title: Incidences, types, and influencing factors of snow disaster-associated injuries in Ningbo, China, 2008.
abstract: OBJECTIVE
  The incidence, types, and influencing factors of injuries due to snow-ice disasters are essential for public health preparedness. This study was designed to assess such factors of injuries during the 22-day snowstorm in Ningbo, Zhejiang Province, China, in 2008.
  
  
  METHODS
  A multistage cluster probability sampling method was applied to select the study population in urban, rural, and mountainous areas. Data including sociodemographic characteristics, frequency, and types of injuries during the snowstorm between January 20 and February 10, 2008, were obtained by face-to-face interviews using a structured questionnaire and by checking the participants' medical records. Univariate and multivariate regression analyses were used to determine the factors significantly associated with the risk of injuries.
  
  
  RESULTS
  A total of 3169 residents of 1416 families took part in this survey. In 581 residents, 602 injuries were identified. Incidences of frostbite, falling injury, and traffic accident-related injury were 12.78%, 5.30%, and 0.50%, respectively. Injury occurred more frequently in women than in men (odds ratio [OR], 1.42; 95% CI, 1.19-1.70). Frostbite occurred more frequently in women than in men (adjusted OR, 1.86; 95% CI, 1.43-2.41) and more frequently in urban areas than in other areas (adjusted OR, 1.65; 95% CI, 1.24-2.20). Travel by bus or car, wearing a scarf, wearing gloves, wearing a raincoat, reducing outdoor activity, and performing regular physical exercise were independent protective factors of frostbite, with an adjusted OR (95% CI) of 0.35 (0.20-0.61), 0.45 (0.33-0.62), 0.35 (0.26-0.48), 0.45 (0.33-0.61), 0.36 (0.27-0.48), and 0.18 (0.13-0.24), respectively. Falling injury occurred more often in mountainous areas than in other areas (adjusted OR, 1.74; 95% CI, 1.27-2.42). Age 45 years or older, working outside more than 15 days, and wearing a raincoat were independent risk factors of falling injury, with an adjusted OR (95% CI) of 2.30 (1.60-3.32), 1.92 (1.36-2.72), and 2.21 (1.56-3.11), respectively. Falling and traffic accident-related injuries were mainly due to slippery roads.
  
  
  CONCLUSIONS
  Frostbite and falling injury were the major injuries caused by an unprecedented snow-ice disaster. Keeping warm and maintaining regular physical exercise appeared to reduce frostbite risk. Public health intervention also reduced the risk of falling and traffic accident-related injuries.
authors.affiliation: Municipal Center for Disease Prevention and Control of Ningbo City, Ningbo, China.
authors.forename: Guozhang
authors.initials: G
authors.lastname: Xu
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Ying
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.forename: Wenjun
authors.initials: W
authors.lastname: Chang
authors.forename: Hongxia
authors.initials: H
authors.lastname: Ni
authors.forename: Yinchao
authors.initials: Y
authors.lastname: Zhu
authors.forename: Rong
authors.initials: R
authors.lastname: Xu
authors.forename: Hongjun
authors.initials: H
authors.lastname: Dong
authors.forename: Nanfeng
authors.initials: N
authors.lastname: Shi
authors.forename: Xu
authors.initials: X
authors.lastname: Ma
authors.forename: Lairong
authors.initials: L
authors.lastname: Xu
authors.forename: Yibiao
authors.initials: Y
authors.lastname: Cai
authors.forename: Jianming
authors.initials: J
authors.lastname: Ping
authors.forename: Yifang
authors.initials: Y
authors.lastname: Han
authors.forename: Guangwen
authors.initials: G
authors.lastname: Cao
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D016000:Cluster Analysis; D003625:Data Collection; D005260:Female; D005627:Frostbite / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D011634:Public Health; D012044:Regression Analysis; D012307:Risk Factors; D017678:Sex Distribution; D012914:Snow; D014947:Wounds and Injuries / Q000453:epidemiology*