Accident; analysis and prevention
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Bicycle helmet efficacy was quantified using a formal meta-analytic approach based on peer-reviewed studies. Only those studies with individual injury and helmet use data were included. Based on studies from several countries published in the period 1987-1998, the summary odds ratio estimate for efficacy is 0.40 (95% confidence interval 0.29, 0.55) for head injury, 0.42 (0.26, 0.67) for brain injury, 0.53 (0.39, 0.73) for facial injury and 0.27 (0.10, 0.71) for fatal injury. ⋯ In conclusion, the evidence is clear that bicycle helmets prevent serious injury and even death. Despite this, the use of helmets is sub-optimal. Helmet use for all riders should be further encouraged to the extent that it is uniformly accepted and analogous to the use of seat belts by motor vehicle occupants.
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On 1st March 1994, a passenger train with a speed of 85 km/h ran into the rear end of a stopped passenger train north of Aarhus, Denmark. No fatalities occurred. Questionnaires were sent to passengers and crew and 113 of 128 (88%) answered. ⋯ Serious thoraco-abdominal injuries were only seen in one patient despite the fact that 37 passengers were thrown againsts tables between the seats in the second class section of the moving train. The tables were fragile and usually gave way. In conclusion, carriage interior has a major influence on personal injuries at railway accidents.
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A group of drink drivers with no prior arrest for drink driving was selected from drink driving arrest records originating in Western Australia between 1987 and 1995. These drink-driving records were linked to road crash records for the same period. The analysis of these combined records focussed on the sequence of driving events (i.e., arrests, crashes and arrests resulting from crashes) and the present article explores the relationship in time between known drink driving incidents and crash involvement. Using multi-variate survival analysis, it was found that if a driver's first drink driving offence resulted from a road crash, especially if this occurred at a younger age, he/she was significantly more likely to drink, drive and crash again.
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In 1995, an experiment was started to give extra medical help by helicopter to patients who needed emergency treatment. The aim of the experiment was not to reduce the transportation time to the hospital, but to bring specialised medical care directly to patients as soon as possible. An evaluation study was carried out to assess the effect of the treatment given by the Helicopter Trauma Team (HTT) on survival and quality of life. ⋯ The survival rate increased for patients in the 'in between' group, but not for patients with a low probability of survival. There was no difference in the quality of life of patients from the HTT and non-HTT groups 15 months after the accident. These findings refute the hypothesis that only the most severely injured patients with a low quality of life profit from HTT-treatment.