Solving the Concussion Crisis: Practical Solutions

On September 25th, concussion experts, including staff and board members from Parachute, gathered at the Konkussion Retreat, an international conference in Ontario, and produced a state-of-the-science white paper on the injury. The goal is to let the world know the progress that has been made in the concussion field and what are the best strategies to dealing with these injuries.

The paper is unprecedented in lining out a clear plan for professional sports leagues, as well as school boards, workers’ compensation boards and more to address concussions head on.

Download the white paper

Canadian Ice Hockey Spinal Injury Registry

Parachute is continuing the biennial hockey spinal injury survey, originally conducted by ThinkFirst Canada. The Canadian Ice Hockey Spinal Injury Registry is a collection of data provided by all practitioners in Canada who may treat spinal injuries in hockey players. The purpose of this Registry is to document the incidence, and associated factors, of spinal injury in ice hockey. The geographical locations of the injury, level of injury, extent of neurological deficit, type of play (e.g., practice, organized, shinny), use of protective equipment and how the injury happened (e.g., pushing and checking from behind) are assessed. Currently, the data spans 1943 to 2009, and we are now completing data collection and analysis for additional years.

Since the first recorded case of a major spinal injury in ice hockey in 1943, the total number of these tragic spinal injuries recorded in our Centre has surpassed 400. Much effort has been made toward the prevention of spinal injuries in hockey. It is essential to maintain accurate statistics in order to determine whether these prevention efforts are effective. The last survey indicated that the annual total number of cases has declined, and that paralyzing injuries have also declined. Please see the last report entitled “Spinal Injuries in Canadian Ice Hockey: An Update to 2005” published in the Clinical Journal of Sport Medicine, 2009; 19(6): 451-456.

The Registry provides a key resource and up-to-date information for researchers, specialists in neurosurgery, orthopedic surgery, and sports medicine as well as for those designing effective injury prevention initiatives. This information is highly beneficial as it monitors the injuries, which then determines the effectiveness of prevention efforts over time. This Registry and survey are made possible thanks to the support of the Rick Hansen Institute, Dr. Tom Pashby Sports Safety Fund, Foster Hewitt Foundation and Hockey Canada. 

Canadian Injury Compass

Along with the Ontario Injury Compass, Parachute also produces Canadian injury reports which each focus on a single injury issue. The Compass provides Canadian data broken down into various categories, along with prevention tips and a list of additional resources.

Ontario Injury Prevention Resource Centre

The Ontario Injury Prevention Resource Centre (OIPRC), operated by Parachute, is a resource centre of Public Health Ontario in the Health Promotion, Chronic Disease and Injury Prevention Department.

The OIPRC has several objectives:

  • To increase the knowledge, skill, and confidence of injury prevention practitioners in the planning, implementation and evaluation of injury prevention initiatives in Ontario.
  • To provide relevant and timely training for practitioners equitably across the province, to meet the needs of the priority populations identified.
  • To provide communication, information and knowledge exchange services.
  • To provide customized data information and assistance, using the most current information available.
  • To engage key stakeholders to advance injury prevention and increase clients' awareness, understanding and access to appropriate injury prevention services and resources.

Visit the OIPRC site.

Research at Parachute

Research plays a central role at Parachute. We are committed to delivering evidence-based injury prevention information and programming to Canadians, and to developing policy positions founded on empirical research. We also produce research reports on a variety of topics. Please see the information in this section for more on research at Parachute.

Ontario Injury Compass

The Ontario Injury Prevention Resource Centre, housed at Parachute, produces injury reports which each focus on a single injury issue. The Compass provides Ontario hospitalization and emergency department data broken down by age, sex and region, along with prevention tips and a list of additional resources.

View the past issues of Ontario Injury Compass

Ontario Injury Data Report

The Ontario Injury Prevention Resource Centre, housed at Parachute, released a detailed snapshot of injury in the province in March 2012: the Ontario Injury Data Report. Nearly two years in the making, the report covering emergency department visits, hospitalizations and deaths by injury, has been greeted with great interest by health units and media outlets. Read the press release, below.

Injury snapshot released for Ontario communities

TORONTO, March 22, 2012 – Today marks the public launch of what may be the most detailed injury snapshot ever prepared for the province of Ontario and its 36 public health units. The Ontario Injury Data Report reveals, for example, that children aged 0-4 landed in emergency departments after a fall from playground equipment at a rate of 152 (per 100,000) in Toronto, compared with 424 (per 100,000) in Peterborough and 251 in Ontario as a whole, while the 2.1 rate (per 100,000) of homicides in Toronto compares to a 0.4 rate in Peterborough and 1.3 in Ontario as a whole.

Prepared by the Ontario Injury Prevention Resource Centre, now housed at SMARTRISK, the report will help public health units across Ontario pinpoint the most pressing injury issues for each age group in their areas. It will also allow injury prevention practitioners to consider how their injury rates compare to Ontario as a whole.

“This is critical information as injury is the leading cause of death for Ontarians aged 1-44, taking the lives of more than 4,600 people each year and placing an economic burden of $6.8 billion on the provincial economy,” said SMARTRISK President and CEO, Dr. Phil Groff. As part of their mandate to protect and promote the health of their local populations, health units are tasked with finding ways to promote injury prevention. This new data report will assist them in setting local prevention priorities.

Included in the Ontario Injury Data Report are emergency room visits (a total of 2.3-million+ injury-related visits to Ontario ERs between fiscal years 2007-2009); hospitalizations (120,000+ from fiscal years 2007-2009); and deaths from injury (more than 18,000 in total between 2001-2005); broken down by cause of injury, health unit and age group. Suicide was found to be the leading cause of injury death in Ontario, followed closely by falls. Regarding non-fatal injuries, however, falls were the leading cause both for people ending up in emergency rooms and for being admitted to hospital.

View the full report

Parachute literature reviews

In order to provide evidence based programming, Parachute develops literature reviews to support many of our programming pieces. Here you will find a list of these reviews available for download.

Parental Influence Over Teen Risk-taking: A review of the literature

Parents have an important influence on the risk-taking behaviours that their children engage in. This literature review outlines the role of parents in children’s behaviours and presents an overview of various programs that have been designed to engage parents.

Suggested citation: Morrish, J., Kennedy, P. and Groff, P. (2011). Parental influence over teen risk-taking: A review of the literature. SMARTRISK: Toronto, ON.

Download the literature review

Child and Adolescent Ski and Snowboard Related Injuries: A review of the literature

Skiing and snowboarding are increasingly popular among adolescents and present various injury risks. This literature review outlines common injuries and the associated etiologies, outlines various influences over these injuries and outlines programming pieces that have been designed to decrease injuries on the ski hill.

Suggested citation: Morrish, J. and Groff, P. (2012). Child and Adolescent ski and snowboard related injuries: A review of the literature. Blair, K (Ed.). SMARTRISK: Toronto, ON.

Download the literature review

Injury data sources

Injury reports

The injury reports listed below provide summaries of national or regional data available on key injury topics, an outline of what works to prevent injuries, and calls to action for further changes needed to keep Canadians safe.  

National injury databases

The Public Health Agency of Canada
The Public Health Agency of Canada researches and analyzes injury data in Canada including emergency room visits, deaths and hospitalizations. The Injury Section of the Public Health Agency of Canada website is a source of national online injury data. It also contains links to reports on injury in Canada. 

Canadian Hospitals Injury Reporting Prevention Program (CHIRPP)
CHIRPP is an injury surveillance program operated by the Public Health Agency of Canada that collects data on injuries seen in the emergency rooms of 10 children's hospitals and four general hospitals.  Injuries in this database do not represent all injuries in Canada.

National Trauma Registry—the Canadian Institute for Health Information
The Canadian Institute for Health Information (CIHI) produces the National Trauma Registry (NTR) report that provides national statistics on injury hospitalizations in Canada. Data comes from the Hospital Morbidity Database, plus data from provincial trauma registries or trauma centres in Canada.

Statistics Canada
This is an administrative database that collects demographic and medical (cause of death) information annually from all provincial and territorial vital statistics registries on all deaths including injuries in Canada.

Canadian Red Cross
The Canadian Red Cross produces annual drowning reports that provide an overview of data and trends on drowning and all other water-related injury fatalities and hospitalizations for near-drownings.

Canadian Motor Vehicle Traffic Collision Statistics from Transport Canada
Transport Canada produces annual reports that provide national statistics on motor vehicle traffic collisions that are compiled from police reports or self-reports. These reports provide details on the circumstances around the crash such as road and weather conditions, number of vehicles involved, type of vehicle and severity of injury.

Economic Burden of Injury reports

Canada (2009)

Released in August 2009, The Economic Burden of Injury in Canada updates and builds on the original 1998 report, outlining the enormous costs of both intentional and unintentional injuries and breaking the data down by province as well as nationally. The study revealed that injury costs Canadians $19.8 billion annually – more than $600 for each man, woman and child in the country. In fact, injury – from falls, traffic, drowning, suicide, violence and other means – remains the leading cause of death for Canadians aged one to 44, taking the lives of 13,667 people in 2004.

Canada (1998)

Released in November 1998, The Economic Burden of Unintentional Injury in Canada is a document filled with compelling statistics. The study highlights the measurable dimensions of injury – it puts a price tag on the economic impact to Canadians.

Ontario (2006)

The full report The Economic Burden of Injury in Ontario, published in 2006.

 

Ontario (1999)

The first of our provincial studies, The Economic Burden of Unintentional Injuries in Ontario was launched in December 1999. Like the national study, it describes the enormous costs of unintentional injury, both human and monetary, to the citizens of Ontario.

Alberta (2002)

The study of The Economic Burden of Unintentional Injuries in Alberta was conducted in 2002. Like the national study, it describes the enormous costs, both human and monetary to the citizens of Alberta. It was prepared for the Alberta Centre for Injury Control & Research by SMARTRISK.

Atlantic Region (2003)

The study of The Economic Burden of Unintentional Injuries in Atlantic Canada was conducted in 2003. It describes the enormous costs of unintentional injury, both human and monetary, to the citizens of Atlantic Canada.

British Columbia (2001)

The study of The Economic Burden of Unintentional Injuries in British Columbia was conducted in 2001. Like the national study, it describes the enormous costs, both human and monetary to the citizens of British Columbia. It was prepared for the British Columbia Injury Research and Prevention Unit (BCIRPU) by SMARTRISK.

Manitoba (2003)

The study of The Economic Burden of Unintentional Injury in Manitoba was conducted in 2003. It describes the enormous costs of unintentional injury, both human and monetary, to the citizens of Manitoba. It was prepared on behalf of IMPACT by SMARTRISK.

Saskatchewan (2001)

The study of The Economic Burden of Unintentional Injuries in Saskatchewan was conducted in 2001. Like the national study, it describes the enormous costs, both human and monetary to the citizens of Saskatchewan.

Research resources

Systematic reviews, injury reports and best practice guides can provide a convenient summary of the key data and /or credible evidence for a particular injury topic from a larger body of research literature. This avoids the need to wade through large amounts of literature or data from a variety of sources. However, creating effective prevention programs involves combining the best available evidence with the real-world experience of practitioners.1 These injury prevention resources can provide credible information that can help in designing injury prevention programs and strategies.

Injury reports

Injury reports listed below are summaries of national or regional data available on key injury topic(s), an outline of what works to prevent injuries, and calls to action for further changes needed to keep us all safe.

  • Child and Youth Unintentional Injury: 1994-2003, 10 Years in Review (English).  Data from the Canadian Institute for Health Information and Statistics Canada is used to capture changes in the death and hospitalization trends for childhood injury over a 10-year period from 1994 to 2003. Download the full report here
  • Child and Youth Unintentional Injury, Atlantic Canada, 10 Years in Review (English) - Data from Statistics Canada is used to capture changes in death trends for unintentional childhood injury over a 10-year period from 1995-2004. The report can be downloaded from the page here.
  • Injury in Review, 2012 Edition: Spotlight on Road and Transport Safety provides surveillance and prevention information on injuries in Canada with a focus on road and transport safety for children, youth and young adults up to 24 years of age. Injury in Review, 2012 Edition was produced by the Public Health Agency of Canada, in collaboration with the Traffic Injury Research Foundation and Safe Kids Canada. Download the full report here, or to order a print copy, email the Public Health Agency of Canada at Injury.Surveillance@phac-aspc.gc.ca.
  • The Public Health Agency of Canada released Injury in Review 2011 - Spotlight on Road and Transport Safety: Select Results, at the 2011 Canadian Injury Prevention and Safety Promotion Conference in Vancouver. Download the full report here
  • The Atlantic Collaborative on Injury Prevention released the report Do injuries discriminate? The social determinants of Injury. Download the full report here
  • 2009 Edition (English) - National report on preventable injuries in Canada and spotlight on consumer product safety. Download the full report here
  • The Centers for Disease Control and Prevention's report, Nonfatal Traumatic Brain Injuries Related to Sports and Recreation Activities Among Persons Aged ≤19 Years — United States, 2001–2009, was published in the Oct. 7, 2011, issue of CDC’s Morbidity and Mortality Weekly Report. View the report
  • The World Health Organization's World Report on Child Injury Prevention is available online. View the report
  • The World Health Organization's Global status report on road safety 2013 is available online. View the report
  • The CIHR Team in Child & Youth Injury Prevention: End of Grant Report // 2010 - 2016.This report details the CIHR Team in Child & Youth Injury Prevention team’s work on enhancing Child and youth injury prevention through partnerships among child and youth injury prevention researchers and committed knowledge users and stakeholders since 2010. Addressing child and youth injury by developmental stages (young children, school age children, adolescents), their approach aims to target relevant causes of injury within these high risk groups, including the burden, risks and circumstances of injury among First Nations and Inuit children and youth. Download the report.
     

Evidence-informed practices 

These guides are created through evidence-based suggestions that contain both findings from systematic reviews and agreement from experts and stakeholders.2

  • Making It Happen - A Community Resource (pedestrian safety) - download the guide here
  • Safer Homes for Children (A Guide for Communities) - download the guide here
  • On the Right Track for Rail Safety - A Community Resource - download the guide here
  • The EuroSafe - Child Safety Good Practice Guide provides injury prevention stakeholders with evidence-based strategy options that address child injury within the areas of education, environment and enforcement. It also has a selection of case studies that illustrate programs in Europe that have applied these strategies and lessons learned for their application. View the guide

Child Safety Good Practice Guide: Good investments in unintentional child injury prevention and safety promotion – Canadian Edition

The Canadian Edition of the Child Safety Good Practice Guide provides the first seminal, comprehensive document in the country from which decision-makers, practitioners and legislators can base their work and recommendations. It is designed to enable Canadian injury prevention practitioners to examine Canadian strategy options for unintentional child injury, move away from what has ‘always been done’ and move toward good investments - strategies that are known to work or have the greatest probability of success. 

This document is based on the 2006 European Child Safety Good Practice Guide, which was launched by the European Child Safety Alliance (the Alliance) in order to provide guidance on proven, effective injury prevention strategies.  Safe Kids Canada formally partnered with the Alliance to bring the Guide to Canada.

Evidence-based good practices are provided in this guide for those considering uptake, transfer and implementation of specific strategies or interventions.  In particular, evidence "at-a-glance” tables include referenced evidence statements and transfer / implementation points on 11 child safety topics, and 17 case studies demonstrate ‘real world’ success in at least one Canadian context. Download the full guide here.

Systematic reviews

These share evidence behind a specific health issue by giving a summary of research from multiple sources that is systematically gathered, reviewed and evaluated against pre-established criteria.3 Systematic reviews help reduce bias, resolve controversy between different findings and provide reliable sources for decision-making.

Harborview Injury Prevention and Research Center Best Practices
This website includes reviews of studies that have been evaluated using some type of comparison group, and measure specific outcomes using injury indicators like deaths, hospitalizations and or observed behaviour change. Studies that measure changes in attitudes, beliefs, self-reported behaviours or knowledge are excluded from the review.

The Cochrane Library Reviews
The Cochrane Library is a collection of databases and systematic reviews that contain high-quality, independent evidence that can inform healthcare decision-making.

Health evidence
Health evidence is an online registry of systematic reviews on the effectiveness of public health and health promotion interventions, including injury prevention and safety.

Centers for disease control and prevention (CDC)- National Center for Injury Prevention and Control
The CDC’s National Center for Injury Prevention and Control is the lead national agency in the United States for injury prevention. The Center’s website lists injury reports and research summaries on a large number of unintentional and intentional injury topics.

Measuring Impact: Young Workers’ Injury Prevention Interventions in Canada. Project team: Parachute, The Sandbox Project, MySafeWork, The CIHR Team in Child and Youth Injury Prevention, Sunnybrook Health Sciences Centre P.A.R.T.Y. Program, The Institute for Work and Health.

The goal of this project is to develop a continuum to measure and assess workplace interventions for youth occupational injury prevention. The continuum is comprised of an evidence-based strategy for the use of metrics to measure young worker injury prevention initiatives, and a framework that can be used to identify key indicators of youth risk of injury in the workplace.

Journals

Injury Prevention journal
This is an international journal dedicated to injury prevention and includes peer-reviewed articles that focus on injury for all ages.  Furthermore, Injury Prevention regularly includes a News and Notes section and many other special features including brief reports, editorials, commentaries, policy forums, fillers, book reviews and correspondence.

Injury research databases

SafetyLit
SafetyLit is an injury research database that provides a weekly e-mail update with summaries of research articles and reports on injury prevention from a variety of disciplines that are relevant to preventing unintentional injuries, violence and self-harm. SafetyLit service scans more than 3,000 scholarly international journals, conference proceedings, government and agency reports to develop these summaries.

PubMed
PubMed is the U.S. National Library Medicine's freely available database of medical literature and can be used to search injury research.

PubMed Central Canada
Pub Med Central Canada is a new initiative launched in 2009 that provides free access to peer-reviewed Canadian health and life sciences literature, including CIHR-funded research.

Endnotes

1 Brussoni M, Towner E, Hayes M. Evidence into practice: combining the art and science of injury prevention. Injury Prevention. Inj Prev 2006; 12(6): 373-7.
2 Raina P. Evidence-based injury prevention: is it necessary? Retrieved May 20, 2007 from BC Injury Research and Prevention Unit
3 Cochrane Health Promotion and Public Health Field. Retrieved March 07, 2007 from http://www.ph.cochrane.org/en/localrevs.html