Examining the effect of the injury definition on risk factor analysis in circus artists.
A secondary data analysis of a prospective cohort study was conducted to explore how different definitions of injury affect the results of risk factor analyses. Modern circus artists (n=1281) were followed for 828,547 performances over a period of 49 months (2004-2008). A univariate risk factor analysis (age, sex, nationality, artist role) estimating incidence rate ratios (IRR) with 95% confidence intervals (95% CI) was conducted using three injury definitions: (1) medical attention injuries, (2) time-loss injuries resulting in ≥1 missed performances (TL-1) and (3) time-loss injuries resulting in >15 missed performances (TL-15). Results of the risk factor analysis were dependent on the injury definition. Sex (females to male; IRR=1.13, 95% CI; 1.02-1.25) and age over 30 (<20 years to >30 years; IRR=1.37, 95% CI; 1.07-1.79) were risk factors for medical attention injuries only. Risk of injury for Europeans compared with North Americans was higher for TL-1 and TL-15 injuries compared with medical attention injuries. Finally, non-sudden load artists (low-impact acts) were less likely than sudden load artists (high-impact acts) to have TL-1 injuries, but the risk of medical attention injuries was similar. The choice of injury definition can have effects on the magnitude and direction of risk factor analyses.
Roger Jackson Centre for Health and Wellness Research, Faculty of Kinesiology, University of Calgary Sport Medicine Centre, Calgary, Alberta, Canada.
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Hamilton
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Meeuwisse
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Emery
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Shrier
D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000328:Adult; D001154:Art; D002170:Canada / Q000453:epidemiology; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D016012:Poisson Distribution; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014947:Wounds and Injuries / Q000145:classification* / Q000453:epidemiology*