In this issue

Issue 7

March 1996

Kingston area group publishes injury profile

The Kingston, Frontenac and Lennox and Addington (KFL&A;) Health Unit in Ontario recently developed a new document based on injury surveillance data from the two Kingston CHIRPP sites, the Kingston General Hospital and Hotel Dieu Hospital.

This report, Injury Profile: Kingston and Area, was created to provide descriptions of important patterns of injury among different subgroups of the population of the Kingston area. The authors expect the profile to be used by planners, health care professionals, injury prevention specialists and community groups to develop and implement prevention programs at the community level. This profile may be updated periodically to reflect trends and patterns of injury over time, giving these groups an opportunity to assess the effectiveness of their interventions.

Who was involved?

In 1995, the KFL&A;/Queen's University Teaching Health Unit formed the Centre for Injury Prevention and Research. The centre conducts injury prevention activities at many different levels, including surveillance, research and program development. Three researchers who work with the centre Pam Carr, William Pickett and Monica Bienefeld compiled and wrote the injury profile. This group collaborated with Medical Director Rob Brison and Nurse/ Coordinator Kathy Bowes at the Kingston and Region Injury Surveillance Program, which comprises the two CHIRPP sites. Program managers within the KFL&A; Health Unit peer-reviewed draft copies of the document and injury control specialists reviewed it externally.

What was done?

Records of injuries experienced by residents of the city of Kingston and the counties of Frontenac, Lennox and Addington were identified from the CHIRPP system for the one-year period ending December 31, 1994. Researchers determined the residence of each injury victim by using postal codes. The data were then converted into a database management system using a program developed by John LeBlanc, an epidemiologist at The Izaak Walton Killam Hospital for Children in Halifax. This program converted the data into a more usable format by aggregating the information into defined categories, and by assigning labels and titles to describe numerically coded data.

The study population was divided into five age groups: children and youth, young adults, middle-aged adults, young elderly and older elderly. These age groups matched those set out in the Mandatory Health Programs and Services Guidelines of the Ontario Ministry of Health (1990).

The profile shows patterns of injury within each age group broken down by time, location, circumstances, nature and treatment of injuries. Using census information, researchers calculated rates of injury for the entire study population and subgroups.

The study population

The Kingston General and Hotel Dieu hospitals, both general hospitals located in Kingston, have been involved in CHIRPP since 1993. The population in the catchment area of these hospitals is about 166,000 people, 65% of whom reside in the urban core. English is the first language of 94% of the population. The average family income in 1991 was approximately $50,000 per year, and the unemployment rate was 8%. The KFL&A; area has a mixed economy, with strong representation in both manufacturing and service-based industries. Kingston is home to three post-secondary institutions, and is a major centre for the Canadian Armed Forces and the federal corrections system.

Recommendations

During 1994, 20,560 injury events were reported at the two Kingston CHIRPP sites, resulting in an overall rate of injury of 125.1/1,000/year. Age- and sex-specific rates of injury for the entire population are shown in Table 1.

Table 1 Frequency and rate of injuries by sex and age group, Kingston and Area, 1994
	Total Population		Males		Females
Age Groups	No. of injuries	Rate/ 1,000/yr.	No. of injuries	Rate/ 1,000/yr.	No. of injuries	Rate/ 1,000/yr.
All ages	20,560	125.1	12,291	153.6	8,267	98.1
<1	157	69.9	70	60.6	87	79.8
1-4	1,368	156.8	822	184.7	546	127.7
5-9	1,434	129.9	843	149.9	591	109.1
10-14	2,096	198.9	1,172	217.6	924	179.2
15-19	2,515	227.6	1,617	279.5	898	170.6
20-24	2,773	214.0	1,802	273.0	971	152.7
25-29	2,009	135.3	1,316	172.9	693	95.7
30-34	1,904	130.7	1,227	170.1	676	92.0
35-39	1,569	117.1	997	149.4	572	85.0
40-44	1,042	84.5	615	100.5	427	68.7
45-49	834	83.8	474	94.9	360	72.7
50-54	659	81.3	375	90.7	283	70.2
55-59	472	62.6	257	69.7	215	55.8
60-64	424	55.9	240	65.8	184	46.7
65-69	336	50.6	147	55.2	189	47.6
70-74	349	69.7	147	76.4	202	65.6
75-79	223	60.9	68	52.3	155	65.7
80-84	182	81.8	56	83.6	126	81.0
85-89	131	108.3	34	117.2	97	105.4
90+	80	123.9	10	90.9	70	129.6
Note: unknown sex = 2; unknown age group = 3

The patterns of injury that were identified indicated priorities for further investigation and intervention. The authors of the profile recommended that public health and other agencies continue to focus on the following:

• investigating hazards for young children in the home environment, and developing, implementing and evaluating programs that target these exposures;
• investigating and reducing safety hazards associated with publicly accessible playgrounds;
• working with community-based organizations to develop and target programs to prevent injuries related to organized sports, especially those occurring during hockey and baseball events;
• working with local industry to evaluate industry-specific programs designed to prevent occupational injuries, since these are the leading cause of injury among adults; and
• working with community groups and local health care agencies to develop, implement and evaluate programs designed to prevent fall injuries among older adults in public, residential and institutional settings.

How are the analyses being used?

These population-based data are being used in several ways. Now that several key areas for further, in-depth investigation have been identified, research projects are being developed to further describe the patterns of injury. Agencies responsible for community prevention programs and other interest groups are actively using these data in the areas of bicycle safety, elder fall injuries, playground safety and sports injuries.

CHIRPP was not designed to determine injury rates, but to conduct surveillance to detect and analyze trends in injury occurrence, based on uniformly collected data. The Kingston and region program is unique within CHIRPP in its ability to calculate injury rates (the frequency with which injuries occur in a defined population). Because the two CHIRPP hospitals in Kingston serve the vast majority of patients in the KFL&A region who report to hospital emergency services for injury, population-based injury rates can be determined. Most other CHIRPP centres exist in areas near non-participating hospitals with emergency departments, making the calculation of rates impossible.

For more information, contact:
Pamela Carr
Manager, Health Promotion Division
KFL&A;/Queen's University
Teaching Health Unit
221 Portsmouth Avenue
Kingston, Ontario
K7M 1V5
Tel.: (613) 549-1232
Fax: (613) 549-7896

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