Biomedical subjects

G Rechnitzer

Publications and source records attributed to G Rechnitzer.

4 recordsLinked to original sources

PubMed2005

Out on a limb: risk factors for arm fracture in playground equipment falls.

OBJECTIVES: To investigate and quantify fall height, surface depth, and surface impact attenuation as risk factors for arm fracture in children who fall from playground equipment. DESIGN: Unmatched case control study. SETTING: Five case hospitals and 78 randomly selected control schools. PARTICIPANTS: Children aged less than 13 years in Victoria, Australia who fell from school playground equipment and landed on their arm. Cases sustained an upper limb fracture and controls had minor or no injury. A total of 402 cases and 283 controls were included. INTERVENTIONS: Children were interviewed in the playground as soon as possible after their fall. MAIN OUTCOME MEASURES: Falls were recreated on site using two validated impact test devices: a headform (measuring peak G and HIC) and a novel anthropometric arm load dummy. Equipment and fall heights, as well as surface depth and substrate were measured. RESULTS: Arm fracture risk was greatest for critical equipment heights above 1.5 m (OR 2.39, 95% CI 1.49 to 3.84, p<0.01), and critical fall heights above 1.0 m (OR 2.96, 95% CI 1.71 to 5.15, p<0.01). Peak headform deceleration below 100G was protective (OR 0.67, 95% CI 0.45 to 0.99, p = 0.04). Compliance with 20 cm surface depth recommendation was poor for both cases and controls. CONCLUSIONS: Arm fracture-specific criteria should be considered for future standards. These include surface and height conditions where critical headform deceleration is less than 100G. Consideration should also be given to reducing maximum equipment height to 1.5 m. Improved surface depth compliance and, in particular, guidelines for surface maintenance are required.

Accidental Falls↗

PubMed2005

Development of the Safe Tractor Assessment Rating System.

We describe the development of the Safe Tractor Assessment and Rating System (STARS), a design-based tractor safety rating system that can be applied to new or used tractors to provide an objective assessment of their inherent safety features. A predictive rating system model, based on technical inspection, was used. Key principles underlying the system included the potential for design features to reduce the risk of an injury event occurring, and to reduce the risk of injury if such an event did occur. The rating system was based on current standards, research literature, injury and fatality data, and farmer input via focus groups. Development was an iterative process involving field, pilot, and inter-rater reliability tests. The final system was divided into six domains: rollover protection, runover protection, user protection, information and controls, pedestrian protection, and options. Within each domain, optimum design features were described for the common or serious potential injury risks, and a score was assigned for each feature. Scores were translated into a star rating, from zero stars for virtually no inherent safety features to five stars for the highest inherent safety, for each of the six domains. STARS distinguished well between older tractor models known to have few inherent safety features and newer tractor models known to have higher levels of inherent safety. STARS can provide tractor manufacturers, dealers, and users with information critical for managing tractor-associated injury risk. In Australia, it is initially being implemented within the curriculum of the technical education and training sector.

Accidents, Occupational↗

PubMed2004

Safe tractor access platforms: from guidance material to implementation.

This article reports on the implementation of published guidelines for retrofitting tractors with safe access platforms, which were developed to reduce the risk of serious injuries and deaths associated with mounting and dismounting. Farmer interviews and engineering-based inspections of ten retrofitted tractors were conducted to gather information regarding benefits and disadvantages of the retrofitting and to assess the construction of the platforms. A scoring system was developed for platform retrofitting, and weighted scores between zero and ten were calculated for tractor access before and after retrofitting. Access was improved on all tractors, although to varying degrees. The average post-retrofit weighted score was 6.3 (range 2.6 to 9.7), compared with the pre-retrofit average of 0.9 (range 0.3 to 1.6). Five tractors received a post-retrofit score of 8.0 or higher. None of the lower-scoring tractors fully met the specifications for placement of the bottom step or rear wheel guard, two key characteristics for runover prevention. Other characteristics associated with a lower post-retrofit score included a low bottom step, high step rises, absence of colored nosing, and the front handrail space not being filled in. Platform retrofitting had little effect on tractor operations and substantially improved ease of access. This is the first published evaluation of a design-based solution for tractor runover injuries. This study shows that general guidelines for retrofitting of safe access platforms can be successfully applied. Mechanisms to increase adherence to the key criteria of bottom step positioning and rear wheel guarding should be included in future promotion.

Accidents, Occupational↗

PubMed2003

Development of a multidisciplinary method to determine risk factors for arm fracture in falls from playground equipment.

OBJECTIVES: To present the development of a novel multidisciplinary method to investigate physical risk factors for playground related arm fracture. RATIONALE: Previous playground injury research has been limited in its ability to determine risk factors for arm fractures, despite their common and costly occurrence. Biomechanical studies have focused exclusively on head injury. Few epidemiological studies have quantified surface impact attenuation and none have investigated specific injury outcomes such as arm fracture. DESIGN: An unmatched case-control study design was developed. An instrumented child dummy and rig were designed to simulate real playground falls in situ. Validated output from the dummy was used to quantify arm load. Other field measurements included equipment height, fall height, surface depth, headform deceleration, and head injury criterion. DISCUSSION: Validated methods of biomechanics and epidemiology were combined in a robust design. The principle strength of this method was the use of a multidisciplinary approach to identify and quantify risk and protective factors for arm fracture in falls from playground equipment. Application of this method will enable countermeasures for prevention of playground related arm fracture to be developed.

Accidental Falls↗