School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
Department of Political, Historical and Cultural Studies, Karlstad University, Karlstad, Sweden.
Inj Prev. 2023 Oct;29(5):378-383. doi: 10.1136/ip-2022-044808. Epub 2023 May 22.
Fall injuries caused by icy road conditions are a prevalent public health problem during winters in Sweden, especially in older populations. To combat this problem, many Swedish municipalities have distributed ice cleats to older adults. While previous research has shown promising results, there is a lack of comprehensive empirical data on the effectiveness of ice cleat distribution. We address this gap by investigating the impact of these distribution programmes on ice-related fall injuries among older adults.
We combined survey data on ice cleat distribution in Swedish municipalities with injury data from the Swedish National Patient Register (NPR). The survey was used to identify municipalities that have distributed ice cleats to older adults at some point between 2001 and 2019. Data from NPR were used to identify municipality-level data on patients who have been treated for injuries related to snow and ice. We used a triple differences design-a generalisation of difference in differences-that compared ice-related fall injury rates before and after intervention in 73 treatment and 200 control municipalities, with unexposed age groups serving as within-municipality controls.
We estimate that the average ice cleat distribution programmes reduced ice-related fall injury rates by -0.24 (95% CI -0.49 to 0.02) per 1000 person-winters. The impact estimate was larger in municipalities that distributed more ice cleats (-0.38 (95% CI -0.76 to -0.09)). No similar patterns were found for fall injuries unrelated to snow and ice.
Our results suggest that ice cleat distribution can decrease the incidence of ice-related injuries among older adults.
在瑞典的冬季，由于道路结冰导致的跌倒伤害是一个普遍存在的公共卫生问题，尤其是在老年人中。为了解决这个问题，许多瑞典市政当局向老年人发放了防滑钉。虽然之前的研究已经显示出了有希望的结果，但关于防滑钉分发的有效性缺乏全面的经验数据。我们通过调查这些分发计划对老年人与冰有关的跌倒伤害的影响来解决这一差距。
我们将瑞典市政当局发放防滑钉的调查数据与瑞典国家患者登记处（NPR）的伤害数据相结合。该调查用于确定在 2001 年至 2019 年间的某个时候向老年人发放过防滑钉的市政当局。来自 NPR 的数据用于确定与雪和冰有关的伤害治疗的市政当局层面的数据。我们使用三重差分设计——差异的广义化——比较了 73 个治疗和 200 个对照市政当局在干预前后与冰有关的跌倒伤害率，未暴露的年龄组作为市政当局内部的对照。
我们估计，平均防滑钉分发计划使与冰有关的跌倒伤害率降低了每 1000 人-冬季 -0.24（95%置信区间 -0.49 至 0.02）。在发放更多防滑钉的市政当局中，估计的影响更大（-0.38（95%置信区间 -0.76 至 -0.09））。对于与雪和冰无关的跌倒伤害，没有发现类似的模式。
我们的研究结果表明，防滑钉分发可以降低老年人中与冰有关的伤害发生率。
