There is a need to determine the role of smoking/vaping related products in Emergency Department (ED) product-related injuries by age and sex to determine if interventions are warranted. These ...products include the combustible tobacco products' paraphernalia to light them (CTPP), electronic nicotine delivery systems (ENDS), and electronic non-nicotine delivery system (ENNDS). Data from the National Electronic Injury Surveillance System (NEISS), years 2012-2022, were examined for injury data associated with CTPP and ENDS/ENNDS. Bivariate comparisons were conducted. There were an estimated 3,142 (95%CI: 2,384-3,975) ED-treated ENDS/ENNDS product-related injuries and 46,116 (95%CI: 38,712-53,520) CTPP product-related injuries. Males were more likely to have an ED-treated ENDS/ENNDS product-related injury than females (proportion 0.93 95%CI: 0.82, 0.98 versus 0.70 95%CI: 0.02, 0.19) as well as a CTPP product-related injury than females (proportion, 0.60 95%CI: 0.56, 0.64 versus 0.40 95%CI: 0.37, 0.44). There were more ED-treated ENDS/ENNDS product-related injuries among persons ≥18 years than <18 years (proportion, 0.89 95%CI: 0.75, 0.96 versus 0.11 95% CI: 0.4, 0.35). There were also more ED-treated CTPP product injuries among persons ≥ 18 years than <18 years (proportion, 0.73 95%CI: 0.68, 0.78 versus 0.27 95%CI: 0.22, 0.32). No change in the proportion of injuries in our sample associated with END/ENNDS over time were observed. There is a need to consider injuries related to ENDS/ENNDS and CTPP product-related injuries in the discussion of the risks associated with smoking/vaping. Although ENDS/ENNDS have had fewer ED-treated injuries, the number of such injuries has remained stable, rather than declined over the previous decade. Injury prevention is a public health imperative and targeted interventions by healthcare providers during routine care, and the use of public service announcements could specifically target adults ≥18 years. Providing peer-to-peer educational programs, and initiating similar programs targeted at males who use CTP and ENDS/ENNDS have the potential to decrease injury risk.
A large proportion of United States (U.S.) youth play basketball, baseball, softball, or T-ball. Each of the activities poses a documented risk of craniofacial and neck injuries. However, few studies ...have assessed the national prevalence of pediatric craniofacial and neck injuries in this population, particularly following the COVID-19 pandemic.
The National Electronic Injury Surveillance System (NEISS) dataset was used to identify pediatric craniofacial and neck injuries associated with basketball, baseball, softball, or T-ball from 2003-2022 in a cross-sectional study. The annual number of injuries before and after the onset of the COVID-19 pandemic with 95% confidence intervals were calculated. Interrupted time series analysis (ITSA) was used to estimate the pandemic's impact on the monthly number of injuries incurred nationally.
Both overall and stratified by sport involvement, the annual number and rate of injuries identified in NEISS decreased significantly after the COVID-19 pandemic. ITSA demonstrated that the monthly number of injuries decreased -4094.4 (95% CI = -5100, -3088.7) immediately after the beginning of the pandemic. The number of injuries began increasing towards pre-pandemic levels at a rate of 110.6 (95% CI = 64, 157.2) injuries per month after the initial plunge.
Prior to the-pandemic, there was a steady decline in craniofacial and neck injuries due to basketball, baseball, softball and T-ball among children, aged <18 years. The shutdown during the initial months of the COVID-19 pandemic resulted in a precipitous drop in such injuries. Current rates are approaching pre-pandemic levels and may exceed them. Continued efforts are needed to keep the pre-pandemic progress.
We used firearm mortality and sales data to assess the impact of HB 4145, a May 2016 law that legalized concealed firearm carry without a permit in West Virginia. Firearm mortality was significantly ...higher (29%) in the years after the enactment of the law; handgun mortality was also higher (48% increase), whereas long gun deaths and firearm sales were unaffected. This may suggest that HB 4145 increased rates of firearm-related mortality in West Virginia without affecting firearm sales in the state. (
2023;113(11):1163-1166. https://doi.org/10.2105/AJPH.2023.307382).
International attention has been drawn to the alarming rates of firearm violence, injury, and fatalities in the US. Much less attention is drawn to the fact that most US firearm deaths are suicides ...and that firearm suicide rates are highest in rural areas. We demonstrate the duality of rurality and firearm suicide using data from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (CDC WONDER), which gathers mortality data reported through state death certificate registries. We extracted national age-adjusted mortality rates for 1999-2020 overall and stratified by urbanization and firearm involvement for both US and West Virginia, a rural state with high rates of firearm ownership.
Background
The logging industry is known to have one of the highest rates of fatal and nonfatal occupational injuries in the United States. Perspectives on why this study is so hazardous may differ ...between logging company owners/operators and workers. In this study, we explored and compared the safety perspectives of logging company owners/operators and workers in West Virginia.
Methods
Using a mixed‐methods approach, we analyzed survey (n = 245) and interview (n = 14) data collected in 2015 from logging company owners/operators and workers in West Virginia. Survey data were analyzed via logistic regression; interview data were analyzed using thematic analysis. Response patterns were contrasted by occupational status (owners/operators vs. workers) in both analyses.
Results
Owners/operators and workers agreed on several aspects of workplace safety including the importance of personal protective equipment and the benefits of mechanization when timber harvesting. Key differences observed between owners/operators and workers included why injuries are underreported and the effects of production pressures on safety.
Conclusion
While there was much agreement, owners/operators and workers in the West Virginia logging industry reported differences in key domains of workplace safety. These differences should be taken into account when designing and implementing safety programs in the logging industry.
The 2010 release of an abuse deterrent formulation (ADF) of OxyContin, a brand name prescription opioid, has been cited as a major driver for the reduction in prescription drug misuse and the ...associated increasing illicit opioid use and overdose rates. However, studies of this topic often do not account for changes in supplies of other prescription opioids that were widely prescribed before and after the ADF OxyContin release, including generic oxycodone formulations and hydrocodone. We therefore sought to compare the impact of the ADF OxyContin release to that of decreasing prescription opioid supplies in West Virginia (WV).
Opioid tablet shipment and overdose data were extracted from The Washington Post ARCOS (2006-2014) and the WV Forensic Drug Database (2005-2020), respectively. Locally estimated scatterplot smoothing (LOESS) was used to estimate the point when shipments of prescription opioids to WV began decreasing, measured via dosage units and morphine milligram equivalents (MMEs). Interrupted time series analysis (ITSA) was used to compare the impact LOESS-identified prescription supply changes and the ADF OxyContin release had on prescription (oxycodone and hydrocodone) and illicit (heroin, fentanyl, and fentanyl analogues) opioid overdose deaths in WV. Model fit was compared using Akaike Information Criteria (AIC).
The majority of opioid tablets shipped to WV from 2006 to 2014 were generic oxycodone or hydrocodone, not OxyContin. After accounting for a 6-month lag from ITSA models using the LOESS-identified change in prescription opioid shipments measured via dosage units (2011 Q3) resulted in the lowest AIC for both prescription (AIC = -188.6) and illicit opioid-involved overdoses (AIC = -189.4), indicating this intervention start date resulted in the preferred model. The second lowest AIC was for models using the ADF OxyContin release as an intervention start date.
We found that illicit opioid overdoses in WV began increasing closer to when prescription opioid shipments to the state began decreasing, not when the ADF OxyContin release occurred. Similarly, the majority of opioid tablets shipped to the state for 2006-2014 were generic oxycodone or hydrocodone. This may indicate that diminishing prescription supplies had a larger impact on opioid overdose patterns than the ADF OxyContin release in WV.
Evidence suggests that rates of occupational injuries in the US are decreasing. As several different occupational injury surveillance systems are used in the US, more detailed investigation of this ...trend is merited. Furthermore, studies of this decrease remain descriptive and do not use inferential statistics. The aim of this study was to provide both descriptive and inferential statistics of temporal trends of occupational injuries treated in US emergency departments (EDs) for 2012 to 2019.
Monthly non-fatal occupational injury rates from 2012 to 2019 were estimated using the national electronic injury surveillance system-occupational supplement (NEISS-Work) dataset, a nationally representative sample of ED-treated occupational injuries. Rates were generated for all injuries and by injury event type using monthly full-time worker equivalent (FTE) data from the US Current Population Survey as a denominator. Seasonality indices were used to detect seasonal variation in monthly injury rates. Trend analysis using linear regression adjusted for seasonality was conducted to quantify changes in injury rates from 2012 to 2019.
Occupational injuries occurred at an average rate of 176.2 (95% CI = ± 30.9) per 10,000 FTE during the study period. Rates were highest in 2012 and declined to their lowest level in 2019. All injury event types occurred at their highest rate in summer months (July or August) apart from falls, slips, and trips, which occurred at their highest rate in January. Trend analyses indicated that total injury rates decreased significantly throughout the study period (- 18.5%; 95% CI = ± 14.5%). Significant decreases were also detected for injuries associated with contact with foreign object and equipment (- 26.9%; 95% CI = ± 10.5%), transportation incidents (- 23.2%; 95% CI = ± 14.7%), and falls, slips, and trips (- 18.1%; 95% CI = ± 8.9%).
This study supports evidence that occupational injuries treated in US EDs have decreased since 2012. Potential contributors to this decrease include increased workplace mechanization and automation, as well as changing patterns in US employment and health insurance access.
Cecal Volvulus: An Evolving Disease Bailey, Kimberly S.; Lundstrom, Eric; Borgstrom, David
The American surgeon,
09/2018, Letnik:
84, Številka:
9
Journal Article
Recenzirano
Given the potential complications associated with delay in diagnosis of this disease process, it is important that clinicians maintain a high index of suspicion. Because the patient with cecal ...volvulus today presents differently from the typical patient, historically, a local chart review was undertaken to investigate what those changes are and the possible causes behind them. Approval for use of this database was obtained from the Institutional Review Board at West Virginia University School of Medicine. Hypothesized causes for such a large number of constipated individuals included, but are not limited to, altered intestinal mobility from diabetes, hypothyroidism, and medications such as opiates, diuretics, antidepressants, antihistamines, and iron and calcium supplements.
Introduction:Injury fatality rates in the United States (US) decreased throughout the majority of the 20th century, mostly due to declining rates of occupational and motor vehicle injuries. However, ...near the beginning of the 21st century, fatal injury rates in the US began to increase. This is principally due to the nation’s opioid epidemic, which has been characterized by different epidemic “waves”, each driven by overdoses associated with specific substances. Given the temporally dynamic nature of US injury trends, this study aimed to explore the application of time series analysis to injury data in the US. First, rates of non-fatal occupational injuries treated in US emergency departments were assessed to determine if non-fatal occupational injury rates mirror the historic decline of fatal occupational injuries in the 20th and 21st centuries. Next, we explored the temporal shift from prescription to illicit opioid overdose deaths in West Virginia (WV) to elucidate the transition between the opioid epidemic’s first and second waves in the state with the highest fatality rates in the nation. Finally, we compared the forecasting performance of three time series models when applied to national US opioid overdose data to explore what time series approaches best predict future rates of overdose.Methods:Study one assessed temporal trends in non-fatal occupational injuries treated in US emergency departments (EDs) using data the National Electronic Injury Surveillance System – Occupational Supplement (NEISS-Work) dataset. Descriptive statistics were used to assess annual injury rate estimates and monthly seasonality. Autoregressive integrated moving average (ARIMA) modeling was used to quantify trends in ED-treated occupational injury rate estimates while controlling for serial data correlation. Analyses were conducted both overall and stratified by injury event type. Study two used data from the Drug Enforcement Agency’s (DEA) Automation of Reports and Consolidated Orders System (ARCOS) database (accessed via The Washington Post) to determine when shipments of oxycodone and hydrocodone tablets to WV began decreasing; tablet shipments were measured both as dosage units and morphine milligram equivalents (MMEs). To identify the exact point when tablet shipments began decreasing, we used locally estimated scatterplot smoothing (LOESS). The point when total tablet shipments began decreasing was used as an intervention point in an interrupted time series analysis (ITSA) of prescription and illicit opioid overdose death rates calculated using data from the WV Forensic Drug Database (FDD), which collects drug death data from the WV Office of the Chief Medical Examiner. Prescription opioid deaths were defined as those involving oxycodone or hydrocodone, while illicit opioid overdoses were defined as those involving heroin or synthetic opioids other than methadone. The ITSA impact of the LOESS-identified points was compared via Akaike Information Criteria (AIC) to that of the 2010 release of an abuse deterrent formulation (ADF) of OxyContin, which is widely cited as a driving factor initiating the transition between the opioid epidemic’s first and second waves. Study three examined the forecasting performance of ARIMA; Error, Trend, and Seasonality (ETS); and Facebook Prophet models when applied to national US opioid overdose death data, both overall and stratified by the type of opioid involved in overdoses. Overdose death counts were extracted from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. Overdose death rates were calculated using monthly all-cause mortality as a denominator. Forecasts were validated used time series cross validation (TSCV), while forecast bias and predictive coverage probability were measured using mean average percent error (MAPE) and Winkler Scores, respectively.Results:Study one found that US ED-treated non-fatal occupational injury rate estimates were highest in 2012 and lowest in 2019. Apart from falls, slips, and trips, all injuries occurred at the highest rate in a summer month. ARIMA modeling found that there was a significant decrease in monthly rate estimates for 2012-2019. Study two found that the point at which opioid tablet shipments (measured via dosage units) to WV began decreasing had a greater impact on changing rates of prescription and illicit opioid overdose rates than the 2010 ADF OxyContin release. Study three found that ETS models accurately forecasted monthly rates US opioidinvolved overdoses while maintaining a high degree of precision relative to ARIMA or Facebook Prophet, particularly during the opioid epidemic’s fentanyl-dominated third wave.Discussion:The findings presented here indicate that although occupational injury rates have likely continued their decades-long decline in the US, the nation’s opioid epidemic has contributed significantly to recent US injury rate increases and is temporally dynamic. Future research should explore trends in other injury data by expanding the methodology used here to other epidemiological contexts.
