Determinants of severe injury and mortality from road traffic accidents among motorcycle and car users in Southern Thailand

Abstract

This study aimed to identify factors associated with severe injury and mortality from road traffic accidents (RTA) among motorcycle and car users in southern Thailand. The data were obtained from the Office of Disease Prevention and Control, Thailand, for years 2008–2013. Chi-squared tests were used to assess associations between determinants and outcomes and these associations were then estimated after adjusting for possible confounding with other factors using logistic regression. Severe injury and mortality contributed 11.6% and 5% to RTA of motorcycle users, and 14.3% and 7.5% for car users. Among motorcycle users, male gender, older age, and not wearing a helmet increased severe injury and mortality rates, whereas drivers had more severe injuries than passengers. Older car users had higher severe injury and mortality rates, whereas not fastening seat belts had higher mortality. Safety device use should be made mandatory for both drivers and passengers. Male motorcycle users and the elderly should be focused on.     

Effects of ethyl alcohol on injuries severity according to injury severity scales in pedestrian fatal injury in traffic crashes

Abstract

Introduction: The dominant cause of injuries in traffic crashes. A significant portion of them affects victims under the influence of ethyl alcohol. The goal of the studies was to assess the correlation between the state of sobriety and the severity of injuries expressed by injury severity scales in fatal pedestrian victims of traffic crashes. Research Material and Method: The data were obtained from the Warsaw Medical University's Department of Forensic Medicine. The analysis covered the data for 2009–2013 and included 200 fatal pedestrian victims hit by passenger cars. The assessment of the effect of risk factors on injury severity expressed in terms of injury severity scales such as Life Threat Indicator (LTI), International Classification based Injury Severity Score (ICISS), Injury Severity Score (ISS) and New Injury Severity Score (NISS), was made using adequately selected methods of statistical analysis. Results: As alcohol concentration increases in women, the values of LTI, ICISS-10 and ICISS-15 decrease, which denotes more severe injuries. In the ISS and NISS, the effect of alcohol concentration on the severity of injuries turned out to be negligible. However, these injuries are significantly heavier in women than in men. According to all the scales used, the older the victims, the milder injuries cause their death. Conclusions: The studies show that ethyl alcohol concentration may harm injury severity, especially in the case of women. The assessment of the severity of injuries in traffic crash victims is significantly influenced by their age and gender. The more risk factors the scale takes into consideration, the more precise is the assessment.     

Geographic analysis of road accident severity index in Nigeria

Before 2030, deaths from road traffic accidents (RTAs) will surpass cerebrovascular disease, tuberculosis, and HIV/AIDS. Yet, there is little knowledge on the geographic distribution of RTA severity in Nigeria. Accident Severity Index is the proportion of deaths that result from a road accident. This study analysed the geographic pattern of RTA severity based on the data retrieved from Federal Road Safety Corps (FRSC). The study predicted a two-year data from a historic road accident data using exponential smoothing technique. To determine spatial autocorrelation, global and local indicators of spatial association were implemented in a geographic information system. Results show significant clusters of high RTA severity among states in the northeast and the northwest of Nigeria. Hence, the findings are discussed from two perspectives: Road traffic law compliance and poor emergency response. Conclusion, the severity of RTA is high in the northern states of Nigeria, hence, RTA remains a public health concern.     

The future of injury prevention in Asia and the Pacific

Unintentional injury is gaining attention in the broad Asia-Pacific region, primarily but not solely associated with rapid and disturbing growth in traffic injury.

Objective. This paper considers the nature and features of the injury problem and of current prevention efforts that are likely to be significant in injury prevention in the Asia Pacific region.

Method. Prior to the first Asia-Pacific Injury Prevention Conference an e-mail discussion on the challenges and needs of injury prevention was conducted and a discussion paper circulated. The analysis was presented at the conference and the issues were taken up at a special regional network meeting, in the conference sessions and in informal discussion.

Results. The paper outlines the injury situation facing the broad Asia-Pacific region, with a particular focus on low- and middle-income countries, outlining the size and nature of the problem. The challenges to prevention are lack of awareness and misconceptions about injury, weak intent and low levels of effort and a lack of capacity. The positive elements of work under way or in prospect are described.

Conclusion. The key tasks are to apply what is already known: to test and trial interventions in low- and middle-income countries; to identify the key causes of injury within the broad categories; and to foster and build partnerships.     

Product involvement in do-it-yourself maintenance injury

Abstract

PROBLEM Numerous activities to promote bicycle safety have been implemented in Norway. The overall effect of these activities has not been evaluated.

method Information about cases of bicycle-related injuries occurring in 1990-1993 was obtained from prospective registration of all injuries treated by hospitals and emergency clinics in four urban centers in NORWAY. Incidence was calculated per number of cyclists, based on data obtained from the 1992 National Bicycle Survey. Temporal changes in injury severity and in age-specific incidence (per bicycle riders) of all injuries, upper-head injuries, other injuries, injuries due to bicycle-motor vehicle collision, and injuries leading to inpatient treatment were analyzed by logistic regression analysis.

RESULTS 3,893 injuries occurred in the study population in 1990-1993. The average annual incidence was 33.1 per 10,000 population aged 4 years and higher, or 47.9 per 10,000 bicyclists. No significant secular trends were found for any of the analyzed parameters.

CONCLUSIONS Bicycle safety promotion measures implemented during 1990-1993 did not significantly reduce the risk of bicycle-related injury in Norway. Effective bicycle safety programs should be implemented, based on the positive experiences from other countries. Injury surveillance systems appear to be a useful tool for evaluating injury prevention programs.     

Measuring contamination in an injury prevention randomized controlled trial

The objective was to study the external causes of death reported in the autopsy centre in Kathmandu, Nepal. A retrospective review of case report documentation of all violent and traumatic death autopsies was conducted in Kathmandu from mid-July 2000 to mid-July 2004. A total of 4383 autopsies were conducted by the Department of Forensic Medicine in Kathmandu. There were 1072 (25%) cases of suicide, 380 (9%) homicide, 1399 (32%) accidental, 598 (14%) deaths as a result of natural diseases and 923 (21%) undetermined causes of death. The number of males was almost twice that of females (sex ratio 2.2:1). Persons aged 15 to 44 years comprised about two-thirds of the total reported fatalities (65.4%). Suicides were mostly reported due to hanging, homicides mostly due to firearms and explosives, accidents mostly due to road traffic injuries. More than 60% of road traffic injuries resulted among pedestrians. Suicides, homicides and accidental deaths remain a poorly identified public health issue in Nepal. Medico-legal autopsy reports can serve as an important tool in understanding fatalities from violence and injuries for countries similar to Nepal. Strengthening a regular mechanism for compilation and utilization of the information, however, remains a major challenge.     

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.     

Epidemiologic features and intervention effect of fall injury among rural school-aged children in southwest China: a short-term cohort study

ABSTRACT

Falls are the top one type in all unintentional injuries. In this study, we aim to explore the epidemiological characteristics of falls and assess the intervention effect. Our research had interviewed 2854 rural children in southwest China. Then, we used School–Family–Individual (SFI) comprehensive education model to conduct an intervention among 1506 children and follow up them for one year. The changes in injury knowledge and incidence rate before and after intervention were compared. We found the fall injury was 37.32% (178/477) and ranked top one in the total injuries. After intervention, the children's fall-injuries-related knowledge was significantly increased by 15.29 percent (P < 0.001). While falls incidence significantly decreased after- intervention (6.24% vs. 3.93%; P < 0.001). From the results we concluded that the falls rate was high and was the prior reason of all injuries. SFI intervention model can effectively reduce the incidence of the fall injury.     

A machine-learning method for improving crash injury severity analysis: a case study of work zone crashes in Cairo,Egypt

Abstract

The quality of vehicular collision data is crucial for studying the relationship between injury severity and collision factors. Misclassified injury severity data in the crash dataset, however, may cause inaccurate parameter estimates and consequently lead to biased conclusions and poorly designed countermeasures. This is particularly true for imbalanced data where the number of samples in one class far outnumber the other. To improve the classification performance of the injury severity, the paper presents a robust noise filtering technique to deal with the mislabels in the imbalanced crash dataset using the advanced machine learning algorithms. We examine the state-of-the-art filtering algorithms, including Iterative Noise Filtering based on the Fusion of Classifiers (INFFC), Iterative Partitioning Filter (IPF), and Saturation Filter (SatF). In the case study of Cairo (Egypt), the empirical results show that: (1) the mislabels in crash data significantly influence the injury severity predictions, and (2) the proposed M-IPF filter outperforms its counterparts in terms of the effectiveness and efficiency in eliminating the mislabels in crash data. The test results demonstrate the efficacy of the M-IPF in handling the data noise and mitigating the impacts thereof.     

Road safety perspectives among employees of a multinational corporation in urban India: local context for global injury prevention

In rapidly developing economies, like urban India, where road traffic injury rates are among the world's highest, the corporate workplace offers a non-traditional venue for road safety interventions. In partnership with a major multinational corporation (MNC) with a large Indian workforce, this study aimed to elicit local employee perspectives on road safety to inform a global corporate health platform. The safety attitudes and behaviours of 75 employees were collected through self-report survey and focus groups in the MNC offices in Bangalore and Pune. Analysis of these data uncovered incongruity between employee knowledge of safety strategies and their enacted safety behaviours and identified local preference for interventions and policy-level actions. The methods modelled by this study offer a straightforward approach for eliciting employee perspective for local road safety interventions that fit within a global strategy to improve employee health. Study findings suggest that MNCs can employ a range of strategies to improve the road traffic safety of their employees in settings like urban India including: implementing corporate traffic safety policy, making local infrastructure changes to improve road and traffic conditions, advocating for road safety with government partners and providing employees with education and access to safety equipment and safe transportation options.     

A review of national policies and programs to prevent unintentional injuries in the Americas

Injuries are a global public health problem, with injury mortality increasing in many regions. We describe a survey of injury policies and programs in 23 countries in the Americas. Most countries surveyed (87%) perceived unintentional injuries to be a significant public health problem. When asked about actual policy agendas, however, just one-fourth (26%) of the countries ranked unintentional injuries among policy makers’ top five concerns. Approximately half of the countries reported having a national injury prevention strategy, injury prevention coordinator, or consultative group. Virtually all countries with national strategies and consultative groups had established them in the 1990s, suggesting that concern about injuries is both recent and growing. Three-fourths (74%) reported that their country had a surveillance system to monitor injury-related mortality and, to a lesser extent, morbidity. The study’s results suggest that most policies and programs for the prevention and control of unintentional injuries have been developed in the past 10 years, and primarily address motor vehicle injuries. It is essential that current efforts be both broadened and strengthened so that the societal burden of unintentional injuries in the Americas can be reduced.     

Promotion and Prevention Contracts in Industry Level Firm to Firm Dyad

ABSTRACT

Purpose

This article aims to introduce and distinguish two features of contract design – prevention and promotion contracts – and compares their effects on opportunism within the distributor–supplier relationship. It also examines the moderating role of ex post contract enforcement strategies.     

Design and construction of an Unintentional Injury Risk Index (UIRI) to measure frequency and severity of accidental injuries in Europe

ABSTRACT

In today's Risk Society, accidental injuries are considered an important public health problem. To design coherent programmes aimed at reducing risk, it is necessary to measure the magnitude of this phenomenon with its changing meaning –from random misfortune to foreseeable and preventable risk. To calculate the total volume of accidental injuries in Europe, the empirical aim of this article, we have designed an adequate measurement instrument: the Unintentional Injury Risk Index (UIRI) counts both the probability (incidence) and the consequences (severity) of injuries. The index calculated for EU countries in 2009 revealed that accidents caused injuries and suffering equivalent to 96.4 deaths per 100,000 population. Based on the index, other specific indices can be calculated, such as personal proneness, country risk or site hazard indices, useful for deepening knowledge on the risk factors for unintentional injuries.