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1.
Epidemiol Health ; 42: e2020002, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32023779

RESUMEN

OBJECTIVES: According to Traffic Police, about 35% of deaths and more than 50% of injuries caused by traffic collision in the roads of Tehran are among drivers and car occupants. This study was conducted to determine areas with the highest number of traffic collisions and perform spatial analysis of traffic collisions involving drivers in Tehran during April 2014 to March 2017. METHODS: The present study was a cross-sectional and descriptive-analytic research. In this study, all traffic collision that driver was accounted (100 percent or less) for crash occurrence which resulted in the death of at least one person (driver, pedestrian or passenger) were included in the analyses. Geographic information system software was used to show spatial distribution of events from zoning maps. Moran index was used in the mathematical analysis in order to determine the distribution pattern of the events from and Getis-Ord G statistics was applied to analyze the hot spots (high risk points). RESULTS: A total number of 519 traffic collisions were investigated in this study. Moreover, 283 cases (54.5%) of the incidents took place in direct routes and 236 cases (45.5%) occurred at intersections. The most frequent events were in the region 4 (57 cases) and the least frequent events were reported in the region 10 (6 cases). Moran statistics show that the distribution of the studied events significantly follows the cluster pattern (p<0.001). CONCLUSIONS: The northeastern and northwest margins of Tehran are the most prone areas for drivers involved with traffic collisions leading to death. Most traffic collisions leading to death take place at highways located at the entrance and exit points of Tehran and highways in regions 2 and 5.


Asunto(s)
Accidentes de Tránsito/mortalidad , Accidentes de Tránsito/estadística & datos numéricos , Estudios Transversales , Sistemas de Información Geográfica , Humanos , Irán/epidemiología , Análisis Espacial
2.
Medicine (Baltimore) ; 99(1): e18567, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31895799

RESUMEN

We investigated the epidemiological and clinical characteristics deaths from road traffic injury (RTI) in Beijing, and provided evidence useful for the prevention of fatal traffic trauma and for the treatment of traffic-related injuries.We retrospectively reviewed death cases provided by the Beijing Red Cross Emergency Center on road traffic injury deaths from 2008 to 2017. We analyzed population characteristics, time distribution, distribution of transportation modes, intervals to death, locations and injured body parts.From 2008 to 2017, there were 3327 deaths from RTI recorded by the Beijing Red Cross Emergency Center, with mainly males among these deaths. The average age at death was 46.19 ±â€Š17.43 years old (46.19, 0.43-100.24). In accidents with more detail recorded, pedestrians and people using nonmotorized transportation modes suffered the most fatalities (664/968, 68.60%). The most commonly injured body parts were the head (2569/3327, 77.22%), followed by the chest (180/3327, 5.41%), abdomen (130/3327, 3.91%), lower extremities (68/3327, 2.04%), pelvis (67/3327, 2.01%), spinal cord (31/3327, 0.93%), and upper extremities (26/3327, 0.78%). Burns accounted for 0.96% (32/3327), and unknown body parts were affected in 11.28% (365/3327). The average time interval from injury to death was 36.90 ±â€Š89.57 h (36.90, 0-720); 46.7% (1554/3327) died within 10 minutes after injury; 9.02% (300/3327) died between 10 min and 1 hour; 30.33% (1009/3327) died between 1 hour and 3 days; 13.95% (464/3327) died between 3 and 30 days.In Beijing, RTI is a significant cause of preventable death, particularly among pedestrians and users of non-motorized vehicles. Head trauma was the most lethal cause of RTI deaths. Our findings suggested that interventions to prevent collisions and reduce injuries, and improved trauma treatment process and trauma rescue system could address a certain proportion of avoidable RTI deaths.


Asunto(s)
Accidentes de Tránsito/mortalidad , Traumatismos Craneocerebrales/mortalidad , Peatones/estadística & datos numéricos , Heridas y Traumatismos/mortalidad , Adulto , Anciano , Beijing/epidemiología , Traumatismos Craneocerebrales/etiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Centros Traumatológicos/estadística & datos numéricos , Heridas y Traumatismos/etiología
3.
J Forensic Sci ; 65(1): 193-195, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31433492

RESUMEN

The interpretation of cranial base injuries has never been investigated from a purely anthropological perspective. Very little exists in forensic literature in order to interpret the significance of cranial base fractures. We analyzed 296 cases of deaths due to skull-brain injuries. The frequency of vault fractures was 75.7% and that of base fractures was 91.9%. We observed the distribution of cases of death according to manner of death and manner of injury and number of fossae involved. These observations were analytically compared to different variables (age, sex, manner of injury, and mode of injury). The study presented the proportion of base fractures associated with vault fractures, and the frequency of absence of base fracture in subjects with no vault fractures. Interesting associations of base fractures to age and manner of death are shown.


Asunto(s)
Lesiones Encefálicas/mortalidad , Base del Cráneo/lesiones , Fracturas Craneales/epidemiología , Accidentes por Caídas/mortalidad , Accidentes de Tránsito/mortalidad , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Italia/epidemiología , Masculino , Persona de Mediana Edad , Abuso Físico/estadística & datos numéricos , Distribución por Sexo , Base del Cráneo/patología , Fracturas Craneales/patología , Heridas por Arma de Fuego/mortalidad , Adulto Joven
4.
Accid Anal Prev ; 134: 105251, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31402051

RESUMEN

Powered two-wheelers (PTWs) are growing globally each year as they are considered an attractive alternative to cars (flexible, small, affordable, fast and easy to park), especially on congested traffic situations. However, PTWs represent an important challenge for road safety. In fact, in 2016, Spain ranked fifth in terms of PTW fatalities among EU 28. For this reason, this paper aims to investigate which are the patterns among crash characteristics contributing to PTW crashes in Spain. Data from 78,611 crashes involving PTWs occurred in Spain in the period 2011-2013 were analyzed. The analysis was performed by using classification trees and rules discovery which are suitable models aimed at extracting knowledge and identifying valid and understandable patterns from large amounts of data previously unknown and indistinguishable. The response variables assessed in this study were severity and crash type. As a result, several combinations of road, environmental and drivers' characteristics associated with severity and typology of PTW crashes in Spain were identified. Based on the analysis results, several countermeasures to solve or mitigate the safety issues identified in the study were proposed. From the methodological point of view, study results show that both the classification trees and the a priori algorithm were effective in providing non-trivial and unsuspected relations in the data. Classification trees structure allowed a simpler understanding of the phenomenon under study while association discovery provided new information which was previously hidden in the data. Given that the results of the two different techniques were never contradictory, we recommend using classification trees and association discovery as complementary approaches since their combination is effective in exploring data providing meaningful insights about PTW crash characteristics and their interdependencies.


Asunto(s)
Accidentes de Tránsito/mortalidad , Minería de Datos/métodos , Motocicletas/estadística & datos numéricos , Algoritmos , Humanos , Curva ROC , España/epidemiología
5.
Accid Anal Prev ; 134: 105247, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31405514

RESUMEN

Using data from the national register of police-reported crashes and from the bridge register of the Norwegian Public Roads Administration, we estimated rates of single-vehicle crashes on road sections adjacent to road bridges and on different sections of the bridges. Data included all single-vehicle personal injury crashes occurring on or close to road bridges in Norway between 2010 and 2016, a total of 219 crashes. All bridges on state and county roads were included. Crash rate was found to be highest in the approach zone of short bridges (last 50 m before bridge) and lowest in the middle of long bridges. On bridges shorter than about 100 m, crash rate was higher in the first than in the last bridge zone. Total crash rate on bridges was close to the figure for the total road network. However, for the approach to short bridges, crash rate was significantly higher than for the total road network, and for the middle part of long bridges it was significantly lower. A supplementary analysis of in-depth data from 31 fatal crashes including both single-vehicle and multiple-vehicle crashes supported the results from the main analysis. A higher proportion of fatal crashes occurred on approaching or entering a bridge than when leaving the bridge, as seen from the direction of travel of the at-fault vehicle. Concerning countermeasures against bridge accidents, particular attention should be payed to the approach zone and to the design of barriers.


Asunto(s)
Accidentes de Tránsito/mortalidad , Entorno Construido , Accidentes de Tránsito/estadística & datos numéricos , Humanos , Noruega , Factores de Riesgo
6.
Accid Anal Prev ; 134: 105329, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31704642

RESUMEN

Though U.S. motor vehicle crashes as a whole have decreased over the past few years, fatalities among vulnerable road users have increased. Pedestrian deaths rose nationally by 27% between 2007 and 2016 accounting for 16% of all motor vehicle fatalities. This increase continues to burden transportation specialists, public health professionals, and community stakeholders. Potential risk factors include characteristics of the built environment, distractions, and pedestrians' use of alcohol and drugs. Pedestrian deaths in Georgia, United States, increased 40% between 2014 and 2016 while drug overdose deaths have increased by 18% during the same period. Concurrent increases in mortality due to pedestrian fatalities and drug overdoses make Georgia a natural environment in which to describe the proximity of drugs among pedestrian fatalities, a topic largely overlooked by the literature. This study explores the epidemiology of pedestrian fatalities in Georgia over a 10-year period with an emphasis on reported substance use among cases. The study employed 10-year data from the Fatality Analysis Reporting System (FARS) administered by the National Highway Traffic Safety Administration. Descriptive methods were used to explore drug screens by person, place, and time. We also examined trends in total drug screens over the examination period. Between 2007 and 2016, 1781 pedestrian crashes were reported to FARS; the fatality rate for this period was 94.5%. Of these, most were male with Blacks and Whites equally represented. Ages 15-64 accounted for 81.1% of cases with most occurring in the Atlanta Metropolitan area. When adjusted for population, one finds higher rates in more rural areas of the state. Data revealed that testing for the presence of drugs occurred among half of reported cases. Of those testing positive, five drug categories emerged; stimulants (45.8%), cannabinoids (21.5%), narcotics (including opioids) (14.1%), depressants (12.1%), and "Other Drugs" (6.3%). Positive drug screens across all drug classifications increased by 178.1% between 2007 and 2016. These findings suggest the need for state-wide policies designed to promote more consistent screening among pedestrians involved in motor vehicle crashes as well as diligence in understanding the role played by drugs among this population. Additional investigation should be conducted to tease out the presence of category-specific drugs among pedestrians. Understanding the epidemiology of pedestrian fatalities in the state, especially in relation to substance use, serves as a first step toward implementing localized preventive efforts.


Asunto(s)
Accidentes de Tránsito/mortalidad , Peatones/estadística & datos numéricos , Detección de Abuso de Sustancias/métodos , Accidentes de Tránsito/prevención & control , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Georgia/epidemiología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Factores de Riesgo , Análisis Espacial , Detección de Abuso de Sustancias/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Adulto Joven
7.
Accid Anal Prev ; 134: 105325, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31706185

RESUMEN

Although mortality trends can be influenced by different ages, periods, and cohorts, few studies have demonstrated the age-period-cohort (APC) effect on road traffic injury (RTI) mortality. Moreover, APC effects in Korea have never been documented despite the high mortality rates from RTIs. This study aimed to describe the trends in mortality from RTIs and examine APC effects on RTI mortality in Korea. Using the national death certificate and census mid-year population estimates data during 1983-2017, trends in age-standardized mortality rates from RTIs were analyzed using Joinpoint regression. Intrinsic estimator regression models were used to estimate APC effects on RTI mortality. Consistent with the trend in period effects, RTI mortality increased sharply with the economic growth in the 1980s, decelerated after the implementation of road safety policies in the early 1990s, plummeted owing to the 1997-1998 financial crisis, and gradually decreased from the early 2000s. A J-shaped age effect indicated that the relative risk of road traffic death surged in people aged ≥65 years. Educational expansion from the mid-1950s turned an increasing birth cohort effect into a continuously decreasing trend after peaking around the 1938-1943 birth cohorts. The risk of road traffic death was relatively high among the Korean Generation Y, i.e., those born in 1978-1983. RTI mortality trends in Korea have been affected by diverse socioeconomic changes through cohort and period effects. Despite the recent favorable trend, RTI mortality remains high, especially among older people. Road safety policies to address the burden of RTIs require further improvement.


Asunto(s)
Accidentes de Tránsito/mortalidad , Heridas y Traumatismos/mortalidad , Adolescente , Adulto , Distribución por Edad , Anciano , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Adulto Joven
8.
Rev Bras Epidemiol ; 22Suppl 3(Suppl 3): e190011.supl.3, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31800850

RESUMEN

BACKGROUND: Unspecified causes of death are among the traditional indicators of quality of information. OBJECTIVE: To verify the performance of the 60 cities in the Data for Health Initiative project and to analyze the reclassification of unspecified external causes of death (UEC). METHODS: Using the 2017 records from the Mortality Information System, the proportion and percent change in UEC were compared after investigation between project cities and other cities, and the percent of reclassification to specific external causes was calculated. RESULTS: The project cities comprised 52% (n = 11,759) of the total UEC in Brazil, of which 64.5% were reclassified after investigation, whereas the other cities reclassified 31% of UEC. Results were similar for men, youth, blacks, metropolitan cities, the Southeast region, and deaths attested by forensic institutes. In the project cities, pedestrian traffic accidents were external causes with greater reclassification. In men, the UEC was reclassified to homicides (23.8%) and accident of terrestrial transportation (ATT) (11.1%), with motorcyclists (4.4%) and pedestrians (4.3%) being the most prominent. In women, these causes were changed to other accident causes (20.8%), ATT (10.6%) and homicides (7.9%). UEC changed to ATT (18.3%) in the age groups of 0-14 years old and to homicides (32.5%) in the age groups of 15-44 years. CONCLUSION: The project cities obtained better results after investigation of UEC, enabling analysis of the reclassification to specific causes by sex and age groups.


Asunto(s)
Causas de Muerte , Certificado de Defunción , Sistemas de Información/normas , Accidentes/mortalidad , Accidentes de Tránsito/mortalidad , Adolescente , Adulto , Distribución por Edad , Anciano , Brasil/epidemiología , Niño , Preescolar , Ciudades/epidemiología , Exactitud de los Datos , Femenino , Homicidio/estadística & datos numéricos , Humanos , Lactante , Masculino , Registros Médicos , Persona de Mediana Edad , Distribución por Sexo , Suicidio/estadística & datos numéricos , Violencia/estadística & datos numéricos , Adulto Joven
9.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-LISBR1.1-46896

RESUMEN

Plataforma com dados indicadores sobre a taxa de mortalidade por acidente de trânsito 2000 a 2015. Brasil Agenda 2030 - objetivo 3 - Saúde e bem estar


Asunto(s)
Desarrollo Sostenible , Accidentes de Tránsito/mortalidad , Indicadores de Salud
10.
BMC Public Health ; 19(1): 1449, 2019 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-31684951

RESUMEN

BACKGROUND: Road traffic injuries (RTIs) have been one of the most critical public health problems in Thailand for decades. The objective of this study was to examine to what extent provincial economy was associated with RTIs, road traffic deaths and case fatality rate in Thailand. METHODS: A secondary data analysis on time-series data was applied. The unit of analysis was a panel of 77 provinces during 2012-2016. Data were obtained from relevant public authorities, including the Ministry of Public Health. Descriptive statistics and econometric models, using negative binomial (NB) regression, negative binomial regression with random-effects (RE) model, and spatial Durbin model (SDM) were employed. The main predictor variable was gross domestic product (GDP) per capita and the outcome variables were incidence proportion of RTIs, traffic deaths and case fatality rate. The analysis was adjusted for key covariates. RESULTS: The incidence proportion of RTIs rose from 449.0 to 524.9 cases per 100,000 population from 2012 till 2016, whereas the incidence of traffic fatalities fluctuated between 29.7 and 33.2 deaths per 100,000 population. Case fatality rate steadily stood at 0.06-0.07 deaths per victim. RTIs and traffic deaths appeared to be positively correlated with provincial economy in the NB regression and the RE model. In the SDM, a log-Baht increase in GDP per capita (equivalent to a growth of GDP per capita by about 2.7 times) enlarged the incidence proportion of injuries and deaths by about a quarter (23.8-30.7%) with statistical significance. No statistical significance was found in case fatality rate by the SDM. The SDM also presented the best model fitness relative to other models. CONCLUSION: The incidence proportion of traffic injuries and deaths appeared to rise alongside provincial prosperity. This means that RTIs-preventive measures should be more intensified in economically well-off areas. Furthermore, entrepreneurs and business sectors that gain economic benefit in a particular province should share responsibility in RTIs prevention in the area where their businesses are running. Further studies that explore others determinants of road safety, such as patterns of vehicles used, attitudes and knowledge of motorists, investment in safety measures, and compliance with traffic laws, are recommended.


Asunto(s)
Accidentes de Tránsito/mortalidad , Accidentes de Tránsito/estadística & datos numéricos , Desarrollo Económico/estadística & datos numéricos , Heridas y Traumatismos/epidemiología , Adolescente , Adulto , Análisis de Datos , Femenino , Producto Interno Bruto/estadística & datos numéricos , Humanos , Incidencia , Masculino , Modelos Econométricos , Análisis Espacial , Tailandia/epidemiología , Heridas y Traumatismos/mortalidad , Adulto Joven
12.
Rev Esp Salud Publica ; 932019 Nov 15.
Artículo en Español | MEDLINE | ID: mdl-31719516

RESUMEN

OBJECTIVE: Traffic accidents constitute a public health problem and are the leading cause of accidental death in the world. Analyze if the type of accident, the age of the victim or the attention provided by the emergency medicalized units (UME) are related to the morbidity and mortality due to traffic accidents in Extremadura (Spain) during the years 2012, 2013, 2014 and 2015. METHODS: Descriptive study of the information in the records of the emergency response coordination center 112. A multivariate analysis was carried out. The prognostic status was introduced as a dependent variable and the type of accident, the age of the accident. RESULTS: The type of accident [odds ratio (OR)=1.745; 95% confidence interval (95% CI=1.488-2.045), the victim's age (OR=1.016; 95% CI=1.013-1.020), UME 4-3 (OR=4.304; 95% CI=2.158-8.587), UME 4-1 (OR=2.463; 95% CI=1.414-4.291) and UME 1-4 (OR=1.990; 95% CI=1.052-3.762) are related to the prognostic status of the victims. CONCLUSIONS: Inter-urban traffic accidents, the victim's age and three UME influence the prognostic status of the victims.


Asunto(s)
Accidentes de Tránsito/mortalidad , Heridas y Traumatismos/etiología , Accidentes de Tránsito/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios Transversales , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , España/epidemiología , Heridas y Traumatismos/epidemiología , Heridas y Traumatismos/terapia , Adulto Joven
13.
Rev Esp Salud Publica ; 932019 Nov 15.
Artículo en Español | MEDLINE | ID: mdl-31719517

RESUMEN

OBJECTIVE: The increase in traffic accidents depends on multiple factors; it generates an economic and public health problem that must be analyzed jointly by agents involved in road safety. The aim of the work was to quantify the effect of various factors in the cost savings due to traffic accidents on interurban roads in Spain. METHODS: It was analyzed, through a lineal regression with panel data model and in the period 2000-2017, how different factors affected cost savings due to the risk of mortality or injury avoided on Spanish interurban roads. RESULTS: A 1% increase in traffic volume led to a reduction in costs per MVKT (million vehiclekilometres travelled) of €162.46 referring to the risk of mortality, €115.32 for serious injuries and €10.10 for mild injuries. This increase in unemployment caused a cost reduction of €31.43, €10.76 and €0.98, respectively. The same increase in the investment in replacement implied a reduction of these costs of €11 for any risk. A 1% increase in the ageing index led to an increase in costs of €276.83 in terms of mortality risk and €257.49 in terms of injury. Foreign tourism generated a cost of more than €40 for any risk. A 1% increase in GDP per capita led to an increase in costs of €155.50, €138.09 and €8.21 for defined risks. The points driving license led to an increase in costs of €785.50 per MVKR when referring to mortality risks. CONCLUSIONS: Determining factors for cost savings: motorization rate, unemployment rate and investment in replacement interurban roads. Determining factors that increased costs: expiry of the effect of the penalty - points driving licence, ageing index of the population, increase in GDP or proportion of foreign travelers.


Asunto(s)
Accidentes de Tránsito/economía , Ahorro de Costo/estadística & datos numéricos , Salud Urbana/economía , Heridas y Traumatismos/economía , Prevención de Accidentes/economía , Prevención de Accidentes/métodos , Accidentes de Tránsito/mortalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Conducción de Automóvil/estadística & datos numéricos , Humanos , Modelos Lineales , Persona de Mediana Edad , Factores de Riesgo , España/epidemiología , Salud Urbana/estadística & datos numéricos , Heridas y Traumatismos/epidemiología , Heridas y Traumatismos/etiología , Adulto Joven
14.
Accid Anal Prev ; 133: 105289, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31586824

RESUMEN

In recent years, the popularity of all-terrain vehicles (ATVs) in the United States (US) has increased, and the number of ATV driver and passenger deaths have also increased substantially in the last few decades. Riders or occupants of ATVs as well as golf carts are particularly vulnerable to injury, not only due to the lack of protection and safety equipment offered by their vehicles, but also the propensity for ejection in the event of a crash. Given the vulnerability of these road users, it's critical to understand factors which may affect injury severity to plan effective countermeasures aimed at reducing these injuries and fatalities. To better understand factors affecting the injury severity of ATV and golf cart riders or occupants involved in police-reported crashes, this study presents an analysis using six years of crash data from the US state of Arizona. Over the analysis period, there were 1769 drivers/passengers of these vehicle types involved in police-reported crashes. Of these occupants/riders, 67.7% were injured or killed as a result of the crash; a proportion significantly higher than police-reported crashes involving most other vehicle types, exhibiting the need to examine factors leading to these injuries and fatalities. In order to analyse factors affecting the injury severity of ATV and golf cart occupants/riders, a random parameters (RP) ordered logit statistical model was developed, which was most appropriate given the ordered nature of injury-severity data. Several person- vehicle- roadway- and environmental-related variables were found to significantly affect the injury severity of riders or occupants of ATVs and golf carts. Given the vulnerability of these road users, it's important for transportation agencies to explore effective countermeasures aimed at reducing the severity of crashes involving these vehicle types. The results of this study provide important insights which can assist in developing effective engineering-, enforcement-, education, or policy-related countermeasures.


Asunto(s)
Accidentes de Tránsito/mortalidad , Vehículos a Motor Todoterreno , Heridas y Traumatismos/mortalidad , Accidentes de Tránsito/prevención & control , Adulto , Arizona/epidemiología , Femenino , Humanos , Puntaje de Gravedad del Traumatismo , Modelos Logísticos , Masculino , Persona de Mediana Edad , Equipos de Seguridad/estadística & datos numéricos , Adulto Joven
15.
BMC Public Health ; 19(1): 1280, 2019 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-31601217

RESUMEN

BACKGROUND: Allowing contraflow cycling on one-way streets has been reported to reduce crash risks in Belgium and the United Kingdom. Similarly, walking against traffic on roadways without sidewalks substantially improves pedestrian safety. This study examined fatalities and head injuries sustained by pedestrians in against-traffic and with-traffic crashes. METHODS: Using police-reported crash data in Taiwan between 2011 and 2016, fatalities and head injuries were compared for pedestrians involved in against-traffic and with-traffic crashes. RESULTS: Of the 14,382 pedestrians involved in crashes, 10,749 and 3633 pedestrians in with-traffic and against-traffic crashes, respectively, were reported. Compared with pedestrians involved in against-traffic crashes, those in with-traffic crashes were more likely to sustain fatalities and head injuries. Results of logistic regression models revealed several influential factors on pedestrian fatalities and head injuries, including elderly pedestrians, male drivers, intoxicated drivers, rural roadways, unlit streets in darkness, limited sight distance, adverse weather conditions, midnight hours, and a heavy vehicle as the crash partner. CONCLUSIONS: Pedestrians in with-traffic crashes were more likely to sustain fatalities and head injuries compared with those in against-traffic crashes. Furthermore, the negative effect of walking with traffic on injuries was more pronounced in reduced-visibility conditions.


Asunto(s)
Accidentes de Tránsito/mortalidad , Accidentes de Tránsito/estadística & datos numéricos , Traumatismos Craneocerebrales/epidemiología , Peatones/estadística & datos numéricos , Caminata/estadística & datos numéricos , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Policia , Taiwán/epidemiología , Adulto Joven
16.
J Forensic Leg Med ; 68: 101868, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31585334

RESUMEN

The aim of this study was to analyze the prevalence of ethanol in individuals (277) subjected to a mandatory medico-legal autopsy in the Institute of Legal Medicine of Las Palmas (Canary Islands, Spain) during 2016-2017, comparing the results with data published in 2015. Blood and/or vitreous humor samples were analyzed by gas chromatography. 31.8% of the individuals were positive to ethanol. We observed a decrease in the prevalence of ethanol among males (p = 0.002). While the prevalence of ethanol was reduced, the concentration among those positive subjects has increased. 11.9% of the series died in a traffic accident and the percentage of positive to ethanol decreased in relation to 2015 (64.3, 25.0, and 35.3%). The number of suicides remains constant, although the age of the suiciders has been significantly reduced (p = 0.022). The results of this study indicate that ethanol is still heavily involved in non-natural deaths.


Asunto(s)
Accidentes de Tránsito/mortalidad , Depresores del Sistema Nervioso Central/análisis , Etanol/análisis , Violencia/estadística & datos numéricos , Cuerpo Vítreo/química , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Distribución por Sexo , España/epidemiología , Adulto Joven
17.
Accid Anal Prev ; 132: 105284, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31518764

RESUMEN

Colorado and Washington legalized recreational marijuana in 2012, but the effects of legalization on motor vehicle crashes remains unknown. Using Fatality Analysis Reporting System data, we performed difference-in-differences (DD) analyses comparing changes in fatal crash rates in Washington, Colorado and nine control states with stable anti-marijuana laws or medical marijuana laws over the five years before and after recreational marijuana legalization. In separate analyses, we evaluated fatal crash rates before and after commercial marijuana dispensaries began operating in 2014. In the five years after legalization, fatal crash rates increased more in Colorado and Washington than would be expected had they continued to parallel crash rates in the control states (+1.2 crashes/billion vehicle miles traveled, CI: -0.6 to 2.1, p = 0.087), but not significantly so. The effect was more pronounced and statistically significant after the opening of commercial dispensaries (+1.8 crashes/billion vehicle miles traveled, CI: +0.4 to +3.7, p = 0.020). These data provide evidence of the need for policy strategies to mitigate increasing crash risks as more states legalize recreational marijuana.


Asunto(s)
Accidentes de Tránsito/mortalidad , Uso de la Marihuana/legislación & jurisprudencia , Colorado/epidemiología , Estudios Controlados Antes y Después , Femenino , Humanos , Washingtón/epidemiología
18.
Accid Anal Prev ; 132: 105283, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31518765

RESUMEN

The rate of road traffic fatalities has long served as a regular indicator to evaluate and compare road safety performance for different administrative divisions. This article introduces a novel method known as the Markov chain spatial model to incorporate the spatial effects into the temporal dynamic of the fatality rates. Compared to the traditional Markov chain model, the proposed spatial Markov chain model can quantify the influence of neighboring sites explicitly in the transition process. A case study using a long duration dataset, from 1975 to 2015 in the 48 lower states of the United Sates, was conducted to illustrate the proposed model. The fatality rates were measured as the number of traffic fatalities per 100 million vehicle miles or per 10,000 residents. The results show that the probability of transition for one state between different levels of traffic fatality risks depends largely on the context of its surrounding neighbors. Another important finding is that relative to the estimates of traditional Markov chain models, states surrounded by neighborhoods with relatively low fatality rates take a longer time to transform to a higher level of fatality risk in the spatial Markov chain model. On the other hand, those with high-risk neighborhoods takes less time to deteriorate. These findings confirm that it is imperative to incorporate spatial effects when modeling the temporal dynamic of safety indicators to assess and monitor the safety trends in the areas of interest.


Asunto(s)
Accidentes de Tránsito/mortalidad , Medición de Riesgo/métodos , Humanos , Cadenas de Markov , Análisis Espacial , Factores de Tiempo , Estados Unidos/epidemiología
19.
Public Health ; 176: 29-35, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31542168

RESUMEN

OBJECTIVES: The aim of the study is to increase seat belt (SB) use and reduce motor vehicle (MV) injuries and death; eight tribal communities implemented evidence-based strategies from the Guide to Community Preventive Services during 2010-2014. STUDY DESIGN: SB use was measured through direct observational surveys and traffic safety activity data. Traffic safety activities included enhanced enforcement campaign events, ongoing enforcement of SB laws, and media. The number of MV injuries (including fatal and non-fatal) was measured through MV crash data collected by police. RESULTS: Percentage change increases in SB use were observed in all eight projects; average annual increases of three projects were statistically significant (ranging from 10% to 43%). Four of the eight projects exceeded their goals for percentage change increases in SB use. Approximately 200 media events and 100 enforcement events focused on SB use were conducted across the eight projects. Five projects had an annual average of ≥100 SB use citations during the project period. MV injuries (fatal and non-fatal combined) significantly decreased in three projects (ranging from a 10% to 21% average annual decrease). CONCLUSIONS: Increases in SB use and decreases in the number of MV injuries can be achieved by tailoring evidence-based strategies to tribal communities.


Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Nativos de Alaska/estadística & datos numéricos , Indios Norteamericanos/estadística & datos numéricos , Cinturones de Seguridad/estadística & datos numéricos , Heridas y Traumatismos/prevención & control , Accidentes de Tránsito/mortalidad , Humanos , Policia , Registros , Cinturones de Seguridad/legislación & jurisprudencia , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Heridas y Traumatismos/etnología , Heridas y Traumatismos/mortalidad
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