Reduced fatalities related to rear seat shoulder belts.
(9/2587)
OBJECTIVE: To determine the effect on fatality rates in crashes of installation of shoulder belts in automobile back seats. METHODS: During 1988-96, fatalities to rear outboard seat occupants of passenger cars, classified by age of occupant and vehicle curb weight were matched to data on model year in which shoulder belts became standard equipment. The same data were obtained from the same years on back seat occupants in crashes from the Crashworthiness Data System. Weighted regression was performed on death rates per occupants in crashes by belt equipment, occupant age, and vehicle weight for all occupants and occupants who claimed to be restrained. RESULTS: The risk of death is significantly lower in vehicles equipped with shoulder belts, midsized to larger cars, and among children. Claimed child restraint use is higher in cars with shoulder belts and claimed use of shoulder belts is higher among adolescents and young adults but lower among those 35 and older. However, older occupants have lower death rates in shoulder belt equipped cars. CONCLUSIONS: Shoulder belts substantially reduce risk of death relative to lap belts at prevalent use rates in each age group. Belt effectiveness when used cannot be estimated precisely because of invalid claimed use, but the lowered rates among vehicles with shoulder belts indicates that effectiveness given prevalent use is far more efficacious than lap belts without shoulder belts. (+info)
Diabetes and automobile crashes in the elderly. A population-based case-control study.
(10/2587)
OBJECTIVE: The aim of this study was to estimate the association between diabetes and its complications and at-fault automobile crashes among older drivers. RESEARCH DESIGN AND METHODS: This was a population-based case-control study. Case subjects were drivers aged > or = 65 years who had been involved in a crash during 1996 in which they were at fault. Two control groups were selected: 1) crash-involved not-at-fault subjects and 2) non-crash-involved subjects. Telephone interviewers collected information on demographic characteristics, driving habits, diabetes sequelae and treatment, other chronic medical conditions, and visual function. RESULTS: Overall, there was no association between diabetes and at-fault crash involvement. The adjusted odds ratio (OR) for diabetes was 1.1 (CI 0.7-1.9) when case subjects were compared with either control group. However, the adjusted OR for diabetes was 2.5 (0.9-7.2) among subjects who had been involved in a crash in the 4 years preceding 1996, while it was only 0.9 (0.5-1.7) among those who had not. There was no evidence of an association between treatment modalities and at-fault crash involvement. Case subjects were, although not significantly (P = 0.25), more likely (OR 2.4) to report neuropathy compared with both control groups, and retinopathy was not associated with increased crash risk. CONCLUSIONS: This study provides no evidence that older drivers with diabetes are at increased risk for automobile crashes. There remains the possibility that those with diabetes who have more severe disease or have had multiple crashes are at increased risk. (+info)
Understanding pedestrians' road crossing decisions: an application of the theory of planned behaviour.
(11/2587)
This paper reports a study applying the Theory of Planned Behaviour (TPB) to the prediction of pedestrians' road crossing intentions. Respondents (N = 210) completed questionnaires which included scenarios of three potentially dangerous road crossing behaviours, followed by measures of attitude, subjective norm, perceived behavioural control, self-identity and intention. The results indicated that the social psychological variables under consideration were able to explain between 39 and 52% of the variance in intentions to cross the road in the manner depicted in the scenarios. The perceived behavioural control component of the TPB emerged as the strongest predictor of pedestrians' intentions, suggesting that perceptions of control have an important role to play in road safety behaviour. The results are discussed in relation to the predictive utility of the TPB in this area and possible interventions to encourage safe road crossing behaviour. (+info)
Injuries in Pakistan: directions for future health policy.
(12/2587)
Injuries result in major financial and productivity losses to nations while inflicting tremendous personal burden on the injured and their families. Two-thirds of the global deaths from injuries occur in the developing world, consuming substantial health sector resources. Pakistan is a developing country with a population of 136 million and no reported estimate of the national impact of injuries. This study presents a profile of injuries in Pakistan, estimates the impact on the country and recommends strategies to further delineate this important public health problem. A methodical review of published, unpublished and government literature was undertaken and data collected for all types of injuries principally over the 1982-1994 period. Motor vehicle injuries, homicides, assaults, work-related injuries, poisonings and risk factors have been included. Selected epidemiological estimates have been generated and the WHO motorization index has been used to assess road-side accident risk. The lack of reliable data and under-reporting of work-related injuries is revealing. The rising time trend in all injuries, the significant loss of life from injuries and the age of those injured have a critical impact on the national economy and health system. Data on injuries in Pakistan are primarily recorded by police authorities and used for legal purposes. Pakistan must institute an information system to evaluate the true impact of injuries and develop national safety standards. Implementation of such standards is especially important for road traffic safety and occupational health in industrial units within the country. (+info)
Motor-vehicle safety: a 20th century public health achievement.
(13/2587)
The reduction of the rate of death attributable to motor-vehicle crashes in the United States represents the successful public health response to a great technologic advance of the 20th century-the motorization of America. Six times as many people drive today as in 1925, and the number of motor vehicles in the country has increased 11-fold since then to approximately 215 million. The number of miles traveled in motor vehicles is 10 times higher than in the mid-1920s. Despite this steep increase in motor-vehicle travel, the annual death rate has declined from 18 per 100 million vehicle miles traveled (VMT) in 1925 to 1.7 per 100 million VMT in 1997-a 90% decrease. (+info)
The carnage wrought by major economic change: ecological study of traffic related mortality and the reunification of Germany.
(14/2587)
OBJECTIVE: To document the effects of sudden economic change on death rates for occupants of cars in the former German Democratic Republic (East Germany). DESIGN: Ecological time series study of East Germany in comparison with the former Federal Republic of Germany (West Germany) before and after reunification in 1990. SETTING: East and West Germany from 1985 to 1996. SUBJECTS: Populations of East and West Germany between 1985 and 1996. MAIN OUTCOME MEASURES: Death rates for occupants of cars. RESULTS: After the reunification of Germany, East Germany experienced a sudden, temporary affluence and a concomitant fourfold increase in death rates for car occupants between 1989 and 1991. Although death rates increased in all age groups, young adults (aged 18-24) were most affected. The death rate per 100 000 population for those aged 18-20 years increased 11-fold between 1989 and 1991; for those aged 21-24 years the increase was eightfold. CONCLUSION: A tragic consequence of the reunification of Germany was a dramatic increase in the death rate for car occupants. Sudden economic change and availability of cars resulted in both a rise in vehicle ownership and an increase in the number of inexperienced drivers on roads that were ill prepared for the increased traffic. The lesson learnt from Germany is that during times of economic change and modernisation, measures to prevent the predictable injury deaths that will result need to be considered. (+info)
Graduated licensing comes to the United States.
(15/2587)
OBJECTIVE: To describe the young driver problem and the emergence of graduated licensing as a way to address it. METHODS: Literature review and commentary. RESULTS: Twenty-four states in the United States adopted versions of graduated licensing in 1996-98; initial results show positive effects. CONCLUSIONS: A major public health movement is under way that can be expected to produce significant reductions in crashes and injuries involving young drivers. (+info)
Validity of self reported crashes and injuries in a longitudinal study of young adults.
(16/2587)
OBJECTIVES: The aim of this study was to determine the validity of self report as a source of information on crashes and injuries. SETTING: This study was part of the Dunedin Multidisciplinary Health and Development Study (DMHDS), which is a longitudinal study of the health, development, and behaviour of a cohort of young New Zealanders. METHOD: At the age 21 assessment DMHDS study members were asked to report serious injury and motor vehicle traffic crashes experienced over the previous three years. The self reported injuries were compared with the New Zealand Health Information Service (NZHIS) public hospital discharge file to determine the completeness of the self reported data. The traffic crashes were compared with the police traffic crash reports to determine the accuracy of self reported crash details. RESULTS: Twenty five (86%) of the 29 unintentional injuries, six (67%) of the nine assaults, and one (14%) of the six self inflicted injuries on the NZHIS file were self reported. The level of agreement between the self reported crash details and those recorded on the traffic crash report was high. CONCLUSIONS: The results show that self reports can be a useful and valid source of injury and crash data. (+info)