The Canadian Child Safety Report Card - A Comparison of Injury Prevention Practices Across Provinces

Background Health-based report cards have been used as a tool to disseminate research findings to parents, government agencies, stakeholders, and the general public. In Canada, health-based report cards such as the Canadian Pediatric Societys report provides a comparison of how provinces measure up to one another on a number of health-based indicators. However, few child health report cards discuss implications for primary prevention policy or practice. Methods The Canadian Child Safety Report Card was developed in three studies using data from the Discharge Abstract Database and provincial coronial data. Interprovincial comparisons were made of measures of morbidity and mortality in chapters two and three. Chapter two focuses on external causes of injury such as falls, poisonings, burns, suffocation, and drowning. Chapter three focuses on transport-related injuries including occupants, cyclists, and pedestrians. Population based morbidity and mortality rates per 100,000 were calculated for children/youth 0-19 years. Percent change in hospitalization and death rates were reported over the 7-year study period (2006-2012). Chapter four ranks provinces to one another through morbidity, mortality, and injury policy measures using evidence-based criteria. Results In Canada, Saskatchewan was the province with the highest rate of injury hospitalization per 100,000 between 2006 and 2012, but incidence decreased from 967 to 852 over the 7-year period, despite not having policies that meet best practice. Ontario had the lowest rate of injury hospitalization per 100,000, however the incidence rate increased slightly from 451 to 479. Only British Columbia decreased the incidence of injuries compared to the Canadian average. The rate decreased from 667 to 515 between 2006 and 2012. This change in incidence over time is observed in a province that complied with best practice evidence-based injury prevention policies. Similar trends were seen in mortality data across provinces. Conclusions This is the first study to compare injuries among children and youth across Canadian provinces in terms of hospitalization, and the enactment of evidence-based policies. This data may allow the influence of all spectrums of prevention by resulting in the harmonization of policy and legislation in Canada. Similar projects in the European Union have started to yield results in terms of harmonizing prevention policies across member states

Epidemiology of sports-related injuries in children and youth presenting to Canadian emergency departments from 2007/08 to 2009/10

Although injuries related to sports and recreation represent a significant burden to children and youth, there is a paucity of information about descriptive epidemiology of sports related injury since 2005. The objective of this study was to provide the descriptive epidemiology of sports-related injuries treated in emergency departments for children and youth aged 5 - 19. Children and youth (5 - 19 years) in CHIRPP (2007 -2010) were included. Descriptive statistics, including frequency by sport, age and sex, and the percent of concussions within each sport were calculated. Out of a total of 56, 691 reported sports-related injuries, soccer accounted for 11,941 injuries. The 10 - 14 age group reported the greatest number of injuries. Males reported a greater number of minor injuries. The largest percentage of concussions (16.7%) was reported in ringette. Injury prevention programs in Canada should focus on improving evidence-based programs to reduce the burden of injuries in all sports

Epidemiology of sports-related injuries in children and youth presenting to Canadian emergency departments from 2007–2010

BACKGROUND: Although injuries related to sports and recreation represent a significant burden to children and youth, few studies have examined the descriptive epidemiology of sports-related injury since 2005, and some sports such as ringette have not been evaluated to date. The primary purpose of this study was to provide the descriptive epidemiology of sports-related injuries treated in emergency departments for children and youth aged 5 – 19. METHODS: A retrospective data analysis was performed using data from the Canadian Hospitals Injury Reporting and Prevention Program [CHIRPP] from fiscal years (April – March) 2007/08 to 2009/10. CHIRPP is a computerized information system designed by the Public Health Agency of Canada that collects information about injuries to people evaluated in emergency departments across 11 pediatric hospitals and 5 general hospitals in Canada. Thirteen sports or activities were analyzed (baseball, basketball, cycling, football, ice hockey, lacrosse, ringette, rugby, skiing, sledding, snowboarding, soccer, and volleyball). Descriptive statistics, including frequency by sport, age and sex, as well as the percent of concussions within each sport were calculated. RESULTS: Out of a total of 56, 691 reported sports and recreational injuries, soccer accounted for the largest proportion of injuries with 11,941 reported cases over the 3 year time period. Of these, approximately 30% were fractures. The 10 – 14 year age group reported the greatest proportion of injuries in 10 out of the 13 sports analyzed. In addition, males reported a greater number of overall injuries than females in 11 out of the 13 sports analyzed. The largest percentage of concussions was reported in ringette; these injuries accounted for 17.1% of overall injuries within this sport. CONCLUSIONS: Injury prevention programs in Canada should focus on improving evidence-based programs to reduce the burden of injuries in all sports

Childhood road traffic injuries in Canada – a provincial comparison of transport injury rates over time

Background: In Canada, road traffic injuries are the leading cause of death among children and youth ≤19. Across the country, there is variability in road traffic injury prevention policies and legislation. Our objective was to compare pediatric road traffic related injury hospitalization and death rates across Canadian provinces. Methods: Population-based hospitalization and death rates per 100,000 were analyzed using data from the Discharge Abstract Database and provincial coroner’s reports. Road traffic related injuries sustained by children and youth ≤19 years were analyzed by province and cause between 2006 and 2012. Results: The overall transport-related injury morbidity rate for children in Canada was 70.91 per 100,000 population between 2006 and 2012. The Canadian population-based injury hospitalization rates from all transport-related causes significantly decreased from 85.51 to 58.77 per 100,000 (− 4.42; p < 0.01; − 5.42; − 3.41) during the study period. Saskatchewan had the highest overall transport related morbidity rate (135.69 per 100,000), and Ontario had the lowest (47.12 per 100,000). Similar trends were observed for mortality rates in Canada. Conclusions: Transport-related injuries among children and youth have significantly decreased in Canada from 2006 to 2012; however the rates vary by province and cause.Medicine, Faculty ofNon UBCPediatrics, Department ofReviewedFacultyResearcherGraduat

An interprovincial comparison of unintentional childhood injury rates in Canada for the period 2006–2012

Objectives To perform an interprovincial comparison of unintentional population-based injury hospitalization and death rates for Canadian children ages 0–19 years and compare trends between 2006 and 2012. Methods Annual population-based hospitalization rates per 100,000 from unintentional injuries were calculated for children/youth (< 19 years) using data from the Discharge Abstract Database between 2006 and 2012. Annual mortality rates were analyzed using provincial coronial data. The mean annual change in the rate of hospitalizations due to unintentional injuries was reported for each province. Results The average annual rate of hospital admissions for unintentional injuries was 305.10 per 100,000 population between 2006 and 2012, and this decreased by − 11.91 over time (p < 0.01, − 15.85; − 7.77). Saskatchewan had the highest average annual morbidity rate (550.76 per 100,000) from all unintentional causes, and Ontario had the lowest average annual rate (238.89 per 100,000). Saskatchewan had the highest average annual rate for all subcauses except for drowning. Ontario was the only province with an average annual injury morbidity rate that was consistently below the Canadian average. The average annual mortality rate from all unintentional injury was highest in Saskatchewan (17.51 per 100,000) and lowest in Ontario (5.99 per 100,000) when compared to Canada (7.97 per 100,000). Conclusion Injury prevention policies vary considerably among provinces. Although the unintentional injury hospitalization rate is decreasing over time, some subcauses such as choking/suffocation have shown an increase in certain provinces. Evidencebased childhood injury prevention policies, such as playground equipment safety and four-sided pool fencing among others, should be standardized across Canada.Medicine, Department ofPediatrics, Department ofReviewedFacult

Effect of reducing the posted speed limit to 30 km per hour on pedestrian motor vehicle collisions in Toronto, Canada - a quasi experimental, pre-post study

Abstract Background Pedestrian related deaths have recently been on the rise in Canada. The effect of changing posted speeds on the frequency and severity of pedestrian motor vehicle collisions (PMVC) is not well studied using controlled quasi-experimental designs. The objective of this study was to examine the effect of lowering speed limits from 40 km/h to 30 km/h on PMVC on local roads in Toronto, Canada. Methods A 30 km/h speed limit on local roads in Toronto was implemented between January 2015 and December 2016. Streets that remained at a 40 km/h speed limit throughout the study period were selected as comparators. A quasi-experimental, pre-post study with a comparator group was used to evaluate the effect of the intervention on PMVC rates before and after the speed limit change using repeated measures Poisson regression. PMVC data were obtained from police reports for a minimum of two years pre- and post-intervention (2013 to 2018). Results Speed limit reductions from 40 km/h to 30 km/h were associated with a 28% decrease in the PMVC incidence rate in the City of Toronto (IRR = 0.72, 95% CI: 0.58–0.89). A non-significant 7% decrease in PMVC incidence rates were observed on comparator streets that remained at 40 km/h speed limits (IRR = 0.93, 95% CI: 0.70–1.25). Speed limit reduction also influenced injury severity, with a significant 67% decrease in major and fatal injuries in the post intervention period on streets with speed limit reductions (IRR = 0.33, 95% CI: 0.13–0.85) compared with a 31% not statistically significant decrease in major and fatal injuries on comparator streets (IRR = 0.69, 95% CI: 0.37–1.31). The interaction term for group and pre-post comparisons was not statistically significant (p = 0.14) indicating that there was no evidence to suggest a pre-post difference in IRRs between the intervention and comparator streets. Conclusions Declines in the rate of PMVC were observed on roads with posted speed limit reductions from 40 km/h to 30 km/h, although this effect was not statistically greater than reductions on comparator streets

Prioritizing a research agenda on built environments and physical activity: a twin panel Delphi consensus process with researchers and knowledge users

BACKGROUND: The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners).METHODS: Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin 'top 10' lists of the most important research needs.RESULTS: From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT.CONCLUSIONS: Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities.</p