Traffic-related Injuries Research Articles

Injuries, Death, and Disability Associated with 11 Years of Conflict in Baghdad, Iraq: A Randomized Household Cluster Survey.

BackgroundThe objective of this study was to characterize injuries, deaths, and disabilities arising during 11 years of conflict in Baghdad.MethodsUsing satellite imagery and administrative population estimated size for Baghdad, 30 clusters were selected, proportionate to population size estimates. Interviews were conducted during April and May 2014 in 900 households containing 5148 persons. Details about injuries and disabilities occurring from 2003 through May 2014 and resultant disabilities were recorded.FindingsThere were 553 injuries reported by Baghdad residents, 225 of which were intentional, and 328 unintentional. For intentional injuries, the fatality rate was 39.1% and the disability rate 56.0%. Gunshots where the major cause of injury through 2006 when blasts/explosions became the most common cause and remained so through 2014. Among unintentional injuries, the fatality rate was 7.3% and the disability rate 77.1%. The major cause of unintentional injuries was falls (131) which have increased dramatically since 2008, followed by traffic related injuries (81), which have steadily increased. The proportion of injuries ending in disabilities remained fairly constant through the survey period.InterpretationIntentional injuries added substantially to the burden of unintentional injuries for the population. For Baghdad, the phases of the Iraqi conflict are reflected in the patterns of injuries and consequent deaths reported. The scale of injuries during conflict is most certainly under-reported. Difficulties recalling injuries in a survey covering 11 years is a limitation, but it is likely that minor injuries were under-reported more than severe injuries. The in- and out-migration of Baghdad populations likely had effects on the events reported which we could not measure or estimate. Damage to the health infrastructure and the flight of health workers may have contributed to mortality and morbidity. Civilian injuries as well as mortality should be measured during conflicts, though not currently done.

Bio-Mechanical Compatibility Assessment of Titanium-Nickel Alloy Fabricated Using Cold Spray Process

This paper presents the bio-mechanical compatibility assessment of Titanium-Nickel (TiNi) alloy fabricated using cold spray (CS) process. This research creates opportunity for meeting the increased demand for biomedical implants in orthopedic surgeries brought by sport and traffic related bone injuries. Due to their exceptional properties, TiNi alloys are promising alternative biomedical materials to the traditional Ti6Al4V alloys. Studies show that the conventional methods for producing TiNi alloys have several challenges. As a contribution towards resolving this problem, this paper studied the bio-mechanical properties of Ti and TiNi structures fabricated using CS process. The results of this study show that the porosity, incipient Young’s modulus, and tensile strength of TiNi and Ti coatings are close to the required values for the biomedical implants. Consequently, this research demonstrates that porous TiNi and Ti structures fabricated by CS are possible candidates for biomedical implants and that CS could be a new process for fabricating near-net shape bio-mechanical compatible materials.

Trauma pattern in a level I east-European trauma center

ObjectiveTo analyze trauma epidemiology, pattern of lesions or death profile in a level I east-European trauma center. MethodsProspective observational study of patients admitted to a level I east-European trauma center and enrolled in our trauma registry, between January 2012 to January 2013, was conducted, with the inclusion criteria: (1) trauma lesions, (2) new injury severity score (NISS) higher than 15. ResultsThere were 141 patients admitted during the study interval, including 102 (72.3%) males, with a mean age of (43.52 ± 19.00) years, and a mean NISS of 27.58 ± 11.32. The trauma etiology was traffic-related injuries 101 (71.6%), falls 28 (19.9%) and crushing injuries 7 (5.0%). Only one case of gunshot wound was encountered in our study. Out of traffic-related injuries, the automobiles were involved in 56 (55.4%) and motorcycles in 9 (8.9%) patients. The bicyclists accounted for 2 (2.0%) of patients and pedestrians hit by vehicles were in 33 (32.7%) cases. High-velocity falls were found in 7 (25.0%) patients, whereas low-velocity falls accounted for 21 (75.0%) of cases. The overall mortality was 30.00%, and these patients presented the mean NISS of 37.63. ConclusionsOur trauma pattern profile is similar to the one found in west-European countries, with a predominance of traffic-related injuries and falls. The severity and anatomical puzzle for trauma lesions were more complex secondary to motorcycle or bicycle-to-auto vehicles collisions. A trauma registry, with prospective enrollment of patients, is a very effective tool for constant improvements in trauma care.

Assessing Trauma Care Capabilities of the Health Centers in Northern Ghana

Traffic-related injury is a major and increasing cause of global mortality, especially in low- and middle-income countries (LMICs). However, trauma systems, personnel, resources, and infrastructure are frequently insufficient to meet the needs of the population in this at-risk population in LMICs. In addition, these resources are not uniformly distributed, coordinated, nor well described within most countries. Trauma care resources have not previously been characterized in the Northern Region of Ghana. We performed uniform site evaluations and interviews at 92 hospitals in Northern Ghana. Trauma systems, material resources, and human resources were quantified. Equipment was characterized as available in the Emergency Department (ED), in the hospital only, or unavailable. Hospitals were categorized as primary, district, or referral. Forty-two primary hospitals, 48 district hospitals, 3 regional hospitals, and 1 teaching hospital were surveyed. Over 95 % of hospitals reported having no training or systems for the care of injured patients. Substantial clinical equipment deficits were found at most primary hospitals. In over 90 % of these hospitals, the majority of circulation and monitoring, airway and breathing, and diagnostic imagining resources were not available. Equipment was also frequently unavailable at district and regional hospitals. When available, these resources were infrequently present in the ED. Although resources may be unavoidably constrained, there are substantial opportunities to improve the systematic management of trauma care and improve the education of the medical providers regarding care of injured patients in the region studied.

Child safety and injury prevention.

1. Jennifer E. Sanders, MD 2. Leora Mogilner, MD 1. Icahn School of Medicine at Mount Sinai, New York, NY 1. 1. Hagan JF, 2. Shaw JS, 3. Duncan PM Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents , 3rd ed. Hagan JF, Shaw JS, Duncan PM, eds. Elk Grove Village, IL: American Academy of Pediatrics; 2008 2. In-Line Skating Injuries in Children and Adolescents. American Academy of Pediatrics Committee on Injury and Poison Prevention and Committee on Sports Medicine and Fitness. Pediatrics. 1998;101(4):720–722 [OpenUrl][1][Abstract/FREE Full Text][2] 3. Child Passenger Safety. American Academy of Pediatrics Committee on Injury, Violence and Poison Prevention. Pediatrics. 2011;127(4):788–792 [OpenUrl][3][Abstract/FREE Full Text][4] 4. SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment . Task Force on Sudden Infant Death Syndrome. Pediatrics. 2011;128(5):1030–1039 [OpenUrl][5][Abstract/FREE Full Text][6] 5. National Action Plan for Child Injury Prevention . Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Atlanta, GACDC, NCIPC; 2012 Unintentional injuries are the leading cause of death in the United States among children older than 1 year of age, adolescents, and young adults. Each year, nearly 9 million pediatric patients are treated in emergency departments for unintentional injuries, and more than 9,000 die from their injuries, amounting to approximately 25 children each day. Common causes of fatal and nonfatal unintentional injury include motor vehicle collisions, drownings, fires, falls, and sports-related injuries. Aside from their morbidity and mortality, these injuries and their treatment result in significant financial burdens for families and society. Children and adolescents are particularly vulnerable to injury because of their size, immature development, natural curiosity, and inexperience. Males have a higher risk of injury compared to females, and the male death rate from injury is twice that of females. A number of social factors suggestive of family stress and disorganization are associated with greater childhood injury, including lower socioeconomic status, lower maternal age, lower maternal education, and an increased number of people living in one household. Injury rates also vary based on geographic location. Fire and burn-related injuries and deaths are greatest in the southern states, while traffic-related injuries are greatest in the Great Plains states and the South. Motor vehicle crashes are a leading cause of preventable deaths across all age groups. Patient visits … [1]: {openurl}?query=rft.jtitle%253DPediatrics%26rft.stitle%253DPediatrics%26rft.aulast%253DCommittee%2Bon%2BInjury%2Band%2BPoison%2BPrevention%2Band%2BComm%26rft.auinit1%253D%2B%26rft.volume%253D101%26rft.issue%253D4%26rft.spage%253D720%26rft.epage%253D722%26rft.atitle%253DIn-line%2BSkating%2BInjuries%2Bin%2BChildren%2Band%2BAdolescents%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpeds.101.4.720%26rft_id%253Dinfo%253Apmid%252F9521966%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=pediatrics&resid=101/4/720&atom=%2Fpedsinreview%2F36%2F6%2F268.atom [3]: {openurl}?query=rft.jtitle%253DPediatrics%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpeds.2011-0213%26rft_id%253Dinfo%253Apmid%252F21422088%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/ijlink?linkType=ABST&journalCode=pediatrics&resid=127/4/788&atom=%2Fpedsinreview%2F36%2F6%2F268.atom [5]: {openurl}?query=rft.jtitle%253DPediatrics%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpeds.2011-2284%26rft_id%253Dinfo%253Apmid%252F22007004%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [6]: /lookup/ijlink?linkType=ABST&journalCode=pediatrics&resid=128/5/1030&atom=%2Fpedsinreview%2F36%2F6%2F268.atom

A83 Road traffic injuries and Alcohol: Double jeopardy in Pacific Island nations fuelled by inequitably distributed determinants of health

Abstract Background Efforts to address the burden of road traffic injuries in Pacific Island countries and territories are theoretically based on initiatives identified by the global road safety community. However, common risk factors targeted, including drink driving, are poorly quantified with respect to contribution to injury-involved crashes and contextual factors that challenge preventive interventions. We investigated the contribution of alcohol to the population-based burden of serious injury-involved road crashes in Fiji (second largest Pacific Island nation). We examine the findings in light of social determinants of health and injury, and the implications for future policy initiatives. Methods We undertook an analysis of the Traffic-Related Injury in the Pacific (TRIP) project funded by the Wellcome Trust and Health Research Council of New Zealand. Specifically, a case-control study of four-wheeled motor vehicles was conducted in Viti Levu, Fiji in 2004/5 involving crash vehicles (recruited through a study specific hospital surveillance system) and a representative sample of control vehicles (recruited from road side surveys). Key informants for the study (drivers of the vehicles) completed standardised self-report surveys. Logistic regression analyses examined the association between alcohol and road traffic injuries, adjusting for relevant confounders. The findings were evaluated and interpreted applying the World Health Organization’s Priority Public Health Conditions Analytical Framework. Results The case control study involving 140 crash vehicles and 752 control vehicles revealed the three-fold excess in the odds of serious injury-involved crashes (resulting in hospital admission or death of a road user) associated with the consumption of alcohol within the 12 h prior to driving (Adjusted Odds Ratio 3.2; 95% confidence interval: 1.1-9.4). Using the Priority Public Health Conditions Analytical Framework, we identified important social parameters influencing inequities in the distribution of alcohol consumption and being a victim of road crashes in Pacific settings. In particular, we found differential distributions in socioeconomic position, exposure to alcohol, vulnerabilities to injury, and related outcomes. Conclusions Alcohol imposes a substantial contribution to the burden of road traffic injury in the Pacific. However, there are several impediments to addressing this problem due to the inequitable distribution of alcohol exposure and road injury which are systemic, avoidable, unfair, and unjust. These findings highlight the imperatives to strengthen policies that address root causes of road injury embedded in inadequately regulated motorization, marketing and supply of alcohol, deficiencies in implementing drink-driving legislation and systemic improvements in transport infrastructure.

Utility of a near real-time emergency department syndromic surveillance system to track injuries in New York City.

BackgroundThe New York City emergency department (ED) syndromic surveillance (SS) system provides near real-time data on the majority of ED visits. The utility of ED SS for injury surveillance has not been thoroughly evaluated. We created injury syndromes based on ED chief complaint information and evaluated their utility compared to administrative billing data.MethodsSix injury syndromes were developed: traffic-related injuries to pedal cyclists, pedestrians, and motor vehicle occupants; fall-related injuries; firearm-related injuries; and assault-related stabbings. Daily injury counts were compared for ED SS and the administrative billing data for years 2008–2010. We examined characteristics of injury trends and patterns between the two systems, calculating descriptive statistics for temporal patterns and Pearson correlation coefficients (r) for temporal trends. We also calculated proportions of demographic and geospatial patterns for both systems.ResultsAlthough daily volume of the injuries varied between the two systems, the temporal patterns were similar (all r values for daily volume exceeded 0.65). Comparisons of injuries by time of day, day of week, and quarter of year demonstrated high agreement between the two systems—the majority had an absolute percentage point difference of 2.0 or less. Distributions of injury by sex and age group also aligned well. Distribution of injury by neighborhood of residence showed mixed results—some neighborhood comparisons showed a high level of agreement between systems, while others were less successful.ConclusionsAs evidenced by the strong positive correlation coefficients and the small absolute percentage point differences in our comparisons, we conclude that ED SS captures temporal trends and patterns of injury-related ED visits effectively. The system could be used to identify changes in injury patterns, allowing for situational awareness during emergencies, timely response, and public messaging.Electronic supplementary materialThe online version of this article (doi:10.1186/s40621-015-0044-5) contains supplementary material, which is available to authorized users.

Automated speed enforcement systems to reduce traffic-related injuries: closing the policy implementation gap

In the USA, traffic-related injuries are responsible for over 33 000 deaths each year1 and are the leading cause of death for individuals aged 1–24 years.2 Traffic-related injuries also take...

Young adult's own and parental social characteristics predict injury morbidity: a register-based follow-up of 135,000 men and women.

BackgroundSociodemographic differences in injury mortality are well-established, but population-level studies on social patterns of injury morbidity remain few in numbers, particularly among young adults. Yet injuries are the leading cause of mortality, morbidity and disability among young people. Studies among children have shown steep social gradients in severe injuries, but less is known on the social patterning of injuries in late adolescence and early adulthood, when young people are in the process of becoming independent adults. This study examines how young adults’ current living arrangements, education, main economic activity, and parental social background are associated with hospital-treated injuries in late adolescence and early adulthood.MethodsThe study uses prospective, individual-level data gathered from several administrative sources. From a representative 11% sample of the total Finnish population, we included young people between ages 17–29 years during the follow-up (N = 134 938). We used incidence rates and Cox proportional hazards models to study hospital-treated injuries and poisonings in 1998–2008.ResultsHigher rates of injury were found among young adults living alone, single mothers, the lower educated and the non-employed, as well as those with lower parental social background, experience of childhood family changes or living with a single parent, and those who had left the parental home at a young age. Injury risks were consistently higher among young adults with lower education, but current living arrangements and main economic activity showed some age-related nuances in the associations: both earlier and later than average transitions in education, employment, and family formation associated with increased injury risks. The social differentials were strongest in poisonings, intentional self-harm, and assaults, but social patterns were also found in falls, traffic-related injuries and other unintentional injuries, underlining the existence of multiple distinct mechanisms and pathways behind the differentials.ConclusionsThe transition to adulthood is a life period of heightened risk of injury, during which both parental social background and the young people’s own social position are important determinants of serious injuries that require inpatient care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1763-9) contains supplementary material, which is available to authorized users.

Traffic accident injuries in a referral Orthopedic Hospital in North West of Iran during summer 2009

Introduction: Road traffic injuries are a major public health problem, requiring huge efforts for effective and sustainable prevention. Because of the high occurrence of traffic accidents in Iran, basic data acquisition is highly needed to implement prevention plans. The present research is conducted as an epidemiological study of the traffic accident victims referred to a referral orthopedic center in North West of Iran. Methods: A cross-sectional study was conducted during a 3 months period from June to September 2009 in Tabriz, Iran. A total of 16681 patients were admitted to the emergency ward, and 3246 patients (19.5%) were hospitalized during this period because of traffic related injuries. After randomization, 630 cases were selected to be enrolled in the study. The location of an accident, position of road users, type of crashed vehicle, cause of accident, type of injury, time interval from accident to hospitalization and treatment outcome were recorded. Statistical analyses were carried out using SPSS software. Results: The mean age of the patients was 31 years (range, 6 months to 98 years) and 77.0% of patients (468 cases) were men. A total of 193 (36.6%) patients sustained traffic accident in open roads and 335 (63.4%) in urban corridors. In 67 (12.9%) of accidents, there was only a single occupant in the vehicle. The time interval between the accident and admission was 6.6 ± 3.2 hours. Of the 608 cases, 45.7% were drivers, 30.3% passengers, and 24.0% pedestrians. Most cases of the car accident happened in urban areas, and the male victims were largely in the driver group. The most frequent type of injury was knee, leg and head trauma. Conclusion: The large number of traffic-related injuries admitted to our emergency ward that comprise mostly young adults should be considered as an alarming signal to policy makers and health providers in our province. Strict control on drivers’ behavior should be taken into account if increasing human loss and injury on the roads are to be averted

Population-based incidence and cost of non-fatal injuries in Iran: a consistent under-recognized public health concern

ObjectivesTo investigate the incidence and determinants of non-fatal injuries, and the cost imposed on victims in an Iranian population aged 15–64 years. DesignCross-sectional household survey. MethodsThree-stage probability sampling was conducted for selection of a representative sample of Iranians. Data on the demographics, history and cost of injury were obtained from face-to-face interviews and telephone calls. ResultsIn total, 7886 subjects were included in this study. The annual incidence rate of all injuries was 905 (95% confidence interval 853–957) per 1000 population (approximately nine injuries per ten Iranians). The mean (±standard error) incidence rates of first aid injuries (FAIs; medical care not required) and medical-attended injuries (MAIs; medical treatment sought) were 737 ± 24 and 168 ± 12 per 1000 population, respectively. Young, urban females were at highest risk for FAIs, and single males were at highest risk for MAIs. The most common injury description was as follows: non-paid work (activity), home (place), inanimate mechanical force (mechanism), upper limb (site of injury) and open wound (type of injury). For MAIs, the most common place of treatment was hospital. Traffic-related injuries had the highest total cost and the lowest out-of-pocket cost. Total and out-of-pocket costs of non-fatal injuries in Iran in 2011 have been estimated to be US$6,111,138,000 and US$1,480,411,000, respectively. ConclusionNon-fatal injuries are an under-recognized public health problem. Cost-control policies are essential to reduce the out-of-pocket cost of injuries.

Assessment of disability with WHODAS II – 12 Item in trauma patients

Background: More than a billion people worldwide live with disabilities and the majority of disabilities are caused by injuries. Objectives: This study describes disability and return to work or daily activities status over 3 months following injury. Patients and Methods: In this prospective follow up study, 140 injured patients aged 15–65 year in Kashan were assessed for disability status with the brief WHODAS II 12-item instrument at 1and 3-months post-injury. Participants were divided into 5 groups as follows: ‘no disability’ to ‘very severe disability’ based on the score. Work status was ascertained at the 3-month assessment with the single question “Are you back at work or back to your daily activities following your injury?” Also demographic characteristics such as age, gender, place of residency, nationality, level of education, and information about type of injury, place of injury, injured organ, injury severity score (ISS), revised trauma score (RTS), and duration of hospital stay were gathered by a checklist. Data analysis was conducted using SPSS and the significance level was set at p < 0.05. Results: The average age of patients was 34.1 ± 14.6 year. In total 86.4% of the participants were male, 78.6% lived in urban areas, 87.1% were Iranian, and 58.6% were employed. A total of 62.1% of trauma patient injuries were traffic related injuries and most of them (75%) were motor cycle accidents. A total of 79.3% of patients had injuries in the extremities with other injuries as follows: head and neck (41.4%), thorax (7.1%), and abdomen (3.6%). The mean disability score at 1and 3-months post injury was 25.9 ± 10.2 and 16.47 ± 7.8, respectively. There was statistically significant differences between disability statuses at 1and 3-months after trauma (P < 0.0001). After 3-months, 79.3% of patients had returned to work or daily activities (mean and SD time of return was 27.7 ± 23.9 days). The disability measures showed a statistically significant relationship with ISS (P < 0.0001) and return to work (P < 0.0001) in trauma patients. Conclusion: Considering more than one third of patients were disabled after 3 months following trauma, this information may help in organize long-term follow up and rehabilitation programs in trauma patients.

Preventing Child Pedestrian Injury: A Guide for Practitioners.

Each year, an estimated 270,000 pedestrians die from road traffic-related injuries, (worldwide) and children are among the most vulnerable. Child pedestrian injuries occur primarily in residential areas, often on the same street or in close proximity to the child's home, and 90% of injured child pedestrians are unaccompanied by an adult at the time of the injury. The cause of these injuries is a complex combination of factors related not only to characteristics of the child but also the built environment, the road configuration, features of the motor vehicle that might reduce injury, and driver behavior. Accordingly, effective interventions must incorporate education, technology, and improved infrastructure. The medical practitioner can not only provide the necessary education but can also be a powerful voice for changes in pedestrian infrastructure that make walking safer. This article explores the current state of childhood pedestrian injuries using examples from the United States and Australia. Pedestrian interventions and the role that primary care and lifestyle practitioners play in promoting safe pedestrian behaviors among their patients and their families are discussed.

Trauma Severity at Level 2 Trauma Center – Attainability of Retrospective Documentation on Severity

Background: Centralizing and specializing in Danish health care is ongoing. Around the country Mobile Emergency Care Units (MECU) are introduced during the past years. Pre-hospital triage is important to evaluate at which trauma level the severely injured patients must be received. The aim of our study was to evaluate changes in the severity in adult traffic related high injury traumas admitted to a level 2 trauma center at Odense University Hospital, Svendborg Hospital (OUH-SH) during the last decade and before and after the introduction of the local MECU through the years 2007-2009. Methods: The study was a retrospective study covering an eleven-year period from 2002-2012. All admissions from traffic accidents to OUH, SH were extracted from the hospital inpatient registry for patients aged 18+. The study was performed as a pilot study including only patients born 1 st -6 th in every month. Based on clinical record reviews and radiology findings, we decided if the patient was Multi Trauma (MT) defined as received by trauma response team and/or CT trauma scanned. Diagnoses were evaluated and maximum Abbreviated Injury Score (mAIS) was assigned dividing patients in severe injured with mAIS ≥ 3 and less injured with mAIS < 3. Data was compared as proportions and confidence intervals and furthermore data before and after the launching of the MECU was dichotomized. Results: A total of 363 traffic injury patients were identified. Five were undeterminable in MT status and 137 non-MT patients were excluded, giving 221 adult MT cases for analysis. Forty-one patients (19%, CI: 14-24) had mAIS ≥ 3. Percentages varied with year from 0-29% with no up- or downwards trend throughout the decade. Proportion of mAIS ≥ 3 in the years before implementing the MECU in Svendborg was 17.1% (CI: 10.2-24.0) versus 23.9% (CI: 11.1-36.7) in the years after the implementation (p = 0.32). The admission rate on MT's dropped from 24 to 15 and for mAIS ≥ 3 from 4 to 3.5. Conclusions: There was no significant change in the proportion of severely injured patients admitted to this level 2 trauma center during the last decade or after implementation of the local MECU in this study. However, a reduction in admission rate for MT's might suggest a reduction in overtriage.

Association Between Mental Health and Traffic Accidents Injuries in Iranian Men

Study of psychological consequences in traffic accident injured has received little attention in Iran. This study aimed to examine association between mental health and traffic related injuries in injured patients admitted into Emergency Department of Golestan hospital affiliated to Jundishapur University of Medical Sciences in Ahvaz, Iran. This study was done on a total of 102 injured men involved in traffic accidents as driver. The controls were consisted of 87 men that were selected from general population and had no history of traffic accident. The data was gathered using General Health Questionnaire (GHQ) and analyzed through multiple univariate Analyses of Variance (ANOVAs). There was a significant difference between individuals with traffic accident and control group in mental health, physical symptoms, depression and social functioning all (p 0.05). There were significant differences between two group in education, occupation status and marital status all (p<0.001). Traffic injuries were associated with mental health and physical symptoms, depression and social functioning components of GHQ. These results highlight the individual burden related to traffic accidents in Iran. © 2015 Asian Network for Scientific Information.

Presence and predictors of persistent pain among persons who sustained an injury in a road traffic crash.

There is a paucity of prospective studies with long follow-up that have examined a wide range of correlates associated with persistent pain outcomes in persons who sustained a mild or moderate injury in a road traffic crash. This study aimed to establish the independent predictors of pain severity over 24 months. A total of 364, 284 and 252 persons with mild/moderate musculoskeletal injuries sustained in a vehicle-related crash participated in telephone interviews in the subacute phase, and at 12 and 24 months, respectively. The numeric rating scale (NRS) assessed pain severity. Pain-Related Self-Statements Scale-Catastrophizing (PRSS-Catastrophizing) and the Short Form Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ) were also administered. After multivariable adjustment, each 1 SD increase in Short Form-12 Physical Component Score (SF-12 PCS) in the subacute phase was associated with 0.73 (p = 0.002) and 1.11 (p < 0.0001) decrease in NRS scores after 12 and 24 months, respectively. Each unit increase in the PRSS-Catastrophizing score in the subacute phase was associated with 0.54 (p = 0.001) and 0.43 (p = 0.03) increase in NRS scores 12 and 24 months later, respectively. Subacute phase OMPSQ scores were positively associated with NRS scores at 12- and 24-month follow-ups (p < 0.0001). Self-perceived physical well-being, pain-related work disability and pain catastrophizing could play a role in determining long-term pain-related outcomes following traffic-related injuries.

Estimating cost of road traffic injuries in Iran using willingness to pay (WTP) method.

We aimed to use the willingness to pay (WTP) method to calculate the cost of traffic injuries in Iran in 2013. We conducted a cross-sectional questionnaire-based study of 846 randomly selected road users. WTP data was collected for four scenarios for vehicle occupants, pedestrians, vehicle drivers, and motorcyclists. Final analysis was carried out using Weibull and maximum likelihood method. Mean WTP was 2,612,050 Iranian rials (IRR). Statistical value of life was estimated according to 20,408 fatalities 402,314,106,073,648 IRR (US$13,410,470,202 based on purchasing power parity at (February 27th, 2014). Injury cost was US$25,637,870,872 (based on 318,802 injured people in 2013, multiple daily traffic volume of 311, and multiple daily payment of 31,030 IRR for 250 working days). The total estimated cost of injury and death cases was 39,048,341,074$. Gross national income of Iran was, US$604,300,000,000 in 2013 and the costs of traffic injuries constituted 6·46% of gross national income. WTP was significantly associated with age, gender, monthly income, daily payment, more payment for time reduction, trip mileage, drivers and occupants from road users. The costs of traffic injuries in Iran in 2013 accounted for 6.64% of gross national income, much higher than the global average. Policymaking and resource allocation to reduce traffic-related death and injury rates have the potential to deliver a huge economic benefit.

Road Traffic Deaths and Injuries Are Under-Reported in Ethiopia: A Capture-Recapture Method

In low and middle income countries road traffic injuries are commonly under-reported. This problem is significantly higher among those less severely injured road users. The objective of this study was to determine the incidence and the level of ascertainment of road traffic injuries and deaths by traffic police and hospital registry. In this study two-sample capture-recapture method was applied using data from traffic police and hospital injury surveillance, through June 2012 to May 2013. The study was conducted on one of the busiest highways in Ethiopia, the Addis Ababa – Hawassa highway. Primary data were collected by accident investigators and hospital emergency nurses using a structured checklist. Four matching variables; name of the victim, sex, place and time of the accidents was used to get the matched cases. During the study period the police independently reported 224 deaths and 446 injuries/billion vehicle kilometer while hospitals reported 123 deaths and 1,046 injuries/billion vehicle kilometer. Both sources in common captured 73 deaths and 248 injuries/billion vehicle kilometer. Taking the two data sources into consideration, the capture-recapture model estimated the incidence of deaths and injuries ranged 368–390 and 1,869–1,895 per billion vehicle kilometer, respectively. The police source captured 57.4%–60.9% of deaths and 23.5%–23.9% of injuries while the hospital sources captured 31.5%–33.4% of deaths and 55.2%–56% of injuries. Deaths and injuries among females, younger age victims, cyclists/motorcyclists and pedestrians were under-reported by traffic police. In conclusion neither of the two sources independently provided accurate coverage of road traffic incident related deaths and injuries. Strengthening both systems is necessary to obtain accurate information on road accidents and human causalities.

Burden of traumatic injuries in Saudi Arabia: lessons from a major trauma registry in Riyadh, Saudi Arabia.

BACKGROUND AND OBJECTIVESIn Saudi Arabia (SA), injuries are the second leading cause of death; however, little is known about their frequencies and outcomes. Trauma registries play a major role in measuring the burden on population health. This study aims to describe the population of the only hospital-based trauma registry in the country and highlight challenges and potential opportunities to improve trauma data collection and research in SA.DESIGN AND SETTINGSUsing data between 2001 and 2010, this retrospective study included patients from a large trauma center in Riyadh, SA.PATIENTS AND METHODSA staff nurse utilized a structured checklist to gather information on patients’ demographic, physiologic, anatomic, and outcome variables. Basic descriptive statistics by age group (≤14 vs >14 years) were calculated, and differences were assessed using student t and chi-square tests. In addition, the mechanism of injury and the frequency of missing data were evaluated.RESULTS10 847 patients from the trauma registry were included. Over 9% of all patients died either before or after being treated at the hospital. Patients who were older than 14 years of age (more likely to be male) sustained traffic-related injuries and died in the hospital as compared to patients who were younger than or equal to years of age. Deceased patients were severely injured as measured by injury severity score and Glasgow Coma Scale (P<.001). Overall, the most frequent type of injury was related to traffic (52.0%), followed by falls (23.4%). Missing values were mostly prevalent in traffic-related variables, such as seatbelt use (70.2%).CONCLUSIONThis registry is a key step toward addressing the burden of injuries in SA. Improved injury classification using the International Classification of Disease-external cause codes may improve the quality of the registry and allow comparison with other populations. Most importantly, injury prevention in SA requires further investment in data collection and research to improve outcomes.

Common mental disorders in public transportation drivers in Lima, Peru.

BackgroundTraffic related injuries are leading contributors to burden of disease worldwide. In developing countries a high proportion of them can be attributed to public transportation vehicles. Several mental disorders including alcohol and drug abuse, psychotic disorders, mental stress, productivity pressure, and low monetary income were found predictors of high rates of traffic related injuries in public transportation drivers. The goal of this study was to estimate the prevalence of common mental disorders in the population of public transportation drivers of buses and rickshaws in Lima, Peru.Methodology/Principal FindingsCross sectional study. A sample of bus and rickshaw drivers was systematically selected from formal public transportation companies using a snowball approach. Participants completed self-administered questionnaires for assessing major depressive episode, anxiety symptoms, alcohol abuse, and burnout syndrome. Socio demographic information was also collected. The analyses consisted of descriptive measurement of outcomes taking into account both between and within cluster standard deviation (BCSD and WCSD). A total of 278 bus and 227 rickshaw drivers out of 25 companies agreed to participate in the study. BCSD for major depressive episode, anxiety symptoms and burnout syndrome was not found significant (p>0.05). The estimated prevalence of each variable was 13.7% (IC95%: 10.7–16.6%), 24.1% (IC95%: 19.4–28.8%) and 14.1% (IC95%: 10.8–17.4%) respectively. The estimated prevalence of alcohol abuse was 75.4% (IC95%: 69–81.7%, BCSD = 12.2%, WCSD = 41.9%, intra class correlation (ICC): 7.8%).ConclusionCommon mental disorders such as alcohol abuse, major depressive episode, anxiety symptoms and burnout syndrome presented higher rates in public transportation drivers than general population.