Trends in occurrences of accidents by venomous animals in brazil: analysis of notifications from 2007 to 2021 / Tendências na ocorrência de acidentes por animais peçonhentos no brasil: análise das notificações de 2007 a 2021 / Tendencias en las ocurrencias de accidentes por animales venenosos en Brasil: análisis de las notificaciones de 2007 a 2021

Os acidentes por animais peçonhentos sãoum problema de saúde pública que apresenta elevado número de casos anuais no Brasil. Objetivo:descrever e analisar as ocorrências de acidentes por animais peçonhentos no Brasil e suas tendências entre 2007 e 2021.Metodologia:oestudo utilizou dados doSistema de Informação de Agravos de Notificação edo Sistema de Informação sobre Mortalidade.A população do estudo foi analisada segundo sexo, faixa etária e região de residência. A análise de tendência da série histórica foi realizada por regressão linear generalizada usando a estimação de Prais-Winsten.Resultados:as taxas de ocorrência padronizadas dobraram no período estudado (53,8/100.000 hab. em 2007 para 111,2/100.000 hab. em 2021). A região Nordeste apresentou a maior taxa de ocorrência padronizada (105,5/100.000 hab.). As regiões Nordeste, Sudeste e Centro-Oeste apresentaram maior taxa bruta de acidentes por escorpiões (75,8, 48,7 e 32,8 acidentes/100.000 hab., respectivamente), enquanto a região Norte por serpentes (54,2 acidentes/100.000 hab.) e a Região Sul por aranhas (60,3 acidentes/100.000 hab.). A taxa de mortalidade observada no período de 2007 a 2020 foi de 1,3 óbitos/1 milhão de hab. Entre as mortes registradas, 39,6% foram por picada de cobra.Conclusões:as tendências no Brasil foram ascendentes para ambos os sexos e para todas as faixas etárias. Apenas as regiões Norte e Sul apresentaram algumas categorias com tendências estacionárias. A análise dos dados epidemiológicos possibilita a identificação de populações-alvo e a elaboração de políticas públicas a fim de prevenir novos acidentes, bem como aprimorar o atendimento às pessoas acometidas por meio do planejamento da distribuição de soros antiofídicos (AU).

Accidents by venomous animals is a public health problem that presents a high number of annual cases in Brazil.Objective:to describe and analyze the occurrences of accidents by venomous animalsin Brazil and their trends between 2007 and 2021.Methodology:the study used Notifiable Diseases Information Systemand Mortality Information Systemdata. The study population wasanalyzed according to sex, age group, and region of residence. Trend analysis of the historical series was performed by generalized linear regression using Prais-Winsten estimation.Results:the standardized occurrence rates doubled during the studied period (53.8/100,000 inhab. in 2007 to 111.2/100,000 inhab. in 2021). The Northeast region had the highest standardized occurrence rate (105.5/100,000 inhab.). The Northeast, Southeast, and Midwest regions had a higher crude rate of accidents caused by scorpions (75.8, 48.7 and 32.8 accidents/100,000 inhab., respectively), while the North region by snakes (54.2 accidents/100,000 inhab.), and the South region by spiders (60.3 accidents/100,000 inhab.). Death rate observed in the period from 2007 to 2020 was 1.3deaths/1 million inhab. Among the deaths registered, 39.6% were from snakebite.Conclusions:trends in Brazil were ascendant for both sexes and for all age groups. Only the North and South regions showed some categories with stationary trends. The analysis of epidemiological data makes it possible the identification of target populations and elaborations of public policies in order to prevent new accidents, as well as the improvement of care for affected people by planning the distribution of antivenom serums (AU).

Los accidentes por animales venenosos son un problema de salud pública que presenta un elevado número de casos anuales en Brasil. Objetivo: describir y analizar lasocurrencias de accidentes por animales venenosos en Brasil y sus tendencias entre 2007 y 2021.Metodología: el estudio utilizó datos del sistema de información de enfermedades de declaración obligatoria(SINAN, según su sigla en portugués)ydelsistema de información de mortalidad. La población delestudio se analizó según sexo, grupo de edad y región de residencia. El análisis de tendencia de la serie histórica se realizó mediante regresión lineal generalizada utilizando la estimación de Prais-Winsten.Resultados: las tasas de ocurrencia estandarizadas se duplicaron durante el período estudiado (de 53,8/100000 hab. en 2007 a 111,2/100000 hab. en 2021). La región Nordeste presentó la mayor tasa de ocurrencia estandarizada (105,5/100000 hab.). Las regiones Nordeste, Sudeste y Medio Oeste presentaron la mayor tasa bruta de accidentes por alacranes (75,8, 48,7 y 32,8 accidentes/100000 hab., respectivamente), mientras que la región Norte por serpientes (54,2 accidentes/100000 hab.), y la Región Sur por arañas (60,3 accidentes/100000 hab.). La tasa de mortalidad observada en el período de 2007 a 2020 fue de 1,3 muertes/1 millón de hab. Entre las muertes registradas, el 39,6% fueron por mordedura de serpiente.Conclusiones: las tendencias en Brasil fueron ascendentes para ambos sexos y para todos los grupos de edad. Solo las regiones Norte y Sur presentaron algunas categorías con tendencias estacionarias. El análisis de datos epidemiológicos posibilita la identificación de poblaciones objetivo y la elaboración de políticas públicas para la prevención de nuevos accidentes, así como la mejora de la atención a las personas afectadas mediante la planificación de la distribución de sueros antiofídicos (AU).

Surveillance of suicide deaths involving gases in Australia using the National Coronial Information System, 2006 to 2017.

BACKGROUND: There have been concerns about the increased use of helium and nitrogen gas as a suicide mechanism in Australia. METHODS: National Coronial Information System data were used to investigate gas-specific suicides in Australia over the period 2006-2017. Characteristics were compared between helium or nitrogen, carbon monoxide and seven other gases. RESULTS: Gas inhalation accounted for 10% (3,103/31,002) of all suicide deaths in Australia between 2006 and 2017. The mean age of individuals who died by suicide was 47.6 years (SD 16.9, R 14-97) and 83.3% were male. The number of gas suicides declined over the study period (IRR=0.96). The fall was associated with a 47% decline in carbon monoxide suicides (IRR=0.93). There was an increase in deaths due to argon (IRR=1.60) and nitrogen (IRR=1.27). Compared to individuals using other non-carbon monoxide gases, individuals who died by suicide from helium or nitrogen were significantly more likely to be older, have a physical illness and/or disability, have contacted a euthanasia group and have accessed instructional material and purchased gas online. CONCLUSIONS: Suicides by carbon monoxide decreased between 2006 and 2017 alongside an increase in argon and nitrogen gas use - particularly among older adults. The ease of access to these gases points to new targets for means restriction. Implications for public health: Identifying the types of gases used in suicide deaths and emerging trends may enable targeted interventions that could potentially reduce access.

Changes in the pattern of paediatric bicycle injuries in relation to helmet use 1980-2014.

INTRODUCTION: This study aimed to describe long-term changes in injury pattern in bicycle accidents among children in relation to the increasing use of bicycle helmets. METHODS: This was a descriptive register study of all children aged 6-14 years with injuries from bicycle accidents who were treated at a Danish university hospital in the 1980-2014 period. Diagnoses and helmet use were analysed and stratified by gender and age group. Diagnoses were grouped into head injuries, severe head injuries, facial injuries, bone fractures, spinal injuries and internal injuries. We defined severe head injuries as skull fractures and intracranial injuries including concussions, haemorrhages and lacerations. RESULTS: We included 13,294 children, 58.7% were boys. From 1980-1984 to 2010-2014, the use of helmets increased from 0% to 49.9% in boys and from 0% to 57.1% in girls. The proportion of boys and girls with head injuries decreased from 31.3% to 17.4% and from 29.6% to 10.1%, respectively. A similar reduction was found in the proportion of children with severe head injuries. In the study period, the proportion of children with facial injuries, fractures, spinal injuries and internal injuries in trunk remained unchanged. Eighteen children died from their injuries, none of whom wore a helmet. CONCLUSIONS: In the study period, the proportion of head and severe head injuries decreased by 50% along with an increase from 0% to 50% in helmet use. The proportion of facial injuries, spinal injuries, bone fractures and injuries to the internal organs remained unchanged. FUNDING: none. TRIAL REGISTRATION: not relevant.

Prevention of occupational injuries and accidents: A social capital perspective.

Prior research has consistently established the pragmatic nature of literature regarding occupational injuries and accidental happenings faced by nursing professionals. However, current realities require a subjective approach to identify preventative measures that could influence occupational health and safety in healthcare sectors. A qualitative design followed a descriptive approach to assess unbiased opinions towards occupational obstructions that lead to accidental happenings. This study used the social capital framework in particular as a support resource to eliminate its detrimental effects on nurse's capacity to serve their patients. The findings extended the fundamental understanding of social capital from social ties to workplace and personal ties as potential mechanisms of support. Healthcare organizations need to redefine their control policies to provide the ultimate support to their care agents. A social capital model offers nursing practitioners and nursing managers an approach for building evidence-based policies with implications for nurse's safety, education and training.

Using Improved Principal Component Analysis to Explore Construction Accident Situations from the Multi-Dimensional Perspective: A Chinese Study.

The improvement of the macro-level accident situation in the Chinese construction industry is currently an urgent task for the government due to the high accident rate. This study intends to use improved principal component analysis to explore the accident situations in the Chinese construction industry from a multi-dimensional perspective, aiming at providing targeted direction on the improvement of the accident situation for the government. Six composite indicators that can quantify the accident situation are firstly selected based on a wide review of the literature and interviews with safety experts, with the original data collected from China institutions. The classical principal component analysis is then improved to examine the correlations between indicators, and further to evaluate accident situations in China provinces. Finally, the features of accident situations are explored and analyzed from a multi-dimensional perspective. The findings show that the improved principal component analysis can retain more dispersion degree information of the original data. Meanwhile, three principal components including the accident frequency, trend, and severity were extracted to quantify the accident situation, and a hierarchical indicator system for the comprehensive evaluation of the accident situation was constructed to deeper understand multi-dimensional characteristics of China's accident situations. Furthermore, there exist great regional differences of accident situations in Chinese provinces. From the overall perspective, the accident situation shows a declining trend from the western backward region to the highly developed eastern coastal region. This study provides a multi-dimensional perspective for the government to formulate safety regulations and improve the accident situation.

Evolución de los accidentes e incidentes en montaña en el País Vasco: 1996-2016 / Changes in mountain accidents and incidents in the Basque Country: 1996-2016

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Unintentional injury mortality among children under age five in urban and rural areas in the Sichuan province of west China, 2009-2017.

This study analysed trends in the unintentional injuries specific mortality rates among children under age five (UI-specific U5MRs) in urban and rural areas in the Sichuan province of western China. Data were obtained from the National Health Statistics Survey System. The Cochran-Armitage trend test was used to analyse the trends in UI-specific U5MRs and the proportion of unintentional injury deaths to total deaths. The Poisson regression model was used to compare the UI-specific U5MRs between rural and urban areas. The overall UI-specific U5MRs decreased from 3.8 to 1.7 per 1,000 live births from 2009 to 2017, with an average annual decline in the rates of 8.78% and 10.05% in urban and rural areas, respectively. The UI risk of death in rural areas was approximately 1.95 times that in urban areas (95% CI: 1.73-2.18; p < 0.01). A total of 49.9% of all the children in the study did not receive any treatment before death caused by UI. The UI-specific U5MRs significantly declined in Sichuan province from 2009 to 2017, but large disparities in UI-specific U5MRs in urban and rural areas still exist. Reducing the U5MRs due to UI should be a major public health concern in western China.

Psychoactive substances in natural and unnatural deaths in Norway and Sweden - a study on victims of suicide and accidents compared with natural deaths in psychiatric patients.

BACKGROUND: The extent of post-mortem detection of specific psychoactive drugs may differ between countries, and may greatly influence the national death register's classification of manner and cause of death. The main objective of the present study was to analyse the magnitude and pattern of post-mortem detection of various psychoactive substances by the manner of death (suicide, accidental, undetermined and natural death with a psychiatric diagnosis) in Norway and Sweden. METHODS: The Cause of Death Registers in Norway and Sweden provided data on 600 deaths in 2008 from each country, of which 200 were registered as suicides, 200 as accidents or undetermined manner of death and 200 as natural deaths in individuals with a diagnosis of mental disorder as the underlying cause of death. We examined death certificates and forensic reports including toxicological analyses. RESULTS: The detection of psychoactive substances was commonly reported in suicides (66 and 74% in Norway and Sweden respectively), accidents (85 and 66%), undetermined manner of deaths (80% in the Swedish dataset) and in natural deaths with a psychiatric diagnosis (50 and 53%). Ethanol was the most commonly reported substance in the three manners of death, except from opioids being more common in accidental deaths in the Norwegian dataset. In cases of suicide by poisoning, benzodiazepines and z-drugs were the most common substances in both countries. Heroin or morphine was the most commonly reported substance in cases of accidental death by poisoning in the Norwegian dataset, while other opioids dominated the Swedish dataset. Anti-depressants were found in 22% of the suicide cases in the Norwegian dataset and in 29% of suicide cases in the Swedish dataset. CONCLUSIONS: Psychoactive substances were detected in 66 and 74% of suicides and in 85 and 66% of accidental deaths in the Norwegian and Swedish datasets, respectively. Apart from a higher detection rate of heroin in deaths by accident in Norway than in Sweden, the pattern of detected psychoactive substances was similar in the two countries. Assessment of a suicidal motive may be hampered by the common use of psychoactive substances in suicide victims.

Time of Injury and Relation to Alcohol Intoxication in Moderate-to-Severe Traumatic Brain Injury: A Decade-Long Prospective Study.

BACKGROUND: Knowledge about the causes and time of injury for traumatic brain injury (TBI) is important for the development of efficient prevention policies. We aimed to study time of injury and relation to alcohol intoxication for moderate-to-severe TBI in a level 1 trauma center in Norway. METHODS: From October 2004 to September 2014, 493 consecutive patients (≥16 years) with moderate (Glasgow Coma Scale [GCS] score 9-13) and severe TBI (GCS score 3-8) were prospectively included in the Trondheim TBI Study (222 patients with moderate and 270 patients with severe TBI). RESULTS: Mean age was 47 years (standard deviation 21 years). Positive blood alcohol concentration (BAC) was found in 29%, and median BAC was 41.5 mmol/L (interquartile range 28.7-54.3), equal to 1.91‰. Admissions were more frequent on Saturdays (relative risk [RR] 2.67, 95% confidence interval [CI] 1.87-3.80) and Sundays (RR 2.10, 95% CI 1.45-3.03) compared with Mondays, and positive BAC was more common on weekends than weekdays (43% vs. 16%). Furthermore, admissions were more frequent in June (RR 2.26, 95% CI 1.44-3.55), July (RR 2.07, 95% CI 1.31-3.28), and December (RR 2.07, 95% CI 1.31-3.28) compared with January. The number of patients with positive BAC was greatest in December (RR 5.75, 95% CI 1.99-16.63), and 70% of these were caused by falls. CONCLUSIONS: Our findings demonstrate that moderate-to-severe TBI admissions display a clear weekly and seasonal variation and that alcohol is an important modifiable risk factor for moderate-to-severe TBI.

Medical marijuana laws and workplace fatalities in the United States.

AIMS: The aim of this research was to determine the association between legalizing medical marijuana and workplace fatalities. DESIGN: Repeated cross-sectional data on workplace fatalities at the state-year level were analyzed using a multivariate Poisson regression. SETTING: To date, 29 states and the District of Columbia have legalized the use of marijuana for medicinal purposes. Although there is increasing concern that legalizing medical marijuana will make workplaces more dangerous, little is known about the relationship between medical marijuana laws (MMLs) and workplace fatalities. PARTICIPANTS: All 50 states and the District of Columbia for the period 1992-2015. MEASUREMENTS: Workplace fatalities by state and year were obtained from the Bureau of Labor Statistics. Regression models were adjusted for state demographics, the unemployment rate, state fixed effects, and year fixed effects. FINDINGS: Legalizing medical marijuana was associated with a 19.5% reduction in the expected number of workplace fatalities among workers aged 25-44 (incident rate ratio [IRR], 0.805; 95% CI, .662-.979). The association between legalizing medical marijuana and workplace fatalities among workers aged 16-24, although negative, was not statistically significant at conventional levels. The association between legalizing medical marijuana and workplace fatalities among workers aged 25-44 grew stronger over time. Five years after coming into effect, MMLs were associated with a 33.7% reduction in the expected number of workplace fatalities (IRR, 0.663; 95% CI, .482-.912). MMLs that listed pain as a qualifying condition or allowed collective cultivation were associated with larger reductions in fatalities among workers aged 25-44 than those that did not. CONCLUSIONS: The results provide evidence that legalizing medical marijuana improved workplace safety for workers aged 25-44. Further investigation is required to determine whether this result is attributable to reductions in the consumption of alcohol and other substances that impair cognitive function, memory, and motor skills.

An interprovincial comparison of unintentional childhood injury rates in Canada for the period 2006-2012.

OBJECTIVES: To perform an interprovincial comparison of unintentional population-based injury hospitalization and death rates for Canadian children ages 0-19 years and compare trends between 2006 and 2012. METHODS: Annual population-based hospitalization rates per 100,000 from unintentional injuries were calculated for children/youth (< 19 years) using data from the Discharge Abstract Database between 2006 and 2012. Annual mortality rates were analyzed using provincial coronial data. The mean annual change in the rate of hospitalizations due to unintentional injuries was reported for each province. RESULTS: The average annual rate of hospital admissions for unintentional injuries was 305.10 per 100,000 population between 2006 and 2012, and this decreased by - 11.91 over time (p < 0.01, - 15.85; - 7.77). Saskatchewan had the highest average annual morbidity rate (550.76 per 100,000) from all unintentional causes, and Ontario had the lowest average annual rate (238.89 per 100,000). Saskatchewan had the highest average annual rate for all subcauses except for drowning. Ontario was the only province with an average annual injury morbidity rate that was consistently below the Canadian average. The average annual mortality rate from all unintentional injury was highest in Saskatchewan (17.51 per 100,000) and lowest in Ontario (5.99 per 100,000) when compared to Canada (7.97 per 100,000). CONCLUSION: Injury prevention policies vary considerably among provinces. Although the unintentional injury hospitalization rate is decreasing over time, some subcauses such as choking/suffocation have shown an increase in certain provinces. Evidence-based childhood injury prevention policies, such as playground equipment safety and four-sided pool fencing among others, should be standardized across Canada.

An analysis of international traveller deaths at the Cliffs of Moher in Ireland, 1993-2017.

Background: Traumatic deaths, and more particularly suicides, during international travel receive a disproportionately low level of attention in the travel medicine literature. We describe the demographic profile of international travellers whose death occurred at the Cliffs of Moher along the Atlantic seaboard in Ireland. Methods: Coroners' files for the 25 years between 1993 and 2017 were interrogated. All cases of death on or at the cliffs were examined, and demographic data were extracted, including date of death, gender, age, nationality, whether the victims were alone at the cliffs prior to their death, whether the fall was witnessed, prevailing weather conditions, post-mortem examinations, toxicology reports and inquest verdicts. Results: Overall, 66 deaths occurred on or at the base of the Cliffs of Moher during the period 1993 through August 2017. In total, 18 (27.3%) of the victims were international visitors to Ireland, including 11 males (61.1%). The mean age of travellers (n = 17) was 34.2 years. Victims were nationals of 12 different countries, with 13 being European nationals. Most deaths occurred in summer (n = 7) or spring (n = 6), with eight deaths (44%) reported at weekends. In total, 15 victims (83.3%) had walked along the cliff path alone. A jump or fall from the cliffs was witnessed in only two cases (11.1%). Post-mortem examinations revealed multiple traumatic injuries consistent with a fall from a height. Four cases had evidence of alcohol intoxication. Suicide or open verdicts were returned in 50% (n = 9) of the cases. Conclusions: Travelling alone to the site, purchasing one-way tickets, or depositing belongings on the clifftop support the possibility of suicidal intent, while being intoxicated could be a co-factor in suicidal jumps or support the possibility of an accidental fall. This knowledge could help to identify travellers at the greatest risk of death at cliffs.

Bereaved families are still embittered after the Sewol ferry accident in Korea: A follow-up study 18 and 30months after the disaster.

INTRODUCTION: The Sewol ferry accident that occurred in April 2014 was one of the most tragic human-made disasters in Korean history. Due to the deaths of hundreds of children, bereaved families likely feel embittered; however, there is little extant research documenting embitterment among those who experienced the disaster. Consequently, we investigated bereaved family members' embitterment and other psychiatric symptoms 18months and 30months after the disaster. METHODS: Data from a cross-sectional survey were obtained 18months (Time 1) and 30months (Time 2) after the disaster. We ascertained socio-demographic variables and variables obtained from a self-reporting questionnaire (i.e., depression, anxiety, posttraumatic stress disorder, complicated grief, and embitterment) among 56 bereaved family members. RESULTS: Bereaved families showed substantial embitterment at Time 1 (64.3%), which increased at Time 2 (76.8%, t=1.761, p=0.084). The participants who displayed increased embitterment at Time 2 also increased in anxiety, post-traumatic stress symptoms, and complicated grief (but not depression). Furthermore, participants who displayed decreased embitterment at Time 2 also decreased in all other psychiatric symptoms. (time×group interaction in depression (F 0.644, p=0.426), anxiety (F 4.970, p=0.030), PTSD (F 10.699, p=0.002), and complicated grief (F 8.389, p=0.005)). CONCLUSIONS: Embitterment of bereaved families had not ceased after 18months and even increased 1year later. Additionally, as embitterment increased, many other psychiatric symptoms also increased, and vice versa. Our results suggest that embitterment is associated or can even influence other psychiatric symptoms; therefore, embitterment should be examined after disasters.

Evaluation of types of poisoning exposure calls managed by the Malaysia National Poison Centre (2006-2015): A retrospective review.

OBJECTIVE: Accidental or intentional poisoning is a public health concern requiring intervention. The current study designs to evaluate the types of poisoning exposure calls received by the Malaysia National Poison Centre (NPC) over a 10-year period. SETTINGS AND DATA SOURCES: The poisoning enquiries database (2006-2015) from the Malaysia NPC was used for the analysis. PARTICIPANTS: The NPC records all telephone calls that it manages using a validated and standardised form. Demographics and types of the poisoning exposure calls were extracted and descriptive analysis was applied. PRIMARY AND SECONDARY OUTCOMES: The primary outcome of this study is to evaluate NPC data for trends in the poisoning exposure calls based on the types and modes of poisoning over a 10-year period. The secondary outcome is to evaluate the characteristics of human exposure cases based on the calls received by the NPC. RESULTS: There was a notable increase in the number of poisoning exposure calls noticed during the 10-year period but dropped significantly in 2012. The highest number of poisoning exposure calls came from Selangor (21.0%), Perak (18.0%) and Negeri Sembilan (9.8%). More than half of the exposure was intentional (53.8%) involving more women (50.3%) as compared with men (41.9%), and in the 20-29 years age group category (33.5%). Exposure mostly occurred at home (96%) through the ingestion route (94.1%). Pharmaceutical products (40.5%), pesticides (31.7%) and household products (20.1%) were the common agents implicated for intentional exposure. CONCLUSIONS: There is an increasing trend in enquiries on poisoning exposure calls made to the NPC. Most of the intentional poisoning exposures occurred among younger women and involved pharmaceuticals, pesticides or household products. Poisoning safety education and other interventions are needed to curb poisoning incidents.

Prévalence des accidents d'exposition au sang et facteurs associés chez les professionnels de santé à l'hôpital de zone de Menontin, Bénin

Introduction: Les accidents d'exposition au sang (AES) constituent une réelle préoccupation pour les professionnels de santé à cause de la gravité des affections qu'ils engendrent. La présente étude a été menée pour évaluer la fréquence des accidents d'exposition au sang (AES) au sein du personnel de l'hôpital de zone de Mènontin et les facteurs qui lui sont associés. Méthode d'étude : Enquête descriptive transversale et analytique incluant 90 agents de santé. Le recueil des données a été fait sur la base d'un questionnaire anonyme et de deux grilles d'observation. Le questionnaire a été remis à chaque agent de santé volontaire après explication des objectifs de l'étude. Une visite de tous les services a été réalisée pour compléter les grilles d'observation. Résultats : L'âge moyen de notre échantillonnage est de 37 ans ± 10. Les femmes ont représentées dans 70% de notre échantillonnage et le sexe ratio est de 0,42.Les infirmiers (32,2%), les techniciens de laboratoire (25,56%) et les aidessoignants (16,7%) étaient les classes professionnelles plus représentées. La fréquence des AES chez les professionnels de santé à l'hôpital de zone de Mènontin est de 40%. Les types d'AES les plus fréquents sont les piqures (44,4%), les projections sur muqueuse (25%) et les coupures (16,7%).le sang a été impliqué dans 86,11% des cas. Les mécanismes de survenue des AES répertoriés étaient essentiellement le recapuchonnage (66,7%) et l'élimination de déchets (25%). L'absence de formation sur les AES et de port de gants influence significativement la survenue des AES. Les AES n'ont pas été déclarés dans 66,7% des cas. Les mesures de prévention et de prise en charge des AES sont inexistantes au sein de l'hôpital de zone de Mènontin. Conclusion : Des séances de sensibilisation du personnel sur les risques liés aux AES s'imposent en vue de leur prévention

Lessons Learnt from Past Incidents and Accidents in Radiation Oncology.

The purpose of this report is to review and compile what have been and can be learnt from incidents and accidents in radiation oncology, especially in external beam and brachytherapy. Some major accidents from the last 20 years will be discussed. The relationship between major events and minor or so-called near misses is mentioned, leading to the next topic of exploring the knowledge hidden among them. The main lessons learnt from the discussion here and elsewhere are that a well-functioning and safe radiotherapy department should help staff to work with awareness and alertness and that documentation and procedures should be in place and known by everyone. It also requires that trained and educated staff with the required competences are in place and, finally, functions and responsibilities are defined and well known.

Unintentional and self-poisoning mortalities in Mexico, 2000-2012.

INTRODUCTION: Poisoning remains a major worldwide public health problem. Mortality varies by country, region and ethnicity. The objective of this study is to analyze recent trends in poisoning mortality in the Mexican population. METHODS: Data regarding mortality induced by poisoning was obtained from a publicly available national database maintained by the National Institute of Statistics and Geography. RESULTS: During the period from 2000 to 2012, average mortality rates for unintentional and self-poisoning were 1.09 and 0.41 per 100000 population, respectively. The highest mortality rate for unintentional poisoning was in older individuals of both genders while the highest mortality for self-poisoning was in older men and young women. Additional studies are needed in Mexico, especially those that analyze risk factors in older individuals and young women.

[Epidemiological data of Hungarian skiers' and snowboarders' medical problems]. / A magyar alpesi sízok és hódeszkázók egészségkárosodásainak összehasonlító statisztikai elemzése.

INTRODUCTION AND AIM: There are no high mountains or any advantageous circumstances for winter sports in Hungary, yet within the 10 million population there are about half a million people (the exact number is 550,000) who tend to go for skiing or snowboarding abroad. Authors compared the injury statistical data with results described in the international literature in order to develop conclusions about the differences in the injury patterns and frequency between the Hungarian ones' and those found in countries with plenty of winter sport possibilities. METHOD: Authors analysed the winter sport injury cases of an insurance company. All the injury happened abroad and the assistance provider of the insurance company has managed the patient treatment and repatriation. Three winter seasons (12 months) data was analysed from the point of view of injuries frequency at different body parts and areas. Due to the fact that only limited information was available a simple statistical method was applied. RESULTS: Of 222 cases 90.5% were ski-related injury and 8.6% were snowboard injury. As for the skiers, the upper limb injuries accounted for 21.9%, the truncal region for 24.4% and the lower limb for 55.8%. Among snowboarders the upper limb injuries accounted for 36.9%, the truncal region for 37% and the lower limb for 26.1%. The most frequent was the knee (36.8%), the wrist (12.4) and the shoulder (11.4) injury. Skier's thumb injury was only 1.5%. The most common snowboard injury was the wrist trauma (31.6%), the head/neck/face was accounted 15.8% of all the injuries. And the ankle was injured in 10.5% of all the cases. The head/neck and the knee injury often combined with injuries of some other body part. 29 patients (13%) had to be repatriated, the most frequent reason for the repatriation was the injury of the lower limb. CONCLUSIONS: The Hungarian sportsmen's injury patterns do not always follow data described in the international literature, but they correspond to data of countries with similar geographical situation. The injury rate of knee and of the shoulder displays same data, the injury rate of the wrist was more frequent than in the international data, and this is true both for skiers and the snowboarders. The Hungarians' injury of the truncal region (mainly the head) was more frequent, but on the other hand the general injury rate of other body parts proved to be a lower number. It seems that the frequent use of the protective equipment and the preventive measures applied by the Hungarians are mirrored in the lower injury figures. Orv. Hetil., 2017, 158(16), 618-624.