A 6-year survey of road traffic accidents in Southwest China: Emphasis on traumatic brain injury

Background: The objective of this study is to provide an up-to-date overview of the patterns of injuries, especially traumatic brain injury (TBI) caused by RTAs and to discuss some of the public health consequences. Methods: A scientific team was established to collect road traffic accidents occurring between 2013 and 2018 in Chongqing, Southwest China. For each accident, the environment-, vehicle-, and person- variables were analyzed and determined. The overall injury distribution and TBI patterns of four types of road users (driver, passenger, motorcyclist and pedestrian) were compared. The environmental and time distribution of accidents with TBI were shown by bar and pie chart. The risks of severe brain injury whether motorcyclist wearing helmets or not were compared and the risk factors of severe TBI in pedestrian were determined by odds ratio analysis. Results: This study enrolled 2131 accidents with 2741 persons of all kind of traffic participants, 1149 of them suffered AIS1+ head injury and 1598(58%) died in 7 days. The most common cause of deaths is due to head injury with 714(85%) and 1266(79%) persons died within 2 hours. Among 423 persons suffered both skull fracture and intracranial injury, 102 (24.1%) have an intracranial injury but no skull fractures, while none of the skull fractures without intracranial injury was found. Besides, motorcyclists without a helmet were at higher risks for all the brain injury categories. The risk of pedestrian suffering severe TBI at an impact speed of more than 70 km/h is 100 times higher than that with an impact speed of less than 40 km/h. Conclusion: It is urgently needed to develop a more reliable brain injury evaluation criterion for better protection of the road users. We believe that strengthening the emergency care to head injury at the scene is the most effective way to reduce traffic fatality.     

Impact of helmet use on traumatic brain injury from road traffic accidents in Cambodia

Objective: Rapid urbanization and motorization without corresponding increases in helmet usage have made traumatic brain injury due to road traffic accidents a major public health crisis in Cambodia. This analysis was conducted to quantify the impact of helmets on severity of injury, neurosurgical indication, and functional outcomes at discharge for motorcycle operators who required hospitalization for a traumatic brain injury following a road traffic accident in Cambodia.

Methods: The medical records of 491 motorcycle operators who presented to a major tertiary care center in Cambodia with traumatic brain injury were retrospectively analyzed using multivariate logistic regression.

Results: The most common injuries at presentation were contusions (47.0%), epidural hematomas (30.1%), subdural hematomas (27.9%), subarachnoid hemorrhages (12.4%), skull fractures (21.4%), and facial fractures (18.5%). Moderate-to-severe loss of consciousness was present in 36.3% of patients. Not wearing a helmet was associated with an odds ratio of 2.20 (95% confidence interval [CI], 1.15–4.22) for presenting with moderate to severe loss of consciousness compared to helmeted patients. Craniotomy or craniectomy was indicated for evacuation of hematoma in 20.0% of cases, and nonhelmeted patients had 3.21-fold higher odds of requiring neurosurgical intervention (95% CI, 1.25–8.27). Furthermore, lack of helmet usage was associated with 2.72-fold higher odds of discharge with functional deficits (95% CI, 1.14–6.49). In total, 30.1% of patients were discharged with severe functional deficits.

Conclusions: Helmets demonstrate a protective effect and may be an effective public health intervention to significantly reduce the burden of traumatic brain injury in Cambodia and other developing countries with increasing rates of motorization across the world.     

The crash severity impacts of fixed roadside objects

INTRODUCTION: This study analyzes the in-service performance of roadside hardware on the entire urban State Route system in Washington State by developing multivariate statistical models of injury severity in fixed-object crashes using discrete outcome theory. The objective is to provide deeper insight into significant factors that affect crash severities involving fixed roadside objects, through improved statistical efficiency along with disaggregate and multivariate analysis. METHOD: The developed models are multivariate nested logit models of injury severity and they are estimated with statistical efficiency using the method of full information maximum likelihood. RESULTS: The results show that leading ends of guardrails and bridge rails, along with large wooden poles (e.g. trees and utility poles) increase the probability of fatal injury. The face of guardrails is associated with a reduction in the probability of evident injury, and concrete barriers are shown to be associated with a higher probability of lower severities. Other variables included driver characteristics, which showed expected results, validating the model. For example, driving over the speed limit and driving under the influence of alcohol increase the probability of fatal accidents. Drivers that do not use seatbelts are associated with an increase in the probability of more severe injuries, even when an airbag is activated. IMPACT ON INDUSTRY: The presented models show the contribution of guardrail leading ends toward fatal injuries. It is therefore important to use well-designed leading ends and to upgrade badly performing leading ends on guardrails and bridges. The models also indicate the importance of protecting vehicles from crashes with rigid poles and tree stumps, as these are linked with greater severities and fatalities.     

Racial disparities in parent knowledge of concussion and recognition of signs and symptoms

Introduction: Concussion is a type of traumatic brain injury that can be sustained through participation in different sports. It is important that a parent be able to identify common and uncommon symptoms of a concussion to ensure the safety and good health of their child. The purpose of this study was to compare knowledge of concussion scores among White and African American parents and guardians. Methodology: This cross-sectional study consisted of a single survey of 53 questions that was given to parents/guardians of high school athletes at a preseason parent meeting. Parent and guardian knowledge of concussion was assessed through a series of 45 questions. Participants were asked to correctly identify signs and symptoms of concussion, answer questions regarding the anatomy of a concussion (i.e. a concussion is an injury to the brain), answer true/false questions about general concussion knowledge, select from a list the consequences of multiple concussions and select from a list the consequences of returning to play too soon from a concussion. Knowledge of concussion was calculated by summing correct responses for the 45 knowledge questions. Racial differences were calculated using an ANCOVA, controlling for socioeconomic school type. The statistical significance level was set a priori p ≤ 0.05 for all analyses. Results: Participants of this study consisted of 176 [115 (65.3%) White, 61 (34.7%) African American] parents/guardians of high school athletes. Significant differences in knowledge of concussion scores between White parents/guardians [38.50 ± 4.55 (85.6% correct)], and African American parents/guardians [35.15 ± 4.97, 78.1% correct)] were identified (F_(1,172) = 4.82, p = 0.03). Conclusion: Knowledge of concussion disparities exist between African American and White parents/guardians. This disparity could cause complications from concussion to surface among children and adolescents participating in sport as their parents/guardians may not be able to correctly identify the signs and symptoms in order to seek proper medical care. Practical Application: Findings from this study highlight quantitative differences in concussion knowledge of parents from different demographics. These findings underline disparities and inequities in access to concussion-health resources that need to be addressed.     

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.     

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.     

Preventing fall-from-height injuries in construction: Effectiveness of a regulatory training standard

Introduction: A regulatory training standard for construction workers using fall protection equipment became mandatory in 2015 in the province of Ontario, Canada. By the end of the transition period in 2017, 418,000 workers had been trained to the new standard. Two primary research questions were posed: (1) To what extent does the WAH training affect practices at the worksite? and (2) Has there been a change in the incidence of fall-from-height injuries coincident with the introduction of the WAH Training Standard? Materials and methods: A longitudinal survey of 633 learners was conducted in 2017 at one-, four- and seven-week post-training. A quasi-experiment estimated the incidence of lost-time injuries attributed to falls from heights in 2017 compared to 2012–2014 for a census of construction workers insured for work disability in Ontario, Canada. Results: Learners self-reported substantial increases in knowledge of and improvements in safe work practices when working at heights. The incidence rate of lost-time claim injuries attributed to falls targeted by the training declined by 19.6% (95% CI: 10.7, −27.6), compared to corresponding declines of 2.1% (95% CI: −6.3, 9.9) for other fall injuries and 7.2% (95% CI: 1.8, 12.3) for non-fall traumatic injuries. The observed decline was largest among the smallest employers (<5 full-time equivalent employees). Conclusion: The evaluation findings provide consistent support for a conclusion that the mandatory training standard was effective in reducing the incidence of injuries targeted by the training. However, the effects were modest and did not eliminate the problem. Practical application: A mandatory training standard should be considered as one approach to preventing traumatic injuries. However, other approaches higher in the hierarchy of risk controls should also be considered.     

Soccer,concussions, and safety: Perceptions of parents of youth soccer participants

Introduction: The rate of concussions in youth soccer is among the highest of all youth sports. Parents play an important role in caring for their children and making decisions regarding whether they should participate in a sport, such as soccer, where concussions are well known. This study examined parental perceptions regarding: (a) coaches’ role in concussion management, (b) heading restriction policies, and (c) overall concussion risk and participation issues. Method: Online surveys were completed by 419 parents of youth soccer players who participated in the largest U.S. youth soccer programs nationwide. Results: Findings indicated 44.5% of the respondents had considered keeping their children from playing organized soccer and 47.2% were concerned about a potential decline in youth soccer participation due to concussions. Nearly 69% of responding parents agreed that heading should be banned for participants 10 years old or younger, while 56.5% thought heading should not be limited for participants 13 or older. Only 35% of parents were very confident about their child’s coach’s ability to properly identify concussions and remove those suspected of a concussion from play. Parents’ socioeconomic status (SES), soccer coaching and playing experience, and previous history of concussion(s) were key predictors of greater perceived risk about concussions. Conclusions: Findings from this study shed light on parents’ perceptions about concussions and related safety issues in youth soccer. Understanding what parents believe about concussions is vital to preserve youth soccer participation and can be used to strengthen education and policies that promote a safer environment for youth sport participants. Practical Applications: Youth soccer coaches can benefit from stronger, comprehensive educational efforts at the league/club level. Additionally, parents of youth athletes who are in the lower SES communities should be targeted to receive concussion safety information and/or interventions that would improve their knowledge, attitude, and practices regarding concussion safety.     

The Costs and Characteristics of Occupational Injuries Admitted to a Trauma Unit

Abstract

Occupational injuries requiring admission to a trauma unit were examined to outline the events surrounding the injury and to examine the costs. Sixty-nine patients were admitted over a 12-month period, representing 4.30% of all work-related injuries attending the emergency department and 4.25% of all admissions to the trauma unit. Most were male (91%), working in skilled trade occupations (65%), with a mean age of 38.8 years. Personal protective equipment was used only by 46% of injured workers who should have been using it. Sixty-one percent of patients believed that their injury was preventable. Half of the injuries were to the upper limb, fall was the most frequent mechanism (25%) and the median duration of admission was 2 days. The direct hospital costs were estimated at over 300 000 GBP. Failure to use protective equipment and to follow health and safety guidelines suggests that opportunities exist for injury prevention.     

Validation of a booted finite element model of the WIAMan ATD lower limb in component and whole-body vertical loading impacts with an assessment of the boot influence model on response

Objective: A novel anthropomorphic test device (ATD) representative of the 50th percentile male soldier is being developed to predict injuries to a vehicle occupant during an underbody blast (UBB). The main objective of this study was to develop and validate a finite element (FE) model of the ATD lower limb outfitted with a military combat boot and to insert the validated lower limb into a model of the full ATD and simulate vertical loading experiments.

Methods: A Belleville desert combat boot model was assigned contacts and material properties based on previous experiments. The boot model was fit to a previously developed model of the barefoot ATD. Validation was performed through 6 matched pair component tests conducted on the Vertically Accelerated Loads Transfer System (VALTS). The load transfer capabilities of the FE model were assessed along with the force-mitigating properties of the boot. The booted lower limb subassembly was then incorporated into a whole-body model of the ATD. Two whole-body VALTS experiments were simulated to evaluate lower limb performance in the whole body.

Results: The lower limb model accurately predicted axial loads measured at heel, tibia, and knee load cells during matched pair component tests. Forces in booted simulations were compared to unbooted simulations and an amount of mitigation similar to that of experiments was observed. In a whole-body loading environment, the model kinematics match those recorded in experiments. The shape and magnitude of experimental force–time curves were accurately predicted by the model. Correlation between the experiments and simulations was backed up by high objective rating scores for all experiments.

Conclusion: The booted lower limb model is accurate in its ability to articulate and transfer loads similar to the physical dummy in simulated underbody loading experiments. The performance of the model leads to the recommendation to use it appropriately as an alternative to costly ATD experiments.     

The role of sales of new motorcycles in a recent increase in motorcycle mortality rates

INTRODUCTION: The National Highway Traffic Safety Administration (NHTSA) has reported that mortality rates from crashes among motorcycle riders in the United States increased from 21.0 per 100 million motorcycle miles traveled in 1997 to 38.4 per 100 million motorcycle miles traveled in 2003. At the same time, annual domestic sales of new, on-road motorcycles increased from 247,000 in 1997 to 648,000 in 2003. METHOD: This study used data from the NHTSA Fatality Analysis Reporting System and annual sales figures for on-road motorcycles to determine if newer motorcycles were more likely to be involved in fatal crashes and if fatal crashes involving newer motorcycles could account for the mortality increase after 1997. RESULTS: Mortality rates were 7.9, 8.1, 5.4, and 2.9 per 10,000 motorcycles sold for motorcycles <1, 1-3, 4-6, and 7-11 years old, respectively, from 1994 to 2003. Assuming complete registration, the number of motorcycles sold during the 2000-2003 time period accounted for 42.4% of the total number of motorcycles registered in 2003. Motorcycles sold during 2000-2003 were associated with 52.5% of all motorcycle deaths in 2003. The increase in the number of deaths associated with motorcycles less than four years old between 1997 and 2003 accounted for 78.1% of the total increase in motorcyclist deaths over this time period. CONCLUSIONS: Two possible explanations for the association between high sales volumes and mortality rates are: (a) increased exposure from more extensive use of motorcycles when they are new; and (b) inexperience with motorcycle riding or with specific motorcycles. IMPACT ON INDUSTRY: This study suggests that the deaths of growing numbers of motorcyclists are a consequence of the financial success of the motorcycle industry.     

9mm子弹对由芳纶、聚乙烯或铝板保护的尸体头骨产生的动态影响实验研究

本文对防护头盔所使用的复合板设计了两个实验来确定其所产生的伤害程度。实验结论:可优化复合材料制成的防弹头盔来避免大范围瞬时变形,从而减少对头部造成的冲击和钝挫伤。     

Children's behavioral traits and risk of injury: Analyses from a case-control study of agricultural households

Problem

Children on family agricultural operations have high risk of injury. The association between children's behavioral traits and their risk of injury is not well understood.

Method

Data from the Regional Rural Injury Study-II were used to assess behavioral risk factors for injury to children ages six to < 20 years. A total of 379 injury events (cases) and 1,562 randomly selected controls were identified. Adjusted odds ratios (OR) and 95% confidence intervals (CI), calculated using logistic regression, were used to estimate injury risk in reference to behavioral traits.

Results

Injury risks were greater for children with high levels of depressive symptoms (OR = 1.9, CI = 1.0-3.7) and aggression (OR = 1.6, CI = 0.9-2.7), and low levels of careful/cautious behavior (OR = 1.8, CI = 1.1-2.9). Children with low levels of self-regulation had reduced risks (OR = 0.4, CI = 0.2-0.8).

Discussion

Results suggest that children's behaviors affect their risk of agricultural injury. Additional research could elucidate mechanisms and inform interventions.

Impact on industry

The development of multifaceted, sustainable approaches for prevention is necessary for this unique population. These findings suggest a need for interventions that incorporate specific behavior-related risk factors in the context of family farms and ranches.     

Disparities in the prevalence of smoke alarms in U.S. households: Conclusions drawn from published case studies

Introduction

Deaths from fires and burns are a leading cause of fatal home injury in the United States. Smoke alarms are one of the most effective interventions to prevent residential fire deaths. Nationwide, more than 95% of homes are estimated to have at least one smoke alarm. There is evidence that homes at highest risk of fire deaths lag behind national averages in smoke alarm use and maintenance.

Method

We compiled a comprehensive list of published studies that focus on smoke alarm prevalence in high-risk homes. Our findings show that there are substantial gaps in both smoke alarm presence and functional status between high-risk homes and national average estimates.

Conclusions

To save more lives, improved efforts are needed to reduce the disparity in smoke alarm prevalence and functional use in the United States.     

Animal-related injuries: a population-based study of a five-state region in the upper Midwest: Regional Rural Injury Study II

PROBLEM: While agricultural injury has been identified among the major causes of occupational injury mortality and morbidity, data have been limited pertinent to the magnitude, consequences, and potential risk factors for animal-related injuries -- a major source of morbidity among agricultural operations. METHODS: Demographics, exposure, and injury data were collected for 1999 and 2001 among agricultural households in a five-state region. Causal models facilitated survey design, data analyses, and interpretation of results; directed acyclic graphs guided multivariate modeling. RESULTS: From 7,420 households (84% response of eligible), a total of 5,045 injury events were reported; 1,016 (20.1%) were animal-related. Multivariate analyses revealed increased risks for those <20 years; residents of all states compared to Minnesota; all age groups compared to 0-4 years; >0 hours worked; and prior agricultural injury history. For those 20+ years, increased risks were identified for: South Dakota residents; males; >0 hours worked; and prior agricultural injury history. For those cases <20 and 20+ years of age, 58% and 46%, respectively, resulted in lost work time on their agricultural operations (31% and 50%, one week or more). CONCLUSIONS: Animal-related injury has a major impact on the agricultural industry. Results serve as a basis for interventions and further research. IMPACT ON INDUSTRY: The impact of animal-related injuries on the agricultural industry appears significant; among age groups <20 and 20+, 85% and 82%, respectively, had some resulting restriction. For all events combined, 29% and 30%, respectively, involved restriction from one week to 3+ months; 12% and 15% involved restriction for one month or more. Among those <20 and 20+ years of age, 58% and 46%, respectively, lost work time on their own agricultural operation as a result of injuries associated with their own operation; 22% and 15% lost one week or more. Moreover, of the non-agriculture-related injuries, 31% and 50% resulted in lost work time on their own operation; 15% and 28%, respectively, lost one week or more. Restrictions such as these can affect the productivity of the operation, resulting in financial impacts, especially on small operations that have few people to manage the required tasks.     

An evaluation of the effectiveness of a baby walker safety standard to prevent stair-fall injuries

PROBLEM: During the early 1990s the number of baby walker injuries treated in U.S. hospital emergency departments averaged almost 25,000 annually; about 80% resulted from falls down stairs. After initiating a regulatory proceeding in 1994, the U.S. Consumer Product Safety Commission staff worked with industry to develop requirements to address the stair-fall hazard. This study evaluates the effectiveness of the stair-fall requirements, which became effective in 1997 as part of a revised voluntary standard. METHOD: Annual baby walker emergency department injury rates were constructed for the 1981-2002 study period. A multivariate negative binomial regression model was used to estimate the effectiveness of the stair-fall requirements in reducing the injury rate. RESULTS: The stair-fall requirements reduced the emergency department injury rate by an estimated 63% (95% CI, 52% to 71%). IMPACT ON INDUSTRY: Given the substantial reduction in walker injuries, and the high level of industry conformance with the stair-fall requirements, the Commission terminated its regulatory proceeding in May, 2002. The success of the baby walker project highlights the ability of government and industry to work together cooperatively to develop effective safety improvements for consumer products.     

The theory of planned behavior (TPB) and texting while driving behavior in college students

Objective: To examine the role of intent and other theory of planned behavior (TPB) constructs in predicting college students' willingness to text while driving (TWD).

Methods: This was a cross-sectional study. 243 male and female college students enrolled in the 2013–2014 academic year in the College of Health, Human Services & Nursing completed a survey on TWD. Inclusion criteria: All races and ethnicities, ≥18 years of age, cell phone owner, and licensed driver.

Results: Over 70% of the sample (n = 243) reported talking on a cell phone and sending and receiving text messages “at least a few times” while driving within the past week. However, only 27% reported being stopped by police. Of these, 22% reported being fined. Within the past 30 days, 26% reported reading or sending TWD and having to slam on the brakes to avoid hitting another car or pedestrian(s) as a result. In all, 47% of the variance in intention to send TWD was accounted for by the full TPB model. Intention, in turn, predicted willingness to TWD. Intention also mediated the relationship between perceived behavioral control and willingness to TWD.

Conclusion: Attitude was found to be the strongest predictor of intention. In addition, intention was found to mediate the relationship of willingness to TWD on perceived behavioral control. These findings highlight potential factors that could be targeted in behavioral change interventions seeking to prevent TWD.     

Evaluation of give kids a boost: A school-based program to increase booster seat use among urban children in economically disadvantaged areas

Objective: This study evaluated the effectiveness of a series of 1-year multifaceted school-based programs aimed at increasing booster seat use among urban children 4–7 years of age in economically disadvantaged areas.

Methods: During 4 consecutive school years, 2011–2015, the Give Kids a Boost (GKB) program was implemented in a total of 8 schools with similar demographics in Dallas County. Observational surveys were conducted at project schools before project implementation (P₀), 1–4 weeks after the completion of project implementation (P₁), and 4–5 months later (P₂). Changes in booster seat use for the 3 time periods were compared for the 8 project and 14 comparison schools that received no intervention using a nonrandomized trial process.

The intervention included (1) train-the-trainer sessions with teachers and parents; (2) presentations about booster seat safety; (3) tailored communication to parents; (4) distribution of fact sheets/resources; (5) walk-around education; and (6) booster seat inspections.

The association between the GKB intervention and proper booster seat use was determined initially using univariate analysis. The association was also estimated using a generalized linear mixed model predicting a binomial outcome (booster seat use) for those aged 4 to 7 years, adjusted for child-level variables (age, sex, race/ethnicity) and car-level variables (vehicle type). The model incorporated the effects of clustering by site and by collection date to account for the possibility of repeated sampling.

Results: In the 8 project schools, booster seat use for children 4–7 years of age increased an average of 20.9 percentage points between P₀ and P₁ (P₀ = 4.8%, P₁ = 25.7%; odds ratio [OR] = 6.9; 95% confidence interval [CI], 5.5, 8.7; P < .001) and remained at that level in the P₂ time period (P₂ = 25.7%; P < .001, for P₀ vs. P₂) in the univariate analysis. The 14 comparison schools had minimal change in booster seat use. The multivariable model showed that children at the project schools were significantly more likely to be properly restrained in a booster seat after the intervention (OR = 2.7; 95% CI, 2.2, 3.3) compared to the P₀ time period and compared to the comparison schools.

Conclusion: Despite study limitations, the GKB program was positively associated with an increase in proper booster seat use for children 4–7 years of age in school settings among diverse populations in economically disadvantaged areas. These increases persisted into the following school year in a majority of the project schools. The GKB model may be a replicable strategy to increase booster seat use among school-age children in similar urban settings.     

Evaluating repeated patient handling injuries following the implementation of a multi-factor ergonomic intervention program among health care workers

Objective

The objective of this study was to evaluate repeated patient handling injuries following a multi-factor ergonomic intervention program among health care workers.

Methods

This was a quasi-experimental study which had an intervention group and a non-randomized control group. Data were collected from six hospitals in Saskatchewan, Canada from September 1, 2001 to December 1, 2006.

Results

A total of 1,480 individuals who had a previous injury were eligible for the study. Medium and small size hospitals in the intervention group had significantly fewer repeated injuries than in the control group. Multivariate analysis showed that the intervention group had 38.1% lower odds of having repeated injury compared to the control group, after adjusting for hospital size.

Conclusions

The work-related repeated injury after a multi-factor intervention program was reduced. The synergistic relationships between components of multi-factor intervention and applicability of injury prevention programs to different settings need to be further explored.

Impact on Industry

Implementing a multi-factor program with the right equipment and training can lower the risk of injury among health care workers.     

剧毒化学品甲苯-2，4-二异氰酸酯运输危险性评估

为探讨低挥发性剧毒化学品甲苯-2,4-二异氰酸酯在运输过程中大量泄漏引起群体中毒事故的可能性以及对环境的影响,对本品的急性毒性、扩散模型、环境转归、生态毒性,以及运输泄漏事故资料进行综合分析和评估。评估结果本品吸人中毒的潜在危险性指数为低度危险物质;扩散模型运输泄漏模拟危险区域下风向距离小于某些非剧毒品;环境转归研究显示本品在环境介质中没有持久性,没有明显的生物蓄积性,生态毒性较低;历年来运输泄漏事故分析未见发生大规模严重群体中毒和环境污染事故。认为本品在运输过程中大量泄漏,不会大范围扩散引起严重群体中毒事故,也不会对环境造成严重和长期的危害,建议在运输环节中运输条件适当放宽,按照一般有毒品进行管理。