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 Montréal 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, 3270 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.