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D J Chalmers

Publications and source records attributed to D J Chalmers.

At least 19 recordsLinked to original sources
PubMed2005

Playing conditions, player preparation and rugby injury: a case-control study.

This paper investigates the effect of player preparation, ground conditions and weather conditions upon the injury risk for Rugby Union players. A population-based case-control study was performed using a sample (n= 1043) of New Zealand Rugby Union players aged 16 y and above. Details concerning game preparation (warm-up and usual position), and ground and weather conditions (precipitation, wind and temperature) were obtained from the players. If players were injured during the season (n= 624) they were asked to provide details about the game in which they were last injured. Uninjured players (n= 419) provided details about the last game in which they played. Injuries were more likely to occur when games were played on hard grounds or in calm or warm conditions. Playing out of position and the duration of warming up did not significantly alter the risk of injury. When player preparation, ground and weather conditions, grade, age, playing position and rugby experience were simultaneously controlled for, hard ground and the absence of wind were associated with increased risk. The influence of these factors may be indirect, through adaptation to the conditions in which a game is played.

Adolescent↗
PubMed2005

An evaluation of mouthguard requirements and dental injuries in New Zealand rugby union.

OBJECTIVES: To document the effects of compulsory mouthguard wearing on rugby related dental injury claims made to ACC, the administrator of New Zealand's accident compensation scheme. METHODS: An ecological study was conducted. Estimates of mouthguard wearing rates were available from prospective studies conducted in 1993, 2002, and 2003. Rugby related dental injury claims were available for the period 1995-2003. Player numbers were available from 1998. Mouthguard wearing was made compulsory during match play for rugby players at under 19 level and below at the beginning of the 1997 season, and for all grades of domestic rugby at the beginning of the 1998 season. Greater powers of enforcement were provided to referees at the beginning of the 2003 season. RESULTS: The self reported rate of mouthguard use was 67% of player-weeks in 1993 and 93% in 2003. A total of 2644 claims was reported in 1995. There was a 43% (90% confidence interval 39% to 46%) reduction in dental claims from 1995 to 2003. On the reasonable assumption that the number of players and player-matches remained constant throughout the study period, the relative rate of injury claims for non-wearers versus wearers was 4.6 (90% confidence interval 3.8 to 5.6). The cumulative savings in claim costs compared with the cost per year if claim numbers had remained constant from 1995 is 1.87 million NZD. CONCLUSION: Although ecological studies have acknowledged weaknesses, the findings provide evidence that mouthguard use is a simple and effective injury prevention strategy for rugby players. The use of mouthguards for all players in both matches and contact practice situations is strongly recommended.

Adolescent↗
PubMed2004

Tackling Rugby injury: lessons learned from the implementation of a five-year sports injury prevention program.

Rugby Union football is a very popular sport in New Zealand but of all the major sports played in that country, it has the highest reported incidence of injury. In 1995, a national rugby injury prevention program was instigated to address this problem. Known as Tackling Rugby Injury, this multifaceted program was implemented over a five-year period. The program was based on the results of a prospective cohort study of rugby injury, known as the Rugby Injury and Performance Project (RIPP), and was organised around seven themes, five relating to the prevention of injury: coaching, fitness, injury management, tackling, and foul play, and two relating to the implementation and evaluation of the program. The purpose of this paper is to describe the lessons learned from the implementation of Tackling Rugby Injury. Qualitative research methods were used to describe the process of implementation, including informant interviews, participant observation, and the scrutiny of written, visual and archival material. Among the lessons learned were the importance of basing injury prevention strategies on scientific evidence rather than popular belief, the difficulty in implementing complex interventions, the advantages of a formal agreement between partners in the implementation of a program, the central role played by coaches in promoting injury prevention strategies, and the value of describing the process of implementation as well as monitoring injury outcomes and changes in knowledge, attitudes and behaviour. It is hoped that other sports wishing to develop injury prevention programs can learn from this experience.

Athletic Injuries↗
PubMed2003

Rugby headgear study.

A two year randomised controlled trial of headgear in Rugby Union football is being conducted in Sydney, Australia. This paper gives an overview of this study in progress and presents results related to the development and laboratory performance of the headgear. The study commenced in 2002. Participants recruited to the study are in the under 13, 15, school open (U18) and colts age groups. There are three study arms: control, IRB-approved headgear, and modified headgear. The IRB approved headgear is a popular model in rugby, the Canterbury Honeycomb model manufactured by BodyArmour in New Zealand. The dimensions of this model were altered by increasing foam density and thickness to produce the modified headgear. In impact energy attenuation tests of 15 and 20 Joules onto a flat anvil, the modified headgear demonstrated average maximum headform accelerations of 23% and 33% of the standard model, respectively. Whether or not this improvement translates into reductions in injury will be determined by a comparison of the rates and severities of head injuries across study arms. Furthermore, these dimensional changes may not be acceptable to rugby players. Player attitudes towards safety and the use of protective clothing, injury history, experience and on-field behaviour will be examined via structured pre- and end of season surveys and analysis of match video.

Adolescent↗
PubMed2003

Biomechanical analysis of arm fracture in obese boys.

OBJECTIVE: To determine the role of the biomechanical factors of force of impact, bone strength, fall height and surface stiffness on the risk of forearm fracture in obese children compared to non-obese children. METHODOLOGY: Anthropometric and dual-energy X-ray absorptiometry bone density data from 50 boys (25 obese pair-matched with 25 non-obese subjects) aged 4-17 years were entered into a rheological-stochastic simulation model of arm impact. RESULTS: Obese children were shown to be at 1.7 times greater risk of fracture compared to non-obese children. Lower fall heights and softer impact surfaces were found not to reduce the relative risk of fracture between obese and non-obese children. CONCLUSIONS: Environmental modifications are unlikely to lower the risk of arm fracture in obese children to the same levels experienced by non-obese children. The best option available for obese children to reduce fracture risk is to take steps to attain a healthy bodyweight.

Accidental Falls↗
PubMed2003

Examining child restraint use and barriers to their use: lessons from a pilot study.

OBJECTIVE: To determine the suitability of four research methods to measure the rate of child restraint device (CRD) use and incorrect use in New Zealand and obtain data on barriers to CRD use. DESIGN AND SETTING: To assess the rates of CRD use among vehicles carrying children 8 years of age and under, two methods were piloted-namely, an unobtrusive observational survey and a short interview and close inspection. A self administered questionnaire and focus group interviews were also piloted to assess CRD use, reasons for use and non-use, and to obtain information on barriers to their use. Respondents to all methods except the focus groups were approached in supermarket car park sites at randomly selected times. Focus groups were established with parents identified through early childhood organisations. All methods were assessed on criteria related to efficiency, representativeness, and ability to obtain the necessary data. RESULTS: The observational survey provided a simple method for identifying rates of CRD use, while the self administered questionnaire obtained data on demographic characteristics and reported the installation and use/non-use of CRDs. The interview/inspection addressed all the questions of both the above methods and enabled incorrect CRD use to be examined. The focus groups provided the most meaningful information of all methods on barriers to CRD use. DISCUSSION: and conclusion: Advantages and limitations of these methods are discussed and some refinements of the original instruments are proposed. The interview/inspection and focus group methods were identified as being more appropriate for efficiently obtaining reliable data on CRD use and identification of barriers to CRD use.

Accidents, Traffic↗
PubMed2002

Infant-furniture-related injuries among preschool children in New Zealand, 1987-1996.

OBJECTIVE: To describe the epidemiology of infant-furniture-related fatalities and hospitalizations in New Zealand, for children aged 0-4 years. METHODS: Infant-furniture-related deaths and hospitalizations were selected from the New Zealand Health Information Service databases for the 10-year period 1987-1996. Intentional injuries were excluded. RESULTS: Forty-three fatalities were identified. Twenty-two fatalities (51%) occurred in cots, while 13 (30%) occurred in beds. Other products involved were prams, push chairs, high chairs, car seats, portable cots and walkers. A total of 1679 infants were hospitalized through infant-furniture-related injuries. Increasing trends in hospitalizations for baby walkers, beds and bunks were observed. CONCLUSIONS: On average, four infants die each year from injuries related to infant furniture, and hospitalizations from injuries associated with infant furniture use are increasing. Mandatory standards are one measure to reduce these numbers, but education is also necessary.

Bedding and Linens↗
PubMed2002

Shopping trolley-related injuries to children in New Zealand, 1988-97.

OBJECTIVE: To describe the epidemiology of shopping trolley related injuries (fatalities and hospitalizations) to children in New Zealand prior to the introduction of a voluntary standard for shopping trolleys. METHODOLOGY: To identify cases, a key word search was conducted of national mortality and hospitalization databases for the years 1988-97. Cases were limited to children under 15 years of age. RESULTS: For the 10 year period investigated, 282 hospitalizations and no fatalities were identified. A significant increasing trend for hospitalizations was detected (chi2 = 17.6, 1 d.f.; P < 0.001). Ninety-two per cent of children hospitalized were aged under 5 years and two-thirds were aged 2 years or younger. Ninety per cent of injuries resulted from falls from trolleys, 84% of injuries were to the head or face and 22% were rated serious (AIS-3) on the Abbreviated Injury Scale. CONCLUSIONS: The incidence of injuries associated with shopping trolleys increased between 1988 and 1997. Following the introduction of a voluntary standard for shopping trolleys in 1999, which included specifications for child harnesses, trends in injury should be monitored.

Accidental Falls↗
PubMed2002

Adolescent injury morbidity in New Zealand, 1987-96.

OBJECTIVES: Adolescents are over-represented in injury statistics. New Zealand is privileged in having a hospital discharge database allowing for analysis of non-fatal injury data at a national level. An epidemiological description of adolescent injury morbidity is provided and options for prevention are discussed. METHOD: People aged 15-19 years admitted to hospital for their injuries in the period 1 987-96 were identified from the New Zealand Health Information Service morbidity data files. The manner, causes, and nature of injury were examined. Injury prevention strategies were reviewed. RESULTS: The incidence of hospitalised injury was 1,886 per 100,000 person years. The victims were male (70%). The leading causes of injury were road traffic crashes, sports injuries, and self poisoning. The most common injury diagnoses were head injuries (29%) and limb fractures (21%). Road traffic crashes produced the highest proportion of serious injuries. CONCLUSIONS: Road traffic crashes, sports injuries, and self inflicted poisoning, stood out as areas with the greatest potential for reducing the burden of injury in late adolescence. Graduated driver licensing shows promise as an injury prevention measure but remains inadequately implemented. Policies to reduce self inflicted poisoning are of unknown efficacy, and evidence is awaited on the effectiveness of measures to reduce injury in sport.

Adolescent↗
PubMed2002

Injury prevention in sport: not yet part of the game?

BACKGROUND: There is a saying in sport that "injury is just part of the game". In other words, injury in sport is seen as inevitable. OBJECTIVE: To examine progress toward reaching the contrary position that "injury prevention is just part of the game". METHODS: The four steps of van Mechelen's "sequence of prevention" model provide a structure for examining progress. RESULTS: What is known about the size of the problem (step 1)? Most is known about more serious injuries and about injuries in élite and professional sport. Least is known about less serious injuries, injury in community level and amateur sport, and injury occurring in recreational activities. What is known about risk factors (step 2)? Despite calls for analytic studies since the early 1980s, few such studies have been reported in the literature. What is known about the effectiveness of preventive measures (step 3)? Few randomized controlled trials have been reported in the literature. Are there systems in place to monitor sports injury (step 4)? Examples are given of systems in North America, Europe, and Australasia. CONCLUSIONS: With a few exceptions, progress has not gone beyond step 1 in van Mechelen's model. Challenges for the future include: deciding where research efforts should be placed, standardization of definitions and methods of data collection and reporting, identification of risk factors and mechanisms of injury, and the evaluation of interventions. Finally, if the field of sports injury prevention is to advance, multidisciplinary collaboration will be required, along with the involvement of the sports community.

Accident Prevention↗
PubMed2001

Child injury morbidity in New Zealand, 1987-1996.

OBJECTIVES: New Zealand is one of a small number of countries that has a national hospital discharge database. The aim of this study was to use these data to provide an epidemiological description of child injury morbidity and to discuss options for prevention. METHODOLOGY: Using national data, all public hospital admissions for the fiscal year 1995/6 were identified and grouped according to cause. This allowed identification of all children (0-14 years) hospitalized for injury in the period 1987-1996. Causes of injury, diagnoses and injury severity were examined in four age groups. RESULTS: Injury was the second leading cause of public hospital admissions. Children were hospitalized with injury at the rate of 1333 per 100 000 person-years. The victims were predominantly male (61%). In all age groups, falls were the leading cause of morbidity. 'Striking events', motor vehicle traffic crashes and poisoning were also major contributors to the child injury toll. The commonest injury diagnosis was a fracture of the upper limb (25%), followed by intracranial injury (18%). CONCLUSIONS: The leading causes of injury morbidity were noted to differ from previously reported leading causes of injury mortality. Review of the data in light of research literature suggests the need for policy changes to make alternatives to motor vehicle transportation safer and to encourage increased use of child restraints in order to reduce road traffic trauma. Legislation requiring child-resistant packaging for all toxic medications and household products is necessary to reduce rates of child poisoning. Further research is required on policies concerning playground equipment heights and surfacing requirements, and on interventions for hot water scalds.

Adolescent↗
PubMed2001

Use of protective equipment in a cohort of rugby players.

PURPOSE: To describe the level of usage of protective devices and equipment in a cohort of New Zealand rugby players. METHODS: Male and female players (N = 327) from a range of competitive grades were followed over the course of the season. Participants were interviewed weekly about their participation in rugby and use of protective equipment. The main outcome measure was percentage of all player-weeks of follow-up for which each equipment item was used. RESULTS: Mouthguards, the most commonly used equipment item, were worn for 64.9% of player-weeks. Mouthguard usage ranged from 55.0% of player-weeks in Schoolgirls grade to 72.9% of player-weeks in Senior A competition. The next most common item was taping of body joints (23.7% of player-weeks). The sites most commonly taped were the ankle, knee, and hand. Overall usage for the other protective equipment items studied (shin guards, padded headgear, head tape, support sleeves, and grease) was below 15%. In general, forwards had higher usage of protective equipment than backs, and male players had higher usage than female players. The most common self-reported reasons for using protective equipment were to prevent injury and because of a past injury. Players exhibited considerable week-to-week variation in their usage of protective equipment. CONCLUSIONS: In general, equipment usage was highest in those at greatest risk of injury, namely, forwards, male players, and the senior grades. The high voluntary use of mouthguards is encouraging and indicative of a base of player support for their role in this sport.

Adolescent↗
PubMed2001

Compliance of Dunedin school playground equipment with the New Zealand playground standard.

OBJECTIVE: Injuries resulting from falls from playground equipment are a public health concern in New Zealand. Like many other countries, New Zealand has a safety standard aimed at reducing the incidence and severity of these injuries by limiting the height from which children can fall from playground equipment and requiring the provision of impact-absorbing surfaces beneath equipment from which falls are possible. The purpose of this study was to examine progress towards achieving compliance with these requirements in Dunedin school playgrounds. METHODS: Sixty-two schools were audited over the summer of 1997/98 and information recorded on equipment type, maximum fall height, surface type, and depth of loose-fill surface materials. Comparisons were made with audits conducted in 1989 and 1981. RESULTS: Substantial increases in the amount of playground equipment and in the provision of impact-absorbing surfaces were observed. A small increase in compliance with the requirement that the maximum fall height of equipment not exceed 2.5 metres was also observed. CONCLUSIONS: Any gains in safety achieved through increased compliance with the height and surface requirements of the New Zealand Standard have been counteracted by the substantial increase in the amount of equipment available in playgrounds. IMPLICATIONS: A more drastic measure is needed to achieve a meaningful reduction in the incidence of injury following falls from playground equipment.

Accidental Falls↗
PubMed2001

The New Zealand rugby injury and performance project. VI. A prospective cohort study of risk factors for injury in rugby union football.

OBJECTIVES: Although the nature of rugby injury has been well documented, little is known about key risk factors. A prospective cohort study was undertaken to examine the association between potential risk factors and injury risk, measured both as an injury incidence rate and as a proportion of the playing season missed. The latter measure incorporates a measure of injury severity. METHODS: A cohort of 258 male players (mean (SD) age 20.6 (3.7) years) were followed through a full competitive season. At a preseason assessment, basic characteristics, health and lifestyle patterns, playing experience, injury experience, training patterns, and anthropometric characteristics were recorded, and then a battery of fitness tests were carried out. RESULTS: A multiple regression model identified grade and previous injury experience as risk factors for in season injury, measured as an injury incidence rate. A second model identified previous injury experience, hours of strenuous physical activity a week, playing position, cigarette smoking status, body mass index, years of rugby participation, stress, aerobic and anaerobic performance, and number of push ups as risk factors for in season injury, measured as proportion of season missed. CONCLUSIONS: The findings emphasise the importance of previous injury as a predictor of injury incidence and of missing play. They also show the importance of considering both the incidence rate and severity of injury when identifying risk factors for injury in sport.

Adolescent↗
PubMed2000

Temporal patterns of injury during a rugby season.

The aim of this study was to describe temporal patterns in the frequency, nature and circumstances of injuries occurring among a cohort of 356 rugby players during a club rugby season in New Zealand. It was found that the rate of injury in games decreased significantly over time in both males and females. The reduction in injury rate over the season was more pronounced in some grades, but no differences were found when examined by gender. playing position, age, ethnicity or by health and fitness types. Trends in injury rate were consistent over the rugby season and did not appear to be the result of a bias involving under-reporting of end-of-season injuries. The types and severity of injury remained relatively constant, but the proportion of injuries occurring in back play fell significantly over the season and injuries were more likely to occur in the trunk body region as the season progressed. This study supported the hypothesis that higher rates of injury occur at the start of the rugby season and decrease over the course of the season. This reduction is consistent over time and across player types, and is not attributable either to decreasing injury severity or to increasing player fitness.

Athletic Injuries↗
PubMed2000

Child injury mortality in New Zealand 1986-95.

OBJECTIVES: Injury has been described as 'the last major plague of the young'. We provide an epidemiological description of injury, as a leading cause of death in New Zealand, and identify options for prevention. METHODS: We identified all deaths due to any cause for the period 1986-95 from the national data and calculated the potential years of life lost for each death. For the same period, we identified all injury deaths for children aged 0-14 years. Causes of injury were examined in four age groups. RESULTS: In the population as a whole, injury was the fourth leading cause of death and the leading cause of potential years of life lost. Injury killed children at the rate of 16.8 per 100,000 person-years. The victims were predominantly male (62%) and 52% were under 5 years of age. In infancy (<1 year of age), suffocation was the leading cause of injury mortality. From 1 to 14 years of age, motor vehicle traffic incidents were the leading cause of mortality. CONCLUSIONS: Motor vehicle traffic incidents, drowning, suffocation and suicide stood out as areas with the greatest potential for reducing child injury mortality. A number of existing prevention strategies show promise (e.g. child restraints), others are inadequately implemented (e.g. swimming pool fencing) or are of unknown efficacy (e.g. government suicide prevention policies). Strategies to reduce infant suffocation and child non-traffic pedestrian deaths remain to be developed and tested.

Adolescent↗
PubMed2000

The incidence, nature, and severity of injuries in New Zealand civil aviation.

BACKGROUND: Strategies to improve aviation safety can be directed at the pre-crash, in-crash, or post-crash phases of aircraft crashes. For resources to be made available for in-crash interventions, and for these to be well designed, it is necessary in the first instance to have a detailed understanding of the injuries sustained in crashes. The purpose of this study was to describe the incidence, nature, and severity of injuries sustained in aircraft crashes and other related events in civil aviation in New Zealand. METHODS: National injury databases were searched for fatalities and hospitalizations sustained in aircraft crashes and related events, and cases were linked with Civil Aviation Authority accident records to identify the aircraft involved. Rates were based on estimates of total hours flown by active pilots. RESULTS: There were 104 fatalities identified for the period 1988-1992, giving a rate of 2.57 per 100,000 flight hours. There were 120 hospitalizations identified for the period 1988-1993, giving a rate of 2.45 per 100,000 flight hours. Most fatalities involved injury to multiple body regions, with at least one injury being sufficient in itself to cause death in 48% of cases. For hospitalizations, the lower extremities (23%), spine (20%), and head and face (18%) were the body regions most commonly injured, with fractures being predominant. While the majority of fatalities and hospitalizations occurred in fixed- and rotary-wing aircraft, the highest rates were for microlight and home-built aircraft. CONCLUSIONS: Different patterns of injury were evident for fixed- and rotary-wing aircraft. Reasons for these are suggested. Future research will seek to determine the relative risk associated with potentially modifiable risk factors.

Abbreviated Injury Scale↗