| 1. |
- Abayazid, Fady, et al.
(författare)
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A New Assessment of Bicycle Helmets: The Brain Injury Mitigation Effects of New Technologies in Oblique Impacts
- 2021
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Ingår i: Annals of Biomedical Engineering. - : Springer Science and Business Media LLC. - 1573-9686 .- 0090-6964. ; 49:10, s. 2716-2733
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Tidskriftsartikel (refereegranskat)abstract
- New helmet technologies have been developed to improve the mitigation of traumatic brain injury (TBI) in bicycle accidents. However, their effectiveness under oblique impacts, which produce more strains in the brain in comparison with vertical impacts adopted by helmet standards, is still unclear. Here we used a new method to assess the brain injury prevention effects of 27 bicycle helmets in oblique impacts, including helmets fitted with a friction-reducing layer (MIPS), a shearing pad (SPIN), a wavy cellular liner (WaveCel), an airbag helmet (Hövding) and a number of conventional helmets. We tested whether helmets fitted with the new technologies can provide better brain protection than conventional helmets. Each helmeted headform was dropped onto a 45° inclined anvil at 6.3 m/s at three locations, with each impact location producing a dominant head rotation about one anatomical axes of the head. A detailed computational model of TBI was used to determine strain distribution across the brain and in key anatomical regions, the corpus callosum and sulci. Our results show that, in comparison with conventional helmets, the majority of helmets incorporating new technologies significantly reduced peak rotational acceleration and velocity and maximal strain in corpus callosum and sulci. Only one helmet with MIPS significantly increased strain in the corpus collosum. The helmets fitted with MIPS and WaveCel were more effective in reducing strain in impacts producing sagittal rotations and a helmet fitted with SPIN in coronal rotations. The airbag helmet was effective in reducing brain strain in all impacts, however, peak rotational velocity and brain strain heavily depended on the analysis time. These results suggest that incorporating different impact locations in future oblique impact test methods and designing helmet technologies for the mitigation of head rotation in different planes are key to reducing brain injuries in bicycle accidents.
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| 2. |
- Bergsten, Eva L., 1969-, et al.
(författare)
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Fall and collision related injuries among pedestrians, sickness absence and associations with accident type and occupation
- 2023
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Ingår i: Journal of Safety Research. - : Elsevier. - 0022-4375 .- 1879-1247. ; 86, s. 357-363
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study explores pedestrian fall accidents and collisions with other road users in the Swedish road transport system, and sickness absence (SA) in relation to accident type, injury, and occupation. Further, it studies the associations between accident type, occupation, and duration of SA. Methods: Data from several national registers were used that included 15,359 working age pedestrians (20–64 years) receiving healthcare after a fall or collision throughout 2014–2016. Individual characteristics, accident type, injury, and occupation were presented and related to SA. Logistic regression was used to estimate odds ratios (OR), with 95% confidence intervals, for associations between accident type, occupation, and SA duration. Results: About 11,000 pedestrians (72%) were involved in fall accidents in the road traffic environment and well over 4,000 in collisions with another road user; 22% of all injured pedestrians had a new SA. The population had a higher proportion of women and individuals in older age groups (≥45). Of the falls, 31% were due to snow or ice, and these were associated with a higher OR for both short SA (<90 days) 1.76 (95% CI 1.56–1.98) and long SA (≥90 days) 1.81 (95% CI 1.51–2.18), compared to the group slipping, tripping, and stumbling. The working sectors health & social care, and construction had the highest ORs for SA. A higher OR was found for health & social care, short SA 1.58 (95% CI 1.38–1.81), long SA 1.79 (95% CI 1.45–2.20) and for construction, short SA 1.56 (95% CI 1.24–1.96), long SA 1.75 (95% CI 1.26–2.44), compared to the sector finance, communication, & cultural service. Conclusions: The OR for having short and long SA was higher in falls due to snow or ice and differed between occupational sectors. Practical implications: This information contributes to the knowledge base for planning a safe road transport system for pedestrians.
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| 3. |
- Bergsten, Eva L., 1969-, et al.
(författare)
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Fall and collision related injuries among pedestrians, sickness absence and associations with accident type and occupation
- 2023
-
Ingår i: Journal of Safety Research. - : Elsevier. - 0022-4375 .- 1879-1247. ; 86, s. 357-363
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study explores pedestrian fall accidents and collisions with other road users in the Swedish road transport system, and sickness absence (SA) in relation to accident type, injury, and occupation. Further, it studies the associations between accident type, occupation, and duration of SA.METHODS: Data from several national registers were used that included 15,359 working age pedestrians (20-64 years) receiving healthcare after a fall or collision throughout 2014-2016. Individual characteristics, accident type, injury, and occupation were presented and related to SA. Logistic regression was used to estimate odds ratios (OR), with 95% confidence intervals, for associations between accident type, occupation, and SA duration.RESULTS: About 11,000 pedestrians (72%) were involved in fall accidents in the road traffic environment and well over 4,000 in collisions with another road user; 22% of all injured pedestrians had a new SA. The population had a higher proportion of women and individuals in older age groups (≥45). Of the falls, 31% were due to snow or ice, and these were associated with a higher OR for both short SA (<90 days) 1.76 (95% CI 1.56-1.98) and long SA (≥90 days) 1.81 (95% CI 1.51-2.18), compared to the group slipping, tripping, and stumbling. The working sectors health & social care, and construction had the highest ORs for SA. A higher OR was found for health & social care, short SA 1.58 (95% CI 1.38-1.81), long SA 1.79 (95% CI 1.45-2.20) and for construction, short SA 1.56 (95% CI 1.24-1.96), long SA 1.75 (95% CI 1.26-2.44), compared to the sector finance, communication, & cultural service.CONCLUSIONS: The OR for having short and long SA was higher in falls due to snow or ice and differed between occupational sectors.PRACTICAL IMPLICATIONS: This information contributes to the knowledge base for planning a safe road transport system for pedestrians.
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| 4. |
- Davidsson, Johan, 1967, et al.
(författare)
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Analys av kollisioner vid hockeyspel med hjärnskakning som utfall
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Detta projekt får anses utgöra en pilotstudie som visar på både möjligheter och svårigheter med att analysera hjärnskakningar hos hockeyspelare utifrån tillgängliga videofilmer, RTP och blodprovsdata. Att konstruera en modell som ger mer detaljerad information om orsaken till hjärnskakning och dess omfattning bedöms som möjlig men svårt. Med tillgång till fler kameravinklar och deras exakta positioner i förhållande till isen kan en bildanalys utföras mycket mer exakt. Man bör också ta i beaktning de relativt få spelare som analyserades. Data från fler spelare bedöms som en framkomlig väg även ifall insamlingsmetoderna och analysen förblir den samma som i den här studien. Ytterligare data skulle sannolikt medföra att analysen av korrelationer med RTP och HUC gav tydligare svar. Även om inte de planerade numeriska modellerna av spelarna gick att förverkliga gav kinematikanalysen användbara resultat; bland annat kollisionshastigheten. Försök att korrelera kollisionshastigheten med RTP gjordes men någon korrelation förelåg inte. Andra faktorer; som hur våldsam rotationen av huvudet var vid kollisionen har känd större inverkan på risken för hjärnskakning än ingångshastigheten. Noterbart är att de erhållna kollisionshastigheterna beror på manuell utplacering av referenspunkter som lagt grunden för koordinatsystemet. Utifrån detta koordinatsystem har sedan hastigheterna erhållits; små fel vid skapandet av koordinatsystemet påverka kollisionshastigheterna stort. Den utförda analysen är baserad på HUC. Den har utförts något annorlunda än på det sett som utvecklarna av HUC avsåg. Fyra bedömare har utfört analysen och det blev uppenbart att några faktorer var svårbedömda. Inför framtida studier där film från kollisioner karakteriseras med hjälp där HUC bör några av beskrivningarna av faktorerna kompletteras. Resultaten i korthet: I stort sätt alla analyserade kollisionerna uppstår i kontakt mellan två spelare. De vanligaste kontakterna var mellan huvud och opponentens axelskydd och mellan huvud och armbåge; 58% respektive 21% av de analyserade kollisionerna. Den drabbade träffades i 66% av kollisionerna i huvudet och 25% i överkroppen. Vanligast var träffar framifrån. Den resulterande huvudrörelsen var oftast komplex alternativt begränsad till sagittalplanet. Efter den första träffen följde det minst en andra huvudträff i 44% av kollisionerna. Hälften av dessa andra träffar var med isen och andra hälften med ringsargen. Kollisionerna skedde i alla zoner och på öppen is samt i närheten av sargen. Lika många av spelarna bedömdes varit medvetna om att en tackling väntade som de som var omedvetna. Straff utdelades som en följd i 34% av kollisionerna; trots att 75% av tacklingarna bedömdes planerade. Kollisionshastigheten varierade mellan 5,0 m/s och 11,6 m/s. RTP är inte en funktion av ålder, riktningen på huvudaccelerationen eller kollisionshastigheten. Resultaten indikerar att RTP var högre när den drabbade blev träffad av en axel relativt av en armbåge. RTP var högre för de spelare som bedömdes omedveten om den förstående tacklingen. RTP var mycket högre för planerade tacklingar i jämförelse med tacklagar som var en följd i en situation där tacklingen är en del i en oplanerad kollision. För varaktiga symptom, d.v.s. för de fyra spelare som inte återgick till spel på elitnivå efter kollisionen, var 75% träffade av motståndarens axel och lika stor andel träffade i huvudet. I alla fyra fallen ansågs den drabbade ej ha kunnat förutse tacklingen samt opponenten bedömdes ha planerat tacklingen. Medelkoncentrationen av blodmarkören NFL sjunker vid mätningarna vid 12 h och vid 36 h relativt 1 h men ökar något vid 144 h relativt 1 h. Medelvärdet av parade NFL-koncentrationerna förblir i stort sätt oförändrade över tiden förutom vid 144 h då det förekommer en icke statistiskt signifikant ökning. Det går att skönja en svag korrelation mellan RTP och förändringen av NFL vid 12 h, 36 h och 144 h i relation till värdena vid 1 h; högre RTP för högre NFL NFL-värden för gruppen RTP ≥ 9 dagar skiljer sig inte signifikant mot värden för gruppen RTP < 9 dagar vid 12h, 26 h eller vid 144 h efter kollisionen. NFL-värdena kan prediktera RTP men resultaten är inte signifikanta. Parade koncentrationer av blodmarkörerna NSE, S100B och tau sjunker signifikant vid 12 h i relation till nivåerna vid 1h efter trauma. Dessa förändringar var inte förväntade. Koncentrationsändringarna av NSE, S100B och tau för gruppen RTP ≥ 9 dagar skiljer sig inte signifikant mot värden för gruppen RTP < 9 dagar vid 12h, 26 h eller vid 144 h efter kollisionen.
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| 5. |
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| 6. |
- Kjeldgård, Linnea, 1985-, et al.
(författare)
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Bicycle crashes and sickness absence - a population-based Swedish register study of all individuals of working ages
- 2019
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Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn recent years, bicycle injuries have increased, yet little is known about the impact of such injures on sickness absence (SA) and disability pension (DP). The aim was to explore SA and DP among individuals of working ages injured in a bicycle crash.MethodA nationwide register-based study, including all individuals aged 16-64years and living in Sweden, who in 2010 had in- or specialized out-patient healthcare (including emergency units) after a bicycle crash. Information on age, sex, sociodemographics, SA, DP, crash type, injury type, and injured body region was used. We analyzed individuals with no SA or DP, with ongoing SA or full-time DP already at the time of the crash, and with new SA >14days in connection to the crash. Crude and adjusted odds ratios (OR) with 95% confidence intervals for new SA were estimated by logistic regression.ResultsIn total, 7643 individuals had healthcare due to a new bicycle crash (of which 85% were single-bicycle crashes). Among all, 10% were already on SA or full-time DP at the time of the crash, while 18% had a new SA spell. The most common types of injuries were external injuries (38%) and fractures (37%). The body region most frequently injured was the upper extremities (43%). Women had higher OR (1.40; 1.23-1.58) for new SA than men, as did older individuals compared with younger (OR 2.50; 2.02-3.09, for ages: 55-64 vs. 25-34). The injury types with the highest ORs for new SA, compared with the reference group external injuries was fractures (8.04; 6.62-9.77) and internal injuries (7.34; 3.67-14.66). Individuals with traumatic brain injury and injuries to the vertebral column and spinal cord had higher ORs for SA compared with other head, face, and neck injuries (2.72; 1.19-6.22 and 3.53; 2.24-5.55, respectively).ConclusionsIn this explorative nationwide study of new bicycle crashes among individuals of working ages, 18% had a new SA spell in connection to the crash while 10% were already on SA or DP. The ORs for new SA were higher among women, older individuals, and among individuals with a fracture.
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| 7. |
- Kjeldgård, Linnea, 1985-, et al.
(författare)
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Diagnosis-specific sickness absence among injured working-aged pedestrians: a sequence analysis
- 2023
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 23:1, s. 367-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The knowledge about the long-term consequences in terms of sickness absence (SA) among pedestrians injured in a traffic-related accident, including falls, is scarce. Therefore, the aim was to explore diagnosis-specific patterns of SA during a four-year period and their association with different sociodemographic and occupational factors among all individuals of working ages who were injured as a pedestrian. METHODS: A nationwide register-based study, including all individuals aged 20-59 and living in Sweden, who in 2014-2016 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Diagnosis-specific SA (> 14 days) was assessed weekly from one year before the accident up until three years after the accident. Sequence analysis was used to identify patterns (sequences) of SA, and cluster analysis to form clusters of individuals with similar sequences. Odds ratios (ORs) with 95% confidence intervals (CIs) for association of the different factors and cluster memberships were estimated by multinomial logistic regression. RESULTS: In total, 11,432 pedestrians received healthcare due to a traffic-related accident. Eight clusters of SA patterns were identified. The largest cluster was characterized by no SA, three clusters had different SA patterns due to injury diagnoses (immediate, episodic, and later). One cluster had SA both due to injury and other diagnoses. Two clusters had SA due to other diagnoses (short-term and long-term) and one cluster mainly consisted of individuals with disability pension (DP). Compared to the cluster "No SA", all other clusters were associated with older age, no university education, having been hospitalized, and working in health and social care. The clusters "Immediate SA", "Episodic SA" and "Both SA due to injury and other diagnoses" were also associated with higher odds of pedestrians who sustained a fracture. CONCLUSIONS: This nationwide study of the working-aged pedestrians observed diverging patterns of SA after their accident. The largest cluster of pedestrians had no SA, and the other seven clusters had different patterns of SA in terms of diagnosis (injury and other diagnoses) and timing of SA. Differences were found between all clusters regarding sociodemographic and occupational factors. This information can contribute to the understanding of long-term consequences of road traffic accidents.
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| 8. |
- Kjeldgård, Linnea, 1985-, et al.
(författare)
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Sequence analysis of sickness absence and disability pension in the year before and the three years following a bicycle crash; a nationwide longitudinal cohort study of 6353 injured individuals
- 2020
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bicyclists are the road user group with the highest number of severe injuries in the EU, yet little is known about sickness absence (SA) and disability pension (DP) following such injuries. Aims: To explore long-term patterns of SA and DP among injured bicyclists, and to identify characteristics associated with the specific patterns. Methods: A longitudinal register-based study was conducted, including all 6353 individuals aged 18–59 years and living in Sweden in 2009, who in 2010 had incident in-patient or specialized out-patient healthcare after a bicycle crash. Information about sociodemographic factors, the injury, SA (SA spells > 14 days), and DP was obtained from nationwide registers. Weekly SA/DP states over 1 year before through 3 years after the crash date were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each identified sequence cluster. Results: Seven clusters were identified: “No SA or DP” (58.2% of the cohort), “Low SA or DP” (7.4%), “Immediate SA” (20.3%), “Episodic SA” (5.9%), “Long-term SA” (1.7%), “Ongoing part-time DP” (1.7%), and “Ongoing full-time DP” (4.8%). Compared to the cluster “No SA or DP”, all other clusters had higher ORs for women, and higher age. All clusters but “Low SA and DP” had higher ORs for inpatient healthcare. The cluster “Immediate SA” had a higher OR for: fractures (OR 4.3; CI 3.5–5.2), dislocation (2.8; 2.0–3.9), sprains and strains (2.0; 1.5–2.7), and internal injuries (3.0; 1.3–6.7) compared with external injuries. The cluster “Episodic SA” had higher ORs for: traumatic brain injury, not concussion (4.2; 1.1–16.1), spine and back (4.5; 2.2–9.5), torso (2.5; 1.4–4.3), upper extremities (2.9; 1.9–4.5), and lower extremities (3.5; 2.2–5.5) compared with injuries to the head, face, and neck (not traumatic brain injuries). The cluster “Long-term SA” had higher ORs for collisions with motor vehicles (1.9;1.1–3.2) and traumatic brain injury, not concussion (18.4;2.2–155.2). Conclusion: Sequence analysis enabled exploration of the large heterogeneity of SA and DP following a bicycle crash. More knowledge is needed on how to prevent bicycle crashes and especially those crashes/injuries leading to long-term consequences.
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| 9. |
- Kjeldgård, Linnea, 1985-, et al.
(författare)
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Sickness absence and disability pension among injured working-aged pedestrians - a population-based Swedish register study
- 2021
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The knowledge is scarce about sickness absence (SA) and disability pension (DP) among pedestrians injured in a traffic-related accident, including falls. Thus, the aim was to explore the frequencies of types of accidents and injuries and their association with SA and DP among working-aged individuals. Methods: A nationwide register-based study, including all individuals aged 16-64 and living in Sweden, who in 2010 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Information on age, sex, sociodemographics, SA, DP, type of accident, injury type, and injured body region was used. Frequencies of pedestrians with no SA or DP, with ongoing SA or full-time DP already at the time of the accident, and with a new SA spell >14 days in connection to the accident were analyzed. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for new SA were estimated by logistic regression. Results: In total, 5576 pedestrians received healthcare due to a traffic-related accident (of which 75% were falls, with half of the falls related to snow and ice). At the time of the accident, 7.5% were already on SA and 10.8% on full-time DP, while 20% started a new SA spell. The most common types of injuries were fractures (45%) and external injuries (30%). The body region most frequently injured was the lower leg, ankle, foot, and other (in total 26%). Older individuals had a higher OR for new SA compared with younger (OR 1.91; 95% CI 1.44-2.53, for ages: 45-54 vs. 25-34). The injury type with the highest OR for new SA, compared with the reference group external injuries, was fractures (9.58; 7.39-12.43). The injured body region with the highest OR for new SA, compared with the reference group head, face, and neck, was lower leg, ankle, foot, and other (4.52; 2.78-7.36). Conclusions: In this explorative nationwide study of the working-aged pedestrians injured in traffic-related accidents including falls, one fifth started a new SA spell >14 days. Fractures, internal injuries, collisions with motor vehicle, and falls related to snow and ice had the strongest associations with new SA.
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| 10. |
- Meredith, Lauren, 1989, et al.
(författare)
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Mapping equestrian injuries and injury incidence in Sweden using insurance registry data
- 2020
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Ingår i: Translational Sports Medicine. - : Hindawi Limited. - 2573-8488. ; 3:1, s. 46-54
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Tidskriftsartikel (refereegranskat)abstract
- A nationwide insurance database including all members of the Swedish Equestrian Federation and acute injuries reported to Folksam Insurance Group during 2017 was used to investigate horse-related injuries and calculate injury incidence nationally. Of the 152 069 insured members during 2017, 907 were injured, an average of 1.2 injuries per injured person. Females represented 96.9% of all those injured and had a higher risk of injury than males (RR = 3.18). The average age of injured equestrians was 30 years, and the highest injury incidence was for riders aged 21-40 years (RR = 8.83) and 41+- year-olds (RR = 7.33). The most common diagnoses included soft-tissue injuries (39%), fractures (36.7%), and concussions (17.3%). The most frequently injured body regions were the head and neck (36.4%) and the upper limbs (22.3%). Horse-related injuries occurred most frequently while riding a horse (86.2%), and the most frequent incident type was a fall (77.4%). The type of incident and activity was not independent from injury type. Injuries to equestrians represent a sizable public health concern. Injury prevention methods should be directed toward females, and protection against injury should be targeted for different incidents. Focus should be on preventing fall injuries, with appropriate matching of horse and rider and horsemanship skills.
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