Sport injuries
Available studies suggest that sport and physical activity injury incidence and the severity of outcomes may be greater in rural and regional areas.
There is limited research into sport injuries in Australia, but available studies suggest that incidence and severity of outcomes may be greater in rural and regional areas, especially for drowning related incidents. 48, 49, 50, 51
One study of regional Victorian hospital showed a higher rate of emergency department presentations for sporting injuries in the winter sporting months, mainly sprains and strains. The increase was not necessarily due to more severe injuries, but probably reflected the increasing need for health care treatment for sports injuries, potentially due to higher participation rates and/or less alternative health services available for treatment. The authors suggested that hospitals might need to optimise for types of injuries during different periods of the year, and also suggested that many of the sports injuries reported could potentially be prevented through injury and risk reduction strategies, which would reduce demand on services. 52
Resources and reading
- Water Safety in Regional and Remote Areas, opens in a new tab, Royal Life Saving Australia, (accessed 15 February 2024). Living and working in remote locations has a huge bearing on people's access to swimming and water safety education as well as emergency care in the event of an accident, all of which put regional and rural communities at greater risk of drowning.
- Next steps for drowning prevention in rural and remote Australia: A systematic review of the literature, opens in a new tab, Danielle H. Taylor, Amy E. Peden, Richard C. Franklin, Australian Journal of Rural Health, Volume 28(5), pp.530-542, (December 2020). Thirty-two studies satisfied inclusion criteria (66% reporting epidemiology; 59% risk factors; and 44% prevention strategies). All (100%) included studies were assessed very low against Grading of Recommendations Assessment, Development and Evaluation. Findings indicate rural populations (ie, excluding major cities) have higher rates of drowning positively correlated with increasing remoteness. Common factors included age (child), natural water bodies, undertaking boating and watercraft activities and alcohol consumption. While a range of prevention strategies has been proposed, only one study outlined a rural drowning prevention strategy which had been implemented and evaluated. Strategies were generally low on the hierarchy of control.
- Increasing trend in the frequency of sports injuries treated at an Australian regional hospital, opens in a new tab, Anna Wong Shee, Angela Clapperton, Caroline F. Finch, Australian Journal of Rural Health, Volume 25(2), pp.125-127, (April 2017). Regional and rural Australians have higher rates of injury death and hospital admissions and experience poorer health outcomes than their metropolitan counterparts. Understanding the injury burden and how it is changing is important for effective health care. In New South Wales, the highest rates of hospital-treated sports injuries are in regional and rural areas. Victoria has experienced increasing numbers of sports injuries requiring hospital treatment statewide. This article investigates the frequency of hospital-treated sports injuries in one large Victorian regional hospital to quantify trends in a regional area and to assess the impact of these injuries on a regional hospital.
- Causal pathways of flood related river drowning deaths in Australia, opens in a new tab, Peden, Amy, Franklin, Richard, Leggat, Peter, et.al., PLoS Currents Disasters, pp.1-24, (2017). There were 129 (16.8%) deaths involving river flooding, representing a crude drowning rate of 0.06 per 100,000 people per annum. Half (55.8%) were due to slow onset flooding, 27.1% flash flooding and the type of flooding was unknown in 17.1% of cases. Those at an increased risk were males, children, driving (non-aquatic transport) and victims who were swept away (p<0.01). When compared to drownings in major cities, people in remote and very remote locations were 79.6 and 229.1 times respectively more likely to drown in river floods. Common causal factors for falls into flooded rivers included being alone and a blood alcohol content ≥0.05% (for adults). Non-aquatic transport incident victims were commonly the drivers of four wheel drive vehicles and were alone in the car, whilst attempting to reach their own home or a friend’s. Flood related river drownings are preventable. Strategies for prevention must target causal factors such as being alone, influence of alcohol, type/size of vehicle, and intended destination. Strategies to be explored and evaluated include effective signage, early warning systems, alternate routes and public awareness for drivers.
- Sporting injuries, seasonal trend and impact on rural Australian hospitals: Implications and recommendations, opens in a new tab, Matthew Birdsey, Rafiqul Islam, Arshad Barmare, Australian Journal of Rural Health, Volume 24(6), pp.402-408, (December 2016). We observed a total of 4537 Emergency presentations and 235 hospitalisations between 2008 and 2012 with sporting injuries. About 78% of injuries presented in the winter sporting months; the rate of injury was higher in the month of ‘May’ across the most data reviewing years. Also, there was a higher proportion of hospital admissions recorded in winter sporting months. We reported that those who played sports in winter were significantly younger than those in summer. Sprains and strains due to different sporting activities were the commonest cause of ED presentations, while falls and collisions were the mostly reported mechanism for sporting injuries. It might be extrapolated from the data that within a regional setting, there is a need to optimise emergency departments and hospital bed availability with emphasis on orthopaedic involvements during the winter sporting months. Many of these sports injuries are preventable and community risk reduction strategies should be applied to reduce the burden to the regional hospitals.
- Rural v metro: geographical differences in sports injury hospital admissions across Victoria, opens in a new tab, Anna Wong Shee, Angela Claperton, Caroline Finch, Medical Journal of Australia, Volume 203(7), (October 2015). Analysis of International Classification of Diseases-coded hospitalisation data routinely collected from all Victorian public and private hospitals admissions over the financial years 2003–04 to 2011–12 was undertaken. They were classified according to the Local Government Area (LGA; 31 metropolitan, 49 rural/regional) of the patients’ usual residence. Population-adjusted sports injury hospital admission rates were based on annual LGA populations; trends were analysed by negative binomial regression. The overall annual number of sports injury-related hospital admissions increased by 34% (n = 8092 to n = 11 359). The regression model found a corresponding 15% increase in the annual population-adjusted sports injury-related hospital admissions rate from 166.0 to 205.01 per 100 000 population. For every year, the population-adjusted rate of sports injury hospital admissions was higher for people residing in rural/regional LGAs than in metropolitan LGAs. Our data demonstrate geographical differences in population-adjusted sports injury hospital admissions rates that have persisted over time. This epidemiological study is the first step to understanding how the burden of sports injuries varies by region in Victoria.
- Drowning deaths in Australian rivers, creeks and streams: A 10 year analysis, opens in a new tab, Peden, A and Queiroga, AC, Royal Life Saving Society Australia, (2014). This report details the number of drowning deaths in Australian rivers, creeks and streams across the last 10 financial years and the circumstances around those deaths. Between 1 July 2002 and 30 June 2012, a total of 2,965 people died as a result of drowning in Australian waterways. Of these 735 people drowned in rivers, creeks and streams, accounting for 25% of all drowning deaths experienced in Australian waterways across this ten year period. This report makes a number of recommendations aimed at expanding our knowledge of river recreational patterns and to reduce drowning deaths in Australian rivers. These include enhanced understanding of the risks of floodwaters, increased awareness and enforcement of legislative requirements regarding use of watercraft whilst under the influence of alcohol in rivers and improving CPR and first aid skills in Remote and Very Remote areas.
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