Objective: Though motor vehicle crashes (MVCs) were the main cause of head trauma from road traffic injuries (RTIs), motorcycle crashes (MCCs) are now a major cause of RTI-related head injury (HI) in many developing countries.
Methods: Using a prospective database of HIs from a neurosurgical practice in a sub-Saharan African developing country, a cross-sectional survey was conducted for the trauma demography and clinical epidemiology of this MCC-related HI.
Results: Motorcycle crashes accounted for 57% (473/833) of all RTI-related HIs in this registry. The victims, with a mean age of 33.1 years (SD = 18.3), consisted mainly of males (83.1%), those of low socioeconomic status (>90%), and those aged between 20 and 40 years old (56%). MCCs involved only riders in 114 cases (114/473, 32.1%), of which 69% were motorcycle–motorcycle crashes. The HI was moderate–severe in 50.8%; clinical symptomatology of significant HI included loss of consciousness (92%), anisocoria (35%), Abbreviated Injury Scale head (AIS–head) score > 3 (28%), and CT-Rotterdam score > 3 (30%). Extracranial systemic injury involved the limbs most frequently, with an Injury Severity Score (ISS) >25 in 49%. The fatality rate was 24%.
MCC-related HI among pedestrian victims involved more vulnerable age groups (the young and elderly) but have lower mean ISS compared to motorcycle passengers (mean ISS = 23.5 [11.6] vs. 27.4 [13.0]; 95% confidence interval [CI], 1.27–6.49; P = .004). In addition, compared to a contemporary cohort of MVC-related HIs in our registry, MCC victims were older (mean age 34.8 years [18.0] vs. 30.8 [18.4]; P = .002); had higher proportions of certain extracranial trauma like long bone fractures (71 vs. 29%; P = .02); and suffered fewer surgical brain lesions (25.5 vs. 17.2%; P = .004).
Conclusions: Motorcycle crashes are now a significant threat to the heads, limbs, and lives of vulnerable road users in developing countries. 相似文献
Various indicators of health have been shown to be associated with traffic crash involvement. As general health is also related to absence from work, the latter variable may be more strongly related to crashes, especially for professional drivers.
Method
Bus driver absence from work was analyzed in association with their crash records. Two British samples and one Swedish sample were used.
Results
One of the British samples yielded fair correlations between crash record and absence, while for the other the effect was restricted to the first three months of driving. The Swedish data had effects in the expected direction but these were not significant.
Discussion
The use of an indirect, overall measurement of health, may be a viable method for predicting the traffic crash involvement for professional drivers, although replications are needed in larger samples and other populations.
Impact on industry
The use of absence records for the identification of at risk drivers would seem to be a simple and useful method for companies with major fleets, and it also shows the importance of promoting employee health and well being at work as a potential method of reducing the cost, not only of absenteeism, but also of crashes in company vehicles. 相似文献
Motor-vehicle crashes are a leading cause of death in the United States. In the event of a crash, seat belts are highly effective in preventing serious injury and death.
Methods
Data from the 2006 Behavioral Risk Factor Surveillance System were used to calculate prevalence of seat belt use by state and territory and by type of state seat belt law (primary vs. secondary enforcement).
Results
In 2006, seat belt use among adults ranged from 58.3% to 91.9% in the states and territories. Seat belt use was 86.0% in states and territories with primary enforcement laws and 75.9% in states with secondary enforcement laws.
Discussion
Seat belt use continues to increase in the United States. Primary enforcement laws remain a more effective strategy than secondary enforcement laws in getting motor-vehicle occupants to wear their seat belts. 相似文献
PROBLEM: Graduated Driver Licensing (GDL) programs vary in the United States in terms of implementation and restrictions. The State of Iowa's GDL program is assessed for its effectiveness in reducing crashes among teenage drivers. METHOD: Time series analysis was used to evaluate police documented crashes involving 16-, 17-, and 18-year-old drivers over a 10 year period, with an intervention identified at the point of GDL implementation. RESULTS: After controlling for seasonal trends and auto-correlative effects, a significant reduction in the crash rate of and 16- and 17-year-old drivers was observed due to the GDL implementation. However, there were no significant reductions in crash rates for 18-year-old drivers. DISCUSSION: The analyses suggest that the Iowa GDL program is effective in reducing the crash rates of 16- and 17-year-old drivers but the effects do not sustain for 18-year-old drivers. IMPACT ON INDUSTRY: The results suggest that the program appears to be working, however further analysis is needed to determine what factors are preventing lasting effects for these teenage drivers. 相似文献