Context: Limited real-world data demonstrate that health care provided by collegiate sports medicine teams across a variety of sports and injury categories could inform appropriate staffing and workload. Objective: To describe athletic training services (ATSs) and physician encounters (PEs) for acute and overuse injuries, stratified by gender and time-loss (TL) status. Design: Descriptive epidemiology study. Setting: Sports medicine facilities at 12 institutions participating in the Pac-12 Health Analytics Program. Patients or Other Participants: National Collegiate Athletic Association Division I collegiate student-athletes. Main Outcome Measure(s): Injury counts were associated with ATSs and PEs. Percentages of cases that received >1 ATSs and PEs were calculated. Descriptive data were provided, and rates per injury and per team-season were calculated. Sports were matched to their Appropriate Medical Coverage of Intercollegiate Athletics risk level. Results: From 27575 injuries, 266871 ATSs were provided with 11 988 PEs associated across 31 different sports (15 men and 16 women) completing 947 team-seasons (416 men and 531 women). Almost half of ATSs (47.2%, n = 125 943) and PEs (48.4%, n = 5797) were dedicated to acute-non-TL (NTL) and overuse-TL and-NTL injuries. Percentages cases receiving any ATS ranged from 41.6% to 85.5%, and PEs ranged from 32.9% to 56.7%. When ATSs were ranked per injury and team-season, the sports with the highest rates were more frequently categorized as lower to moderate risk rather than increased risk in the "Appropriate Medical Coverage of Intercollegiate Athletics" document. Conclusions: Lower-or moderate-risk sports demonstrated substantial health care use in ATS rates per injury and team-season. In addition, those services were frequently directed at overuse and NTL injuries rather than predominantly acute-TL. Our findings suggest a potential mismatch between provider workload and historic risk categorization calculated by injury risk and treatments per injury. These data should inform and update considerations for appropriate staffing levels, differential workload assignments, and alignment with clinical best practices.

CONTEXT:Limited real-world data demonstrate healthcare provided by collegiate sports medicine teams, across a variety of sports and injury categories that could inform appropriate staffing and workload. OBJECTIVE:To describe athletic training (AT) services and physician encounters (PE) for acute and overuse injuries, stratified by gender and time-loss (TL) status. DESIGN:Descriptive epidemiology. SETTING:Sports medicine facilities at 12 institutions participating in the PAC-12 Health Analytics Program. PATIENTS OR OTHER PARTICIPANTS:Division I collegiate student-athletes. MAIN OUTCOME MEASURES:Injury counts were associated with AT services and PE. Percentages of cases which received either none or ≥1 AT service and PE were calculated. Descriptive data were provided with confidence intervals, with rates calculated per-injury and per-team-season. RESULTS:From 27,575 injuries, 266,910 AT services were provided, with 11,988 PE associated across 31 different sports (M 15; W 16) completing 947 team-seasons (M 416; W 531). Almost half of AT services (47.2%) and PE (48.4%) were dedicated to acute-NTL and overuse-TL and -NTL injuries. Percentages of cases receiving any AT services varied by injury category of acute-TL and -NTL and overuse-TL and -NTL (63.9% to 80.1%), while PE ranged from 33% to 59%. When ranking AT services per-injury and per-team-season, the sports with the highest rates were more frequently categorized as low to moderate risk in the Appropriate Medical Coverage of Intercollegiate Athletics, rather than increased risk. CONCLUSIONS:Lower or moderate risk sports demonstrated substantial healthcare utilization in AT service rates per-injury and per-team-season. Additionally, those services were frequently directed at overuse and NTL injuries, rather than predominantly acute-TL. Our findings suggest a potential mismatch between provider workload and historic risk categorization calculated by injury risk and treatments per-injury. These data should inform and update considerations for appropriate staffing levels, differential workload assignments, and alignment with clinical best practices.

PURPOSE: To determine if gender and race/ethnicity (race) were associated with healthcare access and utilization in collegiate student-athletes with sport-related concussion (SRC). METHODS: Using a descriptive epidemiology design, de-identified medical records from August 2016-November 2021 were obtained from a single conference representing 14,030 student-athletes. SRC cases were identified and the following case characteristics extracted: same-day athletic trainer (AT) evaluation, associated physician encounter (PE), and time-loss (TL) vs. non-time-loss (NTL) status. Chi-square tests were used (α < 0.05) to determine if associations by race and gender were present, using 95% confidence intervals (CI) for pairwise comparisons. RESULTS: Of 36,285 sport-related injuries, 1454 (4.0%) were SRCs, of which 501 included race. Only 129 student-athletes with race other than Black or White were included and were combined into a Non-Black/Non-White (NBW) group. Proportions for each variable are reported and stratified by gender and race (Table 1). Same-day AT exam was associated with race when genders were combined (χ2 = 8.4, P = 0.02), and the intersection of race and gender in men (χ2 = 6.9, P = 0.03), however pairwise comparisons showed CI overlap. Associations were significant for PE by gender (χ2 = 8.3, P = 0.004 with women>men) and race (χ2 = 6.4, P = 0.04; CIs overlapped). Association for PE was found for the intersection of gender and race in men, with NBW > Black (χ2 = 9.4, P = 0.009). For TL status, only gender was associated, with men having greater TL status than women (χ2 = 9.7, P = 0.002). CONCLUSION: We found no statistically significant associations for same-day AT evaluation. A larger proportion of women than men and NBW men than Black men, respectively, had a PE following SRC. Women had a higher proportion of NTL concussions than men. Potential differences in access to care and reporting may be present, mitigated by gender, race/ethnicity, and likely sport.

CONTEXT:Health care utilization and the occurrence of non-time-loss (NTL) lateral ankle sprains is not well documented in collegiate athletes but could provide better estimates of injury burden and inform clinician workload.DESIGN:Descriptive epidemiologic study.METHODS:Lateral ankle sprain injury occurrence for Division I collegiate student-athletes in a conference with 32 sports representing 732 team seasons was collected during the 2018-2019 through 2020-2021 academic years. Injuries were designated as acute or overuse, and time-loss (TL) or NTL. Associated health care utilization, including athletic training services (AT services), and physician encounters were reported along with anatomical structures involved and season of occurrence.RESULTS:A total of 1242 lateral ankle sprains were reported over the 3 years from 732 team seasons and 17,431 player seasons, resulting in 12,728 AT services and 370 physician encounters. Most lateral ankle sprains were acute-TL (59.7%), which were associated with the majority of AT services (74.1%) and physician encounters (70.0%). Acute-NTL sprains represented 37.8% of lateral ankle sprains and were associated with 22.3% of AT services and 27.0% of physician encounters. On average, there were 12.7 (5.8) AT services per acute-TL sprain and 6.0 (3.6) per acute-NTL sprain. Most sprains involved "ankle lateral ligaments" (45.6%), and very few were attributed to overuse mechanisms (2.4%).CONCLUSIONS:Lateral ligament sprains are a common injury across many sports and result in substantial health care utilization from ATs and physicians, including NTL lateral ankle sprains. Although TL injuries were the majority of sprains, a substantial proportion of sprains were NTL and accounted for a considerable proportion of health care utilization.

Background Medical services for wildland fire incidents are vital and fire personnel need to be comfortable seeking care and have adequate access to care. Aims The aim of this study was to examine wildland firefighters’ (WLFFs) attitudes towards, opinions of and experiences with the medical services on fire assignments. Methods A survey was used to collect information from WLFFs. The survey covered: (1) demographics, (2) injury descriptions, (3) trust/respect toward medical personnel, and (4) perceived impact of injury treatment on individual and team deployability. Analysis used contingency tables with chi-square tests to compare groups. Key results WLFFs in both groups respect and trust incident medical personnel. Private firefighters compared with agency firefighters report a perception of less access to care, a high level of discouragement to seek care, and a greater concern that seeking care could result in being removed from the incident. Conclusions Although respect and trust are high, there are concerning perceived differences between groups on several aspects of seeking and receiving medical care. Implications Policy changes and culture shifts may be needed to narrow the opinion and perception gaps between private and agency firefighters on multiple aspects of incident medical services.

Institutions sponsoring athletics must be prepared for emergencies. Due to this, more governing bodies are requiring a sports-related emergency action plan (EAP). Yet, the effects of these policies are unknown. We compared adoption of EAPs and associated best practices in Oregon high schools before and after a policy requiring an EAP. Athletic directors were invited to complete a survey during the year before the policy went into effect and again the following year. We assessed whether the school had a written EAP and if they did, was the EAP venue specific, available at the venue, distributed to personnel, and annually reviewed and rehearsed. Pre/post-policy proportions were analyzed using Fisher exact tests for all schools and then schools that completed both surveys. There was a significant increase of schools that reported having an EAP after the policy went into effect (all schools: 55% to 99% [p < 0.001] and schools responding both years: 60% to 98% [p < 0.001]). Venue specific EAPs also significantly increased but only when analyzing all responses (59% to 71% [p = 0.03]). No best practice recommendations related to EAP availability, distribution, review, or rehearsal changed after the policy. Schools met the minimum requirements of the policy, but other related best practices did not significantly improve.

Sports injury surveillance is increasingly documenting overuse and non-time-loss (NTL) injuries, as well as acute and time-loss (TL). Capturing time-loss (TL and NTL) and onset (acute and chronic), particularly for upper extremity injuries, may more accurately describe injury burden. PURPOSE: To describe the epidemiology of upper extremity injuries of acute and overuse onset, stratified by TL and NTL, in collegiate student athletes. METHODS: Electronic medical records from member institutions were migrated to a secure cloud service provider. De-identified injuries from student athletes who authorized their records to be used for research were provided from August 2017 to March 2020 for all sports, representing 351 men’s and 459 women’s team seasons. Quality assurance procedures occurred at the institution, conference, and research team levels. Upper extremity musculoskeletal injuries were identified by onset (acute or overuse) and stratified by time-lost (TL or NTL). Injury frequencies and mean number of injuries per team per season were calculated. RESULTS: Of the 3286 injuries, acute-NTL (n = 1278, 38.9%) and acute-TL (n = 1229, 37.4%) were most frequent and most frequent in males (acute-NTL n = 897, 27.3%; acute-TL 925, 28.1%). Women’s overuse-TL (n = 177, 5.4%) and overuse-NTL (n = 248, 7.5%) were more frequent than men (n = 165, 5.0%; n = 189, 5.8% respectively). Ligament sprain (n = 835, 25.4%) was the most frequent diagnosis in men and women for acute-TL and -NTL injuries, while tendinopathy (n = 240, 7.3%) was most frequent for overuse-TL and -NTL injuries. Football had the highest mean number of injuries per team per season for acute-TL and -NTL (13.5, 15.9), while men’s gymnastics was highest in overuse-TL and -NTL (1.7, 3.2). CONCLUSIONS: Overuse injuries represented 23.7% of the sample and were more frequent in women, though men’s teams had higher mean number of injuries per team per season. Overuse upper extremity injury burden exists in a variety of sports, underscoring the need for injury prevention programs. This project was supported by the Pac-12 Conference’s Student-Athlete Health and Well-Being Initiative. The content of this abstract is solely the responsibility of the authors and does not necessarily represent the official views of the Pac-12 Conference, or its members.

Collegiate student athletes experience general medical injuries and illnesses, however there is limited information on what athletic trainers (AT) and team physicians evaluate and treat, as well as the healthcare utilization associated. PURPOSE: To describe general medical injuries and illnesses by onset (acute and overuse), stratified by time-lost (time-loss [TL] and non-time-loss [NTL]), across collegiate sports teams. METHODS: De-identified electronic medical records were obtained from all teams at sponsoring institutions. Injuries and illnesses coded as “sport-related” by documenting AT from August 2017 to March 2020 were collected, representing 351 men’s and 459 women’s team seasons. Deficiencies, illnesses (environmental, gastrointestinal, infection, metabolic, neurological, or opthalmological), respiratory diseases, and skin conditions were identified. Injury frequencies and mean occurrences per team per season were calculated, describing associated healthcare utilization. RESULTS: A total of 580 cases were identified, representing 2.9% of all injuries/illnesses for that time period (n = 20080). Acute-NTL were most frequent in men (n = 184, 31.7%) and women (n = 94, 16.2%). Acute-TL represented 25.5% of cases for men (n = 148) and 15.3% of cases for women (n = 89). Wrestling (n = 127, 21.9%) and Football (n = 113, 19.5%) had the highest frequencies, while highest mean occurrences per team per season were in Wrestling (n = 127, 14.1) and women’s Rowing (n = 82, 11.7). Infection (n = 196, 33.6%) and illness (n = 192, 32.9%) diagnoses were most frequent. Physician encounters numbered 350, of which 61.7% (n = 216) were for men, with 149 AT Services, of which 64.4% (n = 96) were in men. Medications prescribed (n = 105) were mainly in men (n = 67, 63.8%). CONCLUSIONS: Infection and skin conditions in Wrestling and illnesses in Football and women’s Rowing occurred most frequently. Though infrequent, a variety of other conditions presented that team physicians and ATs must be prepared to recognize and treat. This project was supported by the Pac-12 Conference’s Student-Athlete Health and Well-Being Initiative. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the Pac-12 Conference, or its members.

Commercial fishing is a high-risk occupation, yet there is a lack of surveillance documenting health conditions, health behaviors, and health care coverage among US fishermen. We used publicly available data sources to identify exposures and health outcomes common among fishermen. We utilized the National Institute for Occupational Safety and Health-Worker Health Charts to estimate the prevalence of general exposures, psychosocial exposures, health behaviors, and health conditions from the national surveys National Health Interview Survey - Occupational Health Supplement (NHIS-OHS, 2015) and Behavioral Risk Factor Surveillance System (BRFSS) (2013-2015). We compared fishing workers with both agricultural workers and all-workers. Fishermen commonly reported general exposures, psychosocial exposures, non-standard work arrangements, frequent night shifts, and shift work. The prevalence of musculoskeletal conditions such as carpal tunnel syndrome (33%) and severe low-back pain (27%) was also high. Smoking (45%) and second-hand smoke exposure (25%) were widespread, and 21% reported no health care coverage. National household surveys such as NHIS-OHS, and BRFSS can be utilized to describe the health status of fishermen. This workforce would benefit from increased access to health care and health promotion programs. More comprehensive evaluations of existing data can help to identify occupation-specific health challenges.

Disease‐specific stress can partly explain Sickle Cell Disease (SCD) healthcare utilization. We developed and validated two measures of adult SCD‐specific stress for research and clinical care. A large cohort of adults with SCD completed both the 3‐item Likert‐scale adapted from a previous disease stress measure and a 10‐item Likert‐scale questionnaire drafted specifically to measure SCD stress. They concurrently completed a psychosocial and health‐related quality of life scale battery, then subsequently daily pain diaries. Diaires measured: daily intensity, distress and interference of pain; self‐defined vaso‐occlusive crises (VOC), opioid use, and types of healthcare utilization for up to 24 weeks. Analyses tested Cronbach's alpha, correlation of the three‐item and 10‐item stress scales with the concurrent battery, with percentages of pain days, VOC days, opioid use days, and healthcare utilization days, and correlation of baseline stress and 6‐month stress for the 10‐item scale. Cronbach's alpha was high for both the 3‐item (0.73) and 10‐item (0.83) SCD stress scales, test–retest correlation of 0.55, expected correlation with the concurrent battery, and correlation with diary‐measured healthcare utilization over 6 months. The correlations with the 3‐item scale were stronger, but only statistically significant for depression‐anxiety. The correlation between the two stress scales was 0.59. Both the 3‐item and the 10‐item stress scales exhibited good face, construct, concurrent, and predictive validity as well as moderate test–retest reliability. Further scale validation should determine population norms and response to interventions.

Bone stress injuries (BSI) occur frequently in runners and females. However, their occurrence in other sports, time-lost (TL) status, and associated healthcare utilization is unclear. PURPOSE: To describe bone stress injuries and associated healthcare utilization in a population of collegiate student athletes. METHODS: A descriptive epidemiology design utilizing de-identified electronic medical records from all sponsoring institutions in one NCAA conference was used. Injury occurrences were collected from August 2017 - March 2020, representing 810 team-seasons (351 men’s and 459 women’s). Injuries were identified by onset (acute or overuse) and stratified as TL or non-time-loss (NTL). Lower extremity injury location and injury type were identified. Associated healthcare utilization, including athletic training services (ATS) provided, and injuries resulting in one or more physician encounters (PE), prescribed medication, diagnostic test, procedure, or surgery were determined. Mean BSI per team per season were calculated. RESULTS: A total of 501 BSI were captured, representing 2.5% of all injuries/illnesses in the time period (n = 20080). The majority (n = 341, 68.1%) were in women’s teams. Overuse-NTL BSI comprised 13.8% of the sample (n = 69). The foot was the most frequent location (n = 164, 68.3%). Women’s track and field (n = 106, 21.2%, 2.9) and women’s cross country (n = 86, 17.2%, 2.4) reported the highest occurrence of BSI by sport and highest occurrence per team per season. BSI necessitated 13907 ATS, and 462 BSI required PE, resulting in medications prescribed in 54, tests in 458, procedures in 8, and surgeries in 74 cases. Of ATS, 65% (n = 9056) were for overuse injuries, with women utilizing 77.7% (n = 7037) of them. CONCLUSIONS: Women experienced the majority of BSI, concentrated in running sports. Most BSI in men and women were designated as overuse and resulted in TL, but almost 14% were managed as overuse-NTL. BSI required substantial AT and physician services, and prevention may be possible with data-driven programs. This project was supported by the Pac-12 Conference’s Student-Athlete Health and Well-Being Initiative. The content of this abstract is solely the responsibility of the authors and does not necessarily represent the official views of the Pac-12 Conference, or its members.

Describing student-athlete healthcare utilization for acute versus overuse injuries, stratified by time-loss (TL) and non-time-loss (NTL), may better capture sports medicine clinician workload to inform staffing across teams. PURPOSE: To describe the frequencies of athletic training services (ATS) and physician encounters (PE) resulting from musculoskeletal injuries across a range of Division I athletic teams. METHODS: This descriptive epidemiological study utilized de-identified electronic medical records from all sponsoring institutions in a single NCAA Division I conference. These included men’s and women’s basketball, cross country, golf, gymnastics, rowing, swimming/diving, soccer, tennis, track and field, water polo, volleyball/beach volleyball, men’s baseball, football, wrestling, and women’s field hockey, lacrosse, and softball. Musculoskeletal injury occurrences were collected from August 2018-March 2020, representing 476 team-seasons (204 men’s and 272 women’s). Injury mechanism (acute or overuse) was identified and stratified by time-lost (TL or NTL), and categorized by team. Frequencies and means for ATS and PE per team per season and per player per season were calculated. RESULTS: A total of 12,534 injuries resulted in 171,946 ATS and 5,188 PE. Men’s overuse injuries represented 10.0% (n = 17,197) of ATS and 12.2% (n = 632) of PE; women’s represented 21.0% (n = 36,113) of ATS and 16.9% (n = 877) of PE. Acute-NTL accounted for 8.6% (n = 14,712) and 7.7% (n = 13,310) of ATS and 17.0% (n = 884) and 7.3% (n = 379) of PE in men and women, respectively. Mean ATS and PE per team per season and per player per season demonstrated variation in healthcare utilization by team and injury classification. CONCLUSION: Documenting treatment burden across different injury classifications more comprehensively describes clinician workload by team assignment and provides evidence to support appropriate healthcare staffing. Future research should focus on specific types of services utilized by teams in each injury classification. This project was supported by the Pac-12 Conference’s Student-Athlete Health and Well-Being Initiative. The content of this abstract is solely the responsibility of the authors and does not necessarily represent the official views of the Pac-12 Conference, or its members.

Sports injury surveillance is evolving to document overuse mechanism and non-time-loss (NTL) injuries, in addition to acute and time-loss (TL) injuries, to comprehensively describe injury and treatment burden for student-athletes and clinicians. PURPOSE: To describe musculoskeletal acute and overuse injuries, stratified by TL and NTL, across one conference’s Division I athletic teams. METHODS: This descriptive epidemiological study utilized de-identified electronic medical records from a conference for men’s and women’s cross country, golf, gymnastics, rowing, swimming/diving, tennis, track and field, water polo, men’s baseball, and women’s softball. Each sponsoring member institution provided injury occurrences from August 2018-March 2020, representing 300 team-seasons (134 men’s and 166 women’s). Musculoskeletal injury mechanism (acute or overuse) was identified and stratified by time-lost (TL or NTL). Injury frequencies, mean number of injuries per team per season and per player per season were calculated. RESULTS: Of the 4621 injuries, most were acute (n = 2660, 57.6%) and in females (n = 1431, 53.8%). Overuse injuries (n = 1961, 42.4%) were more frequent in females (n = 1268, 64.7%). NTL represented 39.8% (n = 1840) of injuries, of which n = 1152 (62.6%) were in women. Mean injuries per team per season and per player per season varied by sport and gender (Table 1). CONCLUSION: Nearly 64% of injuries were identified as acute-NTL, overuse-TL or overuse-NTL. Incorporating NTL and overuse mechanisms provides a more comprehensive picture of injury and treatment burden, especially for technical or “low-risk” sports. This project was supported by the Pac-12 Conference’s Student-Athlete Health and Well-Being Initiative. The content of this abstract is solely the responsibility of the authors and does not necessarily represent the official views of the Pac-12 Conference, or its members.Table 1: Injury Frequencies and Means

This article describes the conception, implementation, and evaluation of a wilderness medicine-based first aid class for the commercial fishing industry. Commercial fishing is a dangerous occupation in the United States. Currently, commercial fishermen often only have access to basic first aid classes. Because of its focus on austere environments, hazardous conditions, and distance from definitive medical care-hallmarks of commercial fisheries-wilderness medicine offers a more appropriate approach to decreasing morbidity and mortality in the industry. A 2-d, 16-h pilot wilderness medicine course for commercial fishermen, Fishermen First Aid and Safety Training (FFAST), conducted for Dungeness crab fishermen, was effective and well received, based on pre- and postcourse knowledge, skill, and attitude surveys. FFAST has been approved by the Coast Guard and is being made more widely available to commercial fishermen in the Pacific Northwest. The FFAST program offers an example of how wilderness medicine can improve safety and emergency medical response for a wide variety of austere environments not traditionally linked to the backcountry.

BACKGROUNDCommercial fishing is a hazardous occupation in the United States (US). Injury surveillance data relies heavily on US Coast Guard reports, which capture injuries severe enough to require reporting. The reports do not incorporate the fishermen's perspective on contributing factors to injuries and staying safe while fishing.MATERIALS AND METHODSWe conducted a pre-season survey of Dungeness crab fishermen during 2015 to 2016. Community researchers administered surveys to fishermen. Respondents reported their opinions about factors contributing to injuries and staying safe, which were grouped into similar themes by consen- sus. Descriptive statistics were calculated to explore the number of injuries, crew position, age, and years of experience. Chi-square tests compared perceptions of injury causation, staying safe, and other factors.RESULTSFour hundred twenty-six surveys were completed. Injury causation perceptions were sorted into 17 categories, and staying safe perceptions were sorted into 13 categories. The most frequently cited causes of injury were heavy workload (86, 21.9%), poor mental focus (78, 19.9%), and inexperience (56, 14.3%). The most frequently cited factors in staying safe while fishing were awareness (142, 36.1%), good and well-maintained fishing gear/vessel (41, 10.4%), and best marine practices (39, 9.9%). Opinions were not significantly associated with experiencing an injury in the past while fishing, but some opinions were significantly associated with crew position, age, and years of experience.CONCLUSIONSThe perceptions of fishermen can be evaluated further and incorporated into training or intervention development. The fishermen-led approach of this project lends itself to developing injury pre- vention strategies that are effective, realistic and suitable. The resources available at FLIPPresources.org, such as informational sheets for new fishermen, sample crew agreements, and first aid kit resources, supply workers in this fishery with real solutions for issues they identified through their survey responses.

Objectives: Non-fatal injuries in the high risk US Dungeness crab fishery have been under-documented, despite their potential for lost work time and income, long-term disability, and early unwanted retirement. The Fishermen Led Injury Prevention Program (FLIPP) characterized injuries in this fishery, in order to identify work hazards and inform injury control measures.Methods: The FLIPP injury survey was completed by 426 fishermen in 23 Washington, Oregon, and California fishing ports prior to the 2015-2016 Dungeness crab season; 413 (97%) provided injury information for this analysis. Participants indicated whether they had been injured in the previous 12 months, described the injury, any treatments received, and whether the injury limited their ability to work.Results: Participants were mostly male (98%), more than half (56.6%) worked as deckhands, and reported considerable fishing experience (median = 14 years, interquartile range 5-27). Eighty-nine fishermen (21.5%) reported an injury incident in the past year, of which 49 (55.1%) were limiting. The 89 incidents yielded 102 injuries, of which nearly two-thirds were sprains/strains (23, 22.5%), surface wounds/bruises (17, 15.0%), cuts (18, 17.6%), or punctures (11, 10.8%). More severe injuries, including eight fractures, were rare. The majority of injuries received either no treatment (27, 26.5%) or first aid (35, 34.3%); clinical care was less common (22, 21.6%), and emergency care rare (3, 2.9%).Conclusion: One in five Dungeness crab fishermen reported an injury incident in the previous year. Most injuries were not severe and did not result in clinical care, but approximately half were work-limiting. Control measures must account for the remote and resource-limited workplace in commercial fishing.

BACKGROUND:Alaska's onshore seafood processing industry is economically vital and hazardous. METHODS:Accepted Alaska workers' compensation claims data from 2014 to 2015 were manually reviewed and coded with the Occupational Injury and Illness Classification System and associated work activity. Workforce data were utilized to calculate rates. RESULTS:2,889 claims of nonfatal injuries/illnesses were accepted for compensation. The average annual claim rate was 63 per 1000 workers. This was significantly higher than Alaska's all-industry rate of 44 claims per 1000 workers (RR = 1.42, 95%CI = 1.37-1.48). The most frequently occurring injuries/illnesses, were by nature, sprains/strains/tears (n = 993, 36%); by body part, upper limbs (1212, 43%); and by event, contact with objects/equipment (1020, 37%) and overexertion/bodily reaction (933, 34%). Incidents associated with seafood processing/canning/freezing (n = 818) frequently involved: repetitive motion; overexertion while handling pans, fish, and buckets; and contact with fish, pans, and machinery. CONCLUSIONS:Ergonomic and safety solutions should be implemented to prevent musculoskeletal injuries/illnesses in seafood processing.

Background Structured multicomponent injury prevention programs (IPP) are efficacious for reducing lower extremity (LE) injury risk in athletes, but are not commonly used by high school athletic team coaches in the United States. One barrier to structured IPP adoption is that many coaches report that they incorporate IPP activities into their team's training, and therefore may not perceive IPPs to present any relative advantage over their current practices. Objective To determine if teams whose coaches report including self-selected activities that meet current IPP recommendations have lesser LE injury rates than teams that do not. Methods Training and competition injury events and athletic exposures (AE) of 3853 participants on 274 high school basketball and soccer teams in the U.S. state of Oregon were recorded by sports medicine professionals at 30 high schools for one athletic season. Coaches of 116 of these teams (42%) completed an online survey about their team's activities that was used to determine whether these activities met minimum IPP recommendations. LE injury rates were compared between teams that met or did not meet current recommendations. Findings Teams whose coaches completed the survey had similar LE injury rates (1.32 injuries/1000AEs) compared to teams with non-responsive coaches (1.04 injuries/1000AEs) (Mean difference: 0.28 injuries/1000AEs (95% CI: −0.08 to 0.65), p=0.134). The LE injury rate of teams whose coaches reported meeting IPP recommendations (1.46 injuries/1000AEs, n=77) was not significantly different than teams whose coaches did not (1.05 injuries/1000AEs, n=39) (Mean difference: 0.42 injuries/1000AEs (95% CI: −0.20 to 1.04), p=0.186). Conclusion and policy implications Coach-reported use of activities that meet current IPP recommendations is not protective against LE injury. This suggests that 1) coaches' reports of IPP use may overestimate actual exposure to protective IPP elements, or 2) minimum IPP recommendations may not be stringent enough to facilitate a protective effect in high school athletes.

Background:Pain diary assessment in sickle cell disease (SCD) may be expensive and impose a high respondent burden.Objective:To report whether intermittent assessment could substitute for continuous daily pain assessment in SCD.Design:Prospective cohort study.Setting:Academic and community practices in Virginia. Patients. A total of 125 SCD patients age 16 years or older in the Pain in Sickle Cell Epidemiology Study. Measurements. Using pain measures that summarized all diaries as the gold standard, we tested the statistical equivalence of four alternative strategies that summarized diaries only from the week prior or the month prior to study completion; one week per month; or one day per week (random day). Summary measures included percent pain days, percent crisis days (self-defined), mean pain (0-9 Likert scale) on all days, and mean pain on pain days. Equivalence tests included comparisons of means, regression intercepts, and slopes, as well as measurement of R2.Results:Compared with the gold standard, the one-day-per-week and one-week-per-month strategies yielded statistically equivalent means of six summary pain measures, and the week prior and month prior yielded equivalent means as some of the measures. Regression showed statistically equivalent slopes and intercepts to the gold standard using one-day-per-week and one-week-per-month strategies for percent pain days and percent crisis days, but almost no other equivalence. R2 values ranged from 0.64 to 0.989.Conclusions:It is possible to simulate five- to six-month daily assessment of pain in SCD. Either one-day-per-week or one-week-per-month assessment yields an equivalent mean and fair regression equivalence.

Background Soccer and basketball have two of the highest rates of anterior cruciate ligament (ACL) injury among United States high school sports. The U.S. National Athletic Trainers’ Association (NATA) position statement on prevention of ACL injuries advises preventive training for soccer and basketball athletes – with a specific emphasis on female athletes. Objective To determine whether coach-reported use of training activities that meet NATA IPP recommendations varies by sport (basketball or soccer) and sex. Methods Basketball and soccer coaches from 30 Oregon (USA) high schools were invited to complete an online survey about their team’s activities. Of the 274 coaches contacted, coaches of 32 boys and 28 girls basketball and 25 boys and 31 girls soccer teams responded (42%). Teams were classified as having met the NATA’s IPP recommendations if their coaches reported: 1) providing feedback about correct movement technique, and 2) including activities at least twice per week from ≥3 of the essential exercise categories. Findings There was significant variation by team on meeting IPP recommendations ( X 2 =14.34, p=0.002). A greater proportion of boys [80.0% (95% CI: 59.3%–93.2%)] and girls [83.9% (95% CI: 66.3%–94.6%)] soccer teams were classified as meeting IPP recommendations compared to boys basketball teams [43.8% (95% CI: 26.4%–62.3%)]. Though not statistically significant, girls basketball teams [60.7% (95% CI: 40.6%–78.5%)] were more likely than boys basketball and less likely than boys and girls soccer teams to have coaches who reported meeting IPP recommendations. Conclusion and policy implications Despite greater ACL injury risk in females, sport rather than sex was associated with whether coaches reported meeting IPP recommendations. It may be that widespread acceptance of a sport-specific IPP in the soccer community secondary to deliberate dissemination initiatives by the sport’s governing body may make soccer coaches more likely to have their athletes perform preventive activities or report that they are doing so.