Information from injury data collections is widely used to formulate injury policy, evaluate injury prevention initiatives and to allocate resources to areas deemed a high priority. Obtaining quality data from injury surveillance is essential to ensure the appropriateness of these activities. This thesis seeks to develop a framework to assess the capacity of an injury data collection to perform injury surveillance and to use this framework to assess the capacity of both injury mortality and morbidity data collections in New South Wales (NSW) Australia to perform work-related or motor vehicle crash (MVC)-related injury surveillance. An Evaluation Framework for Injury Surveillance Systems (EFISS) was developed through a multi-staged process, using information from the literature to identify surveillance system characteristics, SMART criteria to assess the suitability of these characteristics to evaluate an injury data collection, and by obtaining feedback on the characteristics from a panel of surveillance experts using a two round modified Delphi study. At the conclusion of development, there were 18 characteristics, consisting of 5 data quality, 9 operational, and 4 practical characteristics, that were identified as important for inclusion within an EFISS. In addition, a rating system was created for the EFISS characteristics, based on available evidence and reasonable opinion. The evaluation of six injury data collections using the EFISS for their capacity to perform either work- or MVC-related injury surveillance illustrated the inability of any of the data collections to enumerate all cases of either work- or MVC-related injury mortality or morbidity in NSW or to capture all of the data considered necessary for work- or MVC-related injury surveillance. This evaluation has identified areas for improvement in all data collections and has demonstrated that for both work- and MVC-related injury surveillance that multiple collections should be reviewed to inform both work- and MVC-related policy development and injury prevention priority setting in NSW. The development of an EFISS has built upon existing evaluation guidelines for surveillance systems and provides an important step towards the creation of a framework specifically tailored to evaluate an injury data collection. Information obtained through an evaluation conducted using an EFISS would be useful for agencies responsible for injury data collections to identify where these collections could be improved to increase their usefulness for injury surveillance, and ultimately, for injury prevention.

Information from injury data collections is widely used to formulate injury policy, evaluate injury prevention initiatives and to allocate resources to areas deemed a high priority. Obtaining quality data from injury surveillance is essential to ensure the appropriateness of these activities. This thesis seeks to develop a framework to assess the capacity of an injury data collection to perform injury surveillance and to use this framework to assess the capacity of both injury mortality and morbidity data collections in New South Wales (NSW) Australia to perform work-related or motor vehicle crash (MVC)-related injury surveillance. An Evaluation Framework for Injury Surveillance Systems (EFISS) was developed through a multi-staged process, using information from the literature to identify surveillance system characteristics, SMART criteria to assess the suitability of these characteristics to evaluate an injury data collection, and by obtaining feedback on the characteristics from a panel of surveillance experts using a two round modified Delphi study. At the conclusion of development, there were 18 characteristics, consisting of 5 data quality, 9 operational, and 4 practical characteristics, that were identified as important for inclusion within an EFISS. In addition, a rating system was created for the EFISS characteristics, based on available evidence and reasonable opinion. The evaluation of six injury data collections using the EFISS for their capacity to perform either work- or MVC-related injury surveillance illustrated the inability of any of the data collections to enumerate all cases of either work- or MVC-related injury mortality or morbidity in NSW or to capture all of the data considered necessary for work- or MVC-related injury surveillance. This evaluation has identified areas for improvement in all data collections and has demonstrated that for both work- and MVC-related injury surveillance that multiple collections should be reviewed to inform both work- and MVC-related policy development and injury prevention priority setting in NSW. The development of an EFISS has built upon existing evaluation guidelines for surveillance systems and provides an important step towards the creation of a framework specifically tailored to evaluate an injury data collection. Information obtained through an evaluation conducted using an EFISS would be useful for agencies responsible for injury data collections to identify where these collections could be improved to increase their usefulness for injury surveillance, and ultimately, for injury prevention.

Physical activity in youth has many benefits, but parallel to these benefits, sport related injuries pose considerable risks.  It is important to public health to address sport related injuries, particularly those affecting young people, who comprise the majority of participants in organised sport in Sweden.  The first study in this research showed that inspections of local sport environments, where injuries often occur, did not occur uniformly. Two additional studies pointed out the need for better surveillance of injuries, and described the use of ambulance attendance reports as a possible improvement to current surveillance systems, with a possibility to improve safety for youth and other sport participants. Two other studies identify risk factors that were specific to football and climbing sports, which can be used to guide targeted safety interventions for the young participants of these sports.  The studies, taken as a whole, provide new information about the factors associated with sport related injuries, particularly for young people, and point out the need for better sport injury surveillance, improved inspection strategies for fields maintained by organised sport clubs in local communities, and the need to address risk factors specific to different sport activities.

OBJECTIVE: To describe the epidemiology of injuries related to cribs, playpens, and bassinets among young children in the United States. METHODS: A retrospective analysis was done using data from the National Electronic Injury Surveillance System for children younger than 2 years of age treated in emergency departments in the United States from 1990 through 2008 for an injury associated with cribs, playpens, and bassinets. RESULTS: An estimated 181 654 (95% confidence interval: 148 548-214 761) children younger than 2 years of age were treated in emergency departments in the United States for injuries related to cribs, playpens, and bassinets during the 19-year study period. There was an average of 9561 cases per year or an average of 12.1 injuries per 10 000 children younger than 2 years old per year. Most of the injuries involved cribs (83.2%), followed by playpens (12.6%) and bassinets (4.2%). The most common mechanism of injury was a fall from a crib, playpen, or bassinet, representing 66.2% of injuries. Soft-tissue injuries comprised the most common diagnosis (34.1%), and the most frequently injured body region was the head or neck (40.3%). Patients with fractures were admitted 14.0% of the time, making them 5.45 (95% confidence interval: 3.80-7.80) times more likely to be hospitalized than patients with other types of injury. Children younger than 6 months were 2.97 (95% confidence interval: 2.07-4.24) times more likely to be hospitalized than older children. CONCLUSIONS: This study is the first to use a nationally representative sample to examine injuries associated with cribs, playpens, and bassinets. Given the consistently high number of observed injuries, greater efforts are needed to ensure safety in the design and manufacture of these products, ensure their proper usage in the home, and increase awareness of their potential dangers to young children.

Studiens syfte är att undersöka hur det nationella målet för trafiksäkerhet går att följa upp på länsnivå via befintlig statistik från polis och sjukvård. Ger de två källorna en likartad bild av förändringen av antalet vägtrafikskadade under den gångna tjugoårsperioden? Undersök- ningen omfattar personer som skadats och överlevt vägtrafikolyckor i Västmanlands län. Data från 1989/1990 respektive 2008/2009 jämförs. De två statistikkällorna ger en likartad bild av förändringen av antalet vägtrafikskadade bilister, motorcyklister och mopedister. Skillnaderna är däremot stora beträffande gång- trafikanter och cyklister. Antalet skadade personer registrerade av sjukvården i länet har minskat under den studerade tidsperioden. Det beror på att antalet skadade gångtrafikanter och cyklister har blivit färre. På grund av förändringar inom sjukvården kan minskningen inte kvantifieras. Det lägre antalet frakturer, främst hos gångtrafikanter men även hos cyklister, visar att det varit en minskning. Antalet skadade bilister har däremot blivit fler, men de skadas lindrigare än 1989/1990. Gruppen allvarligt skadade bilister (ISS > 8) har dock ökat. För perioden 1997 – 2009 har det inte funnits något nationellt definierat trafiksäkerhetsmål för allvarligt skadade. Enligt polisens statistik är antalet svårt skadade vägtrafikanter i länet oförändrat under perioden. Om allvarligt skadad i sjukvårdens mätning definieras som inlagd på sjukhus har antalet allvarligt skadade under perioden minskat med 27 %. Antalet allvarligt skadade definierat som ISS > 8 är oförändrat. / The purpose of the study is to investigate the extent to which it is possible to make a follow- up on the regional level of the national road safety target by using existing police and hospital statistics. Do the two sources provide a similar picture of the changes of the number of persons injured in road traffic accidents during the past twenty years? The survey covers persons injured but survived in road accidents in the county of Västmanland. 2008/2009 figures are compared with 1989/1990 figures. Both sets of statistics provide a similar picture of the changes with regard to the number of injured motorists, motorcyclists and moped drivers. However, concerning pedestrians and cyclists there are significant differences. During the time period being studied, the number of injured persons registered by the hospitals of the county has decreased. This is due to the fact that the number of pedestrians and cyclists injured has decreased. However, it is due to structural changes of the health care difficult to quantify the reduction. The lower number fractures, primarily of pedestrians but also of cyclists, shows that there has been a decrease. On the contrary, the number of injured motorists has increased, but their injuries are less serious than in 1989/1990. However, the number of those motorists with serious injuries (ISS > 8) has increased. For the period 1997 – 2009 there has not had an established national target for the number of seriously injured. According to police statistics, the number of severely injured road users in the county has remained unchanged during the time period being studied. If those being hospitalized in the medical statistics are defined as seriously injured, the number of seriously injured has decreased with 27 %. However, if seriously injured is defined as those with ISS > 8, the number has remained unchanged.

Despite the development of injury surveillance systems for use at large multi sportsevents (Junge 2008), their implementation is still methodologically and practicallychallenging. Edouard (2013) and Engebretsen (2013) have pointed out that thecontext of athletics championships feature unique constraints, such as a limiteddata-collection window and large amounts of data to be recorded and rapidlyvalidated. To manage these logistical issues, Electronic Data Capture (EDC) methodshave been proposed (Bjorneboe 2009, Alonso 2012, Edouard 2013). EDC systemshave successfully been used for surveillance during multi-sport events Derman et al(2013) and its potential for surveillance studies during athletics championships istherefore interesting. The focus for surveillance during athletics championships hasthis far been on injury and illness data collected from team medical staff in directassociation to the competitions. But the most common injury and illness problems inathletics are overuse syndromes (Alonso 2009, Edouard 2012, Jacobsson 2013) andknowledge of risk factors associated to these problems is also relevant in associationto championships. A desirable next step to extend the surveillance routines istherefore to include also pre-participation risk factors. For surveillance of overusesyndromes, online systems for athlete self-report of data on pain and othersymptoms have been reported superior to reports from coaches (Shiff 2010). EDCsystems have also been applied for athlete self-report of exposure and injury data inathletics and other individual sports and have been found to be well accepted with agood efficiency (Jacobsson 2013, Clarsen 2013). There are thus reasons forinvestigating EDC system use by both athletes and team medical staff during athleticchampionships.This thesis used a cross-sectional design to collect qualitative data from athletes andteam medical staff using interviews and “think-aloud” usability evaluation methods(Ericsson 1993; Kuusela 2000). It was performed over 3 days during the 2013European Athletics Indoor Championships in Gothenburg, Sweden. Online EDCsystems for collection of data from athletes and team medical staff, respectively,were prepared for the study. The system for use by team medical staff was intendedto collect data on injuries and illnesses sustained during the championship and thesystem for athletes to collect data on risk factors.This study does not provide a solution in how an EDC effort should be implementedduring athletics championships. It does however points towards usability factorsthat needs to be taken into consideration if taking such an approach.