Trends in sport and active recreation injuries resulting in major trauma or death in adults in Victoria, Australia, 2001–2007

doi:10.1016/j.injury.2011.01.031

Injury

Volume 43, Issue 9, September 2012, Pages 1527-1533

https://doi.org/10.1016/j.injury.2011.01.031 Get rights and content

Abstract

Background

The purpose of this study was to describe patterns and rates of sport and active recreation injuries that result in major trauma or death and to examine trends in these rates for all sport and active recreation activities and key sporting groups, for the period July 2001–June 2007, in Victoria, Australia.

Methods

All sport and active recreation related major trauma cases and deaths were extracted from the Victorian State Trauma Registry (VSTR) and the National Coroners Information System, for the period July 2001–June 2007. Participation data from the Exercise Recreation and Sports Survey (ERASS) was used to establish incidence rates for the group as a whole and for key sporting groups. Poisson regression analysis was used to examine trends in major trauma and death due to participation in sport and active recreation across the six year study period.

Results

There were 1019 non-fatal major trauma cases and 218 deaths. The rate of major trauma or death from sport and active recreation injuries was 6.3 per 100,000 participants per year. There was an average annual increase of 10% per year in the major trauma rate (including deaths) across the study period, for the group as a whole (IRR 1.10, 95% CI, 1.06–1.14). There was no increase in the death rate (IRR = 0.94, 95% CI, 0.87–1.02; p = 0.12). Significant increases were also found for cycling (IRR 1.16, 95% CI, 1.09–1.24) off-road motor sports (IRR 1.10, 95% CI, 1.03–1.19), Australian football (IRR 1.21, 95% CI, 1.03–1.42) and swimming (IRR 1.16, 95% CI, 1.004–1.33).

Conclusion

The rate of major trauma inclusive of deaths, due to participation in sport and active recreation has increased over recent years, in Victoria, Australia. Much of this increase can be attributed to cycling, off-road motor sports, Australian football and to a lesser extent swimming, highlighting the need for co-ordinated injury prevention in these areas.

Introduction

The health benefits of maintaining a physically active lifestyle are well established.22, 25 Consequently, physical activity is widely encouraged as part of global public health initiatives.²⁶ In recent years, developed countries have demonstrated increases in population leisure-time physical activity, especially as other domains of life become more sedentary.¹² Unfortunately however these health benefits can be negated by injury with serious injuries having potential major long-term consequences for the individual and the whole of society.1, 6 It is therefore important to monitor trends, not only in population physical activity levels but also in the number and pattern of injuries associated with physically active pursuits. The first step in effective injury prevention is the development of ongoing, systematic, injury surveillance. The use of comprehensive registries and information systems such as The Victorian State Trauma Registry (VSTR) and the National Coroners Information System (NCIS) is one such method. These systems can monitor changes in injury patterns and priority areas for injury prevention over time and assess the effectiveness of injury prevention programs.

There are numerous studies on the patterns and rates of serious injuries that occur due to participation in sport and active recreation.4, 9, 14 These studies provide useful information, however they afford only a snap-shot view of the situation. Examining injury trends provides additional information important in identifying research priorities and directions. The aim of this study therefore was to examine trends in major trauma and death rates for all sport and active recreation activities and individual key sporting groups, for the period July 2001–June 2007, in Victoria, Australia.

Section snippets

Setting

The state of Victoria has a population of 5.4 million of which 3.8 million (70%) reside in the capital city, Melbourne.² In 2007, approximately 80% of the adult population was estimated to have engaged in sport or active recreation.²⁴

Victorian State Trauma Registry (VSTR)

The VSTR is a state-wide population-based trauma registry that collects information about all major trauma patients admitted to trauma-receiving Victorian hospitals and is subject to rigorous quality assurance processes to ensure that all relevant cases are

Results

During the study period there were 1019 sport and active recreation non-fatal major trauma cases and 218 deaths (58 of which occurred in hospital). The average annual major trauma rate was 5.2, and the death rate was 1.1, per 100,000 participants per year from sport and active recreation injuries. The combined rate of major trauma and deaths was 6.3 per 100,000 participants per year. Off-road motor sports had the highest rate of major trauma and death at 118.9 per 100,000 participants per year,

Discussion

The most important finding of this study was the increase in major trauma rates for sport and active recreation in Victoria, from July 2001 to June 2007. Much of this increase can be attributed to increases in rates associated with off-road motor sports, cycling and Australian football.

Cycling demonstrated an average annual increase of 16% per year in major trauma rates over the study period. This is consistent with another Victorian study which found a significant increase in cycling major

Conclusion

Severe life threatening injuries due to sport and active recreation have increased over recent years. However the death rate has remained unchanged. The increased major trauma rate is predominantly due to increased rates associated with off-road motor sports, cycling and Australian football. Changes in the environment in which these activities take place, or intrinsic mechanisms related to how they are undertaken are likely mechanisms and provide important opportunities for injury prevention. A

Conflict of interest statement

None of the authors involved in the production of the manuscript titled: Trends in sport and active recreation injuries resulting in major trauma or death in adults in Victoria, Australia, 2001–2007 have any financial, personal or other relationships with people or organisations that could inappropriately influence or bias their work.

Acknowledgements

The Victorian State Trauma Registry (VSTR) is funded and approved by the Victorian Department of Health and the Transport Accident Commission. Belinda Gabbe was supported by a Career Development Award from the National Health and Medical Research Council (NHMRC) of Australia and Peter Cameron was supported by a Practitioner Fellowship from the NHMRC. The authors would like to thank the VSTR staff and Steering Committee for their assistance, in particular Andrew Hannaford and Sue McLellan, for

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Citation Excerpt :
Cycling participation rates have increased over time [2], and facilities for cyclists are increasingly attracting Australian government funding [6–10]. However, accompanying this rise in cycling engagement is a concomitant increase in the number of cycling injuries [2–5]. Fractures are the most common injury in hospitalised cyclists [2].
Cycling is an increasingly popular activity which is widely supported by health advocates. In the last year, more than a third of Australians used a bike [1]. While road cycling remains popular, participation in off-road recreational cycling, including mountain biking, bicycle moto cross (BMX) riding, and outdoor leisure cycling, is increasing and this is associated with an increase in the number and cost of cycling injuries [2], [3], [4], [5]. The aim of this study was to describe and compare contemporary patterns of cycling fracture requiring hospitalisation as a function of cycling mode in the Australian Capital Territory region.
This retrospective analysis of cycling-related-fracture hospitalisations in the ACT region described data recorded between July 2012 and December 2019. Logistic regression models were used to calculate probabilities of sustaining a fracture at different sites for each of the cycling modes (on-road, mountain, BMX, leisure, unspecified). These likelihoods were then compared against the on-road fracture profile.
Cycling-related-fracture hospitalisations increased by 32% in the seven years analysed. Of all fracture admissions, 442 (33%) were on-road, 658 (49%) off-road, and 242 (18%) unknown. The majority were male (79%), median age 37 (IQR 16, 52). Median length of stay was two days. The number of fractures per admission ranged from one to thirteen with a median of one. Wrist, clavicle, ribs, and skull were the four most frequent fracture sites for all cycling modes. Fracture profiles of on- and off-road accidents were similar, with the exception of wrist fractures which were more likely in off-road (OR 1.96, p < 0.01) and unspecified cycling accidents (OR 5.07, p < 0.01). Skull fractures comprised 19% of all BMX-related fractures. More than half of all fracture-related admissions required surgery.
With increasing support for sustainable and healthy transport and recreation activities, the fracture profiles of different cycling modes must first be assessed in order to inform strategies to reduce and manage this injury burden.
Online news media reporting of football-related fatalities in Australia: A matter of life and death
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Sports settings are complex systems in which people and components interact in different and unexpected ways,5,6 and as with other complex and open systems,7,8 the likelihood exists for both positive and negative outcomes.9,10 While deaths in Australian sports settings are rare, they do occur.11–14 In Australia, particular risks for death in sports settings are largely unknown because there is no systematic public reporting of fatalities.15
While deaths in sports settings are rare, they do occur. To develop an understanding of the sports and people most at risk, and to identify opportunities for prevention, routine and systematic data detailing the occurrence of these fatalities is required. There is currently no routine reporting of data of this nature in Australia. As there is often strong community interest in these incidents, the media offers an opportunity for surveillance. However before this can occur, understanding of the terminology used by the media is required. The aim of this study was to identify the terminology most frequently used in online Australian news media coverage of football-related deaths.
Retrospective review of online news media.
Three databases were searched for online news media reports of people who died while participating in football (all football codes) in Australia. A descriptive analysis of terminology was undertaken to identify the common language applied.
Thirty-four football-related fatalities in Australia were identified between 2010–2016, via 149 separate articles. The most frequent terms identified in the media items were: Family; Club; Rugby; Football; Player; League; Died; Game; Death; Life; Loved; Hospital; Match; Young; Community; Playing; Friends; Sport; Heart; AFL [Australian Football League].
This study identified terminology used in reporting football-related fatalities in Australia, identifying common reference to terms relating to ‘death’ as metaphors and the frequent celebration of ‘life.’ The findings suggest that a reliance on researcher-generated terminology will be insufficient to reflect media discourse in prospective monitoring of sports deaths for surveillance.
Outcome of proximal femoral fractures caused by cycling in the young and mid-aged
2014, Injury
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Both modes of cycling, road and MTB harbour significant injury risks that have been extensively studied in recent years. Although, the focus on cycling injuries during the past decades was on mainly head injuries [7], significant number of fractures and dislocations occurs in both MTB and road cycling [8–10], mostly involving the upper extremity with the lower extremity next [6], mainly involving lower leg and foot and ankle. Proximal femoral fractures are traditionally considered to be a disease of the elderly caused by simple falls in over 90% of cases [11].
Cycling is gaining more popularity both as a sport, on and off-road and also as a means of commute. Cycling accidents harbour significant injury risks including fractures. Proximal femoral fractures are uncommonly associated with cycling in the young adult population. The purpose of this study is to describe this unique pattern of injury as well as the outcome of proximal femoral fractures caused by cycling in the young to mid age population.
Study design: retrospective cohort study. 23 fractures in 22 patients were available for analysis. 11 were femoral neck fractures, with six displaced ones, and the rest trochanteric fractures. 21 patients were male patients, and the average age was 42 (range 27–60). All patients but two were operated within 24 h from admission. Radiographic analysis included reduction quality, fracture classification and arthritic changes. Clinical outcome was measured using SF-12 and Oxford hip scores.
All fractures healed. Two patients with displaced femoral neck fractures developed avascular necrosis requiring arthroplasty. One patient developed an AVN 2 years after a stable trochanteric fracture but did not require an arthroplasty as of yet. Eight patients required hardware removal due to symptoms. 77% of patients had resumed cycling at the pre-injury level. Mean SF-12 score was 47.1 ± 11.7 for the physical component and 53.7 ± 6.3 for the mental component. Mean oxford hip score as was 40.1 ± 12.2. Radiographic analysis revealed good to acceptable reduction quality. Fracture type, age, cycling type and reduction were not significantly associated with outcome.
Proximal femoral fractures caused by cycling in young to mid-aged adults are an emerging pattern of injury. Overall favourable result can be expected in the majority of cases, with displaced femoral neck fractures having a risk for AVN. Further delineation of the exact cause for this phenomenon is required with possible intervention for injury prevention.
An estimate of injury-related deaths linked to sporting practices in metropolitan France, in 2010
2013, Journal de Traumatologie du Sport
L’exercice physique est bénéfique pour la santé, mais il peut aussi entraîner des accidents, plus ou moins graves, dont certains conduisent au décès. L’objectif de cette étude était d’estimer le nombre de décès traumatiques liés à la pratique sportive en 2010, en France métropolitaine.
L’étude a consisté à recueillir les décès traumatiques survenus en 2010 en France métropolitaine à la suite d’une pratique sportive, quel que soit le contexte de pratique (professionnel, loisir, déplacement). Seuls ont été exclus les décès à vélo, les décès en avion et par noyade survenus hors pratique sportive. Les décès ont été repérés dans des collectes d’institutions publiques, dans les médias accessibles par Internet et sur les sites Internet d’associations et d’organismes publics impliqués dans le sport.
En 2010, 246 personnes sont décédées suite à une pratique sportive en France métropolitaine. Les sports de montagne ont été les plus meurtriers (99 décès) suivis des sports aquatiques (50), de la chasse (27), de la pratique aérienne (23 dont 22 ULM), des sports mécaniques (23) et des sports de vol libre (20 dont dix en parapente et cinq en planeur). Les hommes étaient sept fois plus nombreux que les femmes. Les périodes les plus meurtrières étaient l’été et l’hiver.
Des cas ont échappé à cette comptabilisation, entraînant une sous-estimation dans certains sports (équitation, pêche…) ou lorsque les décès n’ont pas été immédiats. Cette étude simple, qui doit être complétée, a fourni un premier décompte du nombre de décès traumatiques en sport en France métropolitaine.
Physical exercise presents numerous health benefits but it can also lead to accidents, of varying degrees of severity, some of which can result in death. The purpose of this study was to estimate, for the year 2010 in metropolitan France, the number of injury-related deaths linked to sporting practices.
The study consisted in counting the injury-related deaths that occurred in 2010 in metropolitan France following a sporting practice, regardless of the context (professional, leisure or travel). Deaths linked to cycling, deaths in airplanes and deaths by drowning were not considered as sporting practices and so were not included in the study. The figures were collected from documentation compiled by government institutions or available in on-line media and the websites of associations and government organizations involved with sport.
In 2010, 246 people died as a result of a sporting activity in metropolitan France. Mountain sports were the most dangerous (99 deaths), followed by water sports (50), hunting (27), aviation sports (23, of which 22 in ultralight/microlight aircraft), mechanical sports (23) and free flight sports (20, of which 10 were linked to paragliding and five to hang gliding). Seven times more men died than women. The most dangerous periods were summer and winter.
Our study missed some cases, which led to an overly low figure for certain sports (horse riding and fishing, etc.), and missed those people who did not die immediately following their accident. This simple study, which remains to be completed, has provided an initial estimate of the number of injury-related deaths linked to sporting activities in metropolitan France.
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Trends in sport and active recreation injuries resulting in major trauma or death in adults in Victoria, Australia, 2001–2007

Abstract

Background

Methods

Results

Conclusion

Introduction

Section snippets

Setting

Victorian State Trauma Registry (VSTR)

Results

Discussion

Conclusion

Conflict of interest statement

Acknowledgements

J Sci Med Sport

Am J Prev Med

J Am Coll Surg

J Sci Med Sport

12-month outcomes of serious orthopaedic sport and active recreation related injuries admitted to Level 1 trauma centres in Melbourne, Australia

Clin J Sport Med

Population by age and sex, Australian States and Territories

A statewide system of trauma care in Victoria: effect on patients survival

MJA

Sports and recreation related injury episodes in the US population

Inj Prev

Epidemiology and outcome of bicycle injuries presenting to an emergency department in the United Kingdom

Eur J Emerg Med

Long-term outcome of sports injuries: results after inpatient treatment

Clin Rehabil

All-terrain vehicle injuries: are they dangerous? A 6-year experience at a level I trauma center after legislative regulations expired

Am Surg

Incidence of serious injury and death during sport and recreation activities in Victoria, Australia

Br J Sports Med

Mountain biking injuries requiring trauma center admission: a 10-year regional trauma system experience

J Trauma