Projections of hospitalised fall-related injury in NSW, Australia: impacts on the hospital and aged care sectors

Projections of the number, rate and cost of fall-related hospitalised injuries for individuals aged 65 years and older in New South Wales (NSW), Australia were estimated to 2051 for two scenarios: (1) demographic change only using 2008 admission rates; and (2) modelled change using negative binominal regression taking into account current trends in admission rates. Based on demographic change alone, the number and cost of fall injury hospitalisations among older people is expected to increase almost three-fold by 2051. Transfers to permanent residential aged care will also increase 3.2 fold. However, if the fall-related hospitalisation rate sustains its current trend, these increases are projected to be more than ten-fold by 2051. Even with demographic change alone, there will be a significant impact on the resources required to care for older people suffering a fall injury hospitalisation over the next forty years in NSW. The impact on the hospital and aged care sectors will be considerable unless significant improvements occur in the prevention and treatment of fall-related injury in older people.     

Gender differences in DUI offenders in treatment in Texas

OBJECTIVE: This is a study of 8,464 adult women and 21,155 adult males who entered substance abuse treatment in Texas between 2000 and 2005. Participants were either on probation for driving under the influence (DUI), were referred to treatment by DUI probation, or had been arrested for DUI in the past year. METHODS: The female and male clients were compared on demographic characteristics, substance use patterns, DSM-IV diagnoses, and levels of impairment. T tests and chi square tests were used to determine significance and multivariate logistic regression identified predictors of completing treatment and being abstinent at follow-up. RESULTS: The proportion of females who were sent to treatment as a result of DUI increased from 27% in 2000 to 32% in 2005. Females were significantly more likely than males to be White (73% vs. 56%), to have used substances a shorter period of time (17 vs. 19 years), to be seeking custody to regain their children (11% vs. 2%), to meet the DSM criteria for drug dependence (32% vs. 23%), to have injected drugs (31% vs. 23%), to have used substances daily (42% vs. 40%), to have a depressive disorder (16% vs. 7%) or bipolar disorder (12% vs. 5%), and to be have been in treatment before (60% vs. 49%). In contrast, males were more likely to be alcohol dependent (49% vs. 44%). Females were less likely to complete treatment (67% vs. 72%) and reported significantly more days of problems on the 6 domains of the ASI at both admission and at 60-day follow-up. Furthermore, at follow-up, they were more likely to be living with someone who abused alcohol or used drugs (9% vs.7%). CONCLUSIONS: Although females comprised only 29% of the DUI treatment admissions, they were more impaired and experienced more problems than their male counterparts. The findings indicate that additional resources, including treatment for co-occurring mental health problems and living in sober households, may be keys to helping these women achieve abstinence and prevent additional DUI episodes.     

Modeling of BP Texas City refinery incident

This paper presents detailed modeling results of the BP Texas City refinery incident. Three different approaches and explosion modeling tools were used to study the event. The results predicted by all three approaches are similar and all approaches identified a hazard potential comparable to what was witnessed on March 23, 2005. This confirms that quantitative risk assessment (QRA) has the ability to model a realistic scenario, and is therefore useful in safety measure design and emergency preparedness decision making to improve overall safety performance. Had QRA been conducted during a management of change (MOC) decision-making process, personnel trailers likely would not have been sited in such close proximity to the process units. The resulting severe consequences would then not have occurred. This work also aims to emphasize the importance of QRA in process safety management.

The paper presents the authors’ perception of the sequence of events involved in the incident based on the published literature available at the time of writing. It also assesses potential consequences for the perceived sequence of events using a variety of consequence assessment tools. In doing so, the analysis illustrates how this incident could have been prevented in spite of many operational difficulties. The observations and commentary presented in this paper are intended solely for the purpose of process safety enhancement on the basis of the lessons learned. BP has published its own detailed report; the incident is also the subject of a recent investigation by the US Chemical Safety and Hazard Investigation Board, with the CSB's final report being available at http://www.csb.gov/index.cfm?folder=completed_investigations&page=info&INV_ID=52 (as of April 2007).     

Dynamic simulation of the BP Texas City refinery accident

The paper investigates the causes and simulates the dynamics of the events that led to the catastrophic explosion on March 23, 2005 at the British Petroleum (BP) refinery in Texas City (USA) where 15 people died and 180 were injured.The paper follows the timeline of the accident, investigates the premises that characterized its phenomenology, and performs a critical analysis to fill the gaps that can be found in the scientific literature concerning the accident. In particular, a commercial dynamic process simulator (UNISIM) was adopted and integrated with ad hoc models to explain the column flooding and overfilling, the opening of the relief valves, and the flow of a two-phase mixture into the pipe connected to the blowdown system. The main findings are: (1) that the mass balance and the liquid thermal expansion cannot explain the complete flooding and overflow of the isomerization column; (2) the vapor cap used to explain the column overflow is unrealistic in our opinion; (3) the overflow can be explained by the partial vaporization of the feed stream after 1:00 PM and the consequent dispersion of vapor bubbles into the liquid holdup above the feed tray. In particular, tray holes smaller than 8 mm could cause the overflow; (4) there is a significant change in the thermodynamic conditions of the mixture emitted by the column head (temperature, pressure, vapor/liquid fractions) along the 270 m pipeline that connects the relief valves to the blowdown system; (5) the HEM model, together with the initial conditions we applied cannot explain the blowdown drum filling and release, therefore further studies are necessary.     

Hip protectors efficacy and barriers to adoption to prevent fall-related injuries in older adults: findings and recommendations from an international workgroup

The Journal of Safety Research has partnered with the Injury Center at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, USA, to briefly report on some of the latest findings in the research community. This report is the sixth in a series of CDC articles. This conference on Hip Protector Use was held at Boston University in June, 2004 under the sponsorship of the Injury Center. Hip fractures from falls are a major threat to the health and well-being of older adults. One approach to hip fracture prevention is the use of hip protectors (HPs), soft padding or hard shells embedded within specially designed underwear. This conference brought together experts to discuss the efficacy and barriers to using HP. Conclusions from the conference included the need for HP product specifications and standards of safety and efficacy, testing protocols, and efficacy trials. While no single entity was identified to advance these initiatives, this effort should be international and should involve collaboration between researchers, health care providers and policy-makers, and HP manufacturers. Plans are already underway for a second international conference in Europe to follow-up these recommendations and develop strategies for implementation.     

兰州城区大气污染对呼吸系统疾病日住院人数的影响

为了探讨兰州城区大气污染对居民呼吸系统疾病日住院人数的影响,收集2004年1月1日-2007年10月31日兰州城区每日空气污染指数(API)、气象(日均气压、气温、气湿、风速和降水量)资料,以及同时段的居民呼吸系统疾病住院数据,选用广义相加模型(GAM)的Poisson回归,利用非参数平滑函数控制长期趋势、星期效应、气象因素的基础上,研究大气污染对居民呼吸系统疾病日住院人数的影响,并按性别、年龄和呼吸系统疾病类型进行分层分析.结果表明,研究当日API上升1个四分位间距(48个单位)时,当日总的呼吸系统疾病住院人数增加5.50%(95%CI 4.03%～6.99%),并且这种影响具有一定的滞后效应.男性在API上升滞后第1 d RR值最高,为1.058 3(95%CI 1.039 7～1.077 2),女性则在API上升当日RR值最高,除滞后第3 d和第4 d,其他滞后各天RR值均低于男性.API上升对16～64岁人群的影响只在当日和滞后第1 d有意义,对≤15岁者和≥65岁者有显著的滞后效应,以滞后第5 d和第4 d RR值最高,分别为1.063 6(95%CI 1.043 4～1.084 1)和1.047 6(95%CI 1.017 6～1.078 6).API上升当日肺炎和上呼吸道感染(URTI)患者日住院人数增幅最大,RR分别为1.059 5(1.040 7～1.078 7)和1.056 0(1.030 6～1.082 1),肺炎患者日住院人数滞后效应高于URTI.研究表明,大气污染可增加居民呼吸系统疾病住院人数,并对不同性别、年龄和呼吸系统疾病类型的影响存在差异.     

Modelling of BP Texas City refinery accident using dynamic risk assessment approach

Process industries involve handling of hazardous substances which on release may potentially cause catastrophic consequences in terms of assets lost, human fatalities or injuries and loss of public confidence of the company. In spite of using endless end-of-the-pipe safety systems, tragic accidents such as BP Texas City refinery still occur. One of the main reasons of such rare but catastrophic events is lack of effective monitoring and modelling approaches that provide early warnings and help to prevent such event. To develop a predictive model one has to rely on past occurrence data, as such events are rare, enough data are usually not available to better understand and model such behavior. In such situations, it is advisable to use near misses and incident data to predict system performance and estimate accident likelihood. This paper is an attempt to demonstrate testing and validation of one such approach, dynamic risk assessment, using data from the BP Texas City refinery incident.Dynamic risk assessment is a novel approach which integrates Bayesian failure updating mechanism with the consequence assessment. The implementation of this methodology to the BP Texas City incident proves that the approach has the ability to learn from near misses, incident, past accidents and predict event occurrence likelihood in the next time interval.     

Biorhythms and the incidence of industrial accidents

Biorhythm critical days have been suggested as a possible cause of industrial accidents by a number of authors, although the empirical evidence is confusing. This study examined all industry-related accidents in a large Australian timber milling organization over a 15-month period to see if the implied relationships existed. A variety of biorhythm critical day definitions and accident types were analyzed, but no significant results were obtained, suggesting that the proposed theory did not hold in this case.     

The effects of graduated driver licensing on hospitalization rates and charges for 16-and 17-year-olds in North Carolina

OBJECTIVE: To mitigate the high risk of motor vehicle crashes for young beginning drivers, over 40 states and the District of Columbia have implemented graduated driver licensing (GDL) systems that gradually and systematically ease teen drivers into higher risk driving conditions. Evaluations of GDL programs using motor vehicle crash data have demonstrated marked declines in crashes. The objective of this study is to examine the association between the implementation of the North Carolina GDL program and the rate of hospitalization, as well as hospital charges, for 16-and 17-year-old drivers. METHODS: Data were obtained from the North Carolina Hospital Discharge Database for the 26 months before and 46 months after the December 1, 1997, implementation of the GDL program. ARIMA interrupted time series analyses were used to model monthly hospitalization rates, controlling for the hospitalization rates of 25-to 54-year-old drivers. ARIMA analyses were also used to determine whether changes occurred in monthly total hospital charges. RESULTS: Among the 568 16-year-old hospitalized drivers, GDL was associated with a 36.5% decline in the hospitalization rate per population and a 31.2% decline in the total monthly driver hospitalization charges. Although a 12% reduction in the rate of hospitalizations was observed among the 615 17-year-old drivers, the analysis lacked sufficient power to be statistically reliable. No consistent change was observed in the 16-year-old driver total monthly hospital charges. CONCLUSIONS: The North Carolina GDL program was associated with a marked decline in the rate of hospitalizations and hospital charges for 16-year-old drivers. Following the implementation of GDL, over $650,000 in hospital charges have been averted each year for 16-year-old drivers. Analyses suggest these reductions were primarily the result of reduced exposure rather than an improvement in teen driving.     

Effect of loss control service on reported injury incidence

INTRODUCTION: A retrospective analysis evaluated the effectiveness of an insurance carrier's flexible loss control service strategy in reducing workers' compensation policyholders' reported injury and illness claims. OBJECTIVES: To assess the effects of a loss control service strategy on workers' compensation claim frequency rates, on medical-only claim rates, on severity-claim rates, and on claim cost among a group of California employers. METHODS: Eighty-two small- and medium-sized companies with workers' compensation policies expiring in 1999 were randomly selected from a population of policyholders assigned to loss control consultants for two or more years. Claim performance data were obtained for each company's first expired in-force policy year and its 1999 expired policy year. The retrospective design was combined with a control component based on a randomly selected comparison group of 45 companies whose first policy year with the insurer expired in 1999 and who received safety services from the loss control staff. RESULTS: The flexible loss control consultation service strategy was associated with lower average claim rates and costs. Companies assigned to a loss control consultant for two or more years (the "outcome group") had an average claim rate of 1.24 per $10,000 premium, compared with a rate of 1.62 in the "initial group" and a rate of 1.60 in the "comparison group." The average severity-claim rate of the outcome group was 0.32, compared with the initial-year and comparison-group means of 0.48 and 0.46, respectively. The average medical-only claim rate was 0.92, compared with the initial- and comparison-group means of 1.14 and 1.14. The outcome group's average loss ratio was over 10% lower than that of the initial and comparison groups. Statistical analysis indicated that differences among the groups' claim rates and severity-claim rates were [F=(2,206) 4.938, P=0.008] and [F=(2,206) 8.208, P<0.001], respectively. CONCLUSIONS: A loss control service strategy that provides service flexibility and develops partnership between employer and consultant can help reduce the frequency and severity of workers' compensation claims. Barriers to consultation service flexibility, both internal and external, should be identified and removed to enhance service efficacy.     

考虑道路状况的应急配发站启用以及配送优化问题*

为了研究应急物资配发站启用及配送方案优化问题,综合考虑灾难事件下的道路损毁状况、道路复杂程度、需求不确定以及物资拆分配送等特点,以应急物资配发站启用成本、车辆启动成本、运输成本之和最小化为目标,建立应急物资配发站启用及配送模型,设计头脑风暴优化算法,结合算例,对该问题进行仿真,并将结果与遗传算法进行对比,验证模型的可行性和算法的有效性。结果表明,在决策时考虑道路状况能够有效降低系统成本,提高救援效率。     

广州市SARS传播与空气污染相关性研究

探讨SARS传播与空气污染的关系.根据广州市及周边城市自SARS发病以来主要空气污染物的监测统计结果,结合广州市SARS发病例数和气象观测资料等进行相关性研究,并与香港进行对比.结果表明,广州市SARS发病数与发病前5 d的可吸入颗粒物污染浓度密切相关,香港SARS发病数与发病前1～2 d的可吸入颗粒物污染浓度密切相关.研究表明,SARS发病数与发病前空气污染状况有密切关系.     

Traffic speeds associated with implementation of 80 mph speed limits on West Texas rural interstates

Problem

In 2006 Texas raised the daytime speed limit for passenger vehicles on segments of I-10 and I-20 from 75 to 80 mph. Methods: Traffic speeds were measured before and 3, 12, and 16 months after the limit was changed. Results: During the 16-month period following the speed limit increase, mean speeds of passenger vehicles on I-20 increased by 9 mph relative to the comparison road, where no speed limit change occurred and traffic speeds declined. On I-10 mean speeds increased by 4 mph relative to the comparison road. Limiting the analysis to the month before the speed limit change and 1 year later, the proportion of drivers exceeding 80 mph was 18 times higher on I-20 and 2 times higher on I-10. Discussion: The smaller speed increases on I-10 may be related to its proximity to the U.S. border with Mexico. Highly visible border patrol activity coincided with posting of the higher speed limit. Long-term monitoring in other states suggests that traffic speeds in Texas are likely to continue to increase. Impact on Industry: The present study adds to the wealth of evidence that increased speed limits lead to increased travel speeds. The primary countermeasures to reduce the risk of speed-related crashes include highly visible police traffic enforcement and the use of speed cameras accompanied by publicity.     

火灾发生率空间分异及影响因素研究

为了探究我国火灾空间聚集特征与影响因素的空间异质性,采用全局莫兰指数、局部莫兰指数、逐步回归模型、地理加权回归模型、地理探测器方法对我国地级市单元进行研究。研究结果表明:我国火灾发生率具有显著的聚集性;我国火灾发生率较低的“冷点”区域有1个,火灾发生率较高的“热点”区域有4个;人均GDP、城镇居民人均可支配收入、人口密度、年平均气温4 个因素的影响效应具有空间异质性。人均GDP与火灾发生率为正相关,另外3影响因素对火灾发生率的作用表现出正负2种相关关系;2因素交互作用要比单因素作用于火灾发生率时影响力更显著,各影响因素的交互作用类型有非线性增强型和双因子增强型2种。     

Odor fading in natural gas distribution systems

Since natural gas is odorless, to assure the customer safety, odorants are added to it to alarm the consumer in the case of a gas leak. Although the odorization is a common practice in natural gas distribution systems, odor fading has been reported in pipelines, which is a great safety risk. This paper summarizes results of experiments conducted to investigate possible chemical and physical mechanisms responsible for odor fading. In these experiments, X-ray photoelectron spectroscopy (XPS) and gas chromatography were used to check the possible interactions of tertiary butyl mercaptan (TBM) as odorant with the pipe material. Evidences of chemisorption, adsorption and desorption of TBM on the iron oxide inside the pipe were observed. It was found that by increasing pressure, rusted surface of the pipe, and temperature or by decreasing the gas flow rate and odorant concentration the mercaptan removal was increased.     

蓄热式加热炉中温度场分析

以一套蓄热式加热炉为物理模型,数值分析了加热过程中燃气速度、助燃空气速度、助燃空气预热温度以及助燃空气中氧含量对加热炉中钢坯附近区域温度场分布的影响,得出了这些因素对加热炉中钢坯位置附近温度的影响情况与影响规律.研究结果将为蓄热式加热炉在我国的推广与设计提供技术参数和参考模型.     

乐清湾海域生物体内多氯联苯的分布特征

以台州(乐清湾)为例,研究了乐清湾海域生物体内多氯联苯(PCBs)的分布,其中以鱼、贝类和虾为主要实验对象,分析了多氯联苯的来源、浓度及各种影响因素。结果表明,鱼肉中∑PCBs 的残留含量为8.61~23.06ng/g,贝类中∑PCBs 的残留含量为11.77~38.04ng/g,对虾中∑PCBs的残留含量为0.38~11.19ng/g。近海生物体内多氯联苯的来源与当地工业排污、航运、PCBs废旧设施非法处置或封存不当等一系列因素有关。     

Time-related distribution of occupational accidents

Time-related distributions of the frequency of occupational traumatic accidents (3,309) were analyzed in two plants. Data on the distribution of work-related accidents (676,389) throughout Ontario between 1980–1984 were also compiled and compared with the data gathered in the two plants. Time-related distributions of accident frequency were similar for both plants and for the province of Ontario, with accidents peaking around noon. There was a direct relationship between the number of accidents and the level of the activity of the plants. At night, however, between 2 a.m. and 4 a.m., despite a great decrease of activity level, there was a slight increase in accident frequency.     

安全评价中作业场所灭火器配置评价的研究

灭火器具有轻便灵活,易于掌握操作的特点,是扑救初起火灾的重要消防器材,对应急状态下的消防灭火工作尤为重要。在建设项目安全预评价和验收评价中,往往受项目建设内容多,可行性研究报告或初步设计中对消防灭火器配置的设计详细程度有限等因素的影响,评价人员对建设项目作业场所灭火器配置情况是否符合相关规范、标准的要求,更多是通过检查该建设项目是否通过了当地公安消防部门的消防设计审核或消防验收来予以确认,往往很难具体确定作业场所灭火器材的配置包括规格、数量、设置位置是否满足该作业场所的要求。鉴于作业场所灭火器设置的重要性,就如何在建设项目安全评价中更好的对作业场所灭火器材的配备与设计进行评价,本文通过实例进行分析说明。旨在保证项目设计过程中对灭火器材配备的准确性,避免因灭火器配置规格、数量、位置的不当,造成火灾事故现场后果的严重化、扩大化,以减少火灾损失,保障人身和财产安全。