Directory

Richard Franklin | James Cook University - Academia.edu

Skip to main content

Richard Franklin

James Cook University, School of Public health, Tropical Medicine and Rehabilitation Sciences, Faculty Member

Followers

97

Following

37

Co-authors

29

Mentions

131

Public Views

Dr Richard Franklin PhD, MSocSc, BSc, FPHAA, FARL is a Professor of Public Health (Injury Prevention and Safety Promotion) in the College of Public Health, Medical and Veterinary Sciences at James Cook University and Senior Research Fellow with the Royal Life Saving Society - Australia. He has worked in Public Health with a focus on the area of Injury Prevention and Safety Promotion since 1996. He has worked on and published in the areas of general injury prevention, farm safety, rural safety, workplace health and safety, health systems strengthening, health promotion, fall prevention, quad bike safety, alcohol, disasters and aquatic safety. He has a PhD from the University of Sydney using epidemiological approaches to explore trauma due to farming and possible prevention strategies, a Master of Social Science (Health), his thesis explored pre-hospital coronary care and Bachelor of Science from the University of Queensland with a major in psychology. He has previously worked for the Queensland Ambulance Service (QAS), the Australian Centre for Agricultural Health and Safety (a centre of the School of Public Health, University of Sydney) and the Royal Life Saving Society – Australia where the main role of his employment was to translate evidence into practice specifically aimed at preventing rural, farm, road, aquatic, child and older people related injuries.
Address: Australia

less

Vrije Universiteit Amsterdam

Kansas State University

Monash University

École Normale Supérieure de Lyon

Lund University

University of Oxford

University of Technology Sydney

Shamsudin Dr. Mohd Zubairy

International Islamic University Malaysia

Dragos Simandan

Brock University

InterestsView All (6)

Uploads

Papers by Richard Franklin

Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: analysis for the Global Burden of Disease Study 2017

by Tamene Haile and Richard Franklin

The Lancet, 2020

(2020). Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-... more

Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

by Tamene Haile and Richard Franklin

The Lancet, 2018

Background Efforts to establish the 2015 baseline and monitor early implementation of the UN Sust... more Background Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of "leaving no one behind", it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990-2017, projected indicators to 2030, and analysed global attainment. Methods We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the healthrelated SDG index, we transformed the value for each indicator on a scale of 0-100, with 0 as the 2•5th percentile and 100 as the 97•5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings The global median health-related SDG index in 2017 was 59•4 (IQR 35•4-67•3), ranging from a low of 11•6 (95% uncertainty interval 9•6-14•0) to a high of 84•9 (83•1-86•7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030.

Hypoxic Blackout: Diagnosis, Risks, and Prevention

International journal of aquatic research and education, Aug 1, 2015

Royal Life Saving Society-Australia Hypoxic blackout, also called underwater blackout syndrome, i... more Royal Life Saving Society-Australia Hypoxic blackout, also called underwater blackout syndrome, is a distinct and preventable cause of drowning. The sudden and unexpected death of a young, fit swimmer or diver, almost always male, necessitates the consideration of a differential diagnosis which includes four syndromes-preexistent cardiac disease, electrical conduction abnormalities, epilepsy, and hypoxic blackout. The pathophysiology of hypoxic blackout (overriding the carbon dioxide sensor by presubmersion hyperventilation) may be induced by autonomic conflict between cold shock diving reflexes in certain predisposed individuals. Death occurs in both public and private swimming pools and in the sea, and case series include those training for underwater hockey, synchronized swimming, free diving, and playful submersion endurance challenges. The sole preventive stratagem is advocacy for awareness of risks, suitably targeted to "at risk" groups.

A Systematic Review of Large Agriculture Vehicles Use and Crash Incidents on Public Roads

Journal of Agromedicine, Mar 30, 2019

Supplementary Table 2. Review of size of the problem: Number of reported incidents, injuries and/... more Supplementary Table 2. Review of size of the problem: Number of reported incidents, injuries and/or fatalities due to crashes involving large agricultural vehicles outlined in the literature Road Information (Reference) Time Period Number of Incidents Number of Injuries (and severity) Number of Fatalities Denominator Rate/ Proportion Public roads 46 1995-1999 Farm vehicle crashes represent less than 1% of total public road crashes per year Av. 300 per year

Heatwaves and mortality in Queensland 2010–2019: implications for a homogenous state-wide approach

International Journal of Biometeorology, Feb 3, 2023

Heatwaves are a significant cause of adverse health outcomes and mortality in Australia, worsenin... more Heatwaves are a significant cause of adverse health outcomes and mortality in Australia, worsening with climate change. In Queensland, the northeastern-most state, little is known about the impact of heatwaves outside of the capital city of Brisbane. This study aims to explore the impact of heatwaves on mortality across various demographic and environmental conditions within Queensland from 2010 to 2019. The Excess Heat Factor was used to indicate heatwave periods at the Statistical Area 2 (SA2) level. Registered deaths data from the Australian Bureau of Statistics and heatwave data from the Bureau of Meteorology were matched using a case-crossover approach. Relative risk and 95% confidence intervals were calculated across years, regions, age, sex, rurality, socioeconomic status, and cause of death. Heatwaves were associated with a 5% increase in all-cause mortality compared to deaths on non-heatwave days, with variability across the state. The risk of death on a heatwave day versus a non-heatwave day varied by heatwave severity. Individuals living in urban centers, the elderly, and those living in regions of lower socioeconomic status were most impacted by heatwave mortality. The relative risk of dying from neoplasms, nervous system conditions, respiratory conditions, and mental and behavioral conditions increased during heatwaves. As heatwaves increase in Queensland due to climate change, understanding the impact of heatwaves on mortality across Queensland is important to tailor public health messages. There is considerable variability across communities, demographic groups, and medical conditions, and as such messages need to be tailored to risk.

Cervical spine injuries occurring at the beach: epidemiology, mechanism of injury and risk factors

BMC Public Health, Jul 22, 2022

2B.005 Dying to help: fatal bystander rescues in Australian coastal environments

Abstracts, Mar 1, 2021

Drowning of Pet Owners during Attempted Animal Rescues: The AVIR-A Syndrome

International journal of aquatic research and education, Apr 1, 2020

The rescuer who drowns can result from the attempted rescue of a human or an animal. We report he... more The rescuer who drowns can result from the attempted rescue of a human or an animal. We report here a total population analysis of all drowning fatalities for the 14-year period 1-July-2002 to 30-June-2016 which involved an attempted rescue of an animal. Cases were drawn from the Royal Life Saving National Fatal Drowning Database, which in turn, derived its data primarily from the National Coronial Information System (NCIS). Eight people drowned, all adults (ranging in age from 19-74 years), in the attempted rescue of an animal. Seven of the animals were domestic pet dogs, and in two cases farm animals. Six of the eight fatalities occurred in inland waterways. The AVIR-A syndrome, the 'Aquatic Victim Instead of Rescuer-Animal' (AVIR-A) drowning syndrome, is a subset of the AVIR drowning syndrome. Environmental design and regulation are unlikely to prevent this type of fatality. Public awareness, with emphasis on non-contact rescue training should be the approach taken.

Dying to help: Fatal bystander rescues in Australian coastal environments

PLOS ONE, Sep 16, 2020

Bystanders who drown during a rescue attempt in aquatic waterways are becoming an increasingly im... more Bystanders who drown during a rescue attempt in aquatic waterways are becoming an increasingly important issue within drowning prevention. In the Australian context, the majority of these incidents occur in coastal water ways. This study documents and characterizes bystander rescuer fatalities within Australian coastal waterways that occurred between 1 July 2004 and 30 June 2019 in order to provide suggestions for future public safety interventions involving bystander rescuers. Data was sourced through Surf Life Saving Australia's (SLSA) Coastal Fatality Database, which collates information from multiple sources. Sixty-seven bystander rescuer fatalities in coastal waterways were reported during the 15-year period, an average of 4.5 per year, which is a significant proportion of the five fatalities previously reported across all Australian waterways. The majority of coastal bystander rescuer fatality incidents occurred in the state of New South Wales (49%), at beaches (64%), in regional or remote areas (71%), more than 1 km from the nearest lifesaving service (78%), during summer (45%), in the afternoon (72%), in the presence of rip currents (73%), and did not involve the use of flotation devices to assist rescue (97%). The majority of coastal bystander rescuer victims were Australian residents (88%) born in Australia/Oceania (68%), males (81%), aged between 30-44 years old (36%), visitors to the location (55%), either family (69%) or friends (15%) of the rescuee(s), and were attempting to rescue someone younger than 18 years old (64%). Our results suggest future safety intervention approaches should target males, parents and carers visiting beach locations in regional locations during holiday times and should focus on the importance of flotation devices when enacting a rescue and further educating visitors about the rip current hazard. Future research should examine the psychology of bystander rescue situations and evaluate the effectiveness of different safety intervention approaches.

Learning to Swim: An Exploration of Negative Prior Aquatic Experiences Among Children

International Journal of Environmental Research and Public Health, May 19, 2020

Fatal, unintentional drowning in older people: an assessment of the role of preexisting medical conditions

Healthy aging research, 2017

Background: The number of older people (aged 65 y and over) is increasing in Australia and chroni... more Background: The number of older people (aged 65 y and over) is increasing in Australia and chronic medical conditions are common. Aquatic activities provide physical and social benefits; however, understanding the risks related to aquatic activity is important for ongoing health and wellbeing. We explore the impact of preexisting medical conditions on unintentional fatal drowning among older people in Australia. Methods: Using coronial, forensic, and medical histories from the Australian National Coronial Information System, all cases of unintentional death by drowning (or where drowning was a factor) among older people in Australia between July 1, 2002 and June 30, 2012 were investigated. Preexisting medical conditions were reviewed to determine whether they were contributory to drowning. Results: Of the 506 older people who drowned, 69.0% had a preexisting medical condition. The leading contributory medical condition was cardiovascular disease, followed by dementia, depression, epilepsy, and Parkinson disease. All conditions except cardiovascular disease and depression were overrepresented compared with the proportion of the disease in the population. Falling into water was the most common activity immediately before drowning, especially among those with dementia, whereas those with cardiovascular disease were most likely to drown while swimming. Conclusions: Preexisting medical conditions contribute to drowning in older people but with unequal contributions. With the prevalence of medical conditions expected to increase as the population ages, targeted education for older people will be important. Risk management will enable older people to safely participate in aquatic activities.

Blown Away: Cyclone Related Injuries

Injury Prevention, Oct 1, 2012

Pre-Existing Medical Conditions: A Systematic Literature Review of a Silent Contributor to Adult Drowning

International Journal of Environmental Research and Public Health, Jul 21, 2022

“I Want to See a Drowning-Free Philippines”: A Qualitative Study of the Current Situation, Key Challenges and Future Recommendations for Drowning Prevention in the Philippines

International Journal of Environmental Research and Public Health, Jan 6, 2021

Trends in drowning mortality in Portugal from 1992 to 2019: comparing Global Burden of Disease and national data

Injury Prevention, Dec 31, 2021

Introduction Imprecise data systems hinder understanding of drowning burden, even in high-income ... more Introduction Imprecise data systems hinder understanding of drowning burden, even in high-income countries like Portugal, that have a well-implemented death certificate system. Consequently, national studies on drowning mortality are scarce. We aimed to explore drowning mortality in Portugal using national data and to compare these to Global Burden of Disease (GBD) estimates. Methods Data were obtained from the National Institute of Statistics (INE) for 1992-2019, using International Classification of Diseases (ICD)-9 and ICD-10 codes, by sex, age group and cause (unintentional; water transport and intentional). GBD unintentional drowning data were obtained online. Age-standardised drowning rates were calculated and compared. Results INE data showed 6057 drowning deaths, 4327 classified as unintentional (75.2% male; 36.7% 35-64 years; 31.5% 65+years; 15.2% 0-19 years). Following 2001, an increase in accidental drowning mortality and corresponding decrease in undetermined intent was observed, coincident with Portugal's ICD-10 implementation. GBD modelled estimates followed a downward trend at an overall rate of decrease of -0.41/decade (95% CI (-0.45 to -0.37); R 2 adj =0.94; p<0.05). Conversely, INE data showed an increase in the rate of drowning deaths over the last decade (0.35/ decade; 95% CI (-0.18 to 0.89)). GBD estimates were significantly different from the INE dataset (alpha=0.05), either underestimating as much as 0.567*INE in 1996 or overestimating as much as 1.473*INE in 2011. Conclusions While GBD mortality data estimates are valuable in the absence of routinely collected data, they smooth variations, concealing key advocacy opportunities. Investment in country-level drowning registries enables in-depth analysis of incident circumstances. Such data are essential to informing National Water Safety Plans.

Systematic review of the impact of heatwaves on health service demand in Australia

BMC Health Services Research, Jul 28, 2022

Objectives: Heatwaves have been linked to increased levels of health service demand in Australia.... more Objectives: Heatwaves have been linked to increased levels of health service demand in Australia. This systematic literature review aimed to explore health service demand during Australian heatwaves for hospital admissions, emergency department presentations, ambulance call-outs, and risk of mortality. A systematic review to explore peer-reviewed heatwave literature published from 2000 to 2020. Data sources: Articles were reviewed from six databases (MEDLINE, Scopus, Web of Science, PsychINFO, ProQuest, Science Direct). Search terms included: heatwave, extreme heat, ambulance, emergency department, and hospital. Studies were included if they explored heat for a period of two or more consecutive days. Studies were excluded if they did not define a threshold for extreme heat or if they explored data only from workers compensation claims and major events. Data synthesis: This review was prospectively registered with PROSPERO (#CRD42 02122 7395). Forty-five papers were included in the final review following full-text screening. Following a quality assessment using the GRADE approach, data were extracted to a spreadsheet and compared. Significant increases in mortality, as well as hospital, emergency, and ambulance demand, were found across Australia during heatwave periods. Admissions for cardiovascular, renal, respiratory, mental and behavioural conditions exhibited increases during heatwaves. The most vulnerable groups during heatwaves were children (< 18 years) and the elderly (60+). Heatwaves in Australia will continue to increase in duration and frequency due to the effects of climate change. Health planning is essential at the community, state, and federal levels to mitigate the impacts of heatwaves on health and health service delivery especially for vulnerable populations. However, understanding the true impact of heatwaves on health service demand is complicated by differing definitions and methodology in the literature. The Excess Heat Factor (EHF) is the preferred approach to defining heatwaves given its consideration of local climate variability and acclimatisation. Future research should explore evidence-based and spatially relevant heatwave prevention programs. An enhanced understanding of heatwave health impacts including service demand will inform the development of such programs which are necessary to promote population and health system resilience.

70 Exploring the impact of heatwaves on drowning deaths in Queensland, 2010/11–2018/19

Abstracts, Nov 1, 2022

Cervical spine immobilisation is only required in drowning patients at high risk of axial loading of the spine

Emergency Medicine Australasia, Jul 25, 2022

ObjectivesWave forced impacts are known to result in cervical spine injuries (CSI) and approximat... more ObjectivesWave forced impacts are known to result in cervical spine injuries (CSI) and approximately 20% of drownings in Australia occur at the beach. The most common mechanism of injury in studies examining the frequency of CSI in drowning patients is shallow water diving. The aim of the present study was to determine what proportion of CSIs occurring in bodies of water experienced a concomitant drowning injury in a location where wave forced impacts are likely to be an additional risk factor.MethodsElectronic medical records at the Sunshine Coast Hospital and Health Service EDs, Queensland Ambulance Service case records and Surf Life Saving Queensland data between 1 January 2015 and 21 April 2021 were manually linked. Outcomes recorded included victim demographics, scene information, hospital course and patient disposition.ResultsNinety‐one of 574 (15.9%) CSIs occurred in a body of water with risk of drowning. However, only 4 (4.3%) had a simultaneous drowning injury, representing 0.8% (4/483) of drowning presentations. Ten (10.9%) patients reported loss of consciousness, including the four with drowning. The principal mechanism of CSI was a wave forced impact (71/91, 78%). Most injuries occurred at the beach (79/91, 86.8%). Delayed presentation was common (28/91, 31%). A history of axial loading was 100% sensitive when indicating imaging.ConclusionsThe combination of CSI and drowning is uncommon. Cervical spine precautions are only required in drowning patients with signs or a history, or at high risk of, axial loading of the spine. This paper supports the move away from routine cervical spine precautions even in a high‐risk population.

2G.001 Should i really spray that! safety concerns of herbicides and pesticides

Comparing rural traffic safety in Canada and Australia: a scoping review of the literature

Rural and Remote Health, Nov 9, 2022

Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: analysis for the Global Burden of Disease Study 2017

by Tamene Haile and Richard Franklin

The Lancet, 2020

(2020). Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-... more

Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

by Tamene Haile and Richard Franklin

The Lancet, 2018

Background Efforts to establish the 2015 baseline and monitor early implementation of the UN Sust... more Background Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of "leaving no one behind", it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990-2017, projected indicators to 2030, and analysed global attainment. Methods We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the healthrelated SDG index, we transformed the value for each indicator on a scale of 0-100, with 0 as the 2•5th percentile and 100 as the 97•5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings The global median health-related SDG index in 2017 was 59•4 (IQR 35•4-67•3), ranging from a low of 11•6 (95% uncertainty interval 9•6-14•0) to a high of 84•9 (83•1-86•7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030.

Hypoxic Blackout: Diagnosis, Risks, and Prevention

International journal of aquatic research and education, Aug 1, 2015

Royal Life Saving Society-Australia Hypoxic blackout, also called underwater blackout syndrome, i... more Royal Life Saving Society-Australia Hypoxic blackout, also called underwater blackout syndrome, is a distinct and preventable cause of drowning. The sudden and unexpected death of a young, fit swimmer or diver, almost always male, necessitates the consideration of a differential diagnosis which includes four syndromes-preexistent cardiac disease, electrical conduction abnormalities, epilepsy, and hypoxic blackout. The pathophysiology of hypoxic blackout (overriding the carbon dioxide sensor by presubmersion hyperventilation) may be induced by autonomic conflict between cold shock diving reflexes in certain predisposed individuals. Death occurs in both public and private swimming pools and in the sea, and case series include those training for underwater hockey, synchronized swimming, free diving, and playful submersion endurance challenges. The sole preventive stratagem is advocacy for awareness of risks, suitably targeted to "at risk" groups.

A Systematic Review of Large Agriculture Vehicles Use and Crash Incidents on Public Roads

Journal of Agromedicine, Mar 30, 2019

Supplementary Table 2. Review of size of the problem: Number of reported incidents, injuries and/... more Supplementary Table 2. Review of size of the problem: Number of reported incidents, injuries and/or fatalities due to crashes involving large agricultural vehicles outlined in the literature Road Information (Reference) Time Period Number of Incidents Number of Injuries (and severity) Number of Fatalities Denominator Rate/ Proportion Public roads 46 1995-1999 Farm vehicle crashes represent less than 1% of total public road crashes per year Av. 300 per year

Heatwaves and mortality in Queensland 2010–2019: implications for a homogenous state-wide approach

International Journal of Biometeorology, Feb 3, 2023

Heatwaves are a significant cause of adverse health outcomes and mortality in Australia, worsenin... more Heatwaves are a significant cause of adverse health outcomes and mortality in Australia, worsening with climate change. In Queensland, the northeastern-most state, little is known about the impact of heatwaves outside of the capital city of Brisbane. This study aims to explore the impact of heatwaves on mortality across various demographic and environmental conditions within Queensland from 2010 to 2019. The Excess Heat Factor was used to indicate heatwave periods at the Statistical Area 2 (SA2) level. Registered deaths data from the Australian Bureau of Statistics and heatwave data from the Bureau of Meteorology were matched using a case-crossover approach. Relative risk and 95% confidence intervals were calculated across years, regions, age, sex, rurality, socioeconomic status, and cause of death. Heatwaves were associated with a 5% increase in all-cause mortality compared to deaths on non-heatwave days, with variability across the state. The risk of death on a heatwave day versus a non-heatwave day varied by heatwave severity. Individuals living in urban centers, the elderly, and those living in regions of lower socioeconomic status were most impacted by heatwave mortality. The relative risk of dying from neoplasms, nervous system conditions, respiratory conditions, and mental and behavioral conditions increased during heatwaves. As heatwaves increase in Queensland due to climate change, understanding the impact of heatwaves on mortality across Queensland is important to tailor public health messages. There is considerable variability across communities, demographic groups, and medical conditions, and as such messages need to be tailored to risk.

Cervical spine injuries occurring at the beach: epidemiology, mechanism of injury and risk factors

BMC Public Health, Jul 22, 2022

2B.005 Dying to help: fatal bystander rescues in Australian coastal environments

Abstracts, Mar 1, 2021

Drowning of Pet Owners during Attempted Animal Rescues: The AVIR-A Syndrome

International journal of aquatic research and education, Apr 1, 2020

The rescuer who drowns can result from the attempted rescue of a human or an animal. We report he... more The rescuer who drowns can result from the attempted rescue of a human or an animal. We report here a total population analysis of all drowning fatalities for the 14-year period 1-July-2002 to 30-June-2016 which involved an attempted rescue of an animal. Cases were drawn from the Royal Life Saving National Fatal Drowning Database, which in turn, derived its data primarily from the National Coronial Information System (NCIS). Eight people drowned, all adults (ranging in age from 19-74 years), in the attempted rescue of an animal. Seven of the animals were domestic pet dogs, and in two cases farm animals. Six of the eight fatalities occurred in inland waterways. The AVIR-A syndrome, the 'Aquatic Victim Instead of Rescuer-Animal' (AVIR-A) drowning syndrome, is a subset of the AVIR drowning syndrome. Environmental design and regulation are unlikely to prevent this type of fatality. Public awareness, with emphasis on non-contact rescue training should be the approach taken.

Dying to help: Fatal bystander rescues in Australian coastal environments

PLOS ONE, Sep 16, 2020

Bystanders who drown during a rescue attempt in aquatic waterways are becoming an increasingly im... more Bystanders who drown during a rescue attempt in aquatic waterways are becoming an increasingly important issue within drowning prevention. In the Australian context, the majority of these incidents occur in coastal water ways. This study documents and characterizes bystander rescuer fatalities within Australian coastal waterways that occurred between 1 July 2004 and 30 June 2019 in order to provide suggestions for future public safety interventions involving bystander rescuers. Data was sourced through Surf Life Saving Australia's (SLSA) Coastal Fatality Database, which collates information from multiple sources. Sixty-seven bystander rescuer fatalities in coastal waterways were reported during the 15-year period, an average of 4.5 per year, which is a significant proportion of the five fatalities previously reported across all Australian waterways. The majority of coastal bystander rescuer fatality incidents occurred in the state of New South Wales (49%), at beaches (64%), in regional or remote areas (71%), more than 1 km from the nearest lifesaving service (78%), during summer (45%), in the afternoon (72%), in the presence of rip currents (73%), and did not involve the use of flotation devices to assist rescue (97%). The majority of coastal bystander rescuer victims were Australian residents (88%) born in Australia/Oceania (68%), males (81%), aged between 30-44 years old (36%), visitors to the location (55%), either family (69%) or friends (15%) of the rescuee(s), and were attempting to rescue someone younger than 18 years old (64%). Our results suggest future safety intervention approaches should target males, parents and carers visiting beach locations in regional locations during holiday times and should focus on the importance of flotation devices when enacting a rescue and further educating visitors about the rip current hazard. Future research should examine the psychology of bystander rescue situations and evaluate the effectiveness of different safety intervention approaches.

Learning to Swim: An Exploration of Negative Prior Aquatic Experiences Among Children

International Journal of Environmental Research and Public Health, May 19, 2020

Fatal, unintentional drowning in older people: an assessment of the role of preexisting medical conditions

Healthy aging research, 2017

Background: The number of older people (aged 65 y and over) is increasing in Australia and chroni... more Background: The number of older people (aged 65 y and over) is increasing in Australia and chronic medical conditions are common. Aquatic activities provide physical and social benefits; however, understanding the risks related to aquatic activity is important for ongoing health and wellbeing. We explore the impact of preexisting medical conditions on unintentional fatal drowning among older people in Australia. Methods: Using coronial, forensic, and medical histories from the Australian National Coronial Information System, all cases of unintentional death by drowning (or where drowning was a factor) among older people in Australia between July 1, 2002 and June 30, 2012 were investigated. Preexisting medical conditions were reviewed to determine whether they were contributory to drowning. Results: Of the 506 older people who drowned, 69.0% had a preexisting medical condition. The leading contributory medical condition was cardiovascular disease, followed by dementia, depression, epilepsy, and Parkinson disease. All conditions except cardiovascular disease and depression were overrepresented compared with the proportion of the disease in the population. Falling into water was the most common activity immediately before drowning, especially among those with dementia, whereas those with cardiovascular disease were most likely to drown while swimming. Conclusions: Preexisting medical conditions contribute to drowning in older people but with unequal contributions. With the prevalence of medical conditions expected to increase as the population ages, targeted education for older people will be important. Risk management will enable older people to safely participate in aquatic activities.

Blown Away: Cyclone Related Injuries

Injury Prevention, Oct 1, 2012

Pre-Existing Medical Conditions: A Systematic Literature Review of a Silent Contributor to Adult Drowning

International Journal of Environmental Research and Public Health, Jul 21, 2022

“I Want to See a Drowning-Free Philippines”: A Qualitative Study of the Current Situation, Key Challenges and Future Recommendations for Drowning Prevention in the Philippines

International Journal of Environmental Research and Public Health, Jan 6, 2021

Trends in drowning mortality in Portugal from 1992 to 2019: comparing Global Burden of Disease and national data

Injury Prevention, Dec 31, 2021

Introduction Imprecise data systems hinder understanding of drowning burden, even in high-income ... more Introduction Imprecise data systems hinder understanding of drowning burden, even in high-income countries like Portugal, that have a well-implemented death certificate system. Consequently, national studies on drowning mortality are scarce. We aimed to explore drowning mortality in Portugal using national data and to compare these to Global Burden of Disease (GBD) estimates. Methods Data were obtained from the National Institute of Statistics (INE) for 1992-2019, using International Classification of Diseases (ICD)-9 and ICD-10 codes, by sex, age group and cause (unintentional; water transport and intentional). GBD unintentional drowning data were obtained online. Age-standardised drowning rates were calculated and compared. Results INE data showed 6057 drowning deaths, 4327 classified as unintentional (75.2% male; 36.7% 35-64 years; 31.5% 65+years; 15.2% 0-19 years). Following 2001, an increase in accidental drowning mortality and corresponding decrease in undetermined intent was observed, coincident with Portugal's ICD-10 implementation. GBD modelled estimates followed a downward trend at an overall rate of decrease of -0.41/decade (95% CI (-0.45 to -0.37); R 2 adj =0.94; p<0.05). Conversely, INE data showed an increase in the rate of drowning deaths over the last decade (0.35/ decade; 95% CI (-0.18 to 0.89)). GBD estimates were significantly different from the INE dataset (alpha=0.05), either underestimating as much as 0.567*INE in 1996 or overestimating as much as 1.473*INE in 2011. Conclusions While GBD mortality data estimates are valuable in the absence of routinely collected data, they smooth variations, concealing key advocacy opportunities. Investment in country-level drowning registries enables in-depth analysis of incident circumstances. Such data are essential to informing National Water Safety Plans.

Systematic review of the impact of heatwaves on health service demand in Australia

BMC Health Services Research, Jul 28, 2022

Objectives: Heatwaves have been linked to increased levels of health service demand in Australia.... more Objectives: Heatwaves have been linked to increased levels of health service demand in Australia. This systematic literature review aimed to explore health service demand during Australian heatwaves for hospital admissions, emergency department presentations, ambulance call-outs, and risk of mortality. A systematic review to explore peer-reviewed heatwave literature published from 2000 to 2020. Data sources: Articles were reviewed from six databases (MEDLINE, Scopus, Web of Science, PsychINFO, ProQuest, Science Direct). Search terms included: heatwave, extreme heat, ambulance, emergency department, and hospital. Studies were included if they explored heat for a period of two or more consecutive days. Studies were excluded if they did not define a threshold for extreme heat or if they explored data only from workers compensation claims and major events. Data synthesis: This review was prospectively registered with PROSPERO (#CRD42 02122 7395). Forty-five papers were included in the final review following full-text screening. Following a quality assessment using the GRADE approach, data were extracted to a spreadsheet and compared. Significant increases in mortality, as well as hospital, emergency, and ambulance demand, were found across Australia during heatwave periods. Admissions for cardiovascular, renal, respiratory, mental and behavioural conditions exhibited increases during heatwaves. The most vulnerable groups during heatwaves were children (< 18 years) and the elderly (60+). Heatwaves in Australia will continue to increase in duration and frequency due to the effects of climate change. Health planning is essential at the community, state, and federal levels to mitigate the impacts of heatwaves on health and health service delivery especially for vulnerable populations. However, understanding the true impact of heatwaves on health service demand is complicated by differing definitions and methodology in the literature. The Excess Heat Factor (EHF) is the preferred approach to defining heatwaves given its consideration of local climate variability and acclimatisation. Future research should explore evidence-based and spatially relevant heatwave prevention programs. An enhanced understanding of heatwave health impacts including service demand will inform the development of such programs which are necessary to promote population and health system resilience.

70 Exploring the impact of heatwaves on drowning deaths in Queensland, 2010/11–2018/19

Abstracts, Nov 1, 2022

Cervical spine immobilisation is only required in drowning patients at high risk of axial loading of the spine

Emergency Medicine Australasia, Jul 25, 2022

ObjectivesWave forced impacts are known to result in cervical spine injuries (CSI) and approximat... more ObjectivesWave forced impacts are known to result in cervical spine injuries (CSI) and approximately 20% of drownings in Australia occur at the beach. The most common mechanism of injury in studies examining the frequency of CSI in drowning patients is shallow water diving. The aim of the present study was to determine what proportion of CSIs occurring in bodies of water experienced a concomitant drowning injury in a location where wave forced impacts are likely to be an additional risk factor.MethodsElectronic medical records at the Sunshine Coast Hospital and Health Service EDs, Queensland Ambulance Service case records and Surf Life Saving Queensland data between 1 January 2015 and 21 April 2021 were manually linked. Outcomes recorded included victim demographics, scene information, hospital course and patient disposition.ResultsNinety‐one of 574 (15.9%) CSIs occurred in a body of water with risk of drowning. However, only 4 (4.3%) had a simultaneous drowning injury, representing 0.8% (4/483) of drowning presentations. Ten (10.9%) patients reported loss of consciousness, including the four with drowning. The principal mechanism of CSI was a wave forced impact (71/91, 78%). Most injuries occurred at the beach (79/91, 86.8%). Delayed presentation was common (28/91, 31%). A history of axial loading was 100% sensitive when indicating imaging.ConclusionsThe combination of CSI and drowning is uncommon. Cervical spine precautions are only required in drowning patients with signs or a history, or at high risk of, axial loading of the spine. This paper supports the move away from routine cervical spine precautions even in a high‐risk population.

2G.001 Should i really spray that! safety concerns of herbicides and pesticides

Comparing rural traffic safety in Canada and Australia: a scoping review of the literature

Rural and Remote Health, Nov 9, 2022