SafetyLit.org Home

Menu of Literature
Updates by Week

List of
SafetyLit Journals

Other Information

Injury Prevention
Links

Injury Prevention
Books

Publications Available
On-Line from IPW Sites

Other IPW Sites

5 August 2002

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. Many of the journals provide copies (usually for a fee) of reports online. Please consider asking your library to subscribe to the journals from which these abstracts have been gathered.

• How Dangerous Are Drinking Drivers?

  Levitt SD, Porter J. J Polit Econ 2001; 109(6): 1198-1237.
  
  Correspondence: Steven D. Levitt,Department of Economics, University of Chicago, 1126 East 59th Street, Chicago, Illinois 60637 USA; (email: slevitt@uchicago.edu).

  We present a methodology for measuring the risks posed by drinking drivers that relies solely on readily available data on fatal crashes. The key to our identification strategy is a hidden richness inherent in two-car crashes. Drivers with alcohol in their blood are seven times more likely to cause a fatal crash; legally drunk drivers pose a risk 13 times greater than sober drivers. The externality per mile driven by a drunk driver is at least 30 cents. At current enforcement rates the punishment per arrest for drunk driving that internalizes this externality would be equivalent to a fine of $8,000. (Copyright © 2001 The University of Chicago)

• Adolescents alcohol related traffic accidents and mortality in 1999-2000--problem and solutions.

  [Article in Japanese]
  
  Desapriya EB, Iwase N, Shimizu S. Nihon Arukoru Yakubutsu Igakkai Zasshi 2002; 37(3):168-178.
  
  Correspondence: E. B. Desapriya, Institute of Social Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba-shi, Ibaraki 305-8571, JAPAN.

  There are a number of factors that give traffic accidents and injuries a prominent position among public health agenda. Injuries, major public health challenge throughout the world and which account for 10% of global mortality, are often ignored as a major cause of death and may require innovative strategies to reduce their toll. Traffic accidents prevention traditionally have been as the domain of law enforcement, societal responses have primarily been a repressive or containment nature. The role of the health sector has tended to be limited to one of treatment and disability prevention, or in other words, damage control. Global Status Report on alcohol use 2001 revealed that drinking has risen steadily among young people in Japan and children between the ages of 13 and 17 have drunk to intoxication or unconsciousness. It also appears that young people in Japan are beginning to drink at earlier ages, while research has found earlier initiation of alcohol use to be associated alcohol dependence and alcohol related injury in later in life. Motor vehicle traffic accidents are a leading cause of death among children, adolescents and young adults between 16 and 20 years of age even though high school students were prohibited from having drivers licenses by internal school rules, this age group was the primary responsible party for 30% of accidents and fatal accidents in 2000. This underlies the fact that how significant role they play as a contributors to the overall traffic problem in Japan. Unlike major causes of deaths such as cancer and heart diseases and despite the critical problem in public health, there are few epidemiological studies on youth involvement in traffic accidents, morbidity and mortality in Japan.

• UNICEF's child injury league table. An analysis of legislation: more mixed messages.

  Towner E, Towner J. Inj Prev 2002; 8(2):97-100.
  
  Correspondence: E. Towner, Community Child Health , Department of Child Health, University of Newcastle upon Tyne, Donald Court House, 13 Walker Terrace, Gateshead NE8 1EB, UK; (email: e.l.m.towner@ncl.ac.uk)

  This paper presents a summary table and discussion of legislation related to child injury prevention in member countries of the Organisation for Economic Cooperation and Development. The table is an expanded version of the one which appeared in the UNICEF Report Card "Child Deaths by Injury in Rich Countries" (2001). A commentary is provided on the variations in legislation between countries in terms of range and form of measures and an estimate of degree of enforcement. As legislation is generally considered a powerful tool in injury prevention, the paper examines whether those countries with the widest range of legislation and the strongest enforcement have made the most progress in reducing child injury deaths since the 1970s. It also considers whether a commitment to extensive legislation is reflected in a country's position in the UNICEF league table of injury death. The initial conclusion to these two basic issues is that no clear picture can be seen and we thus need to know far more about the relationship between legislation and societies and cultures as they vary from place to place. This paper hopes to stimulate more widespread debate about the role of legislation in different countries. (Copyright © 2002 Injury Prevention - BMJ Publications Group)

• Are we blind to injuries in the visually impaired? A review of the literature.

  Legood R, Scuffham P, Cryer C. Inj Prev 2002; 8(2): 155-160.
  
  Correspondence: Rosa Legood, Health Economics Research Centre, Institute of Health Sciences, University of Oxford, Old Road, Oxford OX3 7LF, UK; (email: rosa.legood@dphpc.ox.ac.uk).

  OBJECTIVES: To review the literature on the risks and types of injuries associated with visual impairment, and to identify pertinent areas for future research.
  
  METHODS: A search of bibliographic databases was conducted in April 2000 for studies published since 1980 and selected studies that met two or more of the following criteria: formal ophthalmic assessment was used; adjustment for confounding variables; large sample size including numbers of visually impaired; and clear definitions and outcomes.
  
  FINDINGS: Thirty one studies were selected. The majority of these studies (20) assessed falls (including eight on hip fracture and four on multiple falls), eight studies reported traffic related injuries, and three studies assessed occupational injury. The evidence on falls, which relate predominantly to older people, suggests that those with reduced visual acuity are 1.7 times more likely to have a fall and 1.9 times more likely to have multiple falls compared with fully sighted populations. The odds of a hip fracture are between 1.3 and 1.9 times greater for those with reduced visual acuity. Studies of less severe injuries and other causes of injury were either poorly designed, underpowered, or did not exist.
  
  DISCUSSION: There are substantial gaps in research on both injuries to which people with visual impairment are especially susceptible and in evaluating interventions to reduce these injuries. It is recommended that in future studies the minimum data captured includes: formal ophthalmic assessment of visual fields and visual acuity, outcome measurement, control for confounders, and the costs of health care resource use and any interventions. (Copyright © 2002 Injury Prevention - BMJ Publications Group)

• Socio-economic differentials in injury risk.

  Petridou E, Tursz A. Inj Control Saf Promot 2001; 8(3): 139-142.
  
  Correspondence: Eleni Petridou, Athens University Medical School, Mikras Asias St. 75, 11527 Athens,GREECE; (email: Epetrid@med.uoa.gr).

  Injuries cause a substantial part of mortality, morbidity and disability world-wide and are responsible for more years of life lost than other nosological entities. The etiology of injuries is multifactorial and the predisposing factors can be divided mainly into human factors and environmentally related risks. Existing data indicate that socio-economic disparities are predictors of both injury morbidity and mortality as well as the long-term outcome of an injury.
  
  However, carefully designed and well organized studies should be conducted in order to evaluate which indices more accurately describe the socio-economic status of an individual in relation to the injury risk and which of these indices can be effectively used for international comparisons.
  
  Moreover, there is a need to assess to what extent the detrimental role of social deprivation is mediated through environmental characteristics rather than through individual attributes. The identification of these component factors of social disparity would facilitate the disclosure of mechanisms through which social factors affect the injury risk. (Copyright © 2001 Swets & Zeitlinger)

• Injuries, inequalities and health in Europe.

  Zwi AB; Leon D, Koupilova I, Sethi D, McKee M. Inj Control Saf Promot 2001; 8(3): 143-148.
  
  Correspondence: Anthony B. Zwi, London School of Hygiene and Tropical Medicine, Kepple St., London Wc1E 7HT, UK; (email: anthony.zwi@lshtm.ac.uk).

  Injuries account for a significant burden of mortality, morbidity, disability and health care costs. They differentially affect age and sex groups and reveal massive inequalities in occurrence within and between countries in Europe. Within countries, the poor suffer most and have least ability to change their exposures to risk. Addressing inequalities in injury occurrence would play a valuable role in reducing the differential burden of ill-health between rich and poor. Despite the evidence for many effective injury-related interventions, limited attention has been devoted to addressing injuries as a public health priority. This paper questions why attention has been limited to date and suggests policy action to support injuries being addressed as a mainstream concern by national and international health policy-makers.
  
  The paper briefly highlights the public health burden of injuries and violence; illustrates the range of inequalities that characterise their occurrence; highlights the scope for public health action and considers the extent to which policies that reduce the overall burden of injuries may also reduce inequalities in their occurrence; and finally examines why there has been a limited policy response to date and suggests ways of advancing the agenda. (Copyright © 2001 Swets & Zeitlinger)

• No reports this week

• No reports this week

• Effectiveness of virtual reality for teaching pedestrian safety.

  McComas J, MacKay M, Pivik J. Cyberpsychol Behav 2002; 5(3): 185-190.
  
  Correspondence: Joan K. McComas, The Rehabilitation Sciences Virtual Reality Lab, University of Ottawa, CANADA; (email: jmccoma@uottawa.ca).

  Sixty percent to 70% of pedestrian injuries in children under the age of 10 years are the result of the child either improperly crossing intersections or dashing out in the street between intersections. The purpose of this injury prevention research study was to evaluate a desktop virtual reality (VR) program that was designed to educate and train children to safely cross intersections. Specifically, the objectives were to determine whether children can learn pedestrian safety skills while working in a virtual environment and whether pedestrian safety learning in VR transfers to real world behavior. Following focus groups with a number of key experts, a virtual city with eight interactive intersections was developed. Ninety-five children participated in a community trial from two schools (urban and suburban). Approximately half were assigned to a control group who received an unrelated VR program, and half received the pedestrian safety VR intervention. Children were identified by group and grade by colored tags on their backpacks, and actual street crossing behavior of all children was observed 1 week before and 1 week after the interventions. There was a significant change in performance after three trials with the VR intervention. Children learned safe street crossing within the virtual environment. Learning, identified as improved street-crossing behavior, transferred to real world behavior in the suburban school children but not in the urban school. The results are discussed in relation to possibilities for future VR interventions for injury prevention. (Copyright © 2002 MA Liebert Publishers)

• Epidemiology of accidents among users of two-wheeled motor vehicles. A surveillance study in two Italian cities.

  LaTorre G, Bertazzoni G, Zotta D, van Beeck E, Ricciardi G. Eur J Public Health 2002; 12(2):99-103.
  
  Correspondence: Giuseppe Latorre, Chair of Hygiene, University of Cassino, Viale Bonomi 8, 03043 Cassino, FR, ITALY; (email: latorre@unicas.it).

  BACKGROUND: This paper describes a study on the epidemiology of accidents among users of two-wheeled motor vehicles in two Italian cities, Rome and Naples.
  
  METHODS: A surveillance study was conducted, recruiting the victims of accidents among users of two-wheeled motor vehicles, visiting the emergency departments of two Italian hospitals. The registration form includes personal data of the involved person, circumstances of the accident, means of arrival at the hospital, type of vehicles involved, helmet use, and eventually third parties involved, and data on the specific injury diagnosis.
  
  RESULTS: 736 injured drivers of two-wheeled motor vehicles were investigated for the study (65.1% males, 34.9% females). The mean age of the victims was 22.92 years; 42.9% of the injuries were the result of a single accident. In 35.5% of the injuries cars were involved and in 8.6% of the cases there was a passenger included. Only 12% of the injured people were wearing a helmet. Most of the lesions concerns the knee or lower leg (27.5%), followed by the head (17.5%), elbow and forearm (8.8%), wrist and hand (8.6%), shoulder and upper arm (8.4%) and ankle and foot (6.9%). Helmet use has a protective effect (OR = 0.23), whereas accidents in Naples and during dark hours are associated with an increased risk of head injury (respectively OR = 1.93, and OR = 1.46).
  
  CONCLUSION: In this study the lower injury risk due to the use of the helmet on the frequency and severity of head trauma was confirmed. Moreover, the results confirm that Emergency Departments can provide essential epidemiological information, and they have already provided clear arguments in favour of extending the compulsory use of helmets to people above 18 years in Italy. (Copyright © 2002 European Journal of Public Health)

• Child bicyclist injuries: are we obtaining enough information in the emergency department chart?

  Moll EK, Donoghue AJ, Alpern ER, Kleppel J, Durbin DR, Winston FK. Inj Prev 2002; 8(2):165-169.
  
  Correspondence: Flaura Winston, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, 19104, USA; (email: flaura@mail.med.upenn.edu).

  OBJECTIVE: The purpose of this study was to assess the range of information relevant to bicyclist injury research that is available on routinely completed emergency department medical records.
  
  METHODS: A retrospective chart review of emergency department medical records was conducted on children who were injured as bicyclists and treated at an urban level I pediatric trauma center. A range of variables relevant to bicyclist injury research and prevention was developed and organized according to the Haddon matrix. Routinely completed free text emergency department medical records were assessed for the presence of each of the targeted elements. In addition, medical records of seriously injured patients (for whom a more structured medical record is routinely used) were compared to free form records of less seriously injured patients to identify differences in documentation that may be related to the structure of the medical record.
  
  FINDINGS: Information related to previous medical history (96% of records), diagnosis (89%), documentation of pre-hospital care (82%), and child traumatic contact points (81%) were documented in the majority of medical records. Information relevant to prevention efforts was less commonly documented: identification of motor vehicle/object involved in crash (58%), the precipitating event (24%), the location of the crash (23%), and documentation of helmet use (23%). Records of seriously injured patients demonstrated significantly higher documentation rates for pre-hospital care and child traumatic contact points, and significantly lower documentation rates for previous medical history, child kinematics, main body parts impacted, and location of injury event.
  
  DISCUSSION: Routinely completed free text emergency department medical records contain limited information that could be used by injury researchers in effective surveillance. In particular information relating to the circumstances of the crash event that might be used to design or target prevention efforts is typically lacking. Routine use of more structured medical records has the potential to improve documentation of key information. (Copyright © 2002 Injury Prevention - BMJ Publishing Group)

• Toxic inhalation fatalities of US construction workers, 1990 to 1999.

  Dorevitch S, Forst L, Conroy L, Levy P. J Occup Environ Med 2002; 44(7):657-662.
  
  Correspondence: Samuel Dorevitch, Occupational Medicine Residency Program, Division of Environmental and Occupational Health Sciences, Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA; (email: sdorevit@uic.edu).

  Construction workers account for a disproportionately large number of occupational fatalities. A small percentage of these deaths is attributable to poisoning. Risk factors for such deaths using national data have not been reported previously. Construction poisoning fatalities from 1990 to 1999 in the Occupational Safety and Health Administration Integrated Management and Information System data set were analyzed. Risk and risk factors were determined using Bureau of Labor Statistics and census data. Eighty-seven poisoning deaths of construction workers are characterized, all attributable to toxic inhalation. Cellular and simple asphyxiants accounted for the largest numbers of fatalities. The majority of these deaths occurred in confined spaces. Water, sewer, and utility line workers are at increased risk for poisoning fatality. Toxic inhalation fatalities in the construction industry are preventable. Extending the Occupational Safety and Health Administration's confined space standard could save lives, particularly among water, sewer, and utility line industry workers. (Copyright © 2002 Lippincott Williams & Wilkins)

• Safety attitudes and beliefs of junior Australian football players.

  Finch C, Donohue S, Garnham A. Inj Prev 2002; 8(2):151-154.
  
  Correspondence: Caroline Finch, Department of Epidemiology and Preventative Medicine, Central and Eastern Clinical School, Monash University, Alfred Hospital, Prahran, Victoria, AUSTRALIA; (email: caroline.finch@med.monash.edu.au).

  OBJECTIVES: To describe the safety attitudes and beliefs of junior (aged 16-18 years) Australian football players.
  
  METHODS: Setting- Six Victorian Football League Under 18 (VFL U18) clubs in Victoria, Australia. Design- Cross sectional survey. Altogether 103 players completed a self report questionnaire about their safety beliefs and perceptions of support when injured, across three contexts in which they played: VFL U18 club, local club, and school.
  
  FINDINGS: Although only 6% believed it was safe to play with injuries, 58% were willing to risk doing so. This increased to almost 80% when players perceived that their chances of being selected to play for a senior elite team would be adversely affected if they did not play. There were significant differences in the perceived level of support for injured players and in the ranking of safety as a high priority across the three settings. In general, the VFL U18 clubs were perceived as providing good support for injured players and giving a high priority to safety issues, but local clubs and particularly schools were perceived to address these issues less well.
  
  DISCUSSION: Junior Australian football players have certain beliefs and perceptions in relation to injury risk that have the potential to increase injuries. These negative beliefs need to be addressed in any comprehensive injury prevention strategy aimed at these players. (Copyright © 2002 Injury Prevention - BMJ Publishing Group)

• Revisions of labeling for personal watercraft: Part 1 - label development.

  Rhoades TP, Franz PJ, Young SL, Wisniewski. Inj Control Saf Promot 2001; 8(2): 71-78.
  
  Timothy P. Rhoades, Applied Safety & Ergonomics, Inc., 3909 Research Park Drive, Suite 300, Ann Arbor, MI 48108, USA; (email: trhoades@appliedsafety.com).

  This two-part paper presents a comprehensive case study related to the development and evaluation of warning labels. In particular, this two-part paper describes the development and evaluation of revised warning labels applicable to a class of products known as personal watercraft (pwcs), and serves as an example application of a general warnings design process described by Frantz et al.1 Part 1, presented in this paper, includes the process of project planning, identifying and analyzing hazards, and developing two preliminary warning labels to address pwc operational hazards. Included are discussions regarding the methods used to address problems frequently encountered in the development of warning labels. Topics of these discussions include the prioritization and selection of hazards to be addressed, message development strategies, avoiding information overload, and organizing the presentation of information using human factors models and concepts. The work conducted in Part 1 resulted in two preliminary labels: one label dealing with issues related to Collision Avoidance and a second label dealing with General Operational Hazards. Part 2, the companion article,2 describes the process of evaluating and revising the preliminary labeling to produce the final labels. Discussions regarding the methods used to address challenges related to the evaluation and revision of warning labels are provided. As a result of the entire process, revised labels for pwcs with increased uniformity will be used by pwc manufacturers, although flexibility for specific model features or future changes in design will be retained. (Copyright © 2001 Swets & Zeitlinger)

• Revisions of labeling for personal watercraft: Part 2 - label evaluation.

  Young SL, Franz P, Rhodes TP, Wisniewski EC. Inj Control Saf Promot 2001; 8(4): 211-227.
  
  Stephen L. Young, Applied Safety & Ergonomics, Inc., 3909 Research Park Drive, Suite 300, Ann Arbor, MI 48108, USA; (email: syoung@appliedsafety.com).

  This two-part paper presents a case study related to the development and evaluation of warning labels for a class of products known as personal watercraft (pwcs). These two papers serve as an example application of a general process1 for developing and evaluating safety information. Part 1, presented in the companion paper,2 describes the process of project planning, identifying and analyzing potential hazards, and developing two preliminary warning labels to address pwc operational hazards. Part 2, the present article, describes the process of evaluating and revising the preliminary labels to produce the final iterations. In all, eleven iterations of the labeling were produced and evaluated. Evaluation took many forms including seeking input from various parties with special expertise, assessing the ease with which words and phrases were understood, and assessing the extent to which people understood the concepts being conveyed by the labels. The results demonstrated that the various components of the final version of the labels were comprehended at rates that ranged from 96.3% to 100%. As a result of the work described in these papers, revised labels for pwcs with increased uniformity will be used by pwc manufacturers, although flexibility for specific model features or future changes in design will be retained. (Copyright © 2001 Swets & Zeitlinger)

• Pattern of injury from personal watercraft.

  Haan JM, Kramer ME, Scalea TM. Am Surg 2002; 68(7):624-627.
  
  James M. Haan, Department of Surgical Critical Care, University of Maryland, Baltimore 21231, USA; (email: jhaan@umm.edu).

  Injury from personal watercraft has continued to increase. Prior attempts to delineate patterns of injury and relative frequencies have yielded varied results. We retrospectively reviewed Trauma Registry data and charts of all patients who suffered personal watercraft injury treated at the R. Adams Cowley Shock Trauma Center between August 1996 and January 2001. Patient demographics included mechanism of injury, injuries sustained, and outcomes. Attempts were made to correlate events around the injury and injury pattern. During the study period 24 patients were treated. Mechanisms consisted of direct collision, fails from the watercraft, handlebar straddle injuries, axial loading, and hydrostatic jet injury. Traumatic brain injury was most common occurring in 54 per cent of patients. Spinal injury was also common occurring in 29 per cent of patients. Axial loading from falls while wave jumping seemed to correlate with skeletal injury. Thoracolumbar spine injury were often skeletally unstable requiring either brace or operative fixation. Inexperience and reckless behavior were found to be the greatest contributing factors. Substance abuse did not influence injury. (Copyright © 2002 Southeastern Surgical Congress)

• Severe accidents due to windsurfing in the Aegean Sea.

  Kalogeromitros A, Tsangaris H, Bilalis D, Karabinis A. Eur J Emerg Med 2002; 9(2): 149-154.
  
  Correspondence: A. Kalogeromitros, Department of Emergency and Critical Care Medicine, General Hospital of Athens 'G. Gennimatas', 154 Mesogion Avenue, Athens 11527, GREECE.

  Windsurfing is a popular sport and has recently become an Olympic event. As an open-air water activity that requires the participant to be in perfect physical condition, windsurfers may be prone to accidents when certain basic rules or procedures are violated. The current study monitored severe injuries due to windsurfing over a period of 12 months in the Aegean Sea in Greece. Our study revealed 22 cases of severe accidents due to windsurfing, with a wide range of injuries including head injuries, spinal cord injuries, and severe fractures of the extremities. Prolonged hospitalization, severe disability and two deaths occurred as consequences of these accidents. The study examined the characteristics of these patients and the possible risk factors and conditions associated with the accidents. We also focused on the most common types of injuries and reviewed the mechanisms that may provoke them. Water sports and particularly windsurfing represent a major challenge for the emergency medical system, especially in the Aegean Sea. Hundreds of islands, kilometres of isolated coasts, millions of tourists, an extended summer period and rapidly changing weather create conditions that constantly test the efficacy of the emergency services. The development of an appropriate infrastructure and maximum control of the risk factors causing these accidents could reduce the morbidity and mortality that, unfortunately but rather predictably, accompany this popular summer activity. (Copyright © 2002 Lippincott Williams & Wilkins)

• The Burden of Injury in Preschool Children in an Urban Medicaid Managed Care Organization.

  Bishai D, McCauley J, Trifiletti LB, McDonald EM, Reeb B, Ashman R, Gielen AC. Ambul Pediatr 2002; 2(4): 279-283.
  
  Correspondence: David Bishai, Center for Injury Research and Policy (Dr Bishai), Johns Hopkins University,624 N. Broadway, Baltimore, MD 21205-1996 USA; (email: dbishai@jhsph.edu).

  BACKGROUND: Efforts to control injuries within managed care organization (MCO) populations require information about the incidence and costs associated with the injuries cared for in MCOs.
  
  OBJECTIVE: This study uses administrative data to measure the rates and the costs of burn, choking, poisoning, blunt, and penetrating injuries in an urban Medicaid MCO.
  
  METHODS: A database was assembled from all medical claims submitted to a Medicaid MCO covering children aged </=6 years in urban Baltimore between the dates of July 1, 1997, and August 7, 1999. The database included claims submitted on behalf of 1732 children observed for 2180 person-years. ICD-9 codes were reviewed to identify claims for burn, poisoning, choking, and blunt/penetrating injuries. Trained coders reviewed outpatient records to assign E-codes.
  
  FINDINGS: A total of 796 injuries occurred. The overall injury rate was 36.5% per year. The total cost of the medical care for these injuries was $863 552, or $396 per covered person-year, representing 42%-55% of the capitated rate received in Baltimore. Falls, being struck by something, and cutting/piercing injuries accounted for 68% of injuries. Emergency departments were the most common service sites for injured children for all injuries except in the case of burns.
  
  DISCUSSION: The children enrolled in this urban Medicaid population had nearly twice the rate of injury when compared to the national average. The medical costs of injuries account for about half of the capitated reimbursement for this age group. (Copyright © 2002 The Ambulatory Pediatric Association)

• Home and leisure accidents in Europe: Survey and hospital data.

  Bardehle D, Fuhr A, Monárrez-Espino J, Heyer C, Rössler G. Inj Control Saf Promot 2001; 8(4): 256-268.
  
  Correspondence: Doris Bardehle, Landesinstitut fur den Offentlichen, Gesundheitsdienst Nordrhien-Westfalen, Westerfeldstrasse 35/37, DE 33 611 Bielefeld, GERMANY; (email: doris.bardehle@loegd.nrw.de)

  Data on Home and Leisure Accidents (HLA) are collected in the Member States of the European Union. The data for the year under review (1996), collected by three countries in hospitals and by three countries via telephone interviews or household surveys, were analysed.
  
  The analysis was focused on the type of injury, mechanism of injury, place of occurrence and body part affected.
  
  The two different methods of data collection were found to lead to different results. Thus, collecting data by surveys leads to a realistic description of minor and severe injuries, while data collected in hospitals include a higher number of severe accidents. Detailed information on nature of injury and cause of injury are provided nation of occurrence, place of ocurrence, and age. (Copyright © 2002 Swets & Zeitlinger)

• Epidemiology of facial fractures in Chile.

  [Article in Spanish]
  
  Rojas RA, Julian G, Lankin J. Rev Med Chil 2002; 130(5): 537-543.
  
  Correspondence: R.A. Rojas, Servicio de Cirugia Maxilofacial, Hospital del Trabajador, Vicuna Mackenna 200, Santiago, Chile; (email: rojasdel@entelchile.net).

  BACKGROUND: Facial trauma has reached a peak in the last decades in the world; however, scanty epidemiological information is available in Chile.
  
  OBJECTIVES: To report the experience in the treatment of mandibular fractures in the maxillofacial unit at Hospital del Trabajador, Santiago.
  
  METHODS: A retrospective study of patients with mandibular fractures treated in a seven years period (1990-1996). Demographic and clinical aspects of the patients are analyzed, with emphasis in causes of trauma, anatomic distribution of the fractures, treatment and complications.
  
  FINDINGS: One hundred and sixty patients (aged 14 to 65 years old) sustained 245 mandibular fractures. Road traffic accidents were the most common cause of fractures (46%). The most common mandibular fracture was subcondylar. Thirty eight patients (24%) presented with associated facial fractures, while 34 (21%) had also other non-facial fractures. Open reduction and internal fixation was performed in 88 subjects. Complications occurred in 60 patients (38%).
  
  DISCUSSION: Road traffic accidents are the main cause of mandibular fractures in this series of patients. The most common mandibular fracture is subcondylar, which can be linked to the high rate of occlusal complications observed.

• The aetiology of perforating ocular injuries in children.

  Thompson CG, Kumar N, Billson FA, Martin F. Br J Ophthalmol 2002; 86(8): 920-922.
  
  C G Thompson, Port Macquarie Eye Centre, 11 Parker Street, Port Macquarie, AUSTRALIA; (email: csthompson@bigpond.com).

  OBJECTIVES: To assess the aetiological factors associated with the occurrence of perforating ocular injuries in children in an urban setting and to assess the visual outcomes of such injuries.
  
  METHODS: All cases of perforating ocular injury presenting to a single paediatric hospital (age less than 16 years) over a 17 year period were identified by a medical record search. All new cases of perforating ocular injury identified were included. All information was obtained retrospectively from the medical records.
  
  FINDINGS: There were 72 cases identified. The commonest causes of perforating ocular injury were sharp tools (knives/scissors) poked by the child into his/her own eye (17%), or objects thrown at the child (17%). Injuries were most likely to have occurred at home (58%). The age range for injuries was 8 months to 14 years 8 months. Perforating ocular injury was most frequent in the 3-6 year group (32%) followed by the 6-9 year group (25%). Males were more frequently involved than females (48-24). There was no correlation between the laterality of the eye, the time of day of the occurrence, or the day of the week of the occurrence. The final acuity achieved was better or equal to 6/12 in 36% and less than 6/60 in 31%. Injuries occurred more frequently on weekends than on weekdays. There were six enucleations (8%). Follow up was for an average period of 25 months.
  
  DISCUSSION: Penetrating ocular injury occurs most frequently in the home setting and mostly as the result of the use of sharp tools or by thrown objects. Prevention of penetrating ocular injury requires greater education of children and their carers especially on the potential dangers within the home. (Copyright © 2002 BMJ Publishing Group)

• An epidemiological study of injury in a low socioeconomic context: implications for prevention.

  Swart L, Seedat M. Inj Control Saf Promot 2001; 8(4): 241-249.
  
  Lu-Anne Swart, University of South Africa, Institute for Social and Health Sciences (ISHS), Lenasia, SOUTH AFRICA.

  Epidemiological information identifying injury magnitude and risks is vital for the development of prevention and safety promotion programmes, especially for low income, marginalised communities where the incidence of injury tends to be disproportionately high. This paper, accordingly, reports on a household survey, conducted in an informal settlement southwest of Johannesburg, South Africa, and designed to gather epidemiological data for the purposes of informing the development of appropriate community-based injury prevention and safety promotion programmes. Data were collected for a one-year period prior to October 1998. An analysis of the data identified the causes of injuries, which residents were most at risk, and where and when injuries most often occurred. By way of conclusion, we make a few recommendations for preventive measures. (Copyright © 2002 Swets & Zeitlinger)

• Validity of death certificate variables in cases of death from external causes, Brazil.

  [Article in Portuguese]
  
  Barros MD, Ximenes R, Lima ML. Rev Saude Publica 2002; 36(3):301-306.
  
  Correspondence: Maria Dilma de A. Barros, Departamento de Medicina Social, Faculdade de Ciencias Medicas, Universidade de Pernambuco, Rua Arnóbio Marques, 310, Santo Amaro, 50100-130 Recife, PE, BRAZIL; (email: dilma@elogica.com.br).

  OBJECTIVE: To validate variables other than the basic cause of death on death certificates from external causes of residents younger than 20 years old living in Recife, Brazil, in 1995.
  
  METHODS: A survey of death records of the Institute of Forensic in Recife was carried out in order to validate death certificate variables included in official mortality registries. Agreement analysis was performed using Kappa indexes and sensitivity. As a result of the methodology used, the study data was considered to be more consistent and therefore regarded as standard.
  
  FINDINGS: Those variables forensic specialists indicated as their direct responsibility showed an excellent (gender, age, and category of violence) and good (type of accident) agreement. However, there were significant discrepancies in those variables seen as either of indirect or no forensic responsibility, such as locality and area where death took place, medical care provided and accident location.
  
  DISCUSSION: Data reveal a dissociation between the reasons for including some variables in death certificates and the obtaining strategy and their social purpose.

• Incidence and description of high chair-related injuries to children.

  Powell EC, Jovtis E, Tanz RR. Ambul Pediatr 2002; 2(4): 276-278.
  
  Elizabeth C. Powell, Division of Pediatric Emergency Medicine, Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL 60614, USA; (email: epowell@northwestern.edu)

  OBJECTIVES: To describe the incidence, circumstances, and types of high chair-related injuries among US children.
  
  METHODS: Retrospective review of data for children 3 years old and younger from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission for 1994-98.
  
  FINDINGS: There were an estimated 40 650 high chair-related injuries (95% confidence interval [CI], 32 657-48 643) to children 3 years old and younger treated in hospital emergency departments in the US during the 5-year study period. An estimated 5231 injuries (13%) were related to use of an attachable high chair (including booster seats), and an estimated 4067 (10%) were related to the use of a youth chair. The annual rate of injury among children </=3 years old was 5.3 per 10 000. The mean age was 10 months (median, 1 year); 56% were boys. Ninety-four percent of injuries resulted from a fall from the chair. Most injuries involved the head (44%) or face (39%). Injury diagnoses included contusions or abrasions (36%), lacerations (25%), closed head injury (21%), and fractures (8%). Two percent of injured children, an estimated 941 (95% CI, 399-1487), were admitted to the hospital during the study period, an annual admission rate of 0.1 per 10 000. There were no significant differences between attachable high chairs, youth chairs, and high chairs in anatomic sites of injury, injury diagnosis, or frequency of hospital admission.
  
  DISCUSSION: Injuries related to high chairs are common, particularly among children in the first year of life. They often result from falls from the chair. The data suggest that restraint use would prevent most of these injuries. (Copyright © 2002 The Ambulatory Pediatric Association)

• Process-evaluation of a home visit programme to prevent falls and mobility impairments among elderly people at risk.

  van Haastregt JC, van Rossum E, Diederiks JP, de Witte LP, Voorhoeve PM, Crebolder HF. Patient Educ Couns 2002; 47(4): 301-309.
  
  Correspondence: Jolanda C.M. van Haastregt, Institute for Rehabilitation Research, P.O. Box 192, 6430 AD, Hoensbroek, THE NETHERLANDS; (email: jolanda.vanhaastregt@irv.nl).

  This paper describes the results of a detailed evaluation of the intervention process of a multifactorial home visit programme aimed at preventing falls and mobility impairments among elderly persons living in the community. The aim of the study is to provide insight in factors related to the intervention process that may have influenced the effectiveness of this home visit programme. The programme consisted of five home visits performed by a community nurse over a period of 1 year. During the home visits the participants were screened for risk factors potentially influencing falls and mobility. The screening was followed by recommendations, referrals, and other actions aimed at dealing with the hazards observed. Data regarding the intervention process were gathered by means of interviews with nurses and participants, and by means of structured forms and questionnaires administered by the nurses during the intervention period. We conclude that our 1-year multifactorial home visit programme consisting of five home visits is feasible for nurses and participants. Despite this, it seems to be an unsuitable intervention technique to reduce falls and mobility impairments among elderly people at risk.

• Depression and falls among community dwelling elderly people: a search for common risk factors.

  Biderman A, Cwikel J, Fried AV, Galinsky D. J Epidemiol Community Health 2002; 56(8): 631-636.
  
  Corrspondence: A Biderman, Department of Family Medicine, Faculty of Medical Sciences, Ben Gurion University of the Negev, POB 653, Beer Sheva 84105, ISRAEL; (email: sbider@netvision.net.il).

  BACKGROUND: Depression and falls are two common conditions that impair the health of older people. Both are relatively underdiagnosed and undertreated problems in primary care.
  
  OBJECTIVES: To investigate whether there was a common set of risk factors that could predict an increased risk of both falls and depression.
  
  METHODS: This was a cohort study drawn from a primary care clinic, with a one year follow up. Dependent measures included: reporting two or more falls in the past year and a score of 7 or over on the S-GDS (Short Geriatric Depression Scale). A parsimonious set of risk factors was selected that predicted both outcomes based on a series of discriminant function analyses. Participants and setting: The setting was a primary care clinic serving a mixed socioeconomic population, in Beer Sheva, Israel. The sample included 283 General Sick Fund members, aged 60 and over, who completed both baseline assessments and one year follow up interviews.
  
  FINDINGS: At the one year follow up, 12% of the sample reported frequent falls in the past year and 25.5% of the sample screened positive for depressive symptoms. A set of five risk factors that included: poor self rated health, poor cognitive status, impaired ADL, two or more clinic visits in the past month, and slow walking speed (g10 seconds over five metres) was successful at discriminating between fallers and non-fallers (86% discrimination) and between those with and without depressive symptoms (76%). For every risk factor added, there was a significant increase in the proportion of respondents who had depressive symptoms. A similar result was found for falls.
  
  DISCUSSION: These results show that there is a common set of risk factors that increase the risk of two common outcomes in geriatric medicine, falls and depression. For a general practitioner or a geriatric physician, it might be easier to detect these risk factors than to diagnose depression or high risk for falls. When these risk factors are detected in patients the physician can then be more active in direct probing about depression and falls.

• Health risk factors among Iowa farmers.

  Park H, Sprince NL, Jensen C, Whitten PS, Zwerling C. J Rural Health 2002; 18(2):286-93.
  
  Correspondence: Hyesook Park, Department of Preventive Medicine, Ewha Womans University, Seoul, KOREA.

  This study compares the prevalence of the health risk factors for chronic disease and injury among farmers with their prevalence among other workers, using data from the Iowa Behavioral Risk Factor Surveillance System. From January 1999 to December 1999, there were 3,620 adults who participated in the survey. This report focuses on the 2,140 subjects who reported they were working. We calculated the percentage with each health risk factor, the adjusted odds ratio (OR) and the associated 95% confidence interval (CI), comparing the prevalence of health risks among farmers and other workers. Most health conditions and risk factors were similar among farmers and other workers. However, we found that farmers had some protective behaviors. They had better oral health (OR = 0.34, 95% CI 0.20-0.57) and were less likely to smoke (OR = 0.14, 95% CI 0.06-0.29) than other workers. In contrast, we found that farmers reported some high-risk behaviors compared to other workers. They were less likely to have smoke detectors at home (OR = 0.39, 95% CI 0.18-0.82), or to have had stool blood screening for colorectal cancer (OR = 0.41, 95% CI 0.1 7-1.00). These results suggest areas for future research to define targeted preventive interventions in farm communities.

• Causes, nature, and outcomes of work-related injuries to adolescents working at farm and non-farm jobs in rural Minnesota.

  Munshi K, Parker DL, Bannerman-Thompson H, Merchant D. Am J Ind Med 2002; 42(2): 142-149.
  
  Correspondence: David L. Parker, Park Nicollet Health Services, Department of Occupational Medicine, 2001 Blaisdell Ave. S, Minneapolis, MN 55404, USA; (email: Parke065@umn.edu).

  BACKGROUND: Although there are many studies on working adolescents, information on youth who simultaneously hold jobs on both a farm and in other sectors of the economy is lacking.
  
  METHODS: Six high schools in rural Minnesota were evaluated for adolescent work practices and injury incidence. A 20-page self-administered survey was administered to students.
  
  FINDINGS: A total of 2,250 students completed the survey, representing 92% of the student body. Students that simultaneously hold both farm and non-farm jobs have a significantly higher proportion of injuries. However, annual injury rates are highest for those working in non-farm only (26.7/100 full-time equivalents, FTEs) or farm only (25.9/100 FTEs) employment when compared with those working simultaneously in farm and non-farm jobs (21.9/100 FTEs).
  
  DISCUSSION: Many rural students employed simultaneously on farm and non-farm jobs work long hours and are at significant risk of work-related injury. The annual injury rates we estimated are higher than those reported in previous studies. (Copyright © 2002 Wiley-Liss)

• Adolescent work patterns and work-related injury incidence in rural Minnesota.

  Parker DL, Merchant D, Munshi K. Am J Ind Med 2002; 42(2): 134-141.
  
  Correspondence: David L. Parker, Park Nicollet Health Services, Department of Occupational Medicine, 2001 Blaisdell Ave. S, Minneapolis, MN 55404, USA; (email: Parke065@umn.edu).

  BACKGROUND: Although there have been many studies on working youth in the United States, we have noted none which have provided a broad picture of adolescent work practices in a rural community.
  
  METHODS: Six high schools in rural Minnesota were evaluated for adolescent work practices. Schools ranged in size from 173 to 525 students in grades 9 through 12. A 20 page self-administered survey examining work practices was administered to students.
  
  FINDINGS: A total of 2,250 students completed the survey, representing 92% of the student body. Twenty-eight percent of students lived on a farm. Approximately 45% of the male students and slightly more than 21% of the females were involved in farm work. Only 2.6% of students were injured during this 8-month time period in farm-related activities, and 5.1% were injured doing non-farm work. Many students reported working long hours.
  
  DISCUSSION: Work represents a serious problem for rural youth. These data are significant in the context of national policy discussion concerning the failure of the Fair Labor Standards Act to regulate the agricultural environment. (Copyright © 2002 Wiley-Liss)

• Injury risks in children of California migrant Hispanic farm worker families.

  McCurdy SA, Samuels SJ, Carroll DJ, Beaumont JJ, Morrin LA. Am J Ind Med 2002; 42(2): 124-133.
  
  Correspondence: Stephen A. McCurdy, Department of Epidemiology and Preventive Medicine, University of California - Davis, One Shields Avenue, Davis, CA 95616-8638, USA; (email: samccurdy@ucdavis.edu).

  BACKGROUND: Few data are available addressing occupational and other injury risks among children of migrant Hispanic farm workers.
  
  METHODS: We conducted the U.C. Davis Farm Worker Injury Study (UCD-FWIS), a longitudinal follow-up study of injury among migrant Hispanic farm worker families living in six Northern California Migrant Housing Centers (MHCs). Nine hundred forty-one children (age < 18 years) were interviewed through parental proxy.
  
  FINDINGS: Fifty-one injuries resulting in medical care or at least one-half day of lost or restricted work or school time occurred among 49 children (3.8 injuries/100 person-years). Open wounds (31.4%) and fractures (29.4%) were most common. Falls comprised over one-third of the cases, followed by being struck and bicycle injuries. Over three-quarters of subjects never use a helmet when riding a bicycle. Seventy-eight (8.3%) children reported employment in the preceding year, typically involving manual agricultural tasks. Two injury cases were occupational and involved agricultural work.
  
  DISCUSSION: Occupational injury was uncommon in this group of children in migrant Hispanic farm worker families. Injury prevention in this population should include a focus on the home and surrounding environment as well as the work place. (Copyright © 2002 Wiley-Liss)

• Occupational risks and injuries in non-agricultural immigrant Latino workers.

  Pransky G, Moshenberg D, Benjamin K, Portillo S, Thackrey JL, Hill-Fotouhi C. Am J Ind Med 2002; 42(2): 117-123.
  
  Correspondence: Glenn Pransky, Liberty Mutual Center for Disability Research, 71 Frankland Road, Hopkinton, MA, USA; (email: glenn.pransky@libertymutual.com).

  OBJECTIVES: To investigate occupational health in urban immigrant Latino workers, using a community-based method.
  
  METHODS: A survey was administered through consecutively selected door-to-door interviews.
  
  FINDINGS: Response rate was 80% (n = 427). Average time in the US was 7.6 years, and average job tenure was 2.8 years. Twenty-five reported exposures to over 10 different hazards, and 18% thought these hazards had harmed their health. Only 31% received any job safety training; 55% had no workers' compensation coverage. Of the 47 (11%) with a work injury in the past 3 years, 27% reported difficulty obtaining treatment, 91% lost time from work (median = 13 days) and 29% had to change jobs because of the injury. The annual occupational injury rate was 12.2/100 full-time workers, compared to an expected rate of 7.1.
  
  DISCUSSION: Urban immigrant workers have increased risk of occupational injuries, with adverse outcomes. (Copyright © 2002 Wiley-Liss)

• No reports this week

• The trajectory of suicidal behavior over time.

  Joiner TE Jr. Suicide Life Threat Behav 2002; 32(1):33-41.
  
  Correspondence: Thomas Joiner, Jr. Department of Psychology, Eppes Building, Florida State University, Tallahassee 32306-1270, USA; (email: joiner@psy.fsu.edu).

  Some empirical work on genetic and prenatal factors in suicidality is presented. These factors may represent enduring predispositions that comprise risk for initial as well as later suicidal behavior. The existence of enduring predispositions does not preclude the possibility, however, that initial suicidal behavior sets processes into motion that spur later suicidal behavior. Based on past conceptual and empirical work, I suggest two psychological processes--cognitive sensitization and opponent processes--that may partly explain the link between past and future suicidal behavior. (Copyright © 2002 American Association of Suicidology)

• A case control study of suicide and attempted suicide in older adults.

  Beautrais AL. Suicide Life Threat Behav 2002; 32(1):1-9.
  
  Correspondence: Annette Beautrais, Canterbury Suicide Project, Christchurch School of Medicine, P.O. Box 4345, Canterbury, NEW ZEALAND; (email: suicide@chmeds.ac.nz).

  Risk factors for serious suicidal behavior among older adults were examined in a case control study of 53 adults aged 55 and older who died by suicide or made medically serious suicide attempts and who were compared with 269 randomly selected comparison subjects. Multivariate analyses suggested that risk of serious suicidal behavior was elevated among those with current mood disorders (OR = 179, CI = 52.8-607.6), psychiatric hospital admission within the previous year (OR = 24.4, CI = 1.9-318.7), limited social network (OR = 4.5, CI = 1.4-14.6). The predominant role of mood disorders was confirmed by population attributable risk (PAR) estimates (73.6%), suggesting that the improved detection, treatment and management of mood disorders should be the primary focus of suicide prevention strategies for older adults. (Copyright © 2002 American Association of Suicidology)

• Explaining the gender difference in self-reported suicide attempts: a nationally representative study of Norwegian adolescents.

  Wichstrom L, Rossow I. Suicide Life Threat Behav 2002; 32(2):101-116.
  
  Correspondence: Lars Wichstrom, Department of Psychology, Norwegian University of Science and Technology/Norwegian Social Research, Trondheim, NORWAY; (email: lars.wichstrom@svt.ntnu.no).

  Predictors of self-reported suicide attempts were studied cross-sectionally and prospectively in order to discern which variables may account for the gender difference in such reports. A representative sample of Norwegian students (N= 9,679) in grades 7-12 were followed from 1992 to 1994. More girls (10.4%) than boys (6.0%) reported a previous attempt and more girls (3.3%) than boys (1.9%) reported an attempt during the study period. The gender difference in previous suicide attempts was significantly reduced when depressed mood was controlled, and was no longer significant when disordered eating was included. There was no gender difference in future attempts when previous attempts, depressed mood, physical appearance, pubertal timing, and romantic involvement were controlled. Girls' higher level of risk factors may account for their higher level of self-reported nonfatal suicidal behavior. (Copyright © 2002 American Association of Suicidology)

• Update of suicide trends in Italy from 1986 to 1996.

  Guaiana G, D'Avanzo B, Barbui C. Soc Psychiatry Psychiatr Epidemiol 2002; 37(6):267-270.
  
  Correspondence: Corrado Barbui, Department of Medicine and Public Health, Section of Psychiatry, University of Verona, Ospedale Policlinico, 37134 Verona, ITALY; (email: corrado.barbui@univr.it).

  Background In some Western countries increasing suicide rates have been observed among males, especially young men, with a decline of female suicides. The present study analysed age-specific and age-standardised suicide rates in Italy. Method From 1986 to 1996 national statistics on numbers of suicides in each sex and age group were examined. Results Overall, suicides have remained substantially stable from 1986 to 1996. Among males over 45 years of age rates progressively decreased, and among subjects below 15 years rates remained stable. In the 15-24 and 25-44 age groups rates progressively rose: an overall increase of 2.76/100,000 and 1.60/100,000 was recorded, respectively. Among females over 45 years of age suicide rates progressively decreased, while rates in the other age groups remained fairly stable. Conclusion The present analysis documents a rise in suicides among young men, and highlights the need for age-specific suicide prevention programmes.

• Suicide ideation in Chinese adolescents.

  Hesketh T, Ding QJ, Jenkins R. Soc Psychiatry Psychiatr Epidemiol 2002; 37(5):230-235.
  
  Correspondence: T. Hesketh, China-UCL Collaborative Health Project, 51A Narada Gardens, Wen Yi Road, Hangzhou 310012, PR CHINA; (email: hesketh@mail.hz.zj.cn).

  BACKGROUND: The suicide rate in China is estimated to be around three times the global average, with women in the 15- to 24-year-old age group particularly vulnerable. Despite this, there is a dearth of information on the prevalence and predictors of depression and suicide ideation in Chinese adolescents.
  
  OBJECTIVES: The specific aims of the study were, therefore, to quantify the rates and severity of self-reported depression and suicide ideation in middle-school students, to examine the relationship between depression and attempted suicide, and to identify socio-demographic associations.
  
  METHODS: A cross-sectional survey using self-completion questionnaires was carried out in six middle schools (predominant age range 13-17 years) in an urban and a rural setting in Zhejiang Province in eastern China.
  
  FINDINGS: There were 1,576 completed questionnaires. One-third of the students had suffered symptoms of severe depression, with 16 % admitting to suicide ideation and 9 % to actually having attempted suicide. Factors independently associated with severe depression were female gender, poor self-reported academic performance and rural residence. Similar factors were associated with suicide ideation and attempted suicide. Depression was less common in those without siblings. Patterns of help-seeking showed reliance on friends and parents, with very low levels of professional help-seeking (around 1 %) and 30 % having sought no help from any source for psychological problems.
  
  DISCUSSION: The results of the study contributed to service developments and the addition of psychological issues to the school health education curriculum.

• An analysis of 'looked but failed to see' accidents involving parked police vehicles.

  Langham M, Hole G, Edwards J, O'Neil C. Ergonomics 2002; 45(3): 167-185.
  
  Correspondence: Martin Langham, School of Cognitive and Computing Sciences, University of Sussex, Falmer, Brighton BN1 9QH, UK; (email: martinl@cogs.susx.ac.uk).

  Drivers who collide with a vehicle that is parked on the hard shoulder of a motorway or dual-carriageway sometimes claim not to have seen it before the collision. Previous research into vehicle conspicuity has taken such 'looked but failed to see' claims at face value, and concentrated on attempting to remedy the problem by making vehicles more conspicuous in sensory terms. However, the present study describes investigations into accidents of this kind which have involved stationary police cars, vehicles which are objectively highly conspicuous. Two laboratory studies showed that experienced drivers viewing a film of dual-carriageway driving were slower to respond to a parked police car as a 'hazard' if it was parked directly in the direction of travel than if it was parked at an angle; this effect was more pronounced when the driver's attention was distracted with a secondary reasoning task. Taken together with the accident reports, these results suggest that 'looked but failed to see' accidents may arise not because the parked vehicle is difficult to see, but for more cognitive reasons, such as vigilance failure, or possession by the driver of a 'false hypothesis' about the road conditions ahead. An emergency vehicle parked in the direction of travel, with only its blue lights flashing, may encourage drivers to believe that the vehicle is moving rather than stationary. Parking at an angle in the road, and avoiding the use of blue lights alone while parked, are two steps that drivers of parked emergency vehicles should consider taking in order to alert approaching drivers to the fact that a stationary vehicle is ahead. (Copyright © 2002 Taylor & Francis)

• Biomechanics of minor automobile accidents: treatment implications for associated chronic spine symptoms.

  Laborde JM. J South Orthop Assoc 2000; 9(3):187-192.
  
  J. Monroe LaBorde, Department of Biomedical Engineering, Tulane University, 3525 Palmyra Street, Suite 402, New Orleans, LA 70115, USA.

  Biomedical experimental data indicate that automobile accidents with no vehicle damage are unlikely to cause injury to the occupants. Soft tissue injuries heal in a few weeks. Chronic pain has never been produced by experimental injury and is much less common in countries without financial payments for accident victims. Chronic pain after no-damage collisions is probably caused by psychologic factors. Psychologic treatment should be added to conventional nonoperative treatment when no objective explanation for chronic symptoms is found.

• Interpersonal violations, speeding violations and their relation to accident involvement in Finland.

  Mesken J, Lajunen T, Summala H. Ergonomics 2002; 45(7):469-483.
  
  Correspondence: Heikki Summala, Traffic Research Unit, Department of Psychology, University of Helsinki, FINLAND; (email: heikki.summala@helsinki.fi).

  OBJECTIVE: To replicate the distinction between errors, lapses and violations, and to identify aggressive violations from normal or highway code violations. Furthermore, the relationship of these behaviours with road traffic accidents was examined.
  
  METHODS: A total number of 1126 Finnish drivers completed a questionnaire containing the Driver Behaviour Questionnaire (DBQ) with extended violations scale, and questions regarding background information, such as age, gender and mileage. Also, questions about previous accidents and fines were asked.
  
  FINDINGS: Factor analysis showed that a four-factor structure seemed more appropriate than the earlier established three-factor structure. The four factors were errors, lapses, speeding violations and interpersonal violations. The two types of violations result from different motives, and seem to be associated with different kinds of affect. Both interpersonal and speeding violations were reported most by young males, which was consistent with earlier findings. Logistic regression analyses indicated that errors predicted active accident involvement after partialling out the effects of demographic variables, whereas interpersonal violations were positively related to involvement in passive accidents. This was presumably due to different reporting tendencies of respondents. Speeding tickets were predicted by speeding and interpersonal violations and lapses and penalties for speeding by both kinds of violations and errors. Penalties for speeding, parking and other offences were predicted by interpersonal violations. (Copyright © 2002 Taylor & Francis)

• Relation between glare and driving performance.

  Theeuwes J, Alferdinck JW, Perel M. Hum Factors 2002; 44(1): 95-107.
  
  Correspondence: Jan Theeuwes, Deptartment of Cognitive Psychology, Vrije Universiteit, Amsterdam, THE NETHERLANDS; (email: j.theeuwes@psy.vu.nl).

  The present study investigated the effects of discomfort glare on driving behavior. Participants (old and young; U. S. and Europeans) were exposed to a simulated low-beam light source mounted on the hood of an instrumented vehicle. Participants drove at night in actual traffic along a track consisting of urban, rural, and highway stretches. The results show that the relatively low glare source caused a significant drop in detecting simulated pedestrians along the roadside and made participants drive significantly slower on dark and winding roads. Older participants showed the largest drop in pedestrian detection performance and reduced their driving speed the most. The results indicate that the deBoer rating scale, the most commonly used rating scale for discomfort glare, is practically useless as a predictor of driving performance. Furthermore, the maximum U. S. headlamp intensity (1,380 cd per headlamp) appears to be an acceptable upper limit. (Copyright © 2002 Human Factors and Ergonomics Society)

• Spinal injuries in motorcycle crashes: patterns and outcomes.

  Robertson A, Giannoudis PV, Branfoot T, Barlow I, Matthews SJ, Smith RM. J Trauma 2002; 53(1):5-8.
  
  Correspondence: Peter V. Giannoudis, Department of Trauma and Orthopaedic Surgery, St. James’s University Hospital, Beckett Street, Leeds LS9 7TF, West Yorkshire, UK; (email: pgiannoudi@aol.com).

  BACKGROUND: The purpose of this study was to determine patterns of spinal injury and clinical outcomes resulting from motorcycle crashes.
  
  METHODS: We analyzed data collected on 1,121 motorcyclists involved in road traffic accidents (from 1993-2000) and identified those who had sustained a spinal injury.
  
  FINDINGS: Spinal injury occurred in 126 (11.2%) riders (112 male riders [88.9%] and 14 female riders [11.1%]), with a mean age of 30.2 years (range, 16-61 years) and Injury Severity Score of 18.8 (range, 4-66). Isolated injuries to the spine occurred in 30 (23.8%) riders. The thoracic spine was injured in 69 (54.8%), the lumbar spine in 37 (29.4%), and the cervical spine in 34 (27.0%) cases. Multiple vertebral levels were affected in 54 (42.9%). Neurologic injury occurred in 25 riders (19.8%), with complete distal neurologic injury in 14 (4 cervical, 9 thoracic, and 1 lumbar). Eleven (8.7%) patients required spinal surgery. There were 13 (10.3%) deaths.
  
  DISCUSSION: The thoracic spine is the most commonly injured spinal region in motorcycle crashes. Multiple level injuries are common. Protocols concentrating on the radiographic clearance of the cervical region may miss a significant number of spinal injuries. Vigilance is required in assessing these patients, who often have multiple injuries. (Copyright © 2002 Lippincott Williams & Wilkins)

• Contrast sensitivity in a dynamic environment: effects of target conditions and visual impairment.

  Long GM, Zavod MJ. Hum Factors 2002; 44(1): 120-132.
  
  Correspondence: Gerald M. Long, Office of Graduate Studies, Villanova University, Pennsylvania 19085, USA; (email: gerald.long@villanova.edu).

  Contrast sensitivity was determined as a function of target velocity (0 degrees - 120 degrees/s) over a variety of viewing conditions. In Experiment 1, measurements of dynamic contrast sensitivity were determined for 24 male and 24 female observers as a function of target velocity for letter stimuli of 2 sizes and 2 durations. Significant main effects were found for target velocity, target size, and target duration, but significant interactions among the variables indicated especially pronounced adverse effects of increasing target velocity for small targets and brief durations. In Experiment 2, the effects of simulated cataracts on dynamic contrast sensitivity were determined for 10 male and 10 female observers. Although the simulated impairment had no effect on traditional acuity scores, dynamic contrast sensitivity was markedly reduced under all conditions but especially with the smaller targets and at higher velocities. Results are discussed in terms of dynamic contrast sensitivity as a useful composite measure of visual functioning that may provide a better overall picture of an individual's visual functioning than does traditional static acuity, dynamic acuity, or contrast sensitivity alone. The measure of dynamic contrast sensitivity may increase understanding of the practical effects of various conditions, such as aging or disease, on the visual system, or it may allow improved prediction of individuals' performance in visually dynamic, situations, such as driving and sports. (Copyright © 2002 Human Factors and Ergonomics Society)

• American film violence: An analytic portrait.

  Browne N, Webb T, Fisher K, Cook B, McArthur D, Peek-Asa C, Kraus J. J Interperson Viol 2002; 17(4): 351-370.
  
  Correspondence: Nick Browne, University of California, Film and Television, Box 951622, 203F Macgowan, Los Angeles CA 90095-1622, USA; (email: nbrowne@tft.ucla.edu).

  This article profiles the violence that occurs in the films that compose the most popular (top-grossing) genres of 1994: comedy, drama, and action. The critical features used to describe film violence are intentionality, frequency, seriousness, consequences, explicitness, and severity (damage to the body of the recipient). Scales for seriousness, explicitness, and severity were systematically applied to the films using frame-by-frame analysis. Although the initiators of violence in American films employ lethal violence in nearly half the violent events, depiction of any consequences to the recipient's body occurs in 1 out of 10 cases. Throughout, the effects of violence on the victim's body are mystified by a form of narrative that occults and minimizes consequences arising from clearly depicted intentional assaults. So far as violence is concerned, the Hollywood body is an impossible one, merely a dramaturgical figure. (Copyright © 2002 Sage Publications)

• Effects of Violent Video Games on Aggressive Behavior: Potential Sex Differences.

  Bartholow BD, Anderson CA. J Exp Soc Psychol 2002; 38(3): 283-290.
  
  Correspondence: Bruce D. Bartholow, Department of Psychology, CB #3270, Davie Hall, University of North Carolina, Chapel Hill, NC 27599-3270, USA; (email: bartholow@unc.edu).

  Evidence of the effects of playing violent video games on subsequent aggression has been mixed. This study examined how playing a violent video game affected levels of aggression displayed in a laboratory. A total of 43 undergraduate students (22 men and 21 women) were randomly assigned to play either a violent (Mortal Kombat) or nonviolent (PGA Tournament Golf) video game for 10 min. Then they competed with a confederate in a reaction time task that allowed for provocation and retaliation. Punishment levels set by participants for their opponents served as the measure of aggression. The results confirmed our hypothesis that playing the violent game would result in more aggression than would playing the nonviolent game. In addition, a Game × Sex interaction showed that this effect was larger for men than for women. Findings are discussed in light of potential differences in aggressive style between men and women.(Copyright © 2002 Elsevier Science)

• Risk factors associated with non-fatal adolescent firearm injuries.

  Paris CA, Edgerton EA, Sifuentes M, Seidel JS, Lewis RJ, Gausche M. Inj Prev 2002; 8(2):147-150.
  
  Correspondence: Carolyn A. Paris, Department of Pediatrics, Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, P.O. Box 5371/CH-04, Seattle, WA 98105, USA; (email: cparis@chmc.org)

  OBJECTIVES: To identify behavioral, environmental, and sociodemographic risk factors associated with non-fatal firearm injuries among inner city adolescents in the United States.
  
  METHODS: A case-control study in which patients with firearm injury serve as cases and those with medical conditions serve as controls at a level I trauma center in a metropolitan area serving a predominately lower socioeconomic status population. Participants- Cases were 45 consecutive patients 11-18 years presenting to the emergency department with non-fatal firearm injury; controls were 50 age and gender matched patients presenting with acute medical problems. Outcome Measure- Odds ratios (OR) and associated 95% confidence interval (CI) as estimates of the magnitude of association between risk factors and non-fatal firearm injury.
  
  FINDINGS: After adjusting for age, gender and socioeconomic status, multivariate analysis identified four risk factors independently associated with firearm injury: living with less than two parents (OR 3.8, 95% CI 1.2 to 12.2), skipping class (OR 7.1, 95% CI 1.7 to 28.9), previous arrest (OR 6.2, 95% CI 1.9 to 20.7), and being African-American (OR 4.2; 95%CI 1.4 to 14.9).
  
  DISCUSSION: Risk factors for adolescents sustaining a non-fatal firearm injury are sociodemographic and environmental, not just behavioral. Thus interventions that foster protective and supportive environments may help prevent firearm injuries. (Copyright © 2002 BMJ Publications Group)

• Asking patients about violence: a survey of 510 women attending social and health services in Trieste, Italy.

  Romito P, Gerin D. Soc Sci Med 2002; 54(12): 1813-1824.
  
  Correspondence: Patrizia Romito, Faculty of Psychology, University of Trieste, Via S. Anastasio 12, 34100 Trieste, ITALY; (email: romito@univ.trieste.it).

  Violence against women is frequent, and has serious consequences for their physical and mental health. Until now, a common response of health services and professionals to victims has been the denial of the violence. The aims of this study were to estimate the prevalence of present and past violence among women attending social and health services in Trieste (Italy) for any reasons, and to evaluate the feasibility of asking them about violence. Five public health care facilities were involved: a hospital-based Emergency Department, two "Consultorio Familiare", and two community-based Social service centers. The final sample consisted of 510 women; the response rate among eligible women was 76% across all facilities. The study revealed a high prevalence of different kinds of violence, mostly perpetrated by men well known to the victim. Among the women interviewed, 10.2% had experienced physical/sexual violence in the last 12 months, regardless of perpetrator. Violence by a male partner or former partner, occurred in 6.4% of women; by other relatives, 1.6% of women; and by "other" persons 3.3% of women. The results demonstrated the feasibility of "asking about violence" in all cases; moreover, those women who had been abused were often eager to talk about it. A systematic approach to the issue of violence is a necessary condition for responding appropriately to the needs of women who have experienced or are experiencing violence. Nevertheless, to avoid the replication of a common bias against victims of violence, health and social personnel should be appropriately trained before "asking all cases" becomes a policy within health and social services. (Copyright © 2002 Elsevier Science)

• Women who are violent: attitudes and beliefs of professionals working in the field of domestic violence.

  Adams SR, Freeman DR. Mil Med 2002; 167(6): 445-50.
  
  Correspondence: Sheila R. Adams, Army Medical Department Center and School, Fort Sam Houston, TX, USA.

  This cross-sectional, exploratory study examines the attitudes and beliefs professionals maintain about encountering women who initiate violence in their relationships. Current assessment and treatment guidelines for women who are violent are also examined. The study included 225 military and civilian domestic violence professionals. The results indicate that professionals encounter women who are violent even when their partners have not been abusive. Professionals also reported that violence by women is often serious and results in injury to male victims. A large percentage of professionals revealed that they are not confident in their abilities to assess the motives of women who use physical violence. In addition, many professionals indicated that there is a lack of appropriate guidelines to assist them in assessing women and that they need more training in this area of domestic violence.

• Prevalence of domestic violence and associated factors among women on a trauma service.

  Melnick DM, Maio RF, Blow FC, Hill EM, Wang SC, Pomerantz R, Kane ML, Graham-Bermann S, Weber J, Farber MS. J Trauma 2002; 53(1): 33-37.
  
  Ronald F. Maio, DO, MS, Department of Emergency Medicine, University of Michigan Medical Center, TC-B1380/0305, 1500 East Medical Center Drive, Ann Arbor, MI 48109 USA; (email: ronmaio@umich.edu).

  BACKGROUND: Despite the increasing recognition of the problem of domestic violence (DV), it has not been studied in surgical populations.
  
  METHODS: Eligible patients underwent screening for a recent history of DV and alcohol abuse (AA). Other demographic, health, and injury-related data were also collected.
  
  FINDINGS: Of 127 subjects entered into the study, 18% screened positive for DV and 21% screened positive for AA. Of those screening positive for DV, 65% screened positive for AA compared with 12% of those screening negative for DV (p < 0.001.) Screening for DV was recommended by a vast majority of subjects, with only 6% of subjects responding that it was not appropriate.
  
  DISCUSSION: Both DV and AA have a high prevalence among female trauma patients admitted to trauma centers. Nearly all subjects recommended screening for DV. Screening for DV should be incorporated into the routine care of female trauma patients. (Copyright © 2002 Lippincott Williams & Wilkins)

• Child maltreatment and adulthood violence: the contribution of attachment and drug abuse.

  Feerick MM, Haugaard JJ, Hien DA. Child Maltreat 2002; 7(3):226-240.
  
  Correspondence: Margaret Freerick, Child Development and Behavior Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892-7510, USA; feerickm@mail.nih.gov).

  This study examined the association between child maltreatment and adult violence in a high-risk sample of women with and without a history of cocaine abuse and the contribution of working models of childhood attachment relationships in understanding this association. Results indicated that whereas childhood physical abuse was associated with adult sexual victimization for cocaine-abusing women, sexual abuse was associated with both partner violence victimization and perpetration for comparison women. Insecure working models of attachment were associated with partner violence victimization for comparison women, independent of the effect of sexual abuse. These findings suggest the importance of research focused on understanding the processes by which child maltreatment may lead to later violence and that examines both childhood and adulthood experiences in understanding pathways to adult violence.

• Turning point: rethinking violence--evaluation of program efficacy in reducing adolescent violent crime recidivism.

  Scott KK, Tepas JJ 3rd, Frykberg E, Taylor PM, Plotkin AJ. J Trauma 2002; 53(1):21-27.
  
  Correspondence: Kamela Scott, Department of Surgery, University of Florida Health Science Center, Jacksonville, Florida 32209, USA; (email: kamela.scott@jax.ufl.edu).

  BACKGROUND: The link between medicine and violence prevention is self-evident, yet the literature reveals few studies that scientifically document effective interventions. The Turning Point: Rethinking Violence (TPRV) program is a unique multiagency program developed to expose, educate, and remediate first-time violent offenders and their parents regarding the real-world consequences of violence. Four key components are integrated into a 6-week, court-ordered program (14 total contact hours): the Trauma Experience (tour, video, discussions), the Victim Impact Panel (presented by parent survivors), Group Process, and Community Networking (individualized mental health referral). We hypothesize that TPRV delivers lower outcomes regarding violence recidivism (VR) when compared with standard court sentencing options (100 hours of community service) for first-time violent offenders.
  
  METHODS: The study group subjects (n = 38) met inclusion criteria and were blindly and randomly sentenced to attend the TPRV program. The control group (n = 38) were pulled from a subject pool of first-time offenders who received standard sentencing options, met the same inclusion criteria with regard to age and types of offenses, and were matched by race to the study group. Both groups were studied for VR within the year after the first violent conviction, and comparison was performed by a (2 analysis of recidivism rates.
  
  FINDINGS: Results reveal a statistically significant difference between the study group and the control group for VR (p < or = 0.05). The study group revealed a recidivism rate of 0.05 within the year after program completion, whereas the control group revealed a recidivism rate of 0.33. The lower recidivism rate also occurred with a shorter overall time investment (14 hours vs. 100 hours).
  
  DISCUSSION: The TPRV program decreases VR when compared with standard sentencing options. The broad-spectrum approach (real-world exposure, parental involvement, peer support, follow-up) appears successful in addressing recidivism, and could potentially reduce the epidemic in adolescent violence and the subsequent impact on trauma care. (Copyright © 2002 Lippincott Williams & Wilkins)

• Abuse during pregnancy and femicide: urgent implications for women's health.

  McFarlane J, Campbell JC, Sharps P, Watson K. Obstet Gynecol 2002; 100(1):27-36.
  
  Correspondence: Judith McFarlane, Health Promotion & Disease Prevention, Texas Woman's University, 1130 John Freeman Boulevard, Houston, TX 77030, USA; (email: jmcfarlane@twu.edu).

  OBJECTIVES:To describe the odds of femicide (homicide of females) for women abused during pregnancy.
  
  METHODS:A ten-city case-control design was used with attempted and completed femicides as cases (n = 437) and randomly identified abused women living in the same metropolitan area as controls (n = 384). The attempted and completed femicide cases were identified from police and medical examiner records. Interviews of attempted femicide victims and a proxy for the femicide victim were compared with data from abused controls, identified via random digit dialing in the same ten cities.
  
  FINDINGS:Abuse during pregnancy was reported by 7.8% of the abused controls, 25.8% of the attempted femicides, and 22.7% of the completed femicides. Five percent of the femicide victims were murdered while pregnant. After adjusting for significant demographic factors, such as age, ethnicity, education, and relationship status, the risk of becoming an attempted/completed femicide victim was three-fold higher (adjusted odds ratio 3.08, 95% adjusted confidence interval 1.86, 5.10) for women abused during pregnancy. Black women had more than a three-fold increase in risk (adjusted odds ratio 3.6, 95% adjusted confidence interval 2.4, 5.5) as compared with white women. Compared with women not abused during pregnancy, controls and attempted/completed femicide victims abused during pregnancy reported significantly higher levels of violence.
  
  DISCUSSIUON:Femicide is an important, but often unreported, cause of maternal mortality. This is the first report of a definite link between abuse during pregnancy and attempted/completed femicide. This research documents the immediate need for universal abuse assessment of all pregnant women. (Copyright © 2002 The American College of Obstetricians and Gynecologists)

The criteria for selecting report for inclusion are simple. If the answer to any of the following questions is "yes", then the report is likely to be included: 1. Do the SafetyLit reviewers find the report interesting? 2. Are SafetyLit readers likely to hear of a report from a colleague? 3. Are SafetyLit readers likely to be questioned about the report from a member of the population they serve? 4. Does the report contain findings that are likely to be used by an adversary to oppose the actions or recommendations of a SafetyLit reader?

If you know of a journal article or a report that you believe should be included in a SafetyLit update, please: Send SafetyLit.org an E-mail Message.

Back to "SafetyLit Update" Menu

Rev. 21-Jun-2002 at 23:16 hours.