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Ulusal Travma Ve Acil Cerrahi Dergisi =... Feb 2024The Coronavirus Disease 2019 (COVID-19) pandemic has led to a unique set of circumstances, straining health-care systems and affecting the way of life in societies...
BACKGROUND
The Coronavirus Disease 2019 (COVID-19) pandemic has led to a unique set of circumstances, straining health-care systems and affecting the way of life in societies around the world. Measures such as social isolation, travel restrictions, and workplace closures have led to an increase in motorcycle use. Consequently, motorcycle accidents have become a significant problem during this period. This study presents detailed research conducted to examine motorcycle accidents during the COVID-19 pandemic and to understand the causes and consequences of the increase in these accidents.
METHODS
This research evaluated records from a single health examination and used various models to analyze motorcycle acci-dents within a specified time period. Additionally, retrospective analyses were conducted to examine associations between motorcycle use and crashes in our country before and after the pandemic. The records of 386 patients who were injured in motorcycle accidents and followed up, received treatment, and were recorded at Biruni University Hospital between November 2015 and April 2023 were retrospectively examined. Noted details included the victims' age, gender, injury mechanism, injury site, injury severity, helmet use, presence and location of fractures, time distribution of the accident, and the severity of other important tissue injuries. The relationship between the injury site, fractures, and accident details, and the "Injury Severity Score" (ISS) was also investigated.
RESULTS
Among the 386 injured victims in motorcycle accidents, 333 were male and 53 were female. Of these, 168 (43.5%) were motorcycle drivers, 137 (35.5%) were motorcycle couriers, and 81 (21%) were pedestrians. A total of 186 (48%) injuries occurred before the pandemic (November 2015-March 2020), while 200 (52%) were sustained during the pandemic. The study indicates a noticeable increase in motorcycle injuries, particularly among motor couriers, especially during the pandemic quarantine periods. Post hoc analysis revealed that motor couriers had significantly lower ISS compared to other professions (p=0.009 and p=0.045, respectively). Motorcyclists who wore helmets were found to have significantly lower ISS than those who did not wear helmets (p<0.05). Furthermore, it was found that the ISS was positively correlated with the number of bone fractures, total soft tissue injury, and significant clinical characteristics (r=0.758, r=0.756, and p<0.001, respectively).
CONCLUSION
This clinical study's findings demonstrate that the measures implemented during the pandemic to limit society's mobility have led to an increase in motorcycle accidents. Notably, there has been a significant rise in the number of accidents, particularly involving individual motorcycle use and motorcycle courier services.
Topics: Humans; Male; Female; Retrospective Studies; Pandemics; Motorcycles; Turkey; Accidents, Traffic; COVID-19; Fractures, Bone; Head Protective Devices
PubMed: 38305652
DOI: 10.14744/tjtes.2024.08791 -
International Journal of Legal Medicine Jul 2024Children involved in car crashes can experience either direct trauma or inertial injuries resulting from interactions with external objects, such as other vehicles, or...
Children involved in car crashes can experience either direct trauma or inertial injuries resulting from interactions with external objects, such as other vehicles, or with the restraint system. Furthermore, improper use of restraint systems can lead to additional severe injuries. Recent reports from international institutions underscored the persistent prevalence of inadequate restraint systems utilization and this widespread issue increases children's vulnerability and risk of injuries.The aim of this study is to provide a systematic review of the literature on injuries sustained in children involved in road accidents describing and analyzing elements useful for forensic assessment.The literature search was performed using PubMed, Scopus and Web of Science from January 1970 to March 2023. Eligible studies have investigated issues of interest to forensic medicine about traffic accidents involving pediatric passengers. A total of 69 studies satisfied the inclusion criteria and were categorized and analyzed according to the anatomical regions of the body affected (head, neck, thoraco-abdominal, and limb injuries), and the assessment of lesions in reconstruction of the accident was examined and discussed.The review highlights that in motor vehicle accidents involving children, the forensic evaluation of both the cause of death and accident dynamics needs to consider several factors, such as the child's age, the type of restraint system employed, and the specific passenger seat occupied. Considering the complexity of the factors that can be involved in this road accident, it is crucial that there is a comprehensive exchange of information between the judge and the medical expert.
Topics: Adolescent; Child; Child, Preschool; Humans; Infant; Accidents, Traffic; Child Restraint Systems; Forensic Medicine; Wounds and Injuries
PubMed: 38337078
DOI: 10.1007/s00414-024-03174-7 -
JMIR Public Health and Surveillance Sep 2023Over the last few decades, although the age-standardized mortality rate (ASMR) of injury has shown a significant declining trend in China, this pattern has dramatically... (Observational Study)
Observational Study
BACKGROUND
Over the last few decades, although the age-standardized mortality rate (ASMR) of injury has shown a significant declining trend in China, this pattern has dramatically reversed recently.
OBJECTIVE
We aimed to elucidate the geographical, demographic, and temporal trends of cause-specific injuries, the reversal phenomenon of these trends, and the fluctuations of injury burden from 2005 to 2019 in China.
METHODS
A longitudinal observational study was performed using the raw data of injury deaths in the National Cause-of-Death surveillance data provided by the disease surveillance points system in 2005-2019. The cause-specific injuries were divided into disparate subgroups by sex, age, urban/rural region, and eastern/central/western areas of China. The burden of injury was assessed using potential years of life lost (PYLL), average years of life lost (AYLL), and PYLL rate (PYLLR). Temporal trends of mortality rates and burden were evaluated using best-fitting joinpoint models.
RESULTS
Injury deaths accounted for 7.51% (1,156,504/15,403,835) of all-cause deaths in China in 2005-2019. The crude mortality rate of all-cause injury was 47.74 per 100,000 persons. The top 3 injury types (traffic accident, falls, and suicide) accounted for 70.57% (816,145/1,156,504) of all injury-related deaths. The ASMR of all-cause injury decreased (P=.003), while the crude mortality rate remained unchanged (P=.52) during 2005-2019. A significant reverse trend in ASMR of all-cause injury was observed in urban older adults since 2013, mainly due to the inverted trend in injuries from falls. A reverse trend in ASMR of suicide was observed among individuals aged 10-24 years, with notable increases by 35.18% (annual percentage change 15.4%, 95% CI 4.1%-28.0%) in men since 2017. The AYLL and PYLLR of all-cause injury among older adults showed consistent ascending trends from 2005 to 2019 (average annual percentage change [AAPC] 6.1%, 95% CI 5.4%-6.9%, 129.04% increase for AYLL; AAPC 5.4%, 95% CI 2.4%-8.4%, 105.52% increase for PYLLR). The AYLL due to suicide for individuals aged 10-24 years showed a considerable upswing tendency (AAPC 0.5%, 95% CI 0.4%-0.7%, 8.02% increase).
CONCLUSIONS
Although the ASMR of all-cause injury decreased in China from 2005 to 2019, the trend in suicide among adolescents and young adults and falls among older adults has been on the rise in recent years. Interventions should be encouraged to mitigate the cause-specific burdens of injury death.
Topics: Adolescent; Male; Young Adult; Humans; Aged; China; Accidents, Traffic; Geography; Longitudinal Studies; Suicide
PubMed: 37713250
DOI: 10.2196/47902 -
F1000Research 2023: Traffic accidents are an important issue for public health and a threat for sustainable development, with pedestrians and cyclists having been recognized as the most... (Observational Study)
Observational Study
: Traffic accidents are an important issue for public health and a threat for sustainable development, with pedestrians and cyclists having been recognized as the most vulnerable actors on the streets. The objective of this study was to analyze the profiles of pedestrians and cyclists who died as a result of traffic accidents in Colombia during the 1998-2019 period. An observational and descriptive study, with the deaths due to traffic accidents in Colombia between 1998 and 2019 as data source. Secondary data were taken from the Vital statistics of Colombia (EEVV), published by Departamento Administrativo Nacional de Estadística (DANE). A trend analysis of the number of deaths during the period under study was performed, and such number was examined against sex to identify potential differences. Multiple correspondence analysis was employed to elaborate the profile of pedestrians and cyclists who die due to traffic accidents. Three profiles were prepared for each road actor: a global profile, one for 1998, and another for 2019. The mortality profiles are different for pedestrians and cyclists, and, in turn, there are also demographic, geographic, and socioeconomic conditions in each type of road actor, which determine higher mortality risks. High population density, younger age group in the cyclists and adults among the pedestrians, low schooling levels and absence of health insurance are suggested as key factors in these profiles. Related to sex, for men is not possible to establish a profile. Women's cases are commonly related to health insurance, age, and population density. Several contextual and demographic characteristics in pedestrians and cyclists allow delimiting mortality profiles. The profiles that were identified suggest the need to articulate road safety policies with other social and development policies in order to coordinate and integrate intersectoral actions that reduce mortality in these road actors.
Topics: Adult; Male; Humans; Female; Accidents, Traffic; Pedestrians; Colombia; Bicycling
PubMed: 37576539
DOI: 10.12688/f1000research.131431.2 -
PloS One 2023Alcohol and drug use (substance use) is a risk factor for crash involvement.
BACKGROUND
Alcohol and drug use (substance use) is a risk factor for crash involvement.
OBJECTIVES
To assess the association between substance use and crash injury severity among older adults and how the relationship differs by rurality/urbanicity.
METHODS
We pooled 2017-2021 cross-sectional data from the United States National Emergency Medical Service (EMS) Information System. We measured injury severity (low acuity, emergent, critical, and fatal) predicted by substance use, defined as self-reported or officer-reported alcohol and/or drug use. We controlled for age, sex, race/ethnicity, road user type, anatomical injured region, roadway crash, rurality/urbanicity, time of the day, and EMS response time. We performed a partial proportional ordinal logistic regression and reported the odds of worse injury outcomes (emergent, critical, and fatal injuries) compared to low acuity injuries, and the predicted probabilities by rurality/urbanicity.
RESULTS
Our sample consisted of 252,790 older adults (65 years and older) road users. Approximately 67%, 25%, 6%, and 1% sustained low acuity, emergent, critical, and fatal injuries, respectively. Substance use was reported in approximately 3% of the population, and this proportion did not significantly differ by rurality/urbanicity. After controlling for patient, crash, and injury characteristics, substance use was associated with 36% increased odds of worse injury severity. Compared to urban areas, the predicted probabilities of emergent, critical, and fatal injuries were higher in rural and suburban areas.
CONCLUSION
Substance use is associated with worse older adult crash injury severity and the injury severity is higher in rural and suburban areas compared to urban areas.
Topics: Humans; United States; Aged; Accidents, Traffic; Cross-Sectional Studies; Emergency Medical Services; Hospitals; Substance-Related Disorders; Wounds and Injuries
PubMed: 37878571
DOI: 10.1371/journal.pone.0293138 -
European Journal of Trauma and... Apr 2024In modern societies, motorcycle accidents have become a great problem for health systems worldwide. In Spain, the size and the power of the engine of 2-wheel vehicles... (Observational Study)
Observational Study
PURPOSE
In modern societies, motorcycle accidents have become a great problem for health systems worldwide. In Spain, the size and the power of the engine of 2-wheel vehicles determine the type of driving license and the age at which these vehicles can be used (mopeds and motorcycles, which at the same time can have a small or large engine capacity). The objective of the present study was to analyze and characterize low- and high-power motorcycle accidents in Spain, between 2014 and 2020, both included and compared these categories with each other.
METHODS
Retrospective, descriptive, and observational study of motorcycle and moped accidents in Spain between 2014 and 2020, both included.
RESULTS
The mortality of motorcycle accident riders in Spain is associated with males aged between 30 and 40 years old, with a high-power motorcycle, and an A or A1 driver's license, who is 6.7 times more likely to die in crossings and highways than a moped, while wearing a helmet, and if not, this increases to 4.89 times. During the COVID-19 pandemic, an increase in death at 24 h after a high-power motorcycle accident was observed, as compared with a large reduction in the total medical assistance provided in 2019-2020.
CONCLUSIONS
High-power motorcycles had higher scores in mortality and morbity rates than low-power ones, with a significant increase in mortality during the pandemic, even though number of accidents and medical assistance provided were drastically reduced.
Topics: Humans; Motorcycles; Spain; Accidents, Traffic; Male; Adult; Retrospective Studies; Female; COVID-19; Head Protective Devices; Middle Aged; Young Adult; SARS-CoV-2
PubMed: 37698643
DOI: 10.1007/s00068-023-02363-0 -
BMC Geriatrics Oct 2023Our aim was to evaluate Spanish family doctors' knowledge about medications that increase the risk of traffic accidents involving older drivers, and to obtain data about...
BACKGROUND
Our aim was to evaluate Spanish family doctors' knowledge about medications that increase the risk of traffic accidents involving older drivers, and to obtain data about the involvement of family doctors in accident prevention activities and the associations between these factors and their demographic and workplace characteristics.
METHODS
A cross-sectional study of 1888 family doctors throughout Spain was carried out from 2016 to 2018. Participants completed a previously validated self-administered questionnaire that explored whether family doctors distinguished between medications associated with a high or low risk of involvement in a traffic accident, investigated the appropriateness of advice given to older patients, and physicians' involvement in preventive activities. Multiple regression models were used to estimate the adjusted association of these variables with each other and with characteristics of family doctors in the sample.
RESULTS
On a scale of 1 (never or hardly ever) to 4 (always), the indexes constructed to evaluate how often family doctors believed they should oversee the use of high-risk and low-risk medications yielded values of 3.38 for the former and 2.61 for the latter (p < 0.001). Only 24% responded correctly to all three items that inquired about the appropriateness of the advice they gave to older patients. On a scale of 1 to 4, the frequency at which family doctors gave older patients advice about preventive measures was 2.85, and only 43% reported allocating time during appointments to provide this advice. These latter two variables were directly associated with appropriate values for the index used to evaluate physicians' oversight of medications associated with a high risk. The perception of risk associated with medications and involvement in preventive activities were both greater among female participants.
CONCLUSIONS
Family doctors correctly identified medications according to their risk of playing a role in traffic accidents, although the recommendations they gave to their patients were not always appropriate. These findings, along with physicians' infrequent involvement in preventive activities, suggest a need to improve family doctors' competencies and increase the resources available to them so that they can provide their older patients with advice on ways to prevent involvement in traffic accidents.
Topics: Humans; Female; Accidents, Traffic; Cross-Sectional Studies; Surveys and Questionnaires; Physicians; Primary Health Care; Automobile Driving
PubMed: 37848841
DOI: 10.1186/s12877-023-04316-z -
Medycyna Pracy Dec 2023The profession of a firefighter is fraught with a significant risk of injuries. Firefighters operate in hazardous zones to mitigate threats and combat fires. Aim of work...
BACKGROUND
The profession of a firefighter is fraught with a significant risk of injuries. Firefighters operate in hazardous zones to mitigate threats and combat fires. Aim of work is to evaluate the accident rate of the officers of the Polish State Fire Service in connection with their service, considering direct participation in rescue operations, and other official duties between the years 2015-2022.
MATERIAL AND METHODS
An 8-year analysis was conducted from reports covered the number of accidents, the number of injured firefighters, the age of the officers, the circumstances of the event, and the type and location of the injury. This includes fire and rescue operations, exercises, training, official trips, sports activities, and technical work related to equipment.
RESULTS
Between 2015 and 2022, there were 12 588 individual and group accidents in various circumstances. Most firefighter accidents occurred during rescue and firefighting operations, as well as during sports activities which dominate as the cause of injuries among firefighters in the observed period (37.8%), and injuries related to rescue and fire-fighting activities constitute 28.5%. Other work activities of firefighters cause 33.7% of injuries. In 2020 was a clear reduction in the number of accidents per 1000 employed firefighters in each observed parameter (total, interventions, sport) while maintaining the average level of firefighter employment (M±SD 30 099±224).
CONCLUSIONS
The most frequent circumstances of injury are slippery and challenging spaces, surfaces, and carelessness. The most common type of body injury is a dislocation and sprain concerning the ankle joint, foot. The most frequent causes of work-related injuries for firefighters, as the results indicate, are participation in team sports and fire-fighting and rescue operations. The most commonly occurring medical consequences resulting from a firefighter's injury are fractures, sprains, and contusions of various body areas. Firefighters are most burdened with injuries in the age group 26-35 years old. Med Pr Work Health Saf. 2023;74(6):469-77.
Topics: Humans; Adult; Poland; Accidents, Occupational; Occupations; Firefighters; Exercise
PubMed: 38160420
DOI: 10.13075/mp.5893.01457 -
Journal of Patient Safety Dec 2023Incident investigation remains a cornerstone of patient safety management and improvement, with recommendations meant to drive action and improvement. There is little... (Review)
Review
BACKGROUND
Incident investigation remains a cornerstone of patient safety management and improvement, with recommendations meant to drive action and improvement. There is little empirical evidence about how-in real-world hospital settings-recommendations are generated or judged for effectiveness.
OBJECTIVES
Our research questions, concerning internal hospital investigations, were as follows: (1) What approaches to incident investigation are used before the generation of recommendations? (2) What are the processes for generating recommendations after a patient safety incident investigation? (3) What are the number and types of recommendations proposed? (4) What criteria are used, by hospitals or study authors, to assess the quality or strength of recommendations made?
METHODS
Following PRISMA-ScR guidelines, we conducted a scoping review. Studies were included if they reported data from investigations undertaken and recommendations generated within hospitals. Review questions were answered with content analysis, and extracted recommendations were categorized and counted.
RESULTS
Eleven studies met the inclusion criteria. Root cause analysis was the dominant investigation approach, but methods for recommendation generation were unclear. A total of 4579 recommendations were extracted, largely focusing on individuals' behavior rather than addressing deficiencies in systems (<7% classified as strong). Included studies reported recommendation effectiveness as judged against predefined "action" hierarchies or by incident recurrence, which was not comprehensively reported.
CONCLUSIONS
Despite the ubiquity of incident investigation, there is a surprising lack of evidence concerning how recommendation generation is or should be undertaken. Little evidence is presented to show that investigations or recommendations result in improved care quality or safety. We contend that, although incident investigations remain foundational to patient safety, more enquiry is needed about how this important work is actually achieved and whether it can contribute to improving quality of care.
Topics: Humans; Delivery of Health Care; Quality of Health Care; Patient Safety; Health Facilities; Safety Management
PubMed: 37712844
DOI: 10.1097/PTS.0000000000001164 -
Substance Abuse Treatment, Prevention,... Jul 2023Data on driving under the influence of alcohol (DUIA) are not always available, accurate, or reliable, making it difficult to study the effects of alcohol policies on... (Review)
Review
The absence of data on driving under the influence of alcohol in road traffic studies: a scoping review of non-randomized studies with vote counting based on the direction of effects of alcohol policies.
BACKGROUND
Data on driving under the influence of alcohol (DUIA) are not always available, accurate, or reliable, making it difficult to study the effects of alcohol policies on road traffic outcomes. The objectives of our study were twofold: 1) to describe how road traffic outcomes of alcohol policies are assessed when DUIA data are missing, and 2) to explore the effects of alcohol policies when DUIA data are missing.
METHODS
We conducted a scoping review of non-randomized studies that assessed the road traffic outcomes of alcohol policies when DUIA data are missing. Until November 2021, we searched studies published between 2000 and 2021, in English or French, via MEDLINE, APA PsycInfo, CINAHL, and SocINDEX. We assessed the risk of bias in the included studies with the Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group. The selection process, data extraction, and the risk of bias assessment were conducted independently and in duplicate. We used vote counting based on the direction of the effects of alcohol policies as a synthesis method. The protocol for this review was published in PROSPERO under record number CRD42021266744.
RESULTS
Twenty-four eligible studies were included. Regarding objective 1, most studies used uncontrolled interrupted time series designs to assess road traffic fatalities resulting from night-time crashes. The reasons for missing DUIA data were generally not reported. Regarding objective 2, we found evidence for an association between alcohol policies and decreased road traffic fatalities. Subgroup analyses found no evidence for an association between methodological modifiers and positive effect directions for road traffic fatalities.
CONCLUSION
Caution is needed when interpreting road traffic outcomes associated with alcohol policies when DUIA data are missing. Greater efforts should be made to improve the reporting of outcomes assessments. Future studies must address several methodological issues (e.g., more granular data, well-defined intervention and implementation, and controlled designs). Our results should be compared to those from others reviews where DUIA data were available to confirm or recalibrate the associations found in studies where DUIA data were missing.
Topics: Humans; Accidents, Traffic; Driving Under the Influence; Ethanol; Public Policy
PubMed: 37507756
DOI: 10.1186/s13011-023-00553-y