Accident; analysis and prevention
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Workplace safety is a recognized concern in emergency medical services (EMS). Ambulance crashes are common and injury rates exceed that of the general working public. Fatigue and sleepiness during shift work pose a safety risk for patients and EMS workers. Changing EMS worker behaviors and improving alertness during shift work is hampered by a lack of instruments that reliably and accurately measure multidimensional beliefs and habits that predict alertness behavior. ⋯ Measurement of sleep, fatigue, and alertness behavior among EMS workers is challenging. We describe the development and psychometric testing of a survey tool that may be useful in a variety of applications addressing sleep, fatigue, and alertness behavior among EMS workers.
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Older adults are at greater risk than younger adults for life-threatening injury after motor vehicle collision (MVC). Among those with life-threatening injury, older adults are also at greater risk of not being transported by emergency medical services (EMS) to an emergency department. Despite the greater risk of serious injury and non-transportation among older adults, little is known about the relationship between patient age and EMS transportation rates for individuals experiencing MVC. ⋯ After adjusting for potential confounders of the relationship between patient age and the decision to transport (patient gender, patient race, air bag deployment, patient trapped or ejected, and injury severity), transport rates were: age 18-64=36.0% (95% confidence interval [CI], 35.9-36.2%); age 65-74=36.6% (95% CI, 36.0-37.1%); age 75-84=37.3% (95% CI, 36.5-38.1%), and age 85-94=38.2% (95% CI, 36.7-39.8%). In North Carolina between 2008 and 2011, the transportation rate was only slightly higher for older adults than for younger adults, and most older adults experiencing MVC and seen by EMS were not transported to the emergency department. These findings have implications for efforts to improve the sensitivity of criteria used by EMS to determine the need for transport for older adults experiencing MVC.
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Comparative Study
How to identify the key factors that affect driver perception of accident risk. A comparison between Italian and Spanish driver behavior.
Road crashes can be caused by different factors, including infrastructure, vehicles, and human variables. Many research studies have focused solely on identifying the key factors that cause road crashes. From these studies, it emerged that human factors have the most relevant impact on accident severity. ⋯ An experiment based on the stated preferences (SP) was carried out with the drivers, and the SP data were analyzed using an ordered probit (OP) model. Interesting findings emerged from different analyses of the data and from the comparisons among the data collected in the two different territorial contexts. We found that both Italian and Spanish drivers consider driving in an altered psychophysical state and violating the overtaking rules to be the most risky behaviors.
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Research measuring levels of enforcement has investigated whether increases in police activities (e.g., checkpoints, driving-while-intoxicated [DWI] special patrols) above some baseline level are associated with reduced crashes and fatalities. Little research, however, has attempted to quantitatively measure enforcement efforts and relate different enforcement levels to specific levels of the prevalence of alcohol-impaired driving. ⋯ While a higher DUI arrest rate was associated with a lower drinking-driver crash rate, sobriety checkpoints did not have a significant relationship to drinking-driver crashes. This appeared to be due to the fact that only 3% of the on-the-road drivers were exposed to frequent sobriety checkpoints (only 1 of 36 police agencies where we received enforcement data conducted checkpoints weekly). This low-use strategy is symptomatic of the general decline in checkpoint use in the U.S. since the 1980s and 1990s when the greatest declines in alcohol-impaired-driving fatal crashes occurred. The overall findings in this study may help law enforcement agencies around the country adjust their traffic enforcement intensity in order to reduce impaired driving in their community.
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The number of pedestrian-motor vehicle accidents and pedestrian deaths in China surged in recent years. However, a large scale empirical research on pedestrian traffic crashes in China is lacking. In this study, we identify significant risk factors associated with fault and severity in pedestrian-motor vehicle accidents. ⋯ Fifth, specific road safety campaigns in rural areas, and education programs especially for young children and teens should be developed and promoted. Moreover, we reveal a country-specific factor, hukou, which has significant effect on the severity in pedestrian accidents due to the discrepancy in the level of social insurance/security, suggesting that equal social security level among urban and rural people should be set up. In addition, establishing a comprehensive liability distribution system for non-urban areas and roadways will be conducive to both pedestrians' and drivers' voluntary compliance with traffic rules.