Subway-Related Trauma: An Urban Public Health Issue with a High Case-Fatality Rate.

BACKGROUND: Between 1990 and 2003, there were 668 subway-related fatalities in New York City. However, subway-related trauma remains an understudied area of injury-related morbidity and mortality. OBJECTIVE: The objective of this study was to characterize the injuries and events leading up to the injuries of all patients admitted after subway-related trauma. METHODS: We conducted a retrospective case series of subway-related trauma at a Level I trauma center from 2001 to 2016. Descriptive epidemiology of patient demographics, incident details, injuries, and outcomes were analyzed. RESULTS: Over 15 years, 254 patients were admitted for subway-related trauma. The mean (standard error of the mean) age was 41 (1.0) years, 80% were male (95% confidence interval [CI] 74-84%) and median Injury Severity Score was 14 (interquartile range [IQR] 5-24). The overall case-fatality rate was 10% (95% CI 7-15%). The most common injuries were long-bone fractures, intracranial hemorrhage, and traumatic amputations. Median length of stay was 6 days (IQR 1-18 days). Thirty-seven percent of patients required surgical intervention. At the time of injury, 55% of patients (95% CI 49-61%) had a positive urine drug or alcohol screen, 16% (95% CI 12-21%) were attempting suicide, and 39% (95% CI 33-45%) had a history of psychiatric illness. CONCLUSIONS: Subway-related trauma is associated with a high case-fatality rate. Alcohol or drug intoxication and psychiatric illness can increase the risk of this type of injury.

[The impact of harmful occupational factors on the morbidity rate of workers of the railway-car repair plant].

The rail transport is the one of the leading sectors of the national economy. More than 50% of the employees of the enterprises of the railway complex work under the unfavourable impact of hazardous and dangerous substances and occupational factors. In the literature issues of working conditions and health of employees of railway carrepairing plant are hardly highlighted. The aim of the study is the evaluation of the morbidity rate shaped under the influence of harmful occupational factors for the elaboration of preventive measures. In the work there were used generally accepted methods of hygienic studies, analysis of morbidity rate with temporary disability (TD), according to records of periodic medical examinations, occupational prevalence. The railway car-repairing plant was established to be characterized by the complex of harmful factors of the working environment and labor process: noise, local vibration, industrial aerosols of complex composition, chemicals, low light, hardness of the labor process. The levels of incidence with temporal disability in the studied groups, depending on the work seniority in the harmful labor conditions, significantly decrease with the experience from 5 to 9 years and increase with the experience more than 10 years. Executed in-depth analysis as of the both morbidity rate and TD, as well results of periodic medical examinations of workers of main shops shows that overall indices of the morbidity rate and TD are significantly higher than in the comparison group; levels of the morbidity rate and TD in the observed groups significantly decline depending on the length of service in hazardous working conditions with a length of the experience offrom 5 to 9 years and increase with the increase in the length of experience of 10 years or more. In the structure of morbidity and TD leading positions are occupied by diseases of the respiratory system, musculoskeletal system and connective tissue, circulatory system and digestive system, diseases of the eye and its appendages. The health damage risk coefficients in the studied groups of workers and the average losses of working time due to the morbidity with TD per 1 employee in all shops are higher than those in the comparison group. The level of the occupational morbidity rate is very low. Harmful working conditions contribute to the development of general and occupationally related diseases.

Activities, postures and comfort perception of train passengers as input for train seat design.

Working in the train is a part of new ways of working. However, the ideal working position is unknown. Moreover, the ideal position for leisure and relaxing is also unknown. This article defines what activities train passengers mainly perform and which corresponding postures are seen. Based on the observations on actual train rides, four main activities could be identified: Reading, Staring/sleeping, Talking and Working on laptop. Working on laptop was the activity with the longest duration and talking had the shortest duration. Associated with these four activities, a top eight of different postures were observed. Except for headrest comfort, comfort scores were not significantly different between activities. The top eight corresponding postures combined with comfort scores showed that per activity different postures were observed and the comfort scores varied in relation to the combination of posture and activity. Nearly for all activities, the majority of passengers preferred adjustability options to fit the seat to the performed activity.

Development of design principles for automated systems in transport control.

This article reports the results of a qualitative study investigating attitudes towards and opinions of an advanced automation system currently used in UK rail signalling. In-depth interviews were held with 10 users, key issues associated with automation were identified and the automation's impact on the signalling task investigated. The interview data highlighted the importance of the signallers' understanding of the automation and their (in)ability to predict its outputs. The interviews also covered the methods used by signallers to interact with and control the automation, and the perceived effects on their workload. The results indicate that despite a generally low level of understanding and ability to predict the actions of the automation system, signallers have developed largely successful coping mechanisms that enable them to use the technology effectively. These findings, along with parallel work identifying desirable attributes of automation from the literature in the area, were used to develop 12 principles of automation which can be used to help design new systems which better facilitate cooperative working. PRACTITIONER SUMMARY: The work reported in this article was completed with the active involvement of operational rail staff who regularly use automated systems in rail signalling. The outcomes are currently being used to inform decisions on the extent and type of automation and user interfaces in future generations of rail control systems.

[Improvement of sanitary and epidemiological safety of rail transport--a requirement of the new legislation of the Russian Federation].

Brief analysis of the legal framework in recent years, both in the sphere of technical regulation, and in the field of sanitary and epidemiological welfare of the population is presented in this article. The necessity of inclusion in the technical regulations for the safety of railway rolling stock and elements of railway infrastructure the requirements for sanitary-epidemiological safety and hygiene regulations has been proved. Fragments of technical regulations for railway equipment and infrastructure elements, including the basic requirements for the sanitary-epidemiological security are presented. The position of authors in the processing of the regulatory framework in the field of sanitary-epidemiological welfare of population in standardization documents in accordance with the requirements of federal law "On technical regulation" has been reflected.

Spatial assignment of emissions using a new locomotive emissions model.

Estimates of fuel use and air pollutant emissions from freight rail currently rely highly on aggregate methods and largely obsolete data which offer little insight into contemporary air quality problems. Because the freight industry is for the most part privately held and data are closely guarded for competitive reasons, the challenge is to produce robust estimates using current reporting requirements, while accurately portraying the spatial nature of freight rail impacts. This research presents a new spatially resolved model for estimating air pollutant emissions (hydrocarbons, carbon monoxide, nitrogen oxides, particulate matter less than 10 µm in diameter, sulfur dioxide, and carbon dioxide) from locomotives. Emission estimates are based on track segment level data including track grade, type of train traffic (bulk, intermodal, or manifest) and the local locomotive fleet (EPA tier certification level and fuel efficiency). We model the California Class I freight rail system and compare our results to regional estimates from the California Air Resources Board and to estimates following U.S. Environmental Protection Agency guidance. We find that our results vary considerably from the other methods depending on the region or corridor analyzed. We also find large differences in fuel and emission intensity for individual rail corridors.

Improving a workstation in an existing cab by means of a participatory approach: the case of subway operators' workstations.

A study was conducted to identify possible solutions for redesigning a subway cab in order to improve the posture of drivers working in a restricted space. The approach used included the participation of a working group comprised of operations, maintenance, and engineering managers as well as several drivers. After 6 meetings in which different simulation techniques were used, the working group proposed changes for increasing the available space inside the cab and three seat designs. The involvement of the actors from the three departments affected by the changes, as well as the operators, throughout the process, was a determining factor in the advancement and acceptance of the projects. The fact that 400 cars are currently in service and must be modified means that it will take several years to implement the modifications in the entire fleet.

From the seat to the system: Re-designing a tram drivers' workstation combining technical and contextual aspects.

Through the detailed account of a design case-study, the paper aims to demonstrate how the activity-oriented approach promotes a systems perspective in ergonomics interventions. Specifically, by presenting an activity-oriented re-design of a tram drivers' workstation, it is shown: (i) how technical and contextual aspects were jointly considered, (ii) how their combination affects workers' activity in a non-trivial manner, and (iii) how this system level view helped generate feasible and sustainable design solutions. First, the activity-oriented theoretical lens is briefly presented, followed by the analysis of the tram driving activity, emphasizing on drivers' efforts to compensate for the original work-system design flaws. Next, key elements of the re-design process are presented, through a concept map, combining technical and contextual aspects, coupled with an account of stakeholder debates and resolution processes. The paper ends with a discussion on the lessons learned, concerning the adopted approach for design interventions in real work situations.

End-of-Life in the railway sector: Analysis of recyclability and recoverability for different vehicle case studies.

The railway system represents one of the most resource-efficient answer to our ever-growing demand for transport service and the development trends for the following years forecast a substantial increase in this sector. Considering the European Union, rolling stock realizes a significant share of both goods and passengers carriage while it is responsible for a derisory quota of environmental impact and energy consumption involved by transportation. Contrary to the low environmental impact, the amount of End-of-Life (EoL) waste generated by rolling stocks in relation to the number of vehicles is notable, much greater than in the case of road vehicles. As railway vehicles are constituted by many heterogeneous components, the EoL rolling stock is a precious source of materials, whose recycling brings measurable economic benefits and needs to be appropriately debated. The paper presents calculation of recoverability/recyclability rate for different typologies of vehicles representative of railway transport; calculation is performed on the basis of primary data and according to the recyclability and recoverability calculation method issued by UNIFE in the context of Product Category Rules (PCR). The typologies of railway vehicles taken into account are electric metro, diesel commuter train and high-speed electric train. The analysis envisages also to replicate the calculation in case innovative materials and manufacturing technologies are adopted in the construction of car-body structure. Results show that recyclability/recoverability rates are abundantly over the quota of 90% for each one of the three trains, these latter being made in major part of metals that benefit from very efficient recovery processes. The adoption of innovative materials and manufacturing technologies for car-body structure involves a scarce reduction of recyclability and recoverability rates (about 2% and 0.2% respectively) due to the introduction of components and materials characterized by critical dismantlability and low efficiency recovery processes; recoverability results less affected by lightweighting because post-shredding thermal recovery treatments are roughly independent with respect to dismantlability. A sensitivity analysis based on different dismantling scenarios reveals that the effectiveness of dismantling has a moderate influence on recyclability/recoverability rate (the variation does not exceed 3%). The low variability of recyclability/recoverability rate can be explained by the following reasons: predominance of metals in trains material composition, efficiency of metals separation processes close to 100%, post-shredding recycling processes of metals characterized by recovery factors equal to the ones of post-dismantling recycling processes.

Application of a human error framework to conduct train accident/incident investigations.

Accident/incident investigations are an important qualitative approach to understanding and managing transportation safety. To better understand potential safety implications of recently introduced remote control locomotive (RCL) operations in railroad yard switching, researchers investigated six railroad accidents/incidents. To conduct the investigations, researchers first modified the human factors analysis and classification system (HFACS) to optimize its applicability to the railroad industry (HFACS-RR) and then developed accident/incident data collection and analysis tools based on HFACS-RR. A total of 36 probable contributing factors were identified among the six accidents/incidents investigated. Each accident/incident was associated with multiple contributing factors, and, for each accident/incident, active failures and latent conditions were identified. The application of HFACS-RR and a theoretically driven approach to investigating accidents/incidents involving human error ensured that all levels of the system were considered during data collection and analysis phases of the investigation and that investigations were systematic and thorough. Future work is underway to develop a handheld software tool that incorporates these data collection and analysis tools.

Human-factors engineering for smart transport: design support for car drivers and train traffic controllers.

The theme Smart Transport can be described as adequate human-system symbiosis to realize effective, efficient and human-friendly transport of goods and information. This paper addresses how to attune automation to human (cognitive) capacities (e.g. to take care of information uncertainty, operator trust and mutual man-machine adaptations). An introduction to smart transport is presented, including examples of best practice for engineering human factors in the vehicle ergonomics and train traffic control domain. The examples are representative of an ongoing trend in automation and they show how the human role changes from controller to supervisor. Section 2 focuses on the car driver and systems that support, or sometimes even take over, critical parts of the driving task. Due to the diversity of driver ability, driving context and dependence between driver and context factors, there is a need for personalised, adaptive and integrated support. Systematic research is needed to establish sound systems. Section 3 focuses on the train dispatcher support systems that predict train movements, detect potential conflicts and show the dispatcher the possibilities available to solve the detected problems. Via thorough analysis of both the process to be controlled and the dispatcher's tasks and cognitive needs, support functions were developed as part of an already very complex supervision and control system. The two examples, although from a different field, both show the need for further development in cognitive modelling as well as for the value of sound ergonomics task analysis in design practice.

Impact of railroad ballast type on frontal plane ankle kinematics during walking.

Five healthy male subjects walked on a control surface (level concrete), and two sloped rock surfaces (walking ballast-rock about 1.9 cm across; main line ballast-rock about 3.8 cm across) while their rearfoot motion (defined throughout as ankle inversion/eversion as seen from the frontal plane) was measured to determine if the different walking surfaces caused different ankle kinematics. The ballast was placed in 5m long trays that were tilted 7 degrees in the transverse plane. Rearfoot motion was measured while the subjects walked the length of the respective surfaces wearing work boots. A repeated measures ANOVA and a subsequent multiple comparison test revealed that the rearfoot range of motion was significantly greater walking on the main line ballast than walking on either the walking ballast or the level concrete. Meanwhile, the mean range of rearfoot motion for walking ballast was not significantly different from that resulting from walking on concrete. Variability was more than twice as great walking on main line ballast than walking on level concrete. Rearfoot angular velocities walking on level concrete and walking ballast were not significantly different, but both were significantly less than walking on main line ballast. Results suggested that rearfoot motion could be reduced if railroads placed walking ballast where trainmen have to walk as part of their jobs.

A practical approach to glare assessment for train cabs.

The assessment of glare is a key consideration in the design of a railway driver's cab. However, unlike assessment of other factors, such as forward visibility, there are no standardised approaches for performing assessments of glare. This paper describes an approach for assessing the impact of glare in a full size mock-up of a railway cab. While it is unrealistic to evaluate every possible lighting condition that may potentially occur in the vehicle cab in service, a pragmatic and practical approach is taken to provide a good level of indicative information about the cab design's likely glare performance. This involves assessing internal light sources, such as internal lights and illuminated controls, and simulating external light sources (e.g. the sun, other trains' headlights) by illuminating the cab mock up windscreen, side and door windows with a single light source manually located in a sequence of discrete positions and orientations and assessing the resulting glare impacts. The paper describes a structured process for assessing and recording the impact of glare and recommending mitigations.

Assessment, re-design and evaluation of changes to the driver's cab in a suburban electric train.

A new type of electric train, called the Tangara, began replacing older trains on the Sydney city and suburban network in 1990. Shortly afterwards, some of the train drivers began reporting pain in the arms while driving the new train. The Ergonomics Unit of Worksafe Australia was then engaged to identify and assess ergonomic problems in the driver's cab. This process included direct observation of drivers at work, distribution of a self-administered questionnaire to all drivers, and analysis of anthropometric problems using a computer-aided design package. The analysis of 193 completed questionnaires and the problems shown by the design study were used in developing an improved design. A mock-up of the modified cab was made and tried out by 134 drivers whose comments led to further changes. The modified design was applied to new production, and existing cabs were modified during major maintenance. By 1996, 96% of the driver's cabs were to the new design. An evaluation of the new design was undertaken using written questionnaires, which were completed by 227 drivers. The results were strongly in favour of the new design, showing the effectiveness of the ergonomic modifications.

[Research and production of air cleaner for traveller train carriage].

After the traveller train carriage is closed, the air pollution would be serious in the carriage. In order to control the air pollution, the air cleaning technology must be studied and the air cleaner for the carriage must be designed. The authors discussed. 1. Working out a technology scheme and main technology parameter for the air cleaner, and the structure design of the air cleaner. 2. Texting the function and performance of the air cleaner. 3. Investigating the effectiveness of the cleaner in same train sections. Thereby it will be confirmed that the air cleaner can improve the air environment in the carriage, and give convincingly security to the health of attendants and travellers.

[Measurement of airborne asbestos fibers on railroad rolling stock]. / Ricerca di fibre di amianto aerodisperse a bordo di rotabili ferroviari circolanti.

In February 1995 the Italian Railways Health Department set up a special study group in order to assess the effectiveness of the measures adopted against hazards due to the presence of asbestos in rolling stock currently in use on the rail network. The group set up specific procedures for sampling and analysis, on the basis of the criteria fixed for civil buildings in Ministerial Decree of 6/9/94, which was subsequently applied to rolling stock by Ministerial Decree of 26/10/95. In accordance with these procedures the study group carried out environmental studies via test runs programmed by the Railways Technical Departments, on trains made up of different types of vehicles. Insulated, completely or partially deinsulated and originally non-insulated vehicles were studied. Samples were analysed via scanning electron microscopy (SEM) with elementary dispersion X spectroscopy (EDXS) carried out by highly qualified public laboratories (ISPESL--National Institute for Prevention and Work Safety, ARPA--Regional Environmental Protection Agency, CRA--Veneto Region, University Departments). Altogether, from the start of the programme up to September 1998, 1464 samples in 170 test runs on 619 rolling stock vehicles were examined. These involved 83 locomotives, 83 electric rail-cars and 453 carriages. The results showed that in over 99% of the samples the fibre concentrations were below 2 fibres/litre, which is the value fixed by law for buildings and rail vehicles in order to qualify for effective decontamination status. Values exceeding 2 fibres/litre were found in only 4 vehicles, which were withdrawn or blocked for further checks. As a precaution, 18 vehicles where concentrations over 1 but less than 2 fibres/litre were found, were also blocked and their return to service has been postponed for further checks and analyses until the results show concentrations below 1 fibre/litre. Environmental analyses carried out up to the present indicate an overall situation comparable to that usually found in the general environmental without any asbestos dispersion sources. Surveillance and investigations are still under way in order to achieve the aims of the safety programme set up by the Italian Railways to ensure health and environmental protection.

Digital redesign of anti-wind-up controller for cascaded analog system.

The cascaded conventional anti-wind-up (CAW) design method for integral controller is discussed. Then, the prediction-based digital redesign methodology is utilized to find the new pulse amplitude modulated (PAM) digital controller for effective digital control of the analog plant with input saturation constraint. The desired digital controller is determined from existing or pre-designed CAW analog controller. The proposed method provides a novel methodology for indirect digital design of a continuous-time unity output-feedback system with a cascaded analog controller as in the case of PID controllers for industrial control processes with the presence of actuator saturations. It enables us to implement an existing or pre-designed cascaded CAW analog controller via a digital controller effectively.

[Mortality in employees of a railway rolling stock factory]. / Studio sulla mortalità degli addetti di un'azienda di produzione di rotabili ferroviari.

A study was carried out on the mortality of 3741 individuals who worked in a factory making railway rolling stock, in which crocidolite was used to insulate the coaches in the 60's and 70's. Employees who had worked in the factory between 1960 and 1995 were included in the study, with the main aim of investigating cancer mortality in these subjects. 9 cases of mesothelioma were known in this factory before starting the study. The follow-up was performed from 1960 to 1996. The SMR's for lung cancer and mesothelioma in 2737 blue-collar workers were 1.23 (CI 95% = 1.00-1.50) and 6.50 (CI 95% = 2.96-12.38) respectively, based on national rates. The excesses were mainly found among subjects who had worked before 1970 with duration of employment exceeding 20 years.

[Ergonomic design of the cabin and panel in a locomotive]. / Ergonomicheskaia razrabotka kabiny i pul'ta upravleniia lokomotiva.

Substantiates the basic principles of the ergonomic design of new switchboard for locomotive driving. These principles were used in the creation of a new switchboard for perspective locomotives. The switchboard was designed with due consideration for the psychological potentialities of man. Automatic safe systems of operation were realized in the design.