Lorann Stallones - Academia.edu (original) (raw)

Papers by Lorann Stallones

Rural and Remote Health, Sep 12, 2019

Introduction: The purpose of this ecological study was to apply Geographic Information System (GI... more Introduction: The purpose of this ecological study was to apply Geographic Information System (GIS) methods to patterns of traumatic injury and access to trauma care to facilitate system planning and advocacy. Methods: Four US state (Colorado) and national data sources were linked to examine county-level disparities. Average ambulance drive times to trauma centers for populated places in each county were estimated and mapped. Results: Independent samples t-tests demonstrated Colorado's rural counties had significantly higher injury hospitalization rates (mean (M)=685.4 v M=566.3; p=0.005)) and fatality rates (M=93.8 v M=71.6, p<0.001), indicating residents with the least access to care are the most impacted by the burden of injury; this finding was supported by GIS analyses of drive times to level I and II trauma centers and underlying injury rates, which are visually displayed. Conclusions: These methods are useful tools for rural public health professionals to conduct system optimization, identify training and resource needs, assess prevention priorities, and advocate for trauma system support.

AAOHN Journal, Aug 19, 2015

Annals of Epidemiology, 2014

Purpose-Little research has been done in China to study injury in individuals with disability. We... more Purpose-Little research has been done in China to study injury in individuals with disability. We investigated impact of type and severity of disability on injury among children with disability in Hubei Province of China. Methods-A sample of 1201 children with disability were matched with 1201 healthy children on gender, age, and neighborhood. Disability type and severity were determined using the Chinese national standards. Caregivers were interviewed face-to-face about nonfatal unintentional injuries suffered by the child in the past 12 months prior to the interview. Univariate Chi-square test and logistic regression models were used to investigate association between disability type/severity and nonfatal unintentional injuries. Results-Injury rate among children with disability was significantly higher than that among children without disability (10.2% vs. 4.4%; P <.001). Children with multiple disabilities had the highest risk of injury after controlling for confounding variables (OR=4.54; 95% CI=2.82, 7.30;

Spine, Mar 1, 2012

Study Design-This was a population-based survey conducted in 2008 in a northern area of China. Ob... more Study Design-This was a population-based survey conducted in 2008 in a northern area of China. Objective-To investigate back pain prevalence and to examine the associations between potential risk factors and back pain among Chinese farmers. Summary of Background Data-Few studies have investigated back pain and its associated risk factors among farmers in low-income and developing nations. Methods-Farmers ages 15 years and older were chosen from 800 families in Heilongjiang Province of People's Republic of China using cluster sampling methods. Complete survey data were obtained from 2045 farmers. The prevalence of self-reported back pain during the previous three-months was reported. Associations between back pain and potential risk factors were examined in logistic regression models which included age, gender, education levels, perceived stress, main farm activities, smoking, and drinking status. Results-A total of 786 (38.4%) farmers reported back pain. Two-thirds of those with back pain (66.0%) reported that back pain affected work quantity and quality. The adjusted odds ratios of reporting back pain increased with advancing age. Females and farmers who experienced stress regularly were also more likely to report back pain. Conclusion-Back pain is a common problem among Chinese farmers and is reported more frequently by females. Significant positive associations of gender, age, and perceived stress with back pain warrant additional study.

Injury Prevention, Sep 1, 2010

Background Sleeping disorder has been found to be associated with occupational injuries among rai... more Background Sleeping disorder has been found to be associated with occupational injuries among railway workers in the France and students in China, but this association has not well been studied in farmers. This population-based study investigated the relationship between sleeping disorders and agricultural work-related injury among farmers in a north eastern province of the Peoples Republic of China. Methods A multistage sample of 2264 farmers was selected from villages in Heilongjiang province. In May 2008, faceto-face interviews were conducted. Complete questionnaires were available for 2198 (97.1%) of the sample. Less than 7% (148) of the sample was excluded after the survey because their primary occupation was not farming. Farmers were questioned about work-related injury in the past year,

Injury Prevention, Sep 1, 2010

International Journal of Environmental Research and Public Health, Sep 11, 2014

The association between sleep and work-related injuries among Chinese farmers has not been well s... more The association between sleep and work-related injuries among Chinese farmers has not been well studied. This study examined the impact of lack of sleep on agricultural work-related injuries among farmers in China. Data were from a cross-sectional survey of farm-workers in northeastern China. Information was obtained on injuries that occurred in 12 months prior to the survey, on eight sleep-related variables, and on socio-demographic variables. Logistic regression analyses were conducted to test the hypothesis that lack of

Injury-international Journal of The Care of The Injured, Mar 1, 2014

Purpose-To identify the annual prevalence and potential risk factors of nonfatal agricultural mac... more Purpose-To identify the annual prevalence and potential risk factors of nonfatal agricultural machinery injuries among agricultural machinery operators in the northern areas of China. Methods-A quota sampling method was used to study 1921 agricultural machinery operators in 5 provinces in northern China. Agricultural machinery injuries that occurred between July 1, 2008, and June 30, 2009 were investigated. Data on nonfatal injuries and related factors were obtained by in-person interviews. Results-The prevalence of agricultural machinery-related injuries among the surveyed operators was 13.1%. Being male, having lower family income and/or poor hearing, being in debt, and feeling stressed were five significant risk factors for injuries. The majority of injuries took place on farmlands (46.6%), roads (26.3%), or in backyards (17.5%). The four most common causes of injuries were being stuck by starting handles that slipped, being slashed or stabbed by sharp objects, being struck by falling objects, and falls from stationary vehicles. Conclusions-The prevalence of agricultural machinery-related injuries in our study was high. Males, low family income, poor hearing, and stress were associated with high risk of injury occurrence.

Frontiers in pain research, Feb 1, 2023

Stallones L and Coetzee JF (2023) A nationwide survey on producer and veterinarian perceptions of... more Stallones L and Coetzee JF (2023) A nationwide survey on producer and veterinarian perceptions of the painfulness of procedures and disease states in dairy and beef cattle.

Injury Prevention, Mar 1, 1997

Objectives-The purpose ofthis study is to describe and compare the distribution of injury deaths ... more Objectives-The purpose ofthis study is to describe and compare the distribution of injury deaths among rural and urban Colorado children that occurred between 1980-8. Method-Death certificates coded E800-E969 were obtained for children who were 0-14 years of age at death between 1980-8 and who were Colorado residents. Average annual rates were computed for rural and urban children, separately by gender. The 1980 census was used to compute rates. Rate ratios were calculated to summarize information related to specific external causes of deaths, contrasting rural and urban children. These differences were evaluated using Z tests. Results-Statistically significant elevated risks were found along rural children for motor vehicle injury deaths. Firearms were involved more often in rural deaths among unintentional injury deaths of children older than 4 years of age, and among homicide related deaths of children 5 years and younger. All rural children who committed suicide used a firearm. Conclusions-Comparisons between rural and urban injury deaths provide important information that can be used to guide prevention strategies. For example, in Colorado, a child restraint law, passed in 1984, covered children under 4 years of age or under 40 pounds. It was not until 1995, however, that legislation was passed requiring restraint of children 5-16 years of age. Traditionally, rural residents are slower to accept new ideas and to alter current practices than urban residents.

Injury Prevention, Jun 1, 2005

To investigate non-fatal unintentional injuries among adults with activity/participation limitati... more To investigate non-fatal unintentional injuries among adults with activity/participation limitations. Design: Injuries in the previous 12 months were reported by a stratified probability sample of noninstitutionalized adults. Based on self reported activity/participation limitations, 2602 respondents were classified into three groups (no limitations, moderate limitations, and severe limitations) and injury characteristics were compared. Results: A total of 19.2% of respondents reported activity/participation limitations. Twenty four percent (95% confidence intervals (CI) 14.5% to 33.6%) with severe and 17.8% (95% CI 13.2% to 22.4%) with moderate limitations were injured, compared with 12.6% (95% CI 10.6% to 14.7%) of respondents without limitations. The odds ratio of injury was 3.72 (95% CI 1.94 to 7.14) for respondents with severe and 1.87 (95% CI 1.25 to 2.77) for respondents with moderate limitations. The leading cause of injuries among respondents with activity/participation limitations was falls. Conclusions: Individuals with activity/participation limitations are at an increased risk for injuries.

Injury Prevention, Apr 1, 2004

Young skiers are at increased risk for injury, however, epidemiological data on skiing related fa... more Young skiers are at increased risk for injury, however, epidemiological data on skiing related fatal injuries among child skiers are scarce. This study aimed to provide information needed to develop injury control and prevention programs. Design and setting: Study subjects came from Colorado, USA and were identified using a death certificate based surveillance system. Fatal injuries were limited to events that occurred at established commercial ski resorts in Colorado, and subjects were classified as child skiers (0-17 years) or adult skiers (>18 years). Main outcome measure: Type and external cause, time, and week day of injury, gender and residency of the decedents. Results: During the study period from 1980-2001, 149 fatal injuries associated with downhill skiing were identified; 21 (14.1%) occurred among child skiers aged (17 years. The age of the youngest decedent was 7 years. In females the proportion of fatal injuries among child skiers was nearly three times that of adults. Traumatic brain injuries were the leading cause of death (67% of all deaths) among children, while multiple internal injuries and traumatic brain injuries accounted for almost equal proportions of fatal injuries among adults. Collision was the leading external mechanism of fatal injuries, accounting for more than two thirds of fatal injuries in both child and adult skiers. Conclusions: Traumatic brain injury was the leading cause and collision was the leading external injury mechanism of fatal injuries associated with downhill skiing among child skiers. This underscores the importance of brain injury prevention strategies, including the use of ski helmets and prevention of collisions on ski slopes. *Fisher's exact two sided test. ÀTotal collision number was used for Fisher's exact test. Key points N Traumatic brain injury was the leading cause of downhill skiing related fatal injuries among child skiers 7-17 years of age. N Collisions, often with trees, were the leading external mechanism for downhill skiing related injuries for both child skiers and adult skiers. N Effectiveness of ski helmets in preventing traumatic brain injuries among child skiers needs to be studied further. N Lack of detailed exposure information (number of skiers and total skiing hours) is one of the major limitations.

Journal of Safety Research, Dec 1, 2016

Although there are hundreds of ATV-related deaths each year in the United States, contributing fa... more Although there are hundreds of ATV-related deaths each year in the United States, contributing factors have not been clearly identified. The purpose of this study was to investigate associations between factors contributing to ATV fatalities using the agent-host-environment epidemiological triangle. Method: Incident reports of ATV fatalities occurring between 2011 and 2013 were obtained from the United States Consumer Product Safety Commission (CPSC). Narrative reports included details of the decedent and a description of the ATV crash. A chi-square automatic interaction detector (CHAID) analysis was performed for three major risk factors representing each facet of the epidemiologic triangle: helmet use (host), type of crash (agent), and location where death occurred (environment). The output of the CHAID analysis is a classification tree that models the relationship between the predictor variables and a single outcome variable. Results: A total of 1193 ATV fatalities were reported to the CPSC during the 3-year study period. In cases with known helmet and/or drug and alcohol use status, descriptive statistics indicated helmets were not worn in 88% of fatalities and use of alcohol or drugs was present in 84% of fatalities. Reoccurring factors within the CHAID analysis included age, helmet use, geographic region of the country, and location (e.g., farm, street, home, etc.) at the time of death. Within the three CHAID models, there were seven significant partitions related to host, one related to agent, and eight related to the environment. Conclusions: This research provides a model for understanding the relationship between risk factors and fatalities. The combination of the CHAID analysis method and the epidemiologic triangle allows for visualization of the interaction between host-agent-environment factors and fatalities. Practical applications: By modeling and characterizing risk factors associated with ATV fatalities, future work can focus on developing solutions targeted to specific factions of ATV users.

Brain Injury, 2009

Primary objective-To examine the hospitalization costs and discharge outcomes of U.S. children wi... more Primary objective-To examine the hospitalization costs and discharge outcomes of U.S. children with TBI and to evaluate a severity measure, the predictive mortality likelihood level. Research design-Data from the 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) were used to report the national estimates and characteristics of TBI-associated hospitalizations among U.S. children ≤ 20 years of age. Percentage of children with TBI caused by motor vehicle crashes (MVC) and falls was calculated according to the predictive mortality likelihood levels (PMLL), death in hospital, and discharge into long-term rehabilitation facilities. Associations with the PMLL, discharge outcomes, and average hospital charges were examined. Results-In 2006, there were an estimated 58,900 TBI-associated hospitalizations among U.S. children, accounting for $2.56 billion in hospital charges. MVCs caused 38.9% and falls caused 21.2% of TBI hospitalizations. The PMLL was strongly associated with TBI type, length of hospital stay, hospital charges, and discharge disposition. About 4% of children with fall or MVC related TBIs died in hospital and 9% were discharged into long-term facilities. Conclusion-The PMLL may provide a useful tool to assess characteristics and treatment outcomes of hospitalized TBI children but more research is still needed.

Injury Prevention, Sep 1, 2010

Animals, Sep 5, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Journal of Safety Research, Dec 1, 2010

Annals of Epidemiology, 2004

To examine the association between workload, health status, social support, depression, and safet... more To examine the association between workload, health status, social support, depression, and safety practices among farm residents. Depression may lead to inattention when performing farm tasks and may reduce the likelihood of engaging in safe practices. There is a paucity of studies examining factors that influence engaging in safety practices among farmers. METHODS: Personal interviews were conducted with farm operators and spouses in an eight-county area in Colorado. The Center for Epidemiologic Studies-Depression (CES-D) scale was used to assess depression. Ten safety practices were assessed for those involved in farm work. Proportional odds and logistic regression were used to model the relationship between safety practices and modifiers of safety behavior. RESULTS: A total of 761 individuals were enrolled, of these 710 were actively involved in farm work. In logistic regression analysis, adjusting for age and gender, CES-D scale depression was significantly associated with being in a high-risk category for: being calm around animals (

American Journal of Preventive Medicine, 2003

Background: Few studies have assessed the relationship between alcohol consumption patterns among... more Background: Few studies have assessed the relationship between alcohol consumption patterns among farm populations and work-related injuries. The purpose of this study was to assess the role of alcohol consumption patterns on farmwork-related injuries. Methods: Prospective cohort study of Colorado farm residents, 1993 to 1995. Self-reported injuries, alcohol consumption, and demographics were assessed over 3 years. A stratified probability sample of farms was selected to include approximately 2.6% of Colorado farm residences with a farm operator living on the property. A total of 485 farms, including 872 individuals, were recruited in the initial cohort. In the second year, 746 individuals were re-interviewed, and in the third year, 653 of the original group participated. Results: Injuries during the study period were assessed in relationship to alcohol consumption. During the 3 years, 150 farm residents reported a total of 215 farmwork-related injuries. An increased risk of injury was associated with increased alcohol consumption. Compared to abstainers, farm residents who drank more frequently had higher farmwork injury incidence rates (3.09 and 3.35 injuries per 10,000 person-days of observation versus 1.94 injuries per 10,000). Farm residents who typically drank three or more drinks per day had a farmwork injury rate of 3.62 per 10,000 person-days (95% confidence interval [CI]ϭ2.38-4.85). Farm residents who typically drank one to two drinks per day had a farmwork-related injury rate of 3.02 per 10,000 person-days (95% CIϭ2.44-3.60). In multivariate models, alcohol consumption frequency and quantity were significantly associated with farmwork-related injuries. Conclusions: Alcohol consumption should be considered in studies of agricultural injuries.

American Journal of Industrial Medicine, 2009

Rural and Remote Health, Sep 12, 2019

Introduction: The purpose of this ecological study was to apply Geographic Information System (GI... more Introduction: The purpose of this ecological study was to apply Geographic Information System (GIS) methods to patterns of traumatic injury and access to trauma care to facilitate system planning and advocacy. Methods: Four US state (Colorado) and national data sources were linked to examine county-level disparities. Average ambulance drive times to trauma centers for populated places in each county were estimated and mapped. Results: Independent samples t-tests demonstrated Colorado's rural counties had significantly higher injury hospitalization rates (mean (M)=685.4 v M=566.3; p=0.005)) and fatality rates (M=93.8 v M=71.6, p<0.001), indicating residents with the least access to care are the most impacted by the burden of injury; this finding was supported by GIS analyses of drive times to level I and II trauma centers and underlying injury rates, which are visually displayed. Conclusions: These methods are useful tools for rural public health professionals to conduct system optimization, identify training and resource needs, assess prevention priorities, and advocate for trauma system support.

AAOHN Journal, Aug 19, 2015

Annals of Epidemiology, 2014

Purpose-Little research has been done in China to study injury in individuals with disability. We... more Purpose-Little research has been done in China to study injury in individuals with disability. We investigated impact of type and severity of disability on injury among children with disability in Hubei Province of China. Methods-A sample of 1201 children with disability were matched with 1201 healthy children on gender, age, and neighborhood. Disability type and severity were determined using the Chinese national standards. Caregivers were interviewed face-to-face about nonfatal unintentional injuries suffered by the child in the past 12 months prior to the interview. Univariate Chi-square test and logistic regression models were used to investigate association between disability type/severity and nonfatal unintentional injuries. Results-Injury rate among children with disability was significantly higher than that among children without disability (10.2% vs. 4.4%; P <.001). Children with multiple disabilities had the highest risk of injury after controlling for confounding variables (OR=4.54; 95% CI=2.82, 7.30;

Spine, Mar 1, 2012

Study Design-This was a population-based survey conducted in 2008 in a northern area of China. Ob... more Study Design-This was a population-based survey conducted in 2008 in a northern area of China. Objective-To investigate back pain prevalence and to examine the associations between potential risk factors and back pain among Chinese farmers. Summary of Background Data-Few studies have investigated back pain and its associated risk factors among farmers in low-income and developing nations. Methods-Farmers ages 15 years and older were chosen from 800 families in Heilongjiang Province of People's Republic of China using cluster sampling methods. Complete survey data were obtained from 2045 farmers. The prevalence of self-reported back pain during the previous three-months was reported. Associations between back pain and potential risk factors were examined in logistic regression models which included age, gender, education levels, perceived stress, main farm activities, smoking, and drinking status. Results-A total of 786 (38.4%) farmers reported back pain. Two-thirds of those with back pain (66.0%) reported that back pain affected work quantity and quality. The adjusted odds ratios of reporting back pain increased with advancing age. Females and farmers who experienced stress regularly were also more likely to report back pain. Conclusion-Back pain is a common problem among Chinese farmers and is reported more frequently by females. Significant positive associations of gender, age, and perceived stress with back pain warrant additional study.

Injury Prevention, Sep 1, 2010

Background Sleeping disorder has been found to be associated with occupational injuries among rai... more Background Sleeping disorder has been found to be associated with occupational injuries among railway workers in the France and students in China, but this association has not well been studied in farmers. This population-based study investigated the relationship between sleeping disorders and agricultural work-related injury among farmers in a north eastern province of the Peoples Republic of China. Methods A multistage sample of 2264 farmers was selected from villages in Heilongjiang province. In May 2008, faceto-face interviews were conducted. Complete questionnaires were available for 2198 (97.1%) of the sample. Less than 7% (148) of the sample was excluded after the survey because their primary occupation was not farming. Farmers were questioned about work-related injury in the past year,

Injury Prevention, Sep 1, 2010

International Journal of Environmental Research and Public Health, Sep 11, 2014

The association between sleep and work-related injuries among Chinese farmers has not been well s... more The association between sleep and work-related injuries among Chinese farmers has not been well studied. This study examined the impact of lack of sleep on agricultural work-related injuries among farmers in China. Data were from a cross-sectional survey of farm-workers in northeastern China. Information was obtained on injuries that occurred in 12 months prior to the survey, on eight sleep-related variables, and on socio-demographic variables. Logistic regression analyses were conducted to test the hypothesis that lack of

Injury-international Journal of The Care of The Injured, Mar 1, 2014

Purpose-To identify the annual prevalence and potential risk factors of nonfatal agricultural mac... more Purpose-To identify the annual prevalence and potential risk factors of nonfatal agricultural machinery injuries among agricultural machinery operators in the northern areas of China. Methods-A quota sampling method was used to study 1921 agricultural machinery operators in 5 provinces in northern China. Agricultural machinery injuries that occurred between July 1, 2008, and June 30, 2009 were investigated. Data on nonfatal injuries and related factors were obtained by in-person interviews. Results-The prevalence of agricultural machinery-related injuries among the surveyed operators was 13.1%. Being male, having lower family income and/or poor hearing, being in debt, and feeling stressed were five significant risk factors for injuries. The majority of injuries took place on farmlands (46.6%), roads (26.3%), or in backyards (17.5%). The four most common causes of injuries were being stuck by starting handles that slipped, being slashed or stabbed by sharp objects, being struck by falling objects, and falls from stationary vehicles. Conclusions-The prevalence of agricultural machinery-related injuries in our study was high. Males, low family income, poor hearing, and stress were associated with high risk of injury occurrence.

Frontiers in pain research, Feb 1, 2023

Stallones L and Coetzee JF (2023) A nationwide survey on producer and veterinarian perceptions of... more Stallones L and Coetzee JF (2023) A nationwide survey on producer and veterinarian perceptions of the painfulness of procedures and disease states in dairy and beef cattle.

Injury Prevention, Mar 1, 1997

Objectives-The purpose ofthis study is to describe and compare the distribution of injury deaths ... more Objectives-The purpose ofthis study is to describe and compare the distribution of injury deaths among rural and urban Colorado children that occurred between 1980-8. Method-Death certificates coded E800-E969 were obtained for children who were 0-14 years of age at death between 1980-8 and who were Colorado residents. Average annual rates were computed for rural and urban children, separately by gender. The 1980 census was used to compute rates. Rate ratios were calculated to summarize information related to specific external causes of deaths, contrasting rural and urban children. These differences were evaluated using Z tests. Results-Statistically significant elevated risks were found along rural children for motor vehicle injury deaths. Firearms were involved more often in rural deaths among unintentional injury deaths of children older than 4 years of age, and among homicide related deaths of children 5 years and younger. All rural children who committed suicide used a firearm. Conclusions-Comparisons between rural and urban injury deaths provide important information that can be used to guide prevention strategies. For example, in Colorado, a child restraint law, passed in 1984, covered children under 4 years of age or under 40 pounds. It was not until 1995, however, that legislation was passed requiring restraint of children 5-16 years of age. Traditionally, rural residents are slower to accept new ideas and to alter current practices than urban residents.

Injury Prevention, Jun 1, 2005

To investigate non-fatal unintentional injuries among adults with activity/participation limitati... more To investigate non-fatal unintentional injuries among adults with activity/participation limitations. Design: Injuries in the previous 12 months were reported by a stratified probability sample of noninstitutionalized adults. Based on self reported activity/participation limitations, 2602 respondents were classified into three groups (no limitations, moderate limitations, and severe limitations) and injury characteristics were compared. Results: A total of 19.2% of respondents reported activity/participation limitations. Twenty four percent (95% confidence intervals (CI) 14.5% to 33.6%) with severe and 17.8% (95% CI 13.2% to 22.4%) with moderate limitations were injured, compared with 12.6% (95% CI 10.6% to 14.7%) of respondents without limitations. The odds ratio of injury was 3.72 (95% CI 1.94 to 7.14) for respondents with severe and 1.87 (95% CI 1.25 to 2.77) for respondents with moderate limitations. The leading cause of injuries among respondents with activity/participation limitations was falls. Conclusions: Individuals with activity/participation limitations are at an increased risk for injuries.

Injury Prevention, Apr 1, 2004

Young skiers are at increased risk for injury, however, epidemiological data on skiing related fa... more Young skiers are at increased risk for injury, however, epidemiological data on skiing related fatal injuries among child skiers are scarce. This study aimed to provide information needed to develop injury control and prevention programs. Design and setting: Study subjects came from Colorado, USA and were identified using a death certificate based surveillance system. Fatal injuries were limited to events that occurred at established commercial ski resorts in Colorado, and subjects were classified as child skiers (0-17 years) or adult skiers (>18 years). Main outcome measure: Type and external cause, time, and week day of injury, gender and residency of the decedents. Results: During the study period from 1980-2001, 149 fatal injuries associated with downhill skiing were identified; 21 (14.1%) occurred among child skiers aged (17 years. The age of the youngest decedent was 7 years. In females the proportion of fatal injuries among child skiers was nearly three times that of adults. Traumatic brain injuries were the leading cause of death (67% of all deaths) among children, while multiple internal injuries and traumatic brain injuries accounted for almost equal proportions of fatal injuries among adults. Collision was the leading external mechanism of fatal injuries, accounting for more than two thirds of fatal injuries in both child and adult skiers. Conclusions: Traumatic brain injury was the leading cause and collision was the leading external injury mechanism of fatal injuries associated with downhill skiing among child skiers. This underscores the importance of brain injury prevention strategies, including the use of ski helmets and prevention of collisions on ski slopes. *Fisher's exact two sided test. ÀTotal collision number was used for Fisher's exact test. Key points N Traumatic brain injury was the leading cause of downhill skiing related fatal injuries among child skiers 7-17 years of age. N Collisions, often with trees, were the leading external mechanism for downhill skiing related injuries for both child skiers and adult skiers. N Effectiveness of ski helmets in preventing traumatic brain injuries among child skiers needs to be studied further. N Lack of detailed exposure information (number of skiers and total skiing hours) is one of the major limitations.

Journal of Safety Research, Dec 1, 2016

Although there are hundreds of ATV-related deaths each year in the United States, contributing fa... more Although there are hundreds of ATV-related deaths each year in the United States, contributing factors have not been clearly identified. The purpose of this study was to investigate associations between factors contributing to ATV fatalities using the agent-host-environment epidemiological triangle. Method: Incident reports of ATV fatalities occurring between 2011 and 2013 were obtained from the United States Consumer Product Safety Commission (CPSC). Narrative reports included details of the decedent and a description of the ATV crash. A chi-square automatic interaction detector (CHAID) analysis was performed for three major risk factors representing each facet of the epidemiologic triangle: helmet use (host), type of crash (agent), and location where death occurred (environment). The output of the CHAID analysis is a classification tree that models the relationship between the predictor variables and a single outcome variable. Results: A total of 1193 ATV fatalities were reported to the CPSC during the 3-year study period. In cases with known helmet and/or drug and alcohol use status, descriptive statistics indicated helmets were not worn in 88% of fatalities and use of alcohol or drugs was present in 84% of fatalities. Reoccurring factors within the CHAID analysis included age, helmet use, geographic region of the country, and location (e.g., farm, street, home, etc.) at the time of death. Within the three CHAID models, there were seven significant partitions related to host, one related to agent, and eight related to the environment. Conclusions: This research provides a model for understanding the relationship between risk factors and fatalities. The combination of the CHAID analysis method and the epidemiologic triangle allows for visualization of the interaction between host-agent-environment factors and fatalities. Practical applications: By modeling and characterizing risk factors associated with ATV fatalities, future work can focus on developing solutions targeted to specific factions of ATV users.

Brain Injury, 2009

Primary objective-To examine the hospitalization costs and discharge outcomes of U.S. children wi... more Primary objective-To examine the hospitalization costs and discharge outcomes of U.S. children with TBI and to evaluate a severity measure, the predictive mortality likelihood level. Research design-Data from the 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) were used to report the national estimates and characteristics of TBI-associated hospitalizations among U.S. children ≤ 20 years of age. Percentage of children with TBI caused by motor vehicle crashes (MVC) and falls was calculated according to the predictive mortality likelihood levels (PMLL), death in hospital, and discharge into long-term rehabilitation facilities. Associations with the PMLL, discharge outcomes, and average hospital charges were examined. Results-In 2006, there were an estimated 58,900 TBI-associated hospitalizations among U.S. children, accounting for $2.56 billion in hospital charges. MVCs caused 38.9% and falls caused 21.2% of TBI hospitalizations. The PMLL was strongly associated with TBI type, length of hospital stay, hospital charges, and discharge disposition. About 4% of children with fall or MVC related TBIs died in hospital and 9% were discharged into long-term facilities. Conclusion-The PMLL may provide a useful tool to assess characteristics and treatment outcomes of hospitalized TBI children but more research is still needed.

Injury Prevention, Sep 1, 2010

Animals, Sep 5, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Journal of Safety Research, Dec 1, 2010

Annals of Epidemiology, 2004

To examine the association between workload, health status, social support, depression, and safet... more To examine the association between workload, health status, social support, depression, and safety practices among farm residents. Depression may lead to inattention when performing farm tasks and may reduce the likelihood of engaging in safe practices. There is a paucity of studies examining factors that influence engaging in safety practices among farmers. METHODS: Personal interviews were conducted with farm operators and spouses in an eight-county area in Colorado. The Center for Epidemiologic Studies-Depression (CES-D) scale was used to assess depression. Ten safety practices were assessed for those involved in farm work. Proportional odds and logistic regression were used to model the relationship between safety practices and modifiers of safety behavior. RESULTS: A total of 761 individuals were enrolled, of these 710 were actively involved in farm work. In logistic regression analysis, adjusting for age and gender, CES-D scale depression was significantly associated with being in a high-risk category for: being calm around animals (

American Journal of Preventive Medicine, 2003

Background: Few studies have assessed the relationship between alcohol consumption patterns among... more Background: Few studies have assessed the relationship between alcohol consumption patterns among farm populations and work-related injuries. The purpose of this study was to assess the role of alcohol consumption patterns on farmwork-related injuries. Methods: Prospective cohort study of Colorado farm residents, 1993 to 1995. Self-reported injuries, alcohol consumption, and demographics were assessed over 3 years. A stratified probability sample of farms was selected to include approximately 2.6% of Colorado farm residences with a farm operator living on the property. A total of 485 farms, including 872 individuals, were recruited in the initial cohort. In the second year, 746 individuals were re-interviewed, and in the third year, 653 of the original group participated. Results: Injuries during the study period were assessed in relationship to alcohol consumption. During the 3 years, 150 farm residents reported a total of 215 farmwork-related injuries. An increased risk of injury was associated with increased alcohol consumption. Compared to abstainers, farm residents who drank more frequently had higher farmwork injury incidence rates (3.09 and 3.35 injuries per 10,000 person-days of observation versus 1.94 injuries per 10,000). Farm residents who typically drank three or more drinks per day had a farmwork injury rate of 3.62 per 10,000 person-days (95% confidence interval [CI]ϭ2.38-4.85). Farm residents who typically drank one to two drinks per day had a farmwork-related injury rate of 3.02 per 10,000 person-days (95% CIϭ2.44-3.60). In multivariate models, alcohol consumption frequency and quantity were significantly associated with farmwork-related injuries. Conclusions: Alcohol consumption should be considered in studies of agricultural injuries.

American Journal of Industrial Medicine, 2009