Conference Presentations by Helena Stigson
IRCOBI, 2019
Few previous studies have examined acute injuries in competitive cycling or training as compared ... more Few previous studies have examined acute injuries in competitive cycling or training as compared to other sports. By using nationwide insurance data including all injured cyclist registered in the Swedish Cycling Federation and all reported injuries during exercise race in Sweden, the objective was to examine acute injuries during competitive cycling or training for different types of cyclists. The injury incidence and injuries leading to permanent medical impairment were examined. All cyclists that were injured during 2008-2017 were included (n=1937). Among the 2666 licensed cyclists the incidence of cyclists injured during training or competition was 44 per 1000 licensed cyclists per year. Focusing on participants in exercise races, the incidence was annually 1.5 injured cyclists per 1000 participants per year. The most commonly injured body region was the upper extremity (41%), followed by head and neck (18%). In total 9.4% of all injured cyclists sustained a permanent medical impairment. Given an injury, non-licensed participants in exercise races were slightly older, and the proportion of females were higher (30% vs. 16%), than among licensed cyclists. The injury incidence among the cyclists was high, and to maintain a healthy and physically active population it is important to make efforts to prevent injuries.
IRCOBI, 2017
Current bicycle helmet standards do not include angular acceleration, for certification even thou... more Current bicycle helmet standards do not include angular acceleration, for certification even though it is known that it is the dominant cause of brain injury. The objective of this study was to develop an improved test method, including oblique impacts, to evaluate helmets sold on the European market. Four physical tests were conducted, shock absorption with straight perpendicular impact and three oblique impact tests. Computer simulations were made to evaluate injury risk. In total, 17 conventional helmets and one airbag helmet were included. All helmets except five showed a linear acceleration lower than 180 g, which corresponds to a low risk of skull fracture. The airbag helmet performed three times better than the conventional helmets (48 g vs. an average of 175 g). The simulations indicated that the strain in the grey matter of the brain during oblique impacts varied between helmets from 6% to 44%, where 26% corresponds to 50% risk for a concussion. The lowest strain was measured in the brain when the airbag helmet was tested. Helmets equipped with Multi-directional Impact Protection System (MIPS) performed better than the others. However, all helmets need to reduce rotational acceleration more effectively. A helmet that meets the current standards does not necessarily prevent concussion.
Papers by Helena Stigson
Research Square (Research Square), Apr 10, 2024
Background: Equestrian sports are practiced all over the world and are a popular leisure activity... more Background: Equestrian sports are practiced all over the world and are a popular leisure activity in Sweden. Equestrianism is the country's second-largest youth sport. Previous studies indicate that equestrianism is accident-prone. However, few previous studies have examined acute equestrian injuries leading to permanent medical impairment. Methods: By using nationwide insurance data including all injured equestrian registered in the Swedish Equestrian Federation, the objective was to examine acute injuries. The injury incidence and injuries leading to permanent medical impairment were examined. All equestrians injured during 2017-2021 were included (n=6876). Injury incidence was calculated separately for males and females as well as for different age groups by dividing the number of insurance claims by the number of members and multiplying by 1000. Risk Ration was calculated between gender. Pearson's chi-squared test was used to analyse differences in distributions for categorical variables. Results: The majority of injuries affected females, correlating with an almost three times higher risk compared to males. Those aged 21-40 years were associated with the highest injury risk (14.26/1000 registered riders). In total twelve percent of all injuries led to permanent medical impairment. Injuries to the upper and lower extremities, along with fractures, had a higher risk of resulting in an impairment. Conclusions: The predominant injuries resulting in permanent medical impairment were arm and leg injuries, but to prevent the most serious injuries that signi cantly affect the rider's daily life, efforts to prevent head and spinal cord neck injuries should be implemented. Head injures remain the most frequent, serious and the most important injuries to prevent and mitigate within equestrian sports.
Accident Analysis & Prevention, 2017
BMC Public Health
Background The knowledge about the long-term consequences in terms of sickness absence (SA) among... more Background The knowledge about the long-term consequences in terms of sickness absence (SA) among pedestrians injured in a traffic-related accident, including falls, is scarce. Therefore, the aim was to explore diagnosis-specific patterns of SA during a four-year period and their association with different sociodemographic and occupational factors among all individuals of working ages who were injured as a pedestrian. Methods A nationwide register-based study, including all individuals aged 20–59 and living in Sweden, who in 2014–2016 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Diagnosis-specific SA (> 14 days) was assessed weekly from one year before the accident up until three years after the accident. Sequence analysis was used to identify patterns (sequences) of SA, and cluster analysis to form clusters of individuals with similar sequences. Odds ratios (ORs) with 95% confidence intervals (CIs) for association of the diff...
Knee Surgery, Sports Traumatology, Arthroscopy, Jul 15, 2023
Purpose To describe injury incidence, time trends in injury incidence, and injury characteristics... more Purpose To describe injury incidence, time trends in injury incidence, and injury characteristics among Swedish Olympic athletes over 22 years based on insurance data, as a first step to inform injury preventive measures among Olympic athletes. Methods The cohort comprised 762 elite athletes (54% males; age 26.5 ± 5.9 years) in 38 sports in the Swedish Olympic Committee support program 'Top and Talent' between 1999 and 2020, with total 3427 athlete-years included. Acute and gradual onset injuries were reported to the insurance registry by the athletes' medical staff. Results A total of 1635 injuries in 468 athletes were registered. The overall injury incidence was 47.7 injuries/100 athleteyears (one injury per athlete every second year). An increasing trend in injury incidence was observed in the first decade 2001 to 2010 (annual change 6.0%, 95% CI 3.3-8.8%), while in the second decade 2011 to 2020 no change was evident (0.4%, 95% CI − 1.9 to 2.7%). Gymnastics, tennis, and athletics had the highest incidence (100.0, 99.3, and 93.4 injuries/100 athlete-years, respectively). Among sport categories, mixed and power sports had the highest incidence (72.8 and 69.5 injuries/100 athlete-years, respectively). Higher incidences were seen in the younger age groups (≤ 25 years) in mixed and skill sports. The injury incidence was comparable between male and female athletes, and summer and winter sports. Most injuries occurred in the lower limb, and specifically the knee (24%), foot/ankle (15%) and spine/pelvis (13%). Conclusion The results on injury patterns in different sports and age groups may guide preventive focus for health and performance teams working with Olympic athletes. Level of evidence II.
Traffic safety research, Feb 22, 2023
Traffic safety research, May 17, 2023
Large corporations are today expected or obliged to report on accidental deaths and serious injur... more Large corporations are today expected or obliged to report on accidental deaths and serious injuries to employed or contracted employed as a part of reporting on sustainability and workplace safety. Data about road crashes are part of such events and are therefore, but not separately, collected and presented. In Europe, 40% to 60% of all work-related accidents resulting in death has been reported to be road traffic accidents. In 2020, the Stockholm Declaration urged all corporations to report on their safety footprint including their entire value chain. The aims of the present study were to use a new definition of safety footprint and to quantify those killed as employed and at work, and those killed in a crash where the other part was at work, as so called third parties, to transports for duty with employed drivers. The Swedish Transport Administration (STA) in-depth database of fatal crashes was used, that covers all fatalities classified as road traffic related and consists of information from the police, medical journals, autopsy reports, accident analyses performed by STA, and witness statements. All fatalities excluding suicides or those caused by sickness occurring during year 2019 were investigated (n = 214). 11% (23/214) of the fatalities occurred when the killed person was at work and 16 while commuting. 37% of the fatal accidents occurred when the killed road user or the other part was at work. In total, almost half of the fatalities in the road transport system were related to work in some way when including both the fatally injured and their collision partners. A larger proportion of nonprivately owned and procured vehicles was found for the vehicles of the collision partners compared to the vehicles of the fatally injured. In approximately one third of the fatal accidents a procurement of a transport service was involved. The Swedish Work Environment Authority (SWEA) identified 10 of the 23 fatalities at work investigated and none of these accidents was found to be investigated by the police as a crime related to the work environment. In conclusion, almost half of the fatalities in the road transport system in 2019 were related to work in some way, either the fatally injured or their collision partners were at work or while commuting. When including the third-party casualties, the problem becomes much bigger and more complex. In Sweden fatalities related to work are under reported, as the SWEA does not receive basic data. Efforts are needed to improve reporting of work-related road
Springer eBooks, 2022
This chapter covers design of rural roads according to the model for safe traffic used in the Vis... more This chapter covers design of rural roads according to the model for safe traffic used in the Vision Zero approach. Based on expected levels of the safety of vehicles and road users, the roads and the road side furniture should be designed to avoid fatalities and serious injuries. An introduction is presented covering the safe system approach and how speed limits of roads should be set to reflect the safety standard of the road in relation human injury tolerance and the capacity to
European Journal of Public Health, 2018
Background: The aims were to study work-disability in patients with low back pain (LBP), treated ... more Background: The aims were to study work-disability in patients with low back pain (LBP), treated non-surgically or with lumbar spine surgery (decompression or fusion), if there were differences in subsequent work-disability related to type of treatment provided, and if these associations differed after changes in the social insurance regulations in 2008 in Sweden. Methods: All non-pensioned residents in Sweden, aged 19-60 years, diagnosed with LBP either in 2004-06 or 2008-10 were included (N = 153 739). Hazard ratios (HR) with 95% confidence intervals for long-term sickness absence (90 net days (LTSA)) and disability pension (DP) for LBP-patients treated non-surgically, with decompression or fusion surgery or a combination of both surgeries were estimated by Cox regression compared to the matched controls from the general population without diagnosed LBP (n = 566 008). Results: LBP-patients had a higher risk of subsequent LTSA (HRs 1.9-3.3) and DP (HRs 1.8-4.8) compared to the controls both before and after changes in social insurance regulations. LBPpatients treated non-surgically, or by decompression or fusion surgery had similar risk estimates for later work-disability before regulation changes. However, after the regulation changes, LBP-patients undergoing fusion surgery had higher risk estimates of both LTSA (HR 3.3) and DP (HR 4.8) than patients treated non-surgically (LTSA HR 2.1; DP HR 2.5) or by decompression surgery (LTSA HR 2.6; DP HR 2.1). Estimates for work-disability significantly attenuated after adjusting for previous sickness absence (SA). Conclusions: Risk for subsequent work-disability among LBP-patients was higher compared to general population. Discrepancies in such risk were explained by the treatment provided, previous SA and changes in the social insurance regulations, specifically LBP-patients treated with fusion surgery had highest risk of subsequent work-disability which even increased after regulation changes. Key messages: Type of treatment provided and changes in social insurance regulations are likely to affect subsequent work disability among patients with diagnosed low back pain. It is important to consider previous sickness absence while providing treatment to patients with low back pain.
European Journal of Public Health, 2019
Background In recent years, bicycle injuries have increased, yet little is known about impact of ... more Background In recent years, bicycle injuries have increased, yet little is known about impact of such injures on sickness absence (SA) and disability pension (DP). The aim was to explore the long-term patterns of SA and DP among injured bicyclists. Methods A longitudinal register-based study was conducted, including all individuals aged 18-59 years and living in Sweden, who in 2010 had incident in- or specialized out-patient healthcare for injuries sustained in a bicycle crash. Information about sociodemographics, the injury, SA, DP, and deaths were obtained from several nationwide registers. Weekly SA/DP data for four years: one year before and three years after the crash were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each sequence cluster. Results Among all 6465 individuals injured in a bicycle crash 2010, five clusters were identified: No SA or DP (60.2...
This study aimed to evaluate developments in car crash safety in cars launched since the 1980s ba... more This study aimed to evaluate developments in car crash safety in cars launched since the 1980s based on real-world crashes occurring years 2000–2019, with focus on the number of injuries leading to permanent medical impairment to different body regions, separated for gender and age. Police-reported two-car crashes were used to calculate relative risk of any injury, fatal and serious injury and fatality, and together with occupant injuries reported by Swedish emergency care centres the risk for permanent medical impairment was assessed. The cars were categorised in ten-year periods according to year of introduction. It was found that vehicle crashworthiness has improved steadily since the 1980s, with largest improvements for serious and fatal injuries and for injuries leading to PMI. Females were found to have higher injury risk for all types of injury severity studied (except for fatal injuries). The risk for serious and fatal injuries and fatal injuries alone was higher for occupan...
Sickness absence is a common consequence of road traffic crashes, with high costs for the individ... more Sickness absence is a common consequence of road traffic crashes, with high costs for the individual and society. Yet, scarcely studied, therefore, the aim was to describe sickness absence among injured car occupants. A population-based study using register data was conducted, including all car occupants of working age living in Sweden, who in 2010 had specialised in-or outpatient healthcare due to a car crash (n=9427). Individuals were categorised based on age, sex, and injury type. Odds ratios with 95% confidence intervals for a new sickness absence spell >14 days were estimated. After excluding the 9% already on sickness absence or disability pension, 10% had a new sickness absence spell >14 days. Sex and crash type were not associated with new sickness absence, while old age and being born outside Europe were associated with higher odds ratios. Odds ratios varied with the type of injury and injured body region. The odds ratio for sickness absence was highest for injuries t...
BMC Public Health, 2021
The knowledge is scarce about sickness absence (SA) and disability pension (DP) among pedestrians... more The knowledge is scarce about sickness absence (SA) and disability pension (DP) among pedestrians injured in a traffic-related accident, including falls. Thus, the aim was to explore the frequencies of types of accidents and injuries and their association with SA and DP among working-aged individuals. A nationwide register-based study, including all individuals aged 16-64 and living in Sweden, who in 2010 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Information on age, sex, sociodemographics, SA, DP, type of accident, injury type, and injured body region was used. Frequencies of pedestrians with no SA or DP, with ongoing SA or full-time DP already at the time of the accident, and with a new SA spell >14 days in connection to the accident were analyzed. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for new SA were estimated by logistic regression. In total, 5576 pedestrians received healthcare due to ...
Background Shared electric scooters (e-scooters) are emerging as a mean of transport around the g... more Background Shared electric scooters (e-scooters) are emerging as a mean of transport around the globe and are commonly used as a “last mile” service. Since august 2018 electric scooters are available in selected cities in Sweden, operated by several different companies. There is a growing concern of their safety as they grow in popularity. Accident data are starting to be available. However, there are limited knowledge regarding injury distribution and how these injuries relate to the vehicle and infrastructure conditions Sweden represent, of which this study contributes. Aim The aim was to investigate the injuries associated with e-scooters in Sweden and to identify accident characteristics to contribute to ongoing technical development, policy and legislation initiatives. In addition, the aim was to observe how different data collection procedures and samples can affect the results.
This article is part of the Proceedings of the 6th Annual International Cycling Safety Conference... more This article is part of the Proceedings of the 6th Annual International Cycling Safety Conference held in Davis, California, USA on September 20th through 23rd in the year 2017.<br><br>Paper ID: 33
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Conference Presentations by Helena Stigson
Papers by Helena Stigson