Total Casualties Research Articles

Safety-belt effectiveness: The influence of crash severity and selective recruitment

While theoretical considerations show that the effectiveness of occupant protection devices declines from 100% at very low crash severity to 0% at high severity, empirical details have been lacking. When overall in-use effectiveness is estimated by applying traditional methods to data sets that lack a measure of severity, large biases are introduced because non-wearing drivers are riskier drivers, an effect that has been called selective recruitment. These effects are investigated empirically using National Accident Sampling System (NASS) data in which crash severity is measured by delta-v, the estimated change in the speed of the car as a result of the crash. Supplemental results are obtained using published police-reported data containing a more easily obtained but less objective severity measure. Both data sets provide information on driver fatalities and injuries, thus allowing four comparisons of effectiveness estimates based only on total casualties with ones taking into account the different severities of crashes by belted and unbelted drivers. The data show consistently that the probability that a driver is belted declines as crash severity increases. Belt effectiveness estimates ignoring this effect are biased upwards by large amounts (for example, 60% compared to 40% for injuries using NASS data). Belts appear more effective at preventing fatalities than at preventing injuries. The results are consistent with a prior estimate, derived using a method unaffected by the biases discussed here, which found that, averaged over all crashes, safety belts reduce driver fatality risk by (42 ± 4).

A Sociology for Special Circumstances: Using the Vietnam War in the Classroom

In this paper I describe a minicourse, adapted to an illiberal pedagogical setting, that draws on the Vietnam War, and I provide a synopsis of its content. My purpose is to suggest a strategy for using the war as a case study for two topics central to the concerns of sociologists-inequality and ideology. Data about the war are marshaled to address two questions: Were the burdens of war equally distributed? and Was the American military handicapped in Vietnam by political constraints? To address the first question, I use information about the draft, draft policy, and American casualties to suggest that policy reproduced institutionalized inequalities of race and class. To the second question I bring to bear measures of American operations-expenditures and destructive force-and total casualties to argue that conservative apologies invoking self-defeating limits ignore the magnitude and consequences of our efforts in Vietnam. Within the synopsis, I incorporate sources for data, note some problems in the data available, make suggestions about interpretation, and address some pedagogical issues.

Necrotizing soft tissue lesions after a volcanic cataclysm

A volcanic cataclysm of major proportions, the fourth largest in terms of total casualties in the history of mankind, wiped out the town of Armero, Colombia, in 1985 resulting in over 23,000 deaths and 4,500 wounded. Among the hundreds of survivors who were transferred to hospitals in the capital city of Bogotá, there was as overwhelming number who developed necrotizing fasciitis. These patients constitute, perhaps, the single largest group of this type of lesions in the recorded literature. Thirty-eight patients with well established necrotizing fasciitis were identified at 4 selected hospitals in Bogotá; 8 of them presented with zygomycetic infection (mucormycosis), a highly lethal entity. Many additional cases were treated at other hospitals in Bogotá and several cities in Colombia. The main clinical features of these 38 patients affected by necrotizing fasciitis are reviewed, with special emphasis on the patients with mucormycosis. Patients with necrotizing fasciitis had an overall mortality rate of 47.7%; patients with mucormycosis, 80%. A plea is made for an early diagnosis, utilizing tissue sampling and microbiological studies, so that prompt and radical treatment can be instituted. This is especially pertinent in situations of natural disasters resulting in massive numbers of casualties and seriously injured survivors.

Disabilities caused by road traffic accidents and their relation to severity scores

The disabilities incurred by 2502 road accident patients admitted in three separate years to an Accident Hospital have been analysed. There were about equal numbers of disabled among pedestrians, motorcyclists and vehicle occupants. This corresponds to the high relative frequency and severity of injuries among motorcyclists. Most of the serious disabilities were caused by head or lower limb injuries. Different severities of disability were not closely correlated with Abbreviated Injury Scale (AIS), (ISS) or (PI) scores or with treatment periods but useful threshold values are described which separate groups with high and low rates of disability. For given severities of injury, disabilities were less severe among young casualties. Comparisons with other studies show rather wide variations in estimates of the incidence of slight disabilities. There is fair agreement with the present findings that serious disabilities occur in about 3% of inpatient hospital cases or in about 1% of total casualties.

Trends and characteristics of road traffic accidents in Nigeria.

THE TRENDS AND characteristics of road traffic accidents in Nigeria were evaluated using data from the police records. The study showed that there has been increasing trends in the case fatality rates, injury and th rates per 100,000 population. There have also been easing trends in the severity of the accidents. During the last ten years (1974-1983) the number of accidents increased by 10.4%, injured cases increased by 43%, cases of deaths increased by 110.6%, total casualties increased by 57.1% and human population increased by 27.2%. The mortality pattern showed that for every five fatal accident victims one subsequent death occurred outside the accident scene. The majority of the accident victims in Nigeria are young adults of the age group 22 to 30 years and about 75% of the accident victims are males. Unsafe acts (reckless and dangerous driving, driving without licence, excess speed, alcoholism, faulty pedestrian attitude, etc.) constitute the major causes of RTAs in Nigeria. Other contributory factors include unsafe driving conditions such as road and vehicle defects. The observations from the present study indicate the need for a regular evaluation of accident trends in relation to a critical evaluation and innovation of accident counter measures in Nigeria.

Disabilities caused by road traffic accidents and their relation to severity scores

The disabilities incurred by 2502 road accident patients admitted in three separate years to an Accident Hospital have been analysed. There were about equal numbers of disabled among pedestrians, motorcyclists and vehicle occupants. This corresponds to the high relative frequency and severity of injuries among motorcyclists. Most of the serious disabilities were caused by head or lower limb injuries. Different severities of disability were not closely correlated with Abbreviated Injury Scale (AIS), (ISS) or (PI) scores or with treatment periods but useful threshold values are described which separate groups with high and low rates of disability, For given severities of injury, disabilities were less severe among young casualties, Comparisons with other studies show rather wide variations in estimates of the incidence of slight disabilities. There is fair agreement with the present findings that serious disabilities occur in about 3% of inpatient hospital cases or in about 1% of total casualties.

Radiation casualties in a nuclear war.

Calculations of the effects of nuclear explosions over London suggest that the proportion and absolute number of radiation fatalities are higher than previously estimated. They are sensitive to the value of LD50 assumed for people, but the number of total casualties, deaths plus injuries, is practically independent of the LD50.

Epidemiological analysis of deaths caused by burns in Osaka, Japan

By referring to all of the death cards recorded for the year of 1978 in the whole area of Osaka Prefecture, we examined deaths due to burn injuries, electric injury and heatstroke, and obtained the following results. 1. 1. Of the total 41 737 deaths, externally induced death took place in 3207 cases (8 per cent), and death due to burn injuries including electric shock and heatstroke took place in 215 cases (2–60 cases against 100 000 population), accounting for 6.7 per cent of all externally induced deaths. In those aged under 40 years, externally induced death ranked highest as the cause of death, and burn injury was one of the chief causes. 2. 2. The sex ratio of burn-induced death was 3: I for males and females, respectively. However, if burn injuries resulting from social factors and suicide were excluded, the sex ratio was not significantly different at 1-3:1. The causes of injury were work accidents, suicide and other accidents at a rate of I: 2: 3. 3. 3. The monthly incidence of injuries was larger in winter when there were many cases of on-the-spot death due to fire, but there was no significant difference in the monthly incidence of post-treatment death. 4. 4. Of the 215 cases, 158 (73–5 per cent) died on the spot, while only 57 cases died after treatment. There were apparent regional differences in the total casualties. Post-treatment death probably occurred in 30 per cent of the total deaths induced by burn injuries. 5. 5. Medical institutions receiving burn victims could be divided into private and public ones at a nearly equal ratio. Public institutions took a significantly larger proportion of this type of casualty than following road accidents. 6. 6. Supplementary investigations revealed that two to three times as many people died at the scene of the accident than died after treatment from severe burns, this amounted to 140 cases a year in the whole area of Osaka Prefecture.

The Vietnam War as a Richardson Process

The general hypothesis of this empirical research is that an escalating limited war follows an action-and-reaction process which is less calculated and more irrational than an 'old- fashioned' declared war. The specific hypothesis is that the Vietnam war can be described by the Richardson arms race equations, with total casualties replacing total arms expenditures. Irregularities in the resulting curves were tested against qualitative events over the time period studied. The general hypothesis was not confirmed; the specific hypothesis was confirmed - the Vietnam escalation appears to be very similar to the arms race preceding World War II with a single sharp change in slope interrupting an otherwise consistant straight line plot. Two events may account for the apparent discontinuity: the Tonkin Bay incident of August 1964 and the Pleiku base incident of February 1965 followed immediately by the U.S. bombing of North Vietnam. It is noted that the events cited correspond to a change of office in the American presidency, and it is speculated therefore that another change of office in January 1969 may lead to a further discontinuity. On the basis of the calculations, it is suggested that peace negotiations and a de-escalation of the fighting are more likely to occur after there is a significant with drawal of American combat troops from Vietnam.

Epidemiology of Accidents

This article examines the different features of accidents which are investigated. It includes all types of accidents, such as labor accidents, transit accidents, and home accidents. In the section on transit accidents, the following aspects are considered to be the most usual aspects investigated: absolute number of accidents; relative numbers--several rates are used (period under study, generally a year, is compared with others; types--the ones considering the total accidents and the ones considering the total casualties); total of registered vehicles; license holder drivers; estimate about the mileage fared; total number of deceases; number of disabling injuries; costs; gravity and frequency trend.

THE USE OF HYPNOSIS IN THE TREATMENT OF ACUTE COMBAT REACTIONS

Neuropsychiatric casualties constituted from 30 to 35 percent of the total combat casualties of the past war. With wards filled, with limited personnel and facilities, with a pitifully small staff able to administer therapy, it seemed of paramount importance to shorten the period of time required for treatment. Various methods were tried, none so controversial and at the same time successful as hypnosis. In the following paper its use, application, limitations and defects will be discussed.

War Wounds of the Urinary Tract

War wounds of the urinary tract do not form a high proportion of the total casualties of war. Ogilvie (1944) found 3 per cent. of total for renal injuries and 2 per cent. for bladder injuries, Blackburn (1944) found 2 per cent. for both sites. The kidneys are more often involved than the other parts of the urinary tract and generally kidney injuries are associated with multiple damage of other adjoining structures, e.g., thorax, spleen, liver, etc. Radiology is very helpful in all cases, but especially so in those cases of non-penetrating injuries of the abdomen where clinical examination suggests to renal involvement. It might be noted here that little reliance can be placed on an estimation of injury to the kidney from the possible line of a wound tract. The method of investigating these injuries will be described in detail, as it is equally applicable to the different forms of renal injury. (1) A plain supine radiograph, a “scout” film, of the abdomen should be made. A 15 × 12 in. film and a stationary...

HOSPITAL CARS FOR RAILWAY SERVICE.

The end of the nineteenth century exhibits marked improvement in the means of alleviating suffering and for saving life. The sick and wounded in the last two wars have had furnished them life-saving appliances and means of transportation never dreamed of in former times. Public sentiment is so exercised in the matter of efficient attention to the needs of the sick and wounded in warfare that it is astonishing that people think or do so little in ordinary civil life in the matter of efficient first aid and comfortable transportation for the much larger number of persons who suffer injury on our railroads. The Interstate Commerce Commission shows that, in round numbers, there were 51,743 railroad casualties to persons in the year just ended. There were 7123 fatalities and 44,620 injuries. The total casualties to the British army in the war in South Africa, up to date, amount to about