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. 2017 Jul/Aug;132(1_suppl):53S-58S.
doi: 10.1177/0033354917706968.

Risk of Fall-Related Injury due to Adverse Weather Events, Philadelphia, Pennsylvania, 2006-2011

Kathryn Gevitz  1 , Robbie Madera  1 , Claire Newbern  1 , José Lojo  1 , Caroline C Johnson  1
Affiliations

Risk of Fall-Related Injury due to Adverse Weather Events, Philadelphia, Pennsylvania, 2006-2011

Kathryn Gevitz et al. Public Health Rep. 2017 Jul/Aug.

Abstract

Objectives: Following a surge in fall-related visits to local hospital emergency departments (EDs) after a severe ice storm, the Philadelphia Department of Public Health examined the association between inclement winter weather events and fall-related ED visits during a 5-year period.

Methods: Using a standardized set of keywords, we identified fall-related injuries in ED chief complaint logs submitted as part of Philadelphia Department of Public Health's syndromic surveillance from December 2006 through March 2011. We compared days when falls exceeded the winter fall threshold (ie, "high-fall days") with control days within the same winter season. We then conducted matched case-control analysis to identify weather and patient characteristics related to increased fall-related ED visits.

Results: Fifteen high-fall days occurred during winter months in the 5-year period. In multivariable analysis, 18- to 64-year-olds were twice as likely to receive ED care for fall-related injuries on high-fall days than on control days. The crude odds of ED visits occurring from 7:00 am to 10:59 am were 70% higher on high-fall days vs control days. Snow was a predictor of a high-fall day: the adjusted odds of snow before a high-fall day as compared with snow before a control day was 13.4.

Conclusions: The association between the number of fall-related ED visits and weather-related fall injuries, age, and timing suggests that many events occurred en route to work in the morning. Promoting work closures or delaying openings after severe winter weather would allow time for better snow or ice removal, and including "fall risk" in winter weather advisories might effectively warn morning commuters. Both strategies could help reduce the number of weather-related fall injuries.

Keywords: falls; syndromic surveillance; weather.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Fall-related emergency department (ED) visits identified through syndromic surveillance of 21 hospitals, Philadelphia, Pennsylvania, 2006-2011. The fall-related ED visit threshold for winter (n = 189) that was used to identify high-fall dates was calculated as the median number of fall-related visits per day during winter months (December through March) plus 3 SDs. Unpublished patient registration data came from 21 hospital EDs throughout the Philadelphia area, collected as part of routine public health syndromic surveillance.
Figure 2.
Figure 2.
a, Geographic distribution of patient home ZIP codes for fall-related emergency department (ED) visits after a winter weather event during winter months (December through March), Philadelphia, Pennsylvania, 2006-2011. Unpublished patient registration data came from 21 hospital EDs throughout the Philadelphia area, collected as part of routine public health syndromic surveillance. b, Geographic distribution of patient home ZIP codes for fall-related ED visits not associated with winter weather events (control days) during winter months (December through March), Philadelphia, Pennsylvania, 2006-2011. Unpublished patient registration data came from 21 hospital EDs throughout the Philadelphia area, collected as part of routine public health syndromic surveillance.
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References

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