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class="form" method="get" name="authors1" action="/"><input type="hidden" name="search_medline" value="yes"/><input type="hidden" name="search_area" value="platform+medline"/><input type="hidden" name="restrictname_author" value="author"/><input type="hidden" name="restricttype_author" value="author"/><input type="hidden" name="restrictterm_author" value=""/><input type="hidden" name="restrictdesc_author" value=""/><span class="ja50-ce-author"><a title="Search for all articles by this author" href="#" onclick="Javascript: return authorSearchSubmitForm(this,'watson0ds','Watson Daniel S.');">Daniel S. Watson</a></span><a class="ja50-ce-cross-ref" name="back-aff1" title="" href="#aff1"><span class="ja50-ce-sup">a</span></a><a class="ja50-ce-cross-ref" name="back-aff2" title="" href="#aff2"><span class="ja50-ce-sup">b</span></a>, <span class="ja50-ce-author"><a title="Search for all articles by this author" href="#" onclick="Javascript: return authorSearchSubmitForm(this,'shields0bj','Shields Brenda J.');">Brenda J. Shields</a></span><a class="ja50-ce-cross-ref" name="back-aff1" title="" href="#aff1"><span class="ja50-ce-sup">a</span></a>, <span class="ja50-ce-author"><a title="Search for all articles by this author" href="#" onclick="Javascript: return authorSearchSubmitForm(this,'smith0ga','Smith Gary A.');">Gary A. Smith</a>, MD, DrPh</span><a class="ja50-ce-cross-ref" name="back-aff1" title="" href="#aff1"><span class="ja50-ce-sup">a</span></a><a class="ja50-ce-cross-ref" name="back-aff3" title="" href="#aff3"><span class="ja50-ce-sup">c</span></a><a class="ja50-ce-cross-ref" name="back-cor1" title="" href="#cor1"><img border="0" src="../../webfiles/images/icon_authorInfo.gif" alt="Corresponding Author Information"/></a><a class="ja50-ce-e-address" href="mailto:gary.smith@nationwidechildrens.org"><img border="0" src="../../webfiles/images/icon_emailAuthor.gif" alt="email address"/></a></form><p/><p class="ja50-article-history"><span class="ja50-ce-date-received">Received 28 May 2009</span><span class="ja50-ce-date-revised">; received in revised form 5 July 2009</span>; accepted <span class="ja50-ce-date-accepted">8 July 2009</span>.  published online 26 March 2010.</p><div class="ja50-ce-abstract" id="abstract"><h3><span class="ja50-ce-section-title">Abstract</span> </h3><div class="ja50-ce-abstract-section"><h5><span class="ja50-ce-section-title">Background</span></h5><p class="ja50-ce-simple-para">Injuries and medical emergencies associated with snow shovel use are common in the United States.</p></div><div class="ja50-ce-abstract-section"><h5><span class="ja50-ce-section-title">Methods</span></h5><p class="ja50-ce-simple-para">This is a retrospective analysis of data from the National Electronic Injury Surveillance System. This study analyzes the epidemiologic features of snow shovel–related injuries and medical emergencies treated in US emergency departments (EDs) from 1990 to 2006.</p></div><div class="ja50-ce-abstract-section"><h5><span class="ja50-ce-section-title">Results</span></h5><p class="ja50-ce-simple-para">An estimated 195 100 individuals (95% confidence interval, 140 400-249 800) were treated in US EDs for snow shovel–related incidents during the 17-year study period, averaging 11 500 individuals annually (SD, 5300). The average annual rate of snow shovel–related injuries and medical emergencies was 4.15 per 100 000 population. Approximately two thirds (67.5%) of these incidents occurred among males. Children younger than 18 years comprised 15.3% of the cases, whereas older adults (55 years and older) accounted for 21.8%. The most common diagnosis was soft tissue injury (54.7%). Injuries to the lower back accounted for 34.3% of the cases. The most common mechanism of injury/nature of medical emergency was acute musculoskeletal exertion (53.9%) followed by slips and falls (20.0%) and being struck by a snow shovel (15.0%). Cardiac-related ED visits accounted for 6.7% of the cases, including all of the 1647 deaths in the study. Patients required hospitalization in 5.8% of the cases. Most snow shovel–related incidents (95.6%) occurred in and around the home.</p></div><div class="ja50-ce-abstract-section"><h5><span class="ja50-ce-section-title">Conclusions</span></h5><p class="ja50-ce-simple-para">This is the first study to comprehensively examine snow shovel–related injuries and medical emergencies in the United States using a nationally representative sample. There are an estimated 11 500 snow shovel–related injuries and medical emergencies treated annually in US EDs.</p></div></div></div><div class="ja50-messages"/><div class="ja50-end"><div class="ja50-affiliation-block"><p class="ja50-ce-affiliation" id="aff1"><a class="ja50-ce-label" href="#back-aff1">a</a> <span class="ja50-ce-textfn">Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA</span></p><p class="ja50-ce-affiliation" id="aff2"><a class="ja50-ce-label" href="#back-aff2">b</a> <span class="ja50-ce-textfn">The Ohio State University College of Medicine, Columbus, OH 43210, USA</span></p><p class="ja50-ce-affiliation" id="aff3"><a class="ja50-ce-label" href="#back-aff3">c</a> <span class="ja50-ce-textfn">Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, USA</span></p></div><p class="ja50-ce-correspondence" id="cor1"><a class="ja50-ce-label" href="#back-cor1"><img src="../../webfiles/images/icon_authorInfo.gif" border="0" alt="Corresponding Author Information"/></a><span class="ja50-ce-text">Corresponding author. Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205. Tel.: +1 614 722 2400; fax: +1 614 722 2448.</span></p><p class="ja50-ce-pii">PII: S0735-6757(09)00371-4</p><p class="ja50-ce-doi">doi:10.1016/j.ajem.2009.07.003</p><p id="copyright" class="ja50-ce-copyright">© 2011 Elsevier Inc. All rights reserved.</p></div><table width="100%" cellpadding="0" cellspacing="0" border="0"><tr><td width="70%" class="abstractTitleCell1a"></td><td width="340" class="abstractTitleCell2a" align="right"><p class="results_text"><span class="text_bold"><img src="../../webfiles/images/transparent.gif" width="340" height="1" alt="" title=""/><br/><a href="../../article/S0735-6757(09)00328-3/fulltext"><img src="../../webfiles/images/btn_previous.gif" border="0" alt="View previous." title="View previous." class="img_align"/></a> 6 of 43 <a href="../../article/S0735-6757(09)00373-8/fulltext"><img src="../../webfiles/images/btn_next.gif" border="0" alt="View next." title="View next." class="img_align"/></a></span></p></td></tr></table></div></td><td class="Body"></td></tr></table></td></tr><tr><td class="contentFooterBody" width="100%" id="contentFooter"><span><table width="100%" cellpadding="0" cellspacing="0" border="0" class="footerTable"><tr><td colspan="1" rowspan="1"><p class="footerText"><a class="footerLink" shape="rect" href="http://www.elsevier.com/"><span><span><span class="xhtmlBlock">Copyright © 2011 Elsevier, Inc. 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