product related injuries - a selectionlawn mowers, were responsible for 22% of yard and garden...

VICTORIAN INJURY SURVEILLANCE SYSTEM HAZARD 22 page 1

Hazard(Edition No. 22)March 1995

Victorian InjurySurveillance System

Monash UniversityAccident Research Centre

SummaryInjuries from architectural glass weremore severe than injuries from otherglass products. The majority of theseinjuries occurred in the homeenvironment, 86% for children and68% for adults. Injuries were mainlyto victims in younger age groups andwere also more severe in these youngervictims. Fighting and quarrelling werethe activities being undertaken by 19%of adult victims at the time of injury.

Lawn mowers, were responsible for22% of yard and garden equipmentinjuries to adults on the VISS database.While three quarters of these injuries

were to adult victims, the admissionrate for child victims was 44%(compared with 18% for adults). Ride-on mowers caused the most severeinjuries with 71% of child victimsrequiring admission to hospital. One-third of all injuries sustained were tothe fingers.

Shopping trolleys were responsiblefor 268 injuries, predominantly tochildren aged under 5 (69%). Fifty-four percent of shopping trolleyinjuries were to the head and face.Injury most commonly occurred whenthe victim stood up in the trolley orwhen the trolley toppled over. Theuse of adjustable safety harnesses to

prevent children from standing in orreaching too far out of trolleys wouldprevent many of the injuries seenhere.

There were 138 chainsaw injuries,predominantly from the LatrobeValley, in the VISS database. Injurieswere mostly lacerations to the fingers,hands and legs followed by foreignbodies in the eyes. Loss of control orslipping of the chainsaw, woodchipsor sawdust entering the eyes, or thechainsaw user slipping were the majorcauses of injury. Only one-third ofchainsaw victims wore safety gear ofany kind.

This edition of Hazard covers product related injury with particular reference to domestic architectural glass, lawnmowers, shopping trolleys and chainsaws. Reference is made to appropriate Australian Standards and recommendationsmade for injury prevention.

Product Related Injuries - a selection

V.I.S.S.


IntroductionIt has been estimated that the cost ofproduct related injury in Australia isin the order of $2.8 billion per annumand that this cost is largely borne bythe consumer and the health system.Product related injuries are determinedby the man-made environment andthe abilities, skills and behaviour ofthe user. The task of improvingconsumer safety is multi-sectoral andin Victoria involves the FederalBureau of Consumer Affairs throughthe Trade Practices Act, the Office ofFair Trading, Standards Australiathrough its mandatory and mostlyvoluntary standards, themanufacturers through product designand safety programs and other injuryprevention and consumer bodies egAustralian Consumers Association,Occupational Health and SafetyAuthority. (Moller, 1984).

The following articles focus on aselection of products - domesticarchitectural glass, lawn mowers,shopping trolleys and chain saws.

DomesticArchitectural GlassInjuriesGiulietta Valuri

The Building Code of Australia hasrequired safety glass installation inlocations in both new and renovatedhomes since April 1991 (Nassau,1995). No clear trend towards injuryreductions from domestic architecturalglass injury can be determined todate. This could be explained by therelatively slow process of introducingsafety glass to existing housing stock,the non-specific nature of codes inhospital admission data, or possiblyby the Australian Standard or BuildingCode requirements being insufficientto make a difference. Further research

would be required to determinewhether the Australian Standardtogether with the Building Code isadequately protective againstdomestic architectural glass injuries.

Most architectural glass injuriesrecorded in the VISS database occurin the home: children 86% and adults68% sustained in the home. Previousstudies conducted in New South Walesalso found that a majority ofarchitectural glass injuries occurredin the home (Jackson, 1981; Maitra &Han, 1990).

Architectural glass in this articleincludes glass windows, doors, showerand bath screens. The following willexamine injuries to children and adultsseparately as data collection for thetwo age groups commenced atdifferent times.

Children (n = 443)During the period 1989 to 1993, 443children (14 years and under)presented to the emergencydepartments of the Royal Children’sHospital, Western Hospital andPreston and Northcote CommunityHospital. Of these, 67% were males.

Most of these injuries (44%) occurredto children under 5 years of age withover half occurring to 1 and 2 yearolds. (Figure 1).

Twenty-six percent of the injurieswere sufficiently severe to requireadmission to hospital with the highestadmission rate being to the 5 to 9 yearolds (30%).

Falls led to a third of the injuriesoccurring, glass collapsing/caving inmade up 10%, injuries from practicaljokes/horse-play 5% and fighting,quarrelling 3%. The majority ofthese fall injuries (88%) occurredwhile the child was playing.

Over three quarters (78%) of theinjuries occurred in the living/sleepingareas of the home.

Seventy-eight percent of injuriesresulted in lacerations, mostly to theupper limbs (53%) and head and face(26%).

Adults (n = 419)Injuries to adults (15 yrs and over)involving domestic architectural glassare based on data collected from theWestern Hospital (2 yrs), Royal

Children Age and Sex Distribution Figure 1

Age (years)

N

0

20

40

60

80

100

120

140

0-4 5-9 10-14

Males

F emales

VISS: RCH, WH, PANCH, 1989 - 1993, < 15 yrs n = 443


Melbourne Hospital (2 yrs), Prestonand Northcote Community Hospital(1 yr) and Latrobe Regional Hospital(3 yrs).

Over two thirds of the injuries were tomales with injuries most commonlyoccurring in the 20 to 24 year agegroup (27% of all adults). (Figure 2.)Sixteen percent required admissionto hospital.

Over half (53%) were involved in aleisure/recreational activity when theinjury occurred, 19% were fighting/quarrelling, 4% intended to harmthemselves, 4% were cleaning and3% were showering/bathing at thetime. The mechanism of injury wasfalls in 36% of cases.

The majority of the injuries (70%)occurred in the living/sleeping area ofthe home and 20% in the garden/garage.

Glass windows and doors were themain factors causing injuries. Alcoholwas reported as a contributing factorin 5%, mainly involved with arguingand fighting. It is suspected that thisfigure is understated.

Lacerations accounted for a highproportion of the injuries (84%),mostly to the upper limbs (69% of alllacerations).

ComparisonThe sex ratios for children and adultswere similar: children 2.2 males to 1female, adults 2.3 to 1.

Injuries to children appear to be moresevere as they have a higher admissionrate. A New South Wales study alsofound that injuries from architecturalglass are more severe than from otherglass and occur mainly in the youngerage groups. (Maitra & Han, 1990).

The proportion of injuries occurringin the living/sleeping area of the homewas quite high in both children andadults with the under 15 year oldsbeing slightly higher. Garden/garage,kitchen, bathroom, laundry and toiletareas were higher in adults whichcould be due to adults being involvedin household activities andmaintenance (do-it-yourself) aroundthe home.

Laceration rates from architecturalglass were high in both categories,though injuries were more severe forchildren (26% admitted) than adults(16% admitted). Table 1 comparesthe distribution of severe lacerationsin children and adults.

Almost all the injuries involvedwindows/window glass (57%children, 76% adults) and glass doors(41% children and 22% adults). Themajority in both adults and childrenwere from windows but windowscaused more injuries to adults than tochildren (76% and 57% respectively).

A comparison between the body partsinjured for children and adults isshown in Figures 3 and 4.

Adult Age and Sex Distribution Figure 2

Age (years)

N

0

10

20

30

40

50

60

70

80

90

15-19 20-24 25-29 30-34 35-39 40-49 50-59 60-69 70-79 80+

Males

F emales

VISS: WH (2 yrs), RMH (2 yrs), PANCH (1 yr), LRH (3 yrs); >= 15 yrs, n = 419

Proportion of Admissions by Body Part Injured Table 1Children and Adults

Body Part(lacerations)

Children(N = 157)

%

Adults(N = 96)

%Forearm 13 27

Finger 12 10

Face & scalp 10 1

Wrist 6 11

Hand 6 11

VISS: RCH, WH, PANCH, RMH, LRH


Body Part Injured - ChildrenFigure 3

VISS: RCH, WH, PANCH, 1989-1993,< 15 yrs(up to 3 injuries per case)

Body Part Injured - AdultsFigure 4

VISS: WH (2 yrs), RMH (2 yrs),PANCH (1 yr), LRH (3 yrs); >= 15 yrs( up to 3 injuries per case)

Window/window glassMost of the window glass relatedinjuries to children occurred whenthey fell through a window (20%), eg.“Playing with sister, lost balance andfell through plate glass window”;when a window dropped on/caughthand (14%), eg. “Opening thewindow. Window dropped down, glassbroke & fell onto finger”; when theyfell out of an open window (11%) orwhen they hit against a window (10%).

Adult injuries, on the other hand, werepredominantly caused when the patientinflicted the injury themselves (19%),eg.“Arguing with girlfriend and punchedthe window in anger.”; when they fellthrough a window (14%), were cut bya window (12%), eg. “Putting in awindow. Cut finger on broken window”;or while fighting (11%), eg. “Fighting,punched window instead of person,broke glass.” Of self inflicted injuries,over half were a result of being angryafter a fight or argument and alcoholwas a contributing factor in 11 cases.

Most of these injuries occurred whenthe patient put their hand through awindow.

Glass DoorsChildren running/walking into glassdoors was one of the main causes ofglass door related injuries (21%) eg.“Running in from verandah into livingroom. Ran through glass slidingdoor.” Hitting against doors, mostlyfrom falls, caused 18% of injuries, eg.“Playing, tripped over, hit head onglass door.”; fingers getting caughtin doors and pushing against glassdoors both caused 10%.

Injuries to adults were mostly fromtripping/slipping and falling throughglass doors (24%), eg. “Walking,tripped and put arm through a glassdoor.” ; hitting against doors (15%),eg. “Running into kitchen and hitagainst glass door.”; and self inflictedinjuries (8%), eg. “Argument brokeout with parents and placed fistthrough glass door.”

Prevention

1. Most glass in domestic settings in Australia is of the annealed variety,which has less strength than safety glass and breaks into sharp pieces. AllAustralian states and territories except South Australia have adopted the1989 revision of the Australian Standard (AS 1288) “Glass in Buildings- Selection and Installation”. Victoria adopted the standard in 1991. Thisrequires that safety glazing materials, either toughened glass, laminatedglass or organic glass be used in some residential situations whereannealed glass was previously acceptable. Annealed glass breaks withrelatively low impact into jagged pieces, whereas toughened glass breaksless readily into small particles with blunt edges.

2. Replace low level glass with safety glass whenever glass is replaced inexisting homes.

3. Reduce the price differential between safety glass and annealed glass.

4. To improve the safety of existing low glass, appropriate plastic filmshould be applied to the glass surface to reduce potential for injury if theglass is shattered.

5. Bars/rails across glass afford visibility and some protection and stickerscan be affixed to identify the presence of glass.


DeathsFour deaths (Victorian Coroners’Facilitation System 1989-1992)resulting from glass doors andwindows involved victims agedbetween 33 and 56, including 3 males.One case was a suicide and alcoholwas a contributing factor in 2 cases.

ReferencesAustralian Standard AS 1288-1989‘Glass in Buildings - Selection andInstallation’, Standards Australia, 1989.

Jackson, RH, “Lacerations from glassin childhood”, British MedicalJournal, Nov 1981, Vol 283; 1310-2.

Maitra, AK, Han K, “Architecturalglass injuries: a case for effectiveprevention”, British Journal ofClinical Practitioners, Dec 1990,Vol 44; 568-70.

Nassau, Peter, Manager Policy andDevelopment, Building ControlCommission, (personalcommunication), March 1995.

Wolf Y.G, Reyna T, Schropp KP,Harmel RP, “Arterial Trauma of theUpper Extremity in Children”, TheJournal of Trauma, Jul 1990, Vol 30;903-5.

VISS DatabaseThe products discussed in theremainder of the article - lawn mowers,shopping trolleys and chainsaws havebeen taken from the database as awhole.

As of February 1995 the VISSdatabase contained 160,000 records.Of the two all age collections (WesternHospital and Latrobe RegionalHospital) only one third of cases areto children. However a bias towardschildren in the total VISS databaseresults in 58% of total cases being tochildren.

The collection periods for eachparticipating hospital are as follows,Royal Children’s Hospital (1988-93),Preston and Northcote CommunityHospital (1989-93), Western Hospital- Footscray and Sunshine campuses(1989-93), Royal Melbourne Hospital(1992-93) and Latrobe RegionalHospital - Traralgon and Moecampuses (1991/92 - Feb. 1995 ).

Lawn MowerInjuries (n = 416)Karen Ashby

Most lawn mowers sold today inAustralia are power mowers of thepetrol fuelled variety, (approximately90%), and cost less than $500.(Choice, 1991 & 1993). Of the 416cases of lawn mower related injuryrecorded on the Victorian InjurySurveillance System database 36%were petrol powered, another 10%were ride-on mowers, 2 were tractormowers, there was only one recordedcase of use of an electric mower. Ofthe remainder only 2 were specificallynoted as being non-powered models,the remainder (54%) were unspecifiedas to the nature of the mower. The416 cases will be discussed in thefollowing article.

Lawn mowers are associated with22% of yard and garden equipmentinjuries, and 0.7% of all injury toadults on the VISS database.

Figure 5 shows the most common agebreakdowns for these cases. Althoughthere are greater frequencies in someage groups there is no obvious agepattern.

Lawn Mower Injuries by Age Fig. 5

Age

Cas

es

0

10

20

30

40

50

60

70

0-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

9

50-5

9

60-6

9

70-7

9

80+

P resentations

Admiss ions

Source: VISS: RCH, PANCH, WH, RMH, LRH n =416


Just over one half of injuries occurredin times of high usage, ie on theweekend, especially on Saturdaysafternoons (17% of cases). Injurieswere more common in the warmermonths, particularly December (15%),October (14%) and January (13%).

Eighty percent of cases occurred in aresidential location, particularly in thevictim’s own home yard (69%).

Just over half of the victims requiredsignificant treatments with 23%requiring a review in the casualtydepartment, another one quarter ofvictims required admission to hospital.

Figure 6 shows the most commonbody parts injured.

Body Part InjuredFigure 6

Source: VISS: RCH, PANCH, WH,RMH, LRH. n = 519(NB: up to 3 injuries per case)

Adults (n=306)Nearly three quarters of lawn mowerinjuries on the VISS database were toadults, particularly those in the 40-60

age group (37%), with malesaccounting for 73% of all adultvictims. With an admission rate of17%, nearly half of the total injuriessustained were to the upperextremities, with just over one thirdof all injuries to the fingers,particularly lacerations (20%),amputations (5%) and fractures (5%).Other common injuries werelacerations to toes, (8%), foreignbodies in the eyes (6%) and lacerationsto the foot (4%).

Gardening or maintenance were themost common activitiesacknowledged at the time of injury.

Causes of InjuryInjuries most commonly occurredwhen the victims either caught a bodypart under, slipped under or were runover by the lawn mower (17% ofcases), eg. “Cutting grass at home,slipped and foot went underneath lawnmower.” and “Patient was gardeningand accidentally put hand under lawnmower”.

A similar proportion of victims (17%)were injured when they were hit by anobject thrown up from the operatinglawn mower, commonly stones ornails.

Twelve percent of victims were injuredwhen clearing wet grass out of themower, taking off the grass catcher orattempting to adjust the height of themower, commonly while the mowerwas still switched on, resulting incatching or lacerating their fingersand hands in or on the blades of themower. The blade tip velocity ofpowered lawn mowers has beenestimated at 371 km/hr, making anyattempts to remove grass or the grasscutter, adjust the height of the mower,or move the mower whilst it is stillturned on, dangerous. (Love et al,1988).

Other injuries occurred when thevictim suffered a laceration from anunspecified part of the mower (9%),fell off, or over the mower (6%),strained or over-exerted while mowingor moving the lawn mower (6%),received a foreign body in the eye(6%) or were bitten by an insect whilstmowing (4%). Other serious injuriesoccurred when the victim was hit bythe blade of the mower when it flewoff an operating lawn mower (3%)and another 2% of victims receivedburns from the mower. A leadingAustralian lawn mower manufacturerhas developed a safety drop devicewhere if the blade disc from a mowercomes loose, it drops away from theengine preventing it from flying outfrom the mower and perhaps hit avictim.

Safety DevicesThe use of safety devices was recordedin only 6% of cases. These devicesincluded work boots, safety glasses,gardening gloves and ear plugs.

Manufacturers in the United Stateshave developed a safety switch thatcuts out the engine on the lawn mowerwhen the operator leaves the normaloperating position eg. to remove thecatcher from the mower. Thesedevices are generally not available onAustralian manufactured lawnmowers but would help to preventmany of the injuries mentioned in thisarticle.

Another safety design is the raising ofthe starter rope handle up the mowerso users are now less likely to placefeet under the mower when starting itas they don’t need to bend/lean so farover the mower.

Concerns with the use of electricpowered lawn mowers usually extendto a fear of running over the powercord causing electrocution. The one


recorded case on the VISS database ofinjury from an electric mower was anelectrocution. However, use of safetydevices such as double insulationproviding a barrier between the metalparts of the mower and the liveconductors, portable safety switcheswhich cut off the electricity in theevent of a live wire becoming earthed,blade rotation indicators and extensioncord grips make these mower safer as

long as the user still exercises carewhen mowing. (Choice, 1991).

Potential buyers should look for alawn mower that meets withAustralian Standards, it seems thatcurrently only 3 companies do so.Lawn mowers are covered by thefollowing standards, - 1992 ‘Approvaland Test Specifications - Electric lawnmowers’, AS3792 - 1992 ‘Ride-on

lawn mowers’, which specifiesrequirements for design andconstruction of powered rotary rideon mowers relating to safety androbustness, and AS2657 - 1985‘Powered Rotary lawn mowers’,which specifies safety requirementsfor rotary lawn mowers including bothpetrol and electric types.

ChildrenThere were 110 injuries to childrenfrom lawn mowers, representing justover one quarter of all mower injurieson the VISS database. These injurieswere predominantly to boys (78%),especially those aged between 10 and14 (37% of all children’s lawn mowerinjuries). There was a one thirdadmission rate for children in this agegroup.

Table 2 shows a breakdown byincident for the cases of child relatedlawn mower injury.

The under 5 age group accounted forone third of all mower related injuriesto children. Predominantly to boys(72%), these injuries occurred in thevictim’s own home yard (72%) and inanother residential yard (10%). Thevictim was commonly playing (82%)when injury occurred, one quarter ofinjuries related to falls, four of whichwere from a ride-on lawn mower. Theadmission rate for this age group wasone third.

Children in the next age group (5-9years) accounted for another 23incidents. Three quarters of injurieswere to boys with 87% of these injuriesoccurring in the victim’s ownbackyard. The admission rate for thisage group of 48% was high.

Twenty-two percent of victims in thisage group were either assisting withmowing or mowing themselves. Justover one quarter of victims were

Children’s Lawn Mower Injuries: most common nature ofinjury and body part Table 3

0-4 yrs%

n = 52

5-9 yrs%

n = 34

10-14 yrs%

n = 64

TOTAL%

n = 150

Upper Extremities 31 53 52 45 finger laceration 2 24 30 19

finger amputation 6 - 8 5

finger burns - 9 - 2

Lower extremities 33 29 39 35

foot lacerations 6 3 8 6

toe lacerations - 3 6 3 metatarsal fractures - 6 - 1

foot amputation - 6 3 4

Head injuries 29 18 8 17 eye haemorrhage 8 3 2 4

face and scalp lacerations 6 3 - 3

Source: VISS: RCH, PANCH, WH, LRH n = 110 (NB: up to 3 injuries per case)

Children’s Lawn Mower Injuries by Mechanism Table 2

Incident0-4

n = 395-9

n = 2310-14n = 48

TOTALn = 110

Object ejected from mower 7 5 4 16

Victim slipped, caught under, run over by mower 4 6 11 21

Clearing grass/catcher, adjusting mower height - 2 8 10

Unspecified laceration 9 3 10 22

Falls 10 5 5 20

Strain or over-exertion - 1 2 3

Burns 8 2 1 11

Poisoning 2 - - 2

Cut by flying blade 1 - 2 3

Electric Shock - - 1 1

Animal/Insect related - - 1 1

Source: VISS: RCH, PANCH, WH, LRH n = 110


caught under or run over by the mower,3 of these victims were passengers ona ride-on mower who fell and werecaught underneath the mower.

Two thirds of victims aged in the 10-14 group were mowing the lawn whenthe injury occurred, however therewas no recorded use of any safetydevice. Sixty percent of these injuriesoccurred in the victim’s own home,another 21% in another residentiallocation. Half of the victims injuredin this age group required admissionto hospital, again a high rate. Althoughno follow-up study was undertaken, itis clear that several injuries were severeand disabling.

Table 3 shows the most commoninjuries sustained by children relatingto lawn mower injuries.

Ride-on MowersRide-on mowers were involved in10% of all lawn mower related injuries(40 cases). These cases representnearly 20% of specified mower relatedinjuries to children and 6% of mowerinjuries to adults. Fifty-three percentof the 40 ride-on mower cases were tochildren aged under 15 years. Seventy-eight percent of the total number ofvictims were male.

Residential locations were the site for78% of these injuries, areas ofproduction accounted for another 8%.In only 2 cases was the use of safetydevices recorded.

Over half of the injuries sustained(57%) were to the lower extremities,with 20% being to the feet. Lacerationsaccounted for half of the types ofinjuries sustained, particularly to thetoes (11%), feet (7%), fingers (7%),face and scalp (5%) and hand (5%).Other injuries sustained wereamputations of the finger (5%),

amputation of the foot (5%) and strain/sprain of the ankle (5%).

Injuries to children were more severethan those of their adult counterpartswith an extremely high admissionrate of 71%. One third of child victims(total n=21) were injured when theywere playing around the mower andwere either not seen by the operatorand hit, or fell in front of the mower.Another 24% of injuries occurredwhen the child was riding on themower on the operator’s lap, and fell,usually under the blades of the mower.All victims injured in this way wereserious enough to be admitted tohospital. Hospital studies have foundthat in the case of injuries related toride-on mowers (to children), theseverity of the injury, the period ofhospitalisation and the need for followup surgery was much greater thanthose victims injured by non-ride ontype lawn mowers. (Johnstone et al,1989).

Adult injuries (total n=19) oftenoccurred when the victim wasrepairing or maintaining the mower(26%), when the mower tipped over(21%), when hit by the mower afterdisembarking or slipping off themower (21%), when their foot slippedoff the decking or went under thedecking coming in contact with themower blades (11%) or were hit onthe head by a branch while mowingunder a tree. Other single casesoccurred when the victim touchedagainst the hot exhaust and attemptedto lift a mower stuck in a gutter. Theadmission rate for the adult victimswas 11%.

An American study, which estimated26,800 ride-on mower related injuriesin the US per year, identified contactwith powered rotating blades as oneof the hazards that produced the most

serious ride-on mower related injuries.(Adler et al 1995). This study foundthat in 92% of cases this type ofcontact involved the mower operatorand in 70% of these cases contactoccurred after the operator had left theoperating position often to undertaketasks such as clearing the dischargechute and changing the height of themower deck. In most cases the engineof the mower was left running whilstthese activities were taking place. Inan attempt to address this problem theAmerican National Standard Institutesvoluntary standard B71.1 wasamended in 1986 to introduce anoperator presence control (OPC). Thisdevice will stop the blade within 5seconds from the operator leaving theoperating position. The US studydiscovered through testing that typicalblade access times for the abovementioned activities wasapproximately between 2-4 seconds,less than the time allowed for bladeshutdown with the OPC. Howeverthe study concluded thatapproximately 200 injuries per yearwere prevented by the introduction ofthe OPC.

Findings from analysis of the VISSdata show that blade contact was madeby the operator in only half of bladecontact cases, the other half of victimswere children either playing in thearea being mowed or riding on theoperators lap. Thus while theintroduction of OPC’s is important inpreventing injury to operators fromblade contact there are other issuesthat also need to be addressed to furtherprevent ride-on mower injury,particularly in the areas of allowingchildren to ride on the lap of theoperator or of play in areas wheremowing is occurring.


Prevention

1. Review of mower designs to reduce the tip speed of the blade, and providea discharge chute so that any objects deflected will be in a downwarddirection.

2. A design modification providing an auto shut off of the engine or a devicewhich reliably quickly prevents the mower blades from turning if theoperator leaves the normal working position or if the mower is leftunattended for a short period of time. Lawn mowers should never be leftunattended while it is still running.

3. Hands should never be placed near blades without first turning off themower, eg prior to attempting to remove the grass catcher or clear cloggedgrass from the mower. It needs to be understood that with current designsthe blades continue to turn briefly after switch-off.

4. Never lift or carry the mower while it is running.

5. Children should be prevented from playing in an area where lawn mowersare in operation and should never be allowed to be passengers on ride-onlawn mowers.

6. Before the commencement of mowing, stones and other debris should beremoved from the area to be mowed to avoid objects being thrown up andcausing injury.

7. Electric lawn mowers should not be used near water such as swimming poolsurrounds, or when it is raining. Particular care should be taken not to pullthe mower towards the operator (reducing the risk of running over thepower cord).

8. Improved consumer awareness of the potential dangers that mowers cancause. Operators should be encouraged to use all available safety featuresand should endeavour to wear all available forms of protective clothingincluding eye protection, boots, gloves and ear muffs when operating alawn mower. Lawn mowers should never be used with bare feet, open toedsandals or thongs.

9. Younger children should not be allowed to operate a lawn mower, if olderchildren are to use a lawn mower they should have attained a reasonableage and maturity, be trained properly, wear the protective clothingmentioned above, and their work should be supervised at all times.

10. Moves should be made towards the implementation of mandatory safetyregulations to ensure that all mowers meet with the Australian Standard.

ReferencesAustralian Standard AS 3792-1992‘Approval and Test Specifications -Electric Lawn Mowers’, StandardsAustralia, 1994.

Australian Standard, AS3792 - 1992‘Ride on Lawn Mowers’, StandardsAustralia, 1994.

Australian Standard, AS2657 - 1985‘Powered Rotary Lawn Mowers’,Standards Australia, 1994.

Choice Magazine, AustralianConsumers Association, November1991, February 1992 and November1993 editions.

Hunter, T.A., Engineering Design forSafety, McGraw-Hill, Inc 1992, p117-118.

Johnstone, B.R., Bennett, C.S., LawnMower Injuries in Children,Australian and New Zealand Journalof Surgery, 59 (59), p713-718 (1989).

“Lawn Mower Injuries”, QueenslandInjury Surveillance & PreventionProject, March 1994.

Love, S.M., Grogan, D.P., Ogden,J.A. Lawn Mower Injuries in Children,Journal of Orthopaedic Trauma, 2(2), p94-101, (1988).

Adler, P., Van Houten, D. andScheers, N.J., US Consumer ProductSafety Commission, An Analysis ofBlade-Access time for Ride-onMowers, ECOSA, 3rd InternationalConference on Product SafetyResearch, Amsterdam 1995.

David Gilmore, Product MarketingManager, VICTA, (personalcommunication), March 1995.

David Moss, Office of Fair Trading,(personal communication), March1995.


Shopping Trolleys(n = 268)Karen Ashby

Victorian Injury Surveillance Systemdata shows head and face injuryaccounts for 69% of shopping trolleyrelated injury to children under five,compared with a 45% rate of injury tothe head and face for cases of allinjuries to children under five recordedby VISS. The following article willdiscuss the 268 cases of shoppingtrolley related injury recorded on theVictorian Injury Surveillance Systemdatabase.

Children aged under 5 years weremost commonly the victims in theseincidents (69% of cases), 58% ofwhich were males. Figure 7 shows anage breakdown for all cases, and showsthat the peak ages for these injuriesare between 1 and 3 years inclusive.

The predominance of injuries in theunder 5 age group is consistent withfindings from the Queensland InjurySurveillance & Prevention Project(QISPP). QISPP found that over a 3year period (1988-91) of 101 cases ofshopping trolley related injury tochildren under 15, 81% of victimswere aged under 5.

Injuries were more common aroundChristmas time (13% in December),the most common days of the weekfor injuries were Thursday through toSaturday, especially between 11.00amand 2.00pm, presumably reflectingtimes of high exposure.

Not surprisingly 77% of injuriesoccurred in areas of commerce. Otherinjury sites were parking areas (7%),the victim’s own home yard (3%) andthe footpath (2%).

Over half (56%) of injuries werecaused by falls from trolleys, of these

18% of the injured children werestanding in the trolley when they fell,18% simply mentioned sitting in thetrolley and 8% were climbing on thetrolley. Another 19% of injuriesoccurred when the trolley toppledover, two thirds of such victims weretravelling inside the trolley when ittipped over, and 9% of victims hitagainst the trolley sustaining an injury.

The use of safety devices was recordedin only 3 cases, with two mentioningthe use of a restraining strap or harness.

The admission rate for these injurieswas 18%, however the majority ofvictims (54%) required only minor orno treatment. Another 11% of victimswere treated and referred to a GeneralPractitioner.

There were 297 separate injuries (upto 3 injuries per case). Just over halfof these injuries were to the head andface especially bruising (18%),concussion (12%) and lacerations(7%). Fractures of the radius/ulnaaccounted for another 3% of injuriessustained. Figure 8 shows the mostcommon body parts injured.

Body Part Injured Figure 8

(NB: Up to 3 injuries per case).VISS: RCH, WH, PANCH, LRH

Shopping Trolley Injuries to Children by Age Figure 7

Age

Ca

ses

0

10

20

30

40

50

60

0 1 2 3 4 5-9 10-14

Source: VISS: RCH, WH, PANCH, LRH n = 231


Children Under 5 Yearsof AgeStudies in the USA reportapproximately 22,000 injuries perannum from shopping trolleys, twothirds of these serious enough torequire medical treatment; they alsoreport a similar age distribution with60% of victims aged under 5 years.(Harrell 1994).

Common injury scenarios for this agegroup are shown below. It must benoted however that often acombination of these incidents led toa single case occurring. Examples ofthese types of incidents are “Sitting ina shopping trolley, brother tried toget up, trolley tipped over.”

Trolley toppled over (n=45)Trolleys have a high centre of gravitythus making them top heavy whenloaded and under many circumstanceseasy to tip over, such incidentsaccounted for nearly one quarter ofinjuries to this age group. Theseincidents were sometimes initiatedby the actions of the victim andsometimes by a person other than thevictim. Nearly one quarter of trolleytips resulted in the victim falling tothe floor. Falling onto concrete,shelving or counters and being hit bythe falling trolley each accounted foranother 11% of cases. Of theremaining cases, 4% were tipped fromthe trolley onto the footpath andanother 4% of victims squashed orcaught their finger in a tipped trolley.

QISPP notes in their report that therisk of having a child in the trolleywas compounded when the trolleytipped over as the trolley was thenlikely to become a mechanism ofinjury also.

Standing, fell from trolley(n=45)Placing a child in the trolley,particularly as they get older andheavier, tends to make the trolley topheavy. When this child stands uptheir chances of falling from or tippingthe trolley increase. Over 60% ofthese cases offered no real explanationother than the victim stood in trolleyand fell out. Other injuries wereincurred when the victim fell afterleaning out of the trolley (11%) andanother 9% when they overbalancedand fell. In five cases the victimactually caused the trolley to tip over(these cases are also noted in thesection above on trolley tips).Common examples of these injuriesare as follows, “Stood up in shoppingtrolley. Lost balance, fell out landingon asphalt” and “Sitting in shoppingtrolley. Stood up onto seat, fell ontothe floor.”

Sitting in trolley (n=44)A child, other than the victim, leaning,climbing onto, pulling over the trolleyor causing the trolley to tip over wasresponsible for nearly one quarter ofthese injuries, eg. “Sitting in shoppingtrolley. Older sibling pulled it over. Hithead on concrete floor “ and “Sitting ina grocery trolley, brother tried to getup, trolley tipped over”. A similaramount of cases occurred when thetrolley the victim was seated in tippedover in unknown circumstances,“Sitting in a shopping trolley, the trolleytipped over and she landed on theground.” (NB - all but one of the totalof 19 cases referred to above were alsorecorded in the 45 cases of trolley tipsmentioned previously). Another threevictims fell when they leaned over toofar while sitting in the trolley (one wasattempting to climb out at the time) and2 fell out when the trolley hit a bump.

A further 41% of these cases wererecorded with not much moreinformation than “Sitting in trolley.Fell out and landed on floor”.

Climbed on trolley (n=19)Climbing out of the shopping trolleywas the activity of just over half ofthese victims, “Climbing out ofshopping trolley, fell out onto hernose”. Another quarter were climbingon the trolley, usually the side wherethey were injured.

Leaning/reaching out of trolley(n=9)This is not only a dangerous practice asit often led to children falling,representing seven of the total casesmentioned here, but also because it cangive the child access to possible harmfulsubstances. In one of the remainingtwo cases the victim was thought tohave gained access to, and ingestedfabric softener. This problem wasaddressed in a US Study (Harrell Reid,1990), which claimed that “a sizeablepercentage of young childrenaccompanying parents on shopping tripsmay be at risk because of a failure torestrain children in shopping carts,failure to monitor children, or acombination of both.” They found thatof their study group of 236 pre-schoolchildren, 24% handled potentiallydamaging products at least once.

Other causesVictims hitting against the trolley (6%),catching fingers in the trolley (6%), andbeing injured when the trolleymalfunctioned (3%) were the mostcommon of the remaining injuries.

Table 4 presents a breakdown of theincidents leading to injuries for eachage group. It must be noted that casesmay appear in more than one categoryif a combination of incidents led toinjury.


ReferencesAustralian Standard 3747-1989‘Harnesses for use in prams, strollers,and high chairs’, Standards Australia1990.

Harrell, A., The Impact of ShoppingCart Restraints and adult supervisionin near injuries to children in GroceryStores, Accident Analysis andPrevention, 26 (4), p493-500, (1994).

Harrell, A., and Reid, E., Safety ofchildren in Grocery Stores: the impactof cartseat use in shopping carts andparental monitoring”, AccidentAnalysis and Prevention, 22 (6), p531-542, (1990).

Shield, J., Child Safety Centre, RoyalChildren’s Hospital, (PersonalCommunication), February 1995.

Public Affairs Department, Coles-MyerGroup, (Personal Communication),February 1995.

“Shopping Trolley Injuries inChildren”, Queensland InjurySurveillance & Prevention Project,March 1992.

Shopping Trolley Injuries by Age and Event Leading toInjury Table 4

0-4n=185

5-9n=29

10-14n=17

Adultn=37

TOTAL(n=268)

Trolley tipped/fell over 45 2 3 1 51

Standing fell from trolley 45 3 2 - 50

Sitting fell from trolley 44 2 1 - 47

Unknown fall 23 3 3 3 32

Climbing out/on trolley 19 3 1 - 23

Hit against trolley 12 2 1 6 21

Ran into/over by trolley 3 5 1 9 18

Finger caught in trolley 11 3 2 1 17

Leaning out of trolley 9 1 - - 10

Tripped over trolley 1 - 1 5 7

Standing on end of trolley 3 3 - - 6

Malfunction of the trolley 5 - - - 5

Child in capsule, capsule fell 3 - - - 3

Other 3 2 2 5 12

Source: VISS: RCH, WH, PANCH, RMH, LRH n = 268

Prevention

1. The use of adjustable shoulder harnesses with side straps in shoppingtrolleys to restrict children’s movements, particularly in relation tostanding up in the trolley, is recommended. Safety harnesses should meetwith the voluntary Australian Standard 3747-1989 ‘Harnesses for use inprams, strollers, and high chairs (including detachable walking reign)’.Adjustable harnesses that fit not only shopping trolleys but high chairs andstrollers by means of plastic clips, can be purchased from the Child SafetyCentre at the Royal Children’s Hospital or leading nursery furnitureretailers for approximately $14.00.

A supermarket chain in Australia (Coles Supermarkets) provides a limitednumber of shopping trolleys with baby capsules securely attached to thetop of the trolley, for both customer convenience and safety. Thisintervention is not aimed at the age group most at risk, 1-3 year olds.

2. Children should be discouraged from riding on the end a trolley. Thispractice is likely to cause the trolley to tip over, perhaps falling onto thechild or as seen in these cases causing a younger sibling to fall/be thrownout of the trolley, practices such as these were a factor in approximately10% of the cases discussed in this article.

3. Stability testing of loaded trolleys (including child passengers) is requiredpossibly leading to design modifications such as a lower centre of gravity.


an additional 59% required significantemergency department treatment.Almost all cases were male andalthough occurring across all ageswere most common in the 30-34 yearage group. Injuries to the older agegroups tended to be more severe.

Injuries most commonly occurred ina home garden (44%) with a further20% occurring in areas of bushland orpaddocks. National InjurySurveillance (NISU) data, as reportedin Choice magazine, also found thatalmost half of injuries occurred in thehome/yard. (Choice July 1994). Twothirds of injuries occurred duringmaintenance and one quarter while onduty at work, particularly whileforestry labouring in the LatrobeValley. (The Latrobe Valley is theonly rural area from which VISScollects data).

Causes of InjuryThe most common causes of injurywhere there was sufficient detail areshown in Table 5. Typical examplesof the most frequent were ‘Slippingor loss of control of the chainsaw’,‘Cutting wood with chainsaw. Sawslipped. Thrown on foot. Saw cutfoot.’, ‘Cutting wood. Lost grip of thechainsaw’.

NISU also reported similar commonsituations leading to injury - Kickback,the operator’s hand slipping whilesawing, operators coming into contactwith the chain after falling and burnsfrom petrol saws still hot after use.(Choice, July 1994).

Nature of InjuriesLacerations were the most frequentlysustained injury (72% of injuries),regardless of how the injury occurred,(44% to the hand, including 28% tothe fingers). Hand injuries accountedfor 38% of all injuries caused by thechainsaw. The figure for lacerations

Table 5

Common Causes of InjuryPresentations

N% of total

cases

Loss of control or slipping of the chainsaw 18 13Woodchips, sticks or sawdust hitting against or embedding in the eye

13 9

Chainsaw user slipping 12 9

Maintenance related, especially sharpening 12 9

Kickback 10 7

Slipping of wood or log being cut 10 7Tree related incidents eg ' Knocked off balance by limb. Cut by chainsaw'

9 7

Chainsaw caught or jammed 8 6

Knocked against or falling onto the chainsaw 5 4

Chainsaw cutting disc related 4 3

Catching fingers in the chainsaw 3 2Body parts too close to the chainsaw while operating. 2 1Injury description not sufficiently detailed 32 23

Total 138 100

Source VISS: RCH,WH,LRH,RMH,PANCH

1 Kickback occurs when the upper quadrant of the nose of the bar contacts a solidobject or when the chain is pinched. The reaction of the cutting force of the chaincauses the chain to rotate in the opposite direction to the required chain movementcausing the saw to be flung back towards the operator. It has potential to causeextremely serious wounds.

1

Chainsaw RelatedInjuries (n=138)Virginia Routley

The chainsaw, particularly the smaller‘consumer’ models, enjoyed anupsurge in sales in the late 70’s andearly 1980’s due to the back-to naturemovement and the energy crisis.However its popularity, as shown byretail figures, has since declined.Environmental restrictions andpopulation spread have made timberless accessible and commercial timberworking has become moremechanised. (Stroud, 1985, PowerEquipment May 1990, March 1992).

Despite this decrease in usage and animprovement over time in safetyfeatures injuries are still occurring.

Chainsaw teeth produce a rippingeffect and cause a ragged, destructiveskin laceration with tissue loss overan 8 to 10mm width. (Riefkohl et al,1986). The wound is oftencontaminated with grease, clothingand sawdust making infection likelyunless there is adequate cleansing.(Stroud, 1985).

To date 138 cases of chainsaw relatedinjuries have presented to VISShospitals during the collection period,particularly the Latrobe RegionalHospital (78% of cases). Chainsawrelated injuries represented 0.2% ofinjury cases on the database (0.5 % atLatrobe Regional Hospital) and 3%of garden equipment injury cases.Twenty-one percent were sufficientlysevere to be admitted to hospital and


is consistent with AccidentCompensation Commission data(1985 to 1989) where 75% of injurieswere of an open wound nature. (Peakeet al, 1989). Abrasions and foreignbodies in eyes accounted for 11% ofthe injuries eg ‘Whilst using achainsaw cutting timber sawdust gotinto eyes, no goggles on’. Chainsawliterature notes that injuries usuallyoccurred to the left side of the bodydue to the required method of holdingthe saw. (Haynes et al, 1980) (Seefigure 9).

Body Part Injured Figure 9

VISS: RCH,WH,PANCH,LCRH,RMH

There were 28 cases associated withchainsaw use admitted to hospital.Lacerations represented 59% ofadmitted cases, fractures 29%. Forfive of the admitted cases the injurywas directly caused by a log or tree,fractures being the most commonoutcome for this scenario. There wereno eye injuries among the admissions.The more serious injuries directly

caused by the chainsaw were ‘Cuttingwood with chainsaw, chainsaw kickedinjured leg’ causing lacerations to thehand, lower leg and a fracturedmetacarpal’; ‘Demolishing building,chainsaw slipped’ causing lacerationsand a fracture to the face/scalp andlacerations to the shoulder , ‘Starteda chainsaw’ causing a fracture andlacerations of the forearm includingnerves and ‘Caught fingers in thechainsaw’ resulting in an amputationof the finger.

As far as could be discerned fromthese initial diagnoses based on theVISS form even serious injuries didnot appear to be as serious as thosereported from American literature inthe 1980’s, especially in regard tokickback injuries to the face and neck.Face and neck (excluding eye) injuriesrepresented 40% of chainsaw relatedadmissions to a hospital in Alabamaover the period 1972-79. (Haynes,1980). In contrast only 7% wereinjuries of this type for admitted caseson the VISS database. Fifty-sixpercent of Accident CompensationCommission Workcare claims (1985-1989) for the Victorian timber industrywere located in the lower limb, 25%in the upper limb. The figures for thehead and neck were negligible. Only2 and possibly 3 of the VISS admissioninjuries were reported to be incurredby chainsaw kickback. There were nodeaths in the 3 year period 1989/90 to1991/92 in Victoria. (Coroner’sFacilitation System). RelevantAustralia-wide or Victorian mortalityfigures previous to this period are notavailable. However there were at least139 deaths from chainsaw relatedinjury in the United States in 1982,international figures being relevantsince all chainsaws are manufacturedoverseas.(Stroud et al, 1985). Itappears that improvements inchainsaw safety may be having an

effect in reducing serious injury. Seethe later section on improvements.

Safety equipmentOnly 33% of the people injured statedthat they had worn safety equipmentof any type. Most commonly wornwere eye protection such as gogglesor face shields (n=17), ear muffs(n=15), boots (n=14), padded trousers(n=12), helmets (n=7), gloves (n=7)and vests (n=3). Injuries from thosewho did not wear protection of anytype were more serious (admissionrate 27% for no protection comparedwith 11% for some type of protection).

In 35 of the 54 cases where safety gearwas worn the protection was notrelated to the injury eg ear muffs andfinger lacerations. For the 15 caseswhich were related 5 injuries to theleg (3 lower leg) were received whensafety pants were worn, 4 werewearing glasses when foreign bodiesentered the eyes, 3 received injuries tothe feet, 2 to the lower leg, whenwearing boots and there was one caseof finger injuries when wearing gloves.Only 2 cases wearing relevantprotective gear were sufficientlyserious to be admitted to hospital.

It should be noted that of those on-the-job two thirds were wearing safetydevices but only one third of those noton-the-job did so.

Forest OperatorsAn injury and safety study wasundertaken in 1989 of 300 professionalchainsaw operators in Victoria. Thesurvey indicated that 14% had incurredan injury in the past 5 years and thatyoung forest labourers and those witha high level of chainsaw use were atthe greatest risk of injury. Thechainsaw operators had criticisms ofthe current design of goggles, meshshields, gloves, cut-resistant pants andboots. (Peake,C, Magill,J, 1989).


Since September 1989 all professionalforest operators must undertakecourses in both Occupational Health& Safety and Environmental Careand pass competency tests in order toreceive a licence from the VictorianDepartment of Conservation andEnvironment. Safety gear, particularlyear and head protection, high visibilityvests, cut-resistant pants and steelcapped boots are emphasised in thesecourses. The enforcement of thewearing of the safety gear and othersafe work practices vary withinVictoria. Australian Paper MillsForests Pty Ltd (APM) are regardedas a model in the occupational healthand safety field. They employ 3 formerforest workers to check on the wearingof safety equipment in logging areasand wage penalties are incurred forthose not dressed correctly. Theinspectors’ role is also to give on-siteremedial training for unsafe workpractices. Gloves and eye protectionare given a lower priority than otherprotective gear. (Coates, 1995).

Australian StandardsThere are two relevant AustralianStandards for chainsaw safety AS2726-1984 ‘Chainsaws - SafetyRequirements’ and AS 2727-1984‘Chainsaws - Guide to Safe WorkingPractices’. These apply to portable,hand-held, electrically or petrol drivenchain saws. The former covers thedesign and construction and themechanical requirements, the latterhazards and protection, safe operationsand maintenance schedules. Theformer standard is mandatory, thelatter is enforced to varying degreesin the workplace. There are norestrictions on the casual user. Thecasual user appeared to have the largestproportion of retail sales during 1989,consumer saws - 37%, farm saws -40%, professional saws - 13%,therefore its importance cannot be

dismissed (Power EquipmentAustralia, 1990).

Improvements in SafetyThere have been several ergonomic,legislative and design improvementswhich have over time facilitatedchainsaw use and improved safety.Examples are mandatory trainingcourses for forest workers, Australianstandards for chainsaws, chain brakes(manual or more recently inertia), sawswhich are easier to work with becausethey are lighter, no longer need to bemanually oiled every 30 seconds, have

more effective muscling devices andanti-vibration handles, lockoutdevices on the trigger so the handmust be wrapped around the pistolgrip for the motor to operate, a rollernose bar to reduce kickback, a chaincatcher in the event the chain isderailed or broken and a non-kickchain with links designed to reducekickback. (Coates,D,1995).

“Raynaud’s phenomena” or “white-finger” caused by chainsaw vibrationis no longer a problem due to the anti-vibration handles.

Main Parts of the Saw Figure 10


Prevention

1. Investigate design change to require two handed operation (since many injuries are to the hand).

2. Given the high proportion of finger and hand lacerations for chainsaw injuries there appears to be a strong case forthe more widespread use of industrial safety gloves or chainsaw mittens both during sharpening and in motion, asnoted in AS 2727.

3. Eye protection does not always protect against foreign bodies (Hazard 17). Safety goggles, but not necessarily safetyglasses, should be effective against woodchips and reduce the risk of damage from finer foreign bodies. A helmetwith a face shield, would be recommended protection.

4. AS 2727 notes that safety boots should incorporate a non-slip, deep tread sole or be fitted with metal sprigs or cleats.Cut-resistant trousers or chaps which have many layers of tough material (22 layers of nylon chameuse for theSpacetime brand ) are generally recommended. They clog up the saw teeth on impact, thereby slowing the blade andreducing the cutting effect. The Australian Standard notes only trousers, without further specification, since testinghas yet to reach consistency. Close fitting clothes should be worn.

5. Time should be taken to properly maintain, including disassembling, and preparing the saw. Correct sharpeningtechniques should be used (as specified in the Stihl safety video).

6. The saw should be started on the ground and not carried long distances when turned on. The chain brake should bestopped or the chain brake applied for distances of over 5 metres. (AS 2727).

7. Safety features are as noted under the safety improvements section and additional design requirements may benecessary to eliminate the problem.

8. In addition to kick-back, push-back and pull-in forces can lead to injury. To counter any reactive forces during cuttingoperations:-

a) Maintain a proper balance and secure footing.

b) Keep a firm grip on the chainsaw with both hands, with the thumb of the hand holding the front handle wrappedaround the handle.

c) Pay full attention to the operation.

(AS 2727-1984).

9. The safety information provided by the manufacturer, eg Stihl video, should be acquired and observed. Choice inits survey of chainsaw brands found most included information on safe operating practices and proper protectiveclothing. The Forestry Commission of NSW sells a book - ‘How to use a chainsaw safely’, if additional informationis required.

10.Use correct tree felling and limbing techniques as described in AS 2727.

11.Safety equipment eg cut-resistant pants, gloves, eye protection should be hired with the chainsaw if not alreadyowned. Responsible hiring agencies should ensure that appropriate protective equipment is supplied.

12.Since gloves may reduce dexterity and eye protection may fog up further research is required into the wearing ofprotective equipment, especially gloves, and into the design of products which are more acceptable. The survey ofVictorian forest workers in 1989 indicated dissatisfaction with the design of eye protectors, gloves, cut-resistantpants, safety boots and hearing protectors for their working environment.


AcknowledgmentsStihl for their video ‘Chainsaws andCommonsense’.

Paul Barnard (aborist), Sampson Brosand Jim Hoban, Cityedge Chainsawand Mower Centre for backgroundinformation.

David Duncan, Product Manager,Endeavour Tools for information oncut-resistant trousers.

Brian Fildes, MUARC, for editorialcomments.

Agricultural Health Unit, Moree,NSW for permission to use theillustrations on pages 15 and 17.

ReferencesAustralian Consumer’s Association ,Choice, July 1994.

Australian Standard AS 2726 - 1984,‘Chainsaws - Safety Requirements’.

Australian Standard AS 2727-1984,‘Chainsaws - Guide to Safe WorkingPractices’.

Coates, D, Training Liaison Officer,Federation of Timber IndustrialAssociations. March, 1995. (Personalcommunication).

Coroner’s Facilitation System,Victoria. 1989/90 to 1992/93.

Haynes, D, Fenno,R, ChainsawInjuries: Review of 33 Cases. Journalof Trauma. Vol. 20. 1980.

Peake,C, Magill,J. Identification ofHazards Associated with ChainsawUse. EG612 Professional Project.Ergonomics Research & DesignCentre, Latrobe University, 1989.

Power Equipment. Australasia.Glenvale Publications. May 1990,March 1992.

Riefkohl, R, Georgiade,G, Barwick,W,Chainsaw Injuries to the Face. AmericanPlastic Surgery. Vol. 16. No. 2 1986.

Stihl. Chainsaws and Commonsensevideo.

Stroud,S, Levi,P.C, Thompson,C.E.Chainsaw Injuries. Journal EmergencyNursing. Vol. 11, No.5. 1985.

Recommended Protective Clothing and EquipmentFigure 11


- INDEX -Subject Edition PagesBabywalkers, update .................................................................................................................. 16,20........................... 1-4,12-13Bunkbeds ......................................................................................................................................... 11 ....................................... 12Bicycles

- Bicycle related injuries ....................................................................................................... 6 ...................................... 1-8- Cyclist head injury study .................................................................................................... 2 ........................................ 2- Cyclist head injury study updates ............................................................................... 7,8,10 ................................. 8,13,9

Burns- Scalds ................................................................................................................................... 3 ...................................... 1-4- Burns prevention ............................................................................................................... 12 .................................... 1-11

Child care settings ........................................................................................................................... 16 .................................... 5-11Data base use, interpretation & example of form ............................................................................ 2 ...................................... 2-5Deaths from injury (Victoria) ......................................................................................................... 11 .................................... 1-11Dishwasher machine detergents - Update ...................................................................................... 18 ....................................... 11Dogs

- Dog related injuries ............................................................................................................. 3 ...................................... 5-6- Dog bite injuries ................................................................................................................ 12 ....................................... 12

Domestic architectural glass ............................................................................................................. 7 .................................... 9-10Domestic Violence .......................................................................................................................... 21 ...................................... 1-9Drownings/near drownings .................................................................................................................

- Immersions .......................................................................................................................... 2 ......................................... 3- Pool fencing legislation, update....................................................................................... 2,7 ...................................... 3,7- Drownings & near-drownings at home ............................................................................... 5 ...................................... 1-4

Exercise bicycles, update ............................................................................................................... 5,9 ...............................6,13-14Home injuries .................................................................................................................................. 14 .................................... 1-16Horse related injuries ........................................................................................................................ 7 ...................................... 1-6Infants - injuries in the first year of life ........................................................................................... 8 .................................... 7-12Intentional injuries .......................................................................................................................... 13 .................................... 6-11Latrobe Valley

- The first three months ......................................................................................................... 9 .................................... 9-13- Latrobe Valley injuries .................................................................................. * March 1992 ...................................... 1-8- Injury surveillance & prevention in the L. V. ..................................................... *Feb 1994 .................................... 1-14

Martial arts ...................................................................................................................................... 11 ....................................... 12Motor vehicle related injuries, non-traffic ..................................................................................... 20 ...................................... 1-9Needlestick injuries......................................................................................................................... 11 ....................................... 12Older people, injuries among.......................................................................................................... 19 .................................... 1-13Off-street parking areas .................................................................................................................. 20 .................................. 10-11Playground equipment ...................................................................................................................... 3 ...................................... 7-9Poisons.................................................................................................................................................

- Child resistant closures ....................................................................................................... 2 ......................................... 3- Drug safety and poisons control ......................................................................................... 4 ...................................... 1-9- Dishwasher detergent, update ........................................................................................10,6................................. 9-10,9

Roller Blades ................................................................................................................................... 15 .................................. 11-13School injuries................................................................................................................................. 10 ...................................... 1-8Skateboard injuries............................................................................................................................ 2 ...................................... 1-2Smoking Related injuries ................................................................................................................ 21 .................................. 10-12Sports

- Sports related injuries.......................................................................................................... 8 ...................................... 1-6- The 5 most common sports ................................................................................................. 9 ...................................... 1-8- Adult sports injury............................................................................................................. 15 .................................... 1-10

Trampolines..................................................................................................................................... 13 ...................................... 1-5VISS: early overview ........................................................................................................................ 1 ...................................... 1-5VISS: how it works ........................................................................................................................... 1 ...................................... 6-8Work Related Injuries ................................................................................................................ 17,18........................... 1-13,1-10* Special edition


VISS StaffDirector: Dr Joan Ozanne-Smith

Co-ordinators: Virginia RoutleyFiona Williams

Research Assistant: Karen Ashby

Administrative Assistant: Christine Chesterman

Data Processors: Julia Palmer Latrobe Regional Hospital

Associate Director: Dr Terry Nolan(Child Injuries)

GeneralAcknowledgementsParticipating HospitalsLatrobe Regional Hospital (Traralgon and Moe)

Christine Chesterman for assistance with analysis.

The contributions to the collection of VISS data by the director and staff of theEmergency Departments of these hospitals, other particpating clinicians, MedicalRecords Departments, and ward staff are all gratefully acknowledged. Thesurveillance system could not exist without their help and co-operation.

Coronial ServicesAccess to coronial data and links with the development of the Coronial Service’sstatistical database are valued by VISS.

National Injury Surveillance UnitThe advice and technical back-up provided by NISU is of fundamental importanceto VISS.

How toAccess VISSData:VISS collects and tabulatesinformation on injury problems inorder to lead to the development ofprevention strategies and theirimplementation. VISS analyses arepublicly available for teaching,research and prevention purposes.Requests for information should bedirected to the VISS Co-ordinators orthe Director by contacting them at theVISS office.

VISS is located at:Building 70Accident Research CentreMonash UniversityWellington RoadClayton, Victoria, 3168

Postal address:

As above

Phone:

Reception (03) 905 1808

Co-ordinators (03) 905 1805(03) 905 1815

Director (03) 905 1810

Fax (03) 905 1809


VISS is a project of the Monash University Accident Research Centre.

Hazard was produced by the Victorian Injury Surveillance Systemwith the layout assistance of Glenda Cairns, Monash University Accident Research Centre.

Illustrations by Jocelyn Bell, Education Resource Centre, Royal Children’s Hospital.

ISSN-1320-0593

Printed by Sands and McDougall Printing Pty. Ltd., North Melbourne

Project Funded byVictorian Health Promotion Foundation

product related injuries - a selectionlawn mowers, were responsible for 22% of yard and garden...

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