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1.
Epidemiol Infect ; 148: e223, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32958089

RESUMO

The coronavirus disease (COVID-19), while mild in most cases, has nevertheless caused significant mortality. The measures adopted in most countries to contain it have led to colossal social and economic disruptions, which will impact the medium- and long-term health outcomes for many communities. In this paper, we deliberate on the reality and facts surrounding the disease. For comparison, we present data from past pandemics, some of which claimed more lives than COVID-19. Mortality data on road traffic crashes and other non-communicable diseases, which cause more deaths each year than COVID-19 has so far, is also provided. The indirect, serious health and social effects are briefly discussed. We also deliberate on how misinformation, confusion stemming from contrasting expert statements, and lack of international coordination may have influenced the public perception of the illness and increased fear and uncertainty. With pandemics and similar problems likely to re-occur, we call for evidence-based decisions, the restoration of responsible journalism and communication built on a solid scientific foundation.


Assuntos
Infecções por Coronavirus/epidemiologia , Recessão Econômica , Saúde Mental , Pneumonia Viral/epidemiologia , Saúde Pública , Acidentes de Trânsito/mortalidade , Betacoronavirus , Comunicação , Infecções por Coronavirus/mortalidade , Surtos de Doenças , Humanos , Influenza Pandêmica, 1918-1919/mortalidade , Pandemias , Pneumonia Viral/mortalidade , Risco , Distância Social
2.
Rev Bras Epidemiol ; 23 Suppl 1: e200010.SUPL.1, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32638989

RESUMO

OBJECTIVE: To analyze the spatial distribution of female mortality due to motorcycle accidents in Brazilian municipalities between 2005 and 2015, as well as the variation in rates in the same period. METHODS: Female mortality rates for the years 2005, 2010 and 2015 were estimated considering a three-year moving average around the base year, standardized by the direct method. Rates were standardized using the same pattern (Brazilian females in 2010) for each year. Then, the empirical Bayes estimator was used to reduce the effect of the random fluctuation. The percentage variation of the standardized rates was also analyzed for different population sizes (less than ten thousand, less than 50 thousand, more than 100 thousand and more than one million inhabitants). RESULTS: Bayesian rates showed a clear increase in female mortality due to motorcycle accidents, especially in the North, Northeast and Midwest regions. In the municipalities of the South and Southeast regions, mainly in the period between 2010 and 2015, there was an apparent decrease in mortality. The percentage variation showed a reduction in the indicator analyzed in the period between 2010 and 2015 for the largest municipalities in the South and Southeast regions. For almost all regions and population sizes, the period between 2010 and 2015 showed a deceleration in the growth of rates. CONCLUSION: The analysis clearly shows concentrations of municipalities with higher mortality, while also showing that the phenomenon has spread to a greater number of municipalities. The studied period allows the identification of different dynamics in female mortality, in a period of significant variation in mortality due to motorcycle accidents.


Assuntos
Acidentes de Trânsito/mortalidade , Motocicletas , Teorema de Bayes , Brasil/epidemiologia , Cidades/epidemiologia , Feminino , Humanos , Densidade Demográfica
3.
Chin J Traumatol ; 23(4): 219-223, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32669222

RESUMO

PURPOSE: Motorcycle accident is a major cause of road traffic injuries and the motorcyclists are considered as vulnerable road users. The present study aimed to determine the epidemiological characteristics of fatal motorcycle crashes in Iran. METHODS: In this cross-sectional study, a total of 28,356 motorcycle traffic fatalities registered in the Legal Medicine Organization of Iran were analyzed during the period between March 2011 and March 2017. The examined variables included demographic characteristics, helmet use, crash mechanisms, crash location, position state, type of counterpart vehicle, cause of death and place of death. In the study, road traffic mortalities involving drivers and/or passenger of motorcycles were included. Cases or events registered without these conditions were excluded from the study. To analyse the data, SPSS statistics 25 and GraphPad Prism 8 softwares were used. RESULTS: Of the 122,682 fatal traffic injury cases, 28,356 (23.1%) were motorcycle users, of whom 95.3% were male and 4.7% were female. Most of the motorcycle fatalities belonged to the age group of 18-24 years (29.1%). Head trauma was the major cause of death (59.0%). Also, the overall proportion of safety helmet use among motorcycle crash victims was estimated at 37.4%. Most of the road traffic crash cases (46.8%) happened out of city and half of people (49.9%) died in hospital. About 77.4% of the victims were motorcycle riders and 21.1% were pillion passengers. The highest rate of mortality belonged to the self-employed (38.4%) and then workers (21.8%) and students (10.2%). In addition, most fatalities occurred in people with low education (77.5%) and the least occurred in university graduates (5.5%). Among 31 provinces of Iran, Fars had the highest (9.3%) occurrence rate and Kohgiluyeh and Buyer-Ahmad had the lowest (0.5%). Most of the crash mechanisms were due to motorcycle-vehicle crashes (80.2%), followed by rollover (9.8%). CONCLUSION: Comprehensive public education and special rules are needed to reduce the rate of deaths in motorcycle crashes.


Assuntos
Lesões Acidentais/epidemiologia , Lesões Acidentais/mortalidade , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Motocicletas , Lesões Acidentais/prevenção & controle , Acidentes de Trânsito/prevenção & controle , Adolescente , Adulto , Criança , Estudos Transversais , Escolaridade , Feminino , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Educação em Saúde , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Adulto Jovem
4.
Medicine (Baltimore) ; 99(23): e20520, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32502002

RESUMO

The objective of this study is to describe the epidemiology and causes of traumatic cardiac arrest (TCA) in Kuwait aiming to provide a preliminary background to update the current guidelines and improve patients' management.This is a retrospective analysis of TCA cases retrieved from emergency medical services archived data between 1 January and 31 December 2017. The TCA cases were sub-grouped based on mechanism of injury then compared in terms of patient demographics, vital signs, patterns of injuries, resuscitation practices, and outcomes.Outcomes; On scene mortality rate and pre-hospital return of spontaneous circulation.Among the 204 TCA patients, 140 patients met the inclusion criteria. This whole group was then divided in to 4 subgroups: road traffic accident (RTA) 76% (n=106), fall from height (FFH) 13% (n = 18), slip/fall 4% (n = 6), and assaults 7% (n = 10). There was significant difference between the four mechanisms in: mean age (P =  < .001), type of injury (P = .005), head injury (P = .005), chest injury (P = .003), GCS score < 9 (P = .004) and initial hypertension (P =  < .001). Initial hypertension and GCS score < 9 were only documented in head injuries of RTA and slip/fall groups. Significant difference was also seen in cardiopulmonary resuscitation (P = .006), airway management (P = .035) and on scene mortality rate (P = .003). All patients who had isolated head injury in FFH were pronounced dead on scene, 60%.Not all TCA incidents are the same, there are different pattern of injuries in each TCA mechanism. Head injuries are predominantly seen in RTA, FFH, slip /falls and chest injuries are seen in assaults. This can influence emergency medical services personals resuscitation plan. Further research is required to address the resuscitation of TCA of different mechanisms.


Assuntos
Parada Cardíaca/etiologia , Traumatismos Torácicos/complicações , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Adulto , Distribuição de Qui-Quadrado , Feminino , Parada Cardíaca/epidemiologia , Parada Cardíaca/mortalidade , Humanos , Escala de Gravidade do Ferimento , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Sistema de Registros/estatística & dados numéricos , Estudos Retrospectivos , Traumatismos Torácicos/epidemiologia
5.
Accid Anal Prev ; 143: 105594, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32474168

RESUMO

BACKGROUND: Alcohol-involved riders tend to engage in other risk-taking behaviours such as un-helmeted riding which could further increases injury severity. The combined effect of alcohol-involved and un-helmeted riding on fatal injuries is rarely investigated. This study investigated the interaction effect between blood alcohol concentration and helmet use on fatal injuries. METHODS: This study used the National Taiwan Traffic Crash Dataset for the period from 2011 to 2015. Data on road crashes involving a motorcycle and an automobile were extracted and analysed. Multiple logistic regression models were used to calculate the adjusted odds ratio (AOR). We calculated an interaction effect for blood alcohol concentration and helmet use based on STROBE guidelines. RESULTS: There were a total of 669,292 motorcyclist casualties; among these casualties, 3459 (0.5 %) motorcyclists sustained fatal injuries. Alcohol-involved riders were 9.47 times (AOR = 9.47; 95 % CI = 8.75-10.25) more likely than sober ones to sustain fatal injuries. Alcohol-involved and un-helmeted riders were approximately 18 times (AOR = 18.1; CI: 15.9-20.4) more likely to sustain fatal injuries than sober and helmeted riders. Riders involved in head-on crashes and approach-turn motorcycle crashes had an increased probability of sustaining fatal injuries by 240 % (AOR = 3.4; 95 % CI = 2.91-4.09) and 132 % (AOR = 2.3; 95 % CI = 2.016-2.67), respectively. CONCLUSIONS: This study found that alcohol-involved riding acts synergistically with un-helmeted riding to increase motorcyclist injury severity.


Assuntos
Acidentes de Trânsito/mortalidade , Dirigir sob a Influência/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Fatores de Risco , Assunção de Riscos , Taiwan/epidemiologia
6.
Accid Anal Prev ; 143: 105582, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32480018

RESUMO

Crash data, from the state of Kentucky, for the 2015-2016 period, show that per capita crash rates and increases in crash-related fatalities were higher than the national average. In an effort to explain why the U.S. Southeast experiences higher crash rates than other regions of the country, previous research has argued the regions unique socioeconomic conditions provide a compelling explanation. Taking this observation as a starting point, this study examines the relationship between highway safety and socioeconomic and demographic characteristics, using an extensive crash dataset from Kentucky. Its focus is single- and two-unit crashes that involve commercial motor vehicles (CMVs) and automobiles. Using binary logistic regression and the quasi-induced exposure technique to analyze data on the socioeconomic and demographic attributes of the zip codes in which drivers reside, factors are identified which can serve as indicators of crash occurrence. Variables such as income, education level, poverty level, employment, age, gender, and rurality of the driver's zip code influence the likelihood of a driver being at fault in a crash. Socioeconomic factors exert a similar influence on CMV and automobile crashes, irrespective of the number of vehicles involved. Research findings can be used to identify groups of drivers most likely to be involved in crashes and develop targeted and efficient safety programs.


Assuntos
Acidentes de Trânsito/mortalidade , Condução de Veículo/estatística & dados numéricos , Veículos Automotores , Adulto , Condução de Veículo/psicologia , Feminino , Humanos , Kentucky/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados Unidos
7.
Tunis Med ; 98(5): 355-362, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32548838

RESUMO

OBJECTIVE: To study the burden of Road Traffic Accidents (RTA) in the Maghreb and its evolution during the period 1990 to 2017. METHODS: We described the RTA in the Maghreb region, while analyzing database provided by the Institute for Health Metrics and Evaluation (IHME) for the period1990-2017. RESULTS: The age-standardized incidence rate of RTA has decreased overall across the Maghreb; it went from 719.57/100000 inhabitants in 1990 to 609.49 per 100,000 inhabitants in 2017. In 2017, the highest mortality rate in the region was noted in Tunisia and it was 30.15 / 100,000 inhabitants (CI95% = 24.05-37.08). The highest and lowest standardized rates for disability adjusted life years or DALYs were observed respectively in Tunisia: 1,311.56 per 100,000 inhabitants (CI95%=1,065.28-1588.68) and in Algeria: 962.68 per 100,000 inhabitants (CI95%=789.50- 1460.12). CONCLUSION: The burden of disease from road accidents is high in the Maghreb countries and the downward trend in the incidence of these accidents is relatively low. These results should encourage decision-makers to elaborate an integrated and multisectorial strategy to improve the situation.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Acidentes de Trânsito/tendências , Acidentes de Trânsito/história , Acidentes de Trânsito/mortalidade , Adolescente , Adulto , África do Norte/epidemiologia , Idoso , Argélia/epidemiologia , Pessoas com Deficiência/estatística & dados numéricos , Feminino , História do Século XX , História do Século XXI , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Morbidade , Anos de Vida Ajustados por Qualidade de Vida , Tunísia/epidemiologia , Adulto Jovem
8.
Soud Lek ; 65(2): 22-26, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32493019

RESUMO

From the National Registry of autopsies and toxicology examinations, we selected the deceased for 2015, 2016, 2017 and January 2018 active road accident participants, i.e. pedestrians, cyclists and motor vehicle drivers. From these, we further selected those who were tested for THC presence. Of the 836 deceased active road accident participants, only 251 (i.e. 30%) were tested for cannabinoids, most often passenger car drivers, 46 percent. Of the 251 people tested, THC was demonstrated in 12 (4.8%), most commonly motorcycle drivers (7.8%) and passenger car drivers (3.4%). Of the 12 positive people, 7 were found to have a possible effect of THC ingestion on the road accident, but only one participant was found to have overdosed on THC, and 2 were reported by the dissecting physician to have had no effect on the accident. In the Czech Republic, when driving under the influence of addictive substances, there is no uniform procedure for qualification, whether it is an offence or an offence, and thus in the award of punishment. While somewhere there is an effort to divide this wrongdoing into offences and crimes, elsewhere it practically always only constitutes an offense. This situation seeks to resolve the instruction of the Attorney-at-chief 1 SL 732/2018 of 29 December 4.2019, which, however, arose without any discussion with the professional public, which is heavily criticized especially for the absurly high limits, which in particular in morphine and cocaine are practically unachievable. At the time of this writing, the impact of this guideline on practice is not clear.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Acidentes de Trânsito/mortalidade , República Tcheca/epidemiologia , Dronabinol , Humanos , Motocicletas
11.
Lancet Glob Health ; 8(6): e819-e828, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32446347

RESUMO

BACKGROUND: The Sustainable Development Goals (SDGs), which aim to halve global traffic deaths by 2020, will not be met by most low-income and middle-income countries (LMICs). In Latin America and the Caribbean (LAC) region, traffic deaths have remained stable at a high-level despite strong progress in other health domains. We evaluated the effects of road safety interventions in LAC and estimated the benefits that vehicle design improvements would have in this region. METHODS: In our study done in October, 2018, we used a counterfactual analysis to assess the reduction in deaths and disability-adjusted life years (DALYs) lost if eight proven vehicle safety technologies were made more widely available in LAC countries. We estimated: (1) country-level incidence of traffic injuries, (2) the effectiveness of technologies through a systematic literature review, (3) the prevalence of car safety technologies, and (4) the lives saved and DALYs averted if all cars had these technologies. We characterised uncertainty in estimates by reporting the sensitivity of the results to alternative modelling assumptions. FINDINGS: Increasing availability of electronic stability control, which includes antilock-brake systems, would have the largest benefits in the LAC region, estimated at 19·4% (sensitivity analysis range 8·6-31·1) fewer deaths and 17·0% (5·7-29·2) fewer DALYs. Increasing use of seatbelts would reduce deaths by 12·1% (9·1-15·5) and DALYs by 12·6% (9·4-16·3). Optimisation for side-impacts would result in 6·3% (3·1-6·5) fewer deaths, and improvements to vehicle front-end design would result in 6·0% (2·2-10·4) fewer deaths. The overall effect of improved vehicle design in the region would be 28·1% (12·8-39·2) fewer deaths, and 29·1% (13·5-39·8) fewer DALYs. Other safety technologies modelled, including airbag (front and side), side door beam, and side structure and padding, have smaller benefits. INTERPRETATION: Regulating and encouraging the use of proven vehicle safety technologies in LMICs would have large gains and needs to be prioritised in the SDG agenda for 2030. FUNDING: Inter-American Development Bank.


Assuntos
Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Veículos Automotores/estatística & dados numéricos , Equipamentos de Proteção/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Pessoas com Deficiência/estatística & dados numéricos , Humanos , América Latina/epidemiologia , Modelos Estatísticos , Saúde Pública , Anos de Vida Ajustados por Qualidade de Vida , Desenvolvimento Sustentável
12.
Accid Anal Prev ; 143: 105513, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32470640

RESUMO

BACKGROUND: In May 2014, the Dominican Republic introduced the 911-emergency response system (ERS) in Santo Domingo. Before its introduction, more than 40 phone numbers were available to report emergencies. The objective of this work is to assess whether this new emergency response system was effective in reducing traffic fatalities. METHODS: Weekly numbers of traffic fatalities per population and per vehicle fleet from January 2013 to December 2015 were obtained from the Ministry of Health and the National Institute of Statistics. A hybrid time-series difference-in-difference analysis using multivariable negative binomial regression models were used to compare trends in rates of traffic fatalities in Santo Domingo to La Romana and Santiago, before and after the introduction of the 911-ERS. RESULTS: Estimates from negative binomial models suggest that the introduction of the 911-ERS in Santo Domingo relative to Santiago-La Romana was associated with a 17% reduction in the Incidence Rate Ratio (IRR) of traffic fatalities per 1 000 000 population (IRR = 0.83, 95% confidence interval [CI]: 0.67; 1.03) and with a 20% reduction in the IRR of weekly traffic fatalities per 1 000 000 vehicle fleet (IRR = 0.80, 95% CI:0.67; 0.99). DISCUSSION: Our findings suggest that transitioning from multiple to one unique emergency phone number should be considered more attentively. Furthermore, the case of the Dominican Republic calls for more theoretical and methodological research to understand how to assess these road safety policies more accurately. Since various studies suggest that 911-ERS mature in the long run, how these systems evolve over time and other related variables should be carefully considered.


Assuntos
Acidentes de Trânsito/prevenção & controle , Sistemas de Comunicação entre Serviços de Emergência/normas , Acidentes de Trânsito/mortalidade , República Dominicana/epidemiologia , Humanos , Modelos Estatísticos
13.
BMC Public Health ; 20(1): 624, 2020 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-32375719

RESUMO

BACKGROUND: In the globe, 1.3 million deaths and around 50 million non-fatal injuries were reported. From all deaths, 90% occur in developing countries. Ethiopia is considered as one of the worst countries in the globe where road traffic accident causes a lot of fatalities and injuries of road users every year. The main objective of the study was to identify the main predictors of fatal car accident. METHODS: The retrospective research design was applied. 255 records were taken from Finote Selam traffic police office, northwest part of Ethiopia from September 2009 to January 2018. The statistical analysis was performed by using SPSS version 23 software. Chi-square for association test and ordinal logistic regression for predictor identification were used. RESULTS: Age of drivers were the responsible causes of fatal road traffic accident (p-value = 0.033). The more experienced drivers decreased the occurrence of fatal traffic accidents. In addition, increasing vehicle service year reduced the occurrence of accidental death. Besides, the occurrence of fatal car accident in autumn season was 0.44 times less than that of in summer season. Additionally, drivers' educational level was played a crucial role in a road traffic accident. For instance, drivers whose educational level was below 12th grade were the most responsible factor for car accident deaths. What is more, it was seen that drivers who drove their vehicles could minimize the occurrence of fatal traffic accident (p-value = 0.010). CONCLUSION: In conclusion, fatal road traffic accidents happened due to drivers' lack of sufficient driving experience and low educational level. In addition, driving on weekends and driving on summer season were disclosed as responsible for fatal car accident. Moreover, drivers with younger age and those who drove a new vehicle likely caused fatal car accident. However, drivers who drive their vehicles seemed to be less responsible for fatal car accident than that of employed.


Assuntos
Acidentes de Trânsito/mortalidade , Condução de Veículo/estatística & dados numéricos , Automóveis/estatística & dados numéricos , Adolescente , Adulto , Cidades , Etiópia/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
14.
BMC Public Health ; 20(1): 722, 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32430028

RESUMO

BACKGROUND: Paediatric, pedestrian road traffic injuries (PPRTIs) constitute a major cause of premature death in Iran. Identification of high-risk areas would be the primary step in designing policy intervention for PPRTI reduction because environmental factors play a significant role in these events. The present study aims to determine high-risk areas for PPRTIs at three different geographical scales, including the grid network, the urban neighbourhood and the street levels in Mashhad, Iran during the period 2015-2019. METHODS: This cross-sectional retrospective study was based on all pedestrian accidents with motor vehicles involving children (less than 18 years of age) between March 2015 and March 2019 in the city of Mashhad, which is the second-most populous city in Iran. The Anselin Local Moran's I statistic and Getis-Ord Gi* were performed to measure spatial autocorrelation and hotspots of PPRTIs at the geographical grid network and neighbourhood level. Furthermore, a spatial buffer analysis was used to classify the streets according to their PPRTI rate. RESULTS: A total of 7390 PPRTIs (2364 females and 4974 males) were noted during the study period. The children's mean age was 9.7 ± 5.1 years. Out of the total PPRTIs, 43% occurred on or at the sides of the streets, 25 of which labelled high-risk streets. A high-high cluster of PPRTI was discovered in the eastern part of the city, while there was a low-low such cluster in the West. Additionally, in the western part of the city, older children were more likely to become injured, while in the north-eastern and south-eastern parts, younger children were more often the victims. CONCLUSIONS: Spatial analysis of PPRTIs in an urban area was carried out at three different geographical scales: the grid network, the neighbourhood and the street level. The resulting documentation contributes reliable support for the implementation and prioritization of preventive strategies, such as improvement of the high-risk streets and neighbourhoods of the city that should lead to decreasing numbers of PPRTIs.


Assuntos
Acidentes de Trânsito/mortalidade , Pedestres/estatística & dados numéricos , Ferimentos e Lesões/mortalidade , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Geografia , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Características de Residência , Estudos Retrospectivos , Análise Espacial , Ferimentos e Lesões/etiologia
15.
Accid Anal Prev ; 142: 105553, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32388143

RESUMO

Children that are unrestrained while travelling in a motor vehicle are more vulnerable to serious injury and death. The greatest levels of crash protection are achieved when children use the most age or size appropriate form of restraint. In this study, we aimed to examine the effectiveness of the introduction of age-appropriate child restraint legislation on serious and fatal injury in five Australian states and territories. For this interrupted time series analysis, we used a segmented regression method to assess the association between the implementation of child-restraint legislation and motor-vehicle related serious injuries and fatalities using data obtained from transport authorities in each jurisdiction. We estimated the change in annual rates after the implementation of legislation with the number of motor-vehicle accidents resulting in fatalities or serious injuries as the outcome, and the total number of injuries (minor, serious and fatal) as an offset in the model. We identified 10882 motor-vehicle related crashes resulting in fatalities (n = 188), serious injuries (n = 1730) and minor injuries (n = 8964). In NSW and VIC, the rate ratio was statistically significant and positive, indicating an increase in the rate of serious injuries and fatalities in the period post-legislation compared to the period prior to legislation. In all other states and territories, we did not find a statistically significant effect of legislation Road safety programs incorporating interventions targeted at increasing awareness of optimal restraint practices, strengthened enforcement and measures to improve the affordability of restraints are needed to support legislation.


Assuntos
Acidentes de Trânsito/mortalidade , Sistemas de Proteção para Crianças/estatística & dados numéricos , Veículos Automotores/legislação & jurisprudência , Ferimentos e Lesões/prevenção & controle , Austrália/epidemiologia , Criança , Sistemas de Proteção para Crianças/economia , Pré-Escolar , Feminino , Humanos , Análise de Séries Temporais Interrompida , Masculino , Ferimentos e Lesões/mortalidade
16.
Accid Anal Prev ; 142: 105576, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32417357

RESUMO

BACKGROUND: The use of an appropriate driving exposure measure is essential to calculate traffic crash rates and risks. Commonly used exposure measures include driving distance and the number of licensed drivers. These measures have some limitations, including the unavailability of disaggregated estimates for consecutive years, low data quality, and the failure to represent the driving population when the crash occurred. However, the length of driving time, available annually from the American Time Use Survey (ATUS), can be disaggregated by age, gender, time-of-day, and day-of week, and addresses the temporal discontinuity limitation of driving distance on the United States (U.S.) national scale. OBJECTIVES: The objective of this study is to determine if the length of driving time as a driving exposure measure is comparable to driving distance by comparing distance-based and time-based fatal crash risk ratios by driver age category, gender, time-of-day, and day-of-week. METHODS: The 2016-2017 National Household Travel Survey (NHTS) provided driving distance, and 2016-2017 Fatality Analysis Reporting System provided the number of drivers in fatal crashes. The distributions of driving distance and length of driving time by driver age category (16-24, 25-44, 45-64, and 65 years or older), gender, time-of-day, day-of-week were compared. Two negative binomial regression models were used to compute the distance-based and time-based fatal crash risk ratios. RESULTS: The distributions of driving-distance were not different from the length-of-driving-time distributions by driver age category, gender, time-of-day, and day-of-week. Driving distance and the length of driving time provide similar fatal crash risk ratio estimates. CONCLUSIONS: The length of driving time can be an alternative to driving distance as a measure of driving exposure. The primary advantage of driving time over driving distance is that, starting from 2003, the disaggregated estimates of the length of driving time are available from ATUS over consecutive years, curtailing the discontinuity limitation of driving distance. Furthermore, the length of driving time is related to drivers' perceived risks about their driving conditions and as a result, may be a better exposure measure than driving distance in comparing crash risks between drivers whose likelihood of traveling in hazardous driving conditions (e.g., nighttime) varies substantially.


Assuntos
Acidentes de Trânsito/mortalidade , Condução de Veículo/estatística & dados numéricos , Medição de Risco/métodos , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Razão de Chances , Fatores de Tempo , Viagem/estatística & dados numéricos , Estados Unidos , Adulto Jovem
19.
PLoS One ; 15(4): e0231182, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32302374

RESUMO

BACKGROUND: Road traffic law enforcement was implemented on 1st April 2011 (the first intervention) and traffic ticket fines have been increased on 1st March 2016 (the second intervention) in Iran. The aim of the current study was to evaluate the effects of the law enforcement on reduction in the incidence rate of road traffic fatality (IRRTF), the incidence rate of road traffic injuries (IRRTI) and the incidence rate of rural road traffic offenses (IRRRTO) in Iran. METHODS: Interrupted time series analysis was conducted to evaluate the impact of law enforcement and increased traffic tickets fines. Monthly data of fatality on urban, rural and local rural roads, injuries with respect to gender and traffic offenses namely speeding, illegal overtaking and tailgating were investigated separately for the period 2009-2016. RESULTS: Results showed a reduction in the incidence rate of total road traffic fatality (IRTRTF), the incidence rate of rural road traffic fatality (IRRRTF) and the incidence rate of urban road traffic fatality (IRURTF) by -21.44% (-39.3 to -3.59, 95% CI), -21.25% (-31.32 to -11.88, 95% CI) and -26.75% (-37.49 to -16, 95% CI) through the first intervention which resulted in 0.383, 0.255 and 0.222 decline in casualties per 100 000 population, respectively. Conversely, no reduction was found in the incidence rate of local rural road traffic fatality (IRLRRTF) and the IRRTI. Second intervention was found to only affect the IRURTF with -26.75% (-37.49 to -16, 95% CI) which led to 0.222 casualties per 100 000 population. In addition, a reduction effect was observed on the incidence rate of illegal overtaking (IRIO) and the incidence rate of speeding (IRS) with -42.8% (-57.39 to -28.22, 95% CI) and -10.54% (-21.05 to -0.03, 95% CI which implied a decrease of 415.85 and 1003.8 in monthly traffic offenses per 100 000 vehicles), respectively. CONCLUSION: Time series analysis suggests a decline in IRTRTF, IRRRTF, and IRURTF caused by the first intervention. However, the second intervention found to be only effective in IRURTF, IRIO, and IRS with the implication that future initiatives should be focused on modifying the implementation of the traffic interventions.


Assuntos
Condução de Veículo/legislação & jurisprudência , Aplicação da Lei , Políticas , População Rural/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Acidentes de Trânsito/economia , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/prevenção & controle , Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo/estatística & dados numéricos , Feminino , Humanos , Análise de Séries Temporais Interrompida , Irã (Geográfico)/epidemiologia , Masculino , Avaliação de Programas e Projetos de Saúde , Ferimentos e Lesões/etiologia , Ferimentos e Lesões/prevenção & controle
20.
J Nippon Med Sch ; 87(4): 220-226, 2020 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-32238730

RESUMO

INTRODUCTION: To increase survival rates of patients with severe trauma from road traffic accidents, Japan launched the D-Call Net (DCN) system, which utilizes advanced automatic collision notification technology to dispatch doctors by helicopter. The DCN system began in November 2015 and, as of October 2019, has dispatched doctors 4 times. CASES: Case 1-Canceled because trauma was mild. Case 2-Doctor made contact with 2 patients with moderate trauma 29 minutes earlier than would have occurred conventionally. This was the first case in the world to use automotive engineering data to dispatch a doctor to a patient. Case 3-An accident involving 3 severely injured patients activated DCN, enabling doctor-patient contact 20 minutes earlier than would have been possible conventionally. Case 4-DCN was ineffective. DISCUSSION: According to 2008 data from Chiba Prefecture, in accidents where victims sustain severe trauma, the interval from accident occurrence to hospital arrival was 67 minutes, even when doctors were dispatched by air ambulance (Doctor-Heli [DH]). Use of accident information for faster doctor dispatch effectively improved survival rates. An algorithm was developed to use accident information to assess trauma severity (severity probability). DCN dispatches doctors by using data, including information on accident site and severity probability, which are sent to smartphones of doctors, thereby reducing the interval from accident to DH request by approximately 17 minutes. DCN is the first system in the world to use automotive engineering information for faster doctor dispatch to traffic accident sites. The system is crucial for improving survival rates and mitigating the aftereffects of traffic accidents.


Assuntos
Acidentes de Trânsito , Resgate Aéreo , Aeronaves , Despacho de Emergência Médica/métodos , Serviços Médicos de Emergência/métodos , Acidentes de Trânsito/mortalidade , Humanos , Japão , Taxa de Sobrevida , Fatores de Tempo , Índices de Gravidade do Trauma
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