of in-line skating in Eastern Sydney was sought from the six local councils.
RESULTS The first presentation to the POWCH for an in-line skating injury was in June 1991. Until June 30, 1993 there had been 139 presentations recorded, of which 73 per cent were male and 27 per cent female Figure 1). A large increase in attendances in summer 1992-93 decreased to about two presentations weekly in autumn 1993 (Figure 2). Half the presentations were from boys aged 10-14 years Figure II. Moat injuries (94 per cent) occurred when the child lost control and fell while moving, For 26 per cent of presentations, injury occurred while skating on the footpath and for 17 per cent injury occurred while skating on a public road (Figure 3). Of the children injured on public roads, one child was involved in a collision with a motor vehicle.
There were 153 injuries recorded for the 139 presentations. Twenty-eight per cent of children were admitted and 62 per cent of the children not admitted had injuries sufficiently serious to warrant outpatient follow-up. Sixty-five per cent of injured children sustained a fracture. Forearm fractures were most frequent: 38 per cent of all injuries were a fracture of the radius andlor ulna and 16 per cent of all injuries were wrist fractures. Four children had fractures of the tibia/flbula and four were concussed. There were no skull fractures or spinal injuries but one child had a fractured coccyx.
Data on safety equipment including helmets, wrist guards and knee and elbow pads were available for 128 presentations. Twenty-seven per cent of presenting children wore some form of protective clothing Only 9 per cent were wearing a helmet at the time of injury. Fifty-six per cent of children wearing pri)tective clothing of any sort and 65 per cent of those who wore no protective clothing sustained a fracture or concussion (x=O.87, df=1. p=O.35).
DISCUSSION The extent of the problem-
The rapid popularity of new consumer products, such as skateboards or in-line skates, resulting in an epidemic of injuries has been previously documented ' and undermines advances in injury prevention and control. \3/hile there have been no child lbtalities associated with in-line skating in NSW', an epidemic of substantial injuries requiring hospital presentation has been recorded in Eastern Sydney since mid-1991. Other injury surveillance centres in NSW and Victoria report a similar epidemic and child injury profile. Children presenting to Emergency Departments because of in-line skating injuries probably represent the more severe end of' the spectrum of injuries occurring in the underlying population of children engaging in the activity. Data about less severe injuries are not routinely available. Safety issues
(i) Protective clothing Protective clothing, Including helmets, wrist guards and padding, is recommended by some manufacturers, the In-line Skaters' Association and others ". Only 27 per cent of children presenting to POWCH with in-line skating injuries were wearing protective clothing at the time of their accidents. Protective clothing usage rates in the community may be higher, if children presenting with injuries are those less likely to be wearing it. Of the children presenting with injuries, wearing protective clothing was not associated with a reduced risk of fracture or concussion. Further study is needed to clarify the role of protective clothing. In the interim, it is not an expensive precaution - $7-$15 an item in comparison with the cost of in-line skates - $90-$500 and its regular usage should be encouraged. Spot checks in Eastern Sydney reveal that protective clothing is located beside in-line skates at points of sale and hire but encouragement of its purchase/usage is not routinely given.
(ii) Product safety There is little infoi-mation to indicate the role of the product in in-line skating injuries, e.g. are some brands more hazardous than others. Product hi-and details are not recorded in ISIS data. A lao-ge range of brands is imported into Australia but there is no Australian standard for in-line skates. A comprehensive mechanism for the evaluation of the safety of new consumer products is arguably needed in Australia. There is only a general safety provision under the Commonwealth Trade Practices Act whereby manufacturers or importers of 'defective goods' are liable to pay compensation if a defect causes injury, death or property darnage. Under the act, 'defective goods' may include those inadequately labelled with safety instructions. Provision of safety information on in-line skate packaging varies from none to extensive advice on the use of protective clothing, the observation of traffic regulations, speed control and surfaces to avoid. Packaging should uniformly display this information and verbal advice should be given routinely at hire outlets,
(iii) The skating environment Few areas are designated for skating in Eastern Sydney and increasingly walkways, shopping malls, cycleways and parks ai-c bearing signs indicating prohibition of skating. Forty-two per cent of children presenting to POWCFI with in-line skating injuries were injured on public roads no' footpaths. Provision of more skating ramps, designated
Language: en |