Features of fatal injuries in older cyclists in vehicle–bicycle accidents in Japan

Objective: The purpose of this study was to identify and better understand the features of fatal injuries in cyclists aged 75 years and over involved in collisions with either hood- or van-type vehicles.

Methods: This study investigated the fatal injuries of cyclists aged 75 years old and over by analyzing accident data. We focused on the body regions to which the fatal injury occurred using vehicle–bicycle accident data from the Institute for Traffic Accident Research and Data Analysis (ITARDA) in Japan. Using data from 2009 to 2013, we examined the frequency of fatally injured body region by gender, age, and actual vehicle travel speed. We investigated any significant differences in distributions of fatal injuries by body region for cyclists aged 75 years and over using chi-square tests to compare with cyclists in other age groups. We also investigated the cause of fatal head injuries, such as impact with a road surface or vehicle.

Results: The results indicated that head injuries were the most common cause of fatalities among the study group. At low vehicle travel speeds for both hood- and van-type vehicles, fatalities were most likely to be the result of head impacts against the road surface.

The percentage of fatalities following hip injuries was significantly higher for cyclists aged 75 years and over than for those aged 65–74 or 13–59 in impacts with hood-type vehicles. It was also higher for women than men in the over-75 age group in impacts with these vehicles.

Conclusions: For cyclists aged 75 years and over, wearing a helmet may be helpful to prevent head injuries in vehicle-to-cyclist accidents. It may also be helpful to introduce some safety measures to prevent hip injuries, given the higher level of fatalities following hip injury among all cyclists aged 75 and over, particularly women.     

A survey of forest workers in New Zealand. Do hours of work, rest, and recovery play a role in accidents and injury?

PROBLEM: A number of structural and organizational changes have occurred recently within the New Zealand Forestry Industry, with concerns being raised about the impact of these changes on the forestry worker in terms of fatigue, sleepiness, and compromised safety. This study explored the relationship of fatigue, and some of its key determinants, with accidents and injuries in a group of forestry industry workers in New Zealand. METHOD: A total of 367 forestry workers responded to a self-administered questionnaire. RESULTS: Fatigue was found to be commonly experienced at work in the forest, with 78% of workers reporting that they experienced fatigue at least "sometimes." This study found that certain groups of workers reported long working hours, reduced sleep, compromised recovery time, and intensely paced work. The results of logistic regression analysis showed that recent sleep, number of breaks taken during the workday, and specific job/tasks were independently associated with reporting of high fatigue levels at work. Near-miss injury events were significantly more common among those reporting a high level of fatigue at work. Accidents and lost-time injury were associated with length of time at work, ethnicity, and having had near-miss injury events. DISCUSSION: Together, these results suggest that fatigue and aspects of work organization, which are likely to be fatiguing, may be associated with compromised safety for forest workers. IMPACT ON INDUSTRY: With an already slim margin of error present in forest operations, an impairment due to increased fatigue may constitute a significant risk factor for accidents and injuries in this workforce. The results indicate the need for further examination of shift and workload management among forestry workers, as well as a role for improving industry awareness about the causes and consequences of fatigue.     

Mortality from road traffic accidents in a rapidly urbanizing Chinese city: A 20-year analysis in Shenzhen, 1994–2013

Objective: This study aimed to describe the trends of motorization and mortality rates from road traffic accidents and examine their associations in a rapidly urbanizing city in China, Shenzhen.

Methods: Using data from the Shenzhen Deaths Registry between 1994 and 2013, we calculated the annual mortality rates of road traffic accidents, in addition to the age- and sex-specific mortality rates and their annual percentage changes (APCs) for the period of 2000–2013. We also examined the associations between mortality rate of road traffic accidents and traffic growth with Spearman's rank correlation analysis and a log-linear model derived from Smeed's law.

Results: A total of 20,196 deaths due to road traffic accidents, including 14,391 (71.3%) male deaths and 5,805 (28.7%) female deaths, were recorded in Shenzhen from 1994 to 2013. The annual mortality rates in terms of deaths per population and deaths per vehicle changed in similar patterns, demonstrating an increase since 1994 and peaking in 1997, followed by a steady decrease thereafter. The decrease in mortality was faster in individuals aged 20 year or older compared to those younger than 20 years. The mortality rates in term of deaths per population were positively correlated with the total number of vehicles per kilometer of road but negatively correlated with the motorization rate in term of vehicles per population. The estimated model for deaths due to road traffic accidents in relation to the total population and the number of registered vehicles was ln (deaths/10,000 vehicles) = ?1.902 × ln (vehicles/population) ? 1.961. The coefficient was statistically significant (P < .001) and the coefficient of determination was 0.966, indicating a good model fit.

Conclusions: We described a generally decreasing trend in the mortality rates of road traffic accidents in a rapidly urbanizing Chinese city based observations in the 20-year period from 1994 to 2013. The decreased mortality rate may be explained by the expansion of road network construction, improved road safety regulations and management, as well as more accessible ambulance services in recent years. Nevertheless, road traffic accidents remain a universal problem of great public health concern in the whole population.     

Acute injuries resulting from accidents involving powered mobility devices (PMDs)—Development and outcomes of PMD-related accidents in Sweden

Objective: Powered mobility devices (PMDs) are commonly used as aids for older people and people with disabilities, subgroups of vulnarable road users (VRUs) who are rarely noted in traffic safety contexts. However, the problem of accidents involving PMD drivers has been reported in many countries where these vehicles have become increasingly popular.

The aim of this study is to extract and analyze national PMD-related accident and injury data reported to the Swedish Traffic Accident Data Acquisition (STRADA) database. The results will provide valuable insight into the risks and obstacles that PMD drivers are exposed to in the traffic environment and may contribute to improving the mobility of this group in the long term.

Methods: The current study is based on data from 743 accidents and 998 persons. An analysis was performed on a subset of data (N?=?301) in order to investigate the development of accidents over a period of 10 years. Thereafter, each accident in the whole data set was registered as either single (N?=?427) or collision (N?=?315).

Results: The results show that there was a 3-fold increase in the number of PMD-related accidents reported to STRADA during the period 2007–2016.

With regard to single accidents, collisions, as well as fatalities, the injury statistics were dominated by males. Single accidents were more common than collisions (N?=?427 and N?=?316, respectively) and the level of injury sustained in each type of accident is on par.

The vast majority of single accidents resulted in the PMD driver impacting the ground (87%), due to either PMD turnover (71%) or the driver falling out of the PMD (16%). The reason for many of the single accidents was a difference in ground level (34%, typically a curb).

Cars, trucks, or buses were involved in 67% of collision events; these occured predominantly at junctions or intersections (70%).

Abbreviated Injury Scale (AIS) 3+ injuries were dominated by hip and head injuries in both single accidents and collision events.

Conclusions: The present study shows that further research on PMD accidents is required, with regard to both single accidents and collision events. To ensure that appropriate decisions are made, future work should follow up on injury trends and further improve the quality of PDM-related accident data. Improved vehicle stability and design, increased usage of safety equipment, proper training programs, effective maintenance services, and development of a supporting infrastructure would contribute to increased safety for PMD drivers.     

Pooled Analysis of Two Swedish Case-Control Studies on the Use of Mobile and Cordless Telephones and the Risk of Brain Tumours Diagnosed During 1997–2003

Here we present the pooled analysis of 2 case–control studies on the association of brain tumours with mobile phone use. Use of analogue cellular phones increased the risk for acoustic neuroma by 5%, 95% confidence interval (CI) = 2-9% per 100 hrs of use. The risk increased for astrocytoma grade III—IV with latency period with highest estimates using >10-year time period from first use of these phone types. The risk increased per one year of use of analogue phones by 10%, 95% CI = 6-14%, digital phones by 11%, 95% CI = 6-16%, and cordless phones by 8%, 95% CI = 5-12%. For all studied phone types OR for brain tumours, mainly acoustic neuroma and malignant brain tumours, increased with latency period, especially for astrocytoma grade III—IV.     

Use of association rules to explore cause–effect relationships in occupational accidents in the Taiwan construction industry

Most models of the incidence of occupational accidents in the construction industry are composed of multiple factors. Although statistical techniques can be used to infer cause-and-effect relationships among these factors, the large number of factors involved and the complexity of the relationships among them make it difficult for managers to identify potential hazards in construction projects and thus develop effective safety procedures. This study addresses this problem by using the association-rule method of data mining in performing an analysis of 1347 accidents in the Taiwan construction industry during the period 2000–2007. The association-rule method enables potential cause-and-effect relationships to be identified among the many factors that play a role in occupational accidents in the construction industry. The study finds that such accidents tend to occur when certain combinations of hazards are present – especially working in high places without protective measures, loss of balance when in motion, failure to use protective equipment, insufficient experience, and injurious contact with unstable structures. These hazards are especially evident in small enterprises with less than 10 persons. The results can help management to formulate effective safety policies with regard to management shortcomings and staff training.     

Unintentional injury deaths in children and youth, 2010–2019

Background: Unintentional injuries are the leading cause of death for children and youth aged 1–19 in the United States. The purpose of this report is to describe how unintentional injury death rates among children and youth aged 0–19 years have changed during 2010–2019. Method: CDC analyzed 2010–2019 data from the National Vital Statistics System (NVSS) to determine two-year average annual number and rate of unintentional injury deaths for children and youth aged 0–19 years by sex, age group, race/ethnicity, mechanism, county urbanization level, and state. Results: From 2010–2011 to 2018–2019, unintentional injury death rates decreased 11% overall—representing over 1,100 fewer annual deaths. However, rates increased among some groups—including an increase in deaths due to suffocation among infants (20%) and increases in motor-vehicle traffic deaths among Black children (9%) and poisoning deaths among Black (37%) and Hispanic (50%) children. In 2018–2019, rates were higher for males than females (11.3 vs. 6.6 per 100,000 population), children aged < 1 and 15–19 years (31.9 and 16.8 per 100,000) than other age groups, among American Indian or Alaska Native (AIAN) and Blacks than Whites (19.4 and 12.4 vs. 9.0 per 100,000), motor-vehicle traffic (MVT) than other causes of injury (4.0 per 100,000), and rates increased as rurality increased (6.8 most urban [large central metro] vs. 17.8 most rural [non-core/non-metro] per 100,000). From 2010–2011 to 2018–2019, 49 states plus DC had stable or decreasing unintentional injury death rates; death rates increased only in California (8%)—driven by poisoning deaths. Conclusion and Practical Application: While the overall injury death rates improved, certain subgroups and their caregivers can benefit from focused prevention strategies, including infants and Black, Hispanic, and AIAN children. Focusing effective strategies to reduce suffocation, MVT, and poisoning deaths among those at disproportionate risk could further reduce unintentional injury deaths among children and youth in the next decade.     

Characteristics of direct causes and human factors in major gas explosion accidents in Chinese coal mines: Case study spanning the years 1980–2010

Major accidents from gas explosions have a high rate of occurrence in Chinese coal mines. The frequency of major gas explosion accidents between the years 1980–2000, and the years 2001–2010 was reviewed. Case studies were also compared. The study of direct causes indicates that during the period 2001–2010 the proportion of accidents caused by deliberate violation was reduced by 31.13% compared with data from 1980 to 2000. However the proportion of accidents caused by mismanagement rose by 32.38% during this period. Direct causes of high occurrence rate accidents include deliberate violations such as illegal blasting, conducting maintenance with the power on, and mismanagement behaviors such as chaotic electromechanical management and chaotic ventilation management. The study of environmental characteristics shows that the proportion of accidents occurring in the heading faces increased by 27.18%. The study of human factors indicates that deliberate violation behaviors showed a high utility–high cost factor. Mismanagement behaviors showed strong correlation with responsibility awareness and weak correlation with technological ability.     

The characteristics of fatal occupational injuries in Korea’s construction industry, 1997–2004

This study is aimed at exploring the characteristics of fatal occupational injuries in Korea’s construction industry and comparing the causes in various occupations within that industry. There were 10,276 fatal occupational injury victims in Korea over 8 years (1997–2004). The mortality risk due to injuries in construction and non-construction industries was calculated, and their causes were compared. The number of victims of fatal occupational injuries in the construction industry was 4333 (42.2% of the total fatal occupational injuries), and the 1 year mortality risk was higher (23.7/100,000 persons) than in non-construction industries (10.4). Falling was the most frequent (52.7%) cause of fatal injuries. In addition, deaths due to structural collapse and electric shock were significantly higher than in other industries. When the distribution of the causal factors in various occupations within the construction industry was investigated, some factors appeared more frequently in certain occupations than in others. As the construction industry encompasses a large proportion of occupational injuries, a reduction in this field alone will substantially contribute to an overall reduction of occupational injuries in Korea. Further research for effective prevention is needed.     

Trends in teen driver licensure,driving patterns and crash involvement in the United States, 2006–2015

IntroductionThe Monitoring the Future (MTF) survey provides nationally-representative annual estimates of licensure and driving patterns among U.S. teens. A previous study using MTF data reported substantial declines in the proportion of high school seniors that were licensed to drive and increases in the proportion of nondrivers following the recent U.S. economic recession.MethodTo explore whether licensure and driving patterns among U.S. high school seniors have rebounded in the post-recession years, we analyzed MTF licensure and driving data for the decade of 2006–2015. We also examined trends in teen driver involvement in fatal and nonfatal injury crashes for that decade using data from the Fatality Analysis Reporting System and National Automotive Sampling System General Estimates System, respectively.ResultsDuring 2006–2015, the proportion of high school seniors that reported having a driver's license declined by 9 percentage points (11%) from 81% to 72% and the proportion that did not drive during an average week increased by 8 percentage points (44%) from 18% to 26%. The annual proportion of black seniors that did not drive was consistently greater than twice the proportion of nondriving white seniors. Overall during the decade, 17- and 18-year-old drivers experienced large declines in fatal and nonfatal injury crashes, although crashes increased in both 2014 and 2015.ConclusionsThe MTF data indicate that licensure and driving patterns among U.S. high school seniors have not rebounded since the economic recession. The recession had marked negative effects on teen employment opportunities, which likely influenced teen driving patterns. Possible explanations for the apparent discrepancies between the MTF data and the 2014 and 2015 increases in crashes are explored.Practical applicationsMTF will continue to be an important resource for clarifying teen driving trends in relation to crash trends and informing strategies to improve teen driver safety.     

Economic and statistical perspectives on traffic safety in Louisiana, 2005–2015

IntroductionThis study examines and applies recent empirical evidence from Mississippi and Alabama on fatal crashes and its relationship with gasoline prices and alcohol consumptions using the Louisiana Crash Data Reports between January 2005 and December 2015.MethodThe negative binomial models is the preferred specification for the Louisiana Crash Data. The marginal effects and related elasticities were calculated to facilitate the interpretation of the results.ResultsFindings suggest that higher gasoline prices reduce fatalities among young drivers. A fewer number of young drivers on the roads are believed to reduce the likelihood of fatal crashes. Underage drinking is still prominent in Louisiana. Extreme temperatures are positively associated with youth and other types of fatal crashes.Practical ApplicationsThis study highlights a huge toll on society in terms of social and economic costs, wealth destruction, and unfulfilled potential of the deceased or incapacitated.     

Identifying common problems in the acquisition and deployment of large-scale,safety–critical,software projects in the US and UK healthcare systems

Public and private organisations are investing increasing amounts into the development of healthcare software. These applications are perceived to offer numerous benefits. Software systems can improve the exchange of information between healthcare facilities. They support standardized procedures that can help to increase consistency between different service providers. Electronic patient records ensure minimum standards across the trajectory of care when patients move between different specializations. Healthcare information systems also offer economic benefits through efficiency savings; for example by providing the data that helps to identify potential bottlenecks in the provision and administration of care. However, a number of high-profile failures reveal the safety concerns that arise when staff must cope with the loss of these applications. In particular, teams have to retrieve paper based records that often lack the detail of electronic systems. Individuals who have only used electronic information systems face particular problems in learning how to apply paper-based fallbacks. The following pages compare two different failures of healthcare information systems in the UK and North America. The intention is to ensure that future initiatives to extend the integration of electronic patient records will build on the ‘lessons learned’ from previous systems.