142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

300692
Wear a Helmet! Traumatic Brain Injury and Helmet Use in San Diego County

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Joshua Smith, PhD, MPH , Emergency Medical Services, County of San Diego Health and Human Services Agency, San Diego, CA
Barbara M. Stepanski, MPH , Emergency Medical Services, County of San Diego Health and Human Services Agency, San Diego, CA
Leslie Ray, MPH, MPPA, MA , Emergency Medical Services, County of San Diego Health and Human Services Agency, San Diego, CA
Isabel Corcos, PhD, MPH , County of San Diego, Emergency Medical Services, County of San Diego, San Diego, CA
Alicia Sampson, MPH, CPH , Health & Human Services Agency, Public Health Services, County of San Diego, San Diego, CA
Sanaa Abedin, MPH , Community Health Statistics Unit, Health Care Policy Administration, County of San Diego Health and Human Services Agency, San Diego, CA
Amelia Kenner-Brininger, MPH, CPH , Emergency Medical Services, County of San Diego, San Diego, CA
Ryan Smith, MPH , Emergency Medical Services, County of San Diego, San Diego, CA
Kimberly De Vera, BS , Emergency Medical Services, County of San Diego Health and Human Services Agency, San Diego, CA
Background:  In San Diego County, the rate of traumatic brain injury (TBI) increased by 55% in emergency department (ED) discharges between 2006 and 2012, more than 22,000 occurring in the final year. While this may be a result of increased awareness, it underscores the magnitude of the TBI problem.

Methods:  Using the CDC definition for TBI, ED discharge, hospitalization, death, and trauma registry data were used to describe TBI trends in the County.  Prehospital and trauma data were used to evaluate helmet use, TBI, and injury severity.

Results:  All data sources revealed a temporal increase in TBI.  Only 35% of prehospital patients and 29% of trauma pedalcyclists aged 17 and younger were wearing helmets.  Helmet use among prehospital patients was lower among older youth, skateboarders, and those in acute status.  Among trauma pedalcyclists, helmet use was positively associated with age (p<0.001) and negatively with TBI occurrence (p=0.006).  There was no association between helmet use and injury severity score (ISS) among pedalcyclists with TBI in motor vehicle accidents.  However, there was an interaction between ISS and age among pedalcyclists with TBI in non-motor vehicle accidents.  Helmet use was associated with lower ISS in those 17 and younger (p=0.025) and higher ISS in those 18 and older (p=0.001).

Conclusions:  While helmet use was significantly protective among those 17 and younger in both the prehospital and trauma registry data, actual helmet use was extremely low in both groups.  Intervention efforts are underway but need continued, intensified support from policy makers.

Learning Areas:

Assessment of individual and community needs for health education
Epidemiology

Learning Objectives:
Describe trends in traumatic brain injury in San Diego County. Compare helmet users to non-helmet users with prehospital data. Evaluate helmet use and traumatic brain injury with trauma registry data.

Keyword(s): Child Health Promotion, Data Collection and Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an epidemiologist for the County of San Diego. I work directly with our prehospital database, the emergency department database, and the trauma registry, responding to data requests from both internal and external customers.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3306.0: Traumatic brain injury