Epidemiology of occupational acute traumatic hand injuries: a literature review

The purpose of this review was to summarize the literature on occupational, acute, traumatic hand injury and suggest directions for future research. In 1996, the leading occupational injury treated in United States' hospital emergency departments was an acute hand injury (e.g. laceration, crush or fracture). These injuries affected 30% of an estimated 3.3 million injured workers (990,000). Cuts and lacerations of the fingers ranked third after back and leg strains in the number of lost workday cases in the USA in 1994. The incidence rate of hand injuries studied in seven manufacturing environments around the world ranged from 4 to 11 per 100 workers per year. Workers aged 24 years or less had the highest risk of hand injury. Men had higher rates of severe hand injury than women.Despite the high frequency and significant amount of lost work time associated with these injuries, they are poorly understood from an etiological perspective. There is only one case-control study of occupational hand injury in the literature. That study suggested an important role for both fixed (age) and transient risk factors (doing an unusual task) at the time of the injury. More analytic epidemiological research is needed to identify potentially modifiable risk or protective factors (e.g. glove use) for acute hand injuries. In this regard, the case-crossover design, a relatively new epidemiological approach using cases as their own controls, could prove an efficient method for determining transient, modifiable risk factors for acute, occupational hand injury.     

Computational investigation of the effects of knee airbag design on the interaction with occupant lower extremity in frontal and oblique impacts

Objective: The lower extremity of the occupant represents the most frequently injured body region in motor vehicle crashes. Knee airbags (KABs) have been implemented as a potential countermeasure to reduce lower extremity injuries. Despite the increasing prevalence of KABs in vehicles, the biomechanical interaction of the human lower extremity with the KAB has not been well characterized. This study uses computational models of the human body and KABs to explore how KAB design may influence the impact response of the occupant's lower extremities.

Methods: The analysis was conducted using a 50th percentile male occupant human body model with deployed KABs in a simplified vehicle interior. The 2 common KAB design types, bottom-deploy KAB (BKAB) and rear-deploy KAB (RKAB), were both included. A state-of-the-art airbag modeling technique, the corpuscular particle method, was adopted to represent the deployment dynamics of the unfolding airbags. Validation of the environment model was performed based on previously reported test results. The kinematic responses of the occupant lower extremities were compared under both KAB designs, 2 seating configurations (in-position and out-of-position), and 3 loading conditions (static, frontal, and oblique impacts). A linear statistical model was used to assess factor significance considering the impact responses of the occupant lower extremities.

Results: The presence of a KAB had a significant influence on the lower extremity kinematics compared to no KAB (P <.05) by providing early restraint and distributing contact force on the legs during airbag deployment. For in-position occupants, the KAB generally tended to decrease tibia loadings. The RKAB led to greater lateral motion of the legs compared to the BKAB, resulting in higher lateral displacement at the knee joint and abduction angle change (51.2 ± 21.7 mm and 15° ± 6.0°) over the dynamic loading conditions. Change in the seating position led to a significant difference in occupant kinematic and kinetic parameters (P <.05). For the out-of-position (forward-seated) occupant, the earlier contact between the lower extremity and the deploying KAB resulted in 28.4° ± 5.8° greater abduction, regardless of crash scenarios. Both KAB types reduced the axial force in the femur relative to no KAB. Overall, the out-of-position occupant sustained a raised axial force and bending moment of the tibia by 0.8 ± 0.2 kN and 21.1 ± 8.7 Nm regardless of restraint use.

Conclusions: The current study provided a preliminary computational examination on KAB designs based on a limited set of configurations in an idealized vehicle interior. Results suggested that the BKAB tended to provide more coverage and less leg abduction compared to the RKAB in oblique impact and/or the selected out-of-position scenario. An out-of-position occupant was associated with larger abduction and lower extremity loads over all occupant configurations. Further investigations are recommended to obtain a full understanding of the KAB performance in a more realistic vehicle environment.     

2016冬季京津冀一次持续重度霾天气过程分析

2016年12月16~21日我国京津冀地区发生了一次持续重度霾天气过程.为了进一步加深对霾的认识和提高对霾的分析预报能力,利用多种资料,对此次重度霾天气过程的环流背景和气象要素等进行了综合性分析.结果表明,此次过程持续时间长,污染强度大,影响范围广,能见度低,以外来输送为主,气溶胶主要分布在600 m以下高度,有一定的极端异常性,静稳天气指数与空气质量指数有较好的对应关系;京津冀地区高空受高压脊前的纬向环流控制,维持偏西气流,冷空气活动弱,以下沉气流为主,水汽含量较低,高空云量较少,低空有暖脊北伸,地面位于高压东南部,受均压场控制,气压梯度较小,受偏南风影响,污染物易于堆积;地面静小风,相对湿度较高,混合层高度较低,不利于污染物的水平和垂直扩散.     

Experimental Verification of the Computerized Method for Work Space Optimization in Conditions of Static Work

The aim of this study was to verify a theoretical model for upper extremity work space optimization. In order to do that, experimental studies were conducted in which two parameters of the electromyography (EMG) signal were analyzed: AMP (amplitude calculated as Root Mean Square) and SZC (coefficient of the slope of the regression line between time and Zero Crossing values). Values of forces in muscles (parameter MOD) were calculated from theoretical studies. A comparison of experimental (AMP, SZC) and theoretical (MOD) parameters was performed by analyzing the coefficient of correlation between those parameters and differentiation of muscular load according to external load value. Analysis showed that the theoretical and experimental results are in step, which means that the developed model can be used for upper extremity work space optimization.     

Small Female Upper Extremity Interaction with a Deploying Side Air Bag

This paper presents a study characterizing the interaction between a deploying side air bag and a small female upper extremity. The results are based on twelve tests with small female cadavers, and fifteen tests with the instrumented SAE 5th percentile female upper extremity attached to the 5th percentile Hybrid III female dummy. The upper extremity was loaded by a deploying seat mounted thoracic side air bag in a static test environment. Three inflators were used that varied in peak pressure and pressure onset rate. Despite kinematic differences between the dummy and cadaver, the moments recorded in the cadaver and dummy were similar. Chondral and osteochondral fractures in the cadaver elbow joints were identified in seven of the twelve cadaver tests, while a simple fracture of the distal humerus head was observed in one test. A linear logistic regression analysis was performed to correlate occurrence of recorded injury and the test parameters. Injury risk functions were constructed using age, forearm acceleration, elbow moment, and air bag inflator level as variables.     

Achondrogenesis type II with normally developed extremities: a case report

We present a case of achondrogenesis type II with normally developed extremities that was confirmed with postmortem ultrasonographic and radiographic examination. The length of the long bones may vary and the diagnosis of achondrogenesis should not be ruled out with normally developed extremities. Intrauterine sonographic examination of the vertebrae is very important and the absence of vertebral body ossification may be the unique finding of achondrogenesis type II. Axial ultrasonographic images and postmortem plain radiographs are useful to clarify the pathology. Copyright © 2002 John Wiley & Sons, Ltd.     

Simulator study of young driver's instinctive response of lower extremity to a collision

Objective: A driver's instinctive response of the lower extremity in braking movement consists of two parts, including reaction time and braking reaction behavior. It is critical to consider these two components when conducting studies concerning driver's brake movement intention and injury analysis. The purposes of this study were to investigate the driver reaction time to an oncoming collision and muscle activation of lower extremity muscles at the collision moment. The ultimate goal is to provide data that aid in both the optimization of intervention time of an active safety system and the improvement of precise protection performance of a passive safety system.

Method: A simulated collision scene was constructed in a driving simulator, and 40 young volunteers (20 male and 20 female) were recruited for tests. Vehicle control parameters and electromyography characteristics of eight muscles of the lower extremity were recorded. The driver reaction time was divided into pre-motor time (PMT) and muscle activation time (MAT). Muscle activation level (A_COL) at the collision moment was calculated and analysed.

Results: PMT was shortest for the tibialis anterior (TA) muscle (243～317 ms for male and 278～438 ms for female). Average MAT of the TA ranged from 28-55 ms. A_COL was large (5～31% for male and 5～23% for female) at 50 km/h, but small (<12%) at 100 km/h. A_COL of the gluteus maximus was smallest (<3%) in the 25 and 100 km/h tests. A_COL of RF of men was significantly smaller than that of women at different speeds.

Conclusions: Ankle dorsiflexion is firstly activated at the beginning of the emergency brake motion. Males showed stronger reaction ability than females, as suggested by male's shorter PMT. The detection of driver's brake intention is upwards of 55ms sooner after introducing the electromyography. Muscle activation of the lower extremity is an important factor for 50 km/h collision injury analysis. For higher speed collisions, this might not be a major factor. The activations of certain muscles may be ignored for crash injury analysis at certain speeds, such as gluteus maximus at 25 or 100 km/h. Furthermore, the activation of certain muscles should be differentiated between males and females during injury analysis.     

Can new passenger cars reduce pedestrian lower extremity injury? A review of geometrical changes of front-end design before and after regulatory efforts

Objective: Pedestrian lower extremity represents the most frequently injured body region in car-to-pedestrian accidents. The European Directive concerning pedestrian safety was established in 2003 for evaluating pedestrian protection performance of car models. However, design changes have not been quantified since then. The goal of this study was to investigate front-end profiles of representative passenger car models and the potential influence on pedestrian lower extremity injury risk.

Methods: The front-end styling of sedans and sport utility vehicles (SUV) released from 2008 to 2011 was characterized by the geometrical parameters related to pedestrian safety and compared to representative car models before 2003. The influence of geometrical design change on the resultant risk of injury to pedestrian lower extremity—that is, knee ligament rupture and long bone fracture—was estimated by a previously developed assessment tool assuming identical structural stiffness. Based on response surface generated from simulation results of a human body model (HBM), the tool provided kinematic and kinetic responses of pedestrian lower extremity resulted from a given car's front-end design.

Results: Newer passenger cars exhibited a “flatter” front-end design. The median value of the sedan models provided 87.5 mm less bottom depth, and the SUV models exhibited 94.7 mm less bottom depth. In the lateral impact configuration similar to that in the regulatory test methods, these geometrical changes tend to reduce the injury risk of human knee ligament rupture by 36.6 and 39.6% based on computational approximation. The geometrical changes did not significantly influence the long bone fracture risk.

Conclusions: The present study reviewed the geometrical changes in car front-ends along with regulatory concerns regarding pedestrian safety. A preliminary quantitative benefit of the lower extremity injury reduction was estimated based on these geometrical features. Further investigation is recommended on the structural changes and inclusion of more accident scenarios.