Using data linkage to assess the impact of motorized recreational vehicle-related injuries in Ohio

Problem

Motorized recreational vehicle (MRV)-related injuries can result in severe medical and financial consequences. The objective of this study was to describe the epidemiology, and clinical and financial impact of MRV-related injuries in Ohio.

Method

Probabilistically linked statewide Emergency Medical Services (EMS) and hospital (inpatient and emergency department) data for 2003 and 2004 were examined. Record pairs with a MRV-related E-code (E821-E823, E825) were included in this study.

Results

There were 2,893 patients with MRV-related injuries, who had linked EMS and hospital records, resulting in more than $15 million in hospital charges and 1,921 inpatient days of hospitalization. The male-to-female ratio was nearly 4:1, and 19% were younger than 16. Almost 82% of cases were not wearing a helmet; there was a trend of decreasing helmet use with increasing age. Mean (SE) inpatient hospital charges and length of stay (LOS) were $22,218 ($1,290) and 3.8 (0.2) days, respectively. The mean (SE) Injury Severity Score (ISS) for inpatients was 9.2 (0.4). Individuals injured on a street/highway were 3.20 times more likely to sustain an ISS ≥ 16 (95% CI: 1.03, 9.88; p = 0.044) and 3.05 times more likely to sustain a traumatic brain injury (TBI) (95% CI: 1.17, 7.94; p = 0.024) than those who were injured at a place designated for sport or recreation. Children aged 12 to 15 and young adults aged 16 to 25 were 2.47 and 2.14 times more likely, respectively, to sustain a TBI than adults aged 36 or older (aged 12 to 15: 95% CI: 1.13, 5.38; p = 0.024; aged 16 to 25: 95% CI: 1.26, 3.64; p = 0.005). Higher ISS was associated with both higher total charges (p < 0.001) and longer LOS (p < 0.001).

Discussion

This study demonstrates that MRV-related injuries are an important public health problem in Ohio, with a substantial clinical and financial impact.

Impact on Industry

Enactment and enforcement of statewide MRV safety legislation and training of MRV users offer valuable opportunities to prevent these costly injuries.     

Evaluation of a healthcare safety climate measurement tool

Problem

Psychometrically validated measurement tools are needed to evaluate an organization's safety climate. In 2000, Gershon and colleagues published a new healthcare safety climate measurement tool to determine its relationship to safe work behavior (Gershon, R., Karkashian, C., Grosch, J., Murphy, L., Escamilla-Cejudo, A., Flanagan, P., et al. (2000). Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. American Journal of Infection Control, 28, 211-21). The present study evaluated the psychometric properties of the Gershon tool when modified to address respiratory rather than bloodborne pathogen exposures.

Method

Medical practitioners, nurses, and nurse aides (n = 460) were surveyed using the modified Gershon tool. Data were analyzed by factor analysis and psychometric properties of the tool evaluated.

Results

Eight safety climate dimensions were extracted from 25 items (Cronbach's alpha range: 0.62 - 0.88). Factor extractions and psychometric properties were reasonably consistent with those of the Gershon tool.

Impact on Industry

The Gershon safety climate tool appears to have sufficient reliability and validity for use by healthcare decision makers as an indicator of employee perceptions of safety in their institution.     

Numerical simulation of hydrogen–air detonation for damage assessment in realistic accident scenarios

An accidental hydrogen release within an equipment enclosure may result in the presence of detonable mixture in a confined environment. From a safety standpoint, it is then useful to assess the potential for damage. In that context, numerical simulation of the sequence of events subsequent to detonative ignition provides a useful tool, although with obvious limitations. This article describes the procedure, summarizes two case studies, and reviews the limitations. First, a hydrogen dispersion pattern is obtained from numerical simulation of dispersion, using a commercial package designed primarily for incompressible flow. This dispersion cloud is then used as the initial condition in an inviscid, compressible, reactive flow simulation. To force detonative ignition, a sufficiently large amount of energy is deposited in a small region that corresponds to the ignition location. Chemistry is modeled using a single step Arrhenius model. Because the wave thickness is small compared with the computational domain, a fine mesh is needed, limiting the practicality of the process to two-dimensional geometries. This is the most significant limitation; it is conservative. The two cases described in the paper include an electrolyzer, in which a small release occurs, leading potentially to some damage to the enclosure, and a reformer, in which the consequences are potentially more serious.     

Carbon capture and storage-desirability from a risk management point of view

Environmental and safety risks related to carbon capture and storage concern leakages and accidental releases during transport and geological storage. Based on principles widely accepted in the EU and beyond in the discussion about the where’s and why’s of nuclear waste repositories, this paper discusses the desirability of carbon capture and storage from a risk management point of view, focusing on environmental risks on the global level (climate change). On this basis it is concluded that, if the key energy issue of coming generations, not just in Europe but all around the world, is not the abundance of fossil resources but rather an unacceptably high probability of global warming due to greenhouse gas emissions, then the solution should not include any massive hiding of the emissions but entirely focus on the avoidance based on improved technology in power plants and other industrial installations.     

中美新化学物质管理制度的比较

简要叙述了中美两国新化学物质管理的基本情况,分别从管理原则、管理范围、管理具体要求、申报种类、评审程序、监督管理等方面重点论述了中美新化学物质管理制度的特点。通过借鉴美国新化学物质管理的优点及经验,提出了强化和完善中国新化学物质管理制度的对策。     

准液膜富集环境水中痕量金属离子

对准液膜法富集环境水中痕量Ｚｎ２＋、Ｃｄ２＋、Ｐｂ２＋进行了研究,此法简单、快速,富集倍数达１００倍,回收率在９５％以上。     

城市生活垃圾生命周期管理

生命周期评价是一种全面的环境管理工具,具有潜在的发展前景。０它通过对产品,产品系统,工艺活动整个生命周期的环境影响环境改善的机会进行评价。根据国际环境毒理与化学学会１９９３年和ＩＳＯ１４０００环境管理体系中关于生命周期评价的技术框架,本文应生命周期评价在城市生产垃圾管理系统中的作用及管理系统的清单分析,影响评价和改善评价进行研究。     

聚焦ISO 14001标准 创建生态旅游岛

结合鼓浪屿区实施ISO14001标准,探讨了其意义,实施步骤和特点,可为其它风景名胜区建立环境管理体系所借鉴。     

中国自然保护区可持续管理模式探讨——伦敦自然保护区管理模式借鉴

近年来,世界各地自然保护区迅速发展,如何有效持续地管理这些自然保护区成为一个重要的问题。文章分析了我国自然保护区现有管理模式的特点与存在的问题,简要介绍了伦敦自然保护区的管理模式现状,根据我国的实际情况,笔者认为中国的自然保护区应采用强制式和完全参与合作式相结合的管理模式,并提出了几点管理模式的改革建议。