Trauma demography and clinical epidemiology of motorcycle crash–related head injury in a neurosurgery practice in an African developing country

Objective: Though motor vehicle crashes (MVCs) were the main cause of head trauma from road traffic injuries (RTIs), motorcycle crashes (MCCs) are now a major cause of RTI-related head injury (HI) in many developing countries.

Methods: Using a prospective database of HIs from a neurosurgical practice in a sub-Saharan African developing country, a cross-sectional survey was conducted for the trauma demography and clinical epidemiology of this MCC-related HI.

Results: Motorcycle crashes accounted for 57% (473/833) of all RTI-related HIs in this registry. The victims, with a mean age of 33.1 years (SD = 18.3), consisted mainly of males (83.1%), those of low socioeconomic status (>90%), and those aged between 20 and 40 years old (56%). MCCs involved only riders in 114 cases (114/473, 32.1%), of which 69% were motorcycle–motorcycle crashes. The HI was moderate–severe in 50.8%; clinical symptomatology of significant HI included loss of consciousness (92%), anisocoria (35%), Abbreviated Injury Scale head (AIS–head) score > 3 (28%), and CT-Rotterdam score > 3 (30%). Extracranial systemic injury involved the limbs most frequently, with an Injury Severity Score (ISS) >25 in 49%. The fatality rate was 24%.

MCC-related HI among pedestrian victims involved more vulnerable age groups (the young and elderly) but have lower mean ISS compared to motorcycle passengers (mean ISS = 23.5 [11.6] vs. 27.4 [13.0]; 95% confidence interval [CI], 1.27–6.49; P = .004). In addition, compared to a contemporary cohort of MVC-related HIs in our registry, MCC victims were older (mean age 34.8 years [18.0] vs. 30.8 [18.4]; P = .002); had higher proportions of certain extracranial trauma like long bone fractures (71 vs. 29%; P = .02); and suffered fewer surgical brain lesions (25.5 vs. 17.2%; P = .004).

Conclusions: Motorcycle crashes are now a significant threat to the heads, limbs, and lives of vulnerable road users in developing countries.     

OSHA职业伤害与疾病记录和报告机制简介

介绍了OSHA《记录和报告职业伤害与疾病》法规的主要内容,分析了中国引入该法规的益处。     

基于人体皮肤热模型的热防护服评价方法研究

在热防护服热防护性能测试装置基础上,用自行研制的新型耐高温模拟皮肤传感器代替铜片热流计测量通过应急热防护服装面料的热流量,将热流量作为热波皮肤模型边界条件,得到人体皮肤表层下80μm处的温度值,从而得到一定条件下人体真实皮肤达到二级烧伤所需时间,用其评价热防护服用织物的热防护性能,并将热波皮肤模型(TWMBT)的测试值与Pennes模型以及铜片热流计的测试结果进行分析比较。采用热波皮肤模型分析织物层下的"皮肤"防热时间更接近实际皮肤达到二级烧伤时间值,可较为精确的量化织物热防护性能,为应急救援热防护服装的热设计提供理论依据。     

Pedestrian fatalities, Atlanta Metropolitan Statistical Area and United States, 2000-2004

Motor vehicle crashes killed almost 5,000 pedestrians in 2005 in the United States. Pedestrian risk may be higher in areas characterized by urban sprawl. From 2000 to 2004, pedestrian fatality rates declined in the United States, but the Atlanta metropolitan statistical area did not experience the same decline. Pedestrian fatality rates for males, Hispanics, and the 15–34 and 35–54 year age groups were higher in Atlanta than in the United States overall. Pedestrian safety interventions should be targeted to high-risk populations and localized pedestrian settings.     

酸雨与镧对大豆幼苗生长的复合伤害效应研究

为探索酸雨与稀土镧对大豆幼苗生长的复合影响及其内在机制,以重要油粮作物大豆(Glycine max)为材料,研究在模拟酸雨pH分别为3.0、3.5、4.5与稀土镧La(Ⅲ)浓度分别为60、100和300mg·L-1处理下大豆幼苗生长及光合作用的变化.结果表明,相对单一酸雨与镧处理,酸雨与La(Ⅲ)复合处理组中大豆幼苗的生长受抑制程度增大,两者呈协同效应,且pH越低,La(Ⅲ)浓度越高,抑制效应越明显.光合参数的变化规律与生长指标近同,相同处理组各光合参数的降幅不一致,其中最大荧光(Fv/Fm)和叶绿素含量(Chl)的降幅范围分别为9.53%～22.75%和9.14%～24.53%,较净光合速率Pn(22.78%～84.7%)、希尔(Hill)反应速率(15.52%～73.38%)和Mg2+-ATPase活性(14.51%～71.54%)小,表明各光合参数对2个胁迫因子的敏感程度存在差异.进一步相关性分析发现,Pn变化主要受Hill反应速率与Mg2+-ATPase活性的影响,而Chl、Fv/Fm次之.表明酸雨与La(Ⅲ)对植物光合过程各环节的作用机制不同,光合作用受阻是影响植物生长的重要因素之一.     

1900个乡镇工业的工伤职业病医疗保障现状分析

在调查的１９００个乡镇工业企业中,有９．３％ 的企业对职工工伤职业病没有任何保障,其中尤其是个体联户所办企业则高达１５％ 。按行业进行分析,最易发生工伤职业病的各种矿山采选业、建材生产业,能给予报销医疗费的企业占７８．５％ ,部分给予报销的企业占１０．２％ ,不予报销企业占１１．３％ 。从保障程度看,能给予全部报销医疗费的企业仍以乡办企业为最高（９３．２％ ）,其次为村办企业（９０．２％ ）和个体联户所办企业（８８．５％ ）     

Using state administrative data to study nonfatal worker injuries: challenges and opportunities

PROBLEM: Administrative data from states have the potential to capture broader representation of worker injury, facilitating examination of trends, correlates, and patterns. While many states use their workers' compensation (WC) data to document frequency and type of injury, few conduct in-depth examinations of patterns of injury and other etiologies. Administrative data are generally an untapped resource. METHOD: Comparisons are made among four state databases used in a study linking worker injuries and patient outcomes in hospitals and nursing homes. RESULTS: Worker injury data varies in terms of inclusion criteria, variables, and coding schemes used. Linkages to organizational level characteristics can be difficult. CONCLUSIONS: Despite limitations, data can be used to study injury patterns and etiologies. Users must be knowledgeable and recognize how database characteristics may influence results.     

Adolescent driver risk taking and driver education: evidence of a mobility bias in public policymaking

PROBLEM: Road traffic injury is the leading cause of death among adolescents in high-income countries. Researchers attribute this threat to driver risk taking, which driver education (DE) attempts to reduce. Many North American authorities grant DE graduates earlier access to unsupervised driving despite no evidence of this being a safety benefit. This theoretical article examines risk taking and DE in relation to an apparent mobility bias (MB) in policymaking. METHOD: The MB is defined, the history and sources of driver risk taking are examined, and the failure of DE to reduce collision risk is analyzed in relation to a potential MB in licensing policies. DISCUSSION: The author argues that DE's failure to reduce adolescent collision risk is associated with a MB that has produced insufficient research into DE programs and that influences public policymakers to grant earlier licensure to DE graduates. Recommendations are made regarding future research on DE and risk taking, coordinated improvements to DE and driver licensing, and a plan to reduce collision risk by encouraging parental supervision after adolescent licensure. IMPACT ON INDUSTRY: Research on adolescent driver risk taking would have direct applications in DE curricula development, driver's license evaluation criteria, graduated licensing (GDL) policies, as well as other aspects of human factor research into the crash-risk problem.     

New Zealand drivers study: developing a methodology for conducting a follow-up study of newly licensed drivers

PROBLEM: In recent years, there has been a significant reduction in traffic crash injury among young people, but they continue to be overrepresented in the traffic crash statistics. To improve this situation, sound scientific evidence is needed to develop effective policies and programs. METHOD: The aim of the proposed study is to provide this evidence by examining early driving and driving-related experiences of newly licensed drivers as they progress through the learner-, restricted-, and full-license stages of the graduated licensing system and to determine the impact of these experiences on subsequent negative traffic-related outcomes (risky driving behavior, injury traffic crashes, noninjury traffic crashes, infringements, convictions). Given the size and complexity of the proposed study, a comprehensive pilot study was undertaken to determine the feasibility of conducting a New Zealand-wide cohort study of newly licensed drivers. RESULTS: This article describes the pilot study process and the methodology that has been developed for the New Zealand-wide study.     

Distractions and the risk of car crash injury: the effect of drivers' age

PROBLEM: Motor-vehicle accidents are one of the major causes of injury in most motorized countries. Driver distractions have been suggested as a contributor to traffic accidents. Moreover, age of the driver seems to have a role in the relationship between distractions and car crashes. But very few studies have investigated the effect of driver's age on this relationship. This exploratory study investigated the association between distractions, both inside and outside the vehicle, and the increased risk of car crash injury among drivers across different ages. METHOD: This study used a case series design to analyze data routinely collected by the NSW police in Australia. A special focus of this study was on how drivers' age affects the risk of car crash injury, which was determined by using a well-documented risk estimation methodology. RESULTS: The results obtained indicated that drivers of all ages, on the whole, are more susceptible to distractions inside the vehicle than distractions coming from outside. Age was shown to affect the relationship between in-vehicle distraction and the risk of car crash injury. A separate analysis was also conducted on hand-held phone usage while driving with results supplementing previous findings reported in the literature. IMPACT TO INDUSTRY: Safety strategies to countermeasure in-vehicle distractions have been suggested and discussed.