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26 November 2001
We are unable to provide photocopies of any the articles and reports abstracted below. Where possible, links have been provided to the publisher of the material and contact information for the corresponding author is listed. Please consider asking your library to subscribe to the journals from which these abstracts have been gathered.
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Costs of alcohol-related crashes: New Zealand estimates and suggested measures for use internationally.
Miller TR, Blewden M. Accid Anal Prev 2001; 33(6): 783-791.
Correspondence: Ted R. Miller, Pacific Institute for Research and Evaluation, 11710 Beltsville Drive, Suite 300, Calverton, MD 20705-3102, USA. (E-mail: miller@pire.org).
This paper presents policy-oriented measures of alcohol-related crash incidence and costs in New Zealand (N.Z.). Costs of crashes, where alcohol probably was a contributing factor were computed from official crash costs and police-reported crash/injury counts adjusted for under-reporting of crashes and of alcohol involvement. Alcohol-related crashes cost an estimated $1.2 billion in N.Z. in 1996. They equate to an estimated $0.75 per drink consumed, $17.80 per km driven above the legal limit of 0.08. and $1,100 per heavy drinker. People other than the drinkers, who caused the crashes, paid half the costs. An estimated one in 90 drunk-driving trips resulted in a crash (and often a drunk driving conviction) while one in 375 crash-free drunk driving trips also resulted in a drunk-driving conviction. Ten measures of alcohol-related crash incidence and costs are recommended for international use. They include number of alcohol-related deaths and injuries; innocent victims and children harmed in crashes caused by drinkers; annual costs and costs paid by people other than the drinker who caused the crash; crash costs per drink consumed, per heavy drinker, per kilometer driven drunk versus sober; probabilities of crash and of drunk-driving conviction.
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Developing a glossary of terms for burden of injury studies.
Mulder S, Larsen CF, Meerding W. Injury Control and Safety Promotion 2001; 8(2): 107-110.
Correspondence: Saakje Mulder, European Consumer Safety Association, P.O. Box 75169, 1070 AD Amsterdam, The Netherlands (E-mail: s.moulder@consafe.nl).
Burden of injury studies are usually conducted by a multidisciplinary team of researchers, economists, physicians, and epidemiologists. Because each discipline has its own 'language' miscommunication can occur. In 1995, the European Consumer Safety Association established a working group to standardize methodologies for burden of injury studies and to establish a database on cost of injury research. A glossary was developed that consists of three parts: concepts in health economics, concepts in health status measurement and valuation, and concepts related to health care practice. The glossary is available via the Internet at: http://www.ecosa.org/csi/ecosa.nsf/glossary.
Physician counseling about safe vehicle travel for children.
Willams AF, Ferguson SA, DeLeonardis DM. J Safety Res 2001; 32(2): 149-156.
Correspondence: Allan F. Williams, Insurance Institute for Highway Safety, 1005 North Glebe Road, Arlington, VA 22201-4751, USA. (E-mail: awilliams@iihs.org).
BACKGROUND: Despite gains in child restraint use, many children still do not travel safely in cars. Physicians play a potentially important role in educating parents about appropriate travel practices and influencing their behavior, although the evidence concerning how well they accomplish this is mixed.
OBJECTIVES: To describe the degree to which physicians provide counseling about safe vehicle travel for children.
METHODS: Telephone interviews were conducted with about 1,500 higher- and lower-income Caucasian, African American, and Hispanic primary caregivers.
RESULTS: The majority of respondents (62%) said their physicians had never talked to them "about transporting your child safely in a car." A higher proportion of pediatricians compared with other physicians provided such information, although less than half did so. More higher-income Caucasians reported such communications, primarily because more of their children went to see pediatricians, and pediatricians more often provided injury-prevention counseling. Eighty percent of the respondents said their physicians had never spoken to them about the dangers that deploying airbags can pose to children in the front seats of vehicles. Respondents reported that their physicians were more likely to have discussed poisoning, burns, and fall prevention than car travel safety.
CONCLUSIONS: Barriers to car travel safety communications by physicians, and how these barriers can be overcome, need to be examined. Motor vehicles are the leading cause of death among children. Physicians, who have high credibility with their patients, need to do a better job of communicating to parents appropriate practices for transporting children safely in motor vehicles. -
Mandatory helmet legislation and children's exposure to cycling.
Macpherson AK, Parkin PC, To TM. Inj Prev 2001; 7(3):228-230.
Correspondence: Allison K. Macpherson Department of Pediatrics, University of Toronto Faculty of Medicine and Population Health Sciences, Hospital for Sick Children Research Institute, 555 University Avenue, Toronto, Ontario, M5G 1X8 CANADA. (E-mail: alison.macpherson@sickkids.on.ca).
BACKGROUND: Mandatory helmet legislation for cyclists is the subject of much debate. Opponents of helmet legislation suggest that making riders wear helmets will reduce ridership, thus having a negative overall impact on health. Mandatory bicycle helmet legislation for children was introduced in Ontario, Canada in October 1995.
OBJECTIVES: To examine trends in children's cycling rates before and after helmet legislation in one health district.
METHODS: Child cyclists were observed at 111 preselected sites (schools, parks, residential streets, and major intersections) in the late spring and summer of 1993-97 and in 1999, in a defined urban community. Trained observers counted the number of child cyclists. The number of children observed in each area was divided by the number of observation hours, resulting in the calculation of cyclists per hour. A general linear model, using Tukey's method, compared the mean number of cyclists per hour for each year, and for each type of site.
RESULTS: Although the number of child cyclists per hour was significantly different in different years, these differences could not be attributed to legislation. In 1996, the year after legislation came into effect, average cycling levels were higher (6.84 cyclists per hour) than in 1995, the year before legislation (4.33 cyclists per hour).
CONCLUSIONS: Contrary to the findings in Australia, the introduction of helmet legislation did not have a significant negative impact on child cycling in this community.
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Investigation of bias after data linkage of hospital admissions data to police road traffic crash reports.
Cryer PC, Westrup S, Cook AC, Ashwell V, Bridger P, Clarke C. Inj Prev 2001; 7(3):234-241.
Correspondence: Colin Cryer, Centre for Health Services Studies, University of Kent, Canterbury, Kent TN3 0TG, UK. (E-mail: P.C.Cryer@ukc.ac.uk).
OBJECTIVES: To determine if a database of hospital admission data linked to police road traffic accident (RTA) reports produce less biased information for the injury prevention policymaker, planner, and practitioner than police RTA reports alone?
METHODS: Data linkage study. STUDY POPULATION: Non-fatal injury victims of road traffic crashes in southern England who were admitted to hospital. DATA SOURCES: Hospital admissions and police RTA reports. MAIN OUTCOME MEASURES: The estimated proportion of road traffic crashes admitted to hospital that were included on the linked database; distributions by age, sex, and road user groups: (A) for all RTA injury admissions and (B) for RTA serious injury admissions defined by length of stay or by nature of injury.
RESULTS: An estimated 50% of RTA injury admissions were included on the linked database. When assessing bias, admissions data were regarded as the "gold standard". The distributions of casualties by age, sex, and type of road user showed major differences between the admissions data and the police RTA injury data of comparable severity. The linked data showed smaller differences when compared with admissions data. For RTA serious injury admissions, the distributions by age and sex were approximately the same for the linked data compared with admissions data, and there were small but statistically significant differences between the distributions across road user group for the linked data compared with hospital admissions.
CONCLUSIONS: These results suggest that investigators could be misinformed if they base their analysis solely on police RTA data, and that information derived from the linked database is less biased than that from police RTA data alone. A national linked dataset of road traffic crash data should be produced from hospital admissions and police RTA data for use by policymakers, planners and practitioners.
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The Effect of Written Informed Consent on Detection of Violence in the Home.
Hollander JE, Schears RM, Shofer FS, Baren JM, Moretti LM, Datner EM. Acad Emerg Med 2001; 8(10): 974-979.
Correspondence: Judd E. Hollander,, Clinical Research Director, Department of Emergency Medicine, Hospital of the University of Pennsylvania, Ground Floor, Ravdin Building, 3400 Spruce Street, Philadelphia, PA 19104-4283. USA (E-mail: jholland@mail.med.upenn.edu).
BACKGROUND: Studies of programmatic interventions for victims of violence in the home may require the use of informed consent. The use of informed consent may result in ascertainment bias, with victims of violence being less likely to participate.
OBJECTIVE: To investigate the effect of written informed consent on the detection of violence in the home during emergency department (ED) screening.
METHODS: The authors performed a nonrandomized, controlled trial of 3,466 patients at an urban university ED. On odd days, patients (n = 1,857) were read a brief scripted statement and screened using standardized questions. On even days, patients (n = 1,609) received standard written informed consent prior to the same screening questions (writ-IC). The main outcome was the number of cases of violence in the home detected using each screening protocol.
RESULTS: Fewer writ-IC patients participated in screening (82% vs 92%; p < 0.001). Despite a higher refusal rate in the writ-IC group, there was no difference in the number of victims detected by each screening method: choked/kicked/bit/punched? (writ-IC, 7.3 vs routine screen, 6.5%; p = 0.3); slapped/grabbed/shoved? (7.3 vs 6.7%; p = 0.4); threatened/actually used knife/gun to scare/hurt you? (8.3 vs 9.4%; p = 0.3); thrown object to harm you? (5.2 vs 4.6%; p = 0.4); forced sex? (5.8 vs 4.7%; p = 0.15); or afraid current/former intimate partner would hurt you physically? (13.9 vs 11.9%; p = 0.9).
CONCLUSIONS: A written informed consent process in screening for violence in the home is associated with a higher refusal rate than routine screening, but use of written informed consent does not result in a lower rate of detection for multiple forms of violence. The authors did not find any support for the hypothesis that the use of written informed consent would decrease detection of violence in the home.
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