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20 August 2001



Alcohol & Other Drugs
  • See: "Effects of Florida's graduated licensing program on the behaviors and attitudes of teenagers" under Transportation (Below)
Occupational Issues
  • Health and safety training in a sample of open-shop construction companies.

    Goldenhar LM, Moran SK, Colligan M. J Safety Research 2001; 32(2): 237-252.

    Correspondence: Linda M. Goldenhar, Institute for Health Policy and Health Services Research, University of Cincinnati Medical Centre, PO Box 670840, Cincinnati, OH 45267-0840, USA (email: linda.goldenhar@uc.edu).

    Compared to other industries, construction has the third-highest death rate. Many agree, and research has shown, that one way to change these statistics is through effective worker safety and health training. Little is known about the quality and nature of safety and health training available to open-shop (nonunion) construction workers. It was the goal of this preliminary study to provide some initial background information about the nature and quality of safety and training in open-shop construction operations. While the majority of contractors surveyed did provide safety and health training, most did not quantitatively evaluate their training programs in terms of reduction in hazardous behaviors or exposures, or increased job satisfaction or productivity.

Injuries at Home
  • When Smoke Alarms Are a Nuisance: A Call to Action.

    Berger LR, Kuklinski DM. Arch Pediatr Adolesc Med 2001; 155(8): 875-876.

    Correspondence: Lawrence R. Berger, MD, MPH, 1409 Cumbres St NE, Albuquerque, NM 87112 USA (email: unavailable).

    In a two-page editorial, the authors discuss the impact of smoke detectors that have been intentionally disabled because of frequent false alarms. The editorial presents statistics on the prevalence of homes having smoke detectors that were intentionally rendered inoperable, address the issue of the relative merits of ionization versus photoelectric detectors, the value of "hush buttons." The authors recommend that retail stores make photoelectric smoke detectors more widely available, that distribution programs switch to photoelectric detectors, and that education programs address the issue of nuisance alarms.

Rural & Agricultural Issues
  • Farm-related fatalities involving children in Australia, 1989-92.

    Mitchell RJ, Franklin RC, Driscoll TR, Fragar LJ. Aust N Z J Public Health 2001; 25(4): 307-314.

    Correspondence: Rebecca J. Mitchell, Injury Prevention and Policy Unit, NSW Health, New South Wales, AUSTRALIA (email: unavailable)

    This report describes the types of and circumstances surrounding unintentional farm-related fatal injuries involving children aged less than 15 years in Australia. Information concerning 115 deaths were obtained from inspection of coronial files for the period 1989-92. Children less than 15 years made up 20% of all unintentional farm-related fatalities in Australia, with children less than 5 years representing 63% of all child fatalities. The majority of children were fatally injured while bystanders to farm work and equipment used on the farm (including dams), with drowning the most common mechanism of the fatal incident for children aged both 5 years or less and 5-9 years. Vehicle accidents were common for children aged 10-14 years.

Suicide
  • Elderly suicide and attempted suicide: one syndrome.

    Salib E, Tadros G, Cawley S. Med Sci Law 2001; 41(3):250-255.

    Correspondence: Emad Salib, Liverpool University, Hollins Park Hospital, Hollin Lane, Winwick Warrington Cheshire WA2 8WA, England UK.

    In this study we explore whether elderly suicide victims who had a previous history of attempted suicide differ from those with no similar history. A group of the elderly, who ended their lives with fatal self-harm (FSH) and had a history of deliberate self-harm (DSH) was compared to a matching group of the elderly who also ended their lives with FSH, but who were not known to have had any history of DSH. The comparison was in respect of epidemiological, social, psychological characteristics, service input and methods of suicide. The elderly, with a history of DSH, were more likely to have been known to the mental health services than the elderly who did not have such a history (P < 0.05). The two groups used similar methods in their final FSH act. The elderly victims of FSH with or without a previous history of DSH share the same characteristics. The two groups appear to be part of one syndrome. Deliberate self-harm in the elderly should be taken seriously as an unsuccessful suicide rather than a manipulative act or a cry for help and attention.

  • Suicide in police--a critical review.

    Hem E, Berg AM, Ekeberg AO. Suicide Life Threat Behav 2001; 31(2):224-233.

    Correspondence: Erlend Hem, Department of Behavioral Sciences in Medicine, Faculty of Medicine, University of Oslo, Norway. (email: erlend.hem@basalmed.uio.no).

    Police officers are commonly referred to as a high-risk group for suicide. This article systematically explores the worldwide literature on suicide in police. None of the recent nationwide studies show elevated suicide rates among police. Other studies show inconsistent results. Conclusively, it is not documented that there is an elevated suicide rate in police. A particular problem in previous research has been methodological shortcomings. The authors recommend further systematic research.

Transportation
  • Does Cell Phone Conversation Impair Driving Performance?

    Strayer D, Drews F, Albert R, Johnson W. Itasca, IL: National Safety Council, 2001. This report is available online at http://www.nsc.org/library/shelf/inincell.htm. However, a the filal version will be published soon in Psychological Science.

    Correspondence: David Strayer, Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, Utah 84112 -0251, USA (email: strayer@psych.utah.edu).

    The researchers sought to determine the extent to which cell phone conversations interfere with driving and, if so, the precise nature of the interference. In particular, the "peripheral interferences" hypothesis attributes interference from cell phones to peripheral factors such as holding the phone while conversing. By contrast, the "attentional hypothesis" attributes interference to the diversion of attention from driving to the phone conversation itself.

    This study was designed to contrast the effects of hand-held and hands-free cell phone conversations on responses to traffic signals in a simulated driving task. The researchers also included control groups who either listened to the radio or listened to a book on tape while performing the simulated driving task. As study participants (SP) performed the simulated driving task, occasional red and green lights were flashed on the computer display. If SPs saw a green light, they were instructed to continue as normal. However, if a red light was presented they were to make a braking response as quickly as possible. This manipulation was included to determine how quickly subjects could react to the red light as well as to determine the likelihood of detecting these simulated traffic signals.

    Sixty-four study participants (32 male, 32 female undergraduate students), who had normal or corrected-to-normal vision and perfect color vision, were randomly assigned to one of the radio control, book-on-tape control, hand-held cell phone, or hands-free cell phone groups. SPs performed a pursuit tracking task in which they used a joystick to maneuver the cursor on a computer display to keep it aligned as closely as possible to a moving target. The target flashed red or green and SPs were instructed to press a "brake button" located in the thumb position on top of the joystick as rapidly as possible when they detected the red light. Red and green lights were equiprobable and were presented in an unpredictable order. An experimental session consisted of three phases: (a) a warm-up interval that lasted 7 minutes, (b) two single-task segments each lasting 7.5 minutes that immediately preceded and then followed the dual-task third phase, and (c) a dual-task segment that lasted 15 minutes. The dual-task condition required the SPs to engage in a conversation with a confederate (or listen to a radio broadcast of their choosing or a book on tape) while concurrently performing the tracking task. The confederate's task was to facilitate the conversation and also to ensure that the subject listened and spoke in approximately equal proportions during the dual-task portions of the experiment.

    A preliminary analysis of detection rates (DR) and reaction times (RT) to traffic signals indicated that there were no differences between hands-free and hand-held cell phone groups. Neither were there differences between radio control and book-on-tape control groups. Therefore, the data were aggregated to form a 2 (Group: Cell Phone vs. Control) x 2 (Task: Single vs. Dual) factorial design.

    Probability (standard deviation) of missing simulated traffic signals in single and dual-task conditions for the cell phone and control groups.
     
    Single-Task
    Dual-Task
    Cell Phone
    0.028 (.05)
    0.070 (.09)
    Control
    0.027 (.04)
    0.034 (.04)

    Mean (standard deviation) reaction time for simulated traffic signals in single and dual task conditions for the cell phone and control groups.
     
    Single-Task
    Dual-Task
    Cell Phone
    534 (67)
    585 (90)
    Control
    543 (65)
    533 (65)

    Overall, miss rates were low; however, the probability of a miss significantly increased when subjects were engaged in conversations on the cell phone, F(1,31)=8.8, p < 0.01. By contrast, the difference between single and dual-task conditions was not reliable for the control group, F(1,31)=0.9, p > 0.36. Analysis of the RT data revealed that subjects in the cell phone group responded slower to simulated traffic signals while engaged in conversation on the cell phone, F(1,31)=29.8, p < 0.01. There again was no indication of a dual-task decrement for the control group.

    The authors state that these data demonstrate that the phone conversation itself resulted in significant slowing in the response to simulated traffic signals, as well as an increase in the likelihood of missing these signals. Moreover, the fact that hand-held and hands-free cell phones resulted in equivalent dual-task deficits indicates that the interference was not due to peripheral factors such as holding the phone while conversing. These findings also rule out interpretations that attribute the deficits associated with a cell phone conversation to simply attending to verbal material, because dual-task deficits were not observed in the book-on-tape control. Active engagement in the cell phone conversation appears to be necessary to produce the observed dual-task interference.

  • Will we all continue to ignore deaths and injuries from road traffic crashes?

    Roberts I. Br Med J 2001; 323(7309): 402.

    Correspondence: Ian Roberts, Public Health Intervention Research Unit, London School of Hygiene and Tropical Medicine, University of London, London WC1B 3DP, UK (email: ian.roberts@lshtm.ac.uk).

    This letter responds to an editorial request for areas of health that are currently neglected but that may later come to dominate the British Medical Journal in 20 year's time. Dr. Roberts proposes road traffic crashes as a candidate. He cites references and estimates that by 2020 road traffic crashes will move from ninth to third in the world disease burden ranking, as measured in disability adjusted life years, and will be in second place in developing countries. In comparison with the burden of disability, funding for research on road traffic crashes (prevention and treatment) is less than for almost any other cause of human misery. Traffic crashes predominantly affect poor people. He states that the million deaths and the 10 million permanent disabilities resulting from road traffic crashes are largely seen as the collateral damage in our car based transportation system.

  • Acceptability of the Checkpoints Parent-Teen Driving Agreement: pilot test.

    Jessica L. Hartos JL, Nissen WJ, Simons-Morton BG. Am J Prev Med 2001; 21(2): 134-141.

    Correspondence: Jessica L. Hartos, PhD, Prevention Research Branch, National Institute of Child Health and Human Development, 6100 Executive Blvd., Room 7B05 MSC 7510, Bethesda, MD 20892-7510 (email: jessica_hartos@nih.gov).

    Parent-teen driving agreements are potentially important tools to facilitate parental management of teen driving and reduce adolescent driving risk. The Checkpoints Parent-Teen Driving Agreement (Checkpoints P-TDA) was designed so that parents could initially impose strict limitations on teen driving in high-risk driving conditions (e.g., at night and with teen passengers) and gradually increase driving privileges over time as teens demonstrate responsible driving behavior. To assess the acceptability of the format and content of the Checkpoints P-TDA, it was pilot tested with a convenience sample of 47 families recruited as their teens tested for a driver's license at five private driving schools in Connecticut. Family members were interviewed at the driving schools about potential limits on teen driving, asked to use the driving agreement, and re-interviewed within 3 months about acceptability of the driving agreement and initial driving limits placed on teens. Most families (38 of 47) used and liked the agreement. In addition, most parents placed the recommended strict initial limits on teen driving related to driving unsupervised at night, with teen passengers, and on high-speed roads. Moreover, parents reported placing more strict limits on their teens' driving than they originally intended.

  • Effects of Florida's graduated licensing program on the behaviors and attitudes of teenagers.

    McCartt AT, Leaf WA, Farmer CM, Ferguson, Williams AF. J Safety Research 2001; 32(2): 119-131.

    Correspondence: Anne T. McCartt, Preusser Research Group, Inc., 7100 Main Street, Trumbull, CT 06611, USA (email: preusser@worldnet.att.net).

    On July 1, 1996, Florida implemented a graduated licensing system for drivers younger than 18. The system included a 6-month learner's permit and nighttime driving restriction and made it easier to suspend the license for moving violations. On January 1, 1997, Florida instituted a zero tolerance law for drinking and driving for drivers younger than 21. To measure any changes in teenagers' behaviors and attitudes following adoption of graduated licensing; a self-administered survey was given in Fall 1996 and Fall 1998 to juniors and seniors from eight high schools selected through a multistage sampling process. Differences between the 1996 and 1998 responses were examined. Of the students who were licensed, almost all in 1996 were licensed under the old law, and almost all in 1998 were licensed under the new law. Licensed teenagers in 1998 were more likely to obtain permits prior to licensure, obtain permits at a younger age, hold permits for a longer period of time, and log more practice miles prior to licensure. Significant declines occurred among licensed teenagers in reported driving after drinking and in reported riding with friends who had been drinking. There were sharp declines in the percentages of students expressing strong opposition to each specific provision of the graduated licensing law. In general, effects reported in this study were seen in the urban and suburban, but not the rural, high schools.

Violence
  • Predictive validity of a screen for partner violence against women.

    Jane Koziol-McLain J, Coates CJ, Lowenstein SR. Am J Prev Med 2001; 21(2): 93-100.

    Correspondence: Jane Koziol-McLain, PhD, RN, Johns Hopkins University, School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205 (email: jkoziol-mclain@son.jhmi.edu).

    While public health leaders recommend screening for partner violence, the predictive value of this practice is unknown. The purpose of this study was to test the ability of a brief three-question violence screen to predict violence against women in the ensuing months. The researchers conducted a prospective cohort study of adult women participating in the Colorado Behavioral Risk Factor Surveillance System (BRFSS), a population-based, random-digit-dialing telephone survey. During 8 monthly cohorts, 695 women participated in the BRFSS; 409 women participated in follow-up telephone interviews approximately 4 months later. Violent events during the follow-up period, measured using a modified 28-item Conflict Tactics Scale, were compared between women who initially screened positive and those who screened negative. Among BRFSS respondents, 8.4% (95% confidence interval [CI]=6.3%–10.5%) had an initial positive screen. During the follow-up period, women who screened positive were 46.5 times (5.4–405) more likely to experience severe physical violence, 11.7 times (5.0– 27.3) more likely to experience physical violence, 3.6 (2.4–5.2) times more likely to experience verbal aggression, and 2.5 times (1.2–5.1) more likely to experience sexual coercion. In a multivariate model, separation from one's spouse and a positive screen were significant independent predictors of physical violence.

  • Serious Injuries and Deaths of Adolescent Girls Resulting From Interpersonal Violence Characteristics and Trends From the United States, 1989-1998.

    Moskowitz H, Griffith JL, DiScala C, Sege RD. Arch Pediatr Adolesc Med 2001; 155(8):903-908

    Correspondence: Harry Moskowitz, MD, Department of Pediatrics, Mount Sinai School of Medicine, Box 1198, One Gustave Levy Place, New York, NY 10029 USA (email: unavailable).

    Little published data are available concerning the death and disability of adolescent girls resulting from interpersonal violence (adolescents are defined as those aged 12-18 years in this study). The authors report the results of a study to determine whether there were sex differences in (a) the characteristics of those who were injured or died, (b) injury severity and outcomes, and (c) injury mechanism; and to describe time trends in these differences. Data concerning serious injuries due to assaults, recorded in the US National Pediatric Trauma Registry (from January 1, 1989, through December 31, 1998), and homicides, recorded in the Web-Based Injury Statistics and Query Reporting System database (from January 1, 1990, through December 31, 1997) were used in the analysis. Six hundred twelve adolescent girls who were seriously injured because of an assault were compared with 2656 adolescent boys who were seriously injured because of an assault. Three thousand four hundred eighty-seven adolescent girls who died due to a homicide were compared with 17 292 adolescent boys who died due to a homicide. Assaulted adolescent girls were more likely to have preexisting cognitive or psychosocial impairments than were adolescent boys (odds ratio, 1.68; 95% confidence interval, 1.12-2.51). Adolescent girls trended toward more injury-related impairments at discharge from the hospital (odds ratio, 1.16; 95% confidence interval, 0.92-1.47). Adolescent girls were more likely to have been stabbed, and less likely to have been shot. Also, adolescent girls were more likely to have been injured at a home or a residence. Compared with all National Pediatric Trauma Registry admissions, assaults declined at the same rate for adolescent girls and boys. The proportion resulting from penetrating trauma declined more slowly for adolescent girls.



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