Integrated model of simulated occupant injury risk and real medical costs

Introduction

The purpose of this study was to develop an integrated methodology that links occupant injury risk functions, estimated in the laboratory, with real world medical treatment costs by using the abbreviated injury score (AIS). Using our model, the expected medical treatment costs for crash injuries to various body regions and of different severities can be investigated.

Methods

First, the simulation results are compared with NHTSA crash data. We used a modified kinematics simulation model that incorporates an F = E^b function as a supplement to the previous Steffan's model to obtain a more accurate acceleration history a(t). Second, head injury criteria HIC₃₆ can be calculated from a(t), and we use the injury probability P as a function of HIC_36, as proposed by Kuppa, to obtain the injury risk function for various AIS values. Third, medical treatment cost models for various AIS values can be calculated by using a regression cost model with real world data. Finally, the injury risk function and medical treatment cost models are linked through AIS values. We establish an integrated methodology and predict medical costs and car safety data using real world police reports, medical treatment costs, and laboratory simulation results.

Results

Using head injuries in frontal crashes as an example, we focus on simulation parameters for different vehicle models, with and without airbags. We specifically examine impact closing speed, Delta-V, and impact directions.

Conclusion

Simulation results can be used to supplement insufficient real crash data, in particular ΔV, and injury risk results from police crash reports.

Impact on industry

The proposed integrated methodology may provide the vehicle industry with a new safety assessment method. Real crash data coupling provides consumers with more realistic and applicable information.     

SO2 inhalation causes synaptic injury in rat hippocampus via its derivatives in vivo

SO₂ remains a common air pollutant, almost half of the world’s population uses coal and biomass fuels for domestic energy. Limited evidence suggests that exposure to SO₂ may be associated with neurotoxicity and increased risk of hospitalization and mortality of many brain disorders. However, our understanding of the mechanisms by which SO₂ causes harmful insults on neurons remains elusive. To explore the molecular mechanism of SO₂-induced neurotoxic effects in hippocampal neurons, we evaluated the synaptic plasticity in rat hippocampus after exposure to SO₂ at various concentrations (3.5 and 7 mg m⁻³, 6 h d⁻¹, for 90 d) in vivo, and in primary cultured hippocampal neurons (DIV7 and DIV14) after the treatment of SO₂ derivatives in vitro. The results showed that SYP, PSD-95, NR-2B, p-ERK1/2 and p-CREB were consistently inhibited by SO₂/SO₂ derivatives in more mature hippocampal neurons in vivo and in vitro, while the effects were opposite in young hippocampal neurons. Our results indicated that in young neurons, SO₂ exposure produced neuronal insult is similar to ischemic injury; while in more mature neurons, SO₂ exposure induced synaptic dysfunctions might participate in cognitive impairment. The results implied that SO₂ inhalation could cause different neuronal injury during brain development, and suggested that the molecular mechanisms might be involved in the changes of synaptic plasticity.     

基于伤害监测的产品安全监管模式研究

鉴于缺陷产品给消费者造成的人身伤害日渐增多,通过分析产品伤害流行病学的模型,提出采用不同的干预措施,包括预警、召回、完善标准和法律等手段,及时消除由缺陷产品引起的各种伤害,而这有赖于对大量的缺陷信息的收集和分析。国外一些发达国家建立的产品伤害监测系统,通过样本医院收集由产品缺陷导致的伤害事故,被证明是一种有效的信息收集手段。为此,我国有关部门开始着手建立产品伤害监测系统的前期研究工作,并进行试点研究,取得大量一手资料。建议借鉴国外的成功经验,尽快建立适合我国国情的产品伤害监测系统,并开展有关重点产品的伤害监测活动。     

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.     

Environmental evaluation for workplace violence in healthcare and social services

PROBLEM: Federal policy recommends environmental strategies as part of a comprehensive workplace violence program in healthcare and social services. The purpose of this project was to contribute specific, evidence-based guidance to the healthcare and social services employer communities regarding the use of environmental design to prevent violence. METHOD: A retrospective record review was conducted of environmental evaluations that were performed by an architect in two Participatory Action Research (PAR) projects for workplace violence prevention in 2000 and, in the second project in 2005. Ten facility environmental evaluation reports along with staff focus group reports from these facilities were analyzed to categorize environmental risk factors for Type II workplace violence. RESULTS: Findings were grouped according to their impact on access control, the ability to observe patients (natural surveillance), patient and worker safety (territoriality), and activity support. DISCUSSION: The environmental assessment findings reveal design and security issues that, if corrected, would improve safety and security of staff, patients, and visitors and reduce fear and unpredictability. IMPACT ON INDUSTRY: Healthcare and social assistance employers can improve the effectiveness of violence prevention efforts by including an environmental assessment with complementary hazard controls.     

甲撑二苯基二异氰酸酯(MDI)生产过程中危险有害因素及对策措施

甲撑二苯基二异氰酸酯 (MDI)生产过程中涉及到了多种危险有害因素。笔者通过对国内现役MDI生产装置进行调研 ,同时结合国内外其他涉及光气生产厂家的情况 ,分析并指出了生产过程中可能出现的危险有害因素 ,从而提出了相应的对策措施     

1900个乡镇工业的工伤职业病医疗保障现状分析

在调查的１９００个乡镇工业企业中,有９．３％ 的企业对职工工伤职业病没有任何保障,其中尤其是个体联户所办企业则高达１５％ 。按行业进行分析,最易发生工伤职业病的各种矿山采选业、建材生产业,能给予报销医疗费的企业占７８．５％ ,部分给予报销的企业占１０．２％ ,不予报销企业占１１．３％ 。从保障程度看,能给予全部报销医疗费的企业仍以乡办企业为最高（９３．２％ ）,其次为村办企业（９０．２％ ）和个体联户所办企业（８８．５％ ）     

Using state administrative data to study nonfatal worker injuries: challenges and opportunities

PROBLEM: Administrative data from states have the potential to capture broader representation of worker injury, facilitating examination of trends, correlates, and patterns. While many states use their workers' compensation (WC) data to document frequency and type of injury, few conduct in-depth examinations of patterns of injury and other etiologies. Administrative data are generally an untapped resource. METHOD: Comparisons are made among four state databases used in a study linking worker injuries and patient outcomes in hospitals and nursing homes. RESULTS: Worker injury data varies in terms of inclusion criteria, variables, and coding schemes used. Linkages to organizational level characteristics can be difficult. CONCLUSIONS: Despite limitations, data can be used to study injury patterns and etiologies. Users must be knowledgeable and recognize how database characteristics may influence results.     

Adolescent driver risk taking and driver education: evidence of a mobility bias in public policymaking

PROBLEM: Road traffic injury is the leading cause of death among adolescents in high-income countries. Researchers attribute this threat to driver risk taking, which driver education (DE) attempts to reduce. Many North American authorities grant DE graduates earlier access to unsupervised driving despite no evidence of this being a safety benefit. This theoretical article examines risk taking and DE in relation to an apparent mobility bias (MB) in policymaking. METHOD: The MB is defined, the history and sources of driver risk taking are examined, and the failure of DE to reduce collision risk is analyzed in relation to a potential MB in licensing policies. DISCUSSION: The author argues that DE's failure to reduce adolescent collision risk is associated with a MB that has produced insufficient research into DE programs and that influences public policymakers to grant earlier licensure to DE graduates. Recommendations are made regarding future research on DE and risk taking, coordinated improvements to DE and driver licensing, and a plan to reduce collision risk by encouraging parental supervision after adolescent licensure. IMPACT ON INDUSTRY: Research on adolescent driver risk taking would have direct applications in DE curricula development, driver's license evaluation criteria, graduated licensing (GDL) policies, as well as other aspects of human factor research into the crash-risk problem.     

New Zealand drivers study: developing a methodology for conducting a follow-up study of newly licensed drivers

PROBLEM: In recent years, there has been a significant reduction in traffic crash injury among young people, but they continue to be overrepresented in the traffic crash statistics. To improve this situation, sound scientific evidence is needed to develop effective policies and programs. METHOD: The aim of the proposed study is to provide this evidence by examining early driving and driving-related experiences of newly licensed drivers as they progress through the learner-, restricted-, and full-license stages of the graduated licensing system and to determine the impact of these experiences on subsequent negative traffic-related outcomes (risky driving behavior, injury traffic crashes, noninjury traffic crashes, infringements, convictions). Given the size and complexity of the proposed study, a comprehensive pilot study was undertaken to determine the feasibility of conducting a New Zealand-wide cohort study of newly licensed drivers. RESULTS: This article describes the pilot study process and the methodology that has been developed for the New Zealand-wide study.