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1.
Neurology ; 95(12 Suppl 2): S11, 2020 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-33199570

RESUMO

OBJECTIVE: Evaluating the TBI incidence during the COVID-19 pandemic era compared with similar period in previous year. BACKGROUND: The emergence of SARS-CoV2 influenced the evolution of governmental and hospital policy worldwide, which might eventually impact many aspects. The incidence of many diseases in the Emergency Department (ED), especially traumatic brain injury (TBI), has been an area of interest. DESIGN/METHODS: Retrospective study comparing TBI incidence before and during COVID-19 pandemic era starting from the declaration of national pandemic date (March 16, 2020) until June 14, 2020 with the comparison of the same period in the previous year. RESULTS: There was an increase in admission rate due to TBI during COVID-19 pandemic compared with the previous year (157/752 (20.9%) vs 106/766 (13.8%), p < 0.001, respectively). While the range of age was similar between COVID-19 and non-COVID-19 era (37.9 ± 14.8 vs 38.6 ± 15.4 years, p = 0.712), male was higher in percentage to experience the injury (131/157 (83.4%) vs 67/106 (63.2%), p < 0.001). During the pandemic era, road traffic injury (97/157 (61.8%) vs 56/106 (52.8%), p = 0.149) as well as moderate-to-severe brain injury tended to increase (30/157 (19.1%) vs 17/106 (16.0%) p = 0.524) albeit statistically insignificant. Although the mortality rate was similar (12/157 (7.6%) vs 9/106 (8.5%), p = 0.804), higher hospitalization rate was observed in the pandemic era (81/157 (51.2%) vs 37/106 (34.9%) p = 0.008). CONCLUSIONS: TBI incidence remained increasing despite entering the COVID-19 era. These phenomena required further investigation and analysis that may possibly be unrelated with the COVID-19, but due to the change of the government policy and its impact, such as the more quiet road after national social distancing.


Assuntos
Lesões Encefálicas Traumáticas/epidemiologia , Serviço Hospitalar de Emergência , Hospitalização/tendências , Mortalidade/tendências , Acidentes de Trânsito/tendências , Adulto , Distribuição por Idade , Feminino , Humanos , Incidência , Indonésia/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Distribuição por Sexo , Índices de Gravidade do Trauma , Adulto Jovem
2.
Injury ; 51(12): 2811-2815, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32958345

RESUMO

INTRODUCTION: In Iran, like most other countries, COVID-19 has had a deep impact on children's lives. Our hypothesis was that, a significant change in the number of pediatric injuries has happened in trauma centers. In the current study, we intend to identify the possible epidemiological shift in pediatric fracture patterns, by comparing the data from 'COVID-19 era' and the mean data from the past 2 years. To the best of our knowledge there are only few reports on epidemiology of pediatric fractures during the COVID-19 outbreak. METHODS: Data are reported in two sections. In the descriptive section, epidemiological data regarding pediatric fractures referred to Taleghani tertiary trauma center, including demographics, distribution curves, etiologies and fracture types are presented during the 'COVID era', from 1 March 2020 to 15 April 2020. In the comparative section, the aforementioned data are compared with mean data from the past 2 years, the 'non-COVID era'. RESULTS: Altogether 117 of the 288 trauma children (40.62%) had a fractured bone (145 fractures). Patients were mostly boys, with a mean age of 9.87 years (SD=5.27). The three most common fracture types in children included distal radius, mid-forearm and humeral supracondylar fractures. Compared to non-COVID era, the number of pediatric trauma admissions dropped from 589 to 288. No significant change happened in the mean age, male/female ratio and percentage of motor vehicle accidents. Proportion of proximal humeral, proximal forearm, carpal, and hand fractures declined. The number of open fractures significantly dropped (from 12 to 2). CONCLUSIONS: In Iran, overall trend of pediatric trauma has been decreasing during the outbreak; but the lack of reduction in proportion of accidents may pose an alarm that an effective lock-down has not been imposed. This study has implications as to preparing appropriate resources particular to common "COVID era fractures".


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Controle de Doenças Transmissíveis/normas , Centros de Traumatologia/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Acidentes de Trânsito/tendências , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pandemias/prevenção & controle , Admissão do Paciente/estatística & dados numéricos , Estudos Retrospectivos , Fatores Sexuais , Centros de Traumatologia/normas , Centros de Traumatologia/tendências , Ferimentos e Lesões/etiologia
3.
Accid Anal Prev ; 144: 105670, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32652332

RESUMO

In 2011, a more severe drunk driving law was implemented in China, which criminalized driving under the influence of alcohol for the first time and increased penalties for drunk driving. The present study aimed to assess effectiveness of the drunk driving law in China in reducing traffic crashes, injuries, and mortality. Data used in this study was obtained from the Traffic Management Bureau of the Ministry of Public Security of the People's Republic of China. An interrupted time series analysis was conducted to analyze annual data from 2004 to 2017, including the number of road traffic crashes, deaths, and injuries caused by drunk driving in China. The average annual incidences of crashes, mortality, and injuries have decreased after the promulgation of drunk driving law in 2011. In the post-intervention period, the increased slope for crashes, mortality and injury rates were, respectively, -0.140 to -0.006, -0.052 to -0.005 and -0.150 to -0.008, indicating a weaker downward trend of dependent variables. The more stringent drunk driving law is not as effective as expected. Drunk driving is still a severe traffic safety problem to be addressed in China. Both legislation and other prevention programs should be adopted to reduce road traffic injuries caused by drunk driving in China.


Assuntos
Lesões Acidentais , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Acidentes de Trânsito/tendências , Dirigir sob a Influência/legislação & jurisprudência , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , China/epidemiologia , Direito Penal , Humanos , Incidência , Análise de Séries Temporais Interrompida
4.
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
5.
J Med Internet Res ; 22(5): e17129, 2020 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-32348273

RESUMO

BACKGROUND: Roadside observational studies play a fundamental role in designing evidence-informed strategies to address the pressing global health problem of road traffic injuries. Paper-based data collection has been the standard method for such studies, although digital methods are gaining popularity in all types of primary data collection. OBJECTIVE: This study aims to understand the reliability, productivity, and efficiency of paper vs digital data collection based on three different road user behaviors: helmet use, seatbelt use, and speeding. It also aims to understand the cost and time efficiency of each method and to evaluate potential trade-offs among reliability, productivity, and efficiency. METHODS: A total of 150 observational sessions were conducted simultaneously for each risk factor in Mumbai, India, across two rounds of data collection. We matched the simultaneous digital and paper observation periods by date, time, and location, and compared the reliability by subgroups and the productivity using Pearson correlations (r). We also conducted logistic regressions separately by method to understand how similar results of inferential analyses would be. The time to complete an observation and the time to obtain a complete dataset were also compared, as were the total costs in US dollars for fieldwork, data entry, management, and cleaning. RESULTS: Productivity was higher in paper than digital methods in each round for each risk factor. However, the sample sizes across both methods provided a precision of 0.7 percentage points or smaller. The gap between digital and paper data collection productivity narrowed across rounds, with correlations improving from r=0.27-0.49 to 0.89-0.96. Reliability in risk factor proportions was between 0.61 and 0.99, improving between the two rounds for each risk factor. The results of the logistic regressions were also largely comparable between the two methods. Differences in regression results were largely attributable to small sample sizes in some variable levels or random error in variables where the prevalence of the outcome was similar among variable levels. Although data collectors were able to complete an observation using paper more quickly, the digital dataset was available approximately 9 days sooner. Although fixed costs were higher for digital data collection, variable costs were much lower, resulting in a 7.73% (US $3011/38,947) lower overall cost. CONCLUSIONS: Our study did not face trade-offs among time efficiency, cost efficiency, statistical reliability, and descriptive comparability when deciding between digital and paper, as digital data collection proved equivalent or superior on these domains in the context of our project. As trade-offs among cost, timeliness, and comparability-and the relative importance of each-could be unique to every data collection project, researchers should carefully consider the questionnaire complexity, target sample size, implementation plan, cost and logistical constraints, and geographical contexts when making the decision between digital and paper.


Assuntos
Acidentes de Trânsito/tendências , Coleta de Dados/normas , Tecnologia da Informação/normas , Papel/normas , Eficiência , Humanos , Prevalência , Fatores de Risco , Inquéritos e Questionários , Telemedicina
7.
J Surg Res ; 249: 163-167, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31982548

RESUMO

BACKGROUND: Road traffic accidents constitute a significant public health burden in Nigeria. In this study, we aim to (1) characterize the temporal burden of road traffic injury (RTI) and mortality rates in Nigeria over a decade, (2) identify regional RTI incidence, mortality trends, and high-risk regions, and (3) assess the impact of state population on injury and mortality. MATERIALS AND METHODS: We retrospectively reviewed aggregate state-level RTI incidence and mortality counts reported by the Federal Road Safety Corps from January 2001 through December 2010. We also reviewed population data from the National Population Commission. In addition to national analyses, regional analyses were performed in Nigeria's six geopolitical zones and one Federal Capital Territory (FCT). Regression analysis was also performed to determine the relationship between population and RTI incidence and mortality. RESULTS: The national median RTI incidence and mortality rates declined by 53% and 75%, respectively, between 2001 and 2010. Analysis by geopolitical zone yielded the greatest increases for both injury and mortality in the FCT and the greatest decreases for both in the South-South region. The average geopolitical zone, apart from the FCT, experienced a 24% decrease in the incidence rate and a 69% decrease in the mortality rate. An analysis of variance, run to assess potential differences in RTI incidence and mortality rates by state population, yielded significant values of P = 0.0023 for injury and P = 0.0002 for mortality. CONCLUSIONS: Acknowledging the potential for underreporting, a more holistic surveillance approach would generate more accurate data for future policy creation to improve clinical outcomes.


Assuntos
Acidentes de Trânsito/tendências , Mortalidade/tendências , Ferimentos e Lesões/epidemiologia , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Geografia , Humanos , Incidência , Nigéria/epidemiologia , Estudos Retrospectivos , Ferimentos e Lesões/etiologia
8.
Cien Saude Colet ; 24(12): 4385-4394, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31778489

RESUMO

Economic crisis is often managed with austerity policies. These measures seem to burden the population disproportionately, with the poorer being more affected. This paper aims to investigate health outcomes performance after the recent Brazilian crisis and gauge whether that pattern also emerged. Public domain data from 2010 to 2017 was used, and it was found that suicide and homicide rates increased after 2014, while mortality by road traffic injuries decreased at the same time. Furthermore, these trends were exacerbated in the North and Northeast regions and in the municipalities with the poorest quintiles of Human Development Index (HDI). The austerity policies followed by the Brazilian economic crisis may have influenced the mortality trends due to external causes, with a possible stronger impact in the North and Northeast regions and among less developed municipalities.


Assuntos
Acidentes de Trânsito/mortalidade , Recessão Econômica , Homicídio/estatística & dados numéricos , Alocação de Recursos/economia , Suicídio/estatística & dados numéricos , Acidentes de Trânsito/tendências , Brasil/epidemiologia , Causas de Morte , Homicídio/tendências , Humanos , Mortalidade/tendências , Áreas de Pobreza , Análise de Regressão , Suicídio/tendências , Fatores de Tempo , Violência
10.
PLoS One ; 14(10): e0223646, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31589622

RESUMO

While road safety in the United States (U.S.) has been continually improving since the 1970's, there are indications that these improvements are becoming increasingly difficult to sustain. Strategic Highway Safety Plans (SHSPs) are prepared by States to guide road safety management, however assessing the appropriateness of these plans remains a significant challenge, especially for the future in which they are to be applied. This study developed a new methodology to assess SHSPs from the perspectives of comprehensive system-based safety management and relevant future issues that can be applied before SHSPs are implemented, thereby avoiding long periods after implementation before assessing the appropriateness of the plans. A rating scale was developed and applied to assess 48 U.S. SHSPs against two key criteria: 1. a comprehensive framework for road safety, and 2. the anticipated changing, difficult and unpredictable nature of future transport and its context. The analysis concluded that current SHSPs have good national oversight with several strengths but were weak in some areas of content and did not address future challenges. Improvements are suggested to strengthen the plans' thoroughness by being consistent with systems theory and practice, as well as ways that these SHSPs can be more resilient to future circumstances. Implementing the recommendations in this paper provides the opportunity to adopt a system-based safety management practice that has been successful in other hazardous industries. Doing so is expected to most efficiently and effectively continue the recent improvements to road safety, which is likely to be increasingly difficult otherwise.


Assuntos
Acidentes de Trânsito/prevenção & controle , Programas Governamentais/tendências , Gestão da Segurança/tendências , Acidentes de Trânsito/tendências , Automóveis/normas , Automóveis/estatística & dados numéricos , Programas Governamentais/métodos , Programas Governamentais/normas , Modelos Teóricos , Gestão da Segurança/métodos , Gestão da Segurança/normas , Estados Unidos
11.
Rev Fac Cien Med Univ Nac Cordoba ; 76(3): 142-147, 2019 08 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31465180

RESUMO

Introduction: The analysis of injuries caused by traffic from a physical and mathematical perspective can help improve road safety strategies. Objective: Predict the dynamics of traffic fatalities in the states of Maryland and Massachusetts for the years 2004 and 2014 in the context of probabilistic random walk. Methods: An analysis was made of the number of total fatalities caused by traffic per year, in the states of Maryland and Massachusetts between the years 1994-2003 and 1994-2013. The behavior of these values was analyzed as a probabilistic random walk; for this, the probabilistic lengths were found for each year, during the period studied and four probability spaces were analyzed, with which it was possible to analyze their behavior, to establish a prediction of the number of total fatalities caused by traffic for the years 2004 and 2014. Results: The predictions for the years 2014 and 2004 for Maryland and Massachusetts when compared with the real values, the percentage of success was 98%. Main conclusion: The predictions for the years 2014 and 2004 for Maryland and Massachusetts when compared with the real values, the percentage of success was 98%. Conclusions: the behavior of traffic fatalities in Maryland and Massachusetts presented a predictable self-organization from the context of probabilistic random walk, constituting a useful tool for analyzing the operation of road safety strategies.


Assuntos
Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/tendências , Humanos , Maryland/epidemiologia , Massachusetts/epidemiologia , Teoria da Probabilidade
12.
PLoS One ; 14(8): e0220785, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31398211

RESUMO

BACKGROUND: Perceived as a minor transportation mode mainly for recreation, cycling and its related safety issues have not been treated as a citywide concern in Hong Kong and have thus received inadequate research efforts. Our study aimed to illuminate the safety challenges faced by cyclists in Hong Kong. METHODS: We examined the police crash records from 1998 to 2017 and developed a Bayesian Poisson state space model to evaluate the longitudinal change in traffic injuries to cyclists. We then used quasi-induced exposure to measure the annual relative risk of crash involvement for cycling. Based on an officially published travel characteristics survey, we further measured the risk of injury for cycling per minutes cycled. RESULTS: Between 1998 and 2017, Hong Kong witnessed a more than twofold increase in the number of cyclist injuries, with an average annual increase rate of 5.18% (95% CI: 0.53%-12.77%). By 2017, cyclists were 2.21 (1.82-2.69) times more likely to be involved in traffic crashes than in 1998. Per 10 million minutes, the injury rates for cycling were 28.64 (27.43-29.70) and 42.54 (41.07-44.02) on weekdays during 2001-2003 and 2010-2012. After adjusting for sex and age groups, cyclists were 1.95 (1.43-2.61) times more likely to be injured in 2010-2012 than in 2001-2003. Per minutes traveled, cyclists also sustained significantly higher risks of fatality and injury than pedestrians, private car drivers and passengers, taxi passengers, public bus passengers, and minibus passengers. A comparison of Hong Kong with other regions suggests that Hong Kong is among the most dangerous areas for cycling in terms of fatality rate per minutes cycled. CONCLUSIONS: Cyclist injuries have become a substantial public health burden in Hong Kong. A range of countermeasures with proven effectiveness should be promptly implemented to improve the safety of these vulnerable road users.


Assuntos
Acidentes de Trânsito/tendências , Ciclismo/lesões , Ciclismo/tendências , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/etiologia , Acidentes de Trânsito/mortalidade , Adolescente , Adulto , Idoso , Automóveis , Feminino , Hong Kong/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Pedestres , Adulto Jovem
13.
West J Emerg Med ; 20(4): 557-572, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31316694

RESUMO

Cannabis legalization has led to significant health consequences, particularly to patients in emergency departments and hospitals in Colorado. The most concerning include psychosis, suicide, and other substance abuse. Deleterious effects on the brain include decrements in complex decision-making, which may not be reversible with abstinence. Increases in fatal motor vehicle collisions, adverse effects on cardiovascular and pulmonary systems, inadvertent pediatric exposures, cannabis contaminants exposing users to infectious agents, heavy metals, and pesticides, and hash-oil burn injuries in preparation of drug concentrates have been documented. Cannabis dispensary workers ("budtenders") without medical training are giving medical advice that may be harmful to patients. Cannabis research may offer novel treatment of seizures, spasticity from multiple sclerosis, nausea and vomiting from chemotherapy, chronic pain, improvements in cardiovascular outcomes, and sleep disorders. Progress has been slow due to absent standards for chemical composition of cannabis products and limitations on research imposed by federal classification of cannabis as illegal. Given these factors and the Colorado experience, other states should carefully evaluate whether and how to decriminalize or legalize non-medical cannabis use.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Uso da Maconha/efeitos adversos , Uso da Maconha/tendências , Acidentes de Trânsito/tendências , Sintomas Comportamentais/induzido quimicamente , Cannabis/química , Colorado/epidemiologia , Dirigir sob a Influência/tendências , Contaminação de Medicamentos , Overdose de Drogas/epidemiologia , Hospitalização/tendências , Humanos , Legislação de Medicamentos , Transtornos Mentais/induzido quimicamente , Serviços de Saúde Mental/tendências , Envenenamento/epidemiologia , Vômito/epidemiologia
14.
Int Health ; 11(5): 327-330, 2019 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-31145800

RESUMO

Every year more than 1.35 million people lose their lives on the road and tens of millions more are injured, some permanently. Since the early 2000s there has been renewed focus on the issue, with the United Nations, World Health Organization and the World Bank placing the issue higher on their agendas. Guided by the United Nations General Assembly, World Health Assembly resolutions and ministerial-level conferences on the global road safety crisis, multisectoral partnerships have synthesised the evidence, advocated for action (there are two Sustainable Development Goal targets with an ambitious goal of reducing deaths and injuries from road traffic crashes by 50%), raised public awareness, generated funding, piloted interventions and monitored progress. And yet the total number of deaths has plateaued despite some sporadic country-level successes. More needs to be done-more people need to be trained in countries to deliver, monitor and evaluate a systems approach to road safety, more solid evidence of what works in low-resource settings is needed (including sustainable transportation options) and there needs to be a greater focus on optimising care and support for those injured in crashes-if we are to begin to see numbers come down in the next decade.


Assuntos
Acidentes de Trânsito/prevenção & controle , Acidentes de Trânsito/tendências , Saúde Global , Segurança , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Humanos , Desenvolvimento Sustentável , Nações Unidas , Organização Mundial da Saúde , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/prevenção & controle
15.
Pan Afr Med J ; 32(Suppl 1): 12, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30949286

RESUMO

Introduction: Road traffic accidents are leading cause of injuries and deaths globally. Low income economies are the most affected. Most causes of RTA are predictable and preventable. This study describes trends and causes of road traffic accidents in Anambra State, South Eastern Nigeria. Methods: We conducted a retrospective study of road traffic accidents from 2010 to 2014. Data were obtained from the Federal Road Safety Commission, Anambra State Command. Information extracted included sex, age, cause of accidents, number of people and type of vehicles involved. Cases were recorded as fatal if any victim died, serious if any victim was hospitalized for more than 24 hours and minor if any victim was hospitalized for less than 24 hours. Causes of accidents were classified into human, mechanical, and climatic factors. Univariate analysis to generate frequencies and proportions was conducted using Microsoft Office Excel 2007. Results: A total of 1,141 road traffic accidents consisting 271 fatalities, 652 serious and 218 minor cases were recorded in Anambra State from 2010-2014. Seven thousand, four hundred and forty-four persons involving 1,816 vehicles were involved in RTA that resulted in 448 deaths and 2,785 injuries. More deaths 348 (77%) and injuries 2009 (72%) occurred more in males than females. Major causes of road traffic accidents were loss of vehicle control 256 (17%) and speed violation 207 (14%). There was an increased number of persons involved in RTA in 2014 (1,842) compared with 2010 (299). In all, 3,233 casualties (deaths and injuries) and crashes (fatal, serious and minor) were recorded out of which 900 (27.8%) casualties and 294 (9.1%) crashes occurred in 2013. Conclusion: Leading causes of road traffic accidents are human factors; speed violation, loss of vehicle control and dangerous driving which are sadly preventable. Sensitization and enforcement of safe road principles among commercial vehicles and car drivers will help curb this menace. Government at all levels should implement strong policies aimed at reducing the speed of vehicles on roads.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/tendências , Adulto , Condução de Veículo/normas , Criança , Feminino , Hospitalização/tendências , Humanos , Masculino , Nigéria/epidemiologia , Estudos Retrospectivos
16.
J Neurol ; 266(Suppl 1): 3-8, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30963255

RESUMO

OBJECTIVES: To determine if the risk of traffic accidents increases after disease onset in patients with acute vestibular disorders. That could provide a valid rationale for guidelines on driving restrictions. METHODS: 5,260,054 patient data (> 18 years of age) from a statutory health insurer were used to identify traffic injuries in incident cases of Menière's disease (MD) and vestibular neuritis (VN) in 2010-2013. Incident diagnoses were defined as the absence of such diagnoses in the preceding 5 years. Comparators were insured individuals with no such diagnoses throughout 2005-2017. The surrogate for traffic injuries were whiplash injuries coded in ICD-10 as diagnosis of sprain of ligaments of the cervical spine without structural changes. RESULTS: We identified 4509 incident patients with Menière's disease and 25,448 with vestibular neuritis and 5,102,655 controls with no such diagnoses throughout the observation period. The incidence of traffic injuries was increased for both vestibular disorders prior to the time point of diagnosis-MD 0.72 [0.47; 0.97] and VN 0.66 [0.56; 0.76] compared to controls (0.46 [0.46; 0.47]). The temporal course of incidence in whiplash injuries showed no increase and was 0.64 [0.41; 0.88] for MD at diagnosis and 0.73 [0.48; 0.98] after diagnosis, for VN it was 0.81 [0.70; 0.92] at diagnosis and 0.65 [0.55; 0.74] after diagnosis. CONCLUSIONS: Although these data were not originally collected to address the research question, they provide a valid body of evidence. There is no rationale for driving restrictions, which substantially interfere with the individuals' quality of life, in patients with incident MD and VN.


Assuntos
Acidentes de Trânsito/tendências , Bases de Dados Factuais/tendências , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/epidemiologia , Traumatismos em Chicotada/diagnóstico , Traumatismos em Chicotada/epidemiologia , Biomarcadores , Feminino , Seguimentos , Humanos , Masculino , Fatores de Risco
17.
Spinal Cord ; 57(8): 692-699, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30842631

RESUMO

STUDY DESIGN: Retrospective population-based cohort study. OBJECTIVES: To characterise the epidemiology of traumatic spinal cord injury (TSCI) among the inhabitants of Saint Petersburg, Russia. SETTING: All hospitals in Saint Petersburg. METHODS: Charts for all individuals admitted to city hospitals from 1st January 1 2012 to 31st December 2016 with acute TSCI were reviewed. Incidence rates were calculated for the whole period and for each year separately. Gender-specific and age-specific incidence rates were calculated, and epidemiological characteristics and possible risk factors were analysed. RESULTS: A total of 361 people were identified. The average annual incidence rate was 17.6 per million, varying from 21.2 (2013) to 13.6 (2016), and 70.9% were men. Mean age at injury was 42.1 years. Injuries from falls represented 49.8% of cases, and motor vehicle accidents 18.9%. The male:female ratio in the low-falls group was 1.2:1, and among the elderly patients, it was 0.5:1. Lesions at the cervical level were involved in 49.3%, thoracic in 24.7%, and lumbar/sacral in 23.5%. TSCI was complete in 16.9%. Concomitant injuries occurred in 47.2% of cases, and traumatic brain injuries in 37.7%. CONCLUSION: TSCI incidence decreased during the observation period and was 2.4 times more common among men than women. In half of the cases, injuries involved the cervical level, and a fall was the most frequent injury cause. Elderly women more often had falls from a low height than men. Multiple injuries-most frequently traumatic brain injuries-were common.


Assuntos
Acidentes por Quedas , Acidentes de Trânsito , Traumatismos da Medula Espinal/diagnóstico , Traumatismos da Medula Espinal/epidemiologia , Acidentes de Trânsito/tendências , Adolescente , Adulto , Idoso , Vértebras Cervicais , Estudos de Coortes , Feminino , Hospitalização/tendências , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Federação Russa/epidemiologia , Adulto Jovem
18.
Int J Epidemiol ; 48(4): 1187-1196, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-30843066

RESUMO

BACKGROUND: To achieve Sustainable Development Goal 3.6 in Iran, we need to have a comprehensive understanding of the distribution of risky behaviours regarding road-traffic injuries at national and sub-national levels. Little is known about the road-use vulnerability patterns of road-traffic injuries in Iran. The aim of this study is to describe the prevalence of self-reported human risk factors in road-traffic injuries using the findings from a large-scale cross-sectional study based on the World Health Organization's stepwise approach to surveillance of non-communicable diseases (STEPs). METHODS: A cross-sectional survey study in 2016 assessed the road-use pattern and prevalence of risky behaviours of people more than 18 years old. In this study, we planned to recruit 31 050 individuals as a representative sample at national and provincial levels. In practice, 30 541 individuals (3105 clusters) from urban and rural areas of Iran were selected. Basic socio-demographic data, major behavioural risk factors such as seatbelt and helmet non-compliance, drunk driving and occupant in a car with a drunk driver were assessed through baseline interviews gathered through an Android tablet-based questionnaire. RESULTS: The overall prevalence of seatbelt and helmet compliance was 75.2% (95% confidence interval: 74.7-75.7) and 13.9% (13.4-14.5), respectively, at the national level. The prevalence of risk-taking behaviours such as drink driving was 0.5% (0.4-0.6) and for being an occupant in a car with a drunk driver was 3.5% (3.2-3.8). At the provincial level, the highest age-standardized prevalence of seatbelt compliance (89.6%) was almost 1.5 times higher than the lowest provincial prevalence (58.5%). In 63% of provinces, the lowest prevalence of seatbelt compliance was observed among people aged 18-24 years old. CONCLUSIONS: In Iran, existing disease-prevention and health-promotion programmes should be expanded to target vulnerable subgroups that have more prevalent human risk factors for road-traffic injuries. Further research is required to investigate the context-specific proximal human risk factors and vulnerability patterns in Iran.


Assuntos
Acidentes de Trânsito/tendências , Condução de Veículo , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Cintos de Segurança/estatística & dados numéricos , Ferimentos e Lesões/prevenção & controle , Adolescente , Adulto , Idoso , Estudos Transversais , Dirigir sob a Influência/estatística & dados numéricos , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Vigilância da População , Prevalência , Fatores de Risco , Comportamento de Redução do Risco , Autorrelato , Adulto Jovem
19.
Environ Sci Pollut Res Int ; 26(12): 11674-11685, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30888616

RESUMO

Road traffic accidents (RTAs) are among the life-threatening issues facing rural as well as sub-/urban communities. Several factors contribute to RTAs ranging from human to technical and natural/environmental impacts. Anthropogenic air pollution and corresponding environmental factors also increase the probability of RTAs. Current study reports the relationship of the weather conditions to RTAs. The study establishes the relevancy of different weather conditions like rainfall, temperature, fog, and wind storm with the incidences of RTAs in rural and urban settings of Vehari, Punjab-Pakistan. The results of the study showed that rainfall, severe coldness, fog, and heat conditions were directly related with the occurrence of RTAs. The percentage of RTAs which occurred due to fog, rainfall, temperature, and other weather-related factors was 34, 25, 21, and 20%, respectively. The age of the driver significantly correlated (R2 = 0.60) with RTAs; the drivers in the age group 40-60 years caused the least RTAs during their drive. Since the smaller vehicles were involved in maximum RTAs, it relates negatively (R2 = 0.82) to vehicles power. Among different vehicles motor bikes were involved in most (42%) of the reported RTAs. Therefore, during severe weather conditions, vehicles with smaller size and young drivers must be dealt with carefully while interacting (crossing, overtaking, and maneuvering) on the roads regardless of rural or urban conditions. Factors including civic sense, traffic education, vehicle size, drivers' maturity, road conditions, and environmental impacts may be considered while designing traffic rules and traffic aware campaigns specific for developing countries such as Pakistan.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Meio Ambiente , Acidentes de Trânsito/tendências , Adulto , Poluição do Ar/estatística & dados numéricos , Países em Desenvolvimento , Humanos , Incidência , Masculino , Veículos Automotores , Paquistão , Fatores de Risco , População Rural , Tempo (Meteorologia) , Adulto Jovem
20.
Pediatrics ; 143(3)2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30718381

RESUMO

: media-1vid110.1542/5984244682001PEDS-VA_2018-2507Video Abstract BACKGROUND AND OBJECTIVE: Unrestrained child passengers are at significant risk of crash-related injury. Previous researchers using nationally representative crash data from 1992 to 1993 found an association between driver and passenger safety-belt use. Our objective in this study is to investigate factors associated with young, unrestrained passengers in fatal and nonfatal motor vehicle crashes using updated national crash data. METHODS: We analyzed 2011-2015 Fatality Analysis Reporting System and National Automotive Sampling System data and included vehicles with a young passenger (≤19 years old) in a crash. Driver and passenger characteristics were compared by using bivariate analyses separately for fatal and nonfatal crashes. Logistic regression analyses were performed on a combined data set to predict passenger restraint use. RESULTS: In unadjusted bivariate models, unrestrained drivers had a higher probability of having an unrestrained passenger across all passenger age groups for both fatal and nonfatal crashes. In multivariate logistic regression models that included both fatal and nonfatal crashes and were adjusted for several driver and passenger characteristics, unrestrained drivers had a higher risk of having an unrestrained young passenger across all age groups. CONCLUSIONS: In both fatal and nonfatal crashes, a driver being unrestrained is a strong predictor of the child passenger also being unrestrained. Policy and regulation to better ensure that drivers are properly restrained (eg, expanding primary seat-belt laws to all states) may serve as effective means for increasing rates of proper child-occupant-restraint use.


Assuntos
Acidentes de Trânsito/mortalidade , Cintos de Segurança , Acidentes de Trânsito/tendências , Adolescente , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Cintos de Segurança/tendências , Adulto Jovem
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