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Objective Farming is a hazardous occupation, with high rates of injury and death. FarmSafe, a whole-country approach, sought to address work-related injury on New Zealand sheep, beef, and dairy farms. More than 10 000 farmers participated in 630 workshops held over two years. This short communication presents the results of an impact evaluation of the FarmSafe Awareness Workshop (FSAW) in its first two years of operation. Methods All FSAW participants completed, and received credit for, formal educational assessments. Pass rates were used to assess safety knowledge, and a quasi-experimental design with intervention and comparison groups was applied to assess attitudes, safety behaviors, and environmental determinants of injury. Results An intervention (N= 111) and two comparison groups (Cl, N=409, and C2, N=78) completed before and after questionnaires. At follow-up, the intervention group (IG) showed a small improvement in attitudes toward safety (IG=79.3, C1=77.4; C2=77.4, P=0.035), but there were no differences between groups for personal safety practice or the safety environment of the farm. However, if a respondent registered their interest in the workshop, but a different person from the same farm attended, there was some improvement in the safety of the farm environment score. Conclusion Well-conducted safety training tailored to farmers was still not enough to change safety practice. Future interventions may be more likely to achieve progress if they are comprehensive, include environmental and enforcement features, and target more than one participant per farm.

Background Agricultural workers experience high rates of occupational injury. There is a lack of analytic studies which provide detailed occupational exposure information to inform intervention development. Methods A feasibility study simulating a six month prospective cohort study was designed and undertaken. The levels of farm and worker participation and retention were analysed to determine the feasibility of the methods for wider deployment. Results Recruitment levels were comparable with other studies, with 24% of farms and 36% of non-owner workers participating. Once recruited, retention was high at 85% and 86% respectively. Conclusions The main challenges identified were in the recruitment process. Once recruited, farms and workers tended to complete the study, indicating that prospective studies in this the agricultural workforce may be feasible. Issues encountered and potential solutions for future studies are discussed.

BackgroundEffective use of routinely collected hospital discharge data (HDD) to estimate injury incidence requires a separate identification of new injuries from readmissions for a previous injury. The aim was to determine the accuracy of a computerised algorithm to identify injury readmissions in HDD.MethodsA random sample of 2000 events (‘key events’) were selected from the 2006 injury subset of New Zealand's HDD. Discharge histories from 1989 to 2007 were extracted for individuals and manually reviewed by at least two people to determine the ‘gold standard’ readmission status of each key event. The algorithm relies on four variables: unique national person identifier, dates of injury, admission and discharge. Reviewers were provided with these variables as well as additional discharge information (eg, discharge type and external cause code narrative) recorded in the HDD. Results of the manual review were compared to those obtained from the algorithm.ResultsThe algorithm assigned 1811 (90.6%) as incident admissions compared to 1800 (90.0%) classified by the gold standard. Agreement was 97.9%, and accuracy measures (sensitivity, specificity, negative predictive value and positive predictive value) ranged from 87% to 99%. No statistically significant differences between readmission assignation by the algorithm and the gold standard were observed by age, nature of injury, external cause of injury or body region.ConclusionsAny country with electronic HDD could readily identify readmissions and, thus, accurately estimate injury incidence from HDD, providing that a unique person identifier and the date of injury were included in addition to the obligatory dates of admission and discharge.

Objectives. In 1999, New Zealand lowered the minimum purchasing age for alcohol from 20 to 18 years. We tested the hypothesis that this increased traffic crash injuries among 15- to 19-year-olds. Methods. Poisson regression was used to compute incidence rate ratios for the after to before incidence of alcohol-involved crashes and hospitalized injuries among 18- to 19-year-olds and 15- to 17-year-olds (20- to 24-year-olds were the reference). Results. Among young men, the ratio of the alcohol-involved crash rate after the law change to the period before was 12% larger (95% confidence interval [CI]=1.00, 1.25) for 18- to 19-year-olds and 14% larger (95% CI=1.01, 1.30) for 15- to 17-year-olds, relative to 20- to 24-year-olds. Among young women, the equivalent ratios were 51% larger (95% CI=1.17, 1.94) for 18- to 19-year-olds and 24% larger (95% CI=0.96, 1.59) for 15- to 17-year-olds. A similar pattern was observed for hospitalized injuries. Conclusions. Significantly more alcohol-involved crashes occurred among 15-to 19-year-olds than would have occurred had the purchase age not been reduced to 18 years. The effect size for 18- to 19-year-olds is remarkable given the legal exceptions to the pre-1999 law and its poor enforcement.

[...]this illustrates that, if used to describe the epidemiology of significant injury defined in terms of (threat of) disability, hospitalizations do not capture most of the cases of interest. Define in their paper what injuries were the focus (but not in terms of the utilization of particular health services, survey response or capture by one or more reporting systems), and indicate how the definition is relevant to the research question Describe the data sources (including their quality) from which the outcome measures were derived Specify the case definition, ie, the methods used to ascertain cases for the study Discuss any mismatch between the injury definition and the case definition used As Injury Prevention is the leading injury prevention journal, we challenge the new Editorial Board to lead such an initiative.

Research in New Zealand into negative effects of excessive drinking on other people, involving violence, interrupted sleep or study, and having to care for the person involved. [(BNI unique abstract)] 5 references

Objective: To examine the use of unspecified codes for the circumstances of injury for New Zealand public hospital discharges at a district health board (DHB) level. Methods: Hospital injury discharges for the period 2000–3 were examined. The use of the International Classification of Diseases unspecified categories was examined for mechanism of injury, activity and place of occurrence. Results: For all DHBs, the combined age-adjusted and mechanism-adjusted usage of unspecified mechanism codes was 7% and ranged from 3% to 11%. Most (57%) of these cases were unspecified falls. The comparable usage for activity was 39% and ranged from 17% to 52%, and for place of occurrence the respective figures were 23% and 7–36%. Only 50% of hospital discharges were completely specified in terms of mechanism of injury, activity and place of occurrence; this varied from 36% to 74% between DHBs. For several DHBs a significant degree of inconsistency was found in performance across mechanism, activity and place of occurrence coding. Conclusions: Those DHBs with a high proportion of cases coded as unspecified would serve the prevention efforts of their communities better by making efforts to determine the cause of this situation and implement measures to reduce the problem.

Objectives—The aim of this study was to determine the validity of self report as a source of information on crashes and injuries. Setting—This study was part of the Dunedin Multidisciplinary Health and Development Study (DMHDS), which is a longitudinal study of the health, development, and behaviour of a cohort of young New Zealanders. Method—At the age 21 assessment DMHDS study members were asked to report serious injury and motor vehicle traffic crashes experienced over the previous three years. The self reported injuries were compared with the New Zealand Health Information Service (NZHIS) public hospital discharge file to determine the completeness of the self reported data. The traffic crashes were compared with the police traffic crash reports to determine the accuracy of self reported crash details. Results—Twenty five (86%) of the 29 unintentional injuries, six (67%) of the nine assaults, and one (14%) of the six self inflicted injuries on the NZHIS file were self reported. The level of agreement between the self reported crash details and those recorded on the traffic crash report was high. Conclusions—The results show that self reports can be a useful and valid source of injury and crash data.

The International Classification of Diseases (ICD) E codes are the most widely used coding frame for categorising the circumstances of injury and poisoning. In 1992 major revisions to the E codes were released. The aim of this paper was to consider whether the changes made are a step forward or backwards in terms of facilitating injury prevention. The approach taken was to reflect on some former injury prevention research needs and the challenges they presented using data coded according to ICD-9, and then to consider how, if at all, ICD-10 has addressed these difficulties. As with ICD-9, there are essentially two axes associated with each cause: intent and mechanism of injury, and these are captured by one code. This approach can have the unintended effect of hiding the significance of some mechanisms of injury. While there have been significant improvements in some areas, such as falls, in others, such as injuries due to firearms, ICD-10 has taken a step backward. In addition the failure to produce mutually exclusive codes presents problems for determining the incidence of downing events. A welcome addition are “optional” activity codes which enable the identification of work related and sport related injury for the first time. Nevertheless, the limited range of codes and absence of coding guides limits their utility. The revised place of occurrence codes do not represent a significant improvement on ICD-9 in that they are limited to 10, they are not mutually exclusive, and they do not adequately cover a range of specific places of occurrence. In summary, relative to its predecessor, ICD-10 represents a significant improvement in many areas. Unfortunately, it still falls far short of the mark for many injury prevention needs.

Identifies and describes the distribution of, and trends in, the characteristics of serious non-fatal hospitalised assault injury for the period 2000-2009 by sociodemographic characteristics, location of incidents, methods used to inflict injury, alcohol involvement, and nature of injury. Examines trends in assault by age, gender, and method. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.