Risk of permanent medical impairment after road traffic crashes: A systematic review / 中华创伤杂志(英文版)

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.

Do automotive window films affect drivers' safety by decreasing vision sensitivity? A Cross-sectional study / Películas automotivas e perda de acuidade visual? Estudo transversal

ABSTRACT Objective: To measure visual acuity in high contrast and low contrast sensitivities in different grades of visible light transmission films in three different positions (front, lateral and rear windows). Methods: Forty-four healthy volunteers between 30-75 y-o, with BCVA better than 0,5, were tested in the 5 following vehicles with different grades of visible light transmission films. Vehicle 1: 75% in the front and 70% in the lateral and rear windows; Vehicle 2: 70% in the front and lateral windows and 28% in the rear; Vehicle 3: 70% in the front, 28% in the lateral and 15% rear; Vehicle 4: 35% in all 3 windows; Vehicle 5: 50% in the front, 20% in the lateral and 15% in the rear. Descriptive statistics were used and the average of the 3 measurements of VA was considered. Wilcoxon Test was applied to compare the average visual acuity in each vehicle and position. P value<0.05 was considered statistically significant. Results: According to the Brazilian Traffic Regulations for driving in categories C/D/E, when low contrast was tested in the front window, all visible light transmissions were borderline, in the lateral window they were all outside the limit, while in the rear window for both low and high contrast, all visible light transmissions tested were outside the limit and also borderline for driving in categories A/B, with the exception of the vehicle with visible light transmission of 35%. Conclusion: Visual acuity is affected, especially in the rear window, by the use of automotive films. The study is an alert that window films is a possible cause of accidents and may contribute to the revision of traffic regulations worldwide.

RESUMO Objetivo: Medir a acuidade visual em alto e baixo contraste nas diversas graduações de transparência de filmes em três janelas de veículos: frontal, lateral e traseira. Métodos: Foram avaliados 44 voluntários saudáveis entre 30 e 75 anos, com acuidade visual melhor corrigida acima de 0,5, em cinco veículos, sendo: veículo 1, com 75% de transparência frontal e 70% na lateral e traseira; veículo 2, com 70% na frontal e na lateral e 28% na traseira; veículo 3, com 70% na frontal, 28% na lateral e 15% na traseira; veículo 4, com 35% nas três janelas; e veículo 5, com 50% na frontal, 20% na lateral e 15% na traseira. Foi realizada estatística descritiva utilizando a média de três medidas consecutivas, com teste de Wilcoxon para comparar a média de acuidade visual em cada janela, e foi considerado estatisticamente significativo quando valor de p<0,05. Resultados: Todas as transparências testadas nos vidros reduziram a acuidade visual em situação de baixo contraste para níveis limítrofes na janela frontal e níveis ilegais na lateral para conduzir veículos nas categorias C/D/E. Na janela traseira, tanto em alto quanto em baixo contraste, todas as transparências mostraram redução da acuidade visual para níveis ilegais para categorias C/D/E e limítrofes para as categorias A/B, exceto na transparência de 35%. Conclusão: A acuidade visual é reduzida pelo uso dos filmes automotivos, especialmente na janela traseira. Condutores de veículos com filmes devem ser alertados pelo risco aumentado de acidentes. Esse dado científico propõe revisões nas regulações de tráfego mundiais.

Musculoskeletal computational analysis on muscle mechanical characteristics of drivers lumbar vertebras and legs in different sitting postures

SUMMARY Using computer-aided engineering (CAE) in the concept design stage of automobiles has become a hotspot in human factor engineering research. Based on human musculoskeletal biomechanical computational software, a seated human-body musculoskeletal model was built to describe the natural sitting posture of a driver. The interaction between the driver and car in various combinations of seat-pan/back-rest inclination angles was analyzed using an inverse-dynamics approach. In order to find out the "most comfortable" driving posture of the seat-pan/back-rest, the effect of seat-pan/back-rest inclination angles on the muscle activity degree, and the intradiscal L4-L5 compression force were investigated. The results showed that a much larger back-rest inclination angle, approximately 15°, and a slight backward seat-pan, about 7°, may relieve muscle fatigue and provide more comfort while driving. Subsequently, according to the findings above, a preliminary driving-comfort function was constructed.

RESUMO O uso de engenharia assistida por computador (CAE) na fase de projeto do conceito do automóvel tornou-se um ponto de acesso na pesquisa de fatores humanos. Com base no software computacional biomecânico musculoesquelético humano, foi construído um modelo musculoesquelético sentado para descrever a postura sentada natural de um condutor. A interação entre um motorista e um carro em várias combinações de ângulos de inclinação do assento-pan/encosto foi analisada usando uma abordagem dinâmica do verso. A fim de descobrir a postura de condução "mais confortável" do assento-pan/encosto, o efeito dos ângulos de inclinação do assento-pan/dorso sobre o grau de atividade muscular e a força de compressão intradiscal L4-L5 foi investigado. Os resultados mostraram que um ângulo de inclinação para trás muito maior, aproximadamente 15°, e um ligeiro assento-pan para trás, cerca de 7°, pode aliviar a fadiga muscular e levar a dirigir em uma posição confortável. Posteriormente, de acordo com as conclusões acima expostas, foi construída uma função preliminar de conforto ao dirigir.

Acidentes Automobilísticos no Brasil em 2017: estudo ecológico dos anos de vida perdidos por incapacidade / Automobile Accidents in Brazil in 2017: ecological study of the disability-adjusted life years

RESUMO Este estudo se propõe a descrever o impacto dos Acidentes Automobilísticos no Brasil, no ano de 2017, sobre os anos de vida perdidos ajustados por incapacidade. Estudo ecológico, com dados secundários da Global Health Data Exchange (Global Burden of Disease 2017) disponibilizados pelo Institute for Health Metricsand Evaluation. Os dados foram obtidos utilizando filtros de causa (ferimentos na estrada por veículo automotor), localização (global, Brasil e sul da América Latina) e indivíduos de ambos os sexos, com idades entre 15 e 49 anos. Foram considerados os anos de vida perdidos por incapacidade e a taxa de mortes por 100 mil habitantes. Os dados foram exportados para o Excel® for Windows 2010 e analisados conforme a literatura. Observa-se, no Brasil, um decréscimo nas taxas de óbitos (19,68%) e de anos de vida perdidos por incapacidade (22,10%) por acidente automobilístico entre indivíduos de ambos os sexos, com idades entre 15 e 49 anos, porém mostram-se superiores as taxas globais e do sul da América Latina. Estudos como este são importantes para o aperfeiçoamento e o direcionamento de politicas públicas específicas, para formular e implementar estratégias de promoção e prevenção da saúde de segurança no trânsito.

ABSTRACT This study aims to describe the impact of Automobile Accidents in Brazil, in the year 2017, on the years of life lost adjusted for disability. Ecological study, with secondary data from the Global Health Data Exchange (Global Burden of Disease 2017) provided by the Institute for Health Metrics and Evaluation (IHME). The data were obtained using cause filters (road injuries by motor vehicle), location (Global, Brazil and Southern Latin America) and individuals of both sexes, aged 15 to 49 years. Rates of death and Disability-Adjusted Life Years per 100 thousand inhabitants were considered. The data were exported to Excel® for Windows 2010 and analyzed according to the literature. It is observed, in Brazil, a decrease in death rates (19.68%) and Disability-Adjusted Life Years (22.10%) per automobile accident among individuals of both sexes, between 15 and 49 years, but they are higher than the Global and Southern rates of Latin America. Studies such as this are important for the improvement and targeting of specific public policies, to formulate and implement strategies for health promotion and prevention of traffic safety.

Avaliação dos sistemas metroviários nas emissões de CO2: análise comparativa das emissões por automóveis, ônibus e metrôs / Evaluation of subway systems in CO 2 emissions: Comparative analysis of emissions from cars, buses and subways

RESUMO O setor de transportes é responsável por uma parcela das emissões globais de dióxido de carbono (CO2). Os estudos científicos publicados sobre emissões de CO2 pelos sistemas de transportes de passageiros tratam basicamente de resultados envolvendo apenas as emissões relacionadas ao consumo dos combustíveis dos automóveis e ônibus. Nos metrôs, geralmente são consideradas as emissões relacionadas à geração da energia elétrica necessária para prover a força de tração dos trens. Não foram identificadas publicações específicas ou padronizadas sobre outras abordagens de cálculos das emissões pelos metrôs. Com isso, este estudo visa fornecer uma contribuição científica no estudo geral das emissões de CO2 pelos metrôs, definindo conceitualmente cinco abordagens de cálculos e realizando uma análise comparativa dos resultados das emissões de CO2 por automóveis, ônibus e metrôs. O resultado desta pesquisa permitiu quantificar a real contribuição dos metrôs quanto à redução das emissões totais do setor de transportes. Na abordagem da energia de tração dos trens, concluiu-se que os Metrôs de São Paulo e Rio de Janeiro emitem 63,5 vezes menos do que os automóveis e 8 vezes menos do que os ônibus.

ABSTRACT The transportation sector is responsible for a portion of the global emissions of carbon dioxide (CO2). Scientific studies published on CO2 emissions by passenger transport systems treat basically results involving only the emissions related to fuel consumption of cars and buses. As for subways, usually emissions related to the generation of electrical energy needed to provide the traction force of the trains are considered. No specific or standardized publications on other approaches to calculate emissions for subways were identified. Thus, this study aims to provide a scientific contribution to the general study of CO2 emissions by subways, conceptually defining five approaches of calculations and conducting a comparative analysis of CO2 emissions by cars, buses and subways. The result of this research allowed to quantify the actual contribution of subways on the reduction of total emissions from the transportation sector. In the traction power of trains approach, it was concluded that the subways of São Paulo and Rio de Janeiro emit 63.5 times less than cars and 8 times less than buses.

Arriscar a vida por uma corrida: risco e corridas ilegais de carros e motos / Risking your life for a race: risks and illegal automobile and motorcycle street races / Arriesgar la vida por una carrera: riesgo y carreras ilegales de autos y motos

O artigo propõe analisar práticas e produção de significados de jovens aficionados por corridas ilegais de carros e de motos ("rachas") e por manobras radicais. A pesquisa etnográfica busca compreender as condutas de risco entre os "rachadores" e o sentido que eles próprios atribuem ao perigo, à aventura e às sensações corpóreas presentes em suas práticas. Isso obriga a alargar os significados de risco e compreender determinadas práticas como contraponto às biopolíticas ou às formas de controle da vida. Os "rachadores" são jovens de classes populares e respondem à impotência social, que os destitui de capital econômico (e social), mediante um capital tecnológico que lhes permite reconhecimento de seus pares e visibilidade social, mesmo que a contrabando, em razão da ilegalidade dessas práticas, quando o risco-aventura torna-se um constitutivo da construção identitária.(AU)

The objective of the present article is to analyze the practices and meanings produced by youths involved in illegal automobile and motorcycle street races and radical maneuvers. This ethnographic study sought to understand risk behaviors among racers and the meaning they attribute to danger, adventure and the body sensations experienced in their practices. To this end, the authors had to adopt a broader meaning of risk and understand certain practices as a counterpoint to biopolitics or forms of life control. The racers are young individuals from lower-income classes, who respond to social impotence, which deprives them of economic (and social) capital, by using technological capital. This gives them status among their peers and social visibility, even if in contraband, as these practices are illegal, and their risks and adventures become a constituting element of identity construction.(AU)

El artículo se propone analizar prácticas y producción de significados de jóvenes aficionados a carreras ilegales de autos y motos y a maniobras radicales. La investigación etnográfica trata de comprender las conductas de riesgo entre los "pilotos" y el sentido que ellos propios atribuyen al peligro, a la aventura y a las sensaciones corporales presentes en sus prácticas. Eso obliga a ensanchar los significados de riesgo y comprender determinadas prácticas como contrapunto a las bio-políticas o a las formas de control de la vida. Los "pilotos" son jóvenes de clases populares y responden a la impotencia social que los destituye de un capital económico (y social) por medio de un capital tecnológico que les permite el reconocimiento de sus pares y visibilidad social, aunque sea de contrabando, debido a la ilegalidad de esas prácticas, cuando el riesgo-aventura pasa a ser un factor constitutivo de la construcción de la identidad.(AU)

Humo de tabaco en vehículos: medición de partículas de materia 2. 5 micras / Smoking in vehicles: measurement of 2. 5 PM matter particles

Introducción: proteger a la población del humo de segunda mano (HSM) es uno de los principios de la Organización Mundial de la Salud en el marco del control del tabaco. Existen pocos datos acerca de la exposición de HSM en vehículos en América del Sur. Este estudio tuvo como objetivo determinar el nivel de dicha exposición. Materiales y método: se midieron niveles de micropartículas de materia de 2,5 micras de diámetro (PM2,5) que vehiculizan el HSM en la vía aérea, en modelos experimentales en autos de fumadores y no fumadores. Resultados: la media de la concentración de PM2,5 fue de 181 µg/m3 en los autos de fumadores y de 0 µg/m3 en los autos de no fumadores (p <0,001). La máxima concentración fue de 2.900 µg/m3 en un auto de fumador estacionado con la ventanilla del conductor parcialmente abierta. Conclusiones: las concentraciones de PM2,5 en vehículos en los que se fuma alcanzó niveles altos, similares a los que se encuentran en ciertos países con políticas de control de tabaco débiles. Este hecho determina la necesidad de nuevas políticas públicas para eliminar el HSM de los vehículos para proteger la salud pública. (AU)

Introduction: Protection from second-hand smoke (SHS) is one of the main principles of the World Health Organization Framework Convention for Tobacco Control. Limited data is available on SHS exposure in vehicles in South America. This study aimed to assess the levels of exposure. Methods: Levels of respirable and fine suspended particles with 2.5 micrometres or less (PM2.5) diameter were measured in different models in smokers' and non-smoker´s vehicles. Results: Median PM2.5 concentration was 181 µg/m3 in "smoking vehicles" and 0 µg/m3 in "non-smoking vehicles" (p<0.001). The highest concentration reached 2.900 µg/m3 in a parked car with the driver's window partially open. Conclusions: Concentration of PM2.5 in vehicles reached high levels, similar to those at certain sites in countries with weak tobacco control policies. These facts underscore a need for new public policies to eliminate SHS in vehicles to protect public health.

Introdução: um dos princípios da Organização Mundial da Saúde no contexto do controle do tabaquismo é proteger a população da fumaça de segunda-mão (HSM). Existem poucos dados sobre a exposição de HSM em veículos na América do Sul. O objetivo deste estudo foi identificar um mecanismo para determinar o nível desta exposição. Materiais e métodos: utilizando modelos experimentais em veículos de fumantes e não fumantes foram medidos os níveis de micropartículas de matéria de 2,5 micras de diâmetro (PM2,5) transportados pela HSM na via aérea. Resultados: á concentração média de PM2,5 foi 181 µg/m3 nos automóveis de fumantes e 0 µg/m3 nos automóveis de não fumantes (p<0.001). A concentração máxima de 2.900 µg/m3 foi encontrada no automóvel estacionado de um fumante com a janela do motorista parcialmente aberta. Conclusões: as concentrações de PM2,5 em veículos de fumantes alcançou níveis altos, similares aos encontrados em alguns países com políticas de controle de tabaco débeis. Este fato determina a necessidade de novas políticas públicas para eliminar a HSM dos veículos para proteger a saúde pública.

Estrangulamento acidental em crianças por fechamento automático de vidro de carro / Accidental strangulation in children by the automatic closing of a car window

RESUMO Entre as principais causas de morte em nosso meio, situam-se acidentes automobilísticos, afogamento e queimaduras acidentais. O estrangulamento é uma injúria potencialmente fatal, além de importante causa de homicídio e suicídio em adultos e adolescentes. Em crianças, sua ocorrência é usualmente acidental. No entanto, nos últimos anos, vários casos de estrangulamento acidental em crianças ao redor do mundo têm sido reportados. Paciente masculino de 2 anos de idade foi vítima de estrangulamento em vidro do carro. Admitido na unidade de terapia intensiva pediátrica com Escala de Coma de Glasgow de 8, piora progressiva da disfunção respiratória e torpor. Paciente apresentou quadro de Síndrome da Angústia Respiratória Aguda, edema agudo de pulmão e choque. Foi manejado com ventilação mecânica protetora, drogas vosoativas e antibioticoterapia. Recebeu alta da unidade de terapia intensiva sem sequelas neurológicas ou pulmonares. Após 12 dias de internação, teve hospitalar alta para casa em ótimo estado. A incidência de estrangulamento por vidro de automóvel é rara, mas de alta morbimortalidade, devido ao mecanismo de asfixia ocasionado. Felizmente, os automóveis mais modernos dispõem de dispositivos que interrompem o fechamento automático dos vidros se for encontrada alguma resistência. No entanto, visto a gravidade das complicações de pacientes vítimas de estrangulamento, é significativamente relevante o manejo intensivo neuroventilatório e hemodinâmico das patologias envolvidas, para redução da morbimortalidade, assim como é necessário implementar novas campanhas para educação dos pais e cuidadores das crianças, visando evitar acidentes facilmente preveníveis e otimizar os mecanismos de segurança nos automóveis com vidros elétricos.

ABSTRACT Among the main causes of death in our country are car accidents, drowning and accidental burns. Strangulation is a potentially fatal injury and an important cause of homicide and suicide among adults and adolescents. In children, its occurrence is usually accidental. However, in recent years, several cases of accidental strangulation in children around the world have been reported. A 2-year-old male patient was strangled in a car window. The patient was admitted to the pediatric intensive care unit with a Glasgow Coma Scale score of 8 and presented with progressive worsening of respiratory dysfunction and torpor. The patient also presented acute respiratory distress syndrome, acute pulmonary edema and shock. He was managed with protective mechanical ventilation, vasoactive drugs and antibiotic therapy. He was discharged from the intensive care unit without neurological or pulmonary sequelae. After 12 days of hospitalization, he was discharged from the hospital, and his state was very good. The incidence of automobile window strangulation is rare but of high morbidity and mortality due to the resulting choking mechanism. Fortunately, newer cars have devices that stop the automatic closing of the windows if resistance is encountered. However, considering the severity of complications strangulated patients experience, the intensive neuro-ventilatory and hemodynamic management of the pathologies involved is important to reduce morbidity and mortality, as is the need to implement new campaigns for the education of parents and caregivers of children, aiming to avoid easily preventable accidents and to optimize safety mechanisms in cars with electric windows.

Errores humanos autorreferenciados por automovilistas de la ciudad de Bahía Blanca, Argentina / Human errors self-reported by automobilists from bahia blanca, Argentina

OBJETIVO: Describir los tipos de errores que referencian los conductores de automóviles que circularon en la ciudad de Bahía Blanca durante el período septiembre 2014 y abril de 2015. MÉTODO: Estudio descriptivo de corte transversal de tipo cuantitativo. Se definió una muestra por conveniencia y se confeccionó una encuesta en formato digital, de tipo estructurada, dirigida a los automovilistas, teniendo como base el "Driver Behaviour Questionnaire" en la versión traducida al español. Luego fue validada mediante el método Delphi. Se analizó con software estadístico SPSS. RESULTADOS: El 30% al realizar un giro, estuvo a punto de chocar con una bicicleta o moto. Un 36,3% sostuvo que por ir distraído, se dio cuenta tarde de que el vehículo de adelante redujo su velocidad debiendo frenar bruscamente para evitar el choque, el 25,3% se olvida de utilizar el guiñe antes de girar o cambiar de carril. El 80,2% usa siempre el cinturón de seguridad. El 11,4% pasa los semáforos en rojo. Un 43,9% utiliza el celular mientras maneja y el 22,9% de los encuestados reconoce que alguna vez condujo por encima del límite legal de alcohol. El 38% se impacienta y acelera bruscamente a la salida de un semáforo y un 62,7% se impacienta y se adelanta de forma arriesgada a un vehículo lento. CONCLUSIONES: El manejo es una situación compleja que requiere de múltiples habilidades pero fundamentalmente una conciencia de respeto y solidaridad sumado a un enfático control punitorio sobre errores voluntarios graves.

OBJECTIVE: To describe the types of errors reported by drivers who commuted in the city of Bahia Blanca between September 2014 and April 2015. METHOD: Quantitative descriptive cross-sectional study. A convenience sample was defined, and a structured digital survey, based on the Spanish-translated version of the "Driver Behaviour Questionnaire", was constructed and then validated using the Delphi method. Data were analyzed with SPSS statistical software. RESULTS: Of the automobilists surveyed, 30% reported having nearly colliding with a bicycle or motorcycle while making a turn; 36.3% said they have had to brake suddenly to avoid a collision because they were distracted and did not realize the vehicle in front of them had slowed down; and 25.3% had forgotten to use the turn signal before turning or changing lanes. In addition, only 80-2% of respondents always wear a seat belt; 11-4% do not respect red lights; 43.9% use their phones while driving; and 22.9% admit driving while intoxicated over the legal alcohol limit. Finally, 38% report being impatient and accelerating out of a traffic light, while 62.7% have riskily passed a slower vehicle, due to impatience. CONCLUSIONS: Driving an automobile is a complex situation that requires multiple skills and, most fundamentally, a sense of respect and solidarity with other drivers, coupled with punitive control of serious yet preventable human errors.

Car and motorcycle deaths: an evolutionary perspective / Mortes por batida de carro e moto: uma perspectiva evolucionista

Abstract Our aim was to assess differences between men and women in the likelihood of exposure to traffic as drivers of cars and motorcycles, and in the risk of dying from a car or a motorcycle crash, in order to verify the extent to which Darwin's Sexual Selection Theory could have predicted the findings and can help to interpret them. Study population was composed of men and women aged 18 to 60 years residents in the state of Rio de Janeiro between 2004 and 2010, and in the state of Rio Grande do Sul between 2001 and 2010. We built frequency distribution tables and drew bar charts in order to check whether there were differences between the sexes and interactions of sex with age. More men exposed themselves to and died in traffic than women, especially the young. Society should have an especially vigilant attitude towards men on the wheel due to their increased innate tendency to exposure to risk. Darwin's sexual selection theory can be an important ally when postulating hypotheses and interpreting epidemiological findings aiming at improving public policies to reduce the excessive number of traffic deaths, especially in societies where machismo is strong or the stimulus to masculinity is exaggerated.

Resumo Objetivamos averiguar diferenças entre homens e mulheres na exposição ao trânsito como motorista de carro e de moto e no risco de morrer por batida desses veículos, para verificar até que ponto a teoria da seleção sexual de Darwin pode predizer os achados e ajudar a interpretá-los. A população de estudo foi composta por homens e mulheres de 18 a 60 anos residentes no Estado do Rio de Janeiro, entre 2004 e 2010, e no Estado do Rio Grande do Sul, entre 2001 e 2010. Elaboramos tabelas de frequência e gráficos de barras para verificar se havia diferenças entre os sexos e interação de sexo com idade. Homens se expuseram e morreram mais no trânsito do que mulheres, especialmente os jovens. A sociedade deveria ter uma atitude especialmente vigilante com homens ao volante devido à tendência inata deles de maior exposição ao risco. A teoria da seleção sexual de Darwin pode ser uma potente aliada na postulação de hipóteses que busquem aperfeiçoar políticas públicas para reduzir a quantidade exagerada de mortes no trânsito, especialmente em sociedades onde o machismo for forte ou o estímulo à masculinidade exagerado.

Automóveis e automobilismo no Rio de Janeiro de 1954 a 1959 / Automobiles and motorsport in Rio de Janeiro between 1954 and 1959

Este artigo buscou evidenciar a trajetória do automobilismo carioca, de 1954 a 1959, demarcando as interseções entre a produção em massa dos automóveis nacionais, sua influência no desenvolvimento urbano do Rio de Janeiro, e a mudança de habitus que a sociedade começava a vivenciar. Metodologicamente foi utilizada uma análise documental aliada a uma pesquisa bibliográfica. Como fonte primária utilizou-se a Revista de Automóveis e os resultados apontaram para: um desenvolvimento urbano liderado pelo automóvel, uma sociedade que transformou os carros em testemunha e cúmplice de sua vida pública e privada, e um automobilismo mal administrado que se deslocou pela cidade de acordo com o crescimento desta

This article searched to evidence the motorsport trajectory in Rio de Janeiro between 1954 and 1959, demarcating the intersections among the national automobiles mass production, its influence in the city development and the habitus change that the society started to live. Methodologically a documentary analysis combined with a literature search was used. As research source was used the magazine "Revista de Automóveis" and the results pointed to: an urban growth leaded by automobiles, a society that transformed them in witness and accomplice of its public and private life, and a motorsport mismanaged which ran through the city according to its growing

Case report of renal cell carcinoma in automobile manufacturing factory worker due to trichloroethylene exposure in Korea

BACKGROUND: The aim of this paper was report first case of renal cell carcinoma developed in a worker who worked in an automobile manufacture line which handles trichloroethylene in Korea. CASE PRESENTATION: To clarify the relationship between the onset of renal cell carcinoma in 52-years old male worker and the exposure to trichloroethylene, document studies and work environment measurement were done. Past work environment exposure data were reviewed and medical history and surgery records of the worker were also reviewed. The patient had no personal risk factor related to renal cell carcinoma except for his smoking habit of quarter a pack per day for twenty years, and since trichloroethylene was not part of measurement criteria, past work environment risk assessment data could not verify the exposure. The exposure level is deduced by analyzing material exposure level of work environments which has similar processes in data from revised research of chemical exposure standard and work environment validity assessment. Evaluation Committee of Epidemiologic Survey decided that there are relevant relationship between the exposure and the disease, though we do not have exact data during that period, most experts agree that in every factories they used trichloroethylene without any direction. CONCLUSIONS: From the relevant medical history and the results of the usage of trichloroethylene in the relevant industries, and initial discovery of renal cell carcinoma at health inspection sonogram in 2001, it can be concluded that suggests significant causal relationship between the exposure to trichloroethylene and renal cell carcinoma onset, thus reporting it to be the first domestic case declared to be occupational disease.

Regulación del transporte y accidentes de tránsito por vehículos motorizados en el Perú / Regulation of transport and traffic accidents by motor vehicles in Peru

Entre 1998 y 2012, en el Perú se han producido más de un millón doscientos mil accidentes terrestres por vehículos automotores con 49 mil fallecidos. A pesar de la aprobación de diversas regulaciones sobre tránsito y seguridad vial, no se observa una tendencia hacia la disminución de las lesiones fatales en los usuarios del tránsito. Las regulaciones parecen no tener un efecto de proteccón sobre los ocupantes de los veh¡culos y peatones, debido a que el número de lesiones fatales se ha incrementado en ambos grupos. Las estadísticas podrían tener variaciones del tipo de usuarios afectados por los accidentes y el número de lesiones fatales para los eventos en v¡as urbanas, peri urbana y carretera.

Between 1998 and 2012, there have been more than one million two hundred thousand land motor vehicle accidents with 49 000 deaths in Peru. Despite the adoption of several regulations on traffic and road safety, there is no a trend towards fewer fatal injuries. Regulations appear not to have a protective effect on the occupants of vehicles and pedestrians, because the number of fatal injuries has increased in both groups. The statistics might have variations on the type of users, affected by the number of accidents, and fatal injuries related to the events in urban and periurban roads, and highways.

A Study of Impact on Head and Neck Using Human Volunteer Low-Speed Rear Impact Tests / 대한법의학회지

Whiplash injury in low-speed traffic accidents are not objectively verified by medical equipment, thereby creating scope for misuse, which has resulted in huge social losses worldwide. The aim of this study was to examine the influence of low-speed vehicular rear-impact collisions on middle-aged men, and to analyze the head and neck injury criteria for the symptomatic human volunteers. Data was examined from the results of 50 dynamic sled tests, originally performed by Hong et al. (2012). In the previous tests, 50 men aged 30~50 years were exposed to an impulse equivalent to a bumper-to-bumper rear collision under medical supervision, and no resulting whiplash injury was identified. In this study, for 6 subjects who experienced dull aches over their bodies, head injury criteria (HIC15) and neck injury criteria (N(km)) were calculated according to the accelerations, forces, and moments at the occipital condyle measured by motion capture system. Although there were no changes in magnetic resonance imaging findings in all subjects at the pre-/post-test orthopedic examination, 6 subjects revealed mild aches around the shoulder, back, or lumbar area, and their symptoms disappeared within 2 days. The head and neck injury criteria, HIC15 (3.086 +/- 2.942) and N(km) (0.077 +/- 0.064) were obtained, and the maximum HIC15 and N(km) were found to be significantly lower than the critical injury assessment reference values (HIC15: 700, N(km): 0.3). Moreover, even though 2 subjects were exposed to the same level of change of velocity (7.9 km/h), each N(km) was significantly different (0.179, 0.057). One can therefore conclude that N(km) can vary according to voluntary movements in the human subject.

Mobilidade urbana: um desafio paulistano / Urban mobility: a challenge for the people of São Paulo

Na “leitura” de uma cidade distingo infraestruturas físicas e sistemas de vida,a fim de avaliar se as primeiras dão suporte adequado às segundas. Para a abordagem e compreensão da cidade dou mais importância a aspectos antropológicos do que aos estatísticos. Para avaliar mobilidade urbana há que considerar três fluxos: os imateriais(informações), cargas (bens) e pessoas. Na de pessoas há expectativa de proximidade de embarque, pontualidade e conforto. Transporte público é sistema, do qual participam os diversos modais, inclusive o do pedestre. No futuro haverá mais locação do que propriedade privada do automóvel; e indústria de reciclagem dos elementos de carros usados. Deve o direito à mobilidade ser gratuito para o usuário ou ser por ele pago com subsídio? Políticas públicas deverão ter no urbanismo um processo de melhor gestão urbana, diminuir necessidade de deslocamentos, alterar o uso do carro, monitorar serviços com participação pública, sistematizar modais, garantir pontualidade e conforto do transporte.

When "reading" a city, I distinguish physical infrastructures from life systems in order to assess whether the former provide adequate support for the latter. To approach and understand a city, I attribute greater importance to anthropological than to statistical aspects. In evaluating urban mobility, we must consider three different flows: of intangibles (information), freight (goods) and people. Regarding the flow of people, the expectations are proximity to boarding points, punctuality and comfort. Public transportation is a system comprising various modes, including pedestrians. In the future, there will be more leasing than ownership of automobiles, as well as an industry devoted to recycling used cars parts. Should the right to mobility be free of charge to users or should they be made to pay, albeit with subsidies? Public policies must apply urban planning to improve urban management, reduce the need to commute, change car usage patterns, monitor services with governmental participation, systematize transportation modes, and ensure punctuality and comfort in transportation.

O plano de mobilidade urbana e o futuro das cidades / The urban mobility plan and the future of cities

O artigo traça um breve histórico sobre a evolução dos problemas da mobilidade, dos cavalos aos carros, e mostra que hoje, tal como há cem anos, a priorização do transporte individual levou a problemas sociais, ambientais e de saúde pública. Em seguida, analisa a Política Nacional de Mobilidade Urbana, ressaltando suas inovações e os pontos de atenção que podem prejudicar sua efetividade. Por fim, destaca a necessidade de se melhorar o transporte coletivo e não motorizado e, concomitantemente, desestimular o uso do automóvel, como formas de se devolver aos cidadãos o direito à cidade e aos serviços essenciais que ela guarda.

The article starts by providing a brief history of the evolution of mobility problems, from horses to cars, and shows that nowadays, as it was 100 years ago, the prioritization of individual transportation facilities leads to social, environmental and health problems. Secondly, the National Urban Mobility Policy analysis highlights some innovations as well as points of attention that may impair its effectiveness. Lastly, the article advocates the necessity of collective and non-motorized transport and, simultaneously, discourages car use as a way of returning to the citizens the right of the city's space and its services.

Niveles de alcohol en sangre y somnolencia en conductores estudiados en simuladores: un metaanálisis / Blood alcohol concentration and somnolence among drivers studied in simulators: a meta-analysis

Introducción: Los accidentes de tránsito ocasionados por conductores que se encuentran bajo el efecto del alcohol constituyen una de las principales causas de accidentalidad y mortalidad vial. Ante este problema, surge la necesidad de definir límites en cuanto al nivel de alcoholemia a partir del cual se pone en riesgo el estado de vigilia necesaria para la conducción. Objetivos: Determinar las concentraciones mínimas de alcohol en sangre con las que se altera el estado de vigilia o se genera algún grado de somnolencia que pone en riesgo la habilidad y la destreza al conducir. Métodos: Metanálisis de la literatura sobre los artículos publicados entre 1999 y 2009 que evaluaron la conducción en simuladores después de la ingesta de diferentes grados de alcohol y en los que se midió la somnolencia que estos grados producen en los conductores. Resultados: Se produce mayor somnolencia en los conductores que están bajo efecto de alcohol. Las diferencias medias estandarizadas (SMD) fueron de 0,81 (IC 95%: 0,54-1,09) para personas con niveles de concentraciones de alcohol en sangre (BAC) menores a 0,05 y de SMD = 1,16 (IC 95 %: 0,93-1,4) para las personas con niveles de BAC mayores a 0,05. En todas las escalas utilizadas para medir somnolencia se corroboró el efecto del alcohol. Conclusiones: En todos los desenlaces se evidenció que, independientemente de la cantidad de alcohol en la sangre (niveles mayores y menores de BAC = 0,05), la ingesta de alcohol está asociada con mayor somnolencia...

Introduction: Traffic accidents caused by drivers under the influence of alcohol are a major cause of road accidents and mortality. Faced with this problem, defining the limit of alcohol levels from which wakefulness for the purpose of driving is jeopardized is critical. Objectives: To determine the minimum concentration of alcohol in blood that alters wakefulness or generates some degree of drowsiness that compromises driving ability and skill. Method: Meta-analysis. Systematic review of eight databases, limited to publications between 1999 and 2009 in which the assessment was made through simulators and blood alcohol concentrations were measured. Results: In all the subgroups studied it was clear that people with some intake of alcohol tend to have some degree of drowsiness compared with those with a blood alcohol level of 0. Standardized mean differences in sleepiness were high. This means there was a great difference between those with blood alcohol concentrations and those without. Conclusions: In all outcomes it was evident that regardless of the amount of alcohol in blood, alcohol intake provoked in the drivers a tendency towards sleepiness. We observed that most simulator studies tend to favor zero alcohol intake while driving because of the high degree of drowsiness that occurs...

Factores asociados con accidentes de tránsito fatales y nofatales en la ciudad de Bogotá, Colombia (2005-2009) / Risk and protection factors associated with fatal and non-fatal traffic accidents in the city of Bogota-Colombia (2005-2009)

Objetivo: Determinar tendencia, magnitud, distribución y factores asociados al trauma fatal y no fatal por accidentes de tránsito en el periodo 2005-2008 en Bogotá. Método: Se revisaron las bases de datos del Sistema de Información de Accidentes de Tránsito y de la Policía Metropolitana de Tránsito; se estudió todo accidente simple-solo latas, con herido o muerto ocurrido. Resultados: Entre 2005 y 2008 se presentaron 141.372 accidentes. En promedio, en estos cuatro años diariamente murió una persona y resultaron heridas 35. El número de accidentes por cada 10.000 vehículos ha disminuido de 266,2 en 2005 a 220,6 en 2008. La mayor proporción de muertos y lesionados se presentó en eventos de atropello, volcamiento y caída del ocupante. Hubo mayor mortalidad en el sexo masculino. El 57% de los muertos en accidentes de tránsito fueron peatones y los más susceptibles a morir fueron los mayores de cincuenta años; en segundo lugar, los motociclistas en edad productiva. Hubo mayor proporción de accidentes en tramos de las vías, y menor, en intersecciones.Hubo mayor letalidad con carros de modelos anteriores a 1980. Conclusiones: Este estudio permitió detallar variables que inciden en la gravedad del accidente, como modelo, tipo de vehículo, condiciones y tipo de la vía, evento y medidas de protección y seguridad de los vehículos, entre otros.

Objective: To determine the trend, magnitude and distribution of fatal and non fatal trauma resulting from traffic accidents in the 2005-2008 period in Bogota. Method: The data base of the Traffic Accidents Information System and that of the National Police were taken into account. All types of accident were studied, including those involving only metal and those accidents that involved injury or death. Results: Between 2005 and 2008, 141,372 accidents took place. During this four-year period, the average number of casualties was one per day and thirty-five persons were injured. The number of accidents per 10,000 vehicles has diminished from 266.2 in 2005 to 220.6 in 2008. The higher mortality rate was found among males. 57% of casualties due to traffic accidents was made up of pedestrians and those more prone to dying were people over the age offifty as well as motor bikers in a productive age. The rate of accidents was higher in road segments and lower at intersections.The number of deaths was higher when vehicles made before 1980 were involved. Conclusions: This study threw light on variables that influence the seriousness of the accident such as model, type of vehicle, conditions and type of road, event and protection and safety measures of vehicles, inter alia.

Utilização de automóveis familiares para o transporte de crianças: um estudo preliminar sobre o uso de dispositivos de retenção infantil / Family car use for transportation of children: a preliminary study of the use of child car seats

OBJETIVOS: determinar a freqüência de utilização de automóveis familiares por usuários de creches na cidade de Maringá, Paraná, Brasil. MÉTODOS: a cidade foi agrupada em seis estratos, de acordo com características sócio-ocupacionais da população e tipo de creches. Utilizando breves entrevistas com os coordenadores das creches foi mensurada a freqüência de utilização de automóveis para o transporte de crianças às creches em cada estrato. RESULTADOS: 62,4% dos usuários de automóveis familiares para o transporte de crianças concentram-se em 32 creches, de quatro estratos. CONCLUSÕES: os quatro estratos que contém a maioria dos usuários de automóveis serão exploradas por estudo futuro para determinar a freqüência de utilização de dispositivos de retenção infantil.

OBJECTIVES: to investigate the frequency of use of the family car for transportation of children to day-care centers in the city of Maringá, State of Paraná, Brazil. METHODS: the city was divided into six strata according to social and occupational characteristics and the day care-center attended. Utilizing short interviews with day-care centers' coordinators it was measured the frequency of use of car for transportation of children to day-care centers to each stratum. RESULTS: 62.4% of the families that use cars for transporting children to day-care centers used 32 of the day-care centers and fell into four of the demographic strata. CONCLUSIONS: the four strata that contain the majority of car users will be explored by future investigation to determine the frequency of use of the child car seat.