Accident; analysis and prevention
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The objective of this study was to do an epidemiological and costs analysis of the impact of road traffic injuries on the demand for emergency room services at hospitals located in the city of Cuernavaca, Mexico. The studied population included injured people who demanded medical attention at the emergency room for injuries due to events in public places, occurring between February and April 2001. Trained interviewers collected the data at the emergency room, 24h a day. ⋯ Differences between patients injured by crashes or as a pedestrian, were: age under 14 years (OR 5.9, CI 2.5-13.9), being unemployed (OR 2.1, CI 1.20-3.96), and being an elementary school student (OR 13.9, CI 3.08-63.13). The present study is, so far, the only one in Mexico to include an epidemiological and costs analysis in approaching the problem of road traffic injuries. Similar methods must be used, especially in developing countries, to reduce this important public health problem.
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This paper presents an evaluation of the effects on road safety of new urban arterial roads in Oslo, Norway, and a synthesis of evidence from similar studies that have evaluated the safety effects of new urban arterial roads in other cities. A before-and-after study was made of four urban arterial road projects in Oslo. The study controlled for general accident trends in Oslo and for regression-to-the-mean. ⋯ Two cases that involved lane additions and converting at-grade junctions to interchanges resulted in a mean accident reduction of 51%, which was highly significant. On the average, the nine arterial road projects from which evidence was summarised resulted in a net induced traffic of 16%, and a net reduction in accident rate (accidents per million vehicle kilometres) of 18%. These effects almost cancel each other, leading to a very small net change in the expected number of accidents.
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This study addresses of the impacts of emergency vehicle (ambulances, police cars and fire trucks) occupant seating position, restraint use and vehicle response status on injuries and fatalities. Multi-way frequency and ordinal logistic regression analyses were performed on two large national databases, the National Highway Traffic Safety Administration's Fatality Analysis Reporting System (FARS) and the General Estimates System (GES). One model estimated the relative risk ratios for different levels of injury severity to occupants traveling in ambulances. ⋯ A third model incorporated non-special use van and passenger car occupants, which otherwise replicated the second model. Our findings suggest that ambulance crewmembers riding in the back and firefighters in any seating position, should be restrained whenever feasible. Family members accompanying ambulance patients should ride in the front-seat of the ambulance.
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The objective of this study was to evaluate the effect of population density on mortality after traffic crashes. Subjects were the drivers of vehicles requiring towing after collisions, sampled by NASS-GES during 1994-1998. Cases were classified by population of crash location (greater or lesser than 25,000) and by population density of the driver's county of residence (using ZIP code and Census data). ⋯ R. 2.10, 95% C. I. 1.62-2.73). The excess risk for residents of rural areas to die in traffic crashes can be attributed in part to post-crash factors.
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This study used national data and a matched case-control design to estimate the relative risk of death by an unintentional gunshot associated with having firearms in the home. A sample of adults who died in the United States in 1993 from unintentional gunshot injuries was drawn from the National Mortality Followback Survey (NMFS) (n=84). Twenty controls were sought for each case from the 1994 National Health Interview Survey (NHIS) and matched to the cases by sex, age group, race, and region of residence (n=1451). ⋯ Tests of homogeneity showed that the effect estimates did not vary significantly across categories of the matching variables. Firearms in the home appear to be a risk factor for unintentional gunshot fatality among adults. The magnitude of the observed effect estimates should be compared with those from additional studies.