Objectives: Motor vehicle collisions (MVCs) are a significant health burden in Saudi Arabia. The literature has consistently indicated that chronic medical conditions, such as diabetes, heart disease, stroke, obstructive sleep apnea, and neurodevelopmental disorders, increase the risk of MVCs. Therefore, assessment of driver fitness by primary care physicians (PCPs) remains a major health intervention that might reduce MVCs. We studied the practices of PCPs in assessing medical fitness to drive in at-risk patients.
Methods: We conducted a cross-sectional study of all 88 government-funded primary care centers in the city of Riyadh, Saudi Arabia. We administered a self-reported questionnaire to PCPs that inquired about their driving risk assessment for specific medical conditions.
Results: Among all PCPs and centers, 189 PCPs (63%) from 74 centers (84%) participated in our survey. The mean age of the PCPs was 40 ± 10 years, and 108 (57%) were men. The average clinical experience of the group was 13 ± 9 years. Fewer than half of PCPs considered diabetes mellitus (45%) and obstructive sleep apnea (46%) as potential risks for MVCs. Approximately 45% of PCPs did not notify any authority or relatives of potential driving issues that they noticed in their patients. Only 15% of the participants believed that PCPs were responsible for alerting authorities about their fitness to drive.
Conclusions: PCPs did not adequately assess their patients' driving history and eligibility. Efforts are needed to improve awareness among PCPs regarding the effects of chronic medical conditions on driving. 相似文献
Introduction: Cycling is one of the main forms of transportation in Denmark. However, while the number of traffic crash fatalities in the country has decreased over the past decade, the frequency of cyclists killed or seriously injured has increased. The high rate of serious injuries and fatalities associated with cycling emphasizes the increasing need for mitigating the severity of such crashes. Method: This study conducted an in-depth analysis of cyclist injury severity resulting from single and multiparty bicycle-involved crashes. Detailed information was collected using self-reporting data undertaken in Denmark for a 12-month period between 1 November 2012 and 31 October 2013. Separate multilevel logistic (MLL) regression models were applied to estimate cyclist injury severity for single and multiparty crashes. The goodness-of-fit measures favored the MLL models over the standard logistic models, capturing the intercorrelation among bicycle crashes that occurred in the same geographical area. Results: The results also showed that single bicycle-involved crashes resulted in more serious outcomes when compared to multiparty crashes. For both single and multiparty bicycle crash categories, non-urban areas were associated with more serious injury outcomes. For the single crashes, wet surface condition, autumn and summer seasons, evening and night periods, non-adverse weather conditions, cyclists aged between 45 and 64 years, male sex, riding for the purpose of work or educational activities, and bicycles with light turned-off were associated with severe injuries. For the multiparty crashes, intersections, bicycle paths, non-winter season, not being employed or retired, lower personal car ownership, and race bicycles were directly related to severe injury consequences. Practical Applications: The findings of this study demonstrated that the best way to promote cycling safety is the combination of improving the design and maintenance of cycling facilities, encouraging safe cycling behavior, and intensifying enforcement efforts. 相似文献
Major industrial accidents, which are a type of technological disaster, are very important due to the security risks and financial damages that threaten the environment and human health in today's industrialization. In this study, it was aimed to propose an approach that will guide the decision makers to choose the emergency assembly point that should be in the distance or shelter where the employees will be not affected by the negative consequences of emergencies within the scope of the obligation of industrial establishments preparing an internal emergency plan for major industrial accidents. For this purpose, in the first stage, modelling studies were carried out with ALOHA (Areal Locations of Hazardous Atmospheres) Software over possible accident scenarios in an industrial establishment containing different types and amounts of hazardous chemicals. As a result of modelling studies, possible toxic emissions, fire and explosion effect distances and threat zones for the industrial establishment were obtained. In the second stage, the weights of the main and sub-selection criteria to be used in determining the assembly point were calculated. This stage was carried out based on the comparison data obtained as a result of the questionnaire applied to professionals with the help of AHP (Analytic Hierarchy Process) method, which is one of the multi-criteria decision making methods. In the last stage, three candidate points were selected considering the physical effect areas determined in the first stage in the boundaries of the establishment, where the employees were evaluated to be affected the minimum from the negative consequences of industrial accidents. These candidate points were evaluated again with the AHP method on the basis of the sub-criteria whose relative weights were determined in the second stage and a selection was made. As a result, an approach that provides the solution of our problem was obtained. 相似文献
Introduction. The aim of this study was to evaluate the trend of occupational injuries in Turkey using epidemiologic criteria such as incidence mortality and fatality/all injuries recorded – rates. Materials and methods. Safety and health data were obtained from the Annual Statistic Books of the Social Insurance Institution (1988–2006) and Social Security Institution (2007–2011) of Turkey. Results. The results from the official data showed that although total employment is increasing the number of occupational injuries and incidence and mortality rates are decreasing. The results also demonstrate that occupational fatality/all injuries recorded – rate is increasing. The fatality/all injuries recorded – rate per 1000 injuries increased to 25.5 in 2011 from 8.6 in 1988. Each work day an average of five people died because of occupational injuries. Discussion and conclusions. The fatality/all injuries recorded – rate (the number of fatal cases per 1000 occupational injuries) is an important indicator of the injury rate for a country. Systems of occupational injury and illness surveillance constitute a critical resource for the management and reduction of occupational injuries and illness. 相似文献
Allometry is the knowledge concerning relations between the features of some beings, like animals, or cities. For example, the daily energy rate is proportional to a mass of mammals rise of 3/4. This way of thinking has spread quickly from biology to many areas of research concerned with sociotechnical systems. It was revealed that the number of innovations, patents or heavy crimes rises as social interaction increases in a bigger city, while other urban indexes such as suicides decrease with social interaction. Enterprise is also a sociotechnical system, where social interaction and accidents at work take place. Therefore, do these interactions increase the number of accidents at work or, on the contrary, are they reduction-driving components? This article tries to catch such links and assess the allometric exponent between the number of accidents at work and the number of employees in an enterprise. 相似文献
This paper focuses on the analysis of the possibility of domino effect in underground parallel pipelines relying on historical accident data and pipeline crater models. An underground pipeline can be considered as safe following an accident with an adjacent gas or liquefied pipeline when it remains outside the ground crater generated. In order to prevent the domino effect in these cases, the design of parallel pipelines has to consider adequate pipeline separations based on the crater width, which is one of the widely used methods in engineering applications. The objective of this work is the analysis of underground petroleum product pipelines ruptures with the formation of a ground crater as well as the evaluation of possible domino effects in these cases. A detailed literature survey has been carried out to review existing crater models along with a historical analysis of past accidents. A FORTRAN code has been implemented to assess the performance of the Gasunie, the Batelle and the Advantica crater models. In addition to this, a novel Accident-Based crater model has been presented, which allows the prediction of the crater width as a function of the relevant design pipeline parameters as well as the soil density. Modifications have also been made to the Batelle and Accident-Based models in order to overcome the underestimation of the crater width. The calculated crater widths have been compared with real accident data and the performance evaluation showed that the proposed Accident-Based model has a better performance compared to other models studied in this work. The analysis of forty-eight past accidents indicated a major potential of underground parallel pipelines domino effect which is proven by two real cases taken from the literature. Relying on the investigated accidents, the crater width was smaller than or equal to 20 m in most cases indicating that the definition of underground pipeline separations at around 10 m would be sufficient to ensure a small probability of the domino effect. 相似文献
The Eulerian atmospheric tracer transport model MATCH (Multiscale Atmospheric Transport and Chemistry model) has been extended with a Lagrangian particle model treating the initial dispersion of pollutants from point sources. The model has been implemented at the Swedish Meteorological and Hydrological Institute in an emergency response system for nuclear accidents and can be activated on short notice to provide forecast concentration and deposition fields.The model has been used to simulate the transport of the inert tracer released during the ETEX experiment and the transport and deposition of 137Cs from the Chernobyl accident. Visual inspection of the results as well as statistical analysis shows that the extent, time of arrival and duration of the tracer cloud, is in good agreement with the observations for both cases, with a tendency towards over-prediction for the first ETEX release. For the Chernobyl case the simulated deposition pattern over Scandinavia and over Europe as a whole agrees with observations when observed precipitation is used in the simulation. When model calculated precipitation is used, the quality of the simulation is reduced significantly and the model fails to predict major features of the observed deposition field. 相似文献