4 February 2002
Do drivers drink more when they use a safe ride?
- Harding WM, Caudillc BD, Moorec BA, Frissellc KC. J Subst Abuse 2001; 13(3): 283-290.
Correspondence: Wayne M. Harding, Social Science Research and Evaluation, Inc., 21-C Cambridge Street, Burlington, MA 01803, USA (email: wayneh@gis.net).
BACKGROUND: Offering drinkers free safe rides (SRs) home can prevent DWI, but some suggest that it may also promote excessive drinking.
OBJECTIVES: To assess the availability of SRs on drinking behavior.
METHODS: Forty-two respondents to surveys completed by 472 drinkers in barrooms reported that they used a SR during the first 9 months they were offered.
RESULTS: Their usual estimated blood alcohol concentration (BAC) was significantly greater when they used a SR than on all occasions when they drank outside their homes. However, only 24% of respondents increased their usual BAC from a "low risk" category (BAC < 0.10) when drinking outside the home, to a "high risk" category (BAC0.10) when using a SR. The majority (72%) of respondents did not change their BAC categories. One decreased his/her BAC from 0.10 when drinking outside the home to < 0.10 when using a SR.
CONCLUSIONS: These findings, coupled with data showing that respondents tended to use SRs infrequently (3.69 times per year), reduce concerns about the mean increase in their BACs when using SRs. Findings do not, however, resolve the issue of whether respondents whose drinking increased when they used a SR did so because a SR was available, or decided not to drive because they drank more. Recommendations for improving SR programs are discussed.
The influence of stimulants, sedatives, and fatigue on tunnel vision: risk factors for driving and piloting.
- Mills KC, Spruill SE, Kanne RW, Parkman KM, Zhang Y. Hum Factors 2001; 43(2):310-327.
Correspondence: Kenneth C. Mills, Profile Associates, Chapel Hill, North Carolina 27514, USA. (email: profiler@intrex.net).
A computerized task was used in two studies to examine the influence of stimulants, sedatives, and fatigue on single-target and divided-attention responses in different parts of the visual field. The drug effects were evaluated over time with repeated behavioral and subjective measures against ascending and descending drug levels. In the first study, 18 fully rested participants received placebo, alprazolam (0.5 mg), and dextroamphetamine (10 mg). Alprazolam impairs performance, whereas dextroamphetamine induces enhancement and tunnel vision. Study 2 exposed 32 participants to fatigue and no fatigue with a repeated-measures crossover design. Four independent groups subsequently received placebo, dextroamphetamine (10 mg), caffeine (250 mg), or alcohol (.07%). Under fatigue, stimulants have no performance-enhancing effects, whereas impairment from alcohol is severe. Under no fatigue, alcohol has a modest effect, caffeine has no effect, and dextroamphetamine significantly enhances divided-attention performance coincident with tunnel vision. Participants rate all drug effects more stimulating and less sedating while fatigued. Implications for transportation safety are discussed. Actual or potential applications of this research include driver and pilot training.
Δ Jump to Top of Page
No reports this week
Δ Jump to Top of Page
No reports this week
Δ Jump to Top of Page
Incidence and causes of home accidents at Ankara Cigiltepe apartments in Turkey.
- Hamzaoglu O, Ozkan O, Janson S. Accid Anal Prev 2002; 34(1):123-128.
Correspondence: Onur Hamzaoglu, 100 Yyl University, Medical Faculty, Department of Public Health, Van, Turkey. (email: ohamzaoglu@ttb.org.tr).
This is a 3-month prospective study aimed at determining the incidence and causes of home accidents in an Ankara military staff resident with 637 households. The study also determined risk factors in the home environment and the families' need of health education. Of all families, 1.5% were exposed to home accidents and the incidence of home accidents was found to be 0.104/person/years. Among the accidents, falls were most common at 44%, whereas cuts constituted 22% and burns 19%. About one quarter of the interventions made by mothers for epistaxis and poisoning (by gasoline, acetone and bleach) were found to aggravate the problems, whereas three quarters of the adults came up with practicable solutions. Well-educated mothers acted better than mothers with less schooling.
Δ Jump to Top of Page
Safety and Health Program Assessment in Relation to the Number and Type of Safety and Health Violations.
- Akbar-Khanzadeh F, Wagner OD. AIHAJ 2001; 62(5): 605-610.
Correspondence: Farhang Akbar-Khanzadeh, Medical College of Ohio, Department of Public Health, 3015 Arlington Ave., Toledo, OH 43614-5803 USA (email: fakbar@mco.edu).
BACKGROUND: The Ohio Bureau of Employment Services (OBES), through the Occupational Safety and Health Administration On-Site Consultation Program, provides safety and health (S&H) consultation services to small high-hazard companies. During a full-service consultation, the S&H Program Assessment Worksheet (Form 33) is completed and the S&H violations are determined. Form 33 consists of 25 indicators, each with a score of 0 (lowest) to 4 (highest) to evaluate a portion of the S&H program.
OBJECTIVES: To examine the hypothesis that employers with a higher score on their S&H program would have fewer S&H violations.
METHODS: A study collected and analyzed data from records maintained in the archives of OBES.
RESULTS: Of 534 full-service site visits performed between June 1995 and December 1996, 107 case files were complete and appropriate for this study. Data analysis revealed that the number of serious violations (SV) and the number of regulatory violations (RV) were significantly (p < 0.01) correlated to all 25 indicators on the S&H Program Assessment Worksheet, whereas the number of other-than-serious violations (OSV) were significantly (p < 0.05) correlated to only 15 indicators. The best predictors of the number of SV were the indicators of Timely Hazard Control and Emergency Planning and Preparation; best predictors of RV were the indicators of Timely Hazard Control and Accountability; and best predictors of OSV were the indicators of Hazard Identification (Self-Inspection) and Emergency Planning and Preparation (Equipment).
CONCLUSIONS: Employers who scored higher on the indicators of the quality of their S&H programs had fewer S&H violations, and the indicators of Hazard Identification, Timely Hazard Control, and Emergency Planning and Preparation showed the highest influence in reducing violations.
Δ Jump to Top of Page
No reports this week
Δ Jump to Top of Page
No reports this week
Δ Jump to Top of Page
No reports this week
Δ Jump to Top of Page
No reports this week
Δ Jump to Top of Page
A study of the prevalence of having fractures and the affecting factors in young male adults throughout childhood and adolescence.
- Yildiz C, Gulec M, Tekbas OF, Atesalp AS, Hasde M, Basbozkurt M. Turk J Pediatr 2001; 43(4):298-302.
Correspondence: C. Yildiz, Department of Orthopedics and Traumatology, Gulhane Military Medical Academy and Faculty, Ankara, Turkey.
Injuries in children and adolescents, who are more sensitive to different risk factors in their social and physical environments, play an important part in mortality and morbidity. Fractures are the most commonly seen problems among these injuries. This cross-sectional study was carried out in a two-year vocational military school in Ankara between 1-10 May 2000. All, 2720 students in the school were included and data were collected via a questionnaire distributed to the students. It was found that 418 (17%) out of 2,461 students we could interview had had a fracture. No statistically meaningful relationship was found between the frequency of having fractures and the educational status of the parents or employment status of the mother. However, it was seen that the frequency of fractures increased as the economical status of the parents increased. The high frequency of fractures in childhood and adolescence in young males, and the traditional practice of going to unlicensed and medically untrained adults, and 'bonesetters' (27% of those surveyed) are two important findings that should be taken into consideration.
See report on injuries in Jamaica under Rural Issues
Δ Jump to Top of Page
Patterns of trauma injuries in rural versus urban Jamaica.
- McDonald A, Dawkins N, Titus I. West Indian Med J 2001; 50(3):214-217.
Correspondence: A. McDonald, Department of Surgery, Radiology, Anaesthesia and Intensive Care, University of the West Indies, Kingston, Jamaica.
Trauma admissions to St Ann's Bay Hospital in rural Jamaica and The University Hospital of the West Indies (UHWI) in the capital city of Kingston are compared. Trauma accounted for 19% and 22% of surgical admissions to UHWI and the St Ann's Bay Hospital, respectively. Sixty-three per cent of trauma cases admitted to the St Ann's Bay Hospital and 56% to the UHWI were due to unintentional injuries (95% CI, -0.05, 0.19). The main cause of unintentional injuries at both hospitals was motor vehicle accidents, accounting for 43% and 37% at UHWI and St Ann's Bay Hospital respectively (95% CI, -0.04, 0.17). The prevalence of falls was significantly higher in St Ann's Bay Hospital compared with UHWI, 41% and 26% respectively (95% CI, 0.10, 0.21). Intentional injuries accounted for 37% of cases in St Ann's Bay Hospital and 44% at UHWI (95% CI, -0.20, 0.04). The prevalence of firearm injuries was significantly higher at the UHWI than in St Ann's Bay Hospital, 55% and 18% respectively (95% CI, -0.15, -0.05). There was no significant difference in age and injury severity scores in the two hospitals but patients remained in hospital significantly longer at UHWI.
Δ Jump to Top of Page
How to act--implementing health and safety promotion in organizations.
- Rosen M, Jansson B. Health Policy Plan 2000; 15(3):247-254.
Correspondence: Bjarne Jansson, Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, Norrbaca Building, S-171 76 Stockholm, Sweden (email: bjarne.jansson@phs.ki.se).
This interdisciplinary review focuses on strategies for implementing health and safety promotion activities in organizations. Theories and models are summarized in a checklist and illustrated by some practical examples from Sweden and abroad: 1. Facts as a basis for decision making; 2. Political and management support; 3. Local data create local involvement; 4. Obstacles and opportunities; 5. Gains for all parties; 6. Concentrate resources; 7. Message penetration; 8. Time to reach consensus; 9. Assessment and recognition; 10. Reliable change agents; 11. Recruit and encourage advocates; 12. Networks; 13. Early success; 14. Implementation involvement. The points illustrated appear obvious and logical, but they are seldom applied in practise.
Δ Jump to Top of Page
No reports this week
Δ Jump to Top of Page
The effect on accident risk of a change in driver education in Denmark.
- Carstensen G. Accid Anal Prev 2002; 34(1):111-121.
Correspondence: Gitte Carstensen, Danish Transport Research Institute, Knuth-Winterfeldts Alle, Building 116 West, DK-2800 Lyngby, Denmark (email: dtf@dtf.dk).
Driver education in Denmark was changed radically in 1986. An evaluation study was undertaken to see whether the new education concept had had any effect on the development in accidents. In an earlier part of the study, it was found that after the change in education the number of accidents involving 18-19-year-olds in the official statistics had decreased more than that involving mature drivers. This fact could not solely be attributed to changes in population size, changes in exposure, mild winters in the period after the change, etc. It seemed, therefore, reasonable to attribute the effect to the changes in driver education. In the present study, two groups of new car drivers trained according to the old and new programs respectively--were followed-up with four questionnaires through their first 5.5 years as drivers. The decrease in accidents found in the official statistics was also found for the drivers in the questionnaire study. The decrease is mainly concentrated in the 1st year of driving, and is found in multiple-vehicle accidents and manoeuvring accidents. The number of single-vehicle accidents did not change. Those who received training which satisfied a number of the basic requirements in the new education program, had a lower accident risk than those whose education did not meet these requirements. This can be seen as an indication that the decrease in accidents is explainable, at least in part, by changes in driver education.
Mental disorders resulting from road traffic accidents.
- Blanchard EB, Veazey, Connie H. Curr Opin Psychiatry 2001; 14(2): 143-147.
Correspondence: Connie H. Veazey, Center for Stress and Anxiety Disorders, 1535 Western Avenue, Albany, NY 12203, USA. (email: connieveazey@aol.com).
This review covers the literature on the psychological consequences of road traffic crashes (RTCs) published since 1999. Three major areas of research in this field were identified. The first area represents prospective research studies that longitudinally assess the progression of mental disorders, primarily post-traumatic stress disorder, after RTAs. The second examines the effects of RTAs on child and adolescent populations. Finally, recent developments in the psychological treatment of post-traumatic stress disorder among RTA survivors are discussed. Such research has identified promising as well as detrimental interventions that have been developed to treat this population.
Psychophysiological reactivity of aggressive drivers: an exploratory study.
- Malta LS, Blanchard EB, Freidenberg BM, Galovski TE, Karl A, Holzapfel SR. Appl Psychophysiol Biofeedback 2001; 26(2):95-116.
Correspondence: Loretta S. Malta, Center for Stress and Anxiety Disorders, 1535 Western Avenue, Albany, New York 12203, USA (email: lm1598@cnsunix.albany.edu).
BACKGROUND: In the United States, motor vehicle crashes are the leading cause of unintentional death and injury. Aggressive driving, which has been identified as a major risk factor for motor vehicle crashes by transportation authorities, is thus an important topic of study.
OBJECTIVES: This study compared the physiological reactivity of self-referred aggressive and nonaggressive drivers.
METHODS: Heart rate, blood pressure, facial muscle activity, and skin resistance were monitored as participants listened to idiosyncratic vignettes of driving and fear-provoking scenarios, as well as during a standard stressor task (mental arithmetic).
RESULTS: Aggressive drivers exhibited significant increases in muscle tension and blood pressure during the driving vignettes, relative to controls. They also responded to the fear vignette and mental arithmetic in a qualitatively different fashion from that of controls. The aggressive drivers responded to these stimuli with less overall heart rate and electrodermal reactivity, but increased blood pressure and muscle tension. In contrast, the controls responded to the fear vignette and mental arithmetic primarily with increased heart rates and decreased skin resistance.
CONCLUSIONS: The findings suggest that both physiological hyperarousal as well as differential responses to stressful stimuli may contribute to aggressive driving. Implications for interventions with this population are discussed.
Children in crashes: mechanisms of injury and restraint systems.
- Lapner PC, McKay M, Howard A, Gardner B, German A, Letts M. Can J Surg 2001; 44(6):445-449.
Correspondence: P.C. Lapner, Department of Surgery, University of Ottawa, CANADA.
OBJECTIVES: To explore the levels of protection offered to children involved in motor vehicle collisions.
DESIGN: A joint study by the Children's Hospital of Eastern Ontario (CHEO) and Transport Canada, Ottawa, conducted in 2 phases: retrospective from 1990 to 1997 and prospective from 1998 to 2000. SETTING: CHEO, a university affiliated tertiary care centre. PATIENTS: Children admitted to CHEO between 1990 and 2000 with spinal trauma due to motor vehicle crashes (MVCs). Phase I of the study involved analysis, in a series of 45 children after MVCs, by location of spinal injury versus belt type. Phase 2 was a prospective study of 22 children injured in 15 MVCs. INTERVENTIONS: A biomechanical assessment of the vehicle and its influence on the injuries sustained. MAIN OUTCOME MEASURES: The nature and extent of the injuries sustained, and the vehicle dynamics and associated occupant kinematics.
RESULTS: The odds ratio of sustaining a spinal injury while wearing a 2-point belt versus a 3-point belt was 24 (95% confidence interval 2.0-2.45, p < 0.1), indicating a much higher incidence with a lap belt than a shoulder strap.
CONCLUSIONS: Proper seat-belt restraint reduces the morbidity in children involved in MVCs. Children under the age of 12 years should not be front-seat passengers until the sensitivity of air bags has been improved. Three-point pediatric seat belts should be available for family automobiles to reduce childhood trauma in MVCs.
Sleep related vehicle accidents on Italian highways.
- Garbarino S, Nobili L, Beelke M, De Carli F, Balestra V, Ferrillo F. G Ital Med Lav Ergon 2001; 23(4):430-434.
Centre of Neurology and Medical Psychology, Health Service of the State Police, Department of the Interior, Italy (email: fifi@dism.unige.it)
Sleepiness has been identified as a significant risk factor for vehicle accidents, and specific surveys are needed for Italy. The aim of this study was to assess incidence and characteristics of sleep-related vehicle-crashes on Italian highways. The database of the Italian National Institute of Statistics (1993-1997) was the source for the survey (50859 accidents with 1632 (3.2%) ascribed to sleep by the police). The distribution of accidents was evaluated by means of the analysis of variance considering the year, the day of the week, the age and the time of day and their interactions as main factors. The relative risk of sleep-related accidents was also evaluated with reference to the relative traffic density as estimated by the Italian Highways Society. The counts of sleep-related accidents, and even more the relative risk, revealed the presence of peaks and troughs in zones at a higher level of sleepiness and alertness respectively. Death of the driver occurred in 11.4% of sleep related accidents versus 5.6% in general accidents. The great majority of sleep-related accidents occurred to drivers under 35 (61.4%) mainly during the night with an increasing trend in the yearly number of sleep-related accidents, especially on weekends. Therefore sleepiness appears a remarkable risk factor and, in our opinion, its incidence as sole or contributory cause of accidents on Italian highways is still underestimated.
See abstract on safe rides programs under Alcohol and Other Drugs
See abstract on stimulants and sedatives under Alcohol and Other Drugs
Δ Jump to Top of Page
Reported frequency of domestic violence: cross sectional survey of women attending general practice.
- Bradley F, Smith M, Long J, O'Dowd T. BMJ 2002; 324(7332):271.
Correspondence: Tom O'Dowd, Department of Community Health and General Practice, Trinity College Centre for Health Sciences, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland (email: todowd@tcd.ie).
OBJECTIVES: To determine exposure to violence by a partner or spouse among women attending general practice and its association with respondents' demographic and personal characteristics; frequency of inquiry about violence by general practitioners; and women's views on routine questioning about domestic violence by general practitioners.
METHODS: Design: Cross sectional, self administered, anonymous survey. Setting: 22 volunteer Irish general practices. Participants: 1871 women attending general practice. Main outcome measures: Proportion who had experienced domestic violence, severity of such violence, and context in which violence occurred.
RESULTS: Of the 1692 women who had ever had a sexual relationship, 651 (39%, 95% confidence interval 36% to 41%) had experienced violent behavior by a partner. 78/651 (12%) women reported that their doctor had asked about domestic violence. 298/651 (46%, 42% to 50%) women had been injured, 60 (20%) of whom reported that their doctor had asked about domestic violence. 1304/1692 (77%, 77% to 80%) were in favor of routine inquiry about domestic violence by their usual general practitioner. 1170 women (69%) reported controlling behavior by their partner and 475 (28%) reported feeling afraid of their previous or current partner. Women who reported domestic violence were 32 times more likely to be afraid of their partner than women who did not report such violence.
CONCLUSIONS: Almost two fifths of women had experienced domestic violence but few recalled being asked about it. Most women favored routine questioning by their practitioner about such violence. Asking women about fear of their partner and controlling behavior may be a useful way of identifying those who have experienced domestic violence.
Identifying domestic violence: cross sectional study in primary care.
- Richardson J, Coid J, Petruckevitch A, Chung WS, Moorey S, Feder G. BMJ 2002; 324(7332):274.
Correspondence: Jo Richardson, Department of General Practice and Primary Care, Barts and The London, Queen Mary's School of Medicine and Dentistry, London E1 4NS UK (email: jo.richardson@gp-F84710.nhs.uk).
OBJECTIVES: To measure the prevalence of domestic violence among women attending general practice; test the association between experience of domestic violence and demographic factors; evaluate the extent of recording of domestic violence in records held by general practices; and assess acceptability to women of screening for domestic violence by general practitioners or practice nurses.
METHODS: Design: Self administered questionnaire survey. Review of medical records. Setting: General practices in Hackney, London. Participants: 1207 women (> 15 years) attending selected practices. Main outcome measures: Prevalence of domestic violence against women. Association between demographic factors and domestic violence reported in questionnaire. Comparison of recording of domestic violence in medical records with that reported in questionnaire. Attitudes of women towards being questioned about domestic violence by general practitioners or practice nurses.
RESULTS: 425/1035 women (41%, 95% confidence interval 38% to 44%) had ever experienced physical violence from a partner or former partner and 160/949 (17%, 14% to 19%) had experienced it within the past year. Pregnancy in the past year was associated with an increased risk of current violence (adjusted odds ratio 2.11, 1.39 to 3.19). Physical violence was recorded in the medical records of 15/90 (17%) women who reported it on the questionnaire. At least 202/1010 (20%) women objected to screening for domestic violence.
CONCLUSIONS: With the high prevalence of domestic violence, health professionals should maintain a high level of awareness of the possibility of domestic violence, especially affecting pregnant women, but the case for screening is not yet convincing.
|
