Road traffic injury among child motorcyclists in Vientiane Capital,Laos: a cross-sectional study using a hospital-based injury surveillance database

This study investigated the distribution of motorcyclists, including drivers and passengers, who were involved in road traffic crashes and admitted to hospital in Vientiane Capital, Laos. The focus was on child motorcycle drivers and passengers under 15 years. A hospital-based injury surveillance database in Vientiane Capital was used. The surveillance was performed in two hospitals. From 1 September to 31 December 2009, 3968 patients were admitted to the participating hospitals with road traffic injuries. Patients under 15 years accounted for 10.8% (427/3968). The majority of patients under 15 years were motorcycle drivers or passengers (71.7%, 306/427). Child motorcyclists including drivers and passengers were less likely to wear a helmet than adults (adjusted odds ratio [OR], 0.3, 95% confidence interval [CI], 0.2–0.5, for children 10–14 years; adjusted OR: 0.1, 95% CI, 0.05–0.4, for children under 10 years). It is suggested that stricter regulation enforcement for child motorcycle drivers and passengers may be needed. In addition, barriers against wearing helmets for motorcycle drivers and passengers in Laos should also be examined in further studies.     

Impact of lowering the legal blood alcohol concentration limit to 0.03 on male, female and teenage drivers involved alcohol-related crashes in Japan

In June of 2002, a revision to part of the Road Traffic Act drastically increased the penalties for drinking and driving offences in Japan. Most notably, the legal blood alcohol concentration (BAC) limit for driving was lowered from 0.05 mg/ml to 0.03 mg/ml. The rationale for the new lower BAC limit was predicated on the assumption that drinking drivers will comply with the new, lower limit by reducing the amount of alcohol they consume prior to driving, thereby lowering their risk of crash involvement. This, in turn, would lead to fewer alcohol-related crashes. A key limitation of previous lower BAC evaluation research in determining the effectiveness of lower legal BAC limit policies is the assumption of population homogeneity in responding to the laws. The present analysis is unique in this perspective and focuses on the evaluation of the impact of BAC limit reduction on different segments of the population. The chief objective of this research is to quantify the extent to which lowering the legal limit of BAC has reduced male, female and teenager involvement in motor vehicle crashes in Japan since 2002. Most notably, the introduction of reduced BAC limit legislation resulted in a statistically significant decrease in the number of alcohol-impaired drivers on the road in Japan, indicating responsiveness to the legal change among adults and teenagers. In addition, this preliminary assessment appears to indicate that the implementation of 0.03 BAC laws and other associated activities are associated with statistically significant reductions in alcohol-involved motor vehicle crashes. In comparison, the rates of total crashes showed no statistically significant decline nor increase in the period following the introduction of the BAC law, indicating that the lower BAC limit only had an effect on alcohol-related crashes in Japan. The evidence suggests that the lower BAC legal limit and perceived risk of detection are the two most important factors resulting in a sustained change in drinking and driving behaviour in Japan. It is recommended that future research and resources in other countries be focused on these factors as determinants to reduced alcohol-related crashes.     

Incidence and characteristics of unintentional injuries among children in a resource limited setting in Kampala,Uganda

ABSTRACT

Given that little is known about the epidemiology of unintentional injuries in children in low-income countries, this study sought to determine the incidence and characteristics of unintentional injuries among children aged ≤18 years in a slum community in Uganda. From a household survey, the incidence and odds ratios for factors associated with unintentional injury characteristics were calculated. Of 1583 children, 706 had suffered 787 unintentional injuries yielding an annual incidence rate of 497 injuries per 1000 children. Commonest injuries were cuts, bites or open wounds (30.6%) and bruises or superficial injuries (28.6%) with majority (75.5%) occurring at home. Boys were more likely to be injured at school (AOR 4.34; 95% CI 1.22–15.54) and to be injured from falls (AOR 1.41; 95% CI 1.01–1.96). Older children (12–18 years) were more likely to suffer from fractures (AOR 2.37; 95% CI 1.26–4.43), concussions and organ system injuries (AOR 3.58; 95% CI 1.03–12.39) and cuts, bites or open wounds (AOR 2.05; 95% CI 1.21–3.48). Older children were less likely to suffer burns or scalds as compared to the young children (AOR: 0.23; 95% CI 0.11–0.50). Unintentional injury incidence rate was high among children with most occurring in the homes.     

Crash-related factors associated with the severity of road traffic injuries in Iran

Although the impact of traffic crashes is very high in Iran, there are few works on the association of crash-related factors with injury severity. This study was conducted on 145 drivers injured on the Qazvin-Loshan road in order to assess this association. The New Injury Severity Score (NISS), based on the conditions of the injured drivers during their first visit to regional hospitals, was used as the main outcome measure. Multiple linear regression analysis was performed by considering logarithmic scale for NISS as response variable and adjusting for the confounding effects, including the transfer to hospital variables. The results showed that high-vehicle damage (i.e. damage with repair cost more than 25% of the pre-crash value of the driver's vehicle) and being trapped inside the motor vehicle raised the NISS by 5.25 (95% confidence interval (CI) 2.51-10.71) and 2.34 (95% CI 1.20-4.67), respectively.     

The strength of science and technology drivers for SME innovation

This analysis feeds into the academic debate on the most proficient innovation mode across firms, placing special emphasis on the characteristic case of small and medium enterprises (SMEs). Of the three main approaches considered, the first stresses the importance of innovation based on science and technology (STI) drivers, such as research and development (R&D) and human capital, whereas the second approach emphasises innovation based on learning by doing, by using and by interacting (DUI); the third, more recent approach is conceived as a combination of the former two (STI?+?DUI). In this paper, the three models are tested on a sample of 409 SMEs that have been supported by a public programme for innovation promotion developed by the Basque Government in Spain. The result is quite different from what is expected, yet it is insightful and potentially useful for both academics and policy-makers. Contrarily to what one would expect, SME innovation output is in fact more sensitive to STI drivers than to DUI drivers.     

Exceeding the speed limit: prevalence and determinants in Iran

Speeding is one of the most common risk behaviours associated with crashes causing signficant injury. The objective of this study is to explore the prevalence and determinants of speeding on a road between Tehran and Hamadan, Iran. In a cross-sectional study in 2009, stretches of the road were studied including three groups of posted speed limits: < 50 km/h, 50–100 km/h and > 100 km/h. Each stretch was evaluated both in daylight and dark. Randomly identified driver's speed was checked by a handheld speed camera and then the driver was invited to participate in a survey. Statistical analysis was performed using Chi-Square, crude and adjusted odds ratio, 95% confidence interval and multiple logistic regression models. Overall, 52.8% of the drivers were travelling more than 10 km/h above the posted limit. Where limits were < 50 km/h, 74.6% of drivers were speeding. This declined to 46.9% for sections with limits between 50 and 100 km/h and to 36.9% for sections posted more than 100 km/h. Finally, more than half the drivers were observed to be speeding. Driving more than the posted limit was far more likely on the areas with the lowest posted speed limits, personal passenger vehicles, modern vehicles not using seat belts, and male drivers.     

Pedestrian and motorists’ actions at pedestrian hybrid beacon sites: findings from a pilot study

The objective of the study was to examine the effects of overweight and obesity on times to recovery among Canadian youth who have suffered one or more types of injury. The data source was the 2002 Canadian Health Behaviour in School-Aged Children (HBSC) survey. The study population included 7266 youth in grades 6 through 10 sampled from all Canadian provinces and territories. Of these, 2831 students reported an injury event and were included in the analysis. Kaplan–Meier curves and hazard ratios (HR) were used to profile survival functions and estimate relative hazards for non-recovery from injury events among normal weight, overweight and obese youth. Youth who were obese and suffered a combined injury (broken bone and strain/sprain) took longer to recover (HR: 1.81, 95% CI 0.99–3.32) compared to normal weight youth. HR for injury recovery in obese youth were not significantly elevated for broken bones (1.15, 95% CI 0.61–2.19) and sprain/strains (1.17, 95% CI 0.73–1.85) in isolation. Obesity was associated with times for injury recovery among injured youth. If these findings are confirmed in other settings, clinicians providing an injury recovery prognosis may need to take into account BMI status and allow for extra recovery time for patients in this age range.     

Incidence,patterns and risk factors for injuries among Ugandan children

There is limited epidemiological data on childhood injuries in developing countries. This study assessed the incidence, patterns and risk factors for injuries among children aged 0–5 years in Wakiso District, Uganda. To determine differences, chi-square and Wilcoxon rank sum tests were used. Risk factors were assessed using Poisson regression. Overall, information from 359 children of mean age 32 months (SD: 18.4) was collected. Annual incidence of injuries was 69.8 per 1000 children/year (95% CI 58.8–80.8). One fatal injury due to burns was reported. Incidence of injuries was less associated with being female (IRR: 0.56, 95% CI 0.34–0.90) and increasing age of the caretaker (IRR: 0.96, 95% CI 0.92–0.99). The high incidence of childhood injuries necessitates the need for interventions to reduce injuries among children.     

Gauging the Effects of Lowering the Blood Alcohol Concentration from 0.10 to 0.08 on the Hospitality Industry

ABSTRACT

Every year in the US, over 20% of all traffic fatalities are caused by drunk drivers. The average Blood Alcohol Concentration (BAC) of fatally injured drivers is 0.17, with almost half of these have a BAC of 0.20 or higher. In October of 2000, a new federal law was passed requiring states to lower the BAC from 0.10 to 0.08 or lose millions in highway funding. Proponents of this legislation feel it will save over 500 lives a year. Those opposed feel this law will target the social drinker, overburden the justice system, and will not address the real problem, the habitual drunk driver. This study looks at these issues concentrating on: other laws that could affect the number of alcohol-related fatalities; the number of fatalities involving habitual offenders; legislative efforts in the state of Indiana; and the effect this legislation could have on the hospitality industry.     

Environmental risk factors contributing to traffic accidents in children: a case-control study

The aim of this study is to identify environmental risk factors related to road accidents in children of Tehran. This case-control study was performed in 2013. The cases were injured pedestrians aged 5–15 who were admitted to major hospitals supervised by Tehran University of Medical Sciences. The sample size for the cases was 273 and for the control group was 546. For the completeness of the clusters, 7 extra persons in case (total = 280) and 14 persons (total = 560) in control group were included. The interference of confounding variables assessed through forward conditional logistic regression. Result shows occurrence of traffic accidents was significantly associate with the width of the alleys or (<5 m: OR = 8.4, 95% CI: 3.3–21.5; 5–8 m: OR = 4.7, 95% CI: 1.8–12.2), distance from home to school((<100 m: OR = 1.7, 95% CI: 1.0–2.8), existence of parking lot (OR = 1.5, 95% CI: 1.0–2.3), traffic congestion (OR = 4.1, 95% CI: 2.6–6.4), traffic speed (OR = 2.1, 95% CI: 1.3–3.2) and existence of pedestrian bridges(OR = 4.2, 95% CI: 2.6–6.8). In the light of the important role of environmental factors in the occurrence of child traffic accidents, alleviating structural risk factors in addition to education and enforcement need more systematic efforts and planning by policymakers and urban planners to attain pedestrian safety goals.     

Fatal violence among children under 15 years in four cities of South Africa, 2001–2005

Homicide rates for South African children were estimated at double the global average in 2000. This article presents a secondary data analysis of the National Injury Mortality Surveillance System (NIMSS), with full coverage in four major metropolitan cities. Child homicide rates for 2001–2005 were calculated within the 0–4, 5–9 and 10–14 year age groups. The homicide rates were similar to the global pattern, with higher rates for boys, and among children aged 0–4 years than for older children. Poisson regression, accounting for city level clustering, was used to investigate age, sex and period effects in the homicide rate. The model indicated that the gender difference was more marked in the 10–14 year age groups (RR = 2.17; 95% CI 1.97–2.38) than in the 5–9 year (RR = 1.43; 95% CI 1.27–1.62) with the 0–4 year age group in-between (RR = 1.80; 95% CI 1.55–2.10). These data confirm previous observations that fatal violence among children is a public health concern, but, given the high rates of homicide among South African adults and other competing public health problems, it is difficult to motivate for action to address the issue of violence against children. Nonetheless, there are sufficient indications that efforts to reduce childhood violence are urgently needed.     

Comparing the characteristics of snowboarders injured in a terrain park who present to the ski patrol,the emergency department or both

Ski patrol report forms are a common data source in ski/snowboard research, but it is unclear if those who only present to the emergency department (ED) are systematically different from those who see the ski patrol. To determine the proportion and characteristics of injured snowboarders who bypass the ski patrol before presenting to the ED, three groups of injured snowboarders were compared: presented to the ED only, ski patrol only and ski patrol and ED. Data were collected from ski patrol Accident Report Forms (ARFs), ED medical records and telephone interviews. There were 333 injured snowboarders (ED only: 34, ski patrol only: 107, both: 192). Ability, time of day, snow conditions or drugs/alcohol predicted ED only presentation. Concussions (RRR: 4.66; 95% CI: 1.83, 11.90), sprains/strains (RRR: 4.22; 95% CI: 1.87, 9.49), head/neck (RRR: 2.90; 95% CI: 1.48, 5.78), trunk (RRR: 4.17; 95% CI: 1.92, 9.09) or lower extremity (RRR: 3.65; 95% CI: 1.32, 10.07) injuries were significantly more likely to present to ski patrol only versus ski patrol and ED. In conclusion, snowboarders who presented to the ED only had similar injuries as those who presented to both.     

Respondents’ recall of injury events: an investigation of recall bias in cross-sectional injury data from the Sudan Household Health Survey 2010

Recall bias is a well-documented limitation of population-based cross-sectional injury surveys. To fill some gaps in this area, we investigated the extent and nature of recall bias in Sudan Household Health Survey (SHHS 2010) injury data. The extent of incomplete recall was measured by comparing the total reported injuries over 12 months with the annualised number of injuries in the four weeks preceding the survey. Multivariable logistic regression was used to investigate the association of socio-demographic variables, injury attributes and interviewee characteristics with differential recall. Relevant interactions were tested. Overall, reported injuries were 33% of the expected. Injuries among children 1–4 years had lower odds of being reported to have occurred earlier than the four weeks preceding the survey than people aged 65 years and over (OR = 0.24, 95% CI 0.12–0.47). Injuries that received inpatient care in the first week were more likely to be recalled than those that did not receive care (OR = 2.07, 95% CI 1.14–3.75). Respondent's age was associated with differential recall. Differential injury recall should be considered when using SHHS 2010 to compare injury occurrence between children under five and older groups or at the level of health care received.     

Risk factors for injury in community-level football: a cohort study

We investigated the independent effect of commonly postulated risk factors on injury incidence in amateur football (soccer), using a prospective cohort design with follow-up over two seasons. A total of 1702 male and female players aged 13 years or older contributed information on 21,797 player-matches. Confirmed, were the effect of male vs. female sex (injury rate ratios (IRR) = 0.81, 95% confidence interval (CI): 0.67–0.97), older age (increasing IRR gradient), New Zealand European ethnicity (IRR = 0.87, 95% CI: 0.74–1.01), being taller (180–189 cm: IRR = 1.32, 95% CI: 1.06–1.63), previous injury (IRR = 1.32, 95% CI: 1.12–1.57), playing against medical advice (IRR = 1.24, 95% CI: 1.03–1.49), playing while recovering from injury (IRR = 1.40, 95% CI: 1.20–1.49), history of cigarette smoking (IRR = 1.27, 95% CI: 1.00–1.61) and time of season (IRR = 0.97, 95% CI: 0.96–0.98). Female, adult, non-European and taller players could be paid particular attention in injury prevention programmes. The need for effective injury management is reinforced. Adding physical conditioning to pre-season training may be required.     

Effect of driver,roadway, collision,and vehicle characteristics on crash severity: a conditional logistic regression approach

The aim of the study is to examine the factors that appear to have a higher potential for serious injury or death of drivers in traffic accidents in Turkey, such as collision type, roadway surface, vehicle speed, alcohol/drug use, and restraint use. Driver crash severity is the dependent variable of this study with two categories, fatal and non-fatal. Due to the binary nature of the dependent variable, a conditional logistic regression analysis was found suitable. Of the 16 independent variables obtained from Turkish police accident reports, 11 variables were found most significantly associated with driver crash severity. They are age, education level, restraint use, roadway condition, roadway type, time of day, collision location, collision type, number and direction of vehicles, vehicle speed, and alcohol/drug use. This study found that belted drivers aged 18–25 years involving two vehicles travelling in the same direction, in an urban area, during the daytime, and on an avenue or a street have better chances of survival in traffic accidents.     

How socioeconomic status influences road traffic injuries and home injuries in Rome

Road traffic injuries (RTI) and home injuries (HI) are a relevant public health problem, especially among people living in deprived areas. The objective of this study was to explore the relationship between morbidity, hospitalisation, mortality from RTI and HI, and socioeconomic status (SES) of the area of residence. RTI and HI surveillance based on the Emergency Information System, the Hospital Information System and the Mortality Registry of Lazio region are the three sources of this study to create a unique surveillance system. For each subject, the SES index (5 levels) of its census tract of residence was obtained. The study population included emergency department admissions (year 2005) of residents in Rome, Italy. Incidence Rate Ratios (IRRs) have been estimated using Poisson Regression. The rates of RTI and HI emergency department visits were higher among the most deprived level of SES (IRR = 1.27, 95% CI: 1.24–1.30; IRR = 1.33, 95% CI: 1.29–1.37, respectively) compared to the most privileged ones; a similar result was found for hospitalisation (IRR = 1.19, 95% CI: 1.08–1.32; IRR = 1.11, 95% CI: 1.01–1.22). A strong relation was found between RTI mortality rates and poor level of SES. The study concluded that RTI and HI incidence were associated to sociodemographic factors.     

Feasibility of routine collection of injured worker occupational information in hospital emergency departments

The aim of this study was to examine injury events and risk-factors among Swedish adult eventing athletes. A cross-sectional study design with retrospective recording of 1-year sports-specific exposure and injury data was used. The invited study population consisted of all members of the Swedish Equestrian Federation with eventing as their primary discipline (n = 513). The participation rate was 70.0%. The total 1-year injury prevalence was 26.6%; the specific 1-year prevalence of traumatic injury was 19.3% and of overuse injury 10.9%. The incidence of traumatic injury events was 0.54 injury events/1000 eventing hours (95% confidence interval (CI), 0.35–0.73 injury events/1000 eventing hours) for novices and 0.35 injury events/1000 eventing hours for qualified riders (95% CI, 0.21–0.49 injury events/1000 eventing hours). A total of 27.9% of the traumatic injury events led to severe injuries (causing more than 3 weeks absence from riding). Attitude to risk-taking was the only factor predicting an athlete becoming injured (p = 0.023), and qualification level was the only risk factor for additional injuries among injured riders (p = 0.003). Our results suggest that injury prevention programs in eventing should also give attention to overuse injuries and that care should be taken when eventing athletes are licensed into higher qualification groups.     

Road traffic mortality in Estonia: alcohol as the main contributing factor

Traffic fatalities are the leading cause of death among the young and middle-aged population in Estonia. The objective of this study was to reveal the pattern of traffic fatalities among the population aged 15 - 64 years and to determine the role of alcohol in their fatalities. The data were collected from post-mortem reports at the Estonian Bureau of Forensic Medicine from 2000 to 2002. Alcohol-related deaths were those with a blood alcohol concentration (BAC) equal or above 0.05 g/100 ml. Out of 512 victims, 401 were males and 111 were females. The greatest group were car occupants (58%) followed by pedestrians (31%). The portion of alcohol-related deaths was 70% among men and 44% among women. The mean BAC and percentage of alcohol-related deaths was significantly higher in pedestrian than in driver fatalities. Alcohol intoxication was identified as the most powerful contributing factor to traffic fatalities. The results provide more evidence for politicians to tackle alcohol abuse and unsafe traffic environments.     

School backpack weights: a survey of students in Ghana,Guatemala and the USA

Cross-sectional studies were conducted in conveniently selected schools in Ghana, Guatemala, and the USA to quantify and compare the percentage of body weight carried by students in their backpacks as well as assess parental knowledge of the backpack weights and contents. Mean backpack weights varied significantly by country and increased significantly with increasing student grade. In the USA, girls significantly carried heavier backpacks (p <.0001). The backpack loads represented an average of 7.7% (95% CI = 7.4–8.0), 9.7% (95% CI = 9.2–10.2), and 9.4% (95% CI = 9.1–9.8) of student body weights in Ghana, Guatemala, and the USA, respectively. No student in Ghana carried a wheeled backpack in contrast to 6% and 2.8%, respectively, in Guatemala and the USA. In Ghana, 4.1 and 73.6% of parents were reported to be aware of their children's backpack weights and contents, respectively, compared to 21.9 and 57.5% in Guatemala, and 7.7 and 55.3% in the USA. Backpack loads respresent a significant percentage of the body weights of students in all three countries. The vast majority of parents are unaware of their child's backpack weight.