Neck injuries among the elderly in Sweden

Neck injuries are some of the most important injuries as they have the potential to influence the spinal cord. A previous national survey of neck injuries in Sweden revealed that injury incidence was increasing for the population over 65 years of age, although it was decreasing for the population as a whole. The aim of this study was therefore to further clarify the magnitude, severity, and external causes of neck injuries in the elderly people in Sweden. A national incidence study, with focus on the age group above 65 years, was undertaken with data from the injury surveillance program at the Swedish National Board of Health and Welfare. The investigation includes cervical vertebral fractures reported between 1987 and 1999, and cervical soft tissue injuries from 1997 to 1999. Data in the hospital discharge register were reported in ICD9 from 1987 to 1996, while data from 1997 to 1999 were reported in ICD10. During the study period 4168 cervical injuries occurred of which 341 were fatal. People above 65 years of age made up 17% of the population and sustained 30% of all cervical injuries and 43% of all fatal cervical injuries. Half of the cervical injuries were axis (C2) fractures. Lower vertebral fractures occurred in 16% of the cases and atlas (C1) fractures in 11%. The cervical soft tissue injuries amount to 19% of all injuries. Fall accidents account for the majority (71%) of the accidents. There is an increasing trend for fall accidents resulting in neck injuries. The male population has a higher incidence for neck fractures than females, disregarding the external cause of injury. The upper cervical injuries are the most common, have the longest hospital treatments, and seem to be caused mainly by low energy falls. Further research is needed to understand the mechanisms of these injuries and in this aspect engineering could contribute with valuable knowledge, through accident simulations with numerical models. The increasing incidence of fall injuries calls for further preventive actions. The public sector should implement preventive strategies to reduce the number of extrinsic accidents, while the health care sector should focus on preventing intrinsic accidents with individual actions for each patient.     

Electrical deaths in the US construction: an analysis of fatality investigations

Electrocution is among the ‘fatal four’ in US construction according to the Occupational Safety and Health Administration. Learning from failures is believed to be an effective path to success, with deaths being the most serious system failures. This paper examined the failures in electrical safety by analysing all electrical fatality investigations (N = 132) occurring between 1989 and 2010 from the Fatality Assessment and Control Evaluation programme that is completed by the National Institute of Occupational Safety and Health. Results reveal the features of the electrical fatalities in construction and disclose the most common electrical safety challenges on construction sites. This research also suggests the sociotechnical system breakdowns and the less effectiveness of current safety training programmes may significantly contribute to worker's unsafe behaviours and electrical fatality occurrences.     

Intervention strategies to eliminate truck-related fatalities in surface coal mining in West Virginia

The main objective of this review was to build upon a previous study on the root causes of truck-related fatalities in surface coal mining operations in West Virginia, and to develop intervention strategies to eliminate these fatalities. This review considers a two-pronged approach to accident prevention: one that is fundamental and traditional (safety regulations, training and education, and engineering of the work environment); and one that is innovative and creative (e.g., applying technological advances to better control and eliminate the root causes of accidents). Suggestions for improving current training and education system are proposed, and recommendations are provided on improving the safety of mine working conditions, specifically safety conditions on haul roads, dump sites, and loading areas. We also discuss various currently available technologies that can help prevent haul truck-related fatal accidents. The results of this review should be used by mine personnel to help create safer working conditions and decrease truck-related fatalities in surface coal mining.     

Cervical injuries in Sweden,a national survey of patient data from 1987 to 1999

Neck injuries are one of the most important injuries as they have the potential to influence the spinal cord. Data from most parts of the world are not sufficient to define a comprehensive view of mortality, morbidity, disability and handicap due to neck injuries. In Sweden, there are no data on the incidence of neck injuries. The aim of this study is to define the national incidence and causes of neck injuries in Sweden. An incidence study was undertaken with data from the injury surveillance program at the Swedish National Board of Health and Welfare. The investigation includes cervical vertebral fractures reported between 1987 and 1999, and cervical soft tissue injuries over a period of three years, from 1997 to 1999. Data between 1987 and 1996 were reported in ICD 9, while data from 1997 to 1999 were reported in ICD 10. During the study period, 14,310 non-fatal and 782 fatal cervical injuries occurred. A decreasing incidence for cervical fractures can be seen for the Swedish population, except for the elderly that have a slight increase in incidence. The incidence for cervical soft tissue injuries is almost constant. Cervical fractures demand longer periods of hospitalization than the soft tissue injuries. Transportation-related cervical fractures have dropped since 1991, while soft tissue injuries increased slowly between 1997 and 1999. Fall accidents are now the largest external cause of cervical fractures, and the population above 65 years accounts for almost 50% of the fall accidents. The male population has a higher incidence of cervical fractures, disregarding age. It is concluded that safety programs for transportation-related injuries in Sweden have been successful, while fall accidents are still substantial. Much more can be done to prevent neck injuries; especially to reduce the number of transportation-related cervical soft tissue injuries and fall injuries in the elderly population.     

Pillion riders' cloth related injuries and helmet wearing patterns: a study of Lahore,Pakistan

This study aims at investigating the burden and pattern of clothing related pillion riders' injuries and their helmet wearing pattern in Lahore, Pakistan. Data were collected for nine months (July 2013 to March 2014), reporting 13,248 motorcycle related injuries, out of which 8751 (66%) cases were related to the clothing related pillion riders' injuries. Out of these injuries 10.30% were severe injuries which can be prevented or reduced by proper safety measure, e.g. wearing helmet. It was also found that most of the fatalities were not wearing helmet. Injuries due to wearing of loose fitting clothes and absence of helmet are not uncommon in Pakistan and other underdeveloped parts of the world. Such accidents may be reduced by creating awareness and safety sense in the riders, where use of safe dress and helmet should be encouraged in order to avoid such fatal damages.     

The neglected epidemic: road traffic accidents in a developing country, State of Qatar

The objective of the study is to explore the pattern of road traffic accidents (RTA) and their causes in the State of Qatar. A total of 52,160 RTA, 1130 injuries and 85 fatalities were registered during the year 2000. The data on RTA, injuries and fatalities was obtained from the Traffic Department of the Ministry of Interior, Supreme Council for Planning and Ministry of Public Health. The major cause of traffic accidents in Qatar was careless driving (71%). Relatively there was a more rapid increase in the number of registered vehicles (155%), but accidents were only (61%) in 2000 compared to the year 1983. The majority of victims (53%) were in the age group (10-40) "the most productive class in Society". Forty-three per cent of the total drivers who died due to RTA were in the age group (10-19) who were unlicensed drivers. In 2000, deaths due to RTA were the third leading cause of death after the diseases of the circulatory system and cancer. In conclusion, it is possible to control the epidemic of road traffic injuries through strict policy interventions, mass media and a national traffic campaign to increase the use of seat belts.     

如何控制和保障施工安全的经验和体会

结合施工实践,通过分析公路施工中常见安全事故的类别及事故发生的原因,着重从施工安全控制的角度介绍如何控制和保障施工安全的经验和体会,以提高施工的安全水平.     

Equipment-related injuries in agriculture: an international perspective

Injuries related to agricultural equipment are a significant cause of morbidity and mortality, in both high-income and low-income countries. Tractors are most often associated with severe injuries and fatalities. All age groups sustain injuries. Injuries to children are also prevalent because the sites of agricultural work overlap homes in rural areas. In the majority of papers reviewed, preventive methods are mostly targeted at behaviour modification and effective medical facilities, whereas only a few authors have highlighted design changes and passive measures for injury control. The effectiveness of suggested interventions is not discussed in the majority of papers except those related to roll-over protection structures, fodder cutting machines and thresher safety devices.     

BUILDING RELATED HOME ACCIDENTS: A PRELIMINARY STUDY

In the period August 1975 to July 1977 the Building Research Station undertook a pilot study to obtain data on home accidents in co-operation with the Watford General Hospital. Subject to precautions regarding medical confidentiality, information was recorded on patients who attended the Accident and Emergency Department of the hospital following an accident in or around a dwelling. In order to facilitate comparison with data on fatalities, use was made of the International Classification of Diseases ‘External Cause of Injury’ system to categorize accident events. It was found that the four main types of non-fatal accident were falls, accidents caused by cutting or piercing instruments, by striking against or being struck by objects, and by hot substances and steam. The study also showed that building features and services might rank relatively highly in terms of the frequency with which they become involved as agents in accidents when compared to other common household items.     

Gender and geographic differences in intentional and unintentional injury mortality among children in Illinois, 1988–1998

Road traffic crashes and injuries constitute a major health, economic and developmental challenge for many African countries. With only 4% of the world's motor vehicles, African roads witness more than 10% of the world total collision fatalities. With further motorisation, the number of road traffic crashes, injuries and fatalities are expected to grow. This study updates on the status, trends, causes, countermeasures and issues in traffic safety in African countries by reviewing studies published in the past 12 years. The study found that traffic fatalities continued its upward trend in recent years. Similar to those in motorised countries, the study identified that human behaviour and incapacitation account for more than 85% of the contributing factors reported by police in Africa. Unlike in developed countries, the victims of traffic casualties are primarily vulnerable road users. Pedestrians alone account for more than 40% of the total fatalities on African roads. Limited countermeasures were reported in the literature. The outcomes of these programmes are mixed and the research methods have inconsistent validity. Investigation in the feasibility of transferring proven programmes from motorised countries is suggested as an efficient measure for traffic safety improvement.     

浅谈建筑施工安全管理

建筑施工是一个繁琐复杂的系统工程,不稳定的危险因素很多,极易产生安全事故。建筑安全的主要问题是手续不全擅自开工、安全防护投入不足、安全生产基础薄弱、安全监理不尽责。要实现安全生产,就必须保证建筑工程严格依法依程序进行,杜绝"开绿灯"现象;建立建设单位"保证金"制度;安全检查常态化,健全组织机构和各项规章制度;实行监理企业安全工作综合考评制度。     

Road safety determinants in low and middle income countries

The objective of this article is to summarize and review the literature on the determinants of road traffic injuries and fatalities, to identify the relevant research gaps in particular for low and middle income countries. We also present a cross-country analysis of the determinants of road traffic injuries and fatalities that take into account a wide range of potential environmental, economic and social factors. The present study focused on differences based on the level of development. The goal was to identify relevant commonalities that may assist in the creation of road safety policies common to countries at a similar level of development. The countries were divided according to the level of gross national income per capita, and these income-level groups were the primary units of interest. The results presented here focus on the differences by income level.     

Socio-economic differentials in injury risk

The aim was to highlight the role of childcare products as causes for mild brain injury (concussion) in small children (0-4 years of age) and to determine the most dangerous products. By childcare products this report means the following items: child and baby furniture, nursing tables, baby walkers, toys, baby carriages, sport equipment for children, playground equipment and security equipment for children. The data were derived from the EHLASS (European Home and Leisure Accident Surveillance System) for 1998 and 1999 and covered a restricted population of Sweden (approximately 5 per cent). According to this register 182 mild brain injuries (concussions) were recorded following a fall, an accident or a blow to the head among children (0-4 years of age) during 1998 and 158 for 1999. Of those injuries, childcare products were the cause of the accident in 84 (46 per cent) and 76 (48 per cent) cases respectively for 1998 and 1999. The number of children admitted for hospital care was 68 (57/84) and 74 (56/76) per cent respectively. The home was the most common place of the accident and play and leisure activity were the most common activities. More than 50 per cent of these accidents took place during daytime. The product type that caused most accidents was nursery furniture and, in this category, the baby walker was the most dangerous. The product type that caused the second most frequent accidents was playground equipment.     

Opportunities,threats and barriers to enacting mandatory child car restraint laws in Iran

Approximately one-third of Iranian children's deaths are caused by injuries. Of these, 36% result from road traffic injuries (RTIs). Both RTIs and fatalities could be reduced by using child car restraints (CCRs). Despite their demonstrated effectiveness, CCRs are not mandatory in Iran. This study was conducted to assess opportunities and barriers in enacting mandatory CCR laws in that country. Using mixed method research, a phenomenological approach was used to explore the experiences and perspectives of road safety stakeholders in regard to opportunities and threats in enacting mandatory CCR laws in Iran. The themes derived from group discussions were used to first develop a structured questionnaire, which was later distributed to and completed by study participants. The study analysis was conducted using scores and rankings from the responses to these questions. Twenty-eight stakeholders participated in the study. Most were male, aged 36.7 ± 5.6 (range 25–59). In terms of identifying the organization that should establish mandatory CCR laws, the Traffic Police Department achieved the highest score of 90 (range 0–100). The participants also thought that the Traffic Police department is responsible to monitor compliance and conduct follow-up investigations (score = 100). In regard to existing barriers in enacting CCR laws, the lack of positive Publicity by mass media and the lack of related laws received scores of 85 and 70, respectively. Enabling factors and opportunities included ‘positive regards or attitude of families towards their child's health,’ ‘officials’ commitment to support such laws' and ‘having adequate resources to raise community awareness of the importance of CCR use. These received scores of 83, 69 and 68, respectively. The results suggest that cooperation and collaboration among stakeholders including the Traffic Police, families and local communities are needed to maximize the likelihood of mandating CCR laws.     

Fatal occupational accidents in Danish fishing vessels 1989-2005

The purpose of the study was to study the circumstances and incidence rates of fatal accidents in inspection obligated and non-inspection obligated Danish fishing vessels to identify areas for prevention. Information about the fatalities came from maritime authority reports, including vessel disaster reports, post mortem reports, maritime inquiries and police reports. The person- and vessel years at risk came from the Danish Directorate of Fisheries. During the period 1989-2005, 114 fatalities occurred. Sixty-one of the fatalities occurred in 36 vessel disasters mainly caused by foundering/capsizing due to stability changes in rough weather and collisions; 39 fatal occupational accidents mainly occurred on the larger inspection obligated trawlers during fishing. In the remaining 14 other fatal accidents, the main causal factors were difficult embarking/disembarking conditions by darkness in foreign ports and alcohol intoxication. In the period 1995-2005, the overall incidence rate was 10 per 10,000 fishermen per year with no down-going trend during that period. The fatal accident rates are still too high, despite the efforts to reduce the risk. Increased focus on regular and repeated safety training for all fishermen and improved safety measures are needed, especially in the underscored areas of sea disasters concerning small vessels and occupational accidents on big vessels. Better registration of time at risk for fishermen is needed to validate the effect of the safety measures.     

Road traffic accidents and policy interventions in Korea

The high rate of road traffic crashes, in conjunction with the absence of order on the road, has long been considered a critical social problem in Korea. The Korean public seems to agree that high priority ought to be placed on policies for improving road safety. Using data from government sources, this study describes what has happened in the area of road traffic crashes since 1970, the causes of traffic crashes, and the relative importance of traffic injuries as a cause of death in Korea. Road traffic crashes in Korea increased nearly eightfold, from 37,000 in 1970 to 290,481 in 2000. The fatalities increased three-fold and injuries ten-fold over the same period. Road traffic injuries were the leading cause of death for people under 29. However, through multiple policy interventions, partly in response to the 2002 FIFA World Cup, about two thousand road traffic deaths and nine thousand traffic-related disabilities were averted in 2001 alone. The policy interventions included enforcement of penalties for seven risky driving behaviours, including drunk driving and speeding, installation of traffic-monitoring cameras, financial rewards for citizens who reported traffic violations, introduction of a road safety evaluation system, correction of accident black spots in existing roads, and road safety education programs. Through multiple policy interventions, road traffic crashes in Korea were reduced in a relatively short time period, along with their associated injuries and fatalities. However, road traffic crashes still pose a major public health problem, threatening the quality of life of the Korean people.     

Occupational accidents in the Netherlands: incidence,mental harm,and their relationship with psychosocial factors at work

This study investigated the incidence of mental harm due to occupational accidents and the relation between psychosocial factors at work and the occurrence of occupational accidents in the Netherlands for the construction industry and health and welfare sector. Analyses revealed that occupational accidents in the construction industry more often involved physical harm, whereas accidents in the health and welfare sector relatively more often resulted in mental harm, in comparison to other sectors. Results showed that psychosocial factors were associated with occupational accidents in both sectors. For the construction industry, high time pressure and exposure to violence and harassment by colleagues or supervisors were associated with occupational accidents. For the health and welfare sector, low autonomy and exposure to violence and harassment by colleagues or supervisors or by people outside the organization were associated with occupational accidents. The present paper stresses the importance of also taking psychological consequences and psychosocial factors at work into account in assessing the occurrence of occupational accidents.     

A retrospective population-based data analyses of unintentional fall mortality and hospitalisation in Taiwan during 2005–2007

The objective of this study is to describe the epidemiology of unintentional fall mortality and hospitalisation and to find the risk factors associated with inpatient mortality. We analysed mortality data from official publications which record the vital statistics and hospitalisation data from National Health Insurance (NHI) Research Database from 2005 to 2007 and fall injuries were classified in accordance with ICD-9-CM E-Codes, including ‘falls on the same level (E885–E886)’, ‘falls on a different level (E880–E884)’ and ‘unspecified falls (E887–E888)’. We used SPSS 18.0 software. During 2005–2007 in Taiwan, there were 3555 deaths and 180,175 inpatients due to unintentional falls and the mortality rate was 5.19 per 100,000 and the hospitalisation rate was 236.14 per 100,000. With regards to deaths, different-level falls were the primary cause, and those aged 25 or more were high-risk groups; with regards to hospitalisation, same-level falls were the primary cause, and those aged 65 or more were the high-risk group. Associated factors for inpatient mortality can be classified by patient characteristics (older age, catastrophic illness, higher Charlson Comorbidity Index (CCI) and head trauma) and hospital-related factors (geographic area, type of hospital, level of hospital and department of care). The high-risk groups were different between ‘same-level’ and ‘different-level’ falls and the findings of this study will be beneficial for concerned authorities to draft up appropriate prevention plans in the future. Moreover, future researchers can further explore different risk factors for injuries using questionnaire surveys or hospital emergency room data.