Temporal factors in motor vehicle crash deaths.
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OBJECTIVE: To summarize fatal motor vehicle crash deaths in the United States by time of day, day of week, month, and season, and to determine why some days of the year tend to experience a relatively high number of deaths. METHOD: Crash deaths were identified and categorized using the Fatality Analysis Reporting System. Days of the year with relatively high crash deaths were compared to the two days that occurred exactly one week before and one week after. RESULTS: On average, motor vehicle crashes in the United States result in more than 100 deaths per day, but there is much day-to-day variability. During 1986-2002 the single day fatality count ranged from a low of 45 to a high of 252. Summer and fall months experience more crash deaths than winter and spring, largely due to increased vehicle travel. July 4 (Independence Day) has more crash deaths on average than any other day of the year, with a relatively high number of deaths involving alcohol. January 1 (New Year's Day) has more pedestrian crash deaths on average, plus it has the fifth largest number of deaths per day overall, also due to alcohol impairment. On other days the high numbers of deaths are likely due to increases in holiday or recreational travel. CONCLUSION: Every day of the year results in many crash deaths, but certain days stand out as particularly risky. The temporal and geographic spread of crash deaths, as well as the view of driving as a routine task, inures the public to this continuing problem. Innovative strategies are needed both to raise awareness and to work toward a solution. (+info)
Does changing the configuration of a motor racing circuit make it safer?
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OBJECTIVES: To assess the pattern of injuries presenting to a racing circuit medical centre in two three-year periods before and after two chicanes were built into the track. METHODS: Medical centre records were used to identify all patients assessed during the two time periods. Those referred to hospital were categorised by injury severity into three groups. RESULTS: The proportions of those attending the medical centre that were referred and admitted to hospital were the same in both periods (12-13% and 3% respectively). During the two study periods, the risk of a severe injury for a car driver decreased from 0.1% to 0.03% (p<0.05). For a motorcyclist, similar values were 0% and 0.2% (not significant). CONCLUSIONS: Chicanes have improved the safety of the racing circuit for car drivers, reducing the risk of injury. (+info)
Increased risk of death or disability in unhelmeted Wisconsin motorcyclists.
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OBJECTIVE: The purpose of this study is to investigate the relationships among motorcycle rider helmet, alcohol use and the full spectrum of health outcomes following crashes. METHODS: Data from the National Highway Traffic Safety Administration-sponsored Crash Outcome Data Evaluation System (CODES) for Wisconsin, 2002, were used to study 2462 motorcycle crash victims. Logistic regression models were used to assess the relationship of helmet and alcohol use with outcomes. RESULTS: Compared to helmeted motorcycle riders, unhelmeted riders were more likely to require inpatient hospitalization (Relative Risk Ratio [RRR] = 1.4; 95% confidence interval [CI]:1.1-1.8) or die (RR = 1.9, 95% CI:1.0-3.7) but equally likely to be treated in emergency departments. Injury patterns differed by helmet use. Unhelmeted riders were more likely to suffer injuries of the head (odds ratio [OR] = 2.3, 95% CI:1.5-3.3) or face (OR = 3.0, 95% CI:2.1-4.2) than helmeted riders. No difference was observed in other injuries, including spine/neck injuries. Reported alcohol use was more prevalent among patients who were inpatients or died, and was associated with higher likelihood of not wearing a helmet (OR = 7.0, 95% CI:4.8-12.9). CONCLUSION: Motorcycle riders who are inpatients or die in a crash are less likely to be helmeted and more likely to sustain head or face injuries. Alcohol use is associated with unhelmeted riding and increased risk of poor outcomes. These findings support policy and educational efforts promoting helmet use, which seek to decrease these tragedies. (+info)
Induction of fibroblast growth factor-9 and interleukin-1alpha gene expression by motorcycle exhaust particulate extracts and benzo(a)pyrene in human lung adenocarcinoma cells.
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Motorcycle exhaust particulates (MEP) contain carcinogenic polycyclic aromatic hydrocarbons including benzo(a)pyrene. This study has determined the ability of MEP to alter the expression of select genes from drug metabolism, cytokine, oncogene, tumor suppressor, and estrogen signaling families of human lung adenocarcinoma CL5 cells. cDNA microarray analyses and confirmation studies were performed using CL5 cells treated with 100 microg/ml MEP extract for 6 h. The results showed that MEP increased the mRNA levels of metabolic enzymes CYP1A1 and CYP1B1, proinflammatory cytokines interleukin (IL)-1alpha, IL-6, and IL-11, fibroblast growth factor (FGF)-6 and FGF-9, vascular endothelial growth factor (VEGF)-D, oncogene fra-1, and tumor suppressor p21. In contrast, MEP decreased tumor suppressor Rb mRNA in CL5 lung epithelial cells. Treatment with 10 microM benzo(a)pyrene for 6 h altered gene expression profiles, in a manner similar to those by MEP. Induction of IL-1alpha, IL-6, IL-11, and FGF-9 mRNA by MEP and benzo(a)pyrene was concentration and time dependent. Cotreatment with 2 mM N-acetylcysteine blocked the MEP- and benzo(a)pyrene-mediated induction. Treatment with MEP or benzo(a)pyrene increased IL-6 and IL-11 releases to CL5 cell medium. Incubation of human lung fibroblast WI-38 with MEP- or benzo(a)pyrene-induced CL5 conditioned medium for 4 days stimulated cell growth of the fibroblasts. Inhalation exposure of rats to 1:10 diluted motorcycle exhaust 2 h daily for 4 weeks increased CYP1A1, FGF-9, and IL-1alpha mRNA in lung. This present study shows that MEP and benzo(a)pyrene can induce metabolic enzyme, inflammatory cytokine, and growth factor gene expression in CL5 cells and stimulate lung epithelium-fibroblast interaction. (+info)
Isolated oculomotor nerve palsy from minor head trauma.
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Isolated third cranial nerve palsies in head trauma patients can be the result of direct or indirect damage to the oculomotor nerve. They are usually associated with severe head trauma. We reported a case of isolated oculomotor nerve palsy associated with minor head injury. No initial loss of consciousness was recalled. Computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance angiography (MRA) of the brain were normal. Previous reports in the literature were reviewed and the possible mechanism of injury was discussed. Head injuries are commonly seen in sports settings. Our case illustrated that even minor head trauma can cause isolated oculomotor nerve palsy in the absence of abnormal brain imaging findings. (+info)
Injuries in elite motorcycle racing in Japan.
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OBJECTIVES: To investigate the incidence and pattern of injuries, relative risks, and factors affecting incidence among elite motorcycle competitors in Japan. METHODS: A total of 117 elite motorcycle competitors including 36 road racers, 60 motocross racers, and 21 trial bike riders completed a questionnaire about injuries. RESULTS: Sixty major injuries (25 in road racing, 32 in motocross, and three in trial bike riding) were reported. The most common injuries were fractures (45), followed by ligament injuries (8), dislocations (5), and soft tissue injuries (2). The overall injury rate was 22.4 per 1000 hours, and the death rate was zero. There was no significant correlation between risk of injury and age, experience, or accumulated competition points. CONCLUSIONS: Injury rates in competitions such as road racing and motocross are high, and therefore additional safety measures are needed to protect competitors from injury. (+info)
Driver dependent factors and the risk of causing a collision for two wheeled motor vehicles.
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OBJECTIVE: To assess the effect of driver dependent factors on the risk of causing a collision for two wheeled motor vehicles (TWMVs). DESIGN: Case control study. SETTING: Spain, from 1993 to 2002. SUBJECTS: All drivers of TWMVs involved in the 181 551 collisions between two vehicles recorded in the Spanish registry which did not involve pedestrians, and in which at least one of the vehicles was a TWMV and only one driver had committed a driving infraction. The infractor and non-infractor drivers constituted the case and control groups, respectively. MAIN OUTCOME MEASURES: Logistic regression analyses were used to obtain crude and adjusted odds ratio estimates for each of the driver related factors recorded in the registry (age, sex, nationality, psychophysical factors, and speeding infractions, among others). RESULTS: Inappropriate speed was the variable with the greatest influence on the risk of causing a collision, followed by excessive speed and driving under the influence of alcohol. Younger and older drivers, foreign drivers, and driving without a valid license were also associated with a higher risk of causing a collision. In contrast, helmet use, female sex, and longer time in possession of a driving license were associated with a lower risk. CONCLUSIONS: Although the main driver dependent factors related to the risk of causing a collision for a TWMV were similar to those documented for four wheeled vehicles, several differences in the pattern of associations support the need to study moped and motorcycle crashes separately from crashes involving other types of vehicles. (+info)
United States pedestrian fatality rates by vehicle type.
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OBJECTIVE: To describe the relation between motor vehicle type and the risk of fatally injuring a pedestrian. DESIGN: The risk of killing a pedestrian was measured as the number of pedestrian fatalities per billion miles of vehicle travel by each vehicle type in the US in 2002 as reported by the National Highway Traffic Safety Administration's Fatality Analysis Reporting System. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Rates for each vehicle type by sex, age, and rural/urban roadway type and rate comparisons using relative risks (RR) and 95% confidence intervals (CIs). RESULTS: Passenger cars and light trucks (vans, pickups, and sport utility vehicles) accounted for 46.1% and 39.1%, respectively, of the 4875 deaths, with the remainder split among motorcycles, buses, and heavy trucks. Compared with cars, the RR of killing a pedestrian per vehicle mile was 7.97 (95% CI 6.33 to 10.04) for buses; 1.93 (95% CI 1.30 to 2.86) for motorcycles; 1.45 (95% CI 1.37 to 1.55) for light trucks, and 0.96 (95% CI 0.79 to 1.18) for heavy trucks. Compared with cars, buses were 11.85 times (95% CI 6.07 to 23.12) and motorcycles were 3.77 times (95% CI 1.40 to 10.20) more likely per mile to kill children 0-14 years old. Buses were 16.70 times (95% CI 7.30 to 38.19) more likely to kill adults age 85 or older than were cars. The risk of killing a pedestrian per vehicle mile traveled in an urban area was 1.57 times (95% CI 1.47 to 1.67) the risk in a rural area. CONCLUSIONS: Outcomes reflect the ways in which a vehicle's characteristics (mass, front end design, and visibility) and its degree of interaction with pedestrians affect its risk per mile. Modifications in vehicle design might reduce pedestrian injury. The greatest impact on overall US pedestrian mortality will result from reducing the risk from the light truck category. (+info)