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Irish Journal of Medical Science Oct 2023Emergency service vehicle (ESV) drivers are an important part of the health, fire and police services. ESV driving is associated with increased crash risk, but little... (Review)
Review
BACKGROUND
Emergency service vehicle (ESV) drivers are an important part of the health, fire and police services. ESV driving is associated with increased crash risk, but little guidance exists in the literature on relevant medical conditions among drivers and their potential for adding to higher crash risks.
AIMS
We undertook a narrative review to examine the role of medical and other conditions in crash risk of ESV drivers.
METHOD
A literature search was conducted using the ScienceDirect and Transport Research International Documentation (TRID) databases. There was no time frame for the search, and results were restricted to review and research articles.
RESULTS
Of 570 papers identified, 13 remained after screening and full-text review. A range of factors have been shown to have an impact on increased crash risk, including the nature of the task, physical features of the equipment, training, experience, environmental conditions and secondary tasks. There was scant information on medical conditions other than alcohol use disorders.
CONCLUSIONS
Given issues of speed, vehicle and environment, it would seem prudent to mandate levels of medical fitness to drive similar to and sometimes exceeding (i.e. colour blindness for traffic signals and alerts, hearing impairment as first responders) those for group 2 drivers with extra stipulations relating to specific service needs such as enhanced visual (such as colour blindness and contrast sensitivity) and auditory function. Further research is needed on the prevalence and emergence of relevant medical conditions among ESV drivers, with due consideration of their application to the driving tasks in each service.
Topics: Humans; Automobile Driving; Accidents, Traffic; Alcoholism; Color Vision Defects; Ambulances
PubMed: 36752949
DOI: 10.1007/s11845-023-03301-0 -
Rhode Island Medical Journal (2013) Jul 2023In 2018, the City of Providence introduced a program in which electronic scooters were deployed for public use. We aim to characterize the burden of craniofacial...
BACKGROUND
In 2018, the City of Providence introduced a program in which electronic scooters were deployed for public use. We aim to characterize the burden of craniofacial injuries associated with these scooters.
METHODS
A retrospective review was conducted of all patients consulted to the plastic surgery service for evaluation of craniofacial injury between September 2018 and October 2022. Data pertaining to patient sociodemographics, site and time of injury, and craniofacial trauma were recorded.
RESULTS
Twenty-five patients sustaining craniofacial trauma were identified over a four-year period. Most patients required soft tissue repair (64%) and bony fractures were sustained by approximately half of all patients (52%). Admission to ICU was uncommon (16%), and there were no fatalities.
CONCLUSIONS
The incidence of craniofacial injury from electronic scooter use is low. However, these injuries may involve extensive surgical reconstruction and ICU admission. We advise the City of Providence to optimize best safety practices and monitoring to minimize risk.
Topics: Humans; Fractures, Bone; Retrospective Studies; Cities; Incidence; Hospitalization; Accidents, Traffic; Head Protective Devices
PubMed: 37368834
DOI: No ID Found -
Bulletin of the World Health... Oct 2023To evaluate the precision and dependability of road traffic mortality data recorded in the World Health Organization Mortality Database and investigate how uncorrected...
OBJECTIVE
To evaluate the precision and dependability of road traffic mortality data recorded in the World Health Organization Mortality Database and investigate how uncorrected data influence vital mortality statistics used in traffic safety programmes worldwide.
METHODS
We assessed country and territory-specific data quality from 2015 to 2020 by calculating the proportions of five types of nonspecific cause of death codes related to road traffic mortality. We compared age-adjusted road traffic mortality and changes in the average annual mortality rate before and after correcting the deaths with nonspecific codes. We generated road traffic mortality projections with both corrected and uncorrected codes, and redistributed the data using the proportionate method.
FINDINGS
We analysed data from 124 countries and territories with at least one year of mortality data from 2015 to 2020. The number of countries and territories reporting more than 20% of deaths with ill-defined or unknown cause was 2; countries reporting injury deaths with undetermined intent was 3; countries reporting unspecified unintentional injury deaths was 21; countries reporting unspecified transport crash deaths was 3; and countries reporting unspecified unintentional road traffic deaths was 30. After redistributing deaths with nonspecific codes, road traffic mortality changed by greater than 50% in 7% (5/73) to 18% (9/51) of countries and territories.
CONCLUSION
Nonspecific codes led to inaccurate mortality estimates in many countries. We recommend that injury researchers and policy-makers acknowledge the potential pitfalls of relying on raw or uncorrected road traffic mortality data and instead use corrected data to ensure more accurate estimates when improving road traffic safety programmes.
Topics: Humans; Accidents, Traffic; Vital Statistics; Databases, Factual; World Health Organization; Records; Wounds and Injuries
PubMed: 37772197
DOI: 10.2471/BLT.23.289683 -
Deutsches Arzteblatt International Jan 2024Persons injured in traffic accidents may have injuries of characteristic types that are of significance for the complex reconstruction of the accident and whose... (Review)
Review
BACKGROUND
Persons injured in traffic accidents may have injuries of characteristic types that are of significance for the complex reconstruction of the accident and whose medicolegally sound clinical documentation is highly important. This is of particular relevance for the approximately 55 000 persons who are severely injured in traffic accidents in Germany each year. Gaps in documentation are often disadvantageous for the injured persons.
METHODS
This review is based on pertinent publications retrieved by a selective literature review, with additional consideration of relevant textbooks in traffic medicine and legal medicine, as well as the guidelines of the AWMF (Association of the Scientific Medical Societies in Germany).
RESULTS
Injuries in traffic accidents typically differ depending on the mode of participation of the injured person in traffic. They must be examined with a view toward the sequence of events of the accident and documented in medicolegally sound fashion. In particular, because of the different mechanical forces involved, it is important to document the seat that the injured person occupied in the automobile, the nature of the collision (pedestrian vs. automobile; bicycle, e-bike, e-scooter, and motorcycle accidents), and the protective devices that were in use.
CONCLUSION
The precise documentation of injuries and examination findings, with critical consideration of their plausibility in relation to the sequence of events of the accident as far as it is known, is an important duty of the physician. This documentation serves as the basis for further judicial steps leading to compensation when legally appropriate.
Topics: Humans; Accidents, Traffic; Documentation; Forensic Medicine; Germany; Physicians
PubMed: 38055024
DOI: 10.3238/arztebl.m2023.0145 -
International Journal of Legal Medicine Nov 2023Real-life driving studies evaluating the impact of alcohol influence on the ability to park a car are rare but necessary to assess a possible impairment to drive a car...
Real-life driving studies evaluating the impact of alcohol influence on the ability to park a car are rare but necessary to assess a possible impairment to drive a car in the event of prosecution. In this study, 29 test persons (13 m, 16 f) completed three test drives with real cars, each made up of three different parking situations. While four test persons remained sober, the majority drank a previously calculated amount of alcohol before the second drive; the aim was to reach a blood alcohol concentration (BAC) of 1.1 g/kg. The third drive took place about 2 h later without any further ingestion of alcohol. The impact of BAC on the number of accidents, time needed to finish the drive, the amount of correction moves and quality of the final parking position (in the centre of the parking space) were analysed. Furthermore, pressure measuring films were applied to the test cars, measuring the average pressure and load in the areas of the accident impact. A significant increase of accidents could be noted with rising BAC. While a single accident happened to both sober and drivers under the influence of alcohol, more than one accident was only seen in drivers after the ingestion of alcohol (> 0.63 g/kg). The BAC had no impact on the other considered aspects. Concludingly, more than one impact site or accident while parking a car can serve as an indication for alcohol impairment of the driver at the time of the accident.
Topics: Humans; Blood Alcohol Content; Male; Adult; Female; Driving Under the Influence; Accidents, Traffic; Middle Aged; Young Adult; Alcohol Drinking; Ethanol; Automobile Driving
PubMed: 37736761
DOI: 10.1007/s00414-023-03082-2 -
Chinese Journal of Traumatology =... Sep 2023To systematically review the risk of permanent disability related to road traffic injuries (RTIs) and to determine the implications for future research regarding... (Review)
Review
PURPOSE
To systematically review the risk of permanent disability related to road traffic injuries (RTIs) and to determine the implications for future research regarding permanent impairment following road traffic crashes.
METHODS
We conducted this systematic review according to the preferred reporting items for systematic reviews and meta-analysis statement. An extended search of the literature was carried out in 4 major electronic databases for scientific research papers published from January 1980 to February 2020. Two teams include 2 reviewers each, screened independently the titles/abstracts, and after that, reviewed the full text of the included studies. The quality of the studies was assessed using the strengthening the reporting of observational studies in epidemiology (STROBE) checklist. A third reviewer was assessed any discrepancy and all data of included studies were extracted. Finally, the data were systematically analyzed, and the related data were interpreted.
RESULTS
Five out of 16 studies were evaluated as high-quality according to the STROBE checklist. Fifteen studies ranked the initial injuries according to the abbreviated injury scale 2005. Five studies reported the total risk of permanent medical impairment following RTIs which varied from 2% to 23% for car occupants and 2.8% to 46% for cyclists. Seven studies reported the risk of permanent medical impairment of the different body regions. Eleven studies stated the most common body region to develop permanent impairment, of which 6 studies demonstrated that injuries of the cervical spine and neck were at the highest risk of becoming permanent injured.
CONCLUSION
The finding of this review revealed the necessity of providing a globally validated method to evaluate permanent medical impairment following RTIs across the world. This would facilitate decision-making about traffic injuries and efficient management to reduce the financial and psychological burdens for individuals and communities.
Topics: Humans; Accidents, Traffic; Disabled Persons; Abbreviated Injury Scale; Databases, Factual; Wounds and Injuries
PubMed: 36577609
DOI: 10.1016/j.cjtee.2022.11.002 -
Journal of Safety Research Dec 2023In recent years, as novel micromobility vehicles (MMVs) have hit the market and rapidly gained popularity, new challenges in road safety have also arisen. There is an...
INTRODUCTION
In recent years, as novel micromobility vehicles (MMVs) have hit the market and rapidly gained popularity, new challenges in road safety have also arisen. There is an urgent need for validated models that comprehensively describe the behavior of such novel MMVs. This study aims to compare the longitudinal and lateral control of bicycles and e-scooters in a collision-avoidance scenario from a top-down perspective, and to propose appropriate quantitative models for parameterizing and predicting the trajectories of the avoidance-braking and steering-maneuvers.
METHOD
We compared a large e-scooter and a light e-scooter with a bicycle (in assisted and non-assisted modes) in field trials to determine whether these new vehicles have different maneuverability constraints when avoiding a rear-end collision by braking and/or steering.
RESULTS
Braking performance in terms of deceleration and jerk varies among the different types of vehicles; specifically, e-scooters are not as effective at braking as bicycles, but the large e-scooter demonstrated better braking performance than the light one. No statistically significant difference was observed in the steering performance of the vehicles. Bicycles were perceived as more stable, maneuverable, and safe than e-scooters. The study also presents arctangent kinematic models for braking and steering, which demonstrate better accuracy and informativeness than linear models.
CONCLUSIONS
This study demonstrates that the new micromobility solutions have some maneuverability characteristics that differ significantly from those of bicycles, and even within their own kind. Steering could be a more efficient collision-avoidance strategy for MMVs than braking under certain circumstances, such as in a rear-end collision. More complicated modeling for MMV kinematics can be beneficial but needs validation.
PRACTICAL APPLICATIONS
The proposed arctangent models could be used in new advanced driving assistance systems to prevent crashes between cars and MMV users. Micromobility safety could be improved by educating MMV riders to adapt their behavior accordingly. Further, knowledge about the differences in maneuverability between e-scooters and bicycles could inform infrastructure design, and traffic regulations.
Topics: Humans; Accidents, Traffic; Protective Devices; Automobiles; Biomechanical Phenomena
PubMed: 38081697
DOI: 10.1016/j.jsr.2023.09.019 -
Journal of Safety Research Sep 2023The aim of this paper is to understand the causes of occupational accidents in Spain's mining sector in order to propose action plans and improve future accident rates.
INTRODUCTION
The aim of this paper is to understand the causes of occupational accidents in Spain's mining sector in order to propose action plans and improve future accident rates.
METHOD
This research analyzed a pool of data on 15,032 accidents occurring in the mining sector and reported to authorities between 2013 and 2018. Accidents are divided into three levels of severity: light, serious, and fatal. We study the influence of 12 variables on the accident severity rate in our sample.
RESULTS
The results show that accident severity is related to age, gender, nationality, length of service, economic activity, company size, accident location, days of injury leave, day of the week, deviation, injury, and specific Spanish region. This sector produces a high rate of serious accidents compared to all other sectors; has a male-dominated, older and experienced workforce; and employs mainly Spanish workers. Its activity is concentrated in larger companies and the work involves the use of heavy machinery and dangerous materials. We offer conclusions and future lines of research to help regulators, companies and workers to improve worker safety.
Topics: Male; Humans; Accidents, Occupational; Research Design; Workforce
PubMed: 37718064
DOI: 10.1016/j.jsr.2023.07.015 -
Journal of Safety Research Dec 2023Bicycle volumes are increasing in many regions worldwide leading to higher relevance of an in-depth understanding of bicyclist safety mechanisms. Detailed studies on...
PROBLEM
Bicycle volumes are increasing in many regions worldwide leading to higher relevance of an in-depth understanding of bicyclist safety mechanisms. Detailed studies on bicyclist safety that consider exposure and distinguish by intersection category and crash types are missing for urban signalized intersections, which are of particular relevance for bicyclist safety.
METHOD
Based on a comprehensive dataset of motorist and bicyclist volumes and infrastructure characteristics for a sample of 269 signalized intersections in two German cities, we utilize a top-down approach to analyze firstly, bicycle crashes of all types and secondly, bicycle crashes by type including turning, right-of-way and loss-of-control. A combination of descriptive statistics and Accident Prediction Models (APM) are applied as analysis methods.
RESULTS
Bicycle volumes are relevant for all types of intersections and crashes, whereas the effect of motor vehicle volumes differ between these different applications. The separation of bicyclists from motor vehicles in time and space increases their safety but also leads to behavioral adaption and risk compensation. The likelihood of right-of-way crashes even increases with more separation in the signaling scheme. The main predictor for loss-of-control crashes in terms of infrastructure are tram tracks.
SUMMARY
This study provides insights on relevant determinants of bicycle crashes at urban signalized intersections at several levels of detail. Exposure variables as well as the physical separation of bicyclists from motor vehicles show consistent effects on bicycle crash numbers whereas the effects of signaling differ between crash types.
PRACTICAL APPLICATIONS
The different types of intersections and crashes follow each specific mechanism of bicyclist safety. The separation of bicyclists and motorists in time and space are paramount at intersections with high bicycle volumes. Risk compensation such as red light running becomes more important as intersections get smaller and motor vehicle volumes decrease.
Topics: Humans; Accidents, Traffic; Safety; Bicycling; Environment Design; Motor Vehicles
PubMed: 38081688
DOI: 10.1016/j.jsr.2023.09.011 -
Journal of Agromedicine Oct 2023The Risk Information System for Commercial Fishing (RISC Fishing) merged information on fishermen and vessel incident types from various databases. This descriptive...
OBJECTIVES
The Risk Information System for Commercial Fishing (RISC Fishing) merged information on fishermen and vessel incident types from various databases. This descriptive study examined linked fisherman injury records (fatal and nonfatal) and vessel incident records in Oregon and Washington from 2000 to 2018 in the RISC Fishing database. The circumstances of incidents and any association with fishermen outcomes were explored to identify injury prevention opportunities.
METHODS
The statistical analyses included a descriptive study of incidents related to the injury characteristics and frequency of outcomes by incident type. Further analyses included contingency tables and Pearson Chi-Square tests for selected variables to determine if there were associations between vessel incident outcomes (fatality, nonfatal injury, no injury).
RESULTS
A total of 375 reported incidents with 93 cases of fatalities, 239 nonfatal injuries, and over 6,575 fishermen with no injury were described. Of fatalities, 90% were due to drowning, with only 2% of victims reported donning survival equipment. Deckhands experienced fatal and nonfatal injuries most frequently. The most common factors associated with nonfatal injuries included contact with objects (event), walking on vessel and hauling gear (work activities), and fractures and open wounds (nature). The most common final event leading to a vessel disaster with no injury being reported was sinking (76%). Distributions between the incident outcomes (fatality, nonfatal injury, and no injury) differed by vessel activity/type, fishery/gear, and event leading to the incident.
CONCLUSION
Linked information of fishermen injury outcomes and vessel incident information showed that events and settings that involve fatalities are qualitatively different from incidents resulting in only nonfatal injuries or uninjured survivors. Vessel-level approaches for mitigating fatalities, such as ensuring vessel stability, improving navigation/operation decisions, and spotlighting survival equipment policies/rescue priorities could have a significant impact. Work task-specific prevention strategies for nonfatal injuries related to the larger vessels (catcher/processors and processors) and smaller vessels (with pot/trap gears) are paramount. The use of linked information provided in reports can provide a fuller incident picture to advance efforts to improve the working conditions of commercial fishermen.
Topics: Humans; Accidents, Occupational; Hunting; Oregon; Washington; Fractures, Bone; Wounds and Injuries
PubMed: 37387508
DOI: 10.1080/1059924X.2023.2229827