Cervical spinal cord injury in rugby union and rugby league: are incidence rates declining in NSW?

OBJECTIVES: To estimate trends in incidence rates of rugby code-related severe cervical spinal cord injuries in New South Wales (NSW) from 1986 to 2003. To evaluate the Australian Spinal Cord Injury Register (ASCIR) for injury surveillance by comparison with two published studies. METHODS: Data were cases of complete and incomplete tetraplegia in rugby union and rugby league admitted to the two spinal units in NSW. Trends in incidence rates were estimated using Poisson regression modelling. RESULTS: There was a small, non-significant decline from 1986 to 2003 in the incidence rate of tetraplegia in rugby union (9.8 vs. 6.1 per 100,000 player-years; p = 0.378) and rugby league (2.3 vs. 1.6 per 100,000 player-years; p = 0.564). The most common causes of injury were scrums for rugby union (35%) and tackles for rugby league (78%). This did not change over time (rugby union, p = 0.118; rugby league, p = 0.288). The ASCIR identified more cases of tetraplegia than insurance claims data and at least 75% of the cases ascertained by medical record review. CONCLUSIONS: There remains an urgent need to further improve safety in rugby union and rugby league. Scrummage in union and tackles in league remain the leading causes of tetraplegia. Rates of tetraplegia were significantly higher and more variable in rugby union than in rugby league. IMPLICATIONS: The ASCIR is a useful tool to monitor trends in spinal cord injury incidence in both rugby codes. Its potential value is constrained by the lack of accurate estimates of player numbers.     

Evaluation of protective equipment for prevention of injuries in rugby union

BACKGROUND: Rugby union has a high rate of injury. The increased use of protective equipment may help mitigate these injuries. This study investigated the injury prevention effectiveness of the protective equipment used in rugby union. METHODS: A cohort of 304 rugby players in Dunedin, New Zealand was followed weekly during the 1993 club season to assess protective equipment use, participation in rugby, and injury outcomes. Generalized Poisson regression was used to model the rate of injury while adjusting for covariates such as level of competition, playing position, and injury history. RESULTS: The use of mouthguards appeared to lower the risk of orofacial injury [rate ratio (RR) = 0.56, 95% confidence interval (CI): 0.07-4.63], and padded headgear tended to prevent damage to the scalp and ears (RR = 0.59, 95% CI: 0.19-1.86). Support sleeves tended to reduce the risk of sprains and strains (RR = 0.58, 95% CI: 0.26-1.27). The risk of concussion was not lessened by the use of padded headgear (RR = 1.13, 95% CI: 0.40-3.16) or mouthguards (RR = 1.62, 95% CI: 0.51-5.11). There was no evidence of protective effects for any other equipment item (taping, shinguards, and grease). CONCLUSIONS: The protective equipment used in rugby union has limited effectiveness in preventing injuries. The results are supportive, however, of a role for mouthguards and padded headgear in preventing orofacial and scalp injuries, respectively, and for support sleeves in preventing sprains and strains.     

Boys soccer league injuries: a community-based study of time-loss from sports participation and long-term sequelae

Background: Youth soccer is important for keeping European childrenphysically active. The aim of this study is to examine injuriessustained in a community soccer league for boys with regardto age-related incidence, time lost from participation and long-termsequelae. Methods: Primary injury data was collected from asoccer league including 1800 players, comprising approximately25% of all boys 13–16 years of age in three Swedish municipalities(population 150 000). Injuries were primarily identified basedon a time loss definition of sports injury. At the end of theseason, a physician interviewed every player who reported injuredto determine whether there were any remaining sequelae. If asequela was confirmed, the physician repeated the interview6, 18 and 48 months after the end of the season. Results: Forty-fourinjuries were recorded during 18 720 player game hours (2.4injuries per 1000 player game hours). The highest injury incidence(6.8 injuries per 1000 player game hours) was recorded in thefirst-year elite divisions. Thirty-two injuries (73%) were categorizedas moderate-severe, and 21 injuries (48%) required medical attention.Eight injuries caused sequelae that remained 6 months afterthe end of the season, and 3 injuries caused sequelae that lasted4 years after the injury event. Conclusion: An overall low injuryrate makes soccer a suitable sport for inclusion in programmesthat promote physical activity among children. When organizingsoccer leagues for boys, injury prevention programmes shouldbe provided to adolescent players when they begin playing incompetitive divisions.     

An ecologic study of protective equipment and injury in two contact sports

BACKGROUND: Contact sports have high rates of injury. Protective equipment regulations are widely used as an intervention to reduce injury risk. The purpose of this study was to investigate the injury prevention effect of regulations governing protective equipment in two full-body contact sports. METHODS: Injury rates in US collegiate football were compared to New Zealand club Rugby Union. Both sports involve significant body contact and have a high incidence of injury. Extensive body padding and hard-shell helmets are mandated in collegiate football but prohibited in Rugby Union. RESULTS: The injury rate in football was approximately one-third the rugby rate (rate ratio [RR] = 0.35; 95% CI: 0.31-0.40). The head was the body site with the greatest differential in injury incidence (RR = 0.11; 95% CI: 0.08-0.16). Rugby players suffered numerous lacerations, abrasions, and contusions to the head region, but the incidence of these injuries in football was almost zero (RR = 0.01; 95% CI: 0.01-0.03). Injury rates were more similar for the knee (RR = 0.61; 95% CI: 0.43-0.87) and ankle (RR = 0.72; 95% CI: 0.46-1.13), two joints largely unprotected in both sports. CONCLUSIONS: The observed differences are consistent with the hypothesis that regulations mandating protective equipment reduce the incidence of injury, although important potential biases in exposure assessment cannot be excluded. Further research is needed into head protection for rugby players.     

Evaluating Tackling Rugby Injury: the pilot phase for monitoring injury

OBJECTIVE: To assess the suitability of two previously unused data sources for monitoring rugby injury throughout New Zealand. METHOD: Interviews were conducted with respondents sampled from players registered with the Rugby Football Unions (RFUs) and players claiming for rugby injuries from the Accident Rehabilitation and Compensation Insurance Corporation (ACC) in Auckland and Dunedin. RESULTS: Of the 500 RFU players sampled, 63% were interviewed and of these 39 (12%) had been injured playing rugby union. Of the 456 ACC claimants sampled, 66% were interviewed and 265 (88%) had been injured playing rugby union. CONCLUSION: Identifying injured players through ACC claims was more efficient, both procedurally and because a smaller sample size was required to detect changes in incidence. IMPLICATIONS: With no routine surveillance of sports injury being undertaken, recording sporting codes in national injury surveillance systems would assist the monitoring of sports injury.     

Changes in sports injuries to children between 1983 and 1998: comparison of case series

BACKGROUND: Sports injuries sustained by children are worrying because they prevent and deter participation in physical activity. Before we can address such injuries we need to understand the size of the problem and whether there have been changes in occurrence. A study of sports injuries to children, carried out in a Cardiff Accident and Emergency department in 1983, provided the data against which to compare data gathered in 1998. METHODS: Data on all sports injuries to children aged 16 and under treated between September and December 1998 were compared with those reported for the same hospital, age group, injury and period in 1983. RESULTS: A total of 953 injuries were treated in 1998, representing an increase of 54 per cent [95 per cent confidence interval (CI) 44-64 per cent]. The male:female distribution remained constant and the majority of injuries were due to rugby and soccer. The number of females injured playing rugby and soccer increased and a wider range of sports led to injuries for both males and females. Amongst 10-15-year-olds injury risk increased from 1 in 78 for boys in 1983 to 1 in 22 in 1998 (p < 0.0001). For girls, the increase was from 1 in 117 to 1 in 55 (p < 0.0001). The number of soccer- and rugby-related fractures increased by 52 per cent (95 per cent CI 22-87 per cent). CONCLUSIONS: Sports injury rates have increased considerably over 15 years. With minimal population change, little variation in minor injuries and only small improvements in data capture, the main reason for change appears to be increased participation.     

Evaluation of potential reduction in blood and body fluid exposures by use of alternative instruments

BACKGROUND: Injuries from needlestick, sharps injuries and splashes lead to exposure to blood and body fluids with the potential for transmission of blood-borne viruses. AIMS: To identify alternative instruments, which if used would improve worker safety. METHODS: Retrospective review of 161 injuries with identification of safer alternative products for instruments that caused injury. The proportion of injuries that could be prevented was calculated [with 95% confidence intervals (CI)]. RESULTS: The average rate of injury was 7.8/1000 employees per annum (95% CI, 6.8-9.4/1000). In the 2 years the highest rates of injury occurred in pre-registration house officers (164/1000; 95% CI, 64-264/1000), phlebotomists (154/1000; 95% CI, 15-291/1000) and senior house officers (45/1000; 95% CI, 13-77/1000). An upper estimate of 65% (95% CI, 58-72%) of incidents would have been preventable with a change to alternative devices. CONCLUSIONS: Change to the use of intrinsically safer instrumentation has the potential to prevent injury to healthcare workers.     

Injuries due to falls from horses

Abstract: This study describes the epidemiology of injuries due to falls from horses in New Zealand. There were 54 fatalities from 1977 to 1986 (0.17 per 100 000 persons per year). There were 773 hospitalisations in 1987 (23.7 per 100 000 persons per year). Head injuries were predominant among both fatal and nonfatal injuries. The incidence of nonfatal head injury in the 10 to 19 age group was significantly higher than the incidence in all older groups (P = 0.003). Young people, particularly females, were the segment of the population most affected by the problem of falls from horses. Reference to data on horse-riding participation rates, however, did not indicate that young people were overrepresented in the series studied. Reference to the same data showed that the rate of hospitalisation due to falls from horses is comparable to the rate for injuries from playing rugby. The magnitude and severity of the problem indicates that there is a need need for helmet use, safe-riding practices, and further research.     

Injury risk in men's Canada West University football

Injury and participation information was collected over 5 years (1993-1997) on varsity men's football players in the Canada West Universities Athletic Association. The locations of acute time-loss injuries or neurologic injures were coded as head and neck, upper extremity (shoulder to hand), or lower extremity (hip to foot). Poisson regression-based generalized estimating equations were used to estimate rate ratios and 95% confidence intervals. Injury rates were higher during games as compared with practice periods (for the head and neck, rate ratio (RR) = 9.75 (95% confidence interval (CI): 7.50, 12.67); for upper extremities, RR = 5.76 (95% CI: 4.46, 7.45); and for lower extremities, RR = 7.06 (95% CI: 6.03, 8.25)). In dry-field game situations, head and neck injury rates were 1.59 times higher on artificial turf than on natural grass (95% CI: 1.04, 2.42). Lower extremity game injury rates were higher on artificial turf than on natural grass under both dry (RR = 1.83, 95% CI: 1.35, 2.48) and wet (RR = 2.31, 95% CI: 1.18, 4.52) field conditions. Injury rates increased with every additional year of participation. Past injury increased the rate of subsequent injury. The effect of an artificial field surface may be related to infrequent use. Risk factors for injury included participation in a game, playing on artificial turf, being a veteran player, and having a past injury.     

Occupational and non-occupational injuries in the United States Army: focus on gender

BACKGROUND: The differences in occupational and non-occupational injuries between military men and women have not been documented. This study compares occupational and non-occupational injuries between male and female United States Army soldiers by examining injury hospitalization rates and characteristics. METHODS: The U.S. Army's Total Army Injury and Health Outcomes Database was searched for hospitalizations with ICD-9-CM codes for injury (800-959.9) between 1992 and 2002. Injury rates were calculated using yearly U.S. Army population data and compared using rate ratios. Injury characteristics were compared among categories of the Trauma Code (on duty; off duty; scheduled training, schemes, and exercises), stratified by gender. RESULTS: Included in this analysis were 792 women for an injury hospitalization rate of 11.0 per 1000 individuals (95% confidence interval [CI]=8.5-13.5) and 4879 men for a rate of 15.5 per 1000 individuals (95% CI=14.0-16.9). While women had significantly more injuries during scheduled training, schemes, and exercises than men (p<0.0001), there were few differences in the cause of those injuries. Women had longer average hospital stays compared to men due to these injuries (9.3 days vs 7.4 days, p=0.002), although these injuries were not more severe (average Injury Severity Score=3.5 for men vs average ISS for women=3.5, p=0.79). There was no difference between the genders in the percent of injuries that occurred off duty; however, men were more likely to get injured due to sports and athletics (p=0.001) and due to fighting (p=0.017) while off duty compared to women. CONCLUSIONS: Injury prevention messages for military personnel should focus on reducing risk factors for both on- and off-duty injuries.     

Parental safety concerns – a barrier to sport and physical activity in children?

OBJECTIVE: To examine the extent to which parents and carers perceive injury and safety risks as serious enough to prevent or discourage their children, aged 5-12 years, from participating in sports/physical activity and to identify factors that influence these perceptions. METHODS: An analysis of the 2001 New South Wales Child Health Survey. RESULTS: More than one-quarter of parents/ carers of active children aged 5-12 years reported discouraging or preventing children from playing a particular sport (34.7% for boys and 16.6% for girls) because of injury and safety concerns. In boys, the most frequently discouraged sport was rugby league (23.2%), followed by rugby union (7.5%) and Australian rules football (2.8%). Among girls, the most frequently discouraged activities were rollerblading (2.7%), rugby league (2.3%) and soccer (2.1%). Multivariate analysis shows that factors independently associated with parents' decision to prevent/discourage their child from engaging in sport/physical activity include their child's age and gender, language spoken at home, presence of disability, and the respondent's relation to the child. CONCLUSIONS AND IMPLICATIONS: Efforts need to be made to modify some sports/ activities, such as football codes, in order to minimise injury and to ensure that children continue enjoying their favourite activity well into adulthood. Guidelines designed to promote physical activity among children and young adolescents need to take into account parental concerns regarding the associated risk of injury.     

Community-based injury prevention: effects on health care utilization.

BACKGROUND: Worldwide, an estimated 78 million people are disabled each year because of unintentional injuries and about 3 million die. The WHO Safe Community model is a framework for community-based injury prevention programmes. The aim of this study is to evaluate the outcome on health care utilization of a Safe Community programme. METHODS: The incidence of injuries treated at health care facilities in an intervention municipality (pop. 41,000) was compared to the injury incidence in a control municipality (pop. 26,000). The incidence was recorded immediately before and one year after programme implementation from registrations made during all first-contact health care visits and from examination of hospital discharge registers. RESULTS: The incidence of health care treated injuries in the intervention area had decreased by 13% (95% CI: 9-16%) from 119 (95% CI: 115-122) per 1000 population-years to 104 (95% CI: 101-107). In the control area, the corresponding injury incidences were 104 (95% CI: 100-108) and 106 (95% CI: 102-109). The hospital-treated injuries in the intervention area decreased by 15% (95% CI: 7-24%) from 19 (95% CI: 17-20) per 1000 population-years to 16 (95% CI: 15-17), while in the control area, the incidences remained at 13 (95% CI: 11-14) per 1000 population-years. Utilization of acute care in the intervention area for reasons other than injuries increased by 8% (95% CI: 6-10%), while in the control area, the number of visits did not show significant change. CONCLUSION: This first controlled evaluation showed that an injury prevention programme based on local action groups can significantly reduce injuries requiring health care in a community. Local prevention can provide a complement to national level campaigns.     

Non-fatal occupational injuries in British agriculture

Objectives

To investigate the incidence, nature and determinants of non‐fatal occupational injuries in British agriculture.

Methods

As part of a postal survey, data on lifetime histories of work in agriculture and occupational accidents were obtained from men born between 1933 and 1977 and residing in three rural areas of England and Wales. Incidence rates for different categories of accident were compared with those derived from statutory reporting. Associations with risk factors were explored by Poisson regression, and summarised by incidence rate ratios (IRRs).

Results

Of the 10 765 responders (response rate = 31%), 3238 (30%) reported at least one occupational accident at the ages of 14–64 years, leading to absence from work for ⩾3 days, including 1492 accidents that could be linked to a specific job listed in the history of agricultural work. The reported incidence of injuries in agriculture was markedly higher than that derived from statutory reporting, particularly for self‐employed farmers. During 1996–2003, the highest rates of agricultural accidents were from handling, lifting or carrying (4.9/1000 person‐years), falls from a height (4.6/1000 person‐years) and injury by animals (3.4/1000 person‐years). After adjustment for calendar period and age, the risk of accidents was elevated in men who had only recently entered agricultural work (IRR 3.7, 95% CI 2.7 to 5.1 for men who had worked in agriculture for up to 1 year relative to those who had entered the industry >25 years earlier), and in those who carried out forestry (IRR 1.7, 95% CI 1.5 to 1.9).

Conclusion

Our findings confirm the substantial underascertainment of serious accidental injuries in agriculture through statutory reporting, particularly for the self‐employed. The risk of accidents is highest in new recruits to the industry and in those undertaking forestry, and these groups should be a target for further preventive action.Although much has been done in developed countries to improve safety in the workplace, accidental injury remains an important cause of morbidity and mortality, particularly in certain industries. In Britain, statistics on occupational accidents are available from notifications to the Health and Safety Executive under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR). Among other things, RIDDOR requires employers to report all accidents in the workplace that cause death, specified serious injuries such as fractures and amputations, or absence from work for longer than three working days. The agricultural industry (farming, forestry and horticulture) has one of the highest rates of fatal occupational accidents nationally.¹ Rates of reported non‐fatal accidents in agricultural workers are lower than in other non‐service industries, but many are self‐employed or work in small businesses, and there is thought to be substantial under‐reporting in these groups.Evidence for this theory is provided by the Labour Force Survey (LFS), data from which suggest that, even among agricultural employees, RIDDOR statistics underestimate rates of reportable injury by a factor of 3–5.¹ However, the number of agricultural workers included in the LFS each year is relatively small, limiting the more detailed conclusions that can be drawn.To find out more about the incidence, nature and determinants of non‐fatal occupational injuries in agricultural workers, we analysed data from a survey of health and work in three rural populations of England and Wales.     

The burden of road traffic injuries in developing countries: the 1st national injury survey of Pakistan

OBJECTIVES: To assess the burden of road traffic injuries in Pakistan-a developing country in South Asia. METHODS: A nationally representative household interview survey, to measure the burden of all injuries for all ages and in both genders using a three-month recall period. RESULTS: The overall incidence of injury events was 41 (CI: 39.2-43.8) per 1000 per year and for road traffic injuries 15 (CI: 13.7-16.5) per 1000 per year. The relative risk for road traffic injuries was found to be higher in males, those 16-45 years old, and those in the professional category of laborers and vendors. CONCLUSIONS: This first national survey reflects the growing impact of injuries, especially road traffic injuries in Pakistan and portends a challenge for the national health system.     

Effects of a participatory ergonomics team among hospital orderlies

BACKGROUND: High rates of work-related injuries are seen among health care workers involved in lifting and transferring patients. We studied the effects of a participatory worker-management ergonomics team among hospital orderlies. METHODS: This prospective intervention trial examined work injuries and other outcomes before and after the intervention, with other hospital employees used as a concurrent control. All orderlies in a 1,200-bed urban hospital were studied using passively collected data (mean employment during study period 100-110 orderlies); 67 orderlies (preintervention) and 88 orderlies (postintervention) also completed a questionnaire. The intervention was the formation of a participatory ergonomics team with three orderlies, one supervisor, and technical advisors. This team designed and implemented changes in training and work practices. RESULTS: The 2-year postintervention period was marked by decreased risks of work injury (RR = 0.50, 95% CI 0.35-0.72), lost time injury (RR = 0.26, 95% CI 0.14-0.48), and injury with three or more days of time loss (RR = 0.19, 95% CI 0.07-0.53). Total lost days declined from 136.2 to 23.0 annually per 100 full-time worker equivalents (FTE). Annual workers' compensation costs declined from $237/FTE to $139/FTE. The proportion of workers with musculoskeletal symptoms declined and there were statistically significant improvements in job satisfaction, perceived psychosocial stressors, and social support among the orderlies. CONCLUSION: Substantial improvements in health and safety were seen following implementation of a participatory ergonomics program.     

A prospective study of injury incidence among North Carolina high school athletes

Sports-related injuries are an issue of concern in high school sports athletes. A prospective cohort study of injury risk factors was conducted from 1996 to 1999 among varsity high school athletes in 12 sports in 100 North Carolina high schools. Data were collected by trained school personnel. Unadjusted and adjusted incidence rates and rate ratios were estimated using Poisson regression models. The overall rate of injury was 2.08 per 1,000 athlete-exposures (95% confidence interval (CI): 1.79, 2.41). At 3.54 per 1,000 athlete-exposures (95% CI: 2.87, 4.37), football had the highest rate of injury of all sports. The adjusted rate ratio for athletes with a history of injury, compared with those without a prior injury, was 1.94 (95% CI: 1.69, 2.22). The injury rate rose with each year of playing experience (rate ratio=1.06, 95% CI: 1.01, 1.12). In a subanalysis restricted to gender-comparable sports, boys had a higher rate of injury than did girls (rate ratio=1.33, 95% CI: 0.99, 1.79). All other factors did not appear to be independent predictors of the injury rate. The influence of prior injury suggests that proper rehabilitation and primary prevention of the initial injury are important strategies for injury control.     

Soccer Injuries in Female Youth Players

A cross-sectional survey of injuries among female youth soccer players found 44.6% (95% confidence interval 34.9%–54.8%) had ever been injured. The injury incidence rate for the current season was 2.2/1000 soccer exposure hours (95% CI 1.5–3.1). Future studies should evaluate modifiable risk factors in youth to identify injury prevention strategies.     

Occurrence and Risk Factors of Unintentional Injuries among 12- to 18-Year-Old Finns – A Survey of 8219 Adolescents

The aim of this study was to evaluate the incidence, nature, and risk factors of unintentional injuries among 12-, 14-, 16- and 18-year-old Finnish adolescents. Of the 8219 respondents (response rate 75%) 5.5% reported an injury that had required medical attention during the past month. The total number of injuries was 506 and the incidence of injuries 62 per 1000 person-months. Boys had a slightly higher injury occurrence rate than girls (OR: 1.33; 95% CI: 1.13-1.59). The most common injuries were sprains (27%), fractures (26%) and wounds (16%) of the upper and lower limbs. In multivariate logistic regression analysis the strongest risk factors of injury were: having experienced violence during past month (OR: 3.6; 95% CI: 2.8-4.6), daily leisure time exercise in sports club (OR: 3.3; 95% CI: 2.3-4.6), having several somatic health complaints weekly (OR: 2.2; 95% CI: 1.7-2.9) and having chronic disease (OR: 2.0; 95% CI: 1.5-2.6). In conclusion, injuries were an important cause of morbidity among our 12-18-year-old adolescents. Adolescents' school success and their parents' education, occupation and employment status were not associated with injuries. The finding that several health and health behaviour variables are important risk factors for injuries challenges the researchers and the society to identify and treat the risk factors that can be modified to reduce the number of adolescent injuries.     

Assessment of occupational eye injury risk and severity: an analysis of Rhode Island workers' compensation data 1998-2002

BACKGROUND: Occupational eye injuries have been recognized as a serious health risk to workers and are in need of further investigation to develop effective interventions. METHODS: Rhode Island workers' compensation claims of ocular injury between 1998 through 2002 (n=8,877) were examined. The Current Population Survey was used to estimate occupational employment levels as a baseline for rate calculations. RESULTS: The estimated ocular injury claim rate was 32.9 per 10,000 workers (95% CI=32.3-33.6), with the cost of claims totaling $1,514,666 and averaging $171 per claim. The highest estimated claim rate of all occupations was found for construction laborers of 373.7 per 10,000 workers (95% CI=267.1-480.3). Relative to the durable manufacturing industry, the highest risk of injury resulting in disability indemnification was the wholesale trade industry (OR=2.18, 95% CI=1.19-4.01, P<0.05). CONCLUSIONS: Many of the eye injuries reported were likely preventable. Greater diligence, training, and safety precautions are needed to reduce the risk of eye injury to employees.     

The incidence rates and risk factor of mild injury for two weeks: using Korea national health and nutrition examination survey 2001

OBJECTIVES: This study was performed to provide the basic data for establishing countermeasures for preventing injury by analyzing the incidence rates, the risk factors, the characteristics of the injury and the utilization of medical care for mild injury that lasted for two weeks. METHODS: We examined the injury survey data among the National Health and Nutrition Survey data. The definition of mild injury that lasted for two weeks was that the injury that caused pain at least once a day for two weeks or the injury for which the usual daily activity of the injured person was severely affected. We used statistical analysis methods such as chi-square test and multiple logistic regression analysis. RESULTS: The incidence rate of injury that lasted for two weeks was 4.7 per 1,000 persons. On the multiple logistic regression, the children and adolescents (OR=3.80, 95%CI=1.63-8.84) had higher rates of injuries than the adults, and the middle and high school (OR=0.51, 95%CI=0.31-0.85) and college(OR=0.34, 95%CI=0.17-0.68) students had lower rates of injuries than the elementary school students. The unemployed (OR=0.39, 95%CI=0.20-0.73) and others (OR=0.38, 95%CI=0.21-0.70) had lower rates of injuries than the blue collar workers. The major causes of injuries were found to be falling and slipping, and the most prevalent place of occurrence was near or at home. CONCLUSIONS: A prevention program needs to be developed and continuous education must be offered to the children, adolescents and blue collar workers.