Medical investigation after a motorcoach strikes the rear of a tractor semitrailer parked on the highway; 13 fatal

Abstract

Objective: The objective of this study was to examine the medical conditions of 2 commercial drivers and the effects of physical barriers to occupant egress in a crash involving a tractor trailer and a motorcoach in order to assess and identify the factors that caused the crash and had a significant effect on occupant extrication.

Methods: Physical evidence from the scene, video evidence, commercial driver information, phone records, toxicology findings, autopsy results, and personal medical information were reviewed.

Results: On October 23, 2016, at 5:16 a.m., a motorcoach carrying a driver and 42 passengers struck the rear of a stopped semitrailer occupied by its driver in the center-right lane of Interstate 10 at highway speed outside Palm Springs, California. The motorcoach driver and 12 passengers died; 11 passengers were seriously injured.

All traffic had been stopped on I-10 early that morning to allow electrical lines to be strung over the highway. Security camera footage showed that the truck arrived at the end of a traffic queue 2?min before traffic flow resumed. Physical evidence indicated that the truck’s parking brake was still engaged at the time of the collision about 2?min later. The truck driver had a body mass index (BMI) between 45.6 and 50?kg/m², which placed him at very high risk of moderate to severe obstructive sleep apnea; he also inaccurately recalled that he had been stopped for 20–25?min and had placed the vehicle in gear just before the collision.

The motorcoach driver was on the return leg of an overnight trip to a casino. Based on his phone records, known driving time, and security camera footage, at the time of the collision he had had 4?h of sleep opportunity in the preceding 35?h. There was no evidence that the motorcoach driver attempted any evasive action before the collision. In addition, postmortem testing revealed a hemoglobin A1C of 11.4%, indicating poorly controlled diabetes; this was apparently undiagnosed prior to the crash.

The motorcoach was equipped with a single loading door at the front of the vehicle; it was rendered inoperable by the collision. Emergency egress was initially carried out through the emergency exit windows, but they repeatedly swung shut, impeding passengers’ efforts to exit. Emergency responders eventually cut open the bus wall to create a larger means of egress. Overall, it took almost 3?h to extricate the occupants from the vehicle.

Conclusions: The National Transportation Safety Board (NTSB) determined that the probable cause of the accident was the truck driver’s falling asleep, most likely due to undiagnosed moderate-to-severe obstructive sleep apnea, and the motorcoach driver’s failure to identify the stopped truck as a hazard requiring evasive action, most likely as the result of fatigue. Additional easy-to-use emergency exits would have decreased the time to extricate the occupants.     

A Benefit‐Cost Analysis of Total Maximum Daily Load Implementation1

Abstract: Total Maximum Daily Load (TMDL) implementation generates benefits and costs from water quality improvements, which are rarely quantified. This analysis examines a TMDL written to address bacteria and aquatic‐life‐use impairments on Abrams and Opequon Creeks in Virginia. Benefits were estimated using a contingent valuation survey of local residents. Costs were based on the number and type of best management practices (BMPs) necessary to achieve TMDL pollution reduction goals. BMPs were quantified using watershed‐scale water quality simulation models (Generalized Watershed Loading Function and Hydrological Simulation Program‐FORTRAN). Based on our projections, the costs to achieve TMDL induced pollution reduction goals outweigh the estimated benefits. Benefit‐cost ratios ranged between 0.1 and 0.3.     

The effect of vegetation on pesticide dissipation from ponded treatment wetlands: quantification using a simple model

Field data shows that plants accelerate pesticide dissipation from aquatic systems by increasing sedimentation, biofilm contact and photolysis. In this study, a graphical model was constructed and calibrated with site-specific and supplementary data to describe the loss of two pesticides, endosulfan and fluometuron, from a vegetated and a non-vegetated pond. In the model, the major processes responsible for endosulfan dissipation were alkaline hydrolysis and sedimentation, with the former process being reduced by vegetation and the latter enhanced. Fluometuron dissipation resulted primarily from biofilm reaction and photolysis, both of which were increased by vegetation. Here, greater photolysis under vegetation arose from faster sedimentation and increased light penetration, despite shading. Management options for employing constructed wetlands to polish pesticide-contaminated agricultural runoff are discussed. The lack of easily fulfilled sub-models and data describing the effect of aquatic vegetation on water chemistry and sedimentation is also highlighted.     

Polybrominated diphenyl ethers (PBDE) in serum: findings from a US cohort of consumers of sport-caught fish

Polybrominated diphenyl ethers (PBDEs) have been used as flame retardants in foams, fabrics and plastics, and are common contaminants of household air and dust and bioaccumulate in wildlife, and are detectable in human tissues and in fish and animal food products. In the Great Lakes Basin sport fish consumption has been demonstrated to be an important source of PCB and DDE exposure. PBDEs are present in the same sport fish but prior to our study the contribution to human PBDE body burdens from Great Lakes sport fish consumption had not been investigated. This study was designed to assess PBDE, PCB and 1,1-bis(4-chlorophenyl)-2,2-dichloroethene (DDE) serum concentrations in an existing cohort of 508 frequent and infrequent consumers of sport-caught fish living in five Great Lake states. BDE congeners 47 and 99 were identified in the majority of blood samples, 98% and 62% respectively. summation operatorPBDE levels were positively associated with age, hours spent outdoors, DDE, summation operatorPCB, years of sportfish consumption, and catfish and shellfish intake, and negatively associated with income and recent weight loss. Other dietary components collected were not predictive of measured summation operatorPBDE levels. In multivariate models, summation operatorPBDE levels were positively associated with age, years consuming sport fish, shellfish meals, and computer use and negatively associated with recent weight loss. Having summation operatorPBDE levels in the highest quintile was independently associated with older age, male gender, consumption of catfish and shellfish, computer use and spending less time indoors. summation operatorPCB and DDE were strongly associated suggesting common exposure routes. The association between summation operatorPBDE and summation operatorPCB or DDE was much weaker and modeling suggested more diverse PBDE sources with few identified multi-contaminant-shared exposure routes. In our cohort Great Lakes sport fish consumption does not contribute strongly to PBDE exposure.     

Partial stroke testing of process shutdown valves: How to determine the test coverage

Partial stroke testing (PST) has recently been introduced as a semi-automatic means to test process shutdown valves. Normally, this type of testing does not disturb the process and can detect many of the failures that traditionally have been revealed only by functional testing. The fraction of all dangerous failures that are detected by PST is called the PST coverage and is decisive for the effectiveness of the PST. So far, limited guidance on how to determine the PST coverage has been given. This paper discusses the application and limitations of PST and suggests a new procedure for how to determine the PST coverage factor.     

Dispositional and contextual determinants of organizational citizenship behavior

This study of 402 professional and administrative employees of a VA hospital addressed the question of whether certain dispositional factors (Agreeableness, Conscientiousness, and Equity Sensitivity) could account for the relationship between contextual work attitudes and organizational citizenship behavior (OCB). Findings indicate this not to be the case. Fairness/satisfaction had independent effects on OCB. Additionally, Conscientiousness predicted some forms of OCB. Neither Agreeableness nor Equity Sensitivity affected OCB. Implications are noted for further inquiry into OCB.     

Overview of particulate exposures in the US trucking industry

As part of a large epidemiologic study of lung cancer, 55,000 subjects, we have conducted a nation-wide survey of particulate exposures in the US trucking industry. The goal is to differentiate the risks from various types of particulate exposures, such as traffic emissions and general air pollution. We hypothesize that exposures defined by job and work site characteristics can be linked with subjects using their personal job histories. This report covers exposures at 36 randomly chosen large truck freight terminals in the US. Measurements were made of PM2.5, elemental carbon (EC), and organic carbon (OC) upwind of the terminal (background) and in work areas, and by personal samples. Significant differences in exposure intensity, microg m(-3), were found for work locations and jobs relative to background levels (GM[GSD]) at terminal sites: PM2.5 9.8[2.34], EC 0.5[3.24], and OC 5.0[1.76]. Using EC as a marker for diesel particles, work locations varied significantly: office 0.3[3.7], dock area 0.7[2.89] and shop area 1.5[3.52]), as did job titles (non-smokers): clerk 0.1[9.98], dock worker 0.8[2.13], and mechanic 2.0[3.82]. Cigarette smoking contributed substantially to personal exposures, approximately doubling PM2.5 and OC, but having less of an effect on EC. Large differences were seen across the terminal sites due to differences in local regional air pollution levels from traffic and other sources. We conclude that it will be possible to estimate current exposures of the cohort using an exposure assignment matrix based on job title, work location, and terminal site. This distribution overlaps substantially with the general public's exposure to these sources.     

Estimating the effects of urban residential development on water quality using microdata

In this study, we examine the impact on water quality of urbanization using disaggregate data from Wake County, North Carolina. We use a unique panel data set tracing the conversion of individual residentially zoned land parcels to relate the density of residential development and the change in residential land use to three measures of water quality. Using a spatial econometrics model, we relate spatially and temporally referenced monitoring station readings to our measures of residential land use while controlling for other factors affecting water quality. We find that both the density of residential land use and the rate of land conversion have a negative impact on water quality. The impacts of these non-point sources are found to be larger in magnitude than those from urban point sources.     

Assessing alternatives for mitigating net greenhouse gas emissions and increasing yields from rice production in China over the next twenty years

Assessments of the efficacy of mitigation of greenhouse gas (GHG) emissions from paddy rice systems have typically been analyzed based on field studies. Extrapolation of the mitigation potential of alternative management practices from field studies to a national scale may be enhanced by spatially explicit process models, like the DeNitrification and DeComposition (DNDC) model. Our objective was to analyze the impacts of mitigation alternatives, management of water, fertilizer, and rice straw, on net GHG emissions (carbon dioxide, methane, and nitrous oxide fluxes), yields, and water use. After constructing a GIS database of soil, climate, rice cropping area and systems, and management practices, we ran DNDC with 21-yr alternative management schemes for each of the approximately 2500 counties in China. Results indicate that, despite large-scale adoption of midseason drainage, there is still large potential for additional methane reductions from Chinese rice paddies of 20 to 60% over 2000-2020. However, changes in management for reducing CH4 emissions simultaneously affect soil carbon dynamics as well as N2O emissions and can thereby reorder the ranking of technical mitigation effectiveness. The order of net GHG emissions reduction effectiveness found here is upland rice > shallow flooding > ammonium sulfate > midseason drainage > off-season straw > slow-release fertilizer > continuous flooding. Most of the management alternatives produced yields comparable to the baseline; however, continuous flooding and upland rice significantly reduced yields. Water management strategies appear to be the most technically promising GHG mitigation alternatives, with shallow flooding providing additional benefits of both water conservation and increased yields.