交通事故与驾驶员因素的关系

目的　探讨驾驶员的生活事件、驾驶紧张、寻衅性驾驶等因素对交通事故的影响。方法　采用生活事件量表、驾驶紧张问卷、寻衅性驾驶行为问卷等测试了 90 5名汽车驾驶员 ,并调查了交通事故经历和影响事故的因素。结果　事故驾驶员的生活事件、驾驶紧张和寻衅驾驶得分分别为 2 1.79± 14 .10、2 3.81± 11.86、9.4 2± 8.2 5 ,明显高于无事故组 (分别为 16 .82± 8.4 5、2 0 .0 9± 10 .6 3、5 .6 6± 7.5 4 ) ,差异有显著性 (P <0 .0 1) ;且交通事故次数与生活事件、驾驶紧张、寻衅性驾驶、疲劳驾驶、每周驾车时间、饮酒指数有明显的相关 (P <0 .0 5 )。Logistic回归 (Forward :LR法 )分析表明 ,交通事故与每周驾驶时间、疲劳驾驶、寻衅性驾驶、饮酒指数的关系密切。结论　驾驶员的生活事件、驾驶紧张、寻衅性驾驶是影响交通事故的重要因素。     

A Preliminary Study of New Parents,Sleep Disruption,and Driving: A Population at Risk?

Background Drowsy driving is estimated to be a causal factor in 2–16 % of vehicular crashes. Several populations are reported to be at high risk for drowsy driving accidents, including shift workers, teenage drivers, medical residents, and pilots. Although new parents are known to have significant sleep disruption, no study has investigated vehicular accidents or near miss accidents in this population. Methods A preliminary cross-sectional, anonymous survey of parents who had given birth within the previous 12 months. Participants were asked about their sleep, including validated measures of sleep disruption, their driving patterns, and information about near miss traffic accidents and actual crashes. Results Overall, 72 participants were enrolled. A large proportion of participants had poor sleep including approximately 30 % with daytime sleepiness, 60 % with poor daytime function and two-thirds with poor sleep quality. The mean sleep duration was only 6.4 h. Although most participants drove <100 miles per week, 22.2 % reported at least one near miss accident and 5.6 % reported a crash. Sleep problems were more common in those with near miss accidents and actual crashes than in those without. Of note, poor sleep quality was associated with a sixfold increase in near miss accidents even after accounting for other factors. Conclusion Poor sleep is common in new parents and we provide preliminary evidence that sleep disruption in this population is associated with near miss motor vehicle accidents. Drowsy driving results in thousands of unnecessary serious injuries and fatalities each year; raising public awareness that new parents are a high-risk group is important.     

某市1994～1998年交通意外伤害水平的变化趋势

[目的 ]　了解某市 1994～ 1998年交通意外伤害水平和变化趋势。　 [方法 ]　对某市公安部门的 5年交通意外伤害统计资料进行流行病学分析 ,并比较不同年龄别的潜在减寿年数 (PYLL)。　 [结果 ]　随着机动车保有量 ,年汽油消耗量的提高 ,该市交通事故发生率有增高趋势 ,但每年交通意外导致的死亡人数却维持在稳定的水平。驾驶员、乘车人、骑车人及行人中 ,男性死亡数和事故发生数均高于女性 ,受伤害对象主要为自行车骑车人及驾驶员。市区的交通意外伤害明显高于郊区 ,季节和月份变化趋势不明显。每小时交通意外伤害的发生数 ,在市区高峰出现在当天的 8:0 0～17:0 0 ,而死亡数趋势呈双峰分布 ,高峰位于 5 :0 0～ 8:0 0和 2 1:0 0～ 2 3 :0 0 ,而在郊区 ,两者的变化较平缓 ,集中趋势不明显。　 [结论 ]　必须针对不同交通参与人员开展健康促进工作 ,加强危险时段和路段的安全管理 ,改善路况和交通设施 ,预防和控制交通意外伤害的发生     

Sleepiness and road accidents among policemen on shif-work on Italian highways: study of the national highway network in the period of 1993-1997

Sleep disorders and daytime sleepiness are the most frequent disturbances reported by shift-workers. Sleepiness and fatigue can increase the risk of human errors and accidents especially during night work. In order to evaluate the time distribution and the possible role of sleepiness on road accidents in policemen on shift-work on highway patrols over 24 hours, we analyzed 1218 car accidents that occurred on the Italian highway network in the period 1993-1997. Accidents occurring during day shifts were significantly correlated with traffic density while accidents occurring during night shifts were not. During the 19:00-01:00 h shift the number of accidents showed a progressively increasing trend with two significant peaks around 23:00 and 01:00 h. Accidents occurring during the 01:00-07:00 h shift did not show significant trends. Information about sleep habits before starting night shifts were obtained by means of telephone interviews. While 85% of the subjects usually took a nap (30-90 min) before the 01:00-07:00 h shift only 15% took a short nap (< 30 minutes) before the 19:00-01:00 h shift. The data can be interpreted as a balance between circadian factors, homeostasis and fatigue related influences and spontaneously adopted counteracting strategies to increase the level of vigilance during night work hours. While a long nap seems to reduce the risk of accidents during the 01:00-07:00 h shift, policemen seem to underestimate the risk of sleepiness during the shift 19:00-01:00 h shift.     

2006—2009年上海市自卸货车及全市交通事故特征分析

目的了解上海市2006—2009年自卸货车道路交通事故的特点,为重型货车道路交通伤害预防提供理论依据。方法分析上海市交警部门提供的全市道路交通伤害数据以及自卸货车道路交通伤害数据。结果 2006—2009年期间全市道路交通事故数以2006年最高,为6588次,2007年后逐步下降,分别为3952次、2745次和2831次,而同期自卸货车道路交通事故数呈现U型趋势,分别为177次、99次、86次和147次。自卸货车事故性质较为严重,98.1%的事故均有人员伤亡。全市道路交通事故一般以二三季度发生较多,且时间段集中在12—18时之间,而自卸货车以二季度发生较多,时间段集中在上午6—12时或12—18时两个时间段。无论是全市还是自卸货车道路交通事故均以年轻驾驶员为主。全市和自卸货车道路交通事故的首要责任认定均为机动车违法,分别占63.8%和73.0%,碰撞特点前3位均为侧面相撞(全市53.0%、自卸53.0%)、正面相撞(全市20.7%、自卸17.3%)和尾随相撞(全市8.8%、自卸8.1%)。结论自卸货车的交通伤害性质严重,必须从人、车、路3方面入手,采取综合性的干预措施才能有效地降低交通伤害的发生和死亡。     

机动车驾驶员道路交通伤害危险因素的病例对照研究

目的：探讨道路伤害中机动车驾驶员的危险因素，为进一步开展交通道路伤害预防提供科学依据。方法：采用病例对照研究方法，通过面询方法收集事故驾驶员和非事故驾驶员的一般情况、睡眠状况、急性困倦、吸烟、饮酒、违章驾驶行为等情况。以SPSS11．5软件进行统计分析。结果：调查了150名事故驾驶员和174名非事故驾驶员。在控制了其他影响因素情况下，驾驶时因感觉/判断错误、疏忽大意、遇紧急情况措施不当和违章操作的OR值（95％CI）分别是137．51（15．773-1198．876）、72．82（18．980-279．344）、25．16（3．097-204．398）和13．27（1．976-89．146）；初中及以下教育程度的驾驶员发生事故的危险性是高中及以上教育程度驾驶员的2．76倍（95％CI：1．082-7．021）；实际驾龄〈5年的驾驶员发生事故的危险性是实际驾龄≥5年的驾驶员的3．04倍（95％CI：1．235-7．457）；驾驶时感觉/判断失误与每周驾驶时间存在交互作用，每周驾驶时间≥40h的驾驶员，因感觉秽4断错误而发生交通事故的危险性低于每周驾驶时间〈40h的驾驶员（OR=0．022，95％CI：0．001-0．371）。结论：驾驶时疏忽大意、感觉/判断错误、遇紧急事故措施不当、违章操作、初中及以下教育程度、实际驾龄短是道路交通伤害中机动车驾驶员的危险因素。     

Slippery road conditions and fatal motor vehicle crashes in the northeastern United States, 1998-2002

OBJECTIVES: We investigated risk factors for fatal motor vehicle crashes on slippery roads in the Northeastern United States, 1998-2002. METHODS: We analyzed data from the Fatality Analysis Reporting System of the National Highway Traffic Safety Administration. RESULTS: Rates of crashes on slippery roads, and ratios of crashes on slippery roads to crashes on dry roads, were greatest among the youngest drivers. Among those aged 16 to 19 years, logistic regression analysis showed significant, independent risks associated with excessive speed for conditions (odds ratio [OR]=1.38), time of day (OR=1.80 for 5:00 to 9:00 am vs 10:00 am to 2:00 pm), time of year (OR=6.17 for January vs July), type of road (OR=1.27 for rural vs urban roads ), and age (OR=1.19 for those aged 16 to 17 years vs those aged 18 to 19 years). Licensure from states with graduated licensing programs was protective against crashes attributed to swerving on slippery roads (adjusted OR = 0.63). Risk factors among drivers older than 19 years were similar but peaked at different times of day and included increased risks for women compared with men. CONCLUSIONS: Driver training programs need to better address hazards presented by slippery roads.     

Associations of short-term exposure to ambient air pollutants with emergency ambulance calls for the exacerbation of essential arterial hypertension

We investigated the association between daily emergency ambulance calls (EAC) for elevated blood pressure that occurred during the time intervals of 8:00–13:59, 14:00–21:59, and 22:00–7:59, and exposure to CO, PM₁₀, and ozone. We used Poisson regression to explore the association between the risk of EAC and short-term variation of pollutants, adjusting for seasonality and weather variables. Before noon, the risk was associated with an interquartile range (IQR) (7.9 μg/m³) increase in PM₁₀ at lag 2–4 days below the median (RR = 1.08, p = 0.031) and with an IQR (0.146 mg/m³) increase in CO at lag 6–7 below the median (RR = 1.05, p = 0.028). During 14:00–21:59, the risk was associated with an IQR (18.8 μg/m³) increase in PM₁₀ on the previous day below the median (RR = 1.04, p = 0.031). At night, EAC were negatively affected by lower O₃ (lag 0–2) below the median (per IQR decrease RR = 1.10, p = 0.018) and a higher PM₁₀ at lag 0–1 above the median for the elderly (RR = 1.07, p = 0.030).     

驾驶员驾驶事故重要危险因素:酒后驾车

目的探讨驾驶员驾驶事故发生的危险因素。方法对上海市711名各类驾驶员做了全面调查 ,并进行事故原因和多因素Logistic回归及逐步判别分析。结果驾驶前饮酒、驾驶过程中吸烟、驾驶过程中打手机、驾照类型、嗜睡和易发怒均为交通事故的危险因素。结论交通安全部门应针对上述因素 ,特别是酒后驾车 ,加强管理和宣教     

合肥市出租车司乘人员安全带佩戴状况调查

目的 调查安徽省合肥市出租车司乘人员安全带的佩戴情况.方法 在合肥市区分别选择5个主干道和5个支路路段观察点,每个观察点于工作日、双休日各观察1 d.自07:00～19:00连续12 h的每1 h时间段内,累计观察前排有乘客乘坐的出租车50车次,共观察12 000车次.结果 合肥市出租车司机安全带正确、不正确佩戴率及未佩戴率分别为44.2%,3.4%,52.4%;前排乘客安全带的正确佩戴率及未佩戴率分别为0.5%和99.5%.司机安全带正确佩戴率工作日高于双休日,且自07:00.19:00呈增高-降低-增高-降低的变化趋势;上午10～11点、下年4～5点时间段较高,中午1点最低;主干道和支路路段上正确佩戴率差异无统计学意义;女司机正确佩戴率高于男司机.结论 .合肥市出租车司乘人员安全带的佩戴率较低,应结合司机佩戴安全带的时间变化规律加强交通监管力度,同时要充分重视对前排乘客安全带使用的干预.     

The risk of accidents among older drivers

The number of older persons holding a driver's license is rapidly increasing, as is the number of older persons driving a car. This paper examines driver accident risk by age group, focusing on the older driver. Two different measures of accident risk are used; involvement in personal injury traffic accidents per million kilometers driven, and involvement in traffic accidents where one or more pedestrians were injured per million kilometers driven. The latter measure is used to refute the assumption that the elderly's risk of being involved in personal injury accidents might, to some extent, be explained by the fact that older drivers generally tend to run a higher risk than younger drivers of being injured in the event of a traffic accident. Another motive is that it provides a measure of the extent to which drivers of different ages present a risk to their fellow road users. This study shows that drivers in the 75-84 age group are at four to six times greater risk than are middle-aged drivers of being involved in personal injury traffic accidents.     

2004～2006年威海市暴雪期间交通伤害特征分析

[目的]了解暴雪期间交通事故伤害发生特点,为制定灾害干预策略提供科学依据。[方法]对2004～2006年威海市12月份的交通伤害发生情况进行分析。[结果]3年的12月,2005年交通事故发生率(1.24次/万辆)最低,但致死率最高(42.35%)。1日内事故好发时段在17:00～、6:00～8:00,2006年在20:00多1个高峰。事故发生率与事故伤亡率2005年环翠区最高,2006年荣成市最高;2004年4市(区)相近。2004和2006年伤亡人员年龄集中在30～45岁,职业集中在工人与农民,交通方式以骑乘摩托车占第1位,为40.80%、37.17%。2005年伤亡人员的年龄、职业、交通方式较2004与2006年相对分散,交通方式为骑乘摩托车和步行并列第1,占30.59%,第3位是骑自行车,3者占77.65%。3年的伤亡人员的性别以男性为主,占75.22%～80.00%,且主要肇事人群均以机动车驾驶人为主,占92.55%～96.16%。[结论]晴朗天气以预防交通事故的发生为主,雪天以预防交通事故的死亡为主;提高机动车驾驶人的综合驾驶素质,开展全民性的交通伤害现状、伤害预防知识宣传,加强雪天交通伤害的急救措施,提高救治水平,降低交通伤害致死率是冬季预防交通伤害的关键。     

Vehicle accidents related to sleep: a review

Falling asleep while driving accounts for a considerable proportion of vehicle accidents under monotonous driving conditions. Many of these accidents are related to work--for example, drivers of lorries, goods vehicles, and company cars. Time of day (circadian) effects are profound, with sleepiness being particularly evident during night shift work, and driving home afterwards. Circadian factors are as important in determining driver sleepiness as is the duration of the drive, but only duration of the drive is built into legislation protecting professional drivers. Older drivers are also vulnerable to sleepiness in the mid-afternoon. Possible pathological causes of driver sleepiness are discussed, but there is little evidence that this factor contributes greatly to the accident statistics. Sleep does not occur spontaneously without warning. Drivers falling asleep are unlikely to recollect having done so, but will be aware of the precursory state of increasing sleepiness; probably reaching a state of fighting off sleep before an accident. Self awareness of sleepiness is a better method for alerting the driver than automatic sleepiness detectors in the vehicle. None of these have been proved to be reliable and most have shortcomings. Putative counter measures to sleepiness, adopted during continued driving (cold air, use of car radio) are only effective for a short time. The only safe counter measure to driver sleepiness, particularly when the driver reaches the stage of fighting sleep, is to stop driving, and--for example, take a 30 minute break encompassing a short (< 15 minute) nap or coffee (about 150 mg caffeine), which are very effective particularly if taken together. Exercise is of little use. CONCLUSIONS: More education of employers and employees is needed about planning journeys, the dangers of driving while sleepy, and driving at vulnerable times of the day.     

疲劳驾驶检测方法的研究

疲劳驾驶是发生严重交通事故的重要原因。本文介绍了当前技术比较先进的三种测量技术(PERCLOS：闭眼的时间占的比例，头部位置传感器，瞳孔测量法)，文献显示每种测量方法都对监测疲劳驾驶有很大的进展。但是，作者认为，没有一种单独的方法能够准确可靠地测量疲劳驾驶。作者在分析疲劳产生的原因、原理和检测方法，对比当前的几种测量方法后，提出改进这些方法的方案。     

1994～2003年我国火灾的流行病学分析

目的　分析 1994～ 2 0 0 3年我国火灾的流行病学特征 ,探讨火灾危险因素和防范措施 ,为预防和控制火灾伤害提供一定理论依据。方法　采用回顾法对我国 1994～ 2 0 0 3年火灾资料进行描述性研究。结果　近十年火灾发生呈现上升趋势 ;群死群伤特大火灾明显增多 ,公众聚集场所是火灾高发场所 ;东部沿海地区火灾严重 ;火灾发生的直接原因 82 .1%为人为因素 ;春季和冬季火灾高发 ,夏季较少 ;白天火灾多于晚上 ;时间以 18:0 0～ 2 0 :0 0多发。结论　我国的火灾总体形势严峻 ,针对火灾危险因素进行积极防范十分必要。     

动态心电图在冠心病临床诊断中的应用观察

目的研究动态心电图在冠心病临床诊断中的应用价值。方法 82例拟诊冠心病患者随机均分成两组,观察组进行动态心电图诊断,对照组则进行常规心电图诊断。对比两组症状检出率以及ST段下移持续时间。结果观察组发现心肌缺血性ST段下移464次,其中SMI发作392次,有症状缺血发作72次,均显著高于对照组(P<0.05)。观察组SMI持续时间(14.6±3.5)min/次,有症状性心肌缺血持续时间(31.2±9.8)min/次,均显著高于对照组(P<0.05)。观察组ST段下移发作高峰时间6～12时为198阵次,12～18共84阵次,18～24时共57阵次,0～6时共47阵次,均显著高于对照组(P<0.05)。结论临床中对于冠心病患者采取动态心电图的诊断,提高了对冠心病临床诊断的检出率,安全性较高,值得临床推荐应用。     

Caffeine withdrawal, sleepiness, and driving performance: what does the research really tell us?

As a psychostimulant, caffeine is thought to reduce road accidents by keeping drivers alert and wakeful. Studies have found that caffeine can improve performance on vigilance tasks and in driving simulators under normal sleeping conditions and after sleep restriction or deprivation. However, there is increasing evidence that these beneficial effects of caffeine are due to withdrawal reversal. Studies comparing the effects of caffeine versus placebo on driving performance have tested habitual caffeine consumers deprived of caffeine from the evening before the test day. The conclusion from this review is, therefore, that improvements in driving performance and alertness after caffeine are likely to represent withdrawal reversal rather than a net beneficial effect of caffeine. Further research using designs that control for caffeine withdrawal are necessary and, accordingly, advice given to the public on use of caffeine as an antidote to tiredness and impaired performance should be reviewed.     

The relationship between working schedule patterns and the markers of the metabolic syndrome: Comparison of shift workers with day workers

Objectives

This study examined the effect of shift work on developing the metabolic syndrome by comparing groups of exposed and unexposed Iranian drivers.

Methods

We considered as night-shift drivers those drivers whose shifts included at least 15 h per week between 9:00 p.m. and 7:00 a.m. Daytime drivers were defined as drivers working regularly without shift work. 3039 shift work drivers were selected. These were matched with non-shift workers. The differences in baseline characteristics and the prevalence of the components of the metabolic syndrome were assessed with Student’s t test, and chi-square tests.

Results

We found central adiposity in 52.0% of the shift workers versus 42.6% of the day workers (p < 0.0001). The hypertension component was not significantly related to shift work (p > 0.05); but there were significant differences as regards other components of the metabolic syndrome (p < 0.0001). Among the shift workers, the odds ratios of the increased FBS, low HDL-C, higher TG levels, as well as higher waist circumference were 1.992 (95% CI: 1.697–2.337), 1.973 (95% CI: 1.759–2.213), 1.692 (95% CI: 1.527–1.874), and 1.460 (95% CI: 1.320–1.616), respectively. The metabolic syndrome was more common among the shift workers (OR = 1.495; 95% CI: 1.349–1.657).

Conclusion

In evaluating such results, further consideration is needed to find pathophysiological clarification; in turn, stress linked to shift work must be considered to likely have had a relevant influence on the outcome. In our opinion, shift work acts as an occupational factor for the metabolic syndrome.     

香港地区儿童家庭意外事故416例分析

目的：了解前来急诊室就医的意外事故儿童的伤害类型、伤害程度等情况,为将来开展“儿童意外事故的预防控制提供参考依据。方法：采用病例的描述性分析。结果：在本次分析的４１６例意外事故儿童中,男童（５６．７％）多于女童（４１．３％）,年龄最小者不中１个月,最大１４岁,平均３．１９％（Ｓｄ,３．０５）岁,４岁以下的受伤儿童占６０％。８６．８％的意外故事发生在儿童家中,其中以客厅、卧室所占比例最大,分别为３８     

Driver impairment at night and its relation to physiological sleepiness

OBJECTIVES: Studies of devices detecting sleepiness need reference points of physiological sleepiness. The present study sought to validate the Karolinska drowsiness score (KDS) as an indicator of physiological sleepiness against driving impairment and eye blink duration during a 45-minute drive in an advanced moving-base driving simulator. METHODS: Data from 19 persons were used in the analysis. Electrooculography, electroencephalography, and electromyography were administered continuously. Physiological sleepiness was quantified by scoring the percentage (0-100%) of the scoring epoch with alpha and theta activity and slow eye movements (KDS). Lateral position and speed were used as measures of driving behavior. Lane departure was defined as two wheels touching the lane markers. Blink duration was used as a secondary indicator of sleepiness. RESULTS: The results showed that, for young drivers, sleepiness increased with time in the task with higher levels. The variability of the lateral position and the mean and variability of the blink duration significantly changed when sleepiness increased to KDS > or =20%. Furthermore, there was an increase in the risk of lane departure for KDS > or =30%. CONCLUSIONS: The results suggest that KDS scoring is a reasonable procedure for estimating physiological sleepiness under conditions of driving. The results also indicate that a younger age is associated with greater sensitivity to sleepiness at the wheel.