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.     

Modeled Summer Background Concentration of Nutrients and Suspended Sediment in the Mid‐Continent (USA) Great Rivers1

Angradi, Ted R., David W. Bolgrien, Matt A. Starry, and Brian H. Hill, 2012. Modeled Summer Background Concentration of Nutrients and Suspended Sediment in the Mid‐Continent (USA) Great Rivers. Journal of the American Water Resources Association (JAWRA) 48(5): 1054‐1070. DOI: 10.1111/j.1752‐1688.2012.00669.x Abstract: We used regression models to predict summer background concentration of total nitrogen (N), total phosphorus (P), and total suspended solids (TSS), in the mid‐continent great rivers: the Upper Mississippi, the Lower Missouri, and the Ohio. From multiple linear regressions of water quality indicators with land use and other stressor variables, we determined the concentration of the indicators when the predictor variables were all set to zero — the y‐intercept. Except for total P on the Upper Mississippi River, we could predict background concentration using regression models. Predicted background concentration of total N was about the same on the Upper Mississippi and Lower Missouri Rivers (430 μg l^?1), which was lower than percentile‐based values, but was similar to concentrations derived from the response of sestonic chlorophyll a to great river total N concentration. Background concentration of total P on the Lower Missouri (65 μg l^?1) was also lower than published and percentile‐based concentrations. Background TSS concentration was higher on the Lower Missouri (40 mg l^?1) than the other rivers. Background TSS concentration on the Upper Mississippi (16 mg l^?1) was below a threshold (30 mg l^?1) designed to protect aquatic vegetation. Our model‐predicted concentrations for the great rivers are an attempt to estimate background concentrations for water quality indicators independent from thresholds based on percentiles or derived from stressor‐response relationships.     

Effects of labelled meaning on the affective quality of housing scenes

A series of studies examined the effects of labelled meaning on affective response to housing scenes. Students at Ohio State University assessed their feelings towards imagined housing (public or private) and cities (Memphis, Houston and San Francisco). Expected differences in the affective quality were found. Responses to color photographs of specific housing scenes labelled as either private condominiums or public housing were obtained. Differences in scene-affect as a function of labelled meaning were found. Responses to housing scenes labelled as located in either Memphis, Houston or San Francisco revealed no differences in scene-affect as a function of label meaning. This latter finding was confirmed in a non-repeated measure examination. Differences in the fittingness, potency or relevance of the information provided may account for the pattern of findings.     

CAPITAL COST OF RURAL WATER DISTRIBUTION SYSTEMS1

ABSTRACT: The cost of water service to rural residents is very high compared to urban areas. This is true even after subsidization by Farmers Home Administration (FmHA) loans and grants. Capital cost data on 44 projects financed by the Ohio office of the FmHA during the period August 1968 to January 1977 are used to derive cost equations for 26 components of rural water distribution systems. These components represent 92 percent of the capital cost of the pipeline distribution systems studied. The data can be used to economically design rural water supply systems from a capital cost viewpoint. More data are needed on operation and maintenance costs as well as central and cluster well costs before totally economic system designs can be undertaken.     

GROUND WATER IN PERSPECTIVE1

ABSTRACT. Owing to their enormous capacity, ground-water reservoirs are at least equal in importance to the ground water itself. As regulators of water movement in the hydrological cycle, these reservoirs surpass all lakes combined, natural and manmade. While many aquifers are not well understood, data on many others are adequate for long-range broad-scale planning. An example is the basalt aquifer of the Snake River Plain in Idaho. However, the area has managerial problems which concern the time, the place and the feasibility of manipulations of water. All continents of the world contain great aquifers. For every huge aquifer, however, hundreds of smaller ones occur, and even these contain astonishing amounts of water. Aquifers in the Ohio River Basin of the United States are good examples. Management of total water resources is a difficult problem at many places. But many problems could be met and many water shortages alleviated or eliminated by use of aquifers, not merely as sources of water, but as reservoirs for management of water.     

Predicting Sustainable Ground Water to Constructed Riparian Wetlands: Shaker Trace,Ohio, USA

Water isotopy is introduced as a tool to design, locate, and select storm water best management practices for the prediction of sustained ground water inflows to prospective constructed wetlands. A primer and application of the stable isotopes, ¹⁸O and ²H, are discussed for riparian wetland restoration areas among an agricultural landscape in southwestern Ohio. Conventional piezometric measurements were ambiguous in identifying groundwater mounding across a transect which includes numerous agricultural tile drains. Instead evaporative potential data represented by δ¹⁸O values indicated a well delineated zone for prospective constructed wetlands. All successful constructed wetland areas thus far at Shaker Trace are represented by ground water with depleted δ¹⁸O values below −9.0‰ VSMOW. Such areas of sustainable ground water inflow could either be due to perched units at depth or simply the result of an increased flow gradient.     

TILE RATIONALE FOR OHIO'S DETERGENT PHOSPHORUS BAN1

ABSTRACT: Ohio signed into law a detergent phosphorus ban on March 26, 1988. This law limits the elemental phosphorus content of household laundry detergents to 0.5 percent in all 35 Lake Erie counties in Ohio by 1990. Ohio's detergent phosphorus ban will help non-compliant municipal wastewater treatment plants achieve compliance with the 1 mg/L effluent phosphorus standard. By limiting the phosphorus content of household laundry detergents, Ohio will also benefit from less phosphorus entering surface waters from combined sewer overflows, communities with treatment plant bypasses, and riparian homes with septic tanks. This is important because most of the phosphorus in laundry detergents is in the bioavailable form and Ohio's Lake Erie shoreline is particularly sensitive to Cladophora problems. When viewed in conjunction with reduced chemical costs for phosphorus removal and savings in sludge disposal costs, Ohio's detergent phosphorus ban is a pragmatic component of an international phosphorus management strategy to protect the Great Lakes.     

ESTIMATION OF VOLUME-DURATION-FREQUENCY RELATIONS OF UNGAGED SMALL URBAN STREAMS IN OHIO1

ABSTRACT: This paper describes methods for estimating volume-duration-frequency relations of urban streams in Ohio with drainage areas less than 6.5 square miles. The methods were developed to assist engineers in the design of hydraulic structures on urban streams for which temporary storage of water is an important element of the design criteria. Multiple-regression equations were developed for estimating maximum flood volumes of d-hour duration and T-year recurrence interval (dV_T). Maximum annual flood-volume data for all combinations of six durations (1, 2, 4, 8, 16, and 32 hours) and six recurrence intervals (2, 5, 10, 25, 50, and 100 years) were analyzed. The significant explanatory variables in the resulting 36 volume-duration-frequency equations are drainage area, average annual precipitation, and basin-development factor. Standard errors of prediction for the 36 dV_T equations range from ±28 percent to ±44 percent.     

Ohio's Balanced Growth Program: a case study of collaboration for planning and policy design

This paper describes the collaborative planning process for a new landscape planning programme in Ohio that seeks to influence land urbanisation patterns through joint local land use decision making on a watershed basis. The programme was developed through a collaborative process by a state agency-appointed task force that included agency staff and a wide range of stakeholders. The paper describes the process in terms of the collaborative mechanisms, the participants, the programmatic outputs, and the social and organisational outcomes that set the foundation for enhanced watershed quality through better land use decision-making practices. Key collaborations formed during the process were inter-agency collaborations, a non-profit organisation that partnered with the agencies, and that of state agencies with local governments to develop watershed-based land use plans. A most critical outcome was creation of a learning community, through an exploratory research process that used multiple methods of data gathering and consensus-building deliberation. The paper is based on a review of published documents and plans, meeting minutes, participant observation of committee and workgroup meetings and interactive research.