• Andersson, A., and L. Chapman, 2011: The use of a temporal analogue to predict future traffic accidents and winter road conditions in Sweden. Meteor. Appl., 18, 125136, https://doi.org/10.1002/met.186.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Arnold, C. M., V. P. M. Dal Bello-Haas, J. P. Farthing, K. L. Crockett, C. R. A. Haver, G. Johnston, and J. Basran, 2016: Falls and wrist fracture: Relationship to women’s functional status after age 50. Can. J. Aging, 35, 361371, https://doi.org/10.1017/S0714980816000337.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Aultman-Hall, L., D. Lane, and R. R. Lambert, 2009: Assessing impact of weather and season on pedestrian traffic volumes. Transp. Res. Rec., 2140, 3543, https://doi.org/10.3141/2140-04.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Avery, J. G., 1982: Fractures during ice and snow. Br. Med. J., 284, 270, https://doi.org/10.1136/bmj.284.6311.270.

  • Bamzar, R., and V. Ceccato, 2015: The nature and the geography of elderly injuries in Sweden. GeoJournal, 80, 279299, https://doi.org/10.1007/s10708-014-9552-z.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Baxter, M. A., C. E. Graves, and J. T. Moore, 2005: A climatology of snow-to-liquid ratio for the contiguous United States. Wea. Forecasting, 20, 729744, https://doi.org/10.1175/WAF856.1.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bell, J., L. Gardner, and D. P. Landsittel, 2000: Slip and fall-related injuries in relation to environmental cold and work location in above-ground coal mining operations. Amer. J. Ind. Med., 38, 4048, https://doi.org/10.1002/1097-0274(200007)38:1<40::AID-AJIM5>3.0.CO;2-F.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bentley, T., and R. Haslam, 2001: Identification of risk factors and countermeasures for slip, trip and fall accidents during the delivery of mail. Appl. Ergon., 32, 127134, https://doi.org/10.1016/S0003-6870(00)00048-X.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Berggård, G., and C. Johansson, 2010: Pedestrians in wintertime—Effects of using anti-slip devices. Accid. Anal. Prev., 42, 11991204, https://doi.org/10.1016/j.aap.2010.01.011.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bland, J. M., and D. G. Altman, 2000: Statistics notes: The odds ratio. BMJ, 320, 1468, https://doi.org/10.1136/bmj.320.7247.1468.

  • Bobb, J. F., K. K. L. Ho, R. W. Yeh, L. Harrington, A. Zai, K. P. Liao, and F. Dominici, 2017: Time-course of cause-specific hospital admissions during snowstorms: An analysis of electronic medical records from major hospitals in Boston, Massachusetts. Amer. J. Epidemiol., 185, 283294, https://doi.org/10.1093/aje/kww219.

    • Search Google Scholar
    • Export Citation
  • Böcker, L., M. Dijst, and J. Prillwitz, 2013: Impact of everyday weather on individual daily travel behaviours in perspective: A literature review. Transp. Rev., 33, 7191, https://doi.org/10.1080/01441647.2012.747114.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bulajic-Kopjar, M., 2000: Seasonal variations in incidence of fractures among elderly people. Inj. Prev., 6, 1619, https://doi.org/10.1136/ip.6.1.16.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bylund, P.-O., J. Johansson, and P. Albertsson, 2016: Injuries sustained during snow removal from roofs resulting in hospital care. Int. J. Inj. Control Saf. Promot., 23, 105109, https://doi.org/10.1080/17457300.2014.992349.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chiu, K. Y., T. P. Ng, and S. P. Chow, 1996: Seasonal variation of fractures of the hip in elderly persons. Injury, 27, 333336, https://doi.org/10.1016/0020-1383(95)00232-4.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • City of Waterloo, 2009: Snow & ice removal by-law. Corporation of the City of Waterloo By-law 09-156, 7 pp., https://www.waterloo.ca/en/government/resources/Documents/By-law/Snow-removal-bylaw.pdf.

  • Clarke, P., J. A. Hirsch, R. Melendez, M. Winters, J. Sims Gould, M. Ashe, S. Furst, and H. McKay, 2017: Snow and rain modify neighbourhood walkability for older adults. Can. J. Aging, 36, 159169, https://doi.org/10.1017/S071498081700006X.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Crawford, J. R., and M. J. Parker, 2003: Seasonal variation of proximal femoral fractures in the United Kingdom. Injury, 34, 223225, https://doi.org/10.1016/S0020-1383(02)00211-5.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • ECCC, 2018: Canadian Climate Normals. Environment and Climate Change Canada, accessed 10 October 2018, http://climate.weather.gc.ca/climate_normals/index_e.html.

  • Elvik, R., and T. Bjørnskau, 2019: Risk of pedestrian falls in Oslo, Norway: Relation to age, gender and walking surface condition. J. Transp. Health, 12, 359370, https://doi.org/10.1016/j.jth.2018.12.006.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fleiss, J. L., 1973: Statistical Methods for Rates and Proportions. John Wiley and Sons, 223 pp.

  • Gevitz, K., R. Madera, C. Newbern, J. Lojo, and C. C. Johnson, 2017: Risk of fall-related injury due to adverse weather events, Philadelphia, Pennsylvania, 2006-2011. Public Health Rep., 132, 53S58S, https://doi.org/10.1177/0033354917706968.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gyllencreutz, L., J. Björnstig, E. Rolfsman, and B.-I. Saveman, 2015: Outdoor pedestrian fall-related injuries among Swedish senior citizens—Injuries and preventive strategies. Scand. J. Caring Sci., 29, 225233, https://doi.org/10.1111/scs.12153.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hagino, H., and Coauthors, 2004: Nationwide survey of hip fractures in Japan. J. Orthop. Sci., 9, 15, https://doi.org/10.1007/s00776-003-0741-8.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hajat, S., Z. Chalabi, P. Wilkinson, B. Erens, L. Jones, and N. Mays, 2016: Public health vulnerability to wintertime weather: Time-series regression and episode analyses of national mortality and morbidity databases to inform the Cold Weather Plan for England. Public Health, 137, 2634, https://doi.org/10.1016/j.puhe.2015.12.015.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hassi, J., L. Gardner, S. Hendricks, and J. Bell, 2000: Occupational injuries in the mining industry and their association with statewide cold ambient temperatures in the USA. Amer. J. Ind. Med., 38, 4958, https://doi.org/10.1002/1097-0274(200007)38:1<49::AID-AJIM6>3.0.CO;2-3.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hemenway, D., and G. A. Colditz, 1990: The effect of climate on fractures and deaths due to falls among white women. Accid. Anal. Prev., 22, 5965, https://doi.org/10.1016/0001-4575(90)90007-8.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Jacobsen, S., D. Sargent, E. Atkinson, W. O’Fallon, and L. Melton III, 1999: Contribution of weather to the seasonality of distal forearm fractures: A population-based study in Rochester, Minnesota. Osteoporosis Int., 9, 254259, https://doi.org/10.1007/s001980050145.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Johansson, O., P. Wanvik, and R. Elvik, 2009: A new method for assessing the risk of accident associated with darkness. Accid. Anal. Prev., 41, 809815, https://doi.org/10.1016/j.aap.2009.04.003.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lauritzen, J. B., P. Schwartz, P. McNair, B. Lund, and I. Transbol, 1993: Radial and humeral fractures as predictors of subsequent hip, radial or humeral fractures in women, and their seasonal variation. Osteoporosis Int., 3, 133137, https://doi.org/10.1007/BF01623274.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Levy, A., N. E. Mayo, and G. Grimard, 1995: Rates of transcervical and pertrochanteric hip fractures in the Province of Quebec, Canada, 1981-1992. Amer. J. Epidemiol., 142, 428436, https://doi.org/10.1093/oxfordjournals.aje.a117651.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Levy, A., D. Bensiom, N. Mayo, and H. Leighton, 1998: Inclement weather and the risk of hip fracture. Epidemiology, 9, 172177, https://doi.org/10.1097/00001648-199803000-00012.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lipscomb, H. J., J. E. Glazner, J. Bondy, K. Guarini, and D. Lezotte, 2006: Injuries from slips and trips in construction. Appl. Ergon., 37, 267274, https://doi.org/10.1016/j.apergo.2005.07.008.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Luukinen, H., K. Koski, and S.-L. Kivelä, 1996: The relationship between outdoor temperature and the frequency of falls among the elderly in Finland. J. Epidemiol. Community Health, 50, 107, https://doi.org/10.1136/jech.50.1.107.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Marshall, E. G., L. Shou-En, S. Zhengyang, J. Swerdel, M. Borjan, and M. E. Lumia, 2016: Work-related unintentional injuries associated with Hurricane Sandy in New Jersey. Disaster Med. Public Health Prep., 10, 394404, https://doi.org/10.1017/dmp.2016.47.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Methorst, R., P. Schepers, N. Christie, M. Dijst, R. Risser, D. Sauter, and B. Wee, 2017: ‘Pedestrian falls’ as necessary addition to the current definition of traffic crashes for improved public health policies. J. Transp. Health, 6, 1012, https://doi.org/10.1016/j.jth.2017.02.005.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mills, B., J. Andrey, and D. Hambly, 2011: Analysis of precipitation-related motor vehicle collision and injury risk using insurance and police record information for Winnipeg, Canada. J. Safety Res., 42, 383390, https://doi.org/10.1016/j.jsr.2011.08.004.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mills, B., J. Andrey, B. Doberstein, S. Doherty, and J. Yessis, 2019: Changing patterns of motor vehicle collision risk during winter storms: A new look at a pervasive problem. Accid. Anal. Prev., 127, 186197, https://doi.org/10.1016/j.aap.2019.02.027.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Modarres, R., T. B. M. J. Ouarda, A. Vanasse, M. G. Orzanco, and P. Gosselin, 2014: Modeling climate effects on hip fracture rate by the multivariate GARCH model in Montreal region, Canada. Int. J. Biometeorol., 58, 921930, https://doi.org/10.1007/s00484-013-0675-6.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mondor, L., K. Charland, A. Verma, and D. L. Buckeridge, 2015: Weather warnings predict fall-related injuries among older adults. Age Ageing, 44, 403408, https://doi.org/10.1093/ageing/afu199.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Morency, P., C. Voyer, S. Burrows, and S. Goudreau, 2012: Outdoor falls in an urban context: Winter weather impacts and geographical variations. Can. J. Public Health, 103, 218222, https://doi.org/10.1007/BF03403816.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Murray, I. R., C. R. Howie, and L. C. Biant, 2011: Severe weather warnings predict fracture epidemics. Injury, 42, 687690, https://doi.org/10.1016/j.injury.2010.12.012.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Nyman, S. R., C. Ballinger, J. E. Phillips, and R. Newton, 2013: Characteristics of outdoor falls among older people: A qualitative study. BMC Geriatr., 13, 125, https://doi.org/10.1186/1471-2318-13-125.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Parachute, 2015: The cost of injury in Canada. Parachute Rep., 177 pp., https://parachute.ca/wp-content/uploads/2019/06/Cost_of_Injury-2015.pdf.

  • Peden, M., K. McGee, and G. Sharma, 2002: The Injury Chart Book: A Graphical Overview of the Global Burden of Injuries. World Health Organization, 76 pp.

    • Search Google Scholar
    • Export Citation
  • Pipas, L., N. Schaefer, and L. Brown, 2002: Falls from rooftops after heavy snowfalls: The risk of snow clearing activities. Amer. J. Emerg. Med., 20, 635637, https://doi.org/10.1053/ajem.2002.35494.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ràliš, Z. A., 1981: Epidemic of fractures during period of snow and ice. Br. Med. J., 282, 603605, https://doi.org/10.1136/bmj.282.6264.603.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ràliš, Z. A., E. A. Barker, I. J. Leslie, W. J. Morgan, A. C. Ross, and S. H. White, 1988: Snow-and-ice fracture in the UK, a preventable epidemic. Lancet, 331, 589590, https://doi.org/10.1016/S0140-6736(88)91383-9.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • RMW, 2018: Year-end 2017 population and household estimates for Waterloo region. Region of Waterloo Planning, Development and Legislative Services, Community Planning Rep. PDL-CPL-17-12, 2 pp.

  • Schepers, P., B. den Brinker, R. Methorst, and M. Helbich, 2017: Pedestrian falls: A review of the literature and future research directions. J. Safety Res., 62, 227234, https://doi.org/10.1016/j.jsr.2017.06.020.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Smith, K. R., and Coauthors, 2014: Human health: Impacts, adaptation, and co-benefits. Climate Change 2014: Impacts, Adaptation, and Vulnerability, Part A: Global and Sectoral Aspects, C. B. Field et al., Eds., Cambridge University Press, 709754.

    • Search Google Scholar
    • Export Citation
  • Smith, R., and D. Nelson, 1998: Fractures and other injuries from falls after an ice storm. Amer. J. Emerg. Med., 16, 5255, https://doi.org/10.1016/S0735-6757(98)90065-1.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stansbury, L. G., A. A. Swinson, J. M. Schmitt, M. B. Stevens, K. R. Kobayashi, C. P. Vangellow, and D. Lampkins, 1995: Work-related injuries associated with falls during ice storms—National Institutes of Health, January 1994. MMWR Wkly., 44, 920922.

    • Search Google Scholar
    • Export Citation
  • Transport Canada, 2016: Canadian motor vehicle traffic collision statistics 2014 collected in cooperation with the Canadian Council of Motor Vehicle Administrators. Transport Canada Doc. T45-3E-PDF, 6 pp., https://www.tc.gc.ca/media/documents/roadsafety/cmvtcs2014_eng.pdf.

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Winter Storms and Fall-Related Injuries: Is It Safer to Walk than to Drive?

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  • 1 Department of Geography and Environmental Management, University of Waterloo, and Meteorological Research Division, Environment and Climate Change Canada, Waterloo, Ontario, Canada
  • 2 Department of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, Canada
  • 3 Department of Geography and Environmental Studies, Wilfrid Laurier University, Waterloo, Ontario, Canada
  • 4 Department of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, Canada
  • 5 School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Abstract

Emergency department visitation data were analyzed using a matched-pair, retrospective cohort method to estimate the effects of winter storms on fall-related injury risks for a midsized urban community in Ontario, Canada. Using a unique definition and classification of winter storm events and dry-weather control periods, relative risks of injury were estimated for total falls and two subcategories (same-level falls involving ice and snow; all other falls) across two storm event types (snowfall only; mixed precipitation). Winter storms were associated with 38% and 102% increases in the mean incidence of same-level falls involving ice and snow during snow events and freezing-rain events, respectively. The incidence of other types of falls was slightly but significantly less during snow events relative to dry-weather control periods. Findings suggest that walking is not safer than driving during winter storms, as same-level falls involving ice and snow accounted for 64% more of the injury burden than motor vehicle collisions. Significant reductions in mean relative risk estimates for fall-related injuries were apparent over the 2009–17 study period indicating possible long-term shifts in exposure, sensitivity, and/or risk-mitigating decisions, actions, and behavior. Consistent and significant effects of government-issued weather warning communications on risk outcomes were not found. Practitioners engaged in developing injury prevention strategies and related public risk messaging, in particular winter weather warnings and advisories, should place additional emphasis on falls and multimodal injury risks in communications related to winter storm hazards.

Corresponding author: Brian Mills, bmills@uwaterloo.ca

Abstract

Emergency department visitation data were analyzed using a matched-pair, retrospective cohort method to estimate the effects of winter storms on fall-related injury risks for a midsized urban community in Ontario, Canada. Using a unique definition and classification of winter storm events and dry-weather control periods, relative risks of injury were estimated for total falls and two subcategories (same-level falls involving ice and snow; all other falls) across two storm event types (snowfall only; mixed precipitation). Winter storms were associated with 38% and 102% increases in the mean incidence of same-level falls involving ice and snow during snow events and freezing-rain events, respectively. The incidence of other types of falls was slightly but significantly less during snow events relative to dry-weather control periods. Findings suggest that walking is not safer than driving during winter storms, as same-level falls involving ice and snow accounted for 64% more of the injury burden than motor vehicle collisions. Significant reductions in mean relative risk estimates for fall-related injuries were apparent over the 2009–17 study period indicating possible long-term shifts in exposure, sensitivity, and/or risk-mitigating decisions, actions, and behavior. Consistent and significant effects of government-issued weather warning communications on risk outcomes were not found. Practitioners engaged in developing injury prevention strategies and related public risk messaging, in particular winter weather warnings and advisories, should place additional emphasis on falls and multimodal injury risks in communications related to winter storm hazards.

Corresponding author: Brian Mills, bmills@uwaterloo.ca
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