25 March 2002
Relation between parental restrictions on movies and adolescent use of tobacco and alcohol.
- Dalton MA, Ahrens MB, Sargent JD, Mott LA, Beach ML, Tickle JJ, Heatherton TF. Eff Clin Pract 2002 Jan-Feb;5(1):1-10
Correspondence: M.A. Dalton, Department of Pediatrics, Dartmouth Medical School, Hanover, NH, USA (email: Dalton@Dartmouth.edu).
BACKGROUND: Viewing smoking and drinking in movies may prompt adolescents to initiate these behaviors. Movies with R ratings contain more smoking than do movies in all other rating categories.
OBJECTIVE: To evaluate the extent to which parents restrict the exposure of adolescents to R-rated movies and to determine whether such restrictions are associated with decreased tobacco and alcohol use in adolescents. DESIGN: Cross-sectional, self-administered survey. METHODS: participants- Students in grades 5 through 8 enrolled in New Hampshire and Vermont schools. Sampling- Fifteen schools in Vermont and New Hampshire were randomly selected from all middle schools with > or = 150 students. OUtcome measures- Students who had tried smoking cigarettes or tried drinking alcohol without parental knowledge.
RESULTS: Of 4544 students surveyed, 18% had tried cigarettes and 23% had tried alcohol. Although 90% were younger than 14 years of age, only 16% were completely restricted from viewing R-rated movies. The prevalence of having tried smoking was 35% for those with no restrictions on viewing R-rated movies, 12% for those with partial restrictions, and 2% for those with complete restrictions. The prevalence of having tried alcohol was 46% for those with no restrictions on viewing R-rated movies, 16% for those with partial restrictions, and 4% for those with complete restrictions. Even after controlling for other factors, including grade, parental disapproval of smoking, maternal supervision, maternal responsiveness, peer and family smoking, and child personality characteristics, children who were completely restricted from viewing R-rated movies were significantly less likely to smoke (relative risk, 0.29; 95% CI, 0.19 to 0.45) or drink (relative risk, 0.30; CI, 0.21 to 0.42) compared with those who had no restrictions on viewing R-rated movies.
CONCLUSION: Limiting the exposure of adolescents to R-rated movies may prevent early use of alcohol and tobacco.
The effects of drug abuse prevention at school: the 'Healthy School and Drugs' project.
- Cuijpers P, Jonkers R, de WI, de JA. Addiction 2002; 97(1): 67-73.
Correspondence: Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht (email: pcuijpers@trimbos.nl).
OBJECTIVES: To examine the effects of the 'Healthy School and Drugs' project, a Dutch school-based drug prevention project that was developed in the late 1980s and disseminated during the 1990s. This programme is currently being used by 64-73% of Dutch secondary schools and it is estimated that at least 350000 high school students receive this intervention each year.
METHODS: A quasi-experimental study in which students of nine experimental (N = 1156) schools were compared with students of three control schools (N = 774). The groups were compared before the intervention, 1 year later, 2 years later and 3 years later. MEASUREMENTS: Self-report measures of tobacco, alcohol and marijuana use, attitudes towards substance use, knowledge about substances and self-efficacy.
RESULTS: Some effects on the use of tobacco, alcohol and cannabis were found. Two years after the intervention, significant effects could still be shown on alcohol use. Effects of the intervention were also found on knowledge, but there was no clear evidence for any effects on attitude towards substance use and on self-efficacy.
CONCLUSIONS: This study shows the Healthy School and Drugs project as implemented in Holland may have some effect on drug use in the children exposed to it.
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Professional perceptions about home safety: cross-national validation of the Home Falls and Accidents Screening Tool (HOME FAST).
- Mackenzie L, Byles J, Higginbotham N. J Allied Health 2002; 31(1): 22-28.
Correspondence: L Mackenzie, Centre for Clinical Epidemiology and Biostatistics, Internal Box 19, Hunter Building, University of Newcastle, Callaghan, NSW 2308, Australia.
The Home Falls and Accidents Screening Tool (HOME FAST) was developed to measure the risk of older people falling within their home environment. If this tool is to be effective, the underlying dimensions perceived by potential raters when using the HOME FAST need to be consistent with the purpose of the tool. The content validation process undertaken to evaluate the HOME FAST and a method to develop a home safety score are described. Experts in home safety assessment were recruited from the British Association of Occupational Therapy, the Chartered Society of Physiotherapists, and the Royal College of Nursing in the United Kingdom. Participants rated each HOME FAST item using a Thurstone technique format. Each item was weighted according to the level of perceived falls risk each expert attributed to the home safety item. Principal components factor analysis identified a two-factor structure interpreted as environment and function underlying the HOME FAST. Results indicated that no item should be deleted from the checklist. Weights were calculated for each item to generate an overall hazard score. Some differences in responses to the degree of risk associated with home safety items were noted between the professional groups. The HOME FAST has captured highly relevant home safety items considered by an expert panel and measures a domain applicable to home safety and falls risk.
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A survey of forest workers in New Zealand: Do hours of work, rest, and recovery play a role in accidents and injury?
- Lilley R, Feyer A-M, Kirk P, Gander P. J Safety Res 2002; 33(1): 53-71.
Correspondence: Rebbecca Lilley New Zealand Environmental and Occupational Health Research Centre (NEOH), Department of Preventive and Social Medicine, Box 913, Dunedin, New Zealand (email: rlilley@gandalf.otago.ac.nz).
BACKGROUND: A number of structural and organizational changes have occurred recently within the New Zealand Forestry Industry, with concerns being raised about the impact of these changes on the forestry worker in terms of fatigue, sleepiness, and compromised safety. This study explored the relationship of fatigue, and some of its key determinants, with accidents and injuries in a group of forestry industry workers in New Zealand.
METHODS: A total of 367 forestry workers responded to a self-administered questionnaire.
RESULTS: Fatigue was found to be commonly experienced at work in the forest, with 78% of workers reporting that they experienced fatigue at least "sometimes." This study found that certain groups of workers reported long working hours, reduced sleep, compromised recovery time, and intensely paced work. The results of logistic regression analysis showed that recent sleep, number of breaks taken during the workday, and specific job/tasks were independently associated with reporting of high fatigue levels at work. Near-miss injury events were significantly more common among those reporting a high level of fatigue at work. Accidents and lost-time injury were associated with length of time at work, ethnicity, and having had near-miss injury events.
CONCLUSIONS: Together, these results suggest that fatigue and aspects of work organization, which are likely to be fatiguing, may be associated with compromised safety for forest workers. Impact on Industry: With an already slim margin of error present in forest operations, an impairment due to increased fatigue may constitute a significant risk factor for accidents and injuries in this workforce. The results indicate the need for further examination of shift and workload management among forestry workers, as well as a role for improving industry awareness about the causes and consequences of fatigue.
Falls and working individuals: role of extrinsic and intrinsic factors.
- Gauchard G, Chau N, Mur J M, Perrin P. Ergonomics 2001; 44(14):1330-1339.
Correspondence: G Gauchard, National Institute for Health and Medical Research (INSERM), U 420, Faculte de Medecine, Vandoeuvre-les-Nancy, France.
Falls are frequent occupational accidents involving workers and lead to important social and economic consequences both for the individual and for the employer. Different factors can modify balance control and lead to falling, especially environment-related and individual factors. The literature would appear to indicate that there have been few studies on the intrinsic factors involving the mechanisms of generating falls. This review determines the main factors involved in the mechanisms of falling, whether related to the environment, work or the individual. Knowledge of the extrinsic and intrinsic factors contributing to the fall could allow securer environment planning and occupational conditions for employers, and the use of balance rehabilitation methods for individuals to reduce the risk of falls.
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Bullying and sexual harassment in the school setting.
- Cavendish R, Salomone C. J Sch Nurs 2001; 17(1):25-31.
Correspondence: Roberta Cavendish, School of Nursing, College of Staten Island, Staten Island, NY, USA.
This article defines bullying and sexual harassment, identifies associated characteristics of the aggressor and the victim, and describes implications for school nurses. The background of federal laws with a focus on the most current 1999 Supreme Court decision, holding a school district liable for damages under federal law (Title IX), is addressed with a case study. Health promotion issues and prevention concepts are outlined in a 10-Point Action Plan to facilitate the prevention and management of bullying and sexual harassment in schools. A survey tool to assess bullying and teaching plans for parents of victims and aggressors are provided. Suggested linkages among approved nursing languages, North American Nursing Diagnosis Association (NANDA) nursing diagnoses (NANDA, 1998), Nursing Interventions Classification interventions (Iowa Intervention Project, 2000), and Nursing Outcomes Classification outcomes (Iowa Outcomes Project, 2000) are included for use in developing nursing care plans for both aggressors and victims of harassment.
Evaluation of the Utah student injury reporting system.
- Spicer RS, Cazier C, Keller P, Miller TR. J Sch Health 2002; 72(2):47-50.
Correspondence: Rebecca Spicer, Children's Safety Network Economics and Insurance Resource Center, Pacific Institute for Research and Evaluation, 11710 Beltsville Drive, Suite 300, Calverton, MD 20705, USA. (email: spicer@pire.org).
The Utah Student Injury Reporting System (SIRS), implemented in 1984 to monitor injuries to students in grades K-12 in Utah schools, has served as a model for surveillance systems created by other states and some European countries. This paper evaluates the Utah experience in developing and administering the SIRS. The evaluation identifies usefulness of the system, discusses the sensitivity of the system in detecting school injuries, estimates the system's costs, and provides suggestions to other states and districts interested in building a cost-effective and efficient surveillance instrument.
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Clinical Ethics: Community versus individual benefit.
- Tobin BM, Leeder SR, Somerville ER. Med J Aust 2002; 176(6): 279-280.
Australian law embodies a "communitarian" conception of the doctor's responsibility to respect the confidentiality of the doctor–patient relationship. This implies that respect for confidentiality sits alongside two other responsibilities: proper care for the patient's general wellbeing and proper attention to the safety of the community. Most jurisdictions now require drivers to advise their local driver-licensing authority of any permanent or long-term injury or illness that affects their ability to drive safely. Some jurisdictions require doctors to inform the driver-licensing authority about patients whose medical condition may impair their driving to the extent that they are likely to endanger the public. This paper discusses the issue of making such a report when unable to persuade a patient to inform the driver-licensing authority of his or her ability to drive safely.
The Illinois .08 law: An evaluation
- Voas RB, Tippetts AS, Taylor EP. J Safety Res 2002; 33(1): 73-80.
Correspondence: Robert B. Voas, Pacific Institute for Research and Evaluation, Calverton Office Park, Suite 300, 11710 Beltsville Drive, Calverton, MD 20705, USA (email: voas@pire.org).
Lowering state blood alcohol concentration (BAC) limits to 0.08, though controversial, has been supported by most evaluation studies to date. The Illinois .08 BAC law implemented in 1997 provided a unique opportunity to evaluate the effect of the law without the simultaneous passage of an administrative license revocation (ALR) law, which has clouded some previous evaluations of the .08 laws. The proportion of all drinking drivers in fatal crashes was compared before versus after implementing the .08 law using time-series analysis to evaluate 12 years of fatal crash data for Illinois and five bordering states. The results showed that the proportion of drinking drivers in fatal crashes decreased by 14% in Illinois and increased by 3% in bordering states. The proportion of drinking drivers in fatal crashes in Illinois, though increasing since 1995, was sharply reduced after passage of the .08 law in 1997, saving more than 100 lives in 1998 and 1999 than it would have without the .08 law.
Flipped out of control: single-vehicle rollover accidents in the Northern Territory.
- Treacy PJ, Jones K, Mansfield C. Med J Aust 2002; 176(6): 260-263.
Correspondence: P John Treacy, Northern Territory Clinical School, Flinders University, PO Box 41326, Casuarina, NT 0811 (email: John.Treacy@nt.gov.au)
OBJECTIVES: To study the incidence of and factors associated with single-vehicle rollover (SVRO) accidents in the "Top End" of the Northern Territory (NT); to identify factors associated with major injury and death from SVRO accidents.
METHODS: Design- Retrospective analysis of records from the NT Department of Transport and Works' police database, Royal Darwin Hospital's trauma database, coroner's records, and case notes from public hospitals in the Top End. Study population- All patients involved in SVRO accidents in the Top End between 1 January 1996 and 31 December 1997 whose accident was documented by the police, who attended a public hospital, or who died. Main outcome measures- Types and incidence of all accidents; details of the accident scene, vehicle features, and population groups associated with SVRO accidents; factors associated with major injury and death.
RESULTS: SVROs accounted for 30% of all accidents and 29% of all injuries and deaths (441 people) in the whole of the NT over the study period. Some of the factors associated significantly more frequently with SVRO accidents were (i) occurrence of the accident on a straight, dry, unsealed road; (ii) presence of a vehicle defect; (iii) travelling at excessive speed; and (iv) the person being male, aged 41–50 years, of Aboriginal descent. Among the 147 people who were admitted to hospital or died from SVRO accidents in the Top End, major injury occurred significantly more frequently if the person was under the influence of alcohol, was not wearing a seatbelt and was ejected; if the accident occurred in a rural area; and if the vehicle was speeding. Major injuries occurred in 21% (31/147), and death was more likely in those with head, chest and neck injuries.
CONCLUSIONS: SVRO accidents are a major cause of morbidity and mortality in the Top End of the NT. Effective methods of limiting speeding, drink-driving and driver fatigue should be sought. Populations most at risk should be targeted.
Effects of uncertainty, transmission type, driver age and gender on brake reaction and movement time.
- Lora Warshawsky-Livne L and David Shinar. J Safety Res 2002; 33(1): 117-128.
Correspondence: David Shinar, Ben-Gurion University of the Negev, Beersheba, Israel (email: shinar@bgumail.bgu.ac.il).
BACKGROUND: Braking time (BT) is a critical component in safe driving, and various approaches have been applied to minimize it.
OBJECTIVES: This study analyzed the components of BT in order to assess the effects of age, gender, vehicle transmission type, and event uncertainty, on its two primary components, perception-reaction time and brake-movement time.
METHODS: Perception-reaction time and brake-movement time were measured at the onset of lights for 72 subjects in a simulator. The six experimental conditions were three levels of uncertainty conditions (none, some, and some+false alarms) and two types of transmission (manual and automatic). The 72 subjects, half male and half female, were
further divided into three age groups (mean of 23, 30, and 62 years). Each subject had 10 trials in each of the three levels of uncertainty conditions.
RESULTS: Transmission type did not significantly affect either perception-reaction time or brake-movement time. Perception-reaction time increased significantly from 0.32 to 0.42 s (P < .05) as uncertainty increased but brake-movement time did not change. Perception-reaction time increased (from 0.35 to 0.43 s) with age but brake-movement time did not change with age. Gender did not affect perception-reaction time but did affect brake-movement time (males 0.19 s vs. females 0.16 s).
CONCLUSIONS: At 90 km/h, a car travels 0.25 m in 0.01 s. Consequently, even such small effects multiplied by millions of vehicle-kilometers can contribute to significant savings in lives and damages.
The effects of music tempo on simulated driving performance and vehicular control.
- Brodsky W. Transportation Res Part F: Psychology and Behaviour 2002; 4(4): 219-241.
Correspondence: Warren Brodsky Department of the Arts, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva 84105, Israel (email: wbrodsky@bgumail.bgu.ac.il).
The automobile is currently the most popular and frequently reported location for listening to music. Yet, not much is known about the effects of music on driving performance, and only a handful of studies report that music-evoked arousal generated by loudness decreases automotive performance. Nevertheless, music tempo increases driving risks by competing for attentional space; the greater number of temporal events which must be processed, and the frequency of temporal changes which require larger memory storage, distract operations and optimal driving capacities. The current study explored the effects of music tempo on PC-controlled simulated driving. It was hypothesized that simulated driving while listening to fast-paced music would increase heart rate (HR), decrease simulated lap time, and increase virtual traffic violations. The study found that music tempo consistently affected both simulated driving speed and perceived speed estimates: as the tempo of background music increased, so too did simulated driving speed and speed estimate. Further, the tempo of background music consistently affected the frequency of virtual traffic violations: disregarded red traffic-lights (RLs), lane crossings (LNs), and collisions (ACs) were most frequent with fast-paced music. The number of music-related automobile accidents and fatalities is not a known statistic. Police investigators, drivers, and traffic researchers themselves are not mindful of the risks associated with listening to music while driving. Implications of the study point to a need for drivers' education courses to raise public awareness about the effects of music during driving.
Previous convictions or accidents and the risk of subsequent accidents of older drivers.
- Daigneault G, Joly P, Frigon JY. Accid Anal Prev 2002; 34(2): 257-261.
Correspondence: Genevieve Daigneaualt, Reseau de Sante Richelieu-Yamaska, Departement des Soins longues durees, St. Hyacinthe, Quebec, Canada J2S 4Y8 (email: gedaigneault@hotmail.com).
The over-involvement of elderly drivers in collisions has a potentially adverse effect on highway safety. The question for most experts in traffic research is whether we can predict the individual risk of accidents and which variables are the best predictors, especially for this population. For a better understanding of the elderly drivers' problems, this study aimed to describe the most common types of accidents in the elderly population of drivers living in Quebec (> or = 65 years of age). The second objective of the study was to analyse the relationship between previous accidents or convictions and the risk of subsequent accidents. The results show that: (1) elderly drivers are characterised by error accidents involving more than one car, especially at intersections, (2) prior accidents are a better predictor for accident risk than prior convictions and (3) these trends steadily increase with each age group (drivers 65 years old to 80 years or more). The results are discussed in relation to the literature on risk behaviour of the elderly drivers.
Evaluating the crash and citation rates of Utah drivers licensed with medical conditions, 1992-1996.
- Vernon DD, Diller EM, Cook LJ, Reading JC, Suruda AJ, Dean JM. Accid Anal Prev 2002 Mar;34(2):237-246.
Correspondence: Donald D. Vernon, University of Utah School of Medicine, Salt Lake City 84108, USA (email: don.vernon@hsc.utah.edu).
BACKGROUND: Medical problems may affect the ability to drive motor vehicles, and programs that control the issuing of driver licenses to individuals with medical conditions exist in most states. The main activity of these programs is the imposition of restrictions upon the driving privileges of individuals with medical conditions that are deemed to pose some risk to public safety. However, little is known about the effectiveness of these licensing programs.
OBJECTIVE: The objective of this study was to compare the rates of adverse driving events (crash, at-fault crash and citations) experienced by drivers licensed with medical conditions to those of age-, sex- and location-matched controls. Separate comparisons were made for drivers reporting medical conditions licensed with full driving privileges, and those with restricted driving privileges (e.g. speed, area and time of day).
METHODS: Design- Retrospective case-control. The study population was all drivers licensed in the state of Utah who reported a medical condition on their driver license application, over the 5-year period 1992-1996. Drivers enter the program by self-reporting their medical problems. Control drivers were chosen from the entire population of drivers licensed in Utah for the same period. Information on driver license status, participation in the medical conditions program, citations, involvement in crashes, and death certificate data was obtained from the relevant state agencies. Probabilistic linkage methodology was used to link the records in these disparate databases for eventual analysis. Rates of citation, crashes and at-fault crashes, expressed as events per 10000 license days, were calculated separately for program drivers and their corresponding control groups for each medical condition category and restriction status. These data were used to determine an estimate of relative risk (RR) and 95% confidence intervals.
RESULTS: As a group, medical conditions drivers had modestly elevated rates of adverse driving events compared with control drivers (RR 1.09-1.74). Rates in the largest medical category, 'cardiovascular conditions', were not higher than controls. Rates were higher than control for some conditions, such as 'alcohol' and 'learning and memory', for some adverse events (RR 2.2 -5.75). Drivers with more than one medical condition appeared comparable to the general group of medical conditions program drivers.
CONCLUSIONS: Drivers in Utah medical conditions program had modestly elevated rates of adverse driving events compared to matched controls. Possible underreporting of medical conditions and accurate assessment of exposure rates are potential weaknesses in the program.
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