Effect of environment on extremely severe road traffic crashes：retrospective epidemic analysis during 2000-2001

Objective: To make an epidemiological analysis of the effect of environment on extremely severe road traffic crashes (RTCs). Methods: Epidemiologic data of extremely severe RTCs associated with environmental factors, including weather, topography, road conditions and other traffic conditions in Mainland China during 2000-2001, were collected and analyzed. Results: ( 1 ) During 2000-2001, there were 3 365 extremely severe RTCs with 13 666 deaths, 12 204 injuries and a direct economical loss of 136 million RMB. ( 2 ) Most extremely severe RTCs occurred in fine weather days and in the daytime. The high occurrence sites were plain areas, horizontal and straight roads, Grade B and C roads, ordinary road segment, and asphalt, smooth and mixed roads. (3) Compared with other RTCs, extremely severe RTCs were more likely to happen under following conditions: on cloudy, snowing, misty and blustering days; in hill and mountainous areas; on crooked and sloping roads; on freeway, Grade A, B, and C roads; mixed roads; ordinary, bridge, narrow and transitional roads; sand and dirt-roads; without traffic control measures; night without lighting. (4) Extremely severe RTCs of mountainous area or crooked and sloping roads were most severe in terms of deaths and injures per crash. Conclusions: Extremely severe RTCs are closely related with environmental factors. Rational road programming, enhancing road establishment and improving road conditions are probably effective measures to reduce the road traffic injuries.     

重庆地区驾驶员血液中乙醇浓度与驾驶能力的关系

目的　探讨重庆地区驾驶员血液中乙醇浓度 (BAC)和驾驶能力的关系 ,为交通安全立法提供科学依据。　方法　随机选择重庆地区 59名驾驶员志愿者 ,建立饮酒后驾车模型、科学的BAC测定以及驾驶能力评价体系 ,对不同BAC下驾驶能力进行测评。　结果　受试者出现驾驶能力损害时的BAC均数为 685.9mg/L ,最小值 190 .0mg/L ,最大值 152 0 .0mg/L ,总体均数 95%可信区间为 60 2 .4～ 70 9.5mg/L。汉族和土家族间、汉族男性和女性间、2 3～ 3 5岁和 3 6～ 56岁年龄组间差异无显著性意义 (P >0 .0 5) ,而既往饮酒量不同的三个组别间差异有显著性意义 (P <0 .0 5)。随着BAC增高 ,驾驶能力受损人数增加。在 2 0 0 .0mg/L有 3 % (2 / 59)的受试者驾驶能力降低 ,80 0 .0mg/L则达到 68% (40 / 59)。　结论　随着BAC增高 ,重庆地区驾驶员驾驶能力受损人数比例增加 ,出现驾驶能力明显损害时BAC为 60 2 .4～ 70 9.5mg/L ,既往酒量较大人群中该值较高     

Mortality among young immigrants to California: injury compared to disease deaths

According to a variety of indicators, immigrants are in better health than the U.S.-born population. Little research, however, has investigated foreign- and U.S.-born differentials in mortality. We investigated adolescent and young adult immigrants' risk of death due to disease and injury, the leading cause of death of young persons in the United States. The death certificates of 15- to 34-year-old California residents who died from 1989 through 1993 comprised the study population. Disease and injury deaths were identified using ICD-9 codes on the California Master Mortality data files. Frequencies and gender-standardized rates and risk ratios were calculated by nativity (U.S., non-U.S.) and by ethnicity and nativity. Immigrants are represented appropriately in unintentional injury deaths but underrepresented in suicides and overrepresented in homicides among 15- to 34-year-old California residents. Hispanics appear to account for the foreign- and U.S.-born differences in suicide and homicide. By contrast, immigrants constitute a lower proportion of disease deaths than expected. Empirical data about health risks to immigrants are needed to develop informed policy. These data indicate that young immigrants, at least in terms of mortality, do not constitute a burden in that they are at lower or similar risk of death than U.S.-born youth. Homicide is the sole exception to this pattern.     

25起职业性急性中毒事故分析

目的了解杭州市重大职业性急性中毒事故发生的原因及其救援情况，进一步提高对重大事故的防范和管理。方法收集杭州市１３年间发生的２５起重大职业性急性中毒事故的劳动卫生调查资料，对事故发生的行业、企业、毒物品种采用流行病学分析方法进行统计分析。结果２５起事故共发生中毒１３１人，死亡２２人，乡镇企业的发生率超过国有企业；引起中毒的毒物共１０种，发病人数在前５位的毒物依次为硫化氢、苯、一氧化碳、光气和有机磷农药；１３１名中毒人员中因救援中毒４０人，死亡８人，救援人员中毒和死亡率高于直接作业工人。结论发生事故的原因以缺乏防护知识最为突出。本研究结果为建立基层应急救援体系提供参考依据。     

长治市小学生道路交通安全问题现况调查

目的 调查分析长治市小学生道路交通安全知识、态度、行为状况,及家庭、学校、社会等因素对其的影响,为有针对性地开展交通伤害预防和控制工作提供依据.方法 采用整群随机抽样的方法,在长治市随机抽取11所小学,每所学校的四至六年级各随机抽取一个班,利用统一问卷进行调查.结果 小学生道路交通安全知识得分P50为80分,小学生道路交通安全行为得分P50为94分.家长平日里是否教学生安全知识与学生交通安全知识得分有关;家长交通行为与学生交通行为有关.多因素Logistic回归分析提示:除学生行为得分(OR =2.046,95％ CI:1.518 ～2.759)外,父母自身的交通行为对发生车祸的影响最为显著.结论 长治市小学生道路交通安全问题严峻,家长责任重大.     

Trauma in Cirrhosis: An Indicator of the Pattern of Alcohol Abuse in Different Societies

While some morbidities associated with the excessive use of alcohol are related to the total amount of alcohol consumed--cirrhosis being an example--other pathologies, such as trauma and those of psycho-social origin, are mainly related to the frequency of acute alcoholic intoxication rather than to the total amount consumed. The balance between these two types of alcohol-associated morbidities can provide an indication of the relative frequency of intoxication, and thus of the pattern of alcohol abuse in a population. Since trauma is highly associated with acute alcoholic intoxication, the prevalence of bone fractures was determined in cirrhotics in nine countries. The prevalence of rib and vertebral fractures on routine chest x-rays showed a 17-fold variation in the different countries, from 2% and 6% in Spain and Italy to 30% and 34% in Canada and the USA, suggesting marked differences in the pattern of alcohol abuse to intoxication. Conversely, the prevalence of cirrhosis is twice as high in Spain and Italy than in Canada and the USA. A strong positive correlation between per capita consumption and cirrhosis mortality (r = 0.86; p less than 0.01) exists among the nine countries studied, while the correlation between per capita alcohol consumption and the prevalence of trauma is not statistically significant (r = 0.40). Supporting a strong association between trauma and alcoholic intoxication, the prevalence of trauma was found to be highly correlated: r = 0.88, p less than 0.002, with the degree of concern for the psycho-social consequences of alcohol abuse in the different countries. Data indicate that trauma can be used as an objective indicator to assess the pattern of alcohol abuse in a population.     

Drug driving among injecting drug users in Sydney, Australia: prevalence, risk factors and risk perceptions

Aims To examine the prevalence of drug driving, the prevalence of drug‐related motor vehicle accidents, risk perceptions of drug driving and factors associated with drug driving among injecting drug users (IDU). Design Cross‐sectional survey. Setting Sydney, Australia. Participants Three hundred current IDU. Findings Ninety‐five per cent had driven a vehicle, 74% in the previous 12 months (‘current drivers’). Eighty‐seven per cent of life‐time drivers reported having drug driven, and 88% of current drivers had drug driven in the previous 12 months. There were no significant sex differences in life‐time or recent drug driving. The most common drugs used before driving in the preceding year were: cannabis, heroin, amphetamines and cocaine. A third of life‐time drivers reported having had a drug driving accident, with males more likely to have done so, and 9% of current drivers reported a drug driving accident in the previous year. The most common drugs that had been used before the most recent drug driving accident were heroin, cannabis and alcohol. Alcohol was perceived to be the most dangerous substance for driving performance and cannabis the least dangerous. Recent drug drivers perceived drug driving to be less dangerous than non‐drug drivers. Recent drug drivers had driven more frequently over the preceding 12 months, had significantly higher levels of dependence, higher frequency of drug use, more extensive polydrug use and were more likely to have used and/or injected a drug in a car in the previous 12 months. Conclusions Drug driving and drug‐related accidents are large‐scale public health problems among IDU. These behaviours pose serious risks to IDU themselves and to the broader community.     

Woodworking injuries: A comparative study of work-related and hobby-related accidents

The primary objective of this study was to describe the injury characteristics and demographics of patients injured during woodworking activities, upon their arrival to the emergency department in a regional of France where this industry is prevalent. The secondary objective was to compare patient and injury characteristics for work-related and hobby-related accidents. A cohort of 87 patients who had suffered a woodworking accident over a two-year period was evaluated; 79 were available for follow-up. The context and circumstances of the accident, nature and location of the injuries and patient demographics were recorded. Hobby-related accidents accounted for two-thirds of the accidents (51/79). Most of the injured workers were either loggers (35%) or carpenters (46%). The hand was injured in 53 cases (67%). Work-related accidents resulted in significantly more serious consequences in terms of hospital stay, work stoppage, resumption of work or retraining than hobby-related accidents. For the workplace accidents, 86% occurred on new machines; more than 25% of the machines involved in accidents at home were over 15 years. Sixty-eight per cent of workers were wearing their safety gear, while only 31% of those injured during recreational woodworking wore the appropriate gear. Several elements of prevention should be improved: information about the need to maintain the equipment, protect the worker with suitable clothing, and learn which maneuvers are considered hazardous. Safety gear should be regularly inspected in the workplace.     

Heavy drinking, alcohol dependence, and injuries at work among young workers in the United States labor force

BACKGROUND: To determine whether heavily drinking and alcohol-dependent workers are at higher risk of occupational injury, we analyzed the nationally representative cohort of people enrolled in the National Longitudinal Survey of Youth since 1979. METHODS: This analysis was restricted to the 8569 respondents in the 1989 annual interview (age 24-32) who were employed during the 6 months before the interview. We studied occupational injuries (excluding sprains or strains) reported within 6 months of the interview in 1989 (cross-sectional analysis) and 1990 (prospective analysis). RESULTS: Among current drinkers, significant two-fold increases in the odds of injury for one or more episodes of heavy drinking were reduced to an odds ratio (OR) of 1.2 (95% confidence interval [CI] = 0.7, 2.1) in the cross-sectional analysis and an OR of 1.6 (CI 1.0, 2.8) in the prospective analysis after adjustment for confounding. No dose-response relationship with the frequency of heavy drinking was found. Alcohol-dependent respondents were not at higher risk of injury in the cross-sectional (OR = 1.1, CI 0.7, 1.8) or prospective (OR = 1.3,CI 0.8, 2.2) analyses after adjustment for confounding. CONCLUSIONS: For young U.S. workers, common occupational injuries (excluding sprains and strains) may not be strongly associated with alcohol dependence. Confounding by other risk factors may explain much of the association between being a heavy drinker and occupational injuries in this population.