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AbstractFalls among older adults (aged 65 years and older) are a public health concern in Canada. Fall-related injuries can cause a reduction in quality of life among older adults, and death. They also entail substantial health care costs. It is essential to monitor fallrelated injuries and deaths among older adults to better understand temporal trends and characteristics and to evaluate fall prevention strategies. We used the most up-to-date data from the Canadian Vital Statistics–Death database, Discharge Abstract Database and National Ambulatory Care Reporting System to analyze the temporal trends of fallrelated mortality, hospitalizations and emergency department (ED) visits among older adults in Canada over more than a decade. Age and sex characteristics were also examined. In 2022, 7189 older adults died due to a fall in Canada (excluding Yukon). From 2010 to 2022, deaths due to falls generally increased in both number and rates. In fiscal year 2023/24, there were 81 599 fall-related hospitalizations in Canada (excluding Quebec) and 212 570 fall-related ED visits in Ontario and Alberta. From fiscal year 2010/11 to 2023/24, even though the overall trend of the rates of fall-related hospitalizations and ED visits did not increase, the numbers generally rose year by year except in 2020/21, the early stage of the COVID-19 pandemic. As for the age and sex characteristics, the rates for deaths, hospitalizations and ED visits rose with advancing age for both men and women. With the aging population, continuous monitoring of the trends is crucial for fall prevention.

RésuméLes chutes chez les aînés (65 ans et plus) constituent un problème de santé publique au Canada. Les blessures liées aux chutes sont susceptibles d’entraîner une réduction de la qualité de vie chez les aînés ou de causer la mort. Elles entraînent également des coûts importants en matière de soins de santé. Il est essentiel de réaliser un suivi des blessures et des décès liés aux chutes chez les aînés afin de mieux en comprendre les tendances temporelles et les caractéristiques et d’évaluer les stratégies de prévention des chutes. Nous avons utilisé les plus récentes données de la Base canadienne de données de l’état civil – Décès, de la Base de données sur les congés des patients et du Système national d’information sur les soins ambulatoires pour analyser les tendances des décès, des hospitalisations et des visites à l’urgence liées aux chutes chez les aînés au Canada sur plus de dix ans. Nous avons également effectué une analyse en fonction de l’âge et du sexe. En 2022, dans l’ensemble du Canada (à l’exception du Yukon), 7 189 aînés sont décédés en raison d’une chute. Entre 2010 et 2022, de manière générale, le nombre et le taux de décès attribuables aux chutes ont augmenté. Au cours de l’exercice 2023-2024, il y a eu 81 599 hospitalisations liées aux chutes dans l’ensemble du Canada (à l’exception du Québec) et 212 570 visites à l’urgence liées aux chutes en Ontario et en Alberta. Entre 2010-2011 et 2023-2024, si la tendance générale des taux d’hospitalisation et de visite à l’urgence liées aux chutes n’a pas augmenté, leur nombre a généralement augmenté d’une année sur l’autre, sauf en 2020-2021, soit au début de la pandémie de COVID-19. En ce qui a trait à l’âge et au sexe, les taux de décès, d’hospitalisation et de visite à l’urgence ont augmenté avec l’âge à la fois chez les hommes et chez les femmes. Compte tenu du vieillissement de la population, la surveillance continue des tendances est essentielle pour la prévention des chutes.

Abstract Background The opioid crisis is a serious public health issue in Canada. There have been many surveillance programs and research studies on opioid-related emergency department (ED) visits at a national, provincial, regional or municipal level. However, no published studies have investigated the in-depth contexts surrounding opioid-related ED visits. In addition, few studies have examined injuries other than poisonings in those visits. The objective of this study is to investigate the contextual factors and co-occurrence of poisonings and injuries among the opioid-related ED visits in a Canadian sentinel surveillance system on injuries and poisonings from 2011 to 2022. Methods This study used a mixed methods design. The data source was the Canadian Hospitals Injury Reporting and Prevention Program. We first selected all opioid-related ED visits during our study period and then identified the contextual factors through a content analysis of the combination of the narrative description and other variables in the patients’ records. The contextual factors were organized into themes as opioid use context, social resource utilization, bystander involvement, and prior naloxone use. The opioid use context was used as a co-variable to examine the other themes and ED presentations (poisonings and other injuries). Quantitative descriptive approach was used to analyze all the contexts and ED presentations. Results The most common opioid use context was non-prescribed opioid use without intention to cause harm, followed by self-poisoning, children’s exposure, and medication error. Various rare contexts occurred. Paramedics participated in 27.9% of visits. Police and security guards were involved in 5.1% and 2.3% of visits, respectively. Child welfare or social workers were involved in 0.4% of visits. Bystanders initiated 18.9% of the ED visits. Naloxone use before arriving at the ED occurred in 23.4% of the visits with a variety of administrators. The majority of patients presented with poisoning effects, either with poisoning effects only or with other injuries or conditions. Conclusions Our study has provided an in-depth analysis of contextual factors and co-occurrence of poisonings and injuries among opioid-related ED visits in Canada. This information is important for ED programming and opioid-related poisoning and injury intervention and prevention.

Abstract Background Detergent packets are common household products; however, they pose a risk of injuries and poisonings, especially among children. This study examined the epidemiological characteristics of pediatric injuries and poisonings related to all types of detergent packets in Canada using emergency department (ED) data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database. Methods The CHIRPP database was searched for ED visit records for injuries and poisonings related to all types of detergent packets between April 1, 2011 and October 12, 2023 (N = 2,021,814) using variable codes and narratives. Data for individuals aged 17 years and younger were analyzed descriptively. Temporal trends in the number of detergent packet-related injuries and poisonings per 100,000 CHIRPP cases were assessed using Joinpoint regression and annual percent change (APC). A proportion ratio and 95% confidence intervals (CI) were calculated to compare the proportion of detergent packet-related cases in CHIRPP during two 34-months periods, pre-COVID-19 pandemic and after the beginning of the pandemic. Results There were 904 detergent packet-related cases among children and youth aged 17 years and younger identified in CHIRPP between April 1, 2011 and October 12, 2023, representing 59.9 cases per 100,000 CHIRPP cases. The majority (86.5%) of cases were among children aged 4 years and younger. Poisonings (58.8%) and eye injuries (30.6%) were the most frequent primary diagnoses. Unintentional ingestion (56.9%) and squeezing/breaking a detergent packet (32.3%) were the most frequent exposure mechanisms. Sixty-five patients (7.2%) were admitted to hospital. The number of detergent packet-related cases per 100,000 CHIRPP cases increased by 5.0% (95% CI 0.8, 10.2) annually between 2012 and 2022. The number of detergent packet-related poisonings per 100,000 CHIRPP cases decreased by 15.3% (95% CI − 22.3, − 10.6) annually between 2015 and 2022, whereas eye injuries showed an average annual percent increase of 16.6% (95% CI 11.2, 23.0) between 2012 and 2022. The proportion of detergent packet-related cases in CHIRPP after the beginning of the pandemic (79.9/100,000 CHIRPP cases) was 1.43 (95% CI 1.20, 1.71) times greater than pre-pandemic (55.7/100,000 CHIRPP cases). Conclusions Detergent packet-related injuries and poisonings are a persisting issue. Continued surveillance and prevention efforts are needed to reduce detergent packet-related injuries and poisonings in Canada, particularly among children and youth.

BackgroundInjuries are among the leading causes for hospitalizations and emergency department (ED) visits. COVID-19 restrictions ensured safety to Canadians, but also negatively impacted health outcomes, including increasing rates of certain injuries. These differences in trends have been reported internationally however the evidence is scattered and needs to be better understood to identify opportunities for public education and to prepare for future outbreaks.ObjectiveA scoping review was conducted to synthesize evidence regarding the impact of COVID-19 restrictions on unintentional injuries in Canada, compared to other countries.MethodsStudies investigating unintentional injuries among all ages during COVID-19 from any country, published in English between December 2019 and July 2021, were included. Intentional injuries and/or previous pandemics were excluded. Four databases were searched (MEDLINE, Embase, Web of Science, SPORTDiscus), and a gray literature search was also conducted.ResultsThe search yielded 3,041 results, and 189 articles were selected for extraction. A total of 41 reports were included from the gray literature search. Final studies included research from: Europe (n = 85); North America (n = 44); Asia (n = 32); Oceania (n = 12); Africa (n = 8); South America (n = 4); and multi-country (n = 4). Most studies reported higher occurrence of injuries/trauma among males, and the average age across studies was 46 years. The following mechanisms of injury were reported on most frequently: motor vehicle collisions (MVCs; n = 134), falls (n = 104), sports/recreation (n = 65), non-motorized vehicle (n = 31), and occupational (n = 24). Injuries occurring at home (e.g., gardening, home improvement projects) increased, and injuries occurring at schools, workplaces, and public spaces decreased. Overall, decreases were observed in occupational injuries and those resulting from sport/recreation, pedestrian-related, and crush/trap incidents. Decreases were also seen in MVCs and burns, however the severity of injury from these causes increased during the pandemic period. Increases were observed in poisonings, non-motorized vehicle collisions, lacerations, drownings, trampoline injuries; and, foreign body ingestions.ImplicationsFindings from this review can inform interventions and policies to identify gaps in public education, promote safety within the home, and decrease the negative impact of future stay-at-home measures on unintentional injury among Canadians and populations worldwide.

Abstract Background Traumatic brain injury (TBI) is a major cause of morbidity and mortality globally. TBI is often associated with other physical or psychological issues resulting in high hospitalization costs. TBI incidence and recovery can vary with the external cause being intentional or unintentional. It is important to monitor the rates of TBI hospitalizations related to different external causes. This study examined the annual rate, comorbidity and length of stay associated with assault-related TBI hospitalizations and compare it with other external causes, by age and sex in Canada from 2010 to 2021. Methods Discharge Abstract Database was used to extract cases of TBI (2010–2021). ICD-10-CA codes were used to classify all cases with TBI as per assault and other external causes (falls; transport; sport, physical activity and recreation; struck by). Additional variables, including age, sex, comorbidity and length of stay, were examined. Time trends were quantified using Joinpoint regression. Results The average annual percent increase for all TBI hospitalizations from 2010 to 2021 was not significant at 0.1%. Females accounted for 35.8% of these TBI hospitalizations. From 2010 to 2021, assault-related TBI hospitalizations showed a significant annual decline of 4.1% for males and a significant increase of 1.2% for females. Increase in TBI hospitalizations related to falls showed an average annual percent increase of 1.4% for males and 2.2% for females. A significant decrease was observed for TBI hospitalizations related to the other three (transport, SPAR and struck by) external causes for both sexes from 2010 to 2021. Infants and children under 10 years of age had higher percentages of cases with comorbidities and higher length of stay for assault-related TBI hospitalizations. Conclusions Assault-related TBI hospitalization rates decreased overall and among males, rates among females increased from 2010 to 2021. These results underscore the importance of targeted prevention efforts for TBI related to different external causes, age and sex, and continued surveillance to monitor the epidemiology of assault-related TBI.

Abstract Background Eating disorders (EDs) are severe mental illnesses associated with significant morbidity and mortality. EDs are more prevalent among females and adolescents. Limited research has investigated Canadian trends of ED hospitalizations prior to the COVID-19 pandemic, however during the pandemic, rates of ED hospitalizations have increased. This study examined rates of ED hospitalizations among children and youth in Canada from 2010 to 2022, by sex, age, province/territory, length of stay, discharge disposition and ED diagnosis. Methods Cases of ED hospitalizations among children and youth, ages 5 to 17 years, were identified using available ICD-10 codes in the Discharge Abstract Database from the 2010/11 to 2022/23 fiscal years. The EDs examined in this study were anorexia nervosa (F50.0), atypical anorexia nervosa (F50.1), bulimia nervosa (F50.2), other EDs (F50.3, F50.8) and unspecified EDs (F50.9). Both cases of total and first-time ED hospitalizations were examined. Descriptive statistics and trend analyses were performed. Results Between 2010/11 and 2022/23, 18,740 children and youth were hospitalized for an ED, 65.9% of which were first-time hospitalizations. The most frequent diagnosis was anorexia nervosa (51.3%). Females had significantly higher rates of ED hospitalization compared to males (66.7/100,000 vs. 5.9/100,000). Youth had significantly higher rates compared to children. The average age of ED hospitalization was 14.7 years. Rates of ED hospitalizations were relatively stable pre-pandemic, however during the pandemic (2020–2021), rates increased. Interpretation Rates of pediatric ED hospitalizations in Canada increased significantly during the pandemic, suggesting that there may have been limited access to alternative care for EDs or that ED cases became more severe and required hospitalization. This emphasizes the need for continued surveillance to monitor how rates of ED hospitalizations evolve post-pandemic.

Abstract Background Opioid-related emergency department (ED) visits in Canada increased during the COVID-19 pandemic, but how trends in volume and case severity changed from pre-pandemic times through the pandemic is not known. Trends in ED visits related to specific types of opioids also remain unclear. Our objective was to describe pre-pandemic trends and how they changed with the onset of COVID-19 and thereafter. Methods Based on data from the Canadian Hospitals Injury Reporting and Prevention Program, we identified opioid-related ED visits and constructed a time series from March 12, 2018 through March 7, 2021—two pre-COVID periods and one COVID period. We used an interrupted time series (ITS) analysis to examine trends in volume and case severity. We compared medians and means of monthly counts and percentages of severe cases between the periods, by sex, age, and opioid type. Results Before the pandemic, there was an increasing trend in fentanyl-related visits for males, females and 25- to 64-year-olds, and a decreasing trend in heroin-related visits for males and 18- to 64-year-olds. Fentanyl-related visits for 18- to 24-year-olds showed an immediate increase at the start of the pandemic and a decreasing trend during the pandemic. Heroin-related visits for 12- to 17-year-olds had an immediate increase at the start of the pandemic; for 18- to 24-year-olds and 45- to 64-year-olds, the prior decreasing pre-pandemic trend ceased. For pooled opioid-related visits, no significant trend in the percentage of severe cases was observed throughout the entire study period. Conclusion This study shows that an ITS approach in trend analysis is a valuable supplement to comparisons of before and after measures (with or without controlling seasonal effects). The findings provide evidence on how ED presentations for opioid use evolved in Canada from 2018 to 2021. The results can inform policies designed to reduce opioid-related harm in the context of a public health emergency.

IntroductionLes blessures demeurent l’une des principales causes de décès et contribuent de manière significative aux hospitalisations chaque année au Canada. La consommation de substances a été associée à une augmentation des blessures intentionnelles et non intentionnelles, conduisant à des hospitalisations. Cette étude analyse les tendances concernant les hospitalisations pour blessures avec diagnostic concomitant de consommation de substances afin de quantifier le fardeau des blessures et de cerner les populations à risque. MéthodologieNous avons analysé les données de la Base de données sur les congés des patients entre 2010-2011 et 2020-2021 pour obtenir des renseignements cliniques et démographiques sur les congés d’hôpital au Canada. Nous avons utilisé les codes de la CIM-10 afin de repérer les hospitalisations pour blessures associées à un code de diagnostic concomitant de consommation de substances, en fonction de l’intentionnalité de la blessure et du type de substance. Nous avons calculé les taux, proportions, taux par âge et taux standardisés pour l’âge, nous avons quantifié les tendances au moyen de la variation annuelle moyenne en pourcentage et nous avons ventilé les résultats par sexe et par groupe d’âge. RésultatsEntre 2010-2011 et 2020-2021, les blessures non intentionnelles ont été en cause dans plus de la moitié des hospitalisations pour blessures associées à une consommation de substances. Les blessures associées à une consommation de substances ont été responsables de 12 % du nombre total d’hospitalisations pour blessures au cours de cette période. Dans l’ensemble, les hospitalisations pour blessures associées à une consommation concomitante de stimulants, d’opioïdes, de cannabinoïdes et d’alcool ont augmenté considérablement chez les hommes et chez les femmes. Les hospitalisations pour blessures non intentionnelles associées à une consommation de substances ont été plus fréquentes plus tard dans la vie, tandis que les hospitalisations pour blessures intentionnelles associées à une consommation de substances ont été plus fréquentes chez les adolescents et les jeunes adultes. ConclusionCes résultats font ressortir les principaux groupes démographiques affichant des taux élevés d’hospitalisations pour blessures associées à une consommation de substances qui bénéficieraient d’efforts de prévention ciblés.

IntroductionInjuries continue to be a leading cause of death and contribute significantly to hospitalizations each year in Canada. Substance use has been associated with an increase in intentional and unintentional injuries, resulting in hospitalizations. This study examines trends in injury hospitalizations with a co-occurring substance diagnosis, to quantify the burden of injuries and identify at risk populations. MethodsWe analyzed Discharge Abstract Database data between 2010/11 and 2020/21, for clinical and demographic information about hospital discharges across Canada. We used ICD-10 codes to identify injury hospitalizations with co-occurring substance diagnostic codes, by injury intent and substance type. Rates, proportions, age-specific rates and age-standardized rates were calculated, trends quantified using average annual percent change and results stratified by sex and age group. ResultsFrom 2010/11 to 2020/21, unintentional injuries accounted for over half of all substance-related injury hospitalizations. Substance-related injuries accounted for 12% of total injury hospitalizations over this period. Overall, substance-related injury hospitalizations with co-occurring use of stimulants, opioids, cannabinoids and alcohol increased significantly among males and females. Unintentional substance-related, injury hospitalizations were more common later in life, and intentional substancerelated injuries were more common among adolescents and young adults. ConclusionThese results highlight key demographic groups with higher rates of substance-related injury hospitalizations that would benefit from targeted prevention efforts.

This work provides an overview of injury patterns in Canadian children and youth aged 1 to 17 years. Self-reported data from the 2019 Canadian Health Survey on Children and Youth were used to calculate estimates for the percentage of Canadian children and youth who experienced a head injury or concussion, broken bone or fracture, or serious cut or puncture within the last 12 months, overall and by sex and age group. Head injuries and concussions (4.0%) were the most commonly reported, but the least likely to be seen by a medical professional. Injuries most frequently occurred while engaging in sports, physical activity or playing.

Cet article fournit un aperçu des profils de blessures subies par les enfants et les jeunes canadiens de 1 à 17 ans. Les données autodéclarées tirées de l’Enquête canadienne sur la santé des enfants et des jeunes (ECSEJ) de 2019 ont servi à calculer les estimations du pourcentage d’enfants et de jeunes canadiens qui ont subi un traumatisme crânien ou une commotion cérébrale, une fracture ou une fêlure ou encore une coupure ou une perforation grave au cours des 12 derniers mois, en général et selon le sexe et le groupe d’âge. Les traumatismes crâniens et les commotions cérébrales (4,0 %) sont les blessures les plus fréquemment déclarées, mais les moins susceptibles d’être évaluées par un professionnel de la santé. Les blessures ont lieu le plus souvent lors de la pratique d’un sport, d’une activité physique ou d’un jeu.

Abstract Background Firearms are a substantial cause of injury-related morbidity and mortality in Canada and globally, though evidence from contexts other than the USA is relatively limited. We examined deaths, hospitalizations and emergency department (ED) visits due to firearm-related injuries in Canada to identify population groups at increased risk of fatal and non-fatal outcomes. Methods We conducted a population-based study using three national administrative databases on deaths, hospitalizations, and ED visits. ICD-10 codes were used to identify firearm-related injuries from January 1, 2016, through December 31, 2020. Fatal and non-fatal firearm injuries were classified as suicide/self-harm, homicide/assault, unintentional, undetermined or legal intervention injuries. We analyzed the data with counts, rates and proportions, stratified by sex, age group, province/territory, and year. Results Over the 5-year period, we identified 4005 deaths, 3169 hospitalizations, and 2847 ED visits related to firearm injuries in various jurisdictions in Canada. Males comprised the majority of fatal and non-fatal injury cases. The highest rates of fatal and non-fatal firearm injuries were among 20- to 34-year-olds. The leading cause of fatal firearm injuries was self-harm (72.3%). For non-fatal firearm hospitalizations and ED visits, assault (48.8%) and unintentional injuries (62.8%) were the leading causes of injury. Rates varied by province and territory. Conclusions Our results showed that males comprised the majority of fatal and non-fatal firearm injuries in Canada. The rates of both fatal and non-fatal firearm injuries were highest among the 20- to 34-year-old age group. This comprehensive overview of the epidemiology of firearm injuries in Canada provides baseline data for ongoing surveillance and policy evaluation related to public health interventions.

Abstract Background Self-harm is a leading cause of morbidity and mortality globally, though the prevalence tends to be highest among adolescents. As an indicator in suicide surveillance, the incidence of self-harm is useful because it is sensitive to social, environmental, and economic conditions. During the COVID-19 pandemic, the epidemiology of self-harm has varied across contexts. This study aims to investigate the changes in self-harm emergency department visits in 2020 compared to a pre-pandemic period in 2018–2019. Methods Self-harm emergency department visits were extracted from the Canadian Hospitals Injury Reporting and Prevention Program database from 2018 to 2020. We compared the data in 2020 with the pre-pandemic baseline in 2018–2019. We examined the changes in volume, the percentages of self-harm cases among all intentional injuries by sex, age group, and the proportions of self-harm cases by method of injury. We also quantified the time trends of the percentages of self-harm cases among all intentional injuries using Joinpoint regression. Results The overall volume of emergency visits related to self-harm was higher in 2020 during weeks 24–51 compared to the average volumes for the same weeks of 2018–2019. Percentage of self-harm among all intentional injury emergency department visits was significantly higher by 6.1% among females (p

IntroductionThe use of motorized scooters is gaining popularity in Canada and elsewhere. This study aims to summarize characteristics of injuries related to use of motorized scooters using data from the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) and to analyze trends. The eCHIRPP collects information associated with the injury event and clinical information related to treatment (the injured body part, the nature of the injury, injury intent and treatment received) from 11 pediatric and 9 general hospitals across Canada. ResultsA free­text search using keywords identified 523 cases related to motorized scooter injuries between January 2012 and December 2019. Most of the injuries reported were among males (62.7%). Fracture/dislocation was the most frequent injury (36.9%),and 14.3% of all patients were admitted to hospital. Joinpoint regression showed a statistically significant increase in injuries related to motorized scooter use between 2012 and 2017 (annual percent change of 18.4%). ConclusionStudy findings indicate the need for continued preventive efforts and improved educational messages on safe riding and the importance of the use of protective equipment to prevent injuries among riders.

IntroductionL’utilisation des trottinettes motorisées gagne en popularité au Canada comme ailleurs. Cette étude vise à résumer les caractéristiques des traumatismes liés à l’utilisation des trottinettes motorisées selon les données de la plate-forme électroniquedu Syst ème canadien hospitalier d’information et de recherche en prévention des traumatismes (eSCHIRPT) et à en analyser les tendances. L’eSCHIRPT recueille des renseignements sur l’événement ayant entraîné le traumatisme et des données cliniques sur le traitement (la partie du corps touchée, la nature et l’intentionnalité du traumatisme ainsi que le traitement administré) auprès de 11 hôpitaux pédiatriques et de 9 hôpitaux généraux du Canada. RésultatsUne recherche en texte libre à l’aide de mots-clés a permis de relever 523 cas de traumatismes liés à l’utilisation d’une trottinette motorisée entre janvier 2012 et décembre 2019. La plupart des traumatismes signalés concernaient des hommes (62,7 %). Le traumatisme le plus fréquent était une fracture ou une luxation (36,9 %) et 14,3 % de l’ensemble des patients ont été admis à l’hôpital. Une régression Joinpoint a montré une augmentation statistiquement significative des traumatismes liés à l’utilisation d’une trottinette motorisée entre 2012 et 2017 (variation annuelle de 18,4 %). ConclusionLes résultats de notre étude indiquent qu’il faut poursuivre les efforts de prévention et améliorer les messages éducatifs sur la conduite sécuritaire et l’importance de l’utilisation d’un équipement de protection pour prévenir les traumatismes chez les utilisateurs.

IntroductionSi la consommation de cocaïne est à l’origine de nombreuses blessures et intoxications, seul un nombre limité d’études a porté sur les blessures liées à la cocaïne. Cette étude a permis d’analyser un large éventail de blessures et d’intoxications liées à la consommation de cocaïne seule et en combinaison avec d’autres substances au Canada,à l’aide des données de surveillance sentinelle saisies dans la plateforme électronique du Système canadien hospitalier d’information et de recherche en prévention des traumatismes (eSCHIRPT). MéthodologieNous avons extrait les dossiers correspondant aux blessures et aux intoxications liées à la consommation de cocaïne, seule ou en combinaison avec d’autres substances, saisis dans la base de données de l’eSCHIRPT entre janvier 2012 et décembre 2019 pour tous les groupes d’âge. Nous avons effectué des analyses descriptives afin d’obtenir la répartition des caractéristiques des patients et des blessures au sein des dossiers mentionnant des intoxications et des blessures liées à la consommation de cocaïne seule ou en combinaison avec d’autres substances. Nous avons réalisé des analyses statistiques afin de déterminer la proportion de blessures liées à la cocaïne pour 100 000 dossiers consignés dans l’eSCHIRPT. Nous avons évalué les tendances relatives aux blessures liées à la cocaïne en utilisant la variation annuelle en pourcentage (VAP). RésultatsDes blessures et des intoxications liées à la cocaïne ont été signalées dans 123 dossiers pour 100 000 dossiers consignés dans l’eSCHIRPT. Des 1 482 patients qui se sont présentés aux urgences des établissements participant au SCHIRPT en lien avec ce type de blessure ou d’intoxication, la majorité avaient consommé de la cocaïne en combinaison avec une ou plusieurs substances (80,0 %; n = 1 186) plutôt que de la cocaïne seule (20,0 %; n = 296). Sur l’ensemble des dossiers associés à la cocaïne, l’intoxication était le diagnostic le plus fréquent (62,7 %; n = 930) et la plupart des blessures et des intoxications étaient non intentionnelles (73,5 %; n = 1 090). Globalement, les déclarations d’incidents relatifs à la cocaïne ont connu une hausse dans l’eSCHIRPT pour tous les groupes d’âge (VAP [total] = 47,8 %, p < 0,05) au cours de la période à l’étude (2012­2019). ConclusionLa proportion plus importante de blessures et d’intoxications liées à la cocaïne chez les adolescents et les jeunes adultes ainsi que la consommation simultanée de cocaïne et d’autres substances révélées par notre étude témoignent de l’importance de procéder à une surveillance exhaustive des blessures et des intoxications liées à la cocaïne ainsi qu’à des interventions de santé publique fondées sur des données probantes

IntroductionConsumption of cocaine can lead to numerous injuries and poisoning. However, only a limited number of studies have explored cocaine-related injuries. This study examined a wide range of injuries and poisonings related to cocaine only and in combination with other substances in Canada using sentinel surveillance data captured by the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP). MethodsInjuries and poisonings related to the use of cocaine only or in combination with other substances were identified in the eCHIRPP database between January 2012 and December 2019 for all ages. Descriptive analyses were performed to investigate the distribution of demographic and injury characteristics in poisoning and injury records related to the use of cocaine only and in combination with other substances. Statistical analyses were conducted to find the proportion of cocaine-related injuries per 100000 eCHIRPP records. Cocaine-related injury trends were assessed using annual percent change (APC). ResultsCocaine-related injuries and poisonings were observed in 123 records per 100 000 eCHIRPP records. Of the 1482 patients who presented to emergency departments of CHIRPP sites with this type of injury or poisoning, the majority involved cocaine use in combination with one or more substances (80.0%; n = 1186), whereas cocaine-only use was the minority (20.0%; n = 296). Among all cocaine-related records, poisoning was the leading diagnosis (62.7%; n = 930) and most injuries and poisonings were unintentional (73.5%; n = 1090). Overall, the trend of cocaine-related eCHIRPP records for all age groups increased over the study period from 2012 to 2019 (APC [total] = 47.8%, p < 0.05). ConclusionOur findings of a higher proportion of cocaine-related injuries and poisonings among adolescents and young adults, as well as the co-consumption of cocaine with other substances, demonstrate the importance of extensive surveillance of cocainerelated injuries and poisonings and the implementation of evidence-based public health interventions.

Abstract Introduction Self-harm is a public health concern that can result in serious injury or death. This study provides an overview of emergency department (ED) visits for patients presenting with substance-related self-harm. Methods Cases of self-harm in the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) database were extracted (April 2011 to September 2019; N = 15,682), using various search strategies to identify substance-related self-harm cases for patients 10 years and older. Cases involving alcohol, cannabis, illicit drugs, or medications (or any combinations of these) were included. Additional variables, including age and sex, location and the severity of injury (hospital admission) were examined. Proportionate injury ratios (PIR) were used to compare emergency department outcomes of self-harm and unintentional injuries involving substance use. Time trends were quantified using Joinpoint regression. For cases requiring hospital admission, text fields were analyzed for contextual factors. Results A total of 9470 substance-related self-harm cases were reported (28.1% of all intentional injury cases), representing 820.0 records per 100,000 eCHIRPP records. While age patterns for both sexes were similar, the number of cases for females was significantly higher among 15-19 year olds. Over half (55%) of cases that identified substance type involved medications, followed by multi-type substance use (19.8%). In the ED, there were proportionally more treatments, observations, and admissions presenting with substance-related self-harm compared to substance-related unintentional injury cases. Among those aged 20+ years, a statistically significant increasing trend of 15.9% per year was observed, while among those aged 10-19 years a significant annual percent change of 16.9% was noted (2011 to 2019). Text field analysis demonstrated suicide attempt or ideation was a reoccurring theme among all age groups. Poor mental health status or conflict with family or an intimate partner were reported stressors, depending on age group. Additional self-harming injuries, such as cutting, were reported among all age groups. Conclusion Our study found that hospital admission for substance-related self-harm was highest for patients aged 15-19 years, especially females, and that they were more likely to use medications. The statistically significant increasing trend of cases found between 2011 and 2019 is notable. Patients showed multiple types of adversities, demonstrating the complexity of this issue.

IntroductionUnintentional falls are a leading cause of injury-related hospital visits among Canadians, especially seniors. While certain meteorological conditions are suspected risk factors for fall-related injuries, few studies have quantified these associations across a wider range of age groups and with population-based datasets. MethodsWe applied a time-stratified case-crossover study design to characterize associations of highly-spatially-resolved meteorological factors and emergency department (ED) visits for falls, in Ontario, among those aged 5 years and older during the winter months (November to March) between 2011 and 2015. Conditional logistic models were used to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs) for these visits in relation to daily snowfall accumulation, including single-day lags of up to one week before the visit, and daily mean temperature on the day of the visit. Analyses were stratified by age and sex. ResultsWe identified 761 853 fall-related ED visits. The odds for these visits was increased for most days up to a week after a snowfall of 0.2 cm or greater (OR = 1.05–1.08) compared to days with no snowfall. This association was strongest among adults aged 30 to 64 years (OR = 1.16–1.19). The OR for fall-related ED visits on cold days (less than −9.4 °C) was reduced by 0.05 relative to days with an average daily temperature of 3.0 °C or higher (OR = 0.95; 95% CI: 0.94, 0.96), and this pattern was evident across all ages. There were no substantive differences in the strength of this association by sex. ConclusionSnowfall and warmer winter temperatures were associated with an increased risk of fall-related ED visits during Ontario winters. These findings are relevant for developing falls prevention strategies and ensuring timely treatment.

IntroductionLes chutes accidentelles sont l’une des principales causes de visites à l’hôpital liées à des blessures chez les Canadiens, en particulier chez les personnes âgées. Bien qu’on soupçonne certaines conditions météorologiques d’être des facteurs de risque des blessures liées aux chutes, peu d’études ont quantifié ces associations auprès d’un large éventail de groupes d’âge et en utilisant des bases de données populationnelles. MéthodologieNous avons appliqué une méthode d’étude de type cas-croisé stratifié en fonction du temps pour caractériser les associations entre les facteurs météorologiques à haute résolution spatiale et les visites aux services d’urgence en raison de chutes en Ontario, chez les personnes âgées de cinq ans et plus, pendant les mois d’hiver (novembre à mars) pour 2011 à 2015. Des modèles logistiques conditionnels ont été utilisés pour estimer les rapports de cotes (RC) avec intervalles de confiance (IC) à 95 % associés à ces visites en fonction de l’accumulation quotidienne de neige (intégrant les écarts variant entre une journée et une semaine avant la visite) et de la température quotidienne moyenne le jour de la visite. Les analyses ont été stratifiées par âge et par sexe. RésultatsNous avons recensé 761 853 visites aux services d’urgence liées à une chute. La probabilité de survenue de ces visites augmente pour la plupart des jours jusqu’à une semaine après une chute de neige de 0,2 cm ou plus (RC = 1,05 à 1,08) par rapport aux jours sans chute de neige. Cette association s’est révélée la plus forte chez les adultes de 30 à 64 ans (RC = 1,16 à 1,19). Le RC des visites aux services d’urgence liées à une chute lors de journées froides (moins de −9,4°C) a été réduit de 0,05 par rapport aux jours où la température quotidienne moyenne était de 3,0°C ou plus (RC = 0,95; IC à 95 % : 0,94 à 0,96), et cette tendance était valide pour tous les âges. Aucune différence notable dans la force de cette association selon le sexe n’a été relevée. ConclusionLes chutes de neige et les températures hivernales plus chaudes sont associées à un risque accru de visites aux services d’urgence liées à une chute pendant les hivers ontariens. Ces conclusions peuvent servir à élaborer les stratégies de prévention des chutes et à s’assurer d’un traitement rapide.

IntroductionOver the last decade, e-cigarette use has been on the rise but with growing health concerns. The objective of this systematic review was to update findings for chronic health outcomes associated with e-cigarette use from the 2018 National Academies of Sciences, Engineering, and Medicine (NASEM) report.MethodsThree bibliographic databases were searched to identify studies comparing the chronic health effects of e-cigarette users (ECU) to non-smokers (NS), smokers, and/or dual users indexed between 31 August 2017 and 29 January 2021. Two independent reviewers screened abstracts and full texts. Data were extracted by one reviewer and verified by a second one. Outcomes were synthesized in a narrative manner using counts and based on statistical significance and direction of the association stratified by study design and exposure type. Risk of bias and certainty of evidence was assessed. The protocol was prospectively registered on Open Science Framework https://osf.io/u9btp.ResultsA total of 180 articles were eligible. This review focused on 93 studies for the 11 most frequently reported outcomes and from which 59 reported on daily e-cigarette use. The certainty of evidence for all outcomes was very low because of study design (84% cross-sectional) and exposure type (27% reported on exclusive ECU, i.e., never smoked traditional cigarettes). Overall, the summary of results for nearly all outcomes, including inflammation, immune response, periodontal and peri-implant clinical parameters, lung function, respiratory symptoms, and cardiovascular disease, suggested either non-significant or mixed results when daily ECU was compared to NS. This was also observed when comparing exclusive ECU to NS. The only notable exception was related to oral health where most (11/14) studies reported significantly higher inflammation among daily ECU vs. NS. Compared to the smokers, the exclusive-ECUs had no statistically significant differences in inflammation orperiodontal clinical parameters but had mixed findings for peri-implant clinical parameters.ConclusionsThis review provides an update to the 2018 NASEM report on chronic health effects of e-cigarette use. While the number of studies has grown, the certainty of evidence remains very low largely because of cross-sectional designs and lack of reporting on exclusive e-cigarette exposure. There remains a need for higher quality intervention and prospective studies to assess causality, with a focus on exclusive e-cigarette use.

Introduction: The overall objective of this study was to demonstrate how information collected by the Consumer Product Safety Program (“the Program”) can be used to identify emerging hazards. Specifically, this study characterized and quantified trends associated with vaping reports received by the Program over the past five years. Methods: Data collated by the Program were extracted for the period from 1 January, 2015 to 30 September, 2019. The data were summarized using descriptive statistics and trends were quantified for annual percent change. In order to compare characteristics of vaping reports, the proportionate injury ratios (PIRs) and corresponding 95% CIs were used to compare vaping-related injuries to all other reports received by the Program. Results: A total of 71 vaping-related reports were received between 1 January, 2015 and 30 September, 2019. During this period, the annual percent change increase in the number of reports received was approximately 73% annually (p < .05). Among the reported injuries, 41% were burn injuries. Proportionally, there were more vaping reports involving males (PIR = 1.89; 95% CI: 1.51–2.36) and individuals between the ages of 15 and 19 years (PIR = 11.53; 95 % CI: 4.95–26.8) as compared to all other reports submitted to the Program. Conclusion: While the number of reports relating to vaping products is small, the results of this analysis suggest that certain groups, including males and youth, are more likely to be the subject of a vaping-related incident.

We examined trends in emergency department (ED) presentation rates for acetaminophenrelated poisonings across Canada. A total of 27123 cases of poisoning were seen in the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) sentinel sites between April 2011 and February 2019; of these, 13.7% were related to acetaminophen use. A significant decreasing trend for both sexes was observed for unintentional poisonings (males: −10.3%; females: −8.0%). For intentional poisonings, there was a significant decrease among females only (−5.9%). Females have consistently displayed higher rates of ED presentations for both unintentional and intentional poisoning.

Information from emergency department (ED) visits for methamphetamine-related injuries and poisonings between 1 April 2011 and 9 August 2019 were captured from 19 sentinel sites across Canada for all ages. Overall, 1093 cases (97.6/100 000 eCHIRPP cases) were identified (59.4% male), with female patients experiencing more poisonings (71% vs 57.4% for males). Unintentional injuries and poisoning accounted for 14.8% of ED presentations. Self-harm (while or as a result of consuming methamphetamine) accounted for 11.4% of cases. The circumstances surrounding injuries and poisonings associated with methamphetamine are varied and include self-harm, fall-related brain injuries, mental illness, criminal activity and other circumstances. These domains should be taken into account when developing mitigation strategies.

Introduction: L’objectif général de cette étude était de montrer comment utiliser les renseignements recueillis dans le cadre du Programme de la sécurité des produits de consommation (le Programme) pour identifier certains dangers émergents. Plus spécifiquement, il s’agissait de caractériser et de quantifier les tendances en matière de vapotage en utilisant les rapports d’incident reçus au cours des cinq dernières années dans le cadre du Programme. Méthodologie: Les données recueillies dans le cadre du Programme ont été extraites pour la période du 1er janvier 2015 au 30 septembre 2019. Nous avons synthétisé les données sous forme de statistiques descriptives et nous avons quantifié les tendances en utilisant la variation annuelle en pourcentage. Dans le but d’établir des comparaisons reposant sur les caractéristiques des rapports d’incident lié au vapotage, nous avons utilisé les rapports proportionnels de blessures (RPB) et les intervalles de confiance (IC) à 95 % correspondants, ce qui permet de comparer les blessures liées au vapotage à l’ensemble des blessures signalées dans le cadre du Programme. Résultats: Au total, 71 rapports d’incident lié au vapotage ont été reçus dans le cadre du Programme entre le 1er janvier 2015 et le 30 septembre 2019. Au cours de cette période, la hausse de la variation annuelle en pourcentage quant au nombre de rapports d’incident reçus s’est établi à environ 73 % annuellement (p $lt; 0,05). Parmi les blessures signalées, 41 % étaient des brûlures. Le nombre de rapports d’incident touchant les hommes (RPB = 1,89; IC à 95 % : 1,51 à 2,36) et les 15 à19 ans (RPB = 11,53; IC à 95 % : 4,95 à 26,8) en lien avec le vapotage était, en proportion, supérieur à celui de l’ensemble des autres signalements dans le cadre du Programme. Conclusion: Bien que le nombre de rapports d’incident lié aux produits de vapotage soit faible, les résultats de notre analyse laisse penser que ces incidents sont davantage susceptibles de survenir au sein de certains groupes, en particulier chez les hommes et chez les jeunes.

Nous avons examiné les tendances dans les taux de consultation aux services des urgences pour une intoxication liée à l’acétaminophène au Canada. Au total, nous avons relevé 27 123 cas d’intoxication dans les sites sentinelles de la base de données électronique du Système canadien hospitalier d’information et de recherche en prévention des traumatismes (eSCHIRPT) entre avril 2011 et février 2019, dont 13,7 % étaient liés à l’utilisation d’acétaminophène. Nous avons observé une tendance décroissante significative des taux au sein de l’ensemble des intoxications involontaires (hommes : −10,3 %; femmes : −8,0 %). Pour les intoxications intentionnelles, une diminution significative a eu lieu chez les femmes (−5,9 %) uniquement. Les femmes ont toujours eu des taux plus élevés de consultation à un service des urgences pour des intoxications, tant involontaires qu’intentionnelles.

Des données sur les consultations à un service des urgences pour des blessures et des intoxications liées à la méthamphétamine entre le 1er avril 2011 et le 9 août 2019 ont été saisies dans 19 sites sentinelles au Canada pour des patients de tous âges. On a recensé au total 1093 cas (97,6/100000 cas de l’eSCHIRPT) (dont 59,4 % de patients de sexe masculin). La proportion d’intoxications était plus élevée chez les femmes que chez les hommes (71 % contre 57,4 %). Les blessures et les intoxications accidentelles étaient en cause dans 14,8 % des consultations à un service des urgences. Les blessures auto­infligées (durant ou à la suite de la consommation de méthamphétamine) étaient à l’origine de 11,4 % des cas. Les circonstances des blessures et les intoxications associées à la méthamphétamine étaient variées : blessures auto­infligées, traumatismes cérébraux liés aux chutes, maladies mentales, activités criminelles et diverses autres situations. Ces facteurs devraient être pris en compte dans la préparation des stratégies de réduction des méfaits.

La cigarette électronique est un dispositif qui, lorsque le liquide à vapoter qu’il contient est chauffé, relâche de la nicotine dans l’organisme de l’utilisateur. Au Canada, la Loi sur le tabac et les produits de vapotage a été adoptée le 23 mai 2018. L’étude dont on rend compte dans cet article avait pour but de décrire les cas de traumatismes et d’intoxications associés à la cigarette électronique et aux substances de vapotage des personnes qui se sont présentées dans un service des urgences du Canada entre 2011 et 2019, cas enregistrés dans la base de données électronique du Système canadien hospitalier d’information et de recherche en prévention des traumatismes (eSCHIRPT). On a extrait au total 68 cas (dont 54,4 % de sexe masculin). Parmi eux, 8 pour la période 2011 à 2014 et 35 (51,5 %) en 2018 et 2019. On a relevé des ingestions, des inhalations et des brûlures.

Electronic cigarettes are devices that deliver nicotine to the user by heating an e-liquid. In Canada, the Tobacco and Vaping Products Act became law on May 23, 2018. The purpose of this study was to describe the cases of injuries and poisonings associated with e-cigarette and vaping substances that presented to Canadian emergency departments within the electronic Canadian Hospitals Injury Reporting and Prevention Program network between 2011 and 2019. A total of 68 cases were retrieved (54.4% males). Of the 68 cases, 8 occurred between 2011 and 2014, while 35 (51.5%) occurred in 2018 or 2019. Ingestions, inhalations and burns were observed.