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BACKGROUND: Road accidents are the leading type of work-related fatalities, but the impact of work-related travel on overall traffic safety has been scarcely studied. OBJECTIVE: The main objective of the present study was to assess drivers' relative road accident risk between work-related and personal journeys. METHODS: A responsible/non-responsible case-control study was performed on a sample of 7,051 road accidents in France from the VOIESUR project. Logistic regression determined odds-ratios according to work-related versus personal travel, and identified risk factors for responsibility, specific to each of the two sub-groups. RESULTS: Drivers traveling on duty or commuting home were significantly less often responsible for accidents than drivers on personal journeys: ORâ=â0.75 [0.63; 0.89] and 0.65 [0.53; 0.80] respectively. Responsibility was significantly more frequent in commuting to versus from work: ORâ=â1.38 [1.06; 1.78]. Among on-duty drivers, professional passenger-transport drivers had the lowest risk of responsibility (ORâ=â0.25 [0.11; 0.58]), while those on temporary or work/study contracts and professional light goods vehicle drivers had the highest risk (ORâ=â11.64 [2.15; 62.94] and ORâ=â29.83 [5.19; 171.38] respectively). When driving under the influence of alcohol, risk of responsibility was higher in commuting home than in personal journeys. CONCLUSION: On-duty drivers showed lower risk of responsibility for an accident than other drivers. However, on-duty drivers on temporary or work/study contracts, who are usually not subject to specific regulations, showed higher risk, and should be the subject of particular attention regarding occupational risk prevention.
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Accidentes de Tránsito , Conducción de Automóvil , Humanos , Estudios de Casos y Controles , Factores de Riesgo , ViajeRESUMEN
Aim: To test whether the occupancy of shorebirds has changed in the eastern Canadian Arctic, and whether these changes could indicate that shorebird distributions are shifting in response to long-term climate change. Location: Foxe Basin and Rasmussen Lowlands, Nunavut, Canada. Methods: We used a unique set of observations, made 25 years apart, using general linear models to test if there was a relationship between changes in shorebird species' occupancy and their species temperature Index, a simple version of a species climate envelope. Results: Changes in occupancy and density varied widely across species, with some increasing and some decreasing. This is despite that overall population trends are known to be negative for all of these species based on surveys during migration. The changes in occupancy that we observed were positively related to the species temperature index, such that the warmer-breeding species appear to be moving into these regions, while colder-breeding species appear to be shifting out of the regions, likely northward. Main Conclusions: Our results suggest that we should be concerned about declining breeding habitat availability for bird species whose current breeding ranges are centered on higher and colder latitudes.
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BACKGROUND: Vehicle accidents are still a heavy social burden despite improvements due the latest technologies and policies. To pursue the trend of decrease, having a more detailed view and understanding of the injury patterns would contribute to inform both the rescue team to optimize victim's management and policymakers in order for them to tackle at best this issue. METHODS: Two complementary analyses of injury associations were performed, one using a biomechanical classification and the other an anatomic one, computed on data stratified by car accident type (lateral or frontal). Our objective is to understand whether these two categories of crash lead to similar or heterogeneous injury association patterns, and analyze these findings from an impact mechanics point of view. Indeed, having an improved understanding of the injury mechanisms would facilitate their diagnosis and prevention. RESULTS: While each type of accident possesses its own injury profile, most injury associations are found for both types. Injuries such as clavicle and rib fractures were identified as involved in a high number of associations. Several associations between fractures and blood vessel injuries were found. CONCLUSIONS: The results suggests three main conclusions: (i) Injury associations are rather independent from crash characteristics, (ii) Clavicle and rib fractures are typical of poly-traumatized victims, (iii) Certain fractures can be used to early detect victims at higher risk of hemorrhage. Overall, this study provide paramedics and doctors with data to orientate them toward a faster and more appropriate decision. Moreover, this exploratory work revealed the potential that injury association analyses have to inform policy-making and issue recommendations to decrease road accident mortality and morbidity.
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Fracturas de las Costillas , Heridas y Lesiones , Humanos , Accidentes de Tránsito , Formulación de Políticas , Bases de Datos Factuales , Políticas , Heridas y Lesiones/epidemiologíaRESUMEN
BACKGROUND AND AIMS: The role of deer (family Cervidae) in ecosystem functioning has traditionally been neglected by forest ecologists due to the animal's scarcity in most parts of the northern hemisphere. However, the dramatic rebound in deer populations throughout the 20th century has brought deer browsing to the forefront of forest ecological questioning. Today there is ample evidence that deer affect tree regeneration, understorey plant and animal diversity, and even litter decomposition. However, the mechanisms underlying the effects of deer on forest ecosystems remain unclear. Among others, the relative role of abiotic factors versus biotic interactions (e.g. herbivory) in shaping plant assemblages remains largely unknown. METHODS: We used a large-scale experiment with exclosures distributed along abiotic gradients to understand the role of black-tailed deer (Odocoileus hemionus sitchensis) on the forest understorey on the Haida Gwaii archipelago (western Canada), a unique context where most of the key ecological effects of deer presence have already been intensively studied. KEY RESULTS: Our results demonstrate that 20 years of deer exclusion resulted in a clear increase in vascular plant richness, diversity and cover, and caused a decline in bryophyte cover. Exclusion also unveiled abiotic (i.e. soil water availability and fertility) filtering of plant assemblages that would otherwise have been masked by the impact of abundant deer populations. However, deer exclusion did not lead to an increase in beta diversity, probably because some remnant species had a competitive advantage to regrow after decades of over browsing. CONCLUSIONS: We demonstrated that long-term herbivory by deer can be a dominant factor structuring understorey plant communities that overwhelms abiotic factors. However, while exclosures prove useful to assess the overall effects of large herbivores, the results from our studies at broader scales on the Haida Gwaii archipelago suggest that exclosure experiments should be used cautiously when inferring the mechanisms at work.
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Ciervos , Ecosistema , Animales , Bosques , Plantas , ÁrbolesRESUMEN
BACKGROUND: In France, like in most developed countries, the number of road accident fatalities is estimated from police data. These estimates are considered to be good-quality, unlike estimates of road injuries admitted to hospital, and especially serious injuries. METHODS: The present study aimed to supply such data from French hospital medical information data-bases (PMSI). In the PMSI data-bases, road accident victims are identified by external causes of morbidity and mortality, which should be systematically recorded in case of injury, but are often missing. We therefore modeled presence/absence of external cause from the relevant subset of the medicine-surgery-obstetrics PMSI data-base using a logistic regression, and then weighting the results by inverse estimated probability. As ICD-10 coding does not include injury severity, we used the AAAM10 conversion instrument developed by the American Association for Automotive Medicine, originators of the Abbreviated Injury Scale, so as to conform to the European Commission's definition of serious injury. RESULTS: The number of road-accident related hospital admissions is estimated to be about 100000 per year; serious injuries increased from about 18000 in 2010 to almost 20000 in 2017, with almost 17000 in 2012 and 2013, with a mean of one fatality per 5 serious injury admissions. CONCLUSIONS: These serious injury estimates are close to those obtained by our team from other data and with a different estimation method. The present method has the advantage of using ICD codes for injured people admitted to hospital. This classification and data source (hospital discharge registry) are also used by most european countries reporting serious injury estimates to the Commission. It allows cost estimation of hospital care, and could be applied to other types of accidental injury.
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Accidentes de Tránsito , Heridas y Lesiones , Escala Resumida de Traumatismos , Europa (Continente) , Francia/epidemiología , Hospitales , Humanos , Heridas y Lesiones/epidemiologíaRESUMEN
Litter decomposition is a key process that allows the recycling of nutrients within ecosystems. In temperate forests, the role of large herbivores in litter decomposition remains a subject of debate. To address this question, we used two litterbag experiments in a quasiexperimental situation resulting from the introduction of Sitka black-tailed deer Odocoileus hemionus sitkensis on forested islands of Haida Gwaii (Canada). We investigated the two main pathways by which deer could modify litter decomposition: change in litter quality and modification of decomposer communities. We found that deer presence significantly reduced litter mass loss after 1 yr, mainly through a reduction in litter quality. This mass loss reflected a 30 and 28% lower loss of carbon (C) and nitrogen (N), respectively. The presence of deer also reduced the ability of decomposers to break down carbon, but not nitrogen. Indeed, litter placed on an island with deer lost 5% less carbon after 1 yr of decomposition than did litter decomposing on an island without deer. This loss in ability to decompose litter in the presence of deer was outweighed by the differences in mass loss associated with the effect of deer on litter quality. Additional effects of feces deposition by deer on the decomposition process were also significant but minor. These results suggest that the effects dramatic continental-scale increases in deer populations may have on broad-scale patterns of C and N cycling deserve closer attention.
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Ciervos , Ecosistema , Animales , Canadá , Bosques , Nitrógeno , Hojas de la PlantaRESUMEN
Increasing evidence-synthesized in this paper-shows that economic growth contributes to biodiversity loss via greater resource consumption and higher emissions. Nonetheless, a review of international biodiversity and sustainability policies shows that the majority advocate economic growth. Since improvements in resource use efficiency have so far not allowed for absolute global reductions in resource use and pollution, we question the support for economic growth in these policies, where inadequate attention is paid to the question of how growth can be decoupled from biodiversity loss. Drawing on the literature about alternatives to economic growth, we explore this contradiction and suggest ways forward to halt global biodiversity decline. These include policy proposals to move beyond the growth paradigm while enhancing overall prosperity, which can be implemented by combining top-down and bottom-up governance across scales. Finally, we call the attention of researchers and policy makers to two immediate steps: acknowledge the conflict between economic growth and biodiversity conservation in future policies; and explore socioeconomic trajectories beyond economic growth in the next generation of biodiversity scenarios.
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Human-driven species annihilations loom as a major crisis. However the recovery of deer and wolf populations in many parts of the northern hemisphere has resulted in conflicts and controversies rather than in relief. Both species interact in complex ways with their environment, each other, and humans. We review these interactions in the context of the ecological and human costs and benefits associated with these species. We integrate scattered information to widen our perspective on the nature and perception of these costs and benefits and how they link to each other and ongoing controversies regarding how we manage deer and wolf populations. After revisiting the ecological roles deer and wolves play in contemporary ecosystems, we explore how they interact, directly and indirectly, with human groups including farmers, foresters, shepherds, and hunters. Interactions with deer and wolves generate various axes of tension, posing both ecological and sociological challenges. Resolving these tensions and conflicts requires that we address key questions using integrative approaches: what are the ecological consequences of deer and wolf recovery? How do they influence each other? What are the social and socio-ecological consequences of large deer populations and wolf presence? Finally, what key obstacles must be overcome to allow deer, wolves and people to coexist? Reviewing contemporary ecological and sociological results suggests insights and ways to improve our understanding and resolve long-standing challenges to coexistence. We should begin by agreeing to enhance aggregate benefits while minimizing the collective costs we incur by interacting with deer and wolves. We should also view these species, and ourselves, as parts of integrated ecosystems subject to long-term dynamics. If co-existence is our goal, we need deer and wolves to persevere in ways that are compatible with human interests. Our human interests, however, should be inclusive and fairly value all the costs and benefits deer and wolves entail including their intrinsic value. Shifts in human attitudes and cultural learning that are already occurring will reshape our ecological interactions with deer and wolves.
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Ciervos/fisiología , Interacción Humano-Animal , Lobos/fisiología , Agricultura/economía , Animales , Análisis Costo-Beneficio , Europa (Continente)/epidemiología , Agricultura Forestal/economía , Humanos , América del Norte/epidemiología , Conducta Predatoria/fisiología , Seguridad/economía , Enfermedades por Picaduras de Garrapatas/economía , Enfermedades por Picaduras de Garrapatas/epidemiología , Enfermedad Debilitante Crónica/economía , Enfermedad Debilitante Crónica/epidemiologíaRESUMEN
CONTEXT AND OBJECTIVE: Among the different products and protective gear used by riders of two-wheeled motorized vehicles, back protectors that are designed to prevent damage to the spinal column are widely used today compared other protections. However, few studies measure their effectiveness. Can their effectiveness be measured? How do they help decrease or change the nature of thoracolumbar traumas that occur? To address these questions and remedy the lack of objective data regarding these products, an epidemiological, clinical, and biomechanical analysis of motorcycle riders who were admitted to a French trauma center after an accident was performed. So, this study investigates the effectiveness of back protectors, including their ability to prevent specific mechanisms of thoracic and lumbar spinal injuries related to TWMV accidents. METHOD: A questionnaire was administered to victims of accidents involving two-wheeled motorized vehicles who were admitted to the trauma room at the Marseille trauma center over the course of 2016. Collect data are related to the victim, the accident scenario, and a detailed description of the observed injuries using AIS (Abbreviated Injury Scale) coding and Magerl classification. Univariate analyses and Fisher tests were performed for victims who were or were not wearing back protectors. RESULTS: This study collected data from 124 victims. Almost half of the victims were wearing a back protector at the time of the accident (53 victims, thus 43% of riders). Collectively, twenty-nine victims who were wearing back protectors had 57 thoracolumbar injuries, and twenty eight victims who were not wearing back protectors had 75 thoracolumbar lesions. The results from this study show that there is no significant difference in the nature and mechanism of thoracolumbar injuries as a function of back protection. The majority of the thoracolumbar injuries were not severe. They were primarily bone injuries, essentially compression fractures, regardless of whether a back protector was worn. CONCLUSION: This study shows that the use of back protection does not decrease the number, type, or mechanism of thoracolumbar injuries associated with accidents involving two-wheeled motorized vehicles. However, it suggests that lumbar vertebral injuries are deflected towards the thoracic vertebrae when back protectors are worn. Finally, it suggests that the design of back protectors should be reconsidered to better protect riders from what are referred to as compression fractures (craniocaudal force), which remain the primary form of fracture regardless of the rider's characteristics, based on the data analyzed.
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Accidentes de Tránsito/estadística & datos numéricos , Fracturas por Compresión/prevención & control , Motocicletas , Ropa de Protección/estadística & datos numéricos , Traumatismos Vertebrales/prevención & control , Escala Resumida de Traumatismos , Adolescente , Adulto , Estudios de Casos y Controles , Femenino , Fracturas por Compresión/epidemiología , Humanos , Vértebras Lumbares/lesiones , Masculino , Persona de Mediana Edad , Traumatismos Vertebrales/epidemiología , Encuestas y Cuestionarios , Vértebras Torácicas/lesiones , Centros Traumatológicos/estadística & datos numéricos , Adulto JovenRESUMEN
INTRODUCTION: Responsibility analysis allows the evaluation of crash risk factors from crash data only, but requires a reliable responsibility assessment. The aim of the present study is to predict expert responsibility attribution (considered as a gold-standard) from explanatory variables available in crash data routinely recorded by the police, according to a data-driven process with explicit rules. METHOD: Driver responsibility was assessed by experts using all information contained in police reports for a sample of about 5000 injury crashes that occurred in France in 2011. Three statistical methods were used to predict expert responsibility attribution: logistic regression with L1 penalty, random forests, and boosting. Potential predictors of expert attribution referred to inappropriate driver actions and to external conditions at the time of the crash. Logistic regression was chosen to construct a score to assess responsibility for drivers and riders in crashes involving one or more motor vehicles, or involving a cyclist or pedestrian. RESULTS: Cross-validation showed that our tool can predict expert responsibility assessments on new data sets. In addition, responsibility analyses performed using either the expert responsibility or our predicted responsibility return similar odds ratios. Our scoring process can then be used to reliably assess responsibility based on national police report databases, provided that they include the information needed to construct the score.
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Accidentes de Tránsito/estadística & datos numéricos , Vehículos a Motor/estadística & datos numéricos , Accidentes de Tránsito/psicología , Adolescente , Adulto , Anciano , Interpretación Estadística de Datos , Bases de Datos Factuales , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Policia , Factores de Riesgo , Adulto JovenRESUMEN
Agricultural landscape homogenization has detrimental effects on biodiversity and key ecosystem services. Increasing agricultural landscape heterogeneity by increasing seminatural cover can help to mitigate biodiversity loss. However, the amount of seminatural cover is generally low and difficult to increase in many intensively managed agricultural landscapes. We hypothesized that increasing the heterogeneity of the crop mosaic itself (hereafter "crop heterogeneity") can also have positive effects on biodiversity. In 8 contrasting regions of Europe and North America, we selected 435 landscapes along independent gradients of crop diversity and mean field size. Within each landscape, we selected 3 sampling sites in 1, 2, or 3 crop types. We sampled 7 taxa (plants, bees, butterflies, hoverflies, carabids, spiders, and birds) and calculated a synthetic index of multitrophic diversity at the landscape level. Increasing crop heterogeneity was more beneficial for multitrophic diversity than increasing seminatural cover. For instance, the effect of decreasing mean field size from 5 to 2.8 ha was as strong as the effect of increasing seminatural cover from 0.5 to 11%. Decreasing mean field size benefited multitrophic diversity even in the absence of seminatural vegetation between fields. Increasing the number of crop types sampled had a positive effect on landscape-level multitrophic diversity. However, the effect of increasing crop diversity in the landscape surrounding fields sampled depended on the amount of seminatural cover. Our study provides large-scale, multitrophic, cross-regional evidence that increasing crop heterogeneity can be an effective way to increase biodiversity in agricultural landscapes without taking land out of agricultural production.
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Agricultura , Biodiversidad , Productos Agrícolas , Ecosistema , Animales , Abejas , Aves , Mariposas Diurnas , Europa (Continente) , Humanos , América del Norte , ArañasRESUMEN
BACKGROUND: The effectiveness of helmet use in preventing or reducing the severity of head injuries has been largely demonstrated. However, the effectiveness of different types of helmets in reducing facial or non-facial head injuries has received much less attention. METHODS: A postal survey on motorized two-wheeler crashes was conducted in 2016. 7148 riders of motorized two-wheelers (MTW) injured in a crash between 2010 and 2014 and identified in the Rhône Trauma Registry were invited to complete a questionnaire in order to collect detailed information about their accidents. The analysis was based on a population of 405 helmeted riders who declared having received an impact on the head. Facial and non-facial head injury risks were estimated according to helmet type (full face or other) by logistic regression, controlled for type of object hit by the head (and gender for risk of non-facial head injury), and weighted to take nonresponse into account. RESULTS: Three-quarter of helmeted MTW drivers were wearing a full-face helmet at the time of the accident. Victims wearing a full-face helmet were about three times less likely to have sustained injury to the face, compared to victims wearing another type of helmet (adjusted OR = 0.31; 95% CI: 0.11-0.83). On the other hand, the presence of non-facial head injury did not vary significantly according to whether a full-face or other helmet was worn (adjusted OR = 0.84; 95% CI: 0.33-2.13). CONCLUSIONS: Our study suggests that full-face helmets provide better facial protection for MTW users compared to other types of helmets, whereas there is no evidence of any difference in protection afforded the skull or the brain.
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Motorcycle accidents lead to a high rate of traffic mortality and morbidity. While helmet development and mandatory wearing have reduced head injuries, little progress has been made regarding trunk protection. Wearable airbag devices represent a promising solution to prevent trunk injuries. Nevertheless, research investigations need to be performed to assess and optimise the efficiency of such devices. This work consisted in the analysis of motorcyclist trunk impact conditions involved in various crash configurations to provide critical information in order to evaluate and improve the performances of airbag devices. First, an epidemiological and an accidentological analysis of data collection related to 252 real accidents, focusing on victims admitted into the shock rooms of two French trauma centres were performed. The data obtained was combined with numerical multibody parametric investigations, allowing the reproduction of 240 accident situations. An original and representative analysis of motorcyclists' impact conditions was provided, weighting the numerical study output data according to the real accident database. The impacted regions of the human body, the impact velocity and the accident chronology obtained in this work made it possible to define critical information for airbag efficiency assessment: the zones and levels of protection, the impacted surfaces as well as the airbag intervention time and the duration of maintained inflation of the airbag.
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Accidentes de Tránsito/estadística & datos numéricos , Airbags , Motocicletas/estadística & datos numéricos , Heridas y Lesiones/prevención & control , Bases de Datos Factuales , Humanos , Masculino , Estadísticas no Paramétricas , Centros Traumatológicos/estadística & datos numéricosRESUMEN
OBJECTIVE: This study assesses the effectiveness of protective clothing (motorcycle jacket, trousers, gloves, knee-high or ankle boots, back protection) for motorized 2-wheeler (MTW) riders. METHODS: This retrospective observational study used injury data from the Rhône Registry of Road Accident Victims, plus a postal survey conducted in 2016. Seven thousand one hundred forty-eight MTW riders involved in accidents between 2010 and 2014 were identified from the Registry and were invited to complete a questionnaire. Nine hundred seventy-nine individuals returned the questionnaire with relevant information; 951 with complete injury descriptions and clothing information were included in the study. The impact of protective clothing on injury risk was estimated using Poisson regression, with weighting for nonrespondents. RESULTS: Sixty-seven percent of MTW riders sustained upper limb injuries and 47% sustained lower limb injuries. Gloves were the most frequent gear worn (76%), followed by jackets (59%) and knee-high or ankle boots (37%). Only 23% had back protection and 0.3% had an airbag. Wearing protective clothing was associated with a lower risk of soft tissue injury to upper and lower limbs: For upper limbs, the risk was lower when one of 2 items (a motorcycle jacket or gloves) was worn (relative risk [RR] = 0.36; 95% confidence interval [CI], 0.18-0.75) and was lowest when both were worn (RR = 0.28; 95% CI, 0.12-0.69); for lower limbs, risk was reduced by wearing both motorcycle trousers and boots (RR = 0.60; 95% CI, 0.40-0.91) but was not significantly reduced when only one of these items was worn (RR = 0.90; 95% CI, 0.67-1.21). This protective effect was mainly due to a reduction in abrasions/lacerations rather than contusions. However, protective clothing did not reduce the risk of fracture, dislocation, or sprain, except for knee-high or ankle boots, which were associated with lower risk of ankle or foot fracture (RR = 0.43; 95% CI, 0.24-0.75). No effect of back protectors was shown. CONCLUSIONS: This study confirms the potential for motorcycle clothing to protect users from injury, in particular abrasions and lacerations. However, it did not show any significant protective effect against more serious injuries, such as fracture, dislocation, or sprain, except for knee-high or ankle boots, which reduced foot and ankle fracture risk. Our results argue for more widespread use of protective clothing by MTW users.
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Accidentes de Tránsito/estadística & datos numéricos , Motocicletas , Ropa de Protección/estadística & datos numéricos , Heridas y Lesiones/epidemiología , Adolescente , Adulto , Femenino , Fracturas Óseas/epidemiología , Alemania/epidemiología , Dispositivos de Protección de la Cabeza/estadística & datos numéricos , Humanos , Luxaciones Articulares/epidemiología , Masculino , Persona de Mediana Edad , Análisis de Regresión , Estudios Retrospectivos , Adulto JovenRESUMEN
Agricultural intensification is one of the main causes for the current biodiversity crisis. While reversing habitat loss on agricultural land is challenging, increasing the farmland configurational heterogeneity (higher field border density) and farmland compositional heterogeneity (higher crop diversity) has been proposed to counteract some habitat loss. Here, we tested whether increased farmland configurational and compositional heterogeneity promote wild pollinators and plant reproduction in 229 landscapes located in four major western European agricultural regions. High-field border density consistently increased wild bee abundance and seed set of radish (Raphanus sativus), probably through enhanced connectivity. In particular, we demonstrate the importance of crop-crop borders for pollinator movement as an additional experiment showed higher transfer of a pollen analogue along crop-crop borders than across fields or along semi-natural crop borders. By contrast, high crop diversity reduced bee abundance, probably due to an increase of crop types with particularly intensive management. This highlights the importance of crop identity when higher crop diversity is promoted. Our results show that small-scale agricultural systems can boost pollinators and plant reproduction. Agri-environmental policies should therefore aim to halt and reverse the current trend of increasing field sizes and to reduce the amount of crop types with particularly intensive management.
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Agricultura/métodos , Productos Agrícolas/fisiología , Ambiente , Polinización , Productos Agrícolas/crecimiento & desarrollo , Francia , Alemania , Reproducción , España , Reino UnidoRESUMEN
OBJECTIVE: The present article identifies and assesses the effect of critical factors on the risk of motorcycle loss-of-control (LOC) crashes. METHOD: Data come from a French project on road crashes, which include all fatal road crashes and a random sample of 1/20th of nonfatal crashes in France in 2011, based on police reports. A case-control study was carried out on a sample of 903 crashes for 444 LOC motorcycle riders (case) and 470 non-LOC and nonresponsible motorcycle riders (control). The sample was weighted due to the randomization of nonfatal crashes. Missing values were imputed using multiple imputation. RESULTS: Road alignment and surface conditions, human factors, and motorcycle type played important roles in motorcycle LOC crashes. Riding in a curve was associated with a 3-fold greater risk of losing control of motorcycle than riding in a straight line. Poor road adhesion significantly increased the risk of losing control; the risk increased more than 20-fold when deteriorated road adhesion was encountered unexpectedly, due to loose gravel, ice, oil, bumps, road marking, metal plates, etc. For motorcyclists, riding with a positive blood alcohol concentration (over or equal to the legal limit of 0.5 g/L) was very dangerous, often resulting in losing control. The risk of LOC crash varied for different types of motorcycle: Riders of roadsters and sports bikes were more likely to have an LOC crash greater than that of riders of basic or touring motorcycles. In addition, LOC risk increased with speed; a model using the square of the traveling speed showed better fit than one using speed itself. CONCLUSION: The LOC crash factors related to riders, vehicles, and road infrastructure identified here were expected but were rarely identified and taken simultaneously into account in previous studies. They could be targeted by countermeasures to improve motorcyclist safety.
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Accidentes de Tránsito/estadística & datos numéricos , Nivel de Alcohol en Sangre , Motocicletas/estadística & datos numéricos , Adulto , Anciano , Estudios de Casos y Controles , Conducta Peligrosa , Francia , Humanos , Persona de Mediana Edad , Factores de Riesgo , Adulto JovenRESUMEN
BACKGROUND: Information about the burden of (non-fatal) road traffic injury is very useful to further improve road safety policy. Previous studies calculated the burden of injury in individual countries. This paper estimates and compares the burden of non-fatal serious road traffic injuries in six EU countries/regions: Austria, Belgium, England, The Netherlands, the Rhône region in France and Spain. METHODS: It is a cross-sectional study based on hospital discharge databases. POPULATION: of study are patients hospitalized with MAIS3+ due to road traffic injuries. The burden of injury (expressed in years lived with disability (YLD)) is calculated applying a method that is developed within the INTEGRIS study. The method assigns estimated disability information to the casualties using the EUROCOST injury classification. RESULTS: The average burden per MAIS3+ casualty varies between 2.4 YLD and 3.2 YLD per casualty. About 90% of the total burden of injury of MAIS3+ casualties is due to lifelong consequences that are experienced by 19% to 33% of the MAIS3+ casualties. Head injuries, spinal cord injuries and injuries to the lower extremities are responsible for more than 90% of the total burden of MAIS3+ road traffic injuries. Results per transport mode differ between the countries. Differences between countries are mainly due to differences in age distribution and in the distribution over EUROCOST injury groups of the casualties. CONCLUSION: The analyses presented in this paper can support further improvement of road safety policy. Countermeasures could for example be focused at reducing skull and brain injuries, spinal cord injuries and injuries to the lower extremities, as these injuries are responsible for more than 90% of the total burden of injury of MAIS3+ casualties.
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Accidentes de Tránsito/estadística & datos numéricos , Lesiones Encefálicas/epidemiología , Extremidad Inferior/lesiones , Años de Vida Ajustados por Calidad de Vida , Traumatismos de la Médula Espinal/epidemiología , Adolescente , Adulto , Distribución por Edad , Estudios Transversales , Personas con Discapacidad/estadística & datos numéricos , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Alta del Paciente/estadística & datos numéricos , Distribución por Sexo , Adulto JovenRESUMEN
OBJECTIVE: The present study estimates pedestrians' risk of death according to impact speed when hit by a passenger car in a frontal collision. METHODS: Data were coded for all fatal crashes in France in 2011 and for a random sample of 1/20th of all road injuries for the same year and weighted to take into account police underreporting of mild injury. A cloglog model was used to optimize risk adjustment for high collision speeds. The fit of the model on the data was also improved by using the square of the impact speed, which best matches the energy dissipated in the collision. RESULTS: Modeling clearly demonstrated that the risk of death was very close to 1 when impact speeds exceeded 80 km/h. For speeds less than 40 km/h, because data representative of all crashes resulting in injury were used, the estimated risk of death was fairly low. However, although the curve seemed deceptively flat below 50 km/h, the risk of death in fact rose 2-fold between 30 and 40 km/h and 6-fold between 30 and 50 km/h. For any given speed, the risk of death was much higher for more elderly subjects, especially those over 75 years of age. These results concern frontal crashes involving a passenger car. Collisions involving trucks are far less frequent, but half result in the pedestrian being run over, incurring greater mortality. CONCLUSIONS: For impact speeds below 60 km/h, the shape of the curve relating probability of death to impact speed was very similar to those reported in recent rigorous studies. For higher impact speeds, the present model allows the curve to rise ever more steeply, giving a much better fit to observed data. The present results confirm that, when a pedestrian is struck by a car, impact speed is a major risk factor, thus providing a supplementary argument for strict speed limits in areas where pedestrians are highly exposed.
Asunto(s)
Aceleración , Accidentes de Tránsito/mortalidad , Accidentes de Tránsito/estadística & datos numéricos , Peatones , Adolescente , Adulto , Anciano , Niño , Preescolar , Bases de Datos Factuales , Femenino , Francia/epidemiología , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Policia , Medición de Riesgo/métodos , Factores de Riesgo , Adulto JovenRESUMEN
INTRODUCTION: This research aims to estimate the relative risks of responsibility for a fatal accident linked to driving under the influence of cannabis or alcohol, the prevalence of these influences among drivers and the corresponding attributable risk ratios. A secondary goal is to estimate the same items for three other groups of illicit drugs (amphetamines, cocaine and opiates), and to compare the results to a similar study carried out in France between 2001 and 2003. METHODOLOGY: Police procedures for fatal accidents in Metropolitan France during 2011 were analyzed and 300 characteristics encoded to provide a database of 4,059 drivers. Information on alcohol and four groups of illicit drugs derived from tests for positivity and potential confirmation through blood analysis. The study compares drivers responsible for causing the accident, that is to say having directly contributed to its occurrence, to drivers involved in an accident for which they were not responsible, and who can be assimilated to drivers in general. RESULTS: The proportion of persons driving under the influence of alcohol is estimated at 2.1% (95% CI: 1.4-2.8) and under the influence of cannabis at 3.4% (2.9%-3.9%). Drivers under the influence of alcohol are 17.8 times (12.1-26.1) more likely to be responsible for a fatal accident, and the proportion of fatal accidents which would be prevented if no drivers ever exceeded the legal limit for alcohol is estimated at 27.7% (26.0%-29.4%). Drivers under the influence of cannabis multiply their risk of being responsible for causing a fatal accident by 1.65 (1.16-2.34), and the proportion of fatal accidents which would be prevented if no drivers ever drove under the influence of cannabis is estimated at 4.2% (3.7%-4.8%). An increased risk linked to opiate use has also been found to be significant, but with low prevalence, requiring caution in interpreting this finding. Other groups of narcotics have even lower prevalence, and the associated extra risks cannot be assessed. CONCLUSION: Almost a decade separates the present study from a similar one previously conducted in France, and there have been numerous developments in the intervening years. Even so, the prevalence of drivers responsible for causing fatal accidents under the influence of alcohol or narcotics has stayed remarkably stable, as have the proportion of fatal accidents which could in theory be prevented if no drivers ever exceeded the legal limits. The overall number of deaths from traffic accidents has dropped sharply during this period, and the number of victims attributable to alcohol and/or cannabis declined proportionally. Alcohol remains the main problem in France. It is just as important to note that one in two drivers considered to be under the influence of cannabis was also under the influence of alcohol. With risks cumulating between the two, it is particularly important to point out the danger of consuming them together.
Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Cannabis/efectos adversos , Etanol/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Conducción de Automóvil/estadística & datos numéricos , Conducir bajo la Influencia/estadística & datos numéricos , Etanol/sangre , Francia/epidemiología , Humanos , Oportunidad Relativa , Prevalencia , Factores de RiesgoRESUMEN
Apart from its role in electron transfer, mitochondrial cytochrome c also plays a role in apoptosis and is subject to nitrosylation. The cleavage of the Fe-Met80 bond plays a role in several processes including the release of Cyt c from mitochondria or increase of its peroxidase activity. Nitrosylation of Cyt c precludes the reformation of the disrupted Fe-Met80 bond and was shown to occur during apoptosis. These physiological properties are associated with a conformational change of the heme center of Cyt c. Here, we demonstrate that NO binding induces pronounced heme conformational changes in the six-coordinate Cyt c-NO complex. Equilibrium and time-resolved Raman data reveal that the heme structural conformation depends both on the nature of the distal iron ligand (NO or Met80) and on the Fe2+ or Fe3+ heme redox state. Upon nitrosylation, the heme ruffling distortion is greatly enhanced for ferrous Cyt c. Contrastingly, the initial strong heme distortion in native ferric Cyt c almost disappears after NO binding. We measured the heme coordination dynamics in the picosecond to second time range and identified Met80 and NO rebinding phases using time-resolved Raman and absorption spectroscopies. Dissociation of NO instantly produces 5-coordinate heme with a domed structure which continues to rearrange within 15 ps, while the initial ruffling distortion disappears. The rates of Cyt c-NO complex formation measured by transient absorption are kon = 1.81 × 106 M-1 s-1 for ferric Cyt c and 83 M-1 s-1 for ferrous Cyt c. After NO dissociation and exit from the heme pocket, the rebinding of Met80 to the heme iron takes place 6 orders of magnitude more slowly (3-5 µs) than Met80 rebinding in the absence of NO (5 ps). Altogether, these data reveal the structural and dynamic properties of Cyt c in interaction with nitric oxide relevant for the molecular mechanism of apoptosis.