[Risk factors for injuries caused by traffic accidents and the impact of an intervention on the road]. / Factores de riesgo de lesión por accidentes de tráfico y el impacto de una intervención sobre la carretera.

OBJECTIVE: To evaluate the effect of interventions at a highway, in the occurrence and severity of injuries by traffic accidents. METHOD: It was made a comparative analysis of two cross-sectional studies in 1994 and 1996. RESULTS: In 1994 the rate was 7.96 accidents/ 100,000 vehicles and in 1996 8.49 / 100,000 vehicles. The increase was not significant (p>0.05). The rate of injured drivers in 1994 was of 2.10 / 100,000 vehicles and of 1.35 / 100,000 vehicles in 1996, which was a significant decrease (p<0.000). The self-report of use of seat belt (63.46% versus 76.6%), the small vehicles involved in accidents (7.9% versus 37.7%), nocturnal schedule (23.7% versus 31.8%) and in Mexico-Cuernavaca direction (45% versus 66.7%), were more frequent in 1996 (p<0.05). The risk of injury, using a logistic regression model, between drivers exposed to the interventions (1996) and those that were not exposed (1994) adjusted by: age, speed, use of seat belt, alcohol intake and external cause, showed a protective effect of the interventions at the highway (OR 0.42 CI95% 0.27-0.66). CONCLUSION: There is an evident need of multisectorial approaches in the study and evaluation of the interventions in the field of the traffic accidents. The present research is a clear example of the repercussions over health of interventions developed by the transportation sector at the highway.

[Methodological aspects of measuring injuries from traffic accidents at the site of occurrence]. / Aspectos metodologicos de la medición en el sitio de ocurrencia de lesiones por accidentes de tráfico.

Traffic accidents are a well-known public health problem worldwide. In Mexico research into risk factors for motor involving vehicles accidents and their consequences has recently been taken into account. The relevant literature does not normally describe the methodological aspects involved in the collection of primary data, since most studies have used secondary data the good quality and validity of which are assumed. The paper presented seeks to discuss and share with researchers in this field, some of the methodological aspects to be considered in the attempt to recreate the scene of the accident and obtain information approximating to reality. The measurements in situ of, such traffic accident variables as injury, use of seat belt, speed and alcohol intake are discussed.

[Violence and its repercussions on health: theoretical reflections and magnitude of the problem in Mexico]. / La violencia y sus repercusiones en la salud; reflexiones teóricas y magnitud del problema en México.

Our understanding of violence gains from perspectives contributed by several different disciplines. The differences among goals and points of view are often reflected in their vocabularies and interfere in to integrate the advances by each of them. Three big disciplines have studied violence, those are: Social Sciences, Criminal Justice and most recently Public Health. This paper discusses the theoretical perspectives by discipline and try to dimensionate the violence problem measured by mortality and morbidity by intentional injuries in México.

[Safety belt use and severity of injuries in traffic accidents]. / Cinturón de seguridad y gravedad de lesiones en accidentes de tráfico en carretera.

OBJECTIVE: To analyze the association between the severity of car accident injuries and the use of safety belts. MATERIAL AND METHODS: The unit of observation and analysis was car drivers in the Mexico-Cuernavaca toll highway. Variables included were those of car drivers, the vehicles and the physical environment at the accident site. Statistical analysis was carried out by means of chi square, odds ratios, 95% confidence intervals and logistic regression. Data was collected in 422 questionnaires for 324 accident events. RESULTS: There were 177 injured people, including 12 deaths, with rates of 67.5 injuries and 4.58 deaths per 10 000 kilometers driven. Variables associated with not using a safety belt (p < 0.05) were: alcohol drinking, vehicle size, night-time and road section. Risk factors for severe injuries were: not using a safety belt (raw OR 4.9, 95% CI 2.2-10.8, adjusted OR 2.94, 95% CI 1.13-7.66); age < 25 years (OR 3.6, 95% CI 1.0-12.7) and > 54 (OR 6.0, 95% CI 1.4-25.0); alcohol drinking (OR 10.8, 95% CI 3.8-30.4); and night time (OR 2.8, 95% CI 1.4-5.8). CONCLUSIONS: Theses findings suggest the need to formulate interventions aimed at enforcing the use of safety belts and prevention of related factors.

[Mother's work and severity of accidental injuries in children]. / El trabajo materno y la gravedad de lesiones accidentales en niños.

A study was conducted in children under five years old, in order to establish the association between the mother's work and the severity of unintentional injuries. The study was carried out at the emergency room of six pediatric hospitals in Mexico City. Cases were children with major injuries that required hospitalization, intensive care, surgery, or who died as a result of the injury. Controls were children of similar age, with minor injuries resolved at the emergency room. Sample size was 350 cases and 350 controls. Variables were grouped according to: mother's occupation; characteristics of the child, socioeconomic status, child care, and those related with home risk factors. Results showed a protective effect on severity of injuries when the mother worked outside home in comparison to mothers who do not work, (or 0.79, 95%CI 0.57-1.07). No differences were found with respect to sex and age of children. Mother age under 24 years old and low schooling (< 3 years of elementary school) were statistically significant with a risk of major injuries (or 2.30, 95%CI 1.5-3.4). Delay of demand of medical care after 60 minutes of injury occurrence is related with a risk of major injury (or 1.68, 95% CI 1.2-2.3). No differences related with household risk factors were found. Results provide valuable information about risk factors related with injury severity and the association with mother's work.

[Avoidable causes of death and their effects on life expectancy. A socio-demographic interpretation. The case of the northern frontier, 1980-1990]. / Causes de muerte evitables y su contribucion al incremento en la esperanza de vida. Una interpretacion sociodemografica. El caso de la frontera norte, 1980-1990.

"This study forms part of [a] research project on the health-disease-death process along the [Mexican] Northern Frontier--a by-product of the socio-economic structure of a specific social formation that determines disease and death--to support regional and sectorial design of policies and actions for the improvement of health conditions for its population.... An important finding is a 4.1 year increase of life expectancy due, among other causes, to a slight decrease in avoidable death causes, although these still produce about 50% of deaths." (SUMMARY IN ENG)

[The risk factors for home accidents in children. A case-control study]. / Factores de riesgo de accidentes en el hogar en niños. Estudio de casos y controles.

INTRODUCTION: The main objective was to determine the risk factors involved in unintentional injuries in children under 10 years old occurring at home. MATERIAL AND METHODS: A Case Control study was conducted in the emergency room of three pediatrics hospitals in Mexico City. The sample size was 160 cases and 320 controls. RESULTS: Boys were more affected than girls (OR) 1.7, C.I. (95%) 1.2-2.5. The age group more affected was two-three years old (OR) 1.6, C.I.1.1-2.2. When children play outside home (roof, stairs, patio) the risk was OR 2.48, C.I. 1.63-3.76. If mother is not encharged of children care (OR) 2.9, C.I. 1.8-4.8. The age > 40 years old of the person encharged of children care (OR) 2.2, C.I. 1.4-3.5. CONCLUSIONS: The results showed us how necessary is to develop injury prevention programs especially to implement passive measures, with target populations people encharged of children care.

[Home accidents in children less than 10 years of age: causes and consequences]. / Acccidentes en el hogar en niños menores de 10 años. Causas y consecuencias.

A case-control study was carried out, aimed at identifying and defining the individual, family, household and childcare social support network characteristics, more likely to be associated with the occurrence of accidental home injuries in 0-9 year-old children. This study was carried out in the emergency units of three pediatric hospitals in the Federal District. In this article we report the results of the descriptive analysis only of the cases. The results were as follows: male children (62%) and the one and two year-old children group (37%) were the most affected. Contusions, head injuries and fractures occupied the first three places, the main three causes being falls from one level to another (mainly in stairways and off the bed) falls on the same level (sliding, tripping or stumbling) and burns with boiling liquids (most frequently boiling water for bathing). A history of injuries was documented in only 15% of cases. Thirty nine percent of cases requested medical attention after one hour of the accident; 51% of these were hospitalized. In 25% of cases, the mother worked outside the home, being absent from 6 to 12 hours. Risk factors occurring most frequently were: unprotected electricity inlets (40%); products within reach of children: cleaning products (38%), makeup products (34%), plastic bags (30%) and tools (30%); lack of protection rails for cradles (30%) and for staircases (48%), and free access to roofs (44%). In 62 percent of cases some care was provided in the house of the injured child; twenty six percent counted on a support network, and 3 percent were by themselves. We present some proposals for epidemiologic and health services research, and stress the necessity to implement health education, social security and health services policies to favorably influence the solution of these problems.