Outdoor falls in an urban context: winter weather impacts and geographical variations

Objectives: Environmental factors associated with winter outdoor falls are poorly understood. This study describes the demographic, spatial and temporal distribution of outdoor falls that occurred in Laval and Montreal Island (Canada) in relation to meteorological conditions. Method: Data on falls, including geographic coordinates, were obtained from ambulance services (December 1, 2008 to January 31, 2009). Meteorological (temperature, precipitation levels) and land use data were used for descriptive analysis and mapping. Results: During the study period, 3,270 falls required ambulance interventions, of which 960 occurred outdoors. Most people injured outdoors were under 65 years of age (59%). Mapping showed a concentration of outdoor falls in central neighbourhoods and on commercial streets in Montreal. Three episodes of excess falls, representing 47% of all outdoor falls, were preceded by rain and followed by falling temperatures, or were concomitant with freezing rain. Conclusion: Our results demonstrate for the first time the distribution of outdoor falls in a densely populated urban setting with a northern climate. To promote active transportation, it is essential to take into account the safety of pedestrian travel. Snow removal and de-icing operations in municipalities should prioritize areas with high pedestrian activity. Key words: Accidental falls; injuries; weather; rain; walking La traduction du resume se trouve a la fin de l'article. Objectifs : Les facteurs environnementaux lies aux chutes exterieures en hiver sont meconnus. Cette etude decrit l'ampleur et la localisation des chutes exterieures survenues a Montreal et a Laval (Canada), ainsi que les conditions meteorologiques associees. Methodologie : Les caracteristiques des chutes exterieures, incluant la localisation geographique, proviennent des interventions ambulancieres (1er decembre 2008 au 31 janvier 2009). L'analyse descriptive inclut les donnees meteorologiques (temperature, precipitations) et l'occupation du territoire. Resultats : En deux mois, 3 270 chutes ont necessite une intervention ambulanciere, dont 960 chutes exterieures. La majorite (59 %) des personnes blessees a l'exterieur ont moins de 65 ans. La cartographie montre une concentration des chutes exterieures dans les quartiers centraux montrealais et sur les rues commerciales. Trois episodes d'exces de chutes, qui representent 47 % des chutes exterieures, sont associees a la pluie suivie d'un refroidissement ou au verglas. Conclusion : Ces resultats demontrent l'etendue et la localisation du probleme des chutes exterieures dans un milieu urbain densement peuple, soumis au climat nordique. La promotion des transports actifs implique une prise en compte de la securite des deplacements a pied. Dans les municipalites, les operations de deneigement et d'epandage d'abrasif devraient prioriser les zones de forte affluence pietonne. Mots cles : chutes; blessures; climat; marche
Falls account for approximately 2,300 deaths and 110,170 hospitalizations each year in Canada. (1) Several studies show seasonal variations in rates of falls and fractures of the hip (2-6) and [...]