Single-vehicle and Multi-vehicle Accidents Involving Motorcycles in a Small City in China: Characteristics and Injury Patterns

IntroductionThere is a gap that involves examining differences between patients in single-vehicle (SV) versus multi-vehicle (MV) accidents involving motorcycles in Shantou, China, regarding the injury patterns and mortality the patients sustained. This study aims to address this gap and provide a basis and reference for motorcycle injury prevention.MethodMedical record data was collected between October 2002 and June 2012 on all motorcycle injury patients admitted to a hospital in the city of Shantou of the east Guangdong province in China. Comparative analysis was conducted between patients in SV accidents and patients in MV accidents regarding demographic and clinic characteristics, mortality, and injury patterns.ResultsApproximately 48% (n = 1977) of patients were involved in SV accidents and 52% (n = 2119) were involved in MV accidents. The average age was 34 years. Collision of a motorcycle with a heavy vehicle/bus (4%) was associated with a 34 times greater risk of death (RR: 34.32; 95% CI: 17.43–67.57). Compared to patients involved in MV accidents, those involved in SV accidents were more likely to sustain a skull fracture (RR: 1.47; 95% CI: 1.22–1.77), an open head wound (RR: 1.46; 95% CI: 1.23–1.74), an intracranial injury (RR: 1.39; 95% CI: 1.26–1.53), a superficial head injury (RR: 1.37; 95% CI: 1.01–1.86), an injury to an organ (RR: 2.01; 95% CI: 1.24–3.26), and a crushing injury (RR: 1.98; 95% CI: 1.06–3.70) to the thorax or abdomen. However, they were less likely to sustain a spinal fracture (RR: 0.58; 95% CI: 0.39–0.85), a pelvic fracture (RR: 0.22; 95% CI: 0.11–0.46), an upper extremity fracture (RR: 0.75; 95% CI: 0.59–0.96), or injuries to their lower extremities, except for a dislocation, sprain, or injury to a joint or ligament (RR: 0.82; 95% CI: 0.49–1.36).ConclusionThe relative risk of death is higher for patients involved in multi-vehicle accidents than patients in single-vehicle accidents, especially when a collision involves mass vehicle(s). Injury to the head dominated motorcycle injuries. Single-vehicle accidents have a higher correlation with head injury or internal injuries to the thorax or abdomen. Multi-vehicle accidents are more correlated with extremity injuries, especially to the lower extremities or external trauma to the thorax or abdomen.     

Factors associated with occupational accidents during part-time work among international students in Japan

This study investigated the status of and risk factors for occupational accidents occurring during part-time work among international students in Japan. In total, 390 international students who had registered with an online survey company were invited to participate in a cross-sectional study using an online self-administered questionnaire in October 2020. Multiple regression analysis was performed to evaluate factors associated with accidents with absence from work. Among 311 participants, 126 (40.5%) had experienced an occupational accident at their part-time job in the past year, and 27 (8.7%) had lost working days because of accidents. The likelihood of accident with work absence was significantly higher among those with high income (adjusted odds ratio [OR] = 4.39, 95% confidence interval [CI]: 1.57–12.24) and language barrier (adjusted OR = 2.37, 95% CI: 1.03–5.47). International students experienced occupational accidents relatively frequently. These results provide insight to guide occupational safety measures for migrants.     

Epidemiology of school accidents during a six school-year period in one region in Poland

Background: The aim of the study was to analyse the incidence of school accidents in relation to school size, urban/rural environment and conditions of physical education classes. Methods: 202 primary schools with nearly 50,000 students aged 7–15 years were studied during a 6-year period in the Wocawek region in Poland. Results: There were in total 3274 school accidents per 293,000 student-years. Accidents during breaks (36.6%) and physical education (33.2%) were most common. Most frequently accidents took place at schoolyard (29.7%), gymnasium (20.2%), and in the corridor and stairs (25.2%). After adjustment for students' age and sex, student–staff ratio and duration of school hours, urban environment increased the probability of accident (OR: 1.25; 95% CI: 1.14–1.38). Middle-size schools (8–23 classes) had similar accident rate as small schools (OR: 0.93; 95% CI: 0.83–1.04), while schools with 24–32 classes (OR: 1.26; 95% CI: 1.10–1.43) and with 33 classes (OR: 1.36; 95% CI: 1.17–1.58) had increased accident rate. Presence of a gymnasium was also associated with increased probability of accident (OR: 1.49; 95% CI: 1.38–1.61). Conclusions: Urban environment, larger school-size and equipment with full-size gymnasium are important and independent risk factors for school accidents. These findings provide some new insights into the epidemiology of school-related accidents and may be useful information for the planning of strategies to reduce accident incidence in schools.     

Association of long working hours with accidents and suicide mortality in Korea

Objectives:The deleterious health effects of long working hours have been previously investigated, but there is a dearth of studies on mortality resulting from accidents or suicide. This prospective study aims to examine the association between working hours and external-cause mortality (accidents and suicide) in Korea, a country with some of the longest working hours in the world.Methods:Employed workers (N=14 484) participating in the Korean National Health and Nutrition Examination Survey (KNHANES) were matched with the Korea National Statistical Office’s death registry from 2007–2016 (person-years = 81 927.5 years, mean weighted follow-up duration = 5.7 years). Hazard ratios (HR) for accident (N=25) and suicide (N=27) mortality were estimated according to weekly working hours, with 35–44 hours per week as the reference.Results:Individuals working 45–52 hours per week had higher risk of total external cause mortality compared to those working 35–44 hours per week [HR 2.79, 95% confidence interval (CI) 1.22–6.40], adjusting for sex, age, household income, education, occupation, and depressive symptoms. Among the external causes of death, suicide risk was higher (HR 3.89, 95% CI 1.06–14.29) for working 45–52 hours per week compared to working 35–44 hours per week. Working >52 hours per week also showed increased risk for suicide (HR 3.74, 95% CI 1.03–13.64). No statistically significant associations were found for accident mortality.Conclusions:Long working hours are associated with higher suicide mortality rates in Korea.     

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。     

Occupational mortality in British commercial fishing, 1976-95

Aims: To establish the causes and circumstances of all deaths occurring at work or related to work among fishermen in British commercial fishing between 1976 and 1995.

Methods: A retrospective study, based on official mortality files, with a population of 440 355 fishermen-years at risk.

Results: Of 616 deaths in British fishing, 454 (74%) were due to accidents at work, and 394 (87%) of these fishermen drowned. A total of 270 accidents were caused by casualties to vessels and 184 by personal accidents. There was no significant decline in the fatal accident rate, 103.1 per 100 000 fishermen-years, between 1976 and 1995. The fatal accident rate was 52.4 times higher (95% CI 42.9 to 63.8) than for all workers in Great Britain during the same period, and this relative risk increased through the 1980s up to 76.6 during 1991–95. Relative risks with the construction (12.3) and manufacturing (46.0) industries were higher than 5 and 20 respectively, during 1959–68. Trawlers foundering in adverse weather was the most frequent cause of mortality from casualties to vessels (115 deaths), and 82 of 145 personal accidents at sea arose during operations involving trawling nets.

Conclusions: When compared with shore based industries, fishing remains at least as hazardous as before. Prevention should be aimed, most importantly, at the unnecessary operation of small vessels and trawling net manoeuvres in hazardous weather and sea conditions. Other measures should focus on preventing falls overboard, reducing fatigue, a more widespread use of personal flotation devices, and improvements in weather forecast evaluation.

     

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。     

Effect of Morning and Evening Exercise on Energy Balance: A Pilot Study

The purpose of this study was to evaluate the feasibility and acceptability of randomizing adults with overweight and obesity (BMI 25–40 kg/m²) to morning (06:00–10:00) or evening (15:00–19:00) aerobic exercise. Participants completed four exercise sessions per week in the morning (AM, n = 18) or evening (PM, n = 15). The exercise program was 15 weeks and progressed from 70 to 80% heart rate maximum and 750–2000 kcal/week. Bodyweight, body composition, total daily energy expenditure (TDEE), energy intake (EI), sleep, sedentary behavior (SB), non-exercise physical activity (NEPA), and maximal aerobic capacity were assessed at baseline and week 15. Study retention was 94% and adherence to the supervised exercise program was ≥90% in both groups. Weight change was −0.9 ± 2.8 kg and −1.4 ± 2.3 kg in AM and PM, respectively. AM and PM increased TDEE (AM: 222 ± 399 kcal/day, PM: 90 ± 150 kcal/day). EI increased in AM (99 ± 198 kcal/day) and decreased in PM (−21 ± 156 kcal/day) across the intervention. It is feasible to randomize adults with overweight and obesity to morning or evening aerobic exercise with high levels of adherence. Future trials are needed to understand how the timing of exercise affects energy balance and body weight regulation.     

Self-Reported Prevalence of Symptomatic Adverse Reactions to Gluten and Adherence to Gluten-Free Diet in an Adult Mexican Population

The prevalence of symptomatic adverse reactions to gluten and adherence to gluten-free diet in Latin American countries is unknown. These measurements are strongly linked to gluten-related disorders. This work aimed to estimate the prevalence of adverse reactions to oral gluten and the adherence to gluten-free diet in the adult Mexican population. To reach this aim, a self-administered questionnaire was designed and tested for clarity/comprehension and reproducibility. Then, a self-administered questionnaire-based cross-sectional study was conducted in the Mexican population. The estimated prevalence rates were (95% CI): 11.9% (9.9–13.5) and 7.8 (6.4–9.4) for adverse and recurrent adverse reactions to gluten respectively; adherence to gluten-free diet 3.7% (2.7–4.8), wheat allergy 0.72% (0.38–1.37); celiac disease 0.08% (0.01–0.45), and NCGS 0.97% (0.55–1.68). Estimated pooled prevalence of self-reported physician-diagnosis of gluten-related disorders was 0.88% (0.49–1.5), and 93.3% respondents reported adherence to gluten-free diet without a physician-diagnosis of gluten-related disorders. Symptom comparisons between those who reported recurrent adverse reactions to gluten and other foods showed statistically significant differences for bloating, constipation, and tiredness (p < 0.05). Gluten-related disorders may be underdiagnosed in the Mexican population and most people adhering to a gluten-free diet are doing it without proper diagnostic work-up of these disorders, and probably without medical/dietician advice.     

An analysis of industrial accidents in the working field with a particular emphasis on repeated accidents

The present study is based on an analysis of routinely submitted reports of occupational accidents experienced by the workers of industrial enterprises under the jurisdiction of Kagoshima Labor Standard Office during a 5-year period 1983 to 1987. Officially notified injuries serious enough to keep employees away from their job for work at least 4 days were utilized in this study. Data was classified so as to give an observed frequency distribution for workers having any specified number of accidents. Also, the accident rate which is an indicator of the risk of accident was compared among different occupations, between age groups and between the sexes. Results obtained are as follows; 1) For the combined total of 6,324 accident cases for 8 types of occupation (Construction, Transportation, Mining & Quarrying, Forestry, Food manufacture, Lumber & Woodcraft, Manufacturing industry and Other business), the number of those who had at least one accident was 6,098, of which 5,837 were injured only once, 208 twice, 21 three times and 2 four times. When occupation type was fixed, however, the number of workers having one, two, three and four times of accidents were 5,895, 182, 19 and 2, respectively. This suggests that some workers are likely to have experienced repeated accidents in more than one type of occupation.(ABSTRACT TRUNCATED AT 250 WORDS)     

No Effect of Chronotype on Hunger or Snack Consumption during a Night Shift with Acute Sleep Deprivation

Night shift workers experience circadian misalignment and sleep disruption, which impact hunger and food consumption. The study aim was to assess the impact of chronotype on hunger and snack consumption during a night shift with acute sleep deprivation. Seventy-two (36f, 36m) healthy adults participated in a laboratory study. A sleep opportunity (03:00–12:00) was followed by a wake period (12:00–23:00) and a simulated night shift (23:00–07:00). Subjective measures of hunger, prospective consumption, desire to eat fruit, and desire to eat fast food were collected before (12:20, 21:50) and after (07:20) the night shift. Snack opportunities were provided before (15:10, 19:40) and during (23:50, 03:30) the night shift. A tertile split of the dim light melatonin onset (DLMO) distribution defined early (20:24 ± 0:42 h), intermediate (21:31 ± 0:12 h), and late chronotype (22:56 ± 0:54 h) categories. There were no main effects of chronotype on any subjective measure (p = 0.172–0.975), or on snack consumption (p = 0.420), and no interactions between chronotype and time of day on any subjective measure (p = 0.325–0.927) or on snack consumption (p = 0.511). Differences in circadian timing between chronotype categories were not associated with corresponding differences in hunger, prospective consumption, desire to eat fruit, desire to eat fast food, or snack consumption at any measurement timepoint.     

Comparison of acute skin reaction following morning versus late afternoon radiotherapy in patients with breast cancer who have undergone curative surgical resection

We investigated the relationship between the time of radiotherapy (RT) and treatment outcomes in breast cancer. Patients with pathologic T1–2N0–1 breast cancer who received adjuvant RT in the morning (before 10:00 AM) or late afternoon (after 3:00 PM) were eligible for inclusion in this study. We retrospectively compared the clinicopathologic characteristics, acute skin reaction, and survival outcomes according to the time of RT. The median follow-up duration was 83 months (range, 10–131 months). From the 395 eligible patients, 190 (48.1%) and 205 (51.9%) patients were classified into the morning RT group and the afternoon RT group, respectively. The clinicopathologic characteristics were relatively well balanced between the treatment groups, except for pathologic N-stage (P = 0.0409). Grade 2 or higher acute skin reaction according to the Radiation Therapy Oncology Group criteria was observed in 39 (9.9%) patients, with a higher frequency in the afternoon RT group than the morning RT group (13.7% vs 5.8%, respectively; P = 0.0088). There was no difference in the failure patterns or survival outcomes between the treatment groups. RT in late afternoon was associated with increased Grade 2 or more skin reaction after RT for breast cancer patients, but treatment outcomes did not differ according to the time of RT. Individualized considerations for treatment should be taken into account to reduce the risk of skin reactions.     

The Influence of Break Timing on the Sleep Quantity and Quality of Fly-in, Fly-out Shiftworkers

Although shift and break timing is known to affect the sleep of shiftworkers, this has not been demonstrated in Fly-in, Fly-out (FIFO) settings which, compared to residential based settings, may be favourable for sleep. This study investigated the sleep quantity and quality of shiftworkers working a FIFO operation comprising of shifts, and therefore breaks, across the 24-h day. The sleep of 24 males (50.43 ± 8.57 yr) was measured using actigraphy and sleep diaries. Morning breaks were associated with less sleep (09:00–12:00 h; 4.4 ± 1.3 h) and a poorer sleep quality (06:00–09:00 h; 3.1 ± 1.0, “average”) compared to breaks beginning between 00:00 h and 03:00 h (6.8 ± 1.7 h; 2.2 ± 0.9, “good”). Sleep efficiency remained constant regardless of break timing (85.9 ± 5.0% to 89.9 ± 3.5%). Results indicate that even in operations such as FIFO where sleeping conditions are near-optimal and the break duration is held constant, the influence of the endogenous circadian pacemaker on sleep duration is evident.     

Comparison of the literature on medical accidents from a medical database and articles in daily newspapers in Japan

PURPOSE: We analyzed the frequency and content of journal reports on medical accidents over the past 15 years, and compared these findings with related articles in daily newspapers as a means of assessing medical professionals' awareness of current public opinion reflected in daily newspaper coverage. METHODS: A search of medical accident reports was conducted using CD-ROM versions of the medical literature database Japana Centra Revuo Medicina (1987-2001), with the key words "medical accident" and "medical error." The numbers of medical accident articles in newspapers and medical lawsuits were taken as indicators of public opinion. Relationships were investigated using correlation and time series analyses. RESULTS: 1) The total number of reports on medical accidents (including medical errors; hereinafter, medical accident reports) in the database was 2,858, equaling 0.78 medical accident reports for each 1,000 reports in the CD-ROM database. 2) The number of medical accident reports was 174 in 1987, gradually increasing to 333 in 2000 and 618 in 2001. 3) The proportion of the reports from the nursing field increased from 8.9% (1989) to 31.7% (1999). In contrast, the proportion concerning the medical field decreased from 68.8% to 50.2%. 4) The number of medical accident articles in two newspapers was investigated. The yearly trends were similar in both of these newspapers, showing an increase in 1999 and a peak in 2000. 5) A review of Supreme Court records revealed that the number of medical lawsuits each year increased gradually from 352 in 1990 to 805 in 2001. 6) There were significant correlations between the number of medical accident reports and the numbers of newspaper articles or medical lawsuits. A time series analysis of these trends showed that the trend in number of medical accident reports was closely linked with those for numbers of newspaper articles and medical lawsuits, with a time lag. CONCLUSION: Research trends in papers on medical accidents from a database of scientific papers were found to correspond with trend curves for medical lawsuits and articles on medical accidents in daily newspapers. It was thus demonstrated that awareness of medical accidents among medical professionals reflects social emphasis.     

Fatal motor vehicle traffic accidents among Native Americans

An atypical number of motor vehicle-related deaths has been observed among Native American populations. Little is known about why Native groups exhibit increased mortality from this cause. To better understand factors influencing these occurrences, I examined fatal motor vehicle traffic accidents between 1980 and 1986 involving persons of Native American descent in New York State, exclusive of New York City. Data were obtained from a review of death certificates and coroner reports. Fatal motor vehicle collisions among Native Americans generally occurred among men (74%), in rural areas (55%), between 9:00 p.m. and 3:00 a.m. (62%), and during weekends (78%). A sizable percentage of motor vehicle deaths resulted from collisions with pedestrians (28%). Death frequently occurred before the accident victim reached a hospital (74%). Median age at death for male victims was eight years greater than for female victims. These data suggest the need for immediate efforts focusing on primary prevention to minimize risk-taking behaviors likely to result in motor vehicle accidents. I discuss behavioral and environmental factors influencing these observations.     

A longitudinal study on the association between quick returns and occupational accidents

Objective:This study aimed to investigate how change in the number of quick returns [(QR) <11 hours between consecutive shifts] longitudinally is associated with risk of occupational accidents among nurses.Methods:Two-year follow-up data from 1692 nurses participating in the Survey of Shiftwork, Sleep and Health among Norwegian nurses (SUSSH) (mean age 40.2, standard deviation 8.3 years, 91% female) were used. Negative binomial regression analyses were conducted to investigate the association between changes in the number of QR after two years and occupational accidents, controlling for demographics, work factors, and occupational accidents at baseline.Results:An increase from having no or a moderate number of QR (1–34 per year) from baseline to the two-year follow-up assessment was associated with an increased risk of occupational accidents, compared to experiencing no change in the number of QR. Those with a moderate number of QR at baseline who experienced an increase after two years had an increased risk of causing harm to patients/others [incident rate ratio (IRR) 8.49, 95% confidence interval (CI) 2.79–25.87] and equipment at work (IRR 2.89, 95% CI 1.13–7.42). Those who had many QR (>34 per year) at baseline but experienced a reduction after two years had a reduced risk of causing harm to themselves (IRR 0.35, 95% CI 0.16–0.73) and patients/others (IRR 0.27, 95% CI 0.12–0.59).Conclusion:A fairly consistent pattern was demonstrated in which changes in the number of QR over the two-year follow-up period was associated with a corresponding change in the risk of occupational accidents.     

Occupational accidents aboard merchant ships

Objectives: To investigate the frequency, circumstances, and causes of occupational accidents aboard merchant ships in international trade, and to identify risk factors for the occurrence of occupational accidents as well as dangerous working situations where possible preventive measures may be initiated.

Methods: The study is a historical follow up on occupational accidents among crew aboard Danish merchant ships in the period 1993–7. Data were extracted from the Danish Maritime Authority and insurance data. Exact data on time at risk were available.

Results: A total of 1993 accidents were identified during a total of 31 140 years at sea. Among these, 209 accidents resulted in permanent disability of 5% or more, and 27 were fatal. The mean risk of having an occupational accident was 6.4/100 years at sea and the risk of an accident causing a permanent disability of 5% or more was 0.67/100 years aboard. Relative risks for notified accidents and accidents causing permanent disability of 5% or more were calculated in a multivariate analysis including ship type, occupation, age, time on board, change of ship since last employment period, and nationality. Foreigners had a considerably lower recorded rate of accidents than Danish citizens. Age was a major risk factor for accidents causing permanent disability. Change of ship and the first period aboard a particular ship were identified as risk factors. Walking from one place to another aboard the ship caused serious accidents. The most serious accidents happened on deck.

Conclusions: It was possible to clearly identify work situations and specific risk factors for accidents aboard merchant ships. Most accidents happened while performing daily routine duties. Preventive measures should focus on workplace instructions for all important functions aboard and also on the prevention of accidents caused by walking around aboard the ship.