Objective: Cycling is associated with numerous health benefits but also the risk of traumatic injury. Recent data demonstrate an increase in overall cycling injuries as well as hospital admissions from 1997 to 2013 in the United States. We seek to better understand the causes of the increase in cycling injuries and hospital admissions.
Methods: Data regarding cycling-related injuries and hospital admissions were obtained from the National Electronic Injury Surveillance System (NEISS). Participation data were derived from the National Sporting Goods Association Sports Participation Survey, and fatality data were collected from the Fatality Analysis Reporting System (FARS). Population estimates were obtained using a complex survey design. Linear regression was used to evaluate univariate relationships between cycling injuries, hospital admissions, deaths, and participation. To evaluate factors associated with hospital admission, we developed a multivariable logistic regression model that included year, age, gender, body part injured, and injury type (i.e., contusion, fracture, or laceration).
Results: The number of individuals who cycle did not change significantly over time, but there was a substantial increase in cycling-related injuries, leading to an increase in per participant injuries from 701/100,000 in 1997 to 1,164/100,000 in 2013. When the injuries were evaluated by age group, younger cyclists have an increased risk for injury, whereas the rise in injuries among older cyclists stemmed from an increase in ridership rather than a unique susceptibility to injury. Trends in hospital admissions and fatalities appeared to be driven by increases in the older age groups. In the multivariable model evaluating factors related to hospital admission, the odds of hospital admission increased for each decade after age 25, as well as male gender and body part injured.
Conclusion: On a per participant basis, the rate of cycling-related injuries and hospital admissions increased between 1997 and 2013. This trend likely reflects a combination of shifting demographics among cyclists with an increase in older cyclists who are at increased risk of severe injury. 相似文献
In this paper we investigate the seasonal autochthonous sources of dissolved organic carbon (DOC) and nitrogen (DON) in the euphotic zone at a station in the upper Chesapeake Bay using a new mass-based ecosystem model. Important features of the model are: (1) carbon and nitrogen are incorporated by means of a set of fixed and varying C:N ratios; (2) dissolved organic matter (DOM) is separated into labile, semi-labile, and refractory pools for both C and N; (3) the production and consumption of DOM is treated in detail; and (4) seasonal observations of light, temperature, nutrients, and surface layer circulation are used to physically force the model. The model reasonably reproduces the mean observed seasonal concentrations of nutrients, DOM, plankton biomass, and chlorophyll a. The results suggest that estuarine DOM production is intricately tied to the biomass concentration, ratio, and productivity of phytoplankton, zooplankton, viruses, and bacteria. During peak spring productivity phytoplankton exudation and zooplankton sloppy feeding are the most important autochthonous sources of DOM. In the summer when productivity peaks again, autochthonous sources of DOM are more diverse and, in addition to phytoplankton exudation, important ones include viral lysis and the decay of detritus. The potential importance of viral decay as a source of bioavailable DOM from within the bulk DOM pool is also discussed. The results also highlight the importance of some poorly constrained processes and parameters. Some potential improvements and remedies are suggested. Sensitivity studies on selected parameters are also reported and discussed. 相似文献