P128: Patterns of injurious falls on snow and ice in public pedestrian areas

Abstract

Introduction: Maintenance of public pedestrian walkways to ensure safety can be onerous during Canadian winters. The costs of maintenance should be weighed against the potential for reducing injuries related to falls. Ice and snow covered surfaces can increase the chance of falling by 3.5 times compared to normal concrete surfaces. The objectiveof this study is to examine patterns of injury occurrence in persons injured when falling due to snow or ice in public areas. Methods: We identified persons presenting to emergency departments in Kingston, ON for treatment of injuries related to falls on ice or snow for a 5 year period ending in March 2015 using data from the Canadian Hospital Injury Reporting and Prevention Program(CHIRPP). Within CHIRPP, there is a series of variables that describes the injury event, location and circumstances. Hospital medical records were reviewed for additional information on anatomic injuries sustained and subsequent use of hospital based resources.Variables were managed and assessed in Excel. A descriptive analysis examined distributions of variables by subgroups of injury occurrence. Results: 674 injury cases of falls on snow and ice were identified. 316 cases (46.9% of cases/ about 60 per year) occurred in public pedestrian areas, the group of primary interest. Of these: 88 cases (27.8%) resulted in fractures; 68 (21.5%) were soft tissue injuries; 46 (14.6%) were head injuries, concussions or intracranial injuries; and 40 (12.7%) were sprains or strains. Of the fractures, 37 (42.0%) involved the upper limb and 33 (37.5%) involved the lower limb. 72 (81.8%) of fractures were managed in the emergency department with orthopedics referral or follow up. The large majority of sprains or strains (85.0%), soft tissue injuries (80.9%) and head injuries (82.6%) were managed in the emergency department without plans for hospital based follow up. Conclusion: Falls on snow and ice frequently occur on public pedestrian areas. The resulting injury can be significant, leading to fractures in upper and lower limbs. These fractures require more use of hospital based resources than other injury types. It is hoped that providing municipal decision makers with information on the frequency and severity of these injuries will lead to improved snow and ice removal in public pedestrian areas.