Belt Wearing Research Articles

Spinal cord injury in children from the wearing of seat belts

Spinal cord injury in children from the wearing of seat belts

Passive fetal heart rate monitor using piezopolymer pressure sensors

Fetal heart rate monitoring is performed routinely by pulsed Doppler ultrasound, but is currently confined to a clinical setting because of the bulkiness and high cost of the equipment. A passive monitor, using piezopolymer pressure sensors located on a belt worn by the mother, has been developed to detect the fetal heart tone and to determine the fetal heart rate through appropriate signal processing. The sensors are constructed to fulfill the following functions: detecting pressure pulses on the abdominal surface, shielding against 60‐Hz interference, isolating the patient electrically, insulating against ambient sound, and canceling maternal rigid‐body motion. The signal processing employs linear prediction techniques to identify the fetal heart tone from among competing background signals and yields a real‐time evaluation of the fetal heart rate. The monitor has been applied to conduct clinical fetal nonstress tests simultaneously with ultrasound, and the results are compared. The monitor is not only ...

Epidemiology of spinal cord lesions in Denmark

Denmark has a population of about 5.2 million. The rehabilitation of spinal cord injured (SCI) takes place in two specialised rehabilitation hospitals. The incidence of new traumatic SCI admitted to these hospitals in the period 1975-1984 was 9.2 per million per year. During this period 92 Danes with non-traumatic and 268 with newly sustained traumatic spinal cord lesions were admitted to the rehabilitation hospital in Hornboek, which uptake area corresponded to South and East Denmark and Greenland and the Faroe Islands. Among the traumatic SCI 47% were due to traffic accidents, 23% to falls to a level below, 8% to attempted suicides, 6% to shallow water diving, and 6% to sporting accidents. The number of SCI caused by traffic accidents was found to decrease coincidently with the introduction of general speed limits and compulsory seat belt wearing. The male/female ratio was for the traumatic SCI 3.3, which was significantly lower than in the preceding 10-year period. 40% of all traumatic SCI were sustained at 15-24 years of age, and 51% had tetraplegia. Traffic accidents gave rise to more cervical, and falls to more caudal lesions. 41% of the traumatic SCI had an improvement in their neurological status after their admission to the neurosurgical department until the discharge from the rehabilitation hospital. Those with incomplete lesions showed greater improvement than those with complete lesions regardless of the level. Complete cervical lesions had significant better remissions than complete thoracic/lumbar lesions.

Characteristics of seat belt users and non-users in a state with a mandatory belt use law

The present study uses statewide seat belt observation data coupled with mail survey and driver history data from 4505 licensed North Carolina drivers to address whether non-users of seat belts are overrepresented in crashes and violations, and whether these crashes differ from the crashes of belt users. It also reports on a more in-depth telephone survey of 204 drivers to learn about reasons for seat belt use and non-use and to identify programs that might bring about a change in behavior. Results show that non-users have 35% more accidents and 69% more violations than users. Drivers most likely to increase their belt wearing as a result of a law include females, non-whites, and those with fewer prior traffic violations. Further characteristics of seat belt users and non-users are examined and the findings used to identify approaches to increase seat belt use including appropriate target populations, public information and education needs, mechanisms for delivering messages, enforcement needs, etc.(A)

The benefit of seat belt legislation in the United Kingdom.

Legislation for compulsory wearing of seat belts by car drivers and front seat passengers has been acclaimed as a major public health advance. Reports from other countries, and two recent evaluative studies in the United Kingdom, have suggested that legislation reduces both deaths and injuries. To assess the effect of the UK law 5 years after its implementation, trends in routine data for 1976-1987 have been reviewed. There were two sources of data: mortality statistics, published by the Office of Population Censuses and Surveys in the quarterly Monitor DH4, and road accident statistics, recorded by the police and published by the Department of Transport. There is a downward trend in deaths over the period, but the data show little impact from the law. One explanation for this lack of effect is the risk compensation hypothesis, which suggests that "safety" improvements are transferred by drivers into increased performance--the amount and speed of travel. Public health policies need to take into account the complex behavioural interactions between travel and safety choices if they are to affect underlying trends.

Aortic ruptures in seat belt wearers

Several investigations have indicated that rupture of the thoracic aorta is one of the leading causes of immediate death in victims of road traffic accidents. In Finland in 1983, 92% of front-seat passengers were seat belt wearers on highways and 82% in build-up areas. The mechanisms of rupture of the aorta have been intensively investigated, but the relationship between seat belt wearing and injury mechanisms leading to aortic rupture is still largely unknown. This study comprises 4169 fatally injured victims investigated by the Boards of Traffic Accident Investigation of Insurance Companies during the period 1972 to 1985. Chest injuries were recorded as the main cause of death in 1121 (26.9%) victims, 207 (5.0%) of those victims having worn a seat belt. Aortic ruptures were found at autopsy in 98 victims and the exact information of the location of the aortic tears was available in 68. For a control group, we analyzed 72 randomly chosen unbelted victims who had a fatal aortic rupture in similar accidents. The location of the aortic rupture in unbelted victims was more often in the ascending aorta, especially in drivers, whereas in seat belt wearers the distal descending aorta was statistically more often ruptured, especially in right-front passengers (p less than 0.05). The steering wheel predominated statistically as the part of the car estimated to have caused the injury in unbelted victims (37/72), and some interior part of the car was the most common cause of fatal thoracic impacts in seat belt wearers (48/68) (p less than 0.001). The mechanism of rupture of the aorta in the classic site just distal to the subclavian artery seems to be rapid deceleration, although complex body movements are also responsible in side impact collisions. The main mechanism leading to rupture of the ascending aorta seems to be severe blow to the bony thorax. This also often causes associated thoracic injuries, such as heart rupture and sternal fracture. Injuries in the ascending aorta were mostly found in unbelted victims and were sustained in frontal impact collisions, the injury-causing part of the car being the steering wheel. Ruptures of the distal descending part of the aorta were frequently associated with fractures of the thoracic vertebra.

BLUNT GASTROINTESTINAL AND MESENTERIC INJURIES IN SEAT BELT WEARERS

Six cases of gastrointestinal and mesenteric injuries in seat belt wearers, which were encountered from May, 1984 to December, 1987 in the Department of Gastroenterological Surgery of Saga Medical School, are reported. The six cases consisted of one case of jejunal perforation, two of perforations of both the small intestine and colon, one of seromuscular tears of both the small intestine and colon, and two of seromuscular tears of the colon. Three of five colonic injuries were seromuscular tears of the colon accompanied with mesenteric tears or hematomas. Five were males and one was femals, and their ages ranged 32 to 69 years with the average of 51.7 years. There was one death that was attributable to the anastomotic leakage followed by septic shock relating to over surgery for her attendant compromised condition. All patients except the female showed favorable and satisfactory postoperative courses. Even a careful preoperative evaluation can not afford an accurate diagnosis to blunt gastointestinal injuries. Computed tomography is the most useful diagnostic imaging for concomittent identification of both intraabdominal free air and fluid collection in such patients. Since the legislation of compulsory seat belt wearing in Japan, it seems that blunt abdominal injury due to seat belt may increase with an increase in number of traffic accidents. It is emphasized that we must carefully evaluate the patients of automobile accidents, bearing the fact in mindthat seat belt wearers have an unusually higher incidence of blunt gastrointestianl and mesenteric injuries.

Motivating Auto Safety Belt Wearing in Industrial Settings:

Employees at an industrial plant (n = 141) participated in 40-minute safety belt "awareness sessions," which for some groups included opportunities to sign buckle up pledge cards. The duration of the pledge period was one week, one month, or three months for different groups of approximately 35 employees each. The awareness sessions, alone or with pledge cards, yielded a three-fold increase in safety belt use (from approximately 20% to 60%), which was sustained over the 13 weeks of post-session observation. While most employees signed pledge cards regardless of the pledge duration, pledging did not produce greater increases in safetey belt use than the awareness sessions without pledge cards. Further, pledge duration had no differential effect on likelihood of signing, or subsequent compliance. The usual white/blue-collar difference was found, with white-collar employees showing higher rates of safety belt use throughout the study. The results suggest strongly that an "intrinsic control" strategy of raising awareness and increasing personal commitment to buckle up can substantially increase safety belt use. The application of this approach as a cost-effective component of an overall program to increase safety belt use is discussed.

Effect of blended paraffinic base oils on abrasive belt grinding of stainless steel

The effect on grinding performance of blended paraffinic base oils of about the same viscosity was examined experimentally with a newly improved apparatus, in which a pressurized air cylinder is installed as the work infeed system. Stock removal was not affected by the kinds of blended base oil, however, abrasive belt wear decreased with the blended base oil as compared with the single base oil.

摩耗と摩擦 ベルトの摩擦と摩耗

摩耗と摩擦 ベルトの摩擦と摩耗

Technical expertise and risk conflict: An institutional study of the British compulsory seat belt debate

Controversy and public conflict seem to be inevitable features of contemporary risk debates. In the face of such disputes, one common response has been to characterise disagreement as a disparity between expert analyses of ‘actual’ risk, and emotional ‘perceptions’ of hazard. This paper uses the example of the British policy debate over compulsory seat belt wear in order to argue that these characterisations are inaccurate and obstructive. Instead, an ‘institutional’ perspective on such issues is advocated - this perspective considers the effect of political and organisational factors in shaping the direction of public debate. The analysis here focuses particularly on expert disagreement over the likely effectiveness of seat belt laws - the debate over ‘risk compensation’ is reviewed both before and after the introduction of seat belt laws as an ‘experimental’ measure.

Compulsory wearing of seat belts in the United Kingdom—the effect on patients and on fatalities

Abstract This is a two‐part study. The main part reports on all car occupant patients coming to the accident and emergency departments of 14 hospitals in the United Kingdom in the years immediately before and after the introduction of seat belt legislation. This included about 5% of such casualties in the country. Using the strict methodology of stating expected changes in the form of hypotheses prior to analysis, it was confirmed that a large number of improvements occurred. These included a reduction in the total number of patients, number of bed days, multiplicity of injuries, injuries to the brain and chest, and many facial injuries. It was confirmed that after legislation there was some increase in neck sprains and sternum fractures. Front‐seat passengers obtained much greater benefits than did drivers. In a much smaller study in fatalities (again covering about 5% of fatalities in the country) it appeared that improvements occurred in head, chest, and abdomen injury, while limb injuries were not gre...

Effects of approximation on postural sway in healthy subjects.

The effect of approximation on the postural sway of healthy subjects wearing a weighted belt around their pelvis was measured. Twenty subjects between the ages of 23 and 30 years stood on a polyurethane foam platform that amplified their postural sway and were filmed from a lateral view. All subjects wore markers over their mandibles, hips, and knees and were filmed three times with the weighted belt worn on a randomly selected trial. Frames from a 10-second interval of film from each trial were studied, and the summed displacement at each bony landmark between each frame of film was calculated. A significant decrease in displacement at the mandible (p less than .02) was found when the weighted belt was worn. The decrease in displacement was not significant at the hip or knee. Approximation was shown to decrease the postural sway of healthy subjects. Further study is indicated to investigate the effect of approximation on patient populations.

Seat Belts and Human Rights: An Appraisal

Mandatory seat belt legislation has been passed in 15 states. Accompanying this action has been a deluge of information concerning the lives saved and the injuries prevented by the wearing of seat belts by the front seat passengers in automobiles. This study presents data relating to the injuries and deaths attributable to their usage. There is virtually no major area of the adult body that has escaped such involvement. Mechanisms by which seat belt injury is effected are described in relation to the restraint systems currently available in the United States and abroad.

Fatal cervical spinal injuries in road traffic accidents

The present study analyses fatal road traffic accidents involving private cars and vans in Finland during the period 1972–1982, in which an injury to the cervical spine was the main cause of death. The material consists of 289 victims; this being 10.5 per cent of all the fatalities in this category of road traffic accidents. Front seat and rear seat passengers seem to have an equal risk of sustaining a fatal cervical spinal injury. However, front seat passengers have a significantly greater chance ( P < 0.001) of having fatal cervical spinal injuries than the drivers. Of the victims 21.1 per cent had worn safety belts but there was no statistical difference between those who did and those who did not wear safety belts. Increasing age seems to increase the risk of fatal cervical spinal injuries. Patients between 16 and 25 years of age had the lowest risk and patients over the age of 60 had the highest risk of sustaining a fatal cervical spinal injury ( P < 0.001). In 48.1 per cent of the cases, the victims were multiply injured and this is similar to other main causes of death in road traffic accidents. Wearers of safety belts had significantly ( P < 0.001) more multiple injuries. Of the patients who died of cervical injury, only 8.8 per cent survived transportation to hospital and 1.4 per cent survived longer than 24 hours. A direct blow was the most common mechanism of the cervical injury (47.1 per cent) and deceleration was found in 13.1 per cent of the cases. Deceleration was more common in victims wearing safety belts ( P < 0.001). The wearing of safety belts could well have saved 39.1 per cent of the fatally injured victims. Furthermore, head and neck supports could have saved 14.3 per cent of the victims whose cervical spinal injury was caused by deceleration.

The effect of variable-rate cash incentives on safety belt use

Following an awareness campaign targeting the use of safety belts at a large pharmaceutical company, the present research examined the effects of a variable-rate cash-incentive strategy designed to further boost the level of plant-wide safety belt use. The observed percentage of belt use showed a sig- nificant increase during the incentive phase and a subsequent decline during short-term follow-up, although levels during follow-up were significantly higher than during baseline. Belt wearing was found to be essentially un- changed 6 months later during long-term follow-up.

Passenger safety in cars.

Comparison of child passengers between January 1983 and 1984 showed an increased use of rear safety restraints after the wearing of front seat belts became mandatory. In 1984, however, only 25% of children were restrained, most commonly in a safety seat.

The effect of seat belt legislation on injuries sustained by car occupants

Details are given of the injuries sustained by 402 car drivers, 209 front seat passengers and 147 back seat passengers involved in road accidents during the two 4-month periods before and after the introduction of the compulsory wearing of seat belts on 1 February 1983. Comparisons are made between the injury patterns in those wearing and not wearing seat belts and in back seat passengers.

THE WORK OF A REGIONAL HEAD INJURY SERVICE

A survey was done of the workload involved in conducting a programme in which all degrees of severity of head injury are managed in one unit staffed by neurosurgeons. Of 1919 patients admitted to the unit in 1981, 93 were classed as severe (in coma), 210 as moderate, and 1616 as minor (fully conscious or confused only) on admission. Although the proportion of intracranial haematomas, multiple injuries, life-threatening complications, and deaths was highest in severe cases, the work of looking after the very large numbers of moderate and minor cases was as great as that of looking after severe cases as defined by number of investigations, operations, and complications, morbidity, and duration of hospital stay. In 1982 the admission policy was changed so that temporary loss of consciousness was no longer an indication for admission. This change resulted in a 24% reduction in number of admissions. Seat-belt legislation, enacted early in 1983, was followed by a further 21% reduction in the admission rate and this was maintained in 1984. Not all of this latter reduction can, however, be attributed to the wearing of seat belts.

Pacemaker discomfort induced by the wearing of seat belts.

A survey was made of 100 consecutive pacemaker recipients to examine problems they may have experienced with seat belts whilst travelling by car, either as drivers (29 patients) or front seat passengers (50 patients). Twenty-one per cent of the drivers and 30% of the front seat passengers had experienced symptoms, usually of a mild nature. Re-siting of the generator was only necessary in 1 patient and no example of electrode displacement was observed. Suggestions are made as to how this problem might be overcome.