Restraint use and seating position among children less than 13 years of age: Is it still a problem?

Introduction

The purpose of this study was to calculate national estimates and examine the extent to which children prematurely use adult seat belts and ride in the front seat of a vehicle during a 30 day period.

Methods

Data were obtained from a nationally representative cross-sectional random-digit-dial telephone survey that included child-specific questions on motor vehicle restraint use and seating position.

Results

Among children less than 13 years, parents reported an estimated 618,337 who rode unrestrained and more than one million who rode in the front seat of a vehicle at least some of the time in the past 30 days. During the same time period, close to 11 million children 8 years and younger reportedly used only adult seat belts.

Discussion

Our results highlight the need for continued outreach to parents regarding optimal restraint use and rear seating position for children every trip, every time.     

The contribution of traumatic brain injury to the medical and economic outcomes of motor vehicle-related injuries in Ohio

Objective

To describe traumatic brain injury (TBI) among injured roadway users. Aim 1 assessed the association of age, gender, alcohol/drug use, safety equipment use, type of roadway user, metropolitan area, and primary payer with motor vehicle-related TBI outcome. Aim 2 assessed the relationship of motor vehicle-related TBI and risk/protective factors with medical and economic outcomes.

Methods

Population-level hospital and trauma databases from the Ohio Hospital Association and Ohio Department of Public Safety, respectively, were probabilistically linked for 2003 through 2006. Injured roadway users (motor vehicle occupants, motorcyclists, bicyclists, pedestrians, and others) were assessed for TBI, ventilator use, intensive care unit (ICU) admission, injury severity score (ISS), need for rehabilitation, death, and total hospital charges.

Results

The odds of a motor vehicle-related TBI were greater among those not using safety equipment (OR = 1.56). The interactions of alcohol/drug use by gender and of alcohol/drug use by location were significant. Sustaining a TBI increased the odds of requiring ventilation (OR = 3.66), being admitted to the ICU (OR = 2.51), having a high ISS (OR = 4.24), requiring rehabilitation (OR = 2.22), or death (OR = 2.52). When compared with a non-TBI, total hospital charges increased by a factor of 1.35 for a TBI. Hospital charges were $46,441 on average for individuals who sustained a TBI, whereas mean hospital charges were $32,614 for patients with a non-TBI.

Conclusions

Among injured roadway users, individuals who sustain a TBI are more likely to require extensive medical care and have injuries resulting in death.

Impact on industry

Prevention strategies aimed at reducing alcohol use and increasing safety device use should be encouraged to reduce the burden of TBI.     

Implied-consent laws: A review of the literature and examination of current problems and related statutes

Problem

A substantial proportion of drivers arrested for DUI refuse the BAC test, thereby reducing the likelihood that they will be convicted and potentially increasing the number of high-risk multiple offenders contributing to alcohol-related crashes.

Method

This paper reviews the information on the current status of implied-consent laws (which impose a sanction on offenders who refuse the BAC test) in the 50 states and the other relevant traffic safety laws and policies that may influence state refusal rates.

Results

Although there appears to be only a weak relationship between state refusal rates and crash rates, there is strong evidence that BAC test refusals significantly compromise the arrest, prosecution, and sentencing of DUI suspects and the overall enforcement of DUI laws in the United States.

Discussion

Laws and policies that may reduce the number of refusals are discussed.

Impact on industry

Alcohol-related crash injuries are an important cost problem for U.S. industry because of property damage from crashes, crash injuries to employees that raise health costs, or the reduction of time on the job resulting from a highway injury.     

Needle stick and sharps injuries among health care workers in Gondar city, Ethiopia

Background

All employees in health care settings handling needles or other sharps are at risk for needle stick and sharps injuries (NSSIs). Health care workers in under developed countries are at greater risk of infection from blood borne pathogens because of the lack of safety devices and the high prevalence of these pathogens.

Objectives

The aim of this study was to assess the prevalence of NSSIs and associated factors among health care workers in government health institutions in Gondar city, Ethiopia.

Methods

Institution based cross sectional study was conducted from May-December, 2010. The study included 344 health care workers who were selected from the source population using simple random sampling technique. Data were collected through interviews using structured and pre-tested questionnaire and the collected data were entered and analyzed using SPSS version 16.0.

Results

The prevalence of NSSIs among health care workers in the preceding 12 months was 106 (30.8%), of which 58 (54.7%) was reported by females. Lack of training on occupational health and safety, working more than 48 h/week, dissatisfaction with work environment and work culture, greater than 10 years of work experience and having low and moderate perception of risk were found to be significantly associated with NSSIs.

Conclusion

The study found high prevalence of NSSIs among health care workers. Effective training, ongoing awareness on the risk of hazards, preventive measures such as engineering control, and post-exposure prophylaxis following NSSIs are essential to reduce the risk of such injuries.     

Tracking the prevalence of rollover protective structures on U.S. farm tractors: 1993, 2001, and 2004

Problem

Between 1992 and 2005, 1412 workers on farms died from tractor overturns. A Rollover Protective Structure (ROPS) is a proven intervention to reduce overturn deaths. However, farm characteristics that are associated with the adoption of ROPS are not well understood.

Methods

ROPS prevalence statistics were derived from National Institute for Occupational Safety and Health (NIOSH) surveys that tracked ROPS use on farms. Data were from the years 1993, 2001, and 2004.

Results

In 1993, 38% of tractors were equipped with ROPS. This increased to 51% by 2004. ROPS prevalence rates were higher on farms in the Southern region of the United States, on farms where the operator was 25-34 years old, and on farms with $100,000 or more of farm sales. Low ROPS prevalence rates were associated with farm operators 65 years old or older and with farms with less than $10,000 of farm product sales.

Summary

The increase in ROPS prevalence between 1993 and 2004 has not been sufficient to decrease the rate of tractor overturn deaths on farms. Incentive programs targeting older farm operators and low-income farm operations are suggested to increase ROPS use on tractors.

Impact on Industry

The study provides farm characteristics associated with low ROPS prevalence rates. The results can be used to target farms for future ROPS promotion activities.     

Whole-body vibration knowledge survey of U.S. occupational safety and health professionals

Problem

Whole-body vibration (WBV) is an occupational issue of concern due to adverse health effects or simple discomfort and annoyance. Unlike in Europe, WBV is an emerging topic in the U.S. safety and health (S&H) professional community. We hypothesized that at least one-half of the U.S. occupational S&H professionals knew little or nothing about WBV.

Method

We conducted a cross-sectional study (survey) of WBV knowledge among members of the American Society of Safety Engineers. A Likert scale (1-none to 5-expert) was used to determine WBV topic knowledge levels (KL_1-5).

Results

Analysis of 2,764 responses revealed that 69.5% of the participants self-reported a less than basic WBV understanding. The WBV KL_1-5 mean for all participants was 1.94 ± 1.00, corresponding to an awareness of WBV without a depth of understanding.

Summary

Many at-risk U.S. workers may not be supported by occupational S&H professionals with adequate WBV knowledge.

Impact on Industry

A significant number of U.S. workers may be exposed to unhealthy levels of whole-body vibration. However, the U.S. occupational safety and health community is generally unprepared to anticipate, monitor, and control the whole-body vibration hazard.     

An economic evaluation of a participatory ergonomics process in an auto parts manufacturer

Problem

We assess the costs and consequences of a participatory ergonomics process at a Canadian car parts manufacturer from the perspective of the firm.

Method

Regression modeling was used with interrupted time series data to assess the impact of the process on several health measures. Consequences were kept in natural units for cost-effectiveness analysis, and translated into monetary units for cost-benefit analysis.

Results

The duration of disability insurance claims and the number of denied workers' compensation claims was significantly reduced. The cost-effectiveness ratio is $12.06 per disability day averted. The net present value is $244,416 for a 23-month period with a benefit-to-cost ratio of 10.6, suggesting that the process was worth undertaking (monetary units in 2001 Canadian dollars).

Discussion

Our findings emphasize the importance of considering a range of outcomes when evaluating an occupational health and safety intervention.

Impact on industry

Participatory ergonomics process can be cost-effective for a firm.     

Trends and characteristics of animal-vehicle collisions in the United States

Introduction

Since 1990, fatal animal-vehicle collisions (AVCs) in the United States have more than doubled. This paper examines annual AVC trends in the United States over a 19-year period, seasonal and diurnal patterns of AVC risk, the geographic distribution of crash risk by state, and the association between posted speed limit and AVC crash risk in darkness.

Method

AVCs were compiled from the Fatality Analysis Reporting System (FARS) and the General Estimates System (GES) for the years 1990-2008 to examine annual crash trends for fatal and nonfatal crashes. Seasonal trends for fatal AVCs were examined with the aggregated FARS dataset; seasonal trends for fatal and nonfatal AVCs were also examined by aggregating four years of Michigan crash data. State-by-state distributions of fatal AVCs were also described with the aggregated FARS dataset. Finally, the relationship between posted speed limit and the odds that a fatal or nonfatal AVC occurred in darkness were examined with logistic regressions using the aggregated FARS and Michigan datasets.

Results

Between 1990 and 2008, fatal AVCs increased by 104% and by 1.3 crashes per trillion vehicle miles travelled per year. Although not all AVCs involve deer, daily and seasonal AVC crash trends follow the general activity pattern of deer populations, consistent with prior reports. The odds that a fatal AVC occurred in darkness were also found to increase by 2.3% for each mile-per-hour increase in speed; a similar, albeit smaller, effect was also observed in the aggregated Michigan dataset, among nonfatal crashes.

Conclusion

AVCs represent a small but increasing share of crashes in the United States. Seasonal and daily variation in the pattern of AVCs seem to follow variation in deer exposure and ambient light level. Finally, the relative risk that a fatal and nonfatal AVC occurred in darkness is influenced by posted speed limit, suggesting that a driver's limited forward vision at night plays a role in AVCs, as it does in pedestrian collisions.

Impact on Industry

The association between speed limit and crash risk in darkness suggests that AVC risk might be reduced with countermeasures that improve a driver's forward view of the road.     

Dissociation between driving performance and drivers' subjective estimates of performance and workload in dual-task conditions

Introduction

The current study measured how concurrent driving and in-vehicle activities of different levels of engagement varied in terms of performance and subjective estimates of demand and performance.

Method

In this test track study, 41 younger and older drivers completed a series of cognitive tasks while driving an instrumented vehicle. One task involved an engaging guessing game where drivers tried to guess the identity of an object. The other task involved a simple mental arithmetic task.

Results

We observed some dissociation between drivers' performance and their subjective reports. For instance, drivers tended to estimate their performance as better for the more engaging guessing task than the arithmetic task, though their performance was actually worse. At the same time, subjective estimates of workload across the two tasks did not vary in the dual-task condition even though they did in the single-task baseline conditions, suggesting that drivers failed to account for the added demands in dual-task situations.

Conclusions

We discuss the implications of these findings for driver safety.

Impact on Industry

Crashes due to distraction can carry tremendous costs for employers, in terms of injury, disability, and loss of potentially productive work years, whether these crashes occur on or off the job.     

Effect of enhanced seat belt reminders on driver fatality risk

Objective

Enhanced seat belt reminders in automobiles have been shown to increase belt use rates by approximately 3 percentage points. The objective of this study was to estimate the effect of enhanced seat belt reminders on driver fatality risk.

Method

Data included all passenger vehicle driver deaths and vehicle registration counts in the United States for calendar years 2000-2007. Driver fatality rates per vehicle registration per year were compared for otherwise identical vehicle models with and without enhanced seat belt reminders.

Results

Driver fatality rates were 6% lower for vehicles with enhanced seat belt reminders compared with vehicles without enhanced belt reminders. After adjusting for vehicle age differences, the estimated effect of enhanced belt reminders on driver fatality risk ranged from a 9% reduction for General Motors vehicles to a 2% increase for Honda vehicles. Combining all manufacturers, enhanced belt reminders reduced fatality risk by approximately 2%. Although not statistically significant, the 2% reduction in fatality risk agrees with what should be expected from a 3 percentage point increase in seat belt use rates.

Conclusions

Enhanced seat belt reminders have raised driver belt use rates and reduced fatality rates, but more aggressive systems may be needed for some drivers. It can be inferred that nonfatal injury rates also have been reduced.

Impact on Industry

Manufacturers should be encouraged to put enhanced seat belt reminders on all vehicles as soon as possible.     

Television news' coverage of motor-vehicle crashes

Problem

Traffic crashes are a major cause of injury and death. Although it has been argued that a skewed estimation of personal risks may be partly attributable to news representations of mortality causes, the manners in which traffic crashes are covered in the news have not received much attention in the literature.

Method

The current study used content analysis to examine the framing of traffic crashes in television news.

Results

The data indicated that Flemish television news does not report traffic crashes from a public health perspective and consequently it misses opportunities to inform the public on the causes and consequences of risk-taking in traffic.

Impact on industry

It is important that professionals are aware of these findings and stress contextual factors surrounding traffic crashes in their communication with journalists. This may lead to more accurate reports and a more accurate risk perception of viewers.     

Hepatitis B virus infection among health care workers in Public Teaching Hospitals in Khartoum State, Sudan

Background

Hepatitis B virus (HBV) infection is a global public health problem. It is estimated that there are more than 300 million HBV carriers in the world.

Aim

The study aimed to examine the sero-prevalence of hepatitis B virus (HBV) markers among health care workers (HCWs) in Public Teaching Hospitals in Khartoum State, in the year 2004.

Methods

The study is an observational, cross sectional, facility-based study. It was conducted on stratified two-stage cluster random sample of 843 subjects. The study followed non-parametric statistical methods, using Z-test for single proportion.

Results

Among the 843 subjects tested for all HBV markers (Anti-HBc, HBsAg, HBsAb, and HBeAg), the prevalence of Anti-HBc, HBsAg, HBsAb, and HBeAg was found to be 57% (CI 95%:53-60%), 6% (CI 95%:4.0-8.0%), 37% (CI 95%:34-40%) and 9% (CI 95%:7-11%) respectively. P < 0.05.

Conclusion

Seroprevalence of all HBV markers (P < 0.05) was found to be significantly high, while the rate of immunity against HBV infection was low among health care workers In Public Teaching Hospitals in Khartoum State, Sudan.     

Increasing self-awareness among older drivers: The role of self-screening

Introduction

Self-screening by older drivers has shown considerable promise for increasing self-awareness about functional abilities associated with safe driving. The purpose of this study was to improve upon existing self-screening instruments by focusing entirely on “health concerns” that affect driving - that is, the symptoms that people experience due to medical conditions and the medications used to treat them - rather than the medical conditions or medications themselves.

Method

A computer-based, easy-to-use self-screening instrument for older drivers was developed to provide individualized feedback intended to increase self-awareness about declines in driving-related abilities, as well as suggestions for behavioral changes or safety tips to maintain safe driving, further evaluation from a physician/health professional, and vehicle modifications to help compensate for driving-related declines.

Results

This paper describes the development of the self-screening instrument and summarizes findings relative to increasing self-awareness among older drivers. This research represents an important first step in improving self-awareness among older drivers through self-screening.     

Bystander injury evaluation of children from midwestern agricultural operations

Background

With more than a million youth living on agricultural operations, it is important for parents to understand the consequences of bystander injuries that children experience in these environments. We identified the childhood injuries for bystander status and compared the severity of these injuries to the working children in the Regional Rural Injury Study-II (RRIS-II).

Methods

RRIS-II followed 16,546 children (∼ 85% of eligible) from rural communities in the Midwest for two six-month recall periods in 1999 and 2001. Demographic, injury, and exposure data were collected through comprehensive computer-assisted telephone interviews. Child injuries were cataloged using narrative scenarios into four categories: (a) directly work-related; (b) indirectly work-related; (c) non-working accomplice; and (d) non-working attendant; the latter three all being bystander categories. Poisson regression modeling was used to calculate rates of bystander injuries. Frequencies were used for comparison of severity measures.

Results

Among the 463 child injuries (aged < 20 yrs), 102 were bystander injuries. Of the bystander-related injuries, 14 were identified as indirectly work-related (working bystanders), 27 as non-working accomplice (passengers/tag-alongs), and 60 as non-working attendant (playing on the operation). The overall rate of bystander injuries was 6.4 per 1,000 people, 95% CI (5.0, 8.1). Males, compared with females, had more than twice the injury rate (8.7; 95% CI 6.4-11.8, and 3.9; 95% CI 2.7-5.7, per 1,000 people, respectively). Bystanders in this population had more severe injuries with 4% having life-threatening circumstances; of these, 4% of the accomplices and 2% of the attendants subsequently died.

Conclusions

Children who live or work on agricultural operations are vulnerable to many hazards. Therefore, this study examined child injuries and found a clear difference in the consequences of these injuries between working-related and bystanding-related injuries.

Impact on Industry

Unlike occupations such as construction and mining, where laws and organizations have been created for the protection of bystanders, agricultural bystanders have remained unprotected and have had to face the consequent injury and death outcomes. As public health professionals considering these risks, it is necessary that we work to develop more intervention studies and continue to propose suggestive guidelines for child safety in these environments so as to challenge family traditions and possibly spark public policies that will give further protection to this population.     

What vehicle features are considered important when buying an automobile? An examination of driver preferences by age and gender

Introduction

Certain vehicle features can help drivers avoid collisions and/or protect occupants in the event of a crash, and therefore, might play an important role when deciding which vehicle to purchase. The objective of this study was to examine the importance attributed to key vehicle features (including safety) that drivers consider when buying a car and its association with age and gender.

Methods

A sample of 2,002 Canadian drivers aged 18 years and older completed a survey that asked them to rank the importance of eight vehicle features if they were to purchase a vehicle (storage, mileage, safety, price, comfort, performance, design, and reliability). ANOVA tests were performed to: (a) determine if there were differences in the level of importance between features and; (b) examine the effect of age and gender on the importance attributed to these features.

Results

Of the features examined, safety and reliability were the most highly rated in terms of importance, whereas design and performance had the lowest rating. Differences in safety and performance across age groups were dependent on gender. This effect was most evident in the youngest and oldest age groups.

Conclusions

Safety and reliability were considered the most important features. Age and gender play a significant role in explaining the importance of certain features.

Impact on Industry

Targeted efforts for translating safety-related information to the youngest and oldest consumers should be emphasized due to their high collision, injury, and fatality rates.     

A classification tree based modeling approach for segment related crashes on multilane highways

Introduction

This study presents a classification tree based alternative to crash frequency analysis for analyzing crashes on mid-block segments of multilane arterials.

Method

The traditional approach of modeling counts of crashes that occur over a period of time works well for intersection crashes where each intersection itself provides a well-defined unit over which to aggregate the crash data. However, in the case of mid-block segments the crash frequency based approach requires segmentation of the arterial corridor into segments of arbitrary lengths. In this study we have used random samples of time, day of week, and location (i.e., milepost) combinations and compared them with the sample of crashes from the same arterial corridor. For crash and non-crash cases, geometric design/roadside and traffic characteristics were derived based on their milepost locations. The variables used in the analysis are non-event specific and therefore more relevant for roadway safety feature improvement programs. First classification tree model is a model comparing all crashes with the non-crash data and then four groups of crashes (rear-end, lane-change related, pedestrian, and single-vehicle/off-road crashes) are separately compared to the non-crash cases. The classification tree models provide a list of significant variables as well as a measure to classify crash from non-crash cases. ADT along with time of day/day of week are significantly related to all crash types with different groups of crashes being more likely to occur at different times.

Conclusions

From the classification performance of different models it was apparent that using non-event specific information may not be suitable for single vehicle/off-road crashes.

Impact on Industry

The study provides the safety analysis community an additional tool to assess safety without having to aggregate the corridor crash data over arbitrary segment lengths.     

Coverage of motor vehicle crashes with injuries in U.S. newspapers, 1999-2002

Problem

The aims of the study were to evaluate information on motor-vehicle crashes with injuries provided in newspaper reports and to assess the frequency of thematic and episodic reporting of motor-vehicle crashes.

Method

The study used Fatal Analysis Reporting System (FARS) derived variables to code a nationally representative sample of U.S. newspaper reports of motor-vehicle crashes from 1999-2002. A total of 473 newspaper reports of motor-vehicle crashes with injuries were included. Information on the crash event, people involved, and vehicles was extracted. The reports were coded for episodic and thematic news framing.

Results

A majority of newspaper reports used episodic framing. The majority of reports included information on the type of crash, but characteristics about people and vehicles were rarely reported.

Discussion

Lack of information in newspapers makes them an incomplete source from which to influence public perceptions and attitudes.

Impact on industry

This provides an opportunity for news print media to improve public health content.

Impact on industry

Newspapers represent an important source of public information; they are, however, an incomplete source [Voight, B., Lapidus, G., Zavoski, R., & Banco, L. (1998). Injury reporting in Connecticut newspapers. Injury Prevention, 4, 292-294.; Baullinger, J., Quan, L., Bennett, E., Cummings, P., & Williams, K. (2001). Use of Washington state newspaper for submersion injury surveillance. Injury Prevention, 7, 339-342]. To increase the accuracy of information provided to the public through media sources, there is a need for increased communication between public health professionals and reporters.The results of this study raise concerns about the contents of motor-vehicle crash information provided in newspapers and suggest that newspapers do not provide information to allow public perception to be in accord with the importance of motor-vehicle crash injuries and health promoting actions to reduce risk of injury. More balanced and detailed information in newspapers would provide an opportunity for news print media to improve public health programs and public perception about the impact of motor-vehicle crashes on safety for all.     

Differences in urban and rural accident characteristics and medical service utilization for traffic fatalities in less-motorized societies

Introduction

Fatalities from traffic accidents in less-motorized societies are an important global issue. We aimed to characterize the geographic differences of fatalities in such societies to facilitate the development of targeted interventions.

Method

This study linked police reports, hospital data, and vital registration data from Taiwan with special reference to accident factors in pre-hospital deaths and medical care in hospital deaths.

Results

A higher percentage of pre-hospital deaths were observed following rural as compared to urban traffic accidents. The deaths due to rural accidents can be attributed to lower use of restraints (i.e., helmets or seat belts), lower percentage of motorcyclists, and more highway accidents. A higher percentage of victims in rural accidents were transported to distant medical centers rather than to local hospitals.

Conclusion

Specific interventions, such as intelligent emergency medical systems, campaigns for helmets and seat belt usage, enforcement of helmets and seat belt use, and speed control measures should be targeted to rural areas.

Impact on industry

Cooperation between the vehicle industry and emergency medical providers in rural traffic accident rescue teams may decrease the numbers of deaths in these regions.     

Effect of a nurse back injury prevention intervention on the rate of injury compensation claims

Problem

This study evaluated the effect of introducing a No Lifting policy on back injuries to nurses, across an entire health care system.

Methods

Methods included: analysis of the data for all public health agencies in the Australian state of Victoria; compensation data from the Victorian Workcover Authority; data about workforce and program implementation from a retrospective survey of agencies; longitudinal analysis of standardized workers compensation claim rates for back injuries before, during and after the intervention.

Results

A statistically significant decline in back injury claim rates during implementation contrasted with no statistically significant trends within the periods before and after the intervention. A statistically significant reduction occurred in mean quarterly standard back injury claim incidence rates per 1,000 equivalent fulltime nursing staff (EFTNS), representing a 24% reduction in standard back injury claims/1000 EFTNS.

Discussion

Ergonomics principles encourage changing the work environment to suit the worker. This approach delivered a significant improvement in the immediate term.

Impact of industry

The substantial decline in back injury rates signifies a major improvement in the safety of a critical aspect of the work environment for nurses.