Surveillance for injuries: cluster of finger amputations from snowblowers

In an investigation of the health effects of a Christmas eve snowstorm in 1982, a review of emergency room records in the Denver area identified a cluster of 17 cases of finger amputations. Fifteen (88) percent of these amputations were associated with snowblower use. An additional 12 persons with hand or finger injuries without amputations from snowblowers were identified. A case-control study was performed comparing these patients with a control group who had used snowblowers. Patients were more likely than controls to have had their machines become clogged with snow (odds ratio [OR], 3.4, 95 percent confidence limits [CL], 0.74-15.4). Using a hand to dislodge trapped snow was the only risk factor identified for the patients (OR, 116; 95 percent CL, 16-820). No differences were found for other variables such as type of snowblower, instruction for use, or previous experience using a snowblower. The findings suggest that the most feasible measure to prevent such injuries is a change in snowblower design to preclude entry of a hand while the machine is running. This investigation illustrates the importance of surveillance in detecting and controlling injuries. Without such surveillance, the similarity among injuries reported on this paper would not have been recognized. Ongoing surveillance for injuries might identify other clusters of injuries.