Pain and pain treatment were associated with traffic accident involvement in a cohort of middle-aged workers

BACKGROUND AND OBJECTIVE: To assess the influence of medical conditions on road traffic accidents among a cohort of middle-aged workers and pensioners. STUDY DESIGN AND SETTING: A longitudinal study of 13,548 participants from a cohort study of French workers. Follow-up data covered the 1989-2000 period. Adjusted hazards ratios (HR(adj)) for serious accidents were computed by Cox's proportional hazards regression with time-dependent covariates adjusted for age, occupation, annual mileage in 2001, alcohol consumption, and number of reported health problems. RESULTS: Men who reported treated dental or gingival problems (HR(adj)=8.57, 95% confidence interval CI=2.70-27.2) and women who reported treated renal colic or kidney stones (HR(adj)=9.71, 95% CI=2.40-39.3) were much more likely to have a serious traffic accident. Treated glaucoma, hiatal hernia or gastric ulcers, and diabetes among women and treated cataract among men were also found to be associated with the risk of serious traffic accidents. CONCLUSIONS: This study raises the hypothesis that pain and pain treatment (singly or in combination) could increase the risk of road traffic accident and confirms that medical conditions traditionally found to be associated with traffic accident involvement of older drivers are also risk factors for middle-aged drivers.     

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。     

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.     

Childhood injuries: a population-based study of emergency room visits in Jerusalem

A study of childhood injuries of 0-17-year-old Jewish children based on emergency room records of the four major hospitals and the first aid stations was conducted in Jerusalem during 1986. The incidence of visits was 99.7/1000 child-years with 95% confidence intervals (CI) = 98.0-101.5. The rate was 97.2/1000 child-years (CI = 94.4-100.0) among the 0-5-year-old, 114.6/1000 child-years (CI = 111.3-118.0) in the 6-12 age group, and was 93.6/1000 child-years (CI = 90.1-97.1) among 13-17-year-old. The male to female rate ratio was 1.7 for the 0-5-year-olds, 2.1 for the 6-12-year-olds and 2.3 for the 13-17-year-olds. The most frequent causes of injuries were falls, 38.5/1000 child-years (CI = 37.4-39.6), being struck or caught, 21.1/1000 child-years (CI = 20.3-21.9), and road accidents, 5.4/1000 child-years (CI = 5.0-5.8). Only burns among children aged 6 years and over and poisoning among 13-17-year-olds showed a higher incidence among females than among males. The head was the most frequently injured part of the body (45.2/1000 child-years, CI = 44.0-46.4). Head injuries decreased as age increased, while injuries to the extremities and trunk increased with increasing age. Two per cent of the injured children were admitted to hospital.     

Alcohol, psychoactive substances and non-fatal road traffic accidents - a case-control study

ABSTRACT: BACKGROUND: The prevalence of alcohol and other psychoactive substances is high in biological specimens from injured drivers, while the prevalence of these psychoactive substances in samples from drivers in normal traffic is low. The aim of this study was to compare the prevalence of alcohol and psychoactive substances in drivers admitted to hospital for treatment of injuries after road traffic accidents with that in drivers in normal traffic, and calculate risk estimates for the substances, and combinations of substances found in both groups. METHODS: Injured drivers were recruited in the hospital emergency department and drivers in normal conditions were taken from the hospital catchment area in roadside tests of moving traffic. Substances found in blood samples from injured drivers and oral fluid samples from drivers in moving traffic were compared using equivalent cut off concentrations, and risk estimates were calculated using logistic regression analyses. RESULTS: In 21.9% of the injured drivers, substances were found: most commonly alcohol (11.5%) and stimulants eg. cocaine or amphetamines (9.4%). This compares to 3.2% of drivers in normal traffic where the most commonly found substances were z-hypnotics (0.9%) and benzodiazepines (0.8%). The greatest increase in risk of being injured was for alcohol combined with any other substance (OR: 231.9, 95% CI: 33.3- 1615.4, p < 0.001), for more than three psychoactive substances (OR: 38.9, 95% CI: 8.2- 185.0, p < 0.001) and for alcohol alone (OR: 36.1, 95% CI: 13.2- 98.6, p < 0.001). Single use of non-alcohol substances was not associated with increased accident risk. CONCLUSION: The prevalence of psychoactive substances was higher among injured drivers than drivers in normal moving traffic. The risk of accident is greatly increased among drivers who tested positive for alcohol, in particular, those who had also ingested one or more psychoactive substances. Various preventive measures should be considered to curb the prevalence of driving under the influence of psychoactive substances as these drivers constitute a significant risk for other road users as well as themselves.     

Emotional stress and traffic accidents: the impact of separation and divorce

BACKGROUND: Personal responses to stressful life events are suspected of increasing the risk of serious traffic accidents. METHODS: We analyzed data from a French cohort study (the GAZEL cohort), including a retrospective driving behavior questionnaire, from 13,915 participants (10,542 men age 52-62 years and 3373 women age 47-62 years in 2001). Follow-up data covered 1993-2000. Hazard ratios for serious accidents (n = 713) were computed by Cox's proportional hazard regression with time-dependent covariates. Separate analyses were also performed to consider only at-fault accidents. RESULTS: Marital separation or divorce was associated with an increased risk of a serious accident (all serious accidents: hazard ratio 2.9, 95% confidence interval = 1.7-5.0; at-fault accidents: 4.4, 2.3-8.3). The impact of separation and divorce did not differ according to alcohol consumption levels. Other life events associated with increased risk of serious accident were a child leaving home (all accidents: 1.2, 0.97-1.6; at-fault accidents: 1.5, 1.1-2.1), an important purchase (all accidents: 1.4, 1.1-1.7; at-fault accidents: 1.6, 1.2-2.1), and hospitalization of the partner (all accidents: 1.4, 1.1-2.0). CONCLUSION: This study suggests that recent separation and divorce are associated with an increase in serious traffic accidents.     

Risky driving behaviour in young people: prevalence, personal characteristics and traffic accidents

OBJECTIVES: This research aimed to examine the prevalence of risky driving behaviour among young people, the characteristics of those who engage in risky driving behaviour, and the association between risky driving behaviours and accident risk. METHODS: Data were gathered during the course of the Christchurch Health and Development Study. As part of this longitudinal study, data were gathered on self-reported risky driving behaviours (18-21 years), traffic accidents (18-21 years) and a variety of individual characteristics for 907 participants who reported having driven a motor vehicle. RESULTS: More than 90% of drivers engaged in some form of risky driving behaviour. Those most likely to engage in frequent risky driving behaviours were: males (p < 0.0001), who exhibited alcohol (p < 0.0001) or cannabis abuse (p < 0.001) in adolescence, who were involved in violent/property crime (p < 0.01) and who affiliated with delinquent or substance-using peers (p < 0.05). There was a strong (p < 0.0001) association between the extent of risky driving behaviour and traffic accident risk. CONCLUSIONS: Risky driving behaviours are common among young people, particularly among young males prone to externalizing behaviours (substance abuse, crime and affiliations with deviant peers). Risky driving is strongly linked to traffic accident risk. IMPLICATIONS: There is a continued need to target risky driving behaviours among young people. Efforts to reduce risky driving should be targeted in particular at the high-risk group of young males prone to externalizing behaviours. More generally, the results suggest the need for a multistrategy approach to the reduction of traffic accidents that focuses on the full spectrum of risky driving behaviours.     

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.     

Medical student attitudes to risk taking and self-perceived influence on medical practice

CONTEXT: Little has been published on medical student risk-taking attitudes and behaviours and whether students think these attributes will affect how they treat patients. OBJECTIVES: Our aims were to assess for an association between risk-taking attitudes and behaviours, such as problematic substance use, self-reported risky behaviours, and self-reported accidents, and to test for an association between risk-taking attitudes and student perceptions of the influence of these attitudes on future clinical practice. METHODS: Three consecutive classes of Year 2 medical students (n=315) completed a self-administered, 29-item questionnaire. Risk-taking attitudes were evaluated using a 6-question, risk-taking scale adapted from the Jackson Personality Inventory (JPI). RESULTS: A significant positive correlation was demonstrated between risk-taking attitudes (JPI) and problematic substance use (r=0.34; P<0.01), self-reported risky behaviours (r=0.47; P<0.01), and self-reported accidents (r=0.33; P<0.01). Students who did not think their attitudes toward risk would affect their clinical decision making scored significantly higher on our measure of risk-taking attitudes (t306=-4.60; P<0.01). Students who did not think that their drinking, drug taking or sexual behaviour would affect how they counselled patients on these matters scored significantly higher on our measure of problematic substance use (t307=-2.51; P=0.01). CONCLUSIONS: Although risk-taking attitudes have been associated with significant differences in clinical decision making among doctors, in our sample students with high risk-taking attitudes and behaviours were significantly less likely than their colleagues to think their attitudes would affect their clinical practice. Implications for medical education are discussed.     

全国死亡9人以上重大交通安全事故流行病学分析

目的分析中国重大交通事故的流行病学特征。方法对国家安全生产监督管理总局2001年1月1日—2008年10月31日期间死亡9人以上的重大交通事故调查报告资料进行描述性研究。结果共发生463起重大事故,死亡6819人,重伤2841人,轻伤2496人。道路、轮船、航空、铁路交通事故死亡人数分别为5271、1142、295、111人。各省按事故发生频次排序前5位是:贵州(37)、云南(35)、浙江、(34)、四川(33)、广东(30)。结论重大交通事故与司机、道路情况、车辆情况、违规驾驶、自然条件等多因素相关,交通事故频次、死伤人数增长很快,地区分布严重失衡。     

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.     

Accidents with exposure to biological material contaminated with HIV in workers at a third level hospital in Madrid

BACKGROUND: Human Immunodeficiency Virus (HIV) is an occupational hazard among healthcare professionals accidentally contaminated with HIV-positive blood. This study is aimed at describing the characteristics of the accidents involving blood of HIV-positive patients recorded over a sixteen-year period at a general hospital. METHODS: Epidemiological study of the accidents reported in 2001 involving biological material from an HIV-positive source by the healthcare personnel of a general hospital throughout the 1986-2001 period entailing the presence of biological material from HIV-positive serology individuals. Individual, time and place-related variables, in addition to the initial serologies and those throughout the protocolized follow-up were studied for those individuals involved in these accidents. RESULTS: A total 550 accidents entailing an HIV-positive source were reported. The average number of accidents was 34.4/year. The accidental exposure rate for the period under study was 7.5/1000 workers/year. The professional group showing the highest accident rate was the nursing staff (54.4%). Percutaneous injuries were the most frequent (80.2%). The mean exposure rate was 2.6/100 beds/year. The anatomical areas involved to the greatest degree were the fingers (75.6%). A total 53.4% of those injured completed the serological follow-up without having shown any seroconversion. CONCLUSIONS: Throughout the sixteen-year period under study, the annual incidence of accidents involving an HIV-positive source increased from the 27 accidents reported in 1986 to the 60 accidents reported in 1990, there having been a downward trend as of that point in time, to the point of 12 accidents having been recorded in 2001.     

Females do not have more injury road accidents on Friday the 13th

Background

This study reinvestigated the recent finding that females – but not males – die in traffic accidents on Friday the 13th more often than on other Fridays (Näyhä S: Traffic deaths and superstition on Friday the 13th. Am J Psychiatry 2002, 159: 2110–2111). The current study used matched setting and injury accident data base that is more numerous than fatality data. If such an effect would be caused by impaired psychic and psychomotor functioning due to more frequent anxiety among women, it should also appear in injury crashes.

Methods

We used the national Finnish road accident database for 1989–2002. To control seasonal variation, 21 Fridays the 13th were compared in a matched design to previous and following Fridays, excluding all holidays, on number of accidents, male/female responsibility for accidents, and the number of dead, injured and overall number of active participants (drivers, pedestrians and bicyclists) as a consequence of the accident.

Results

There were no significant differences in any examined aspect of road injury accidents among the three Fridays, either in females or males. Women were not overrepresented in crashes that occurred on Fridays 13th.

Conclusion

There is no consistent evidence for females having more road traffic crashes on Fridays the 13th, based on deaths or road accident statistics. However, this does not imply a non-existent effect of superstition related anxiety on accident risk as no exposure-to-risk data are available. People who are anxious of "Black Friday" may stay home, or at least avoid driving a car.

     

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。     

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.     

Modeling Frequency of Injuries per Vehicle Crash in Gurage Zone,Southern Ethiopia

BackgroundTraffic accident is the most serious problem in developing countries like Ethiopia, which is among the leading cause of death with the highest increasing rate from year to year in Ethiopia. This research aimed to identify the associated factors on the frequency of injuries per vehicle crash in Gurage zone.MethodsA retrospective study was conducted to identify the contributing factors of a number of injuries per accident. The data were collected from all traffic control and investigation office of 13 Woredas (Districts) for the past five consecutive years from 2013 to 2017. Negative Binomial Regression model was employed to identify the associated factors that affect the number of injuries per accident.ResultsA total of 334 accidents recorded in the last five years from 2013 to 2017 in Gurage zone. Two hundred eight three (84.73%) of the accidents were caused 610 number of injuries. The significantly associated factors of frequency of injuries per road traffic accidents were Drivers'' Age (IR: 0.9813; CI: 0.9664 - 0.9962), Drivers'' Sex: Female (IR : 1.6386; CI : 1.2176 - 2.0596), Drivers'' vehicles ownership: Hired (IR: 1.4216; CI: 1.1697 - 1.6735) and non-drivers'' related variables, like weather condition: Rainy (IR: 1.6041; CI: 1.2552 - 1.9529), road shape: street-square (IR: 1.7421 ; CI: 1.1908 - 2.2934) and vehicle type: Isuzu (load)(IR: 1.6845; CI : 1.2592 - 2.1098) Minibus (IR: 2.7253; CI 2.3129 - 3.1377).ConclusionsThis study found that, Driver''s related factors: Driver''s Age, Sex, Drivers'' vehicle ownership, and non-drivers'' related variables: Weather condition, Road shape, and Vehicle type were identified as significantly associated factors on the frequency of injuries per vehicle crash in Gurage Zone.     

Effect on road traffic injuries of criminalizing road traffic offences: a time-series study

Objective

To determine the effect of criminalizing some traffic behaviours, after the reform of the Spanish penal code in 2007, on the number of drivers involved in injury collisions and of people injured in traffic collisions in Spain.

Methods

This study followed an interrupted times–series design in which the number of drivers involved in injury collisions and of people injured in traffic collisions in Spain before and after the criminalization of offences were compared. The data on road traffic injuries in 2000–2009 were obtained from the road traffic collision database of the General Traffic Directorate. The dependent variables were stratified by sex, age, injury severity, type of road user, road type and time of collision. Quasi-Poisson regression models were fitted with adjustments for time trend, seasonality, previous interventions and national fuel consumption.

Findings

The overall number of male drivers involved in injury collisions dropped (relative risk, RR: 0.93; 95% confidence interval, CI: 0.89–0.97) after the reform of the penal code, but among women no change was observed (RR: 0.99; 95% CI: 0.95–1.03). In addition, 13 891 men (P < 0.01) were prevented from being injured. Larger reductions were observed among young male drivers and among male motorcycle or moped riders than among the drivers of other vehicles.

Conclusion

The findings suggest that criminalizing certain traffic behaviours can improve road safety by reducing both the number of drivers involved in injury collisions and the number of people injured in such collisions.     

An evaluation of the official swedish statistics on seriously injured in road traffic accidents.

Only 32 per cent of the category "seriously injured" in road traffic accidents were correctly registered as such in the official road traffic accident statistics. Furthermore, 25 percent were registered, though wrongly, as "slightly injured". Consequently almost one-half of the seriously injured were not registered at all, and they constituted a drop-out which contributes a bias to the statistics obtained. False registration is primarily associated with short-term hospitalization and absence of surgical operations during the hospital stay, i.e. slight injuries, and low age. The material analysed was comprised of 2689 individuals from hospital or road traffic accident statistics covering the Uppsala hospital region during 1966.     

Historical trends in road accident types,deaths and casualties in Western Australia

Abstract: Road accident casualties are major consumers of health service resources in Australia, using inpatient care, accident and emergency treatment and other facilities. We analysed hospitalisations resulting from road accidents in Western Australia from 1968 to 1987 to examine trends in accident types, deaths and casualties. Data from the Western Australian Health Department's Hospital Morbidity System were used. Although hospitalisations from road accidents generally decreased, they were still higher than the Australian average in 1985. The rate of decline in hospitalisations was similar to that for fatalities and was not generally related to age or sex. There was some evidence of a more rapid decline in the rate of severe injuries than in minor ones. Further steps need to be taken to reduce the number of casualties from road accidents, as road accidents represent a major public health problem in Western Australia.