Road accidents,an occupational risk

Road accidents sustained at work represent between 20% and 40% of work fatalities in most industrialised countries, yet few data on occupational road accident risk factors have been published. A case control study was performed to assess the role of work-related risk factors in the occurrence of occupational road accidents. A preliminary qualitative study was carried out to identify possible occupational factors in occupational road accidents, and to draw up the case control study. Cases were recruited from the Rhône road trauma registry (France), controls from voting lists. A telephone interview was performed. Exposure to road risk was measured as a percentage of work time. One hundred and forty-six cases and 440 matched controls were interviewed. Accident risk was found to increase with exposure. Driving was associated with more difficult working conditions than found in jobs not involving driving. These difficulties, however, were not systematically associated with increased occupational road accident risk. Among factors which still emerge after adjustment for road risk exposure, there are scheduling issues (inflexible schedule organisation, lack of consecutive rest-days, lack of flexibility in performing the work), difficulties of communication with superiors, low seniority in the activity, low educational level and physical constraints at work. This study highlights some possible occupational road accident risk factors. Given the chosen case/control methodology, the findings may be considered as advancing our knowledge of the subject, but need confirmation by further studies.     

Current practice of first-trimester ultrasound screening for structural fetal anomalies in developed countries

Objectives

First-trimester ultrasound screening is increasingly performed to detect fetal anomalies early in pregnancy, aiming to enhance reproductive autonomy for future parents. This study aims to display the current practice of first-trimester ultrasound screening in developed countries.

Method

An online survey among 47 prenatal screening experts in developed countries.

Results

First-trimester structural anomaly screening is available in 30 of the 33 countries and is mostly offered to all women with generally high uptakes. National protocols are available in 23/30 (76.7%) countries, but the extent of anatomy assessment varies. Monitoring of scan quality occurs in 43.3% of the countries. 23/43 (53.5%) of the respondents considered the quality of first-trimester ultrasound screening unequal in different regions of their country.

Conclusions

First-trimester screening for structural fetal anomalies is widely offered in developed countries, but large differences are reported in availability and use of screening protocols, the extent of anatomy assessment, training and experience of sonographers and quality monitoring systems. Consequently, this results in an unequal offer to parents in developed countries, sometimes even within the same country. Furthermore, as offer and execution differ widely, this has to be taken into account when results of screening policies are scientifically published or compared.     

Deprived neighborhoods and risk of road trauma (incidence and severity) among under 25year-olds in the Rhône Département (France)

Introduction

Previous research has shown that there are inequalities with regard to traffic accident risk between different social categories. This study describes the influence of the type of residential municipality (with or without deprived urban areas, “ZUS, zones urbaines sensibles”), used as an indicator of contextual deprivation, on the incidence and severity of road trauma involving people of under 25 years of age in the Rhône.

Method

Injury data were taken from The Rhône Road Trauma Registry. The study covers the 2004–2007 period, with 13,589 young casualties. The incidence of traffic injury of all severities were computed according to the type of municipality and the age, gender, and type of road user. The ratios of the incidences of deprived municipalities, compared with others were calculated. Subsequently the severity factors and incidences according to the severity level (ISS 1–8, ISS 9+) were studied.

Results

For the main types of road users except motorized two-wheeler users, the incidences were higher in the deprived municipalities: the greatest difference was for pedestrians, where the incidences were almost twice those of other municipalities. This excess risk, constituting a health inequality topic rarely considered, was even greater in municipalities with two or three ZUSs. It was essentially observed for minor injuries among motorists, cyclists, and pedestrians.

Conclusions

While the incidence increased among people less than 25 years of age, the severity of road injuries was lower in deprived neighborhoods, contrary to what is suggested by other studies. This lower severity disappeared when taking into account the crash characteristics.

Impact on industry

The incidence of injuries as a pedestrian, cyclist or motorist is higher among young people living in deprived municipalities. These areas should therefore be the targets of dedicated education programs, as well as further investigations about urban planning.