On-Scene Injury Severity Prediction (OSISP) Algorithm for Truck Occupants

Objective: The aim of this study is to develop an on-scene injury severity prediction (OSISP) algorithm for truck occupants using only accident characteristics that are feasible to assess at the scene of the accident. The purpose of developing this algorithm is to use it as a basis for a field triage tool used in traffic accidents involving trucks. In addition, the model can be valuable for recognizing important factors for improving triage protocols used in Sweden and possibly in other countries with similar traffic environments and prehospital procedures.

Methods: The scope is adult truck occupants involved in traffic accidents on Swedish public roads registered in the Swedish Traffic Accident Data Acquisition (STRADA) database for calendar years 2003 to 2013. STRADA contains information reported by the police and medical data on injured road users treated at emergency hospitals. Using data from STRADA, 2 OSISP multivariate logistic regression models for deriving the probability of severe injury (defined here as having an Injury Severity Score [ISS] > 15) were implemented for light and heavy trucks; that is, trucks with weight up to 3,500 kg and ??16,500 kg, respectively. A 10-fold cross-validation procedure was used to estimate the performance of the OSISP algorithm in terms of the area under the receiver operating characteristic curve (AUC).

Results: The rate of belt use was low, especially for heavy truck occupants. The OSISP models developed for light and heavy trucks achieved cross-validation AUC of 0.81 and 0.74, respectively. The AUC values obtained when the models were evaluated on all data without cross-validation were 0.87 for both light and heavy trucks. The difference in the AUC values with and without use of cross-validation indicates overfitting of the model, which may be a consequence of relatively small data sets. Belt use stands out as the most valuable predictor in both types of trucks; accident type and age are important predictors for light trucks.

Conclusions: The OSISP models achieve good discriminating capability for light truck occupants and a reasonable performance for heavy truck occupants. The prediction accuracy may be increased by acquiring more data. Belt use was the strongest predictor of severe injury for both light and heavy truck occupants. There is a need for behavior-based safety programs and/or other means to encourage truck occupants to always wear a seat belt.     

Bifocal/varifocal spectacles, lighting and missed-step accidents

Good lighting and the correct use of spectacles generally improve vision and presumably reduce the risk of accidents. However, bifocal and varifocal spectacles can increase the risk of misjudging distances when negotiating underfoot hazards. In some circumstances, the portion of the lens used for close work may inadvertently be used where accurate judgement of distance is necessary. This paper reports results from two studies of patient interviews using the Merseyside Accident Information Model; the first a study of accidents which occurred during paid employment (1504 cases) and the second of 1326 accidents mainly in domestic and leisure activities. Underfoot accidents were identified by the first unforeseen event perceived by the patient. The relationship between underfoot events and the type of spectacles worn by the patient at the time of accident was analysed. In both studies there was a significant association between accidents where the first event was ‘missed edge of’ (step) and wearing bifocal/varifocal spectacles. Corporal movements reported in both studies indicated that ‘stepping down’ when wearing bifocal/varifocal spectacles, increased the risk of ‘missed edge’ accidents. In the work environment corporal movements associated with manual handling of loads also increased the risk of ‘missed edge’ accidents when wearing bifocal/varifocal spectacles.     

A comparative assessment of waste incinerators in the UK

The uptake in Europe of Energy from Waste (EfW) incinerator plants has increased rapidly in recent years. In the UK, 25 municipal waste incinerators with energy recovery are now in operation; however, their waste supply chains and business practices vary significantly. With over a hundred more plant developments being considered it is important to establish best business practices for ensuring efficient environmental and operational performance. By reviewing the 25 plants we identify four suitable case study plants to compare technologies (moving grate, fluidised bed and rotary kiln), plant economics and operations. Using data collected from annual reports and through interviews and site visits we provide recommendations for improving the supply chain for waste incinerators and highlight the current issues and challenges faced by the industry. We find that plants using moving grate have a high availability of 87–92%. However, compared to the fluidised bed and rotary kiln, quantities of bottom ash and emissions of hydrogen chloride and carbon monoxide are high. The uptake of integrated recycling practices, combined heat and power, and post incineration non-ferrous metal collections needs to be increased among EfW incinerators in the UK. We conclude that one of the major difficulties encountered by waste facilities is the appropriate selection of technology, capacity, site, waste suppliers and heat consumers. This study will be of particular value to EfW plant developers, government authorities and researchers working within the sector of waste management.     

Driving disability and dizziness

PROBLEM: People with dizziness caused by vestibular (i.e., inner ear) disorders complain of difficulty driving. Physicians occasionally warn their patients with vestibular disorders not to drive. Few studies have asked patients about their driving performance, so little data are available. METHOD: Using the Driving Habits Questionnaire, the authors did structured interviews with people with several different vestibular disorders and with normal subjects. The self-reported crash rate and rate of citations for moving violations did not differ between the subject groups. RESULTS: Patients report reduced driving skills, particularly in situations when visual information is reduced, rapid head movements are used, and specific path integration or spatial navigation skills are needed.     

Factors affecting conviction rates of intoxicated driver patients in two large trauma centers

Objective: Outcomes from previous studies report the driving under the influence (DUI) conviction rates for trauma patients in several cities within Canada and the United States over the last 2 decades. This study reports charge, conviction, and prosecution rates for trauma patients at 2 level I trauma centers servicing a large metropolitan city.

Methods: A retrospective review of the trauma databases was completed to identify patients meeting inclusion criteria. Four hundred sixty patients were identified and their records were compared with the district attorney's records for DUI charges and convictions.

Results: The conviction rate for this study was 8.7%, demonstrating continued low rates of conviction despite growing interest and public awareness of drinking and driving.

Conclusions: We discuss legal considerations that providers should consider when treating patients who have been drinking and driving.     

The distribution and composition of hydrocarbons in sediments from the Fladen Ground, North Sea, an area of oil production

The distribution and composition of hydrocarbons in sediment from the Fladen Ground oilfield in the northern North Sea have been investigated. The total PAH concentrations (2- to 6-ring parent and alkylated PAHs, including the 16 US EPA PAHs) in sediments were relatively low (<100 microg kg(-1) dry weight). The PAH, the Forties crude and diesel oil equivalent concentrations were generally higher in sediment of fine grain size and higher organic carbon concentration. PAH distributions and concentration ratios indicated a predominantly pyrolytic input, being dominated by the heavier, more persistent, 5- and 6-ring compounds, and with a high proportion of parent PAHs. The n-alkane profiles of a number of the sediments contained small, high boiling point, UCMs, indicative of weathered oil arising from a limited petrogenic input. The geochemical biomarker profiles of the sediments that contained UCMs showed a small bisnorhopane peak and a high proportion of norhopane relative to hopane, indicating that there was contamination from both Middle Eastern and North Sea oils. Therefore contamination was not directly as a result of oil exploration activity in the area. The most likely source of petrogenic contamination was from general shipping activity.