title: Snow shovel-related injuries and medical emergencies treated in US EDs, 1990 to 2006.
abstract: BACKGROUND
  Injuries and medical emergencies associated with snow shovel use are common in the United States.
  
  
  METHODS
  This is a retrospective analysis of data from the National Electronic Injury Surveillance System. This study analyzes the epidemiologic features of snow shovel-related injuries and medical emergencies treated in US emergency departments (EDs) from 1990 to 2006.
  
  
  RESULTS
  An estimated 195 100 individuals (95% confidence interval, 140 400-249 800) were treated in US EDs for snow shovel-related incidents during the 17-year study period, averaging 11 500 individuals annually (SD, 5300). The average annual rate of snow shovel-related injuries and medical emergencies was 4.15 per 100 000 population. Approximately two thirds (67.5%) of these incidents occurred among males. Children younger than 18 years comprised 15.3% of the cases, whereas older adults (55 years and older) accounted for 21.8%. The most common diagnosis was soft tissue injury (54.7%). Injuries to the lower back accounted for 34.3% of the cases. The most common mechanism of injury/nature of medical emergency was acute musculoskeletal exertion (53.9%) followed by slips and falls (20.0%) and being struck by a snow shovel (15.0%). Cardiac-related ED visits accounted for 6.7% of the cases, including all of the 1647 deaths in the study. Patients required hospitalization in 5.8% of the cases. Most snow shovel-related incidents (95.6%) occurred in and around the home.
  
  
  CONCLUSIONS
  This is the first study to comprehensively examine snow shovel-related injuries and medical emergencies in the United States using a nationally representative sample. There are an estimated 11 500 snow shovel-related injuries and medical emergencies treated annually in US EDs.
authors.affiliation: Center for Injury Research and Policy, Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Watson
authors.forename: Brenda J
authors.initials: BJ
authors.lastname: Shields
authors.forename: Gary A
authors.initials: GA
authors.lastname: Smith
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019567:Back Injuries / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004630:Emergencies / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D022125:Lacerations / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D012189:Retrospective Studies; D012914:Snow; D017695:Soft Tissue Injuries / Q000453:epidemiology / Q000209:etiology; D013898:Thoracic Injuries / Q000453:epidemiology / Q000209:etiology; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult