Road accidents in a city in southern Brazil]

The study was conducted in the municipality of Londrina, a medium-sized city of southern Brazil. Analysis was performed in the characteristics of road accidents that had occurred during the first semester of 1996, resulting in 3,643 victims. Car or small truck collisions were the most common type of accident. The rate of motorcycle-related injuries (per 1,000 registered vehicles) was seven times higher than that resulting from cars or small trucks. Fatality rates were higher for motorcyclists who collided with stationary objects (29.4%) and pedestrians who were injured by lorries or buses (22.2%), in comparison with a mean fatality rate of 1.8%. This information may provide a basis for the implementation of public policies aiming at reducing accidents.     

Causes and effects of road traffic accidents in Saudi Arabia

In Saudi Arabia the motor vehicle is the main means of transportation. Between 1971 and 1997; 564,762 people died or were injured in road traffic accidents, a figure equivalent to 3.5% of the total population in Saudi Arabia. During this period 66,914 people have died on the roads in Saudi Arabia due to road accidents, amounting to one person killed and four injured every hour. Over 65% of accidents occur because of vehicles travelling at excess speed and/or drivers disobeying traffic signals. Of deaths in Ministry of Health hospitals, 81% are due to road traffic accidents and 20% of their beds are occupied by traffic accidents victims. Also, 79.2% of patients admitted to Riyadh Armed Forces Hospital with spinal injuries has sustained their injuries as a result of a motor vehicle accident. We recommend compulsory use of safety seat belts in vehicles and the setting up of a new database to collect, store and analyse information relating to the road traffic accidents.     

Profile of motorcycle accident victims treated at a public hospital emergency department

The number of accidents involving motorcycles has increased in Brazil. The objective of this study was to identify the type of victims of these accidents who were treated at an emergency department in Piauí State, Brazil. The sample included 430 such victims in this quantitative study. Most were male, 15-24 years of age, and from the State of Piauí itself. 301 of the victims were drivers of the motorcycles, 81 were passengers, and 48 were struck or run over by the motorcycles. 76.05% of the accidents occurred from Thursday to Sunday. 80.75% had temporary sequelae, and 53.33% of the accidents occurred at night. In 69.3% of the cases, victims suffered lacerations; 51.4% fractures; 27.44% hematomas; and 20.7% head trauma. Among the accident victims, motorcycle drivers, and those suspected of alcohol consumption, 52.07% were not wearing a helmet at the time of the accident. Most of the victims were discharged from hospital, while 14 died. In conclusion, injuries from motorcycle accidents deserve attention, especially to plan preventive measures to help control their occurrence in the State.     

Motorcyclist traffic accidents and risk factors: a Singapore study

Motorcyclist accidents cause significant morbidity and mortality in Singapore. To elucidate personal and environmental factors associated with such accidents, we studied 198 motorcyclists who were hospitalized in Singapore General Hospital between April 1986 and June 1987. The patients were mostly young and almost exclusively male with a high proportion of Malays. Most accidents occurred on Sundays and at night. Ten percent of the victims took alcohol before the accident. Most had low injury severity scores (ISS). Less experienced drivers had a significantly higher ISS than those with one year or longer of driving experience. Vigorous control of drunken driving, through public education and intensive breath testing, should reduce the incidence of traffic accidents.     

Analysis of early treatment of accidents at work and on the way to or from work with special consideration of traumatic-hemorrhagic shock

The study investigates the quality of the management of occupational accidents and of accidents on the way to or from work. Special consideration is given to the prevention and effective early treatment of traumatic-hemorrhagic shock, which in serious accidents is often the pathophysiological cause of reversible or irreversible damage of organ systems, disability or death. In a series of 725 consecutive occupational accidents, accidents on the way to or from work and road accidents over a period of 2 years, and in 31 additional individual cases, the emergency treatment and further care of patients with incipient or advanced shock were examined. Assessment was based on protocols of initial emergency treatment and medical records of further hospital care. Specific attention was given to the development of shock-induced organ damage. When the emergency physician arrived at the site of the accident, of the 725 cases, 82 patients showed early signs of shock, 37 were in advanced shock, and 24 were dead. In accidents with early intervention of experienced medical personnel, securing of the airways, control of bleeding and sufficient substitution of volume and oxygen were usually done professionally, but analysis of the management of other cases showed delays and various shortcomings. In 25% of those who died, protracted circulatory shock due to insufficient volume substitution was the cause of death. Occupational rehabilitation failed in two thirds of the patients with advanced shock, but only in one third of the patients with incipient shock. The study demonstrates that immediate intervention by non-professionals in first aid, rapid arrival of the emergency care team, sufficient volume and oxygen substitution along with other emergency measures, and rapid transport to an appropriate trauma care facility, all improved the prognosis of the accident victims. Specific areas for improvement in the management of accident victims were found, especially in co-operation and co-ordination among non-professional first aid providers, occupational health and auxiliary personnel, and emergency medicine professionals.     

萧山区居民车祸死亡原因分析

目的分析萧山区车祸死亡流行病学特征,为预防和控制道路交通事故提供依据。方法利用萧山区死因监测系统2002—2007年资料,采用ICD—10编码进行伤害死因分类统计,计算车祸死亡率、死因构成等。结果萧山区车祸死亡率为26．28／10万,居伤害夕E因的首位,男性高于女性,车祸死亡率随着年龄的增加上升。9种车祸死亡类型中,位居首位的是人-车碰撞造成行人死亡,46．4％为60岁以上老年人。骑（乘）摩托车车祸死亡主要集中在20～59岁之间,占总摩托车死亡的91．8％,主要危害男性,占87．1％。结论车祸已成为威胁萧山区健康的重要公共卫生问题,社会各部门应积极采取相应措施,加强道路交通法规的宣传和教育工作,减少交通事故的发生和死亡。     

Trends in traffic accidents in Campinas, São Paulo State, Brazil: the increasing involvement of motorcyclists

In order to describe trends in traffic accidents, mortality, vehicle types, fleet sizes, and victims' characteristics in Campinas, S?o Paulo State, Brazil, from 1995 to 2008, this study analyzed vehicle rates, traffic accident rates per inhabitant and per vehicle, case-fatality rates, proportional mortality, mortality rates, and rates ratios. The motorcycle fleet increased 241%. Although the case-fatality rate of motorcycle users from 2000 to 2008 decreased, in 2008 they accounted for 49.3% of fatal accidents on public byways in Campinas. Motorcycles were responsible for the highest run-over rate (66.7 pedestrians/1,000 accidents) and highest pedestrian fatality rate (4 deaths/1,000 accidents). Men showed much higher mortality rates than women. Pedestrian victims were mainly elderly; most vehicle occupants in traffic accidents were in the 15 to 29-year age bracket. From 2006 to 2008, nearly 80% of vehicle users 15 to 39 years of age were motorcyclists. Motorcycle accident prevention should be a priority, using multi-institutional measures.     

Drugs and fatal traffic accidents in the Czech Republic

INTRODUCTION: The aim of the study was to determine the prevalence of psychotropic drug use in active participants in traffic accidents who died during the accident or shortly after it due to injuries resulting from the accident. METHODS: A special mortality register containing data of all forensic autopsies was analysed. The studied sample consisted of persons who died during traffic accidents and were active participants in those ones (pedestrians, cyclists, or drivers), and were toxicologically tested during the forensic examination. RESULTS: The sample consisted of 1,213 cases, 1,039 (85.7%) males and 174 (14.3%) females who died in 2003-2005. Ethanol was found in 34.7% of cases, however a significant declining trend over the years was noted. The proportion of positive detections for any psychotropic drug other than alcohol was 7.2%; benzodiazepines were found most frequently (3.6%), followed by cannabis (2.2%), and stimulants (1.7% of the sample). Positive findings of ethanol were significantly more common among males, whereas positive benzodiazepine tests were more frequent in females. Positive cases were significantly younger than negative ones for ethanol, volatile substances, stimulants, and cannabis; in cases of positive medicaments tests, the positive cases were significantly older than the negatives.     

Analysis of biases in epidemiological knowledge of road accidents in France

BACKGROUND: In France, as in many countries, road casualty statistics are mostly based on police reports. It is generally recognized that these data are incomplete but no measurement has been made of the degree of under-reporting and thus of associated biases. This study aims to demonstrate and quantify these biases. METHODS: The study compares, after data linkage, the 10,202 people reported injured or killed in 1996 in the medical road accident victims Register in the Département du Rh?ne (France), with the 4,572 victims reported by the police during the same year and in the same area. This Département was chosen, as it is the only region in France where these two independent data sources coexist. Two types of possible biases are studied: injury severity classification bias and selection bias induced by underreporting. RESULTS: The study shows that the definition of "serious injury" used by the police exaggerates the severity of the victim's condition in over half the cases. This bias depends on road user group. This bias is maximum for pedestrians: compared to a slightly injured car occupant, a pedestrian with the same injury severity level has significantly more chance to be considered as severely injured (RR=1.78; 95% CI: 1.11-2.87). Conversely, significant selection biases are related to data collection by the police. The multivariate analysis shows that the underreporting of victims increases if no third party is involved (i.e. without any other vehicle or pedestrian), and reduces with injury severity. It also varies by road user group (with the largest underreporting for cyclists). Among the most seriously injured in accidents involving third parties, motor cyclists and car users are the most reported category and pedestrians the least (RR=0.80; 95% CI: 0.70-0.92). Biases in Register selection are much more limited and basically concern underreporting of victims of minor accidents who did not require medical care. CONCLUSIONS: This study confirms and quantifies misleading distortions in police statistics used to assess road accidents. These results concern the relevant indicators to be used to define road safety issues.     

2010-2019年中国人群主要伤害死亡水平与变化趋势

目的分析2010-2019年中国人群主要伤害死亡水平和变化趋势, 为伤害干预工作的开展提供依据。方法收集2010-2019年全国疾病监测地区主要伤害死亡数据, 通过计算4种主要伤害粗死亡率和标化死亡率来描述主要伤害死亡状况, 采用Joinpoint回归模型分析标化死亡率变化趋势。结果 2010-2019年伤害标化死亡率总体呈持续下降趋势(AAPC=-3.5%, P<0.001), 意外跌落标化死亡率总体呈上升趋势(AAPC=1.0%, P=0.104)。主要伤害死亡率随年龄增长呈波动上升趋势, 50～79岁人群意外跌落标化死亡率呈上升趋势(50～岁组AAPC=3.9%, 60～岁组AAPC=5.6%, 70～岁组AAPC=4.6%, 均P<0.001)。男性主要伤害标化死亡率均高于女性, 男性道路交通事故和溺水下降速度较女性更快(男性道路交通事故组AAPC=-5.3%, 女性道路交通事故组AAPC=-3.8%;男性溺水组AAPC=-4.0%, 女性溺水组AAPC=-3.5%, 均P<0.001), 女性自杀及后遗症下降速度较男性更快(女性AAPC=-6.4%, 男性A...     

2 583例院前救治道路交通伤患者特征分析

目的 了解2014年镇江地区院前救治的道路交通伤患者的流行病学特征。 方法 采用回顾性分析方法,分析>14岁的道路交通伤患者的年龄、性别、日期和时间、患者的损伤部位、伤害类型等。 结果 2 583例患者中,男1 455例(56.3%),女1 128例(43.7%),男女例数之比为1.29:1。患者的年龄15~93岁,平均年龄(46.49 ±15.58)岁。10月发生道路交通伤的患者最多,共336例(13.01%),2月最少,共107例(4.14%);8:00-9:00发生道路交通伤的患者最多,共194例(7.51%),03:00-04:00发生道路交通伤的患者最少,共9例(0.35%)。头部和四肢是最常见的身体损伤部位,占总人数的78.17%,出现2处及以上损伤部位的人数为220人,占总人数的8.52%。道路交通伤害导致的严重患者有124例(4.81%),中度患者647例(25.04%),轻度患者1 812例(70.15%)。 结论 镇江地区交通伤害以男性青壮年为主,损伤以头部和四肢为主,大部分是轻度患者。     

Head injury in road traffic accidents. A prospective Study in Tr?ndelag, Norway, 1979-80

The purpose of the present prospective investigation was to study the epidemiology of head injuries sustained in road traffic accidents. The characteristics of all 503 head-injured patients admitted to hospitals in the two counties of Tr?ndelag province, Norway, in 1979 and 1980 are described. The annual incidence was 89 per 100 000 inhabitants. There was a male preponderance in all categories of victims. The highest male to female ratio was found in motorcyclists and mopedists (6.3:1). Pedal cycle accidents accounted for 33% of all accidents, constituting the most common cause of head injury on the roads in the period from May to the end of September. There were more pedal cycle accidents in the present series than in previous studies on road traffic accidents.     

Barriers in the care of patients who have experienced a traumatic event: the perspective of general practice

BACKGROUND: Previous research has indicated that GPs encounter barriers in the care of patients who have experienced a traumatic event. OBJECTIVES: The aims of the present study were to map barriers GPs encounter in the care of patients who experience a traumatic event and solutions for these barriers, and to estimate the influence of GP characteristics on the number of barriers experienced. METHODS: Telephone interviews were conducted among a sample of 500 Dutch GPs stratified by sex. Topics covered barriers in the care of victims of: accidents, incest in the past, ongoing physical or sexual abuse of adults, and ongoing physical or sexual abuse of children. RESULTS: The response rate was 44%. GPs are regularly confronted with patients who have experienced a traumatic event. GPs experience 10% barriers in care of patients who have difficulties getting over an accident, 13% in the care of incest victims, 16% in the care of adults who are physically or sexually abused, and 20% in the care of physically or sexually abused children. Most of the GPs recently updated their knowledge of care of victims of traumatic events, but still the majority feel in need of additional expert training. CONCLUSION: GPs experience the greatest number of barriers in the care of children who are abused. GP characteristics were not related to the number of barriers. However, seeing more victims was related to fewer barriers. To facilitate GP care of victims of traumatic events, GP training and continuing medical education should focus especially on skills education regarding the detection and initial treatment of traumatic events of ongoing physical or sexual abuse.     

Performance d’un système d’information hospitalier pour étudier l’accidentologie routière dans le bassin de recrutement d’un hôpital

BackgroundRoad traffic accidents in France are mainly analyzed through reports completed by the security forces (police and gendarmerie). But the hospital information systems can also identify road traffic accidents via specific documentary codes of the International Classification of Diseases (ICD-10). The aim of this study was therefore to determine whether hospital stays consecutive to road traffic accident were truly identified by these documentary codes in a facility that collects data routinely and to study the consistency of results from hospital information systems and from security forces during the 2002–2008 period.MethodsWe retrieved all patients for whom a documentary code for road traffic accident was entered in 2002–2008. We manually checked the concordance of documentary code for road traffic accident and trauma origin in 350 patient files. The number of accidents in the Grenoble area was then inferred by combining with hospitalization regional data and compared to the number of persons injured by traffic accidents declared by the security force.ResultsThese hospital information systems successfully report road traffic accidents with 96% sensitivity (95%CI: [92%, 100%]) and 97% specificity (95%CI: [95%, 99%]). The decrease in road traffic accidents observed was significantly less than that observed was significantly lower than that observed in the data from the security force (45% for security force data against 27% for hospital data).ConclusionOverall, this study shows that hospital information systems are a powerful tool for studying road traffic accidents morbidity in hospital and are complementary to security force data.     

Fatal work-related accidents in UK merchant shipping from 1919 to 2005

BACKGROUND: Historically, merchant seafaring was the most hazardous occupation in Britain. However, fatal accident rates have fallen sharply in the last 30 years. AIMS: To establish the causes of all fatal accidents and their trends among seafarers who were employed in UK merchant shipping from 1919 to 2005 and to compare with those in the general workforce and in other industries. METHODS: A historical study, based on examinations of death inquiry files from 1976 to 2005 and official mortality returns from 1919 to 1975, with a total population of 11.90 million seafarer-years at risk. RESULTS: From 1919 to 2005, there were 17,386 deaths from accidents in UK shipping, 6,074 from shipping disasters and 11,312 from personal accidents. Over time, there were large reductions in mortality rates for all the main types of fatal accident, except accidents on deck. Major causes of mortality from shipping disasters were vessels foundering in typhoons, storms and severe gales, explosions in cargo holds and collisions in poor visibility. Fatal accident rates were higher among British seafarers than among Lascars. The relative risk of an accident in UK shipping-compared with the general British workforce-was similar in 2001 to that in 1961. CONCLUSIONS: There have been major improvements in health and safety that have led to substantial reductions in fatal accident rates in UK merchant shipping throughout most of the last 90 years. This mirrors comparable improvements in the fatal accident rate among the general workforce of Great Britain.     

2004-2009年上海市虹口区车祸死亡分析

目的了解2004-2009年上海市虹口区车祸的死亡情况,为预防道路交通伤害提供依据。方法根据上海市虹口区全死因登记监测系统收集的车祸死亡资料,用描述性方法分析车祸死亡率、死亡人员职业构成、减寿人年数(PYLL)等。结果虹口区2004-2009年车祸死亡率为6.08/10万,占伤害总死亡的14.22%,居伤害死亡的第一位。男性车祸死亡率高于女性,且6年中上海市虹口区居民车祸死亡率呈波动趋势。行人的死亡占交通事故总死亡的37.15%。摩托车驾驶员的死亡率为16.19/10万,远高于非机动车人员及其他机动车驾驶员的死亡率。6年来,交通事故总的减寿年数为4785.00人年,减寿最严重的是小汽车碰撞车祸所引起的人员死亡。结论车祸死亡是可以采取相应措施加以控制的。     

Factors associated with pre-hospital care in victims of traffic accidents

This was a cross-sectional study of all victims of traffic accidents in Belo Horizonte, Minas Gerais State, Brazil, admitted to the three largest public hospitals in the city from November 10 to December 14, 2003, to identify characteristics associated with the use of pre-hospital emergency treatment and investigate whether the time between the accident and hospital admission was shorter among these victims. The association between pre-hospital treatment and target variables was assessed by prevalence ratios obtained from Poisson regression. Among 1,564 victims, 778 (49.7%) were transported in vehicles with pre-hospital treatment. Pre-hospital treatment was less common for bicyclists and pedestrians. The prevalence ratio was higher among victims with more severe injuries (AIS = 2 and AIS>or= 3), older victims (30-39 years, 40-49 years, >or= 50 years), those who reported alcohol use, and when the time between accident and hospital admission was less than 60 minutes. According to the results, pre-hospital treatment is more frequent among severely injured victims and helps reduce the time between the accident and hospital admission.     

Road-traffic-related mortality in Iran: a descriptive study

Road traffic accidents are considered to be the second highest cause of mortality in Iran. A study was conducted to describe road-traffic-related mortality data in Iran in a given period. All Iranian mortality data on road traffic accidents between March 1999 and 2000 (one complete Iranian calendar year) were obtained. The main variables studied were deceased's gender, age, education level, status (i.e. driver, car occupant, etc.), cause and place of death. A total of 15?482 individuals died from road traffic accidents in Iran in the study period. A disproportionate number of deceased individuals were male (79%), mostly aged 40 years or less (65%), and who were pedestrians or car occupants (62%). Head injury was the most common cause of road-traffic-related mortality (66%) in males and females of all ages. Following road traffic accidents, 57% of deaths occurred pre-hospital. Head injury is the most common single cause of mortality attributable to road traffic accidents in Iran, and since most deaths occur pre-hospital, it seems many are preventable. To overcome this major public health problem, there is an urgent need to develop a comprehensive injury control policy and strategy in Iran.     

Vitamin A reserve of liver in health and coronary heart disease among ethnic groups in Singapore

1. The vitamin A content of human liver tissue was determined in 363 autopsy samples. The sample comprised a total of 181 subjects dying after accidents and 182 dying from coronary heart disease among Singapore ethnic groups of both sexes. 2. The medium vitamin A reserve was 146 mg/kg in accident victims and 141 mg/kg in those who had died of coronary heart disease. Of all the samples 16% contained less than 40 mg/kg, 45% had 100-300 mg/kg, while 9% contained more than 500 mg/kg liver. 3. Among the accident victims, Indians had the lowest median liver vitamin A reserve (118 mg/kg) compared with that in other ethnic groups (137 mg/kg in Chinese, 191 mg/kg in Malays, 155 mg/kg in Caucasians). 4. The ethnic distribution of vitamin A reserve in coronary deaths was similar to that in accident victims. 5. There was no significant difference between the sexes in hepatic vitamin A reserve. 6. The distribution of vitamin A reserve in all the groups was skewed to the right.