SafetyLit: 19 August 2002

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19 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.

Defining binge drinking quantities through resulting blood alcohol concentrations.

Lange JE, Voas RB. Psychol Addict Behav 2001; 15(4):310-316.

Correspondence: James Lange, San Diego State University, Student Health Services, 5500 Campanile Drive, San Diego, CA 92182, USA; (email: jlange@mail.sdsu.edu).

(Copyright © 2002 American Psychological Association)

Binge drinking as a researchable construct has generally been defined as 5 or more drinks on one occasion. However, no study has been conducted to determine whether the binge concept that implies excessive drunkenness is being optimally captured within that level. Random interviews of drinkers returning from visiting bars in Tijuana, with breath tests, provided both blood alcohol concentration (BAC) measurements and the self-reported number of drinks consumed. Results indicate that currently used definitions of binge drinking predict relatively low BACs and may not be capturing the excessive-drunkenness quality of the term. Consumption duration may explain the lower BACs.
Differential effects of ethanol on motor coordination in adolescent and adult rats.

White AM, Truesdale MC, Bae JG, Ahmad S, Wilson WA, Best PJ, Swartzwelder HS. Pharmacol Biochem Behav 2002; 73(3): 673-677.

Correspondence: Aaron M. White, Department of Psychiatry, Duke University Medical Center, Building 16, Room 24 (151E), VAMC, Durham, NC 27705, USA; (email: aaron.white@duke.edu).

(Copyright © 2002 Elsevier Science)

Recent evidence suggests that adolescence represents a unique period of sensitivity to the effects of ethanol. Adolescent animals are more sensitive than adults to many of the effects of ethanol, including ethanol-induced learning and memory impairments, while being less sensitive to others, including ethanol-induced sedation. It is well known that ethanol produces dramatic impairments in balance and motor coordination. While previous research suggests that adolescents and adults do not differ in their sensitivity to the effects of relatively low doses of ethanol on motor coordination, it is not known whether differences in performance would emerge at higher doses. The present study compared the impact of a range of ethanol doses (1.0, 2.0 and 3.0 g/kg) on motor coordination in adolescent [postnatal day (PD) 35-40] and adult (PD 70-75) rats. Motor coordination was assessed using the tilting plane test before ethanol administration (baseline) and at 15, 30, 60, 120 and 180 min after ethanol administration. Performance was not affected by 1.0 g/kg ethanol in either age group. However, adults were more impaired than adolescents at nearly every time point following administration of both 2.0 and 3.0 g/kg ethanol. The results provide further evidence that adolescents and adults are differentially sensitive to the behavioral effects of ethanol. Given the critical role of motor coordination in the ability to operate motor vehicles and the central role of balance and coordination in field sobriety tests, these data could have important implications if extended to human subjects.

No reports this week

No reports this week

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 AM, Kirk P, Gander P. J Safety Res 2002; 33(1):53-71.

Correspondence: Rebecca Lilley, Department of Preventive and Social Medicine, New Zealand Environmental and Occupational Health Research Center, Box 913, Dunedin, NEW ZEALAND; (email: rlilley@gandalf.otago.ac.nz).

(Copyright © 2002 Elsevier Science)

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.

METHOD: A total of 367 forestry workers responded to a self-administered questionnaire.

FINDINGS: 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.

DISCUSSION: 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. 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.

Behavior Change Counseling in the Emergency Department to Reduce Injury Risk: A Randomized, Controlled Trial.

Johnston BD, Rivara FP, Droesch RM, Dunn C, Copass MK. Pediatrics 2002; 110(2): 267-274.

Correspondence: Brian D. Johnston, Division of General Pediatrics, Department of Pediatrics, University of Washington, Seattle, Washington 98104, USA; (email: bdj@u.washington.edu).

(Copyright © 2002 American Academy of Pediatrics)

OBJECTIVE: To determine whether a brief session of behavior change counseling (BCC), offered to injured adolescents in the emergency department (ED) as a therapeutic intervention, could be used to change injury-related risk behaviors and the risk of reinjury.

METHODS: Design- A randomized, controlled trial. Participants- Adolescents between 12 and 20 years old who were undergoing treatment for an injury in the ED and who were cognitively able to participate in the intervention. Setting- An urban ED at a level 1 pediatric trauma center. Intervention- Study participants completed a baseline risk behavior prevalence assessment. Participants were then randomly assigned to receive BCC or routine ED care. Those in the treatment group underwent a brief session of BCC with a study social worker focused on changing an identified injury-related risk behavior (seatbelt use, bicycle helmet use, driving after drinking, riding with an impaired driver, binge drinking, or carrying a weapon). Participants were recontacted 3 months and 6 months after enrollment to assess the prevalence of positive behavior change and the interim occurrence of medically treated injuries.

FINDINGS: We enrolled 631 participants (78% of those eligible) and obtained follow-up for 76% at 3 months and 75% at 6 months. The relative risk of a positive behavior change with respect to seatbelt use was 1.34 (95% confidence interval [CI]: 1.00, 1.79) at 3 months, favoring the intervention group. The relative risk for the same outcome was 1.47 (95% CI: 1.09, 1.96) at 6 months. A positive change in bicycle helmet use was 1.81 (95% CI: 1.02, 3.18) times more likely at 3 months and 2.00 (95% CI: 1.00, 4.00) times more likely at 6 months in the intervention group. There was no effect of the intervention on changes in other target behaviors. Over the 6-month follow-up period, the risk of reinjury requiring medical attention did not differ between treatment groups.

DISCUSSION: Brief BCC can be delivered to adolescents undergoing treatment for injury in the ED and can be used to address injury-related risk behaviors. The intervention was associated with a greater likelihood of positive behavior change in seatbelt and bicycle helmet use. This effect lasted over 6 months of follow-up. BCC was not associated with changes in other risk behaviors and could not be shown to significantly reduce the risk of reinjury.

An evaluation of an engineering control to prevent carbon monoxide poisonings of individuals on and around houseboats.

Earnest GS, Dunn KH, Hall RM, McCleery RE, McCammon JB. Am Ind Health Assn J 2002; 63(3): 361-369.

Correspondence: Gary Scott Earnest, U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, 4676 Columbia Parkway, Cincinnati, OH 45226, USA; (email gse0@cdc.gov).

(Published by the American Industrial Hygiene Association and Allen Press)

From 1990 to 2000, a total of 111 carbon monoxide (CO) poisonings occurred on Lake Powell near the Arizona and Utah border. Seventy-four of the poisonings occurred on houseboats, and 64 were attributable to generator exhaust alone. Seven of the 74 houseboat-related CO poisonings resulted in death. Although many of the reported CO poisonings occurred to members of the general public, some poisonings involved workers performing houseboat maintenance. The National Institute for Occupational Safety and Health evaluated an engineering control retrofitted to a houseboat gasoline-powered generator to reduce the hazard of CO poisoning from the exhaust. The control consisted of a water separator and a 17-foot exhaust stack that extended 9 feet above the upper deck of the houseboat. When compared to a houseboat having no engineering controls, study results showed that the exhaust stack provides a dramatically safer environment to individuals on or near the houseboat. CO concentrations were reduced by 10 times or more at numerous locations on the houseboat. Average CO concentrations near the rear swim deck of the houseboat, an area where occupants frequently congregate, were reduced from an average of 606.6 ppm to 2.85 ppm, a reduction greater than 99%. CO concentrations were also reduced on the upper deck of the houseboat. Hazardous CO concentration in the confined area beneath the near swim deck were eliminated. Based on the results of this study, it is clear that houseboats having gasoline-powered generators that have been outfitted from the factory or retrofitted with an exhaust stack that extends well above the upper deck of the boat will greatly reduce the hazard of CO poisoning.
Discrepant advice from poison centres and their medical directors.

Juurlink DN, Szalai JP, McGuigan MA. Can J Clin Pharmacol 2002; 9(2): 101-105.

Correspondence: David N. Juurlink, Sunnybrook and Women's College Health Sciences Centre, Rm. G-106, 2075 Bayview Ave., Toronto ON M4N 3M5, CANADA; (email: david.juurlink@ices.on.ca).

(Copyright © 2002 Plusus Group and Canadian Society for Clinical Pharmacology)

OBJECTIVES: To characterize the recommendations of the medical directors of North American poison information centers for gastrointestinal decontamination of a hypothetical poisoned patient, and to examine the extent to which those recommendations agree with the advice previously issued by their poison information centers for the same scenario.

METHODS: The medical directors of 72 poison centers in the United States and Canada were contacted and invited to participate in a survey. Each participant was asked to provide specific advice for gastrointestinal decontamination of a hypothetical patient presenting 1 h after a potentially life-threatening ingestion (32.5 g) of enteric-coated acetylsalicylic acid. The directors were then presented with the recommendation their poison centers had previously issued for the same overdose scenario. The main outcome measures were perceived agreement with their own center's recommendation and director-center concordance for each method of gastrointestinal decontamination.

FINDINGS: Sixty-seven of 72 (93%) medical directors participated in the survey. They issued 30 different management suggestions for our hypothetical patient, and were in full agreement with their own centers 27% of the time. Concordance was moderate for recommendations on syrup of ipecac (k=0.468, P < 0.001), and fair for whole bowel irrigation (k=0.348, P=0.005) and the use of sorbitol with activated charcoal (k=0.305, P=0.005). Concordance was poorest for advice on gastric lavage (k=0.093, P=0.445) and multidose charcoal (k=0.039, P=0.745).

DISCUSSION: The medical directors of North American poison centers offer widely varying advice on gastrointestinal decontamination for a hypothetical patient who is acutely poisoned with enteric-coated acetylsalicylic acid. Their advice was often different from that previously issued by their respective centers.

Snowmobile fatalities aspects on preventive measures from a 25-year review.

Ostrom M, Eriksson A. Accid Anal Prev 2002; 34(4): 563-568.

Correspondence: Anders Eriksson,Department of Community Medicine and Rehabilitation, Section of Forensic Medicine, Umeå University, P.O. Box 7642, SE-907 12 Umeå, SWEDEN; (email: erikssona@co.oakland.mi.us).

(Copyright © 2002 Elsevier Science)

During October 1973 through May 1998, 157 snowmobile fatalities were autopsied in Northern Sweden, including 131 riders, 15 passengers, six occupants with unknown position and five victims pulled by a snowmobile. Most fatalities occurred during March and April (41%), on weekends/holidays (75%), between 18:00 and 02:00 h (59%), during darkness (63%), in clear weather (84%) and at leisure time (94%). The median age was 39 years and 92% were men. The most common causes of death were blunt trauma (53%) and drowning (38%). A total of 64% were inebriated by alcohol, with a mean blood alcohol concentration of 1.7 g/l. More inebriated victims were found during weekends/holidays than on weekdays (75 vs. 51%) and during nighttime than during daytime (92 vs. 52). Driving into water was the most common event (38%) followed by collisions with immobile objects (20%). Alcohol and speeding were the most common contributors to the crashes, while flotation snowmobile suit and helmet use were considered to be the most important injury prevention factors.

No reports this week

Differences in cause-specific patterns of unintentional injury mortality among 15-44-year-olds in income-based country groups.

Ahmed N, Andersson R. Accid Anal Prev 2002; 34(4): 541-551.

Correspondence: Niaz Ahmed, Department of Public Health Sciences, Karolinska Institute, Stockholm, SWEDEN; (email: niaz.ahmed@ks.se).

(Copyright © 2002 Elsevier Science)

OBJECTIVES: The aim of the present study was to investigate the cause-specific patterns of unintentional injury mortality among 15-44-year-olds in various income-based country groups, and to analyze which specific causes contribute the most to the unintentional injury mortality in each country group.

METHODS: Cross-sectional data on the five most common causes of unintentional injury mortality by age-sex specific subgroups were compiled for 57 countries from the World Health Statistics Annuals for the year 1993 (1991-1994 if information for 1993 was unavailable). Data were categorized into four income-based country groups according to their gross national product (GNP) per capita for the year 1993. The differences between means and rate ratios of low, lower-middle, and upper-middle income countries were calculated by comparing them with those of the high-income countries. Regression analysis was performed to determine the trends in the direction of income for each specific cause of unintentional injury mortality by age-sex.

FINDINGS: For any of the specific causes of unintentional injury mortality there was an inverse relationship between mortality rates and GNP per capita except for motor vehicle traffic (MVT) among the 15-24-year-old age group. MVT accidents were the most common cause and contributed 26-77% of all unintentional injury mortality. The second most common cause was poisoning in all country groups except low-income countries where drowning dominated for males and mixed causes for females. Upper-middle income countries represented the highest MVT mortality in all age-sex subgroups except among 15-24-year-old females for which high-income countries displayed the highest rate. For other causes, lower-middle income represented the highest rates with a few exceptions. In the 15-24-year age group, the rate ratio of motor vehicle traffic mortality was higher in high-income countries compared to low-income countries, while in the 35-44-year age group, all other country groups showed a higher rate ratio than high-income countries. Drowning for males and burns for females in the low and middle-income countries were significantly higher than in high-income countries.
Incidence and patterns of spinal cord injury in Australia.

O'Connor P. Accid Anal Prev 2002; 34(4): 405-415.

Correspondence: Peter O'Connor, AIHW National Injury Surveillance Unit, Research Centre for Injury Studies, Flinders University, Bedford Park, SA, AUSTRALIA; (email: peter.oconnor@nisu.flinders.edu.au).

(Copyright © 2002 Elsevier Science)

The objective of this paper is to report on the epidemiology of spinal cord injury (SCI) based on the Australian SCI register and to discuss the implications for prevention. All adult cases of SCI are reported to the registry. The case reports for 1998/1999 were aggregated and described. The age adjusted rate of persisting SCI was 14.5 per million of population. Rates were highest in young adults and in males. The vast majority of cases (93%) were due to unintentional injury. Forty-three percent were due to motor vehicle crashes, principally from motor vehicle rollover. Cases of SCI from falls, aquatic activities, and working for income are also described. Incomplete cervical cord injuries were most common (38%), particularly as a result of motor vehicle crashes and low falls. The study indicates that the surveillance of SCI needs to be improved internationally so that comparative studies can be undertaken. It is recommended that the Centers for Disease Control case definition be adopted. Australia is one of the few countries that have a register based on that case definition, and the only one that has a register covering a full national adult population. The results presented on the basis of this data source provide some hitherto unavailable information on the incidence rates and patterns of SCI. National population based surveillance is fundamental to an understanding of the epidemiology, and hence the prevention, of this severe and costly health and welfare problem.
A statewide population-based study of gender differences in trauma: validation of a prior single-institution study.

Gannon CJ, Napolitano LM, Pasquale M, Tracy JK, McCarter RJ. J Am Coll Surg 2002; 195(1): 11-18.

Correspondence: Lena M. Napolitano, Department of Surgery, University of Maryland School of Medicine,10 N Greene St, Room 5C-122, Baltimore, MD 21201 USA; (email: lnapolitano@smail.umaryland.edu).

(Copyright © 2002 American College of Surgeons)

BACKGROUND: Women usually have lower mortality rates than men do at any age. This pattern is observed for most causes of death from chronic diseases. Significant controversy still exists about gender differences in outcomes in trauma. We previously reported no differences in in-hospital mortality based on gender in a large single-institution study (n= 18,892) that had a significant limitation in that it was not population based. This current study was performed to validate our earlier findings in a separate, statewide, population-based dataset of trauma victims.

METHODS: Prospective data were collected on 22,332 trauma patients (18,432 blunt, 3,900 penetrating) admitted to all trauma centers (n = 26) in Pennsylvania over 24 months (January 1996 to December 1997). Gender differences in in-hospital mortality were determined for the entire dataset and for the subsets of blunt and penetrating injury patients. A second analysis examined all blunt injury patients and excluded all patients with a hospital length of stay of less than 24 hours, eliminating patients who expired soon after admission. The null hypothesis was that female gender is protective in trauma outcomes.

FINDINGS: Multiple logistic regression analysis identified age (odds ratio [OR] 1.03, confidence interval [CI] 1.02 to 1.03), Injury Severity Score (OR 1.06, CI 1.05 to 1.06), non-Caucasian race (OR 1.72, CI 1.39 to 2.15), blunt injury type (OR 0.327, CI 0.26 to 0.41), and Revised Trauma Score (OR 0.44, CI 0.41 to 0.47) as independent predictors of in-hospital mortality in trauma. Preexisting diseases, including cardiac disease (OR 1.53, CI 1.12 to 2.09) and malignancy (OR 4.08, CI 1.64 to 10.17), were also identified as independent predictors of in-hospital mortality in trauma. Female gender was not associated with decreased mortality (OR 0.83, CI 0.67 to 1.03, p = 0.093). A second multiple regression analysis in blunt trauma patients admitted for longer than 24 hours (which eliminated early deaths and patients with minor injuries) determined that in-hospital mortality was not significantly different in male or female blunt trauma patients stratified by Injury Severity Score and age. The same factors that were predictive of in-hospital mortality in the total dataset were also significant in this secondary analysis.

DISCUSSION: These population-based data confirm that female gender does not adversely affect in-hospital mortality in trauma when patients are appropriately stratified for other variables, including Injury Severity Score and age, that do significantly affect outcomes.

No reports this week

Farm-related fatal injury of young and older adults in Australia, 1989-1992.

Mitchell RJ, Franklin RC, Driscoll TR, Fragar LJ. Aust J Rural Health 2002; 10(4): 209-219.

Correspondence; Rebecca J. Mitchell, Injury Prevention and Policy Unit, NSW Health, LMB 961, North Sydney, New South Wales 2059, AUSTRALIA; (email: rmitc@doh.health.nsw.gov.au).

(Copyright © 2002 Blackwell Publishers)

This paper describes the types of, and circumstances surrounding, unintentional farm-related fatal injuries involving young and older adults in Australia. Information was obtained from an inspection of coronial files for the period 1989-1992. Around 14% of all farm-related fatalities in Australia during 1989-1992 were of young adults aged 15-24 years and approximately one-quarter were of older adults aged >/= 55 years. Young adults were commonly fatally injured in motor vehicle incidents and in incidents involving firearms. Tractors were the most common agent involved in fatal incidents involving older adults. Intervention measures to prevent fatalities of older adults in agriculture should focus on the safe use of tractors, while for young adults it appears prevention efforts should center around safe use of firearms and operation of motor vehicles on the farm. Ways to overcome barriers to the use of injury prevention measures in rural Australia should be further explored.

No reports this week

Examination of affective, cognitive, and behavioral factors and suicide-related outcomes in children and young adolescents.

Nock MK, Kazdin AE. J Clin Child Adolesc Psychol 2002; 31(1): 48-58.

Correspondence: Matthew Nock, Department of Psychology, Yale University, P.O. Box 208205, New Haven, CT 06520-8205, USA; (email: matthew.nock@yale.edu).

(Copyright © 2002 Lawrence Erlbaum Associates)

Examined the role of affective, cognitive, and behavioral factors in the occurrence of suicidal ideation, suicide attempts, and suicidal intent in child and young adolescent (N = 175, ages 6 to 13 years) psychiatric inpatients. The results indicated that (a) self-reported depressed mood, negative automatic thoughts, hopelessness about the future, and anhedonia were all significantly associated with suicide-related outcomes, and these relations remained statistically significant even after depressed mood was controlled; (b) suicidal participants (both ideators and attempters) were distinguished from nonsuicidal participants by higher scores on measures of depressed mood, negative automatic thoughts, and hopelessness; and (c) participants who reported making a suicide attempt were distinguished from those who did not by higher scores on a measure of anhedonia and a higher number of previous suicide attempts. The results demonstrate the importance of negative automatic thoughts and anhedonia, and provide support for the role of hopelessness and previous suicide attempts in the occurrence of different suicide-related outcomes in children and young adolescents.
Does legalized gambling elevate the risk of suicide? An analysis of U.S. counties and metropolitan areas.

McCleary R, Chew KS, Merrill V, Napolitano C. Suicide Life Threat Behav 2002; 32(2):209-221.

Correspondence: Richard D. McCleary, Department of Environmental Analysis and Design, School of Social Ecology, University of California, Irvine 92697-7070, USA; (email: mccleary@uci.edu).

(Copyright © 2002 American Association of Suicidology)

This study addresses a possible link between suicide and casino gambling. Resident suicide rates are analyzed for (a) a 1990 cross-section of 148 U.S. metropolitan areas and (b) before and after the advent of legalized casinos in five U.S. counties. Data are drawn from government and gaming industry sources. In cross-section, metro area suicide is strongly correlated with region, accidental death and homicide rates, age and race composition, and economic vitality, followed by a modest net positive correlation with casino presence. By contrast, the time series analysis yields no evidence of a gambling effect.
Self-immolation a common suicidal behavior in eastern Sri Lanka.

Laloe V V, Ganesan M. Burns 2002; 28(5): 475-480.

Correspondence: Veronique Laloe, Medecins Sans Frontieres, 50 Lady Manning Drive, Batticaloa, Sri Lanka; (email: veronique.laloe@bigfoot.com).

(Copyright © 2002 International Society for Burn Injuries)

A high number of self-burning injuries are noted in Batticaloa. The epidemiology, outcome and psychosocial aspects of 87 patients admitted with such burns over a 2-year-period was studied. The patients were compared with accidental burns and patients using other methods of suicide. Seventy nine percent of the victims were females and 72% were in the 15-34 years age-group. Most had marital problems. The majority were Tamils, but Muslims were fairly well represented. The median extent of burn was 48% of total body surface area (TBSA), with the top of the body mainly affected. The use of fire proved to have a high mortality in a group of patients who did not really want to die; 61 (70%) died. Mortality was higher than for accidental burns after matching for age and burn extent. The survivors had long hospital stays and suffered severe disfigurement. The cases where the patient denied self-harm, but in which the injuries were suggestive of this motive, were strikingly similar in age, sex and burn extent to the suicide group. In contrast, poison suicide records showed a male predominance and a gross under-representation of Muslims. Fire is a very significant method of suicide in our area. Social make-up and poor problem-solving ability may be contributing factors.
Additive impact of childhood emotional, physical, and sexual abuse on suicide attempts among low-income African American women.

Anderson PL, Tiro JA, Price AW, Bender MA, Kaslow NJ. Suicide Life Threat Behav 2002; 32(2): 131-138.

Correspondence: Page L. Anderson, Georgia State University, USA.

(Copyright © 2002 American Association of Suicidology)

This study examines the association between exposures to multiple forms of childhood abuse (emotional, physical, sexual) and adult suicidal behavior in a sample of low-income, African American women. We hypothesized a linear relation between childhood abuse and risk for making a suicide attempt, such that the more forms of childhood abuse to which a woman was exposed, the greater her risk would be to make a suicide attempt. Logistic regression analyses revealed that, compared to women who did not report any experiences of childhood abuse, women who experienced one, two, or three forms of abuse were 1.83, 2.29, or 7.75 times more likely to attempt suicide, respectively (all statistically significant). Furthermore, compared to women who reported one or two types of abuse, women who reported all three types of abuse were statistically more likely to attempt suicide. These findings have implications for clinicians working with African American women who report either childhood abuse or exhibit suicidal behavior.
Sex-specific predictors of suicidality among runaway youth.

Leslie MB, Stein JA, Rotheram-Borus MJ. J Clin Child Adolesc Psychol 2002; 31(1): 27-40.

Correspondence: Michelle Burden Leslie, Department of Psychology, Yale University, USA; (email: michelle.leslie@yale.edu).

(Copyright © 2002 Lawrence Erlbaum Associates)

Examined predictors of suicidality (ideation and attempts) among 348 adolescent runways (197 boys; 56% African American; M age = 16) using sex-specific models that tested the impact of the three domains of the Social Action Model: individual characteristics, interpersonal influences, and life events. Twenty-five percent of the girls and 14% of the boys had attempted suicide at least once. Male suicidality was mainly predicted by individual characteristics: identifying as gay, emotional distress, fewer conduct problems, and avoidant reasons for drug use. The interpersonal influence of suicidal friends also predicted suicidality. Variables from all three domains influenced girls: individual characteristics of lower age, lower self-esteem, and emotional distress; interpersonal influence of suicidal friends; and life events of having lived on the streets and assaults. Findings suggest some sex-specific interventions, but decreasing emotional distress and lessening the influence of suicidal friends may be useful for both boys and girls.
Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood.

Johnson JG, Cohen P, Gould MS, Kasen S, Brown J, Brook JS. Arch Gen Psychiatry 2002; 59(8): 741-749.

Correspondence: Jeffrey G. Johnson, New York State Psychiatric Institute, 1051 Riverside Dr, Unit 60, New York, NY 10032, USA; (email: jjohnso@pi.cpmc.columbia.edu).

(Copyright © 2002 American Medical Association)

BACKGROUND: Data from a community-based longitudinal study were used to investigate the association between childhood adversities, interpersonal difficulties during adolescence, and suicide attempts during late adolescence or early adulthood.

METHODS: A community sample of 659 families from Upstate New York was interviewed in 1975, 1983, 1985 to 1986, and 1991 to 1993. During the 1991-1993 interview, the mean age of the offspring was 22 years.

FINDINGS: Maladaptive parenting and childhood maltreatment were associated with an elevated risk for interpersonal difficulties during middle adolescence and for suicide attempts during late adolescence or early adulthood after age, sex, psychiatric symptoms during childhood and early adolescence, and parental psychiatric symptoms were controlled statistically. A wide range of interpersonal difficulties during middle adolescence were associated with risk for suicidal behavior after the covariates were controlled. Profound interpersonal difficulties during middle adolescence mediated the association between maladaptive parenting or childhood maltreatment and suicide attempts during late adolescence or early adulthood.

DISCUSSION: Maladaptive parenting and childhood maltreatment may be associated with a risk for severe interpersonal difficulties during adolescence. These interpersonal difficulties may play a pivotal role in the development of suicidal behavior. Youths who are at an elevated risk for suicide may tend to be in need of mental health services that can help them to cope with an extensive history of profound interpersonal difficulties, beginning in childhood and continuing through adolescence.

Perceived risk among parents concerning the travel situation for children with disabilities.

Falkmer T, Gregersen NP. Accid Anal Prev 2002; 34(4): 553-562.

Correspondence: Torbjorn Falkmer, Swedish National Road and Transport Research Institute, VTI, SE-581 95, Linköping, SWEDEN; (email: torbjorn.falkmer@vti.se).

(Copyright © 2002 Elsevier Science)

The aim of this study was to describe perceived risk among parents concerning the travel situation for children with disabilities, in addition to their self-reported knowledge of regulations and standards. The results from the present questionnaire study showed that entering and exiting the vehicles often required manual assistance and, thus, was perceived as risky, creating worry among parents. Parents were also worried about professional drivers' lack of knowledge about the child, incautious driving behavior and lack of adequate safety measures. A poor postural sitting position was a problem in all vehicles. Half of the parents lacked knowledge about the regulations and standards for school transportation and Special Transport Systems. Lack of information seems to be one underlying reason for the parents' worries. Comprehensive information, focused on the special needs of children with disabilities in their transportation, would probably reduce the parents' worries significantly.
Restraints and occupant kinematics in vehicular rollovers.

Meyer SE, Herbst B, Forrest S, Syson SR, Sances A Jr, Kumaresan S. Biomed Sci Instrum 2002; 38: 465-469.

Correspondence: Steven E. Meyer, Safety Analysis & Forensic Engineering, 495 Pine Avenue, Goleta, CA 93117, USA; (email: info@saferesearch.com).

(Copyright © 2002 Instrument Society of America)

Occupant kinematics and the potential for injury in vehicular rollover crashes are dramatically affected by various restraint system characteristics. This study reviews previous research that utilized various methodologies and test fixtures to evaluate restrained occupant motions, primarily in the vertical direction, during both inverted and quasi-static simulated rollover environments. Additional laboratory tests were conducted in order to understand the static and dynamic excursion of restrained humans and surrogates in typical production motor vehicles under inverted circumstances. These tests indicated that volunteer occupants restrained within a complete vehicle by typical production 3 point seat belts will move vertically towards the vehicle roof structure by approximately 50-150 mm in production vehicles, depending on occupant size and belt configuration, when inverted and subjected to a static 1 g acceleration. Dynamic inverted vehicle drop testing in 3-point belt production vehicles, resulting in 4 to 11 g impacts, resulted in surrogates moving only about an additional 23 to 55 mm beyond the static inverted 1 g excursions.
The effectiveness of antilock braking systems in reducing accidents in Great Britain.

Broughton J, Baughan C. Accid Anal Prev 2002; 34(3): 347-355.

Correspondence: Jeremy Broughton, Transport Research Laboratory, Crowthorne, Berkshire RG45 6AU, UK; (email: jbroughton@trl.co.uk).

(Copyright © 2002 Elsevier Science)

Antilock braking systems (ABS) are fitted to many new cars with the aims of improving their ability to steer while braking heavily and of reducing stopping distances on some road surfaces. This paper presents the findings of a project that assessed the effectiveness of ABS in reducing accidents in Great Britain. A large postal survey was carried out of the owners of modern cars. asking for details of any accidents in which they had been involved during the previous year as well as factors that might influence their likelihood of being involved in an accident. Questions were also asked to test respondents' knowledge of ABS. ABS cars differed in several respects from non-ABS cars, as did the two groups of drivers. Consequently, a sophisticated statistical analysis was required to provide unbiased estimates of the effectiveness of ABS. Various results did not achieve statistical significance, but the overall stability of the results indicates that real effects have been measured. They confirm that ABS does have the potential to reduce the number of accidents, but show that this has not been fully achieved. One reason may be that many drivers have little or no knowledge of ABS.
The antilock braking system anomaly: a drinking driver problem?

Harless DW, Hoffer GE. Accid Anal Prev 2002; 34(3): 333-341.

Correspondence David W. Harless, Department of Economics, Virginia Commonwealth, University, Box 844000, Richmond, VA 23284, USA; (email: dwharles@vcu.edu).

(Copyright © 2002 Elsevier Science)

Antilock braking systems (ABS) have held promise for reducing the incidence of accidents because they reduce stopping times on slippery surfaces and allow drivers to maintain steering control during emergency braking. Farmer et al. (Accident Anal. Prevent. 29 (1997) 745) provide evidence that antilock brakes are beneficial to nonoccupants: a set of 1992 model General Motors vehicles equipped with antilock brakes were involved in significantly fewer fatal crashes in which occupants of other vehicles, pedestrians, or bicyclists were killed. But, perversely, the risk of death for occupants of vehicles equipped with antilock brakes increased significantly after adoption. Farmer (Accident Anal. Prevent. 33 (2001) 361) updates the analysis for 1996- 1998 and finds a significant attenuation in the ABS anomaly. Researchers have put forward two hypotheses to explain this antilock brake anomaly: risk compensation and improper operation of antilock brake-equipped vehicles. We provide strong evidence for the improper operation hypothesis by showing that the antilock brake anomaly is confined largely to drinking drivers. Further, we show that the attenuation phenomenon occurs consistently after the first three to four years of vehicle service.
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).

(Copyright © 2002 Taylor & Francis)

The aim of the present study was 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 behaviors with road traffic accidents was examined. A total number of 1126 Finnish drivers completed a questionnaire containing the Driver Behavior 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. 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 offenses were predicted by interpersonal violations. The implications of these results are discussed.
Driving in young adults with attention deficit hyperactivity disorder: knowledge, performance, adverse outcomes, and the role of executive functioning.

Barkley RA, Murphy KR, Dupaul GI, Bush T. J Int Neuropsychol Soc 2002; 8(5): 655-672.

Correspondence: Russell A. Barkley, Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester 01655, USA; (email: Barkleyr@ummhc.org).

(Copyright © 2002 Cambridge Press)

Past studies find that attention deficit hyperactivity disorder (ADHD) creates a higher risk for adverse driving outcomes. This study comprehensively evaluated driving in adults with ADHD by comparing 105 young adults with the disorder (age 17-28) to 64 community control (CC) adults on five domains of driving ability and a battery of executive function tasks. The ADHD group self-reported significantly more traffic citations, particularly for speeding, vehicular crashes, and license suspensions than the CC group, with most of these differences corroborated in the official DMV records. Cognitively, the ADHD group was less attentive and made more errors during a visual reaction task under rule-reversed conditions than the CC group. The ADHD group also obtained lower scores on a test of driving rules and decision-making but not on a simple driving simulator. Both self- and other-ratings showed the CC group employed safer routine driving habits than the ADHD group. Relationships between the cognitive and driving measures and the adverse outcomes were limited or absent, calling into question their use in screening ADHD adults for driving risks. Several executive functions also were significantly yet modestly related to accident frequency and total traffic violations after controlling for severity of ADHD. These results are consistent with earlier studies showing significant driving problems are associated with ADHD. This study found that these driving difficulties were not a function of comorbid oppositional defiant disorder, depression, anxiety, or frequency of alcohol or illegal drug use. Findings to date argue for the development of interventions to reduce driving risks among adults with ADHD.
Motor vehicle collision factors influence severity and type of TBI.

Hillary FG, Schatz P, Moelter ST, Lowry JB, Ricker JH, Chute DL. Brain Inj 2002; 16(8): 729-741.

Correspondence: Frank G. Hillary, University of Medicine and Dentistry, Newark, NJ, USA.

(Copyright © 2002 Taylor & Francis)

OBJECTIVE: To analyse the relationship between motor vehicle collision factors and TBI.

METHODS: Research design: Retrospective design analyzed the difference between the types of brain injuries sustained in distinct collision configurations. Medical charts and police accident reports were reviewed for individuals sustaining TBI in 168 motor vehicle collisions between 1985-1998.

FINDINGS: Lateral collisions and collisions involving contact with a fixed object were associated with the most severe brain injuries. Analysis of safety restraints revealed that seatbelts not only reduce the probability of injury, but they also mediate the severity of brain injury when it is sustained.

DISCUSSION: Future research should focus the prevention of injury by better defining the minimum physical thresholds at which brain injury might be sustained and the mechanisms by which these thresholds are achieved during natural collisions.

Head injury by gunshots from blank cartridges.

Geese A, Koops E, Lohmann F, Westphal M, Puschel K. Surg Neurol 2002 Apr;57(4):268-277.

Correspondence: Alf Giese, Department of Neurosurgery, University Hospital Eppendorf, 20246 Hamburg, GERMANY; (email: unavailable).

(Copyright © 2002 Elsevier Science)

BACKGROUND: Blank cartridge handguns are generally underestimated in their capacity to inflict serious and potentially life threatening injuries. The predominant reasons for these injuries are suicide or suicide attempts, followed by accidental injuries.

METHODS: A series of 26 gas gunshots to the neurocranium is presented. The injury pattern relevant to neurosurgical practice is illustrated in a case summary of 7 selected cases and the clinical courses as well as outcomes are presented.

FINDINGS: The injury pattern demonstrates that the energy density of the gas jet and the high temperatures of the exploding gas volume cause extensive soft tissue injuries. In close-range shots the gas jet takes on physical properties of a projectile. In these injuries impression fractures and dislocation of bone fragments are common.

DISCUSSION: Gas handguns, contrary to public opinion, are dangerous weapons and may inflict potentially fatal injuries to the neurocranium when fired at close range. These weapons are frequently used in criminal or careless activities predominantly by young males. Extensive CNS injuries including hematomas, subarachnoid hemorrhage, foreign body contamination, and increased intracranial pressure are frequently observed.
Trends in mass murder.

Lester D. Psychol Rep 2002; 90(3 Pt 2): 1122.

Correspondence: David Lester, Psychology Program, The Richard Stockton College of New Jersey, Pomona 08240-0195, USA; (email: lesterd@stockton.edu).

Psychological Reports is not online. The postal address is Box 9229, Missoula MT 59807, USA.

(Copyright © 2002 Psychological Reports)

From 1976 to 1996, the proportion of murder incidents with 5 or more victims showed no linear trend or association with selected social indicators, e.g., birth rate, unemployment rate, and homicide rate.
Gun availability and use of guns for murder and suicide in Canada: a replication.

Bridges FS. Psychol Rep 2002; 90(3 Pt 2): 1257-1258.

Correspondence: Francis S. Bridges, Division of Health, Leisure, and Exercise Science, The University of West Florida, Pensacola, 32514-5750, USA; (email: fbridges@uwf.edu).

Psychological Reports is not online. The postal address is Box 9229, Missoula MT 59807, USA.

(Copyright © 2002 Psychological Reports)

Following Lester, the rate of accidental death from firearms was associated with the percentage of firearms used in suicides and on homicide victims except for persons aged 55+ yrs.

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Rev. 17 Aug-2002 at 23:16 hours.