Nebraska Injury Prevention and Control News
   Issue #75                                                                       November 2017
In the News
Study links youth football to greater risk of later health problems
Playing tackle football under the age of 12 exposes children to repetitive head impacts that may double their risk of developing behavioral problems and triple their chances of suffering depression later in life, according to a study published Tuesday in Nature magazine’s journal, Translational Psychiatry.

The research, conducted by Boston University’s Chronic Traumatic Encephalopathy Center, provides the most powerful evidence to date that playing contact football before age 12 may cause brain changes throughout life.

“This study adds to growing research suggesting that incurring repeated head impacts through tackle football before the age of 12 can lead to a greater risk for short- and long-term neurological consequences,” said Michael Alosco, the study’s lead author, a postdoctoral fellow at Boston University School of Medicine.

Read the full article here .
Injuries on stairs occur in all age groups and abilities
Child injuries in ATVs dropped after age-restriction law
(Reuters Health) - Restricting use of off-road vehicles, including all-terrain vehicles (ATVs), for younger children and teens may help curb the number of youth who get seriously injured in crashes, a U.S. study suggests.

Researchers examined data on youth who received emergency treatment for injuries in off-road vehicles (ORV) in Massachusetts before and after a 2010 state law banning kids under 14 from riding without adult supervision and requiring older teens to take driving classes.

Emergency room visit rates for kids age 10 to 13 with ORV injuries fell by half in the three years after the law took effect, compared with the nine years before, the study found. Emergency room visits also dropped by 33 percent for children age 9 and under, and by 39 percent for teens 14 to 17.
“Our study brings renewed hope that legislation, when done well, can be another tool to help save children’s lives when it comes to off-road vehicles designed for adults,” said lead study author Dr. Michael Flaherty of Massachusetts General Hospital and Harvard Medical School in Boston.

Read the full article here.
More than 1 million Americans injure themselves on stairs each year, according to a study in the American Journal of Emergency Medicine.

Older adults, younger children and women reported more injuries, but all ages show up in emergency departments for sprains, strains, bumps and fractures.

“Stairs are a common source of injury among all ages, and the frequency and rate of stair-related injuries are increasing,” said senior author Dr. Gary Smith of Nationwide Children’s Hospital in Columbus, Ohio.

Continue reading full article here .
CDC Reports Rising Rates of Drug Overdose Deaths in Rural Areas
Rates of drug overdose deaths are rising in nonmetropolitan (rural) areas, surpassing rates in metropolitan (urban) areas, according to a  Morbidity and Mortality Weekly Report (MMWR) released today by the Centers for Disease Control and Prevention (CDC).

This report analyzed trends in illicit drug use and illicit drug use disorders from 2003-2014, and drug overdose deaths from 1999-2015 in urban and rural areas. Understanding differences in illicit drug use, illicit drug use disorders, and drug overdose deaths in urban and rural areas can help public health professionals to identify, monitor, and prioritize responses.

Rising Rates of Drug Overdose Deaths In Rural Areas Continued

Key Findings
  • Drug overdose death rates (per 100,000 population) for urban areas were higher than in rural areas in 1999 (6.4 versus 4.0). The rates converged in 2004, and by 2015 the rural rate (17.0) was slightly higher than the urban rate (16.2).
  • The percentage of people reporting past-month use of illicit drugs declined for youth aged 12-17 over a 10-year period but increased substantially in other age groups.
  • Among people reporting illicit drug use in the past year, drug use disorders decreased during the study period.
Safe Kids Nebraska
How to Make School Zones Safer with Protected Bike Lanes
What would you think if you were walking or biking in your city and saw a group of people linking hands in the middle of the street? That’s exactly what happened on Second Avenue in New York City on a Tuesday morning in August 2017. Bike safety advocates were holding hands to make two points.

First, that the city must continue making progress on bike and pedestrian safety in school zones. And second, that protected bike lanes are proven lifesavers. Commuters biking to work and school showed their appreciation for these advocates with cheers and high-fives. Similar demonstrations made the same points in places ranging from Boise, Idaho to Mexico City. These groups prove we can use imagination in advocating for safety change.

One of the major issues in school zones is that increased traffic makes the roads feel less safe—so parents are worried about sending kids off to school on bikes. One innovation that can make an impact is a protected bike lane. The key difference between protected and conventional bike lanes is that protected bike lanes have objects such as bollards, flexible poles or planters providing physical separation between the bike lane and vehicle traffic. Thanks to these separations, protected bike lanes are proven to be safer and also make bike riders feel safer. They also help parents feel comfortable allowing their kids to bike to school.

Read the full article here .
What is a Tether?
Find out how the top tether makes a difference during a car crash. Click here for an explanation of what a tether is, why it is important and how to use it properly to keep kids safe while in the car.

Motor Vehicle Safety
National Teen Driver Safety Week
October 15-21 was Teen Driver Safety Week but promoting teen driver safety should keep going. Earning a driver’s license has long been a rite of passage for America’s teens—a first step toward freedom and independence. Click here for some tips to let your young driver know that obeying the rules of the road is a prerequisite for the privilege of driving throughout the year.
USDOT Releases 2016 Fatal Traffic Crash Data
The U.S. Department of Transportation’s National Highway Traffic Safety Administration today released fatal traffic crash data for calendar year 2016. According to NHTSA data, which was collected from all 50 states and the District of Columbia, 37,461 lives were lost on U.S. roads in 2016, an increase of 5.6 percent from calendar year 2015.

The number of vehicle miles traveled on U.S. roads in 2016 increased by 2.2 percent, and resulted in a fatality rate of 1.18 deaths per 100 million VMT – a 2.6-percent increase from the previous year.

NHTSA found that distracted driving and drowsy driving fatalities declined, while deaths related to other reckless behaviors – including speeding, alcohol impairment, and not wearing seat belts – continued to increase. Motorcyclist and pedestrian deaths accounted for more than a third of the year-to-year increase.

The 2016 national data shows that:
  • Distraction-related deaths (3,450 fatalities) decreased by 2.2 percent;
  • Drowsy-driving deaths (803 fatalities) decreased by 3.5 percent;
  • Drunk-driving deaths (10,497 fatalities) increased by 1.7 per­cent;
  • Speeding-related deaths (10,111 fatalities) increased by 4.0 percent;
  • Unbelted deaths (10,428 fatalities) increased by 4.6 percent;
  • Motorcyclist deaths (5,286 fatalities – the largest number of motorcyclist fatalities since 2008) increased by 5.1 percent;
  • Pedestrian deaths (5,987 fatalities – the highest number since 1990) increased by 9.0 percent; and
  • Bicyclist deaths (840 fatalities – the highest number since 1991) increased by 1.3 percent.
NHTSA continues to work closely with its state and local partners, law enforcement agencies, and the more than 350 members of the  Road to Zero Coalition  to help address the human choices that are linked to 94 percent of serious crashes. NHTSA also continues to promote vehicle technologies that hold the potential to reduce the number of crashes and save thousands of lives every year, and may eventually help reduce or eliminate human error and the mistakes that drivers make behind the wheel.

Click here  to view 2016 Fatal Motor Vehicle Crashes: Overview

Click here   to view  2016 Quick Facts
 Older Adult Falls 
Fall Prevention Programs in Nebraska Continue
Nebraska is proud to support fall prevention efforts as part of our year-round commitment to the health and livelihood of older Nebraskans. The DHHS Injury Prevention Program works in collaboration with several local/district health departments around the state to implement two evidence-based programs to prevent older adult falls.

Tai Chi Moving for Better Balance is designed to improve older adult’s balance. Practice of tai chi has been shown to reduce chances of falling, to help improve and maintain mobility, functional independence, and quality of life. It is a gentle form of exercise that is appropriate for older adults.

Stepping On addresses multiple fall risk factors: improving lower limb balance and strength, improving environmental and behavioral safety in both the home and community, and encouraging vision and medical screenings to check for poor vision and possible medication problems.

With recently awarded funding from the Public Health and Health Services Block Grant, these programs are being implemented by the following agencies: Elkhorn Logan Valley Public Health Department, Four Corners Health Department, Public Health Solutions District Health Department, South Heartland District Health Department, Scotts Bluff County Health Department, and Aging Partners. The Injury Prevention Program provides training and technical assistance and works with the local agency to ensure fidelity to the program. The local health departments work with local partners to offer Tai Chi and/or Stepping On classes to reach individuals in the communities they serve. At any given time of the year, there are approximately 30 – 40 classes going on.
Watch this short 3 minute video about what older Nebraskans learn and do at Stepping On classes!

Study Finds Female Youth Soccer Players Five Times More Likely than Boys to Return to Play Same Day Following Concussion
Findings especially concerning since girls also sustain concussions at higher rates, according to abstract of new research to be presented at American Academy of Pediatrics 2017 National Conference & Exhibition.

CHICAGO – A new study found girls were significantly more likely than boys to return to play the same day following a soccer-related concussion, placing them at risk for more significant injury.
The study abstract, "Gender Differences in Same-Day Return to Play Following Concussion Among Pediatric Soccer Players," will be presented on Saturday, Sept. 16, during the American Academy of Pediatrics 2017 National Conference & Exhibition in Chicago.

The study examined young athletes, average age 14, who sustained a concussion while playing soccer and who were treated at a pediatric sports medicine clinic in Texas. Of the 87 athletes diagnosed with a soccer-related concussion, two-thirds (66.7 percent) were girls. Among them, more than half (51.7 percent) resumed playing in a game or practice the same day as their injury, compared to just 17.2 percent of boys.

Read full article here.
Brain Safety Game
The app aims to teach children:
  • the different ways the brain can get hurt during sports activities.
  • how important it is to tell a coach, parent, or other adult when an injury occurs.
  • the importance of taking time to rest and recover if they have a concussion.

Click here to learn how to talk to your children about concussions, where to download the app, and more.
Prescription Drug Overdose
Study Finds Increasing Number of Children Arrive at Emergency Departments Addicted to Opioids
Research to be presented at American Academy of Pediatrics (AAP) 2017 National Conference & Exhibition in Chicago found the number of pediatric patients testing positive for opioid addiction or dependency in U.S. emergency departments jumped by more than half between 2008 and 2013.

CHICAGO – Showing the opioid epidemic knows no age limits, new research suggests more than 100 children test positive for opioid addiction or dependency each day in U.S. emergency departments.

The study abstract, "Opioid abuse in children: An emerging public health crisis," will be presented on Monday, Sept. 18, during the American Academy of Pediatrics (AAP) 2017 National Conference & Exhibition in Chicago. Researchers performed a retrospective analysis of the 2008–2013 data from the Nationwide Emergency Department (ED) Sample, the largest all-payer ED database in the United States.

Read full article here .
DHHS Releases Opioid Prescribing Resource for Health Care Providers
The Nebraska Department of Health and Human Services continues to take action to help prevent prescription drug overdose in Nebraska. The department developed and is now releasing a new opioid prescribing resource for providers.

“Although opioids can be a useful option for pain management, inappropriate use can result in significant harms,” said Dr. Tom Williams, Chief Medical Officer and Director of Public Health for DHHS. “This guidance document will assist in making clinical decisions easier and provide effective options to treat pain while ensuring patient safety.”

The Nebraska Pain Management Guidance Document promotes consistent, safe and effective pain management standards for Nebraska prescribers. It is not a requirement, rather it’s a tool for clinicians to voluntarily use. The document includes information on treating acute pain, chronic pain, and non-opioid options for pain treatment, treating pain in special populations, and opioid tapering/discontinuation.

DHHS worked with partners including the Nebraska Medical Association and professional boards and physicians to create the pain management guidance which is being shared with all health care providers who prescribe and dispense prescription medication. Provider training is also in development. 

Find the press release and the featured drug overdose prevention initiatives here
Nebraska Pain Management Guidance Document
Download the full guidance document here.
Help Prevent Motor Vehicle Crashes this Holiday Season
Statistical data provided from the Nebraska Office of Highway Safety shows in the year 2015 there were 32,818 total motor vehicle crashes with 10,497 of those crashes resulting in injuries. The months of November and December are peak travel months, as many families will excited to travel to spend time with friends and family. Motorists need to prepare for travel, to protect themselves and their passenger’s from potential tragedy, as a motor vehicle accidents claimed 245 lives in Nebraska in 2015 (NOHS, 2016).

Before you take off for holiday travel consider the following:

  • Is your vehicle tuned up and ready for travel – prepare for winter conditions in case you are stranded.
  • Are you physically ready to make the trip – if you are tired, stop take a break, or delay travel to prevent fatigue related accidents.
  • Restrain yourself and your passenger’s properly.
  • Give yourself plenty of time to get from one destination to the other, avoid speeding, and aggressive driving.
  • Pay attention to changes in the weather, and review travel plans anticipating changes in road conditions.
  • Do not drive if you having been drinking – choose a designated driver who will remain alcohol free.
  • Do not text or talk on the phone while driving – since driving needs your full attention, designate a passenger to provide communications for you while you travel.
  • Be flexible with your travel plans, and do not set un-realistic expectations of yourself.
The Nebraska Statewide Trauma System wants to prevent you from becoming a statistic of motor vehicle crashes. Be smart and do your part to be a responsible driver this holiday season. For more information about the Nebraska Statewide Trauma System or for questions please contact: Crystal Dailey RN, BSN, Trauma Nurse Specialist, DHHS EMS/Trauma Program @ or 402-722-4300.
We are approaching holiday season! Fill a cup with your favorite adult beverage and celebrate. Just remember that if you get behind the wheel drunk, you will get busted. Even at night, cops are out there looking for drunk drivers and they will see you before you see them. The biggest party of the year doesn't need to turn into the biggest bust of the year. Drive Sober or Get Pulled Over.
Quick Links
Contact Information

Peg Ogea-Ginsburg, MA         
Injury Prevention Program Coordinator  

Jason Kerkman, MPH 
Safe Kids Nebraska Coordinator 

Amy Reynoldson
Prescription Drug Overdose Prevention Coordinator

Jeanne Bietz, MA 
Motor Vehicle Safety Coordinator

Ashley Newmyer, MPH, CPH
Epidemiology Surveillance Coordinator

Felicia Quintana-Zinn, MS, MBA
Prescription Drug Overdose Prevention Epidemiologist

Celeste Reker, MPH                        
Crash Outcome Data Evaluation Data Analyst  
Injury Prevention and Control E-News is a monthly newsletter distributed to partners of the Nebraska Department of Health and Human Services Injury Prevention and Control Program.