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BMC Public Health Nov 2023Carnage on roads is a growing concern in Nigeria. Over 27 persons, equivalent to more than 4 families, die daily from road traffic crashes. Two direct factors of a road...
BACKGROUND AND OBJECTIVE
Carnage on roads is a growing concern in Nigeria. Over 27 persons, equivalent to more than 4 families, die daily from road traffic crashes. Two direct factors of a road crash are road quality and vehicle quality. To interrogate and compare both factors to road traffic accidents, the longitudinal study regressed secondary data on death tolls against road quality and vehicle quality.
MATERIALS AND METHODS
Data on the estimated number of vehicles imported into Nigeria (1992-2021) served as the indicator of vehicle quality on Nigerian roads. The longitudinal study regressed secondary data on death tolls (2013-2019) against road quality (2006-2019) and vehicle quality (1992-2021).
RESULTS
Results showed that road quality is degenerating as well as vehicle quality in Nigeria, resulting in increase in the number of road traffic crashes and the attendant death tolls. For every 1% decrease in road quality, death tolls from road traffic crashes in Nigeria increased by 0.00642% at 5% significance, and for every decrease in vehicle quality, death tolls from road traffic crashes in Nigeria increased by 0.327% at 5% significance.
CONCLUSION
The study recommended increased advocacy on the sanctity of life and the need for all tiers of government to prioritize policy and implementation of improving the road quality and vehicle quality to reduce road traffic crashes and save lives on Nigerian roads.
Topics: Humans; Accidents, Traffic; Nigeria; Longitudinal Studies; Risk Factors; Allied Health Personnel
PubMed: 37932715
DOI: 10.1186/s12889-023-17089-2 -
Archives of Women's Mental Health Aug 2023Maternal mortality and overdose deaths have both been on the rise in the USA, but the relationship between the two is unclear. Recent reports have pointed toward...
Maternal mortality and overdose deaths have both been on the rise in the USA, but the relationship between the two is unclear. Recent reports have pointed toward accidental overdoses and suicides as leading causes of maternal mortality. This short communication collected data on psychiatric-related deaths, suicide and drug overdose, from each state's Maternal Mortality Review Committee to better conceptualize the rate at which these deaths are occurring. Data was collected from each state's most recent online MMRC legislative report and met inclusion criteria if the reports included the number of deaths due to suicide and accidental overdoses during each review period, as well if the report encompassed data from 2017. Fourteen reports met inclusion criteria, cumulatively reviewing 1929 maternal deaths. Of these deaths, 603 (31.3%) were due to accidental overdose, while 111 (5.7%) were due to suicide. These findings highlight the need for increased psychiatric care in the pregnant and postpartum period, specifically for substance use disorders. Increasing screening for depression and substance use, decriminalizing substance use during pregnancy, and extending Medicaid coverage to 12 months postpartum on a national level are all interventions that could significantly reduce maternal deaths.
Topics: Pregnancy; Female; United States; Humans; Suicide; Analgesics, Opioid; Maternal Death; Opioid Epidemic; Substance-Related Disorders; Drug Overdose
PubMed: 37284906
DOI: 10.1007/s00737-023-01334-z -
Medicine, Science, and the Law Oct 2023Although it is known that elderly pedestrians are at increased risk of injury and death from vehicle crashes the specific pattern of lethal injuries related to age has...
Although it is known that elderly pedestrians are at increased risk of injury and death from vehicle crashes the specific pattern of lethal injuries related to age has not been extensively studied. Data on the numbers of pedestrian fatalities and ages were obtained from 1990 to 2020 from the Traffic Accident Reporting System, The University of Adelaide, Adelaide, South Australia and detailed autopsy data on fatal pedestrian crashes from the pathology database at Forensic Science SA, Adelaide, South Australia from 2000 to 2020. Fatal injuries were separated into the following regions: head/face, spine, chest, abdomen and limbs/skeleton. Analysis of 634 cases of pedestrian fatalities (1990-2020) showed a significant decline in numbers over the years ( < 0.001). Analysis of fatal injuries in 219 cases (2000-2020) showed a significant reduction in the proportion of fatal head injuries with increasing age ( < 0.05), a significant increase in the proportion of fatal chest injuries with increasing age ( < 0.01) and a significant increase in the proportion of fatal limb/skeletal injuries with increasing age ( < 0.05). Older pedestrians are, therefore, more likely to sustain lethal chest and limb/skeletal injuries than head injuries compared to those who are younger, presumably due to greater physical fragility that occurs with age, with loss of protective muscle bulk and bone density.
Topics: Humans; Aged; Pedestrians; Accidents, Traffic; Craniocerebral Trauma; Thoracic Injuries; Autopsy; Wounds and Injuries
PubMed: 36474413
DOI: 10.1177/00258024221143968 -
Drug and Alcohol Dependence Reports Sep 2023Fentanyl and fentanyl analogs have increased the overdose mortality rates in the United States, significantly impacting states like Ohio. We examined carfentanil...
INTRODUCTION
Fentanyl and fentanyl analogs have increased the overdose mortality rates in the United States, significantly impacting states like Ohio. We examined carfentanil overdose deaths, other contributing Cause of Death (COD) drugs, and drug seizure trends from 2016 to 2020 in Northeast Ohio.
MATERIALS AND METHODS
We studied death investigation data from the Cuyahoga County, Ohio Medical Examiner's Office (CCMEO) of all fatal accidental opioid overdoses as well as drug seizure data from Cuyahoga County Regional Forensic Science Laboratory (CCRFSL). We also compared decedents' race, gender, age, residential locality, drugs contributing to the COD in opioid cases, and for carfentanil, fentanyl, and cocaine seizures in Cuyahoga County from 2016 to 2020 ( = 2948).
RESULTS
Decedents' had an average of three different drugs contributing to their COD. A bimodal carfentanil spike was observed in fatal accidental overdoses in Cuyahoga County for the years 2017 and 2019. Decedents in urban residency, who were Non-Hispanic, White and younger, significantly predicted the presence of carfentanil contributing to the COD. In 2020, decedents who were Black and older were significantly associated with cocaine contributing to the COD. Carfentanil and carfentanil-related overdoses were significantly correlated.
DISCUSSION
The pervasiveness of illicitly manufactured fentanyl and fentanyl analog (e.g., carfentanil) mixtures with other drugs are changing the demographics of persons who fatally overdose in Cuyahoga County, OH. Significant trending shifts can also be observed for the presence of carfentanil in decedent and seizure county data.
CONCLUSIONS
Local data of drug-related overdose deaths and drug seizures from a medical examiner's office and affiliated forensic laboratory lab can be used for timely public health surveillance, and informing prevention, and intervention at the county level.
PubMed: 37711883
DOI: 10.1016/j.dadr.2023.100187 -
Current Sports Medicine Reports Dec 2023Adequate outdoor fitness equipment is essential for physical activity in lower income neighborhoods. San Francisco, CA, in the United States will be highlighted as a...
Adequate outdoor fitness equipment is essential for physical activity in lower income neighborhoods. San Francisco, CA, in the United States will be highlighted as a city with a large death rate, which could be improved by installing, promoting, and allowing access to fitness equipment. More than 2700 accidental overdose deaths have occurred since the year 2019, with a projected cumulative death rate expected to exceed 3000 human lives by the end of 2023. A contrast of the health inequities is illuminated in one of the nation's wealthiest cities. This is a call to action to bring about change, save lives, and promote healthier behavior.
Topics: Humans; United States; Health Equity; Exercise; Drug Overdose
PubMed: 38055748
DOI: 10.1249/JSR.0000000000001119 -
BMJ Paediatrics Open Oct 2023Injury is one of the main causes of death and disability in the world. This study was designed to determine the trend of mortality rate and years of life lost (YLLs) due...
INTRODUCTION
Injury is one of the main causes of death and disability in the world. This study was designed to determine the trend of mortality rate and years of life lost (YLLs) due to unintentional injuries in children in southern Iran.
METHOD
In this cross-sectional study, we extracted all death reports due to unintentional injuries based on age, gender and the year of death based on International Classification of Diseases (ICD-10)from the Electronic Death Registration System. The YLL analysis due to premature death related to unintentional injuries was executed by the 2015 YLL template from the WHO using the Excel V.2016 software. To examine the trend of crude mortality rate and YLL rates for different years, joinpoint regression was used based on the log-linear model.
RESULTS
During the 16-year study period (2004-2019), 6590 deaths due to unintentional injuries in children aged 0-19 years have occurred. The total YLLs due to unintentional injuries were 138 482 in males and 53 168 in females. The three main causes of YLLs in our study were transportation injuries (67.37%), drowning (7.19%) and burns (6.70%). According to the joinpoint regression analysis, the 16-year trend of YLL rate due to premature mortality was decreasing; the annual per cent change was -5.2% (95% CI -6.5% to -3.9%, p<0.001) for males and -4.3% (95% CI -5.7% to -3.0%, p<0.001) for females.
CONCLUSION
Based on the findings of this study, the trend of mortality and YLL rate has been decreasing. Road traffic injuries were the most frequent injuries and the most common cause of death. Mortality rates fell by half. To improve child survival, injuries must now be recognised as a major child health problem, and to prevent deaths from injuries in children, early and preventive measures should be taken into account.
Topics: Male; Female; Humans; Child; Iran; Cross-Sectional Studies; Accidental Injuries; Mortality, Premature; Cause of Death
PubMed: 37844972
DOI: 10.1136/bmjpo-2023-002144 -
Current Problems in Cardiology Jan 2024Commotio cordis is a rare but life-threatening condition characterized by sudden cardiac arrest resulting from a blunt chest impact. While commotio cordis has... (Review)
Review
Commotio cordis is a rare but life-threatening condition characterized by sudden cardiac arrest resulting from a blunt chest impact. While commotio cordis has traditionally been associated with sports-related activities, a significant proportion of cases occur in non-sport-related settings, such as assaults, motor vehicle accidents (MVAs), and daily activities. This critical review examines the epidemiology, clinical characteristics, and outcomes of non-sports-related commotio cordis cases, highlighting the need for increased awareness and improved management in these contexts. The review analyzes existing literature, drawing attention to the demographics of non-sports-related cases, which predominantly affect adolescents and young adults, with males being the primary demographic. In contrast to sport-related cases, non-sports-related commotio cordis cases exhibit a wider age range and a higher proportion of female subjects. Mortality rates are significantly higher in non-sports-related commotio cordis cases, largely due to lower rates of cardiopulmonary resuscitation (CPR), limited access to automated external defibrillators (AEDs), and delayed initiation of resuscitative efforts compared to sport-related incidents. This underscores the critical importance of increasing awareness and preparedness in non-sport-related settings. To mitigate the risks associated with non-sports-related commotio cordis, efforts should focus on early recognition of the condition, timely administration of CPR, and the widespread availability and accessibility of AEDs in various environments. Enhanced awareness and education can potentially lead to a reduction in mortality and improved outcomes for individuals affected by commotio cordis outside of sports-related activities. In conclusion, commotio cordis is not exclusive to sports and presents a significant health risk in non-sport-related scenarios. This review emphasizes the urgent need for increased awareness, preparedness, and resuscitation measures in non-sports contexts to address the higher mortality associated with these cases.
Topics: Male; Adolescent; Young Adult; Humans; Female; Commotio Cordis; Death, Sudden, Cardiac; Defibrillators; Sports
PubMed: 37890546
DOI: 10.1016/j.cpcardiol.2023.102165 -
Frontiers in Public Health 2023Extreme temperatures and air pollution have raised widespread concerns about their impact on population health.
BACKGROUND
Extreme temperatures and air pollution have raised widespread concerns about their impact on population health.
AIM
To explore the quantitative exposure risks of high/low temperatures and types of air pollutants on the health of various populations in urban areas in China, this study assessed the effects of temperature and air pollutants on daily non-accidental deaths in Rencheng District, Jining City, China from 2019 to 2021.
METHODS
A combination of Poisson regression models and distributed lag non-linear models was used to examine the relationships between temperature, air pollutants, and daily non-accidental deaths. We found that temperature and air pollutants had a significant non-linear effect on non-accidental mortality. Both high and low temperatures had a noticeable impact on non-accidental deaths, with heat effects occurring immediately and lasting 2-3 days, while cold effects lasted for 6-12 days. The relative risks of non-accidental deaths from PM, NO, and SO were highest in winter and lowest in autumn. The relative risk of non-accidental deaths from O was highest in spring, with no significant variations in other seasons. Older adults (≥75) and outdoor workers were at the greatest risk from temperature and air pollutant exposure.
CONCLUSIONS/INTERPRETATION
Exposure to extreme temperatures and air pollutants in the Rencheng District was associated with an increased mortality rate. Under the influence of climate change, it is necessary for policymakers to take measures to reduce the risk of non-accidental deaths among residents.
Topics: Humans; Aged; Temperature; Air Pollution; Air Pollutants; Hot Temperature; China
PubMed: 37601203
DOI: 10.3389/fpubh.2023.1241385 -
Traffic Injury Prevention 2024The history of airbags was reviewed for benefits and risks as they became a supplement to lap-shoulder belts. Sled and crash tests were evaluated and field data was... (Review)
Review
OBJECTIVE
The history of airbags was reviewed for benefits and risks as they became a supplement to lap-shoulder belts. Sled and crash tests were evaluated and field data was analyzed for airbag effectiveness. Field data on airbag deaths and studies on mechanisms of deployment injury were analyzed. The history was reviewed as airbags evolved from the early 1970s to today.
METHODS
Airbag benefits were determined from NHTSA crash tests with unbelted and belted dummies in 40, 48, and 56 km/h (25, 30, and 35 mph) frontal impacts with and without airbags. The literature was reviewed for testing of passive restraints with and without airbags. Recent NCAP tests were compared with earlier tests to determine the change in occupant responses with seatbelts and supplemental airbags in modern vehicles. 1994-2015 NASS-CDS field data was analyzed for MAIS 4 + F injury. Risks were compared for belted and unbelted occupants in frontal impacts by delta V. Airbag risks were identified from field deployments and research. The 1973-76 GM fleet had two deaths due to the occupant being out-of-position (OOP). The mechanisms of injury were determined. From 1989-2003, NHTSA investigated 93 driver, 184 child passenger, and 13 adult passenger airbag deaths. The data was reviewed for injury mechanisms. Second generation airbags essentially eliminated OOP airbag deaths. More recently, three suppliers were linked to airbag rupture deaths. The circumstances for ruptures were reviewed.
RESULTS
The risk for serious head injury was 5.495% in drivers and 4.435% passengers in 40-48 km/h (25-30 mph) frontal crash tests without belts or airbags. It was 80.5% lower at 1.073% in drivers and 82.0% at 0.797% in passengers with belts and airbags in 35 mph NCAP crash tests of 2012-20 MY vehicles. NASS-CDS field data showed a 15.45% risk for severe injury (MAIS 4 + F) to unbelted occupants and 4.68% with belted occupants in 30-35 mph frontal crash delta V with airbags, as deployed. The reduction in risk was 69.7% with belt use and airbags deploying in 96.1% of crashes. There were benefits over the range of delta V. Two airbag deaths were studied from the 1970s GM fleet of airbags. The unbelted driver death was caused by punchout force with the airbag cover blocked by the occupant and membrane forces as the airbag wrapped around the head, neck or chest with the occupant close to the inflating airbag. The unbelted child death was from airbag inflation forces from pre-impact braking causing the child to slide forward into the deploying airbag. Research showed that unrestrained children may have 13 different positions near the passenger airbag at deployment. NHTSA investigation of first generation airbag deaths found most driver deaths were females (75.3%) sitting forward on the seat track, close to the driver airbag. Seatbelt use was only 30%. Most child deaths (138, 75.4%) involved no or improper use of the lap-shoulder belts. Of these, 115 deaths involved pre-impact braking. Only 37 (20.2%) children were in child seats with 29 in rear-facing and 8 in forward-facing child seats. Eight child deaths (4.4%) occurred with lap-shoulder belt use. Airbag designs changed. More recently, Takata airbags were related to at least 24 deaths by airbag rupture prompting a recall; the successor company Joyson had an airbag recall. ARC airbags have experienced a chunk of the inflator propelled into the driver during deployment with several deaths leading to a recall.
CONCLUSIONS
Airbags are effective in preventing death and injury in crashes. They provide the greatest protection in combination with seatbelt use. NHTSA estimated airbags saved 28,244 lives through 1-1-09 while causing at least 320 deployment deaths, which has prompted improved designs, testing, and recalls.
Topics: Adult; Child; Female; Humans; Male; Air Bags; Accidents, Traffic; Abbreviated Injury Scale; Seat Belts; Risk Assessment; Wounds and Injuries
PubMed: 38408114
DOI: 10.1080/15389588.2024.2315889 -
Revista Espanola de Salud Publica Jun 2024Data on drownings tend to underestimate mortality from this cause. The objective of this study was to describe fatal drownings recorded in Catalonia between 2019 and... (Observational Study)
Observational Study
OBJECTIVE
Data on drownings tend to underestimate mortality from this cause. The objective of this study was to describe fatal drownings recorded in Catalonia between 2019 and 2022 through forensic sources, present their characteristics, and assess the utility of this information for monitoring drowning mortality.
METHODS
A retrospective observational study based on the register of judicial deaths from the Institute of Legal Medicine and Forensic Sciences of Catalonia was carried out. Data on medicolegal aetiology, aquatic environment, age, gender, date of death, and municipality of origin were analysed. Statistical analysis was based on the comparison of proportions test based on Chi-square for categorical variables and the Mann Whitney U test for the comparison of numerical variables.
RESULTS
A total of 310 drownings were recorded, with a mean age of 57.2 years and a male predominance (77.1%). The majority of drownings were unintentional (71.3%), followed by suicides (15.5%), and cases of undetermined intent (12.6%). Compared to intentional drownings, unintentional and undetermined intent drownings had a higher percentage of males than females (81.2% vs. 56%, p<0.001), and fewer cases with Spanish nationality than foreign or undetermined nationality (60% vs. 92%, p<0.001). Middle-aged and older individuals accounted for the majority of deaths, but among unintentional drownings, those recorded in pools included significantly higher percentages of children and adolescents aged zero-fourteen years than those occurring in natural waters.
CONCLUSIONS
The results highlight the importance of drowning mortality in Catalonia and the need to strengthen preventive activities, especially for children and during episodes of intense heat. Medicolegal sources are useful for monitoring drowning mortality, but it would be beneficial if they incorporated information on variables such as place of residence and nationality.
Topics: Humans; Male; Female; Spain; Middle Aged; Retrospective Studies; Drowning; Aged; Adult; Child; Adolescent; Child, Preschool; Young Adult; Infant; Aged, 80 and over; Infant, Newborn; Sex Distribution
PubMed: 38899691
DOI: No ID Found