Use Of Protection Devices Research Articles

Use Of Mouthguard Rates Among Athletes During 2009 IIHF Word U18 Championship

The purpose of this study was to determine the attitudes of mouthguard users in the 2009 International Ice Hockey Federation (IIHF) Word U18 Championship Div. III Group B Turkey. The participants’ appreciation in the use of protective devices, such as mouthguards, during sport activities was also evaluated. In this study a 10-item questionnaire was distributed to 82 athletes of ice hokey in 2009 IIHF Word U18 Championship. The Championship composed of 4 national teams [Bulgaria (Bul), Ireland (Irl), Iceland (Isl) and Turkey (Tur)]. Of all players were males and there average ages were Bul. 16.55, Irl. 16.2, Isl. 17.0, Tur. 17.3 . The result of questionnaires indicated that none of the athletes used mouthguards while participating in sports. The use of mouthguards is rare in sports, because all of athletes wear helmets and face masks associated with their helmets. IIHF rules required that athletes, who fewer than 18 years, should wear face masks during sport activities, but not mandatory of wearing mouth guards. The same 10-item questionnaire was distributed to 16 athletes of national ice hokey team of Turkey. Athletes, who are older than 18 years, usually wear not face masks but wear helmets and moutguards. There sportsmen’s 25 % used mouthguards while participating in sports, but this number is not enough. Doctors and dentists need to recommend a more intensive education of athletes in sports medicine and sports dentistry.

An Overview of the Impact of Lifestyle Behaviors on the Operative Dentistry

Objective: This review provides important insights into how the personal lifestyle behaviors may affect the oral health, especially with respect the Operative Dentistry field. Thus, the effect of lifestyle behavior on the dental hard tissues and restorative materials was explored, aiming to assess preventive and restorative strategies. Materials and Methods: Studies focusing on the potential effects of lifestyle behaviors on the restorative dentistry were used as a resource data. The collected literature was based on the original scientific full-papers from peerreviewed journals in PubMed database. Results: Lifestyle behaviors may lead to changes in the appearance of dental tissue and dental restorations. The frequent consumption of coffee, tea, red wine and tobacco can lead to discoloration of tooth and resin-based materials. In addition, cigarette smoke may hinder the adhesive bonding mechanism and also may affect the physical properties of restorative materials. Occupational exposure to acid environment, addicted to acid drinks and regular/competitive swimmers should be aware of the potential risk for dental erosion. Moreover, since sports injuries can seriously lead to tooth and facial damage, the use of protective devices during sports activities should be emphasized, especially for athletes and regular practitioners of high-risk activities. Conclusion: Lifestyle behaviors may jeopardize the dental tissues and accelerate the aging process of aesthetic dental restorations. Thus, the widespread knowledge of this potential risks on the oral health and restorative dentistry is beneficial for targeting educational health care programs, preventive and reparative therapies.

Workplace-related traumatic injuries: insights from a rapidly developing Middle Eastern country.

Traumatic workplace-related injuries (WRIs) carry a substantial negative impact on the public health worldwide. We aimed to study the incidence and outcomes of WRIs in Qatar. We conducted occupational injury surveillance for all WRI patients between 2010 and 2012. A total of 5152 patients were admitted to the level 1 trauma unit in Qatar, of which 1496 (29%) sustained WRI with a mean age of 34.3 ± 10.3. Fall from height (FFH) (51%) followed by being struck by heavy objects (FHO) (18%) and motor vehicle crashes (MVC) (17%) was the commonest mechanism of injury (MOI). WRI patients were mainly laborers involved in industrial work (43%), transportation (18%), installation/repair (12%), carpentry (9%), and housekeeping (3%). Use of protective device was not observed in 64% of cases. The mean ISS was 11.7 ± 8.9, median ICU stay was 3 days (1–64), and total hospital stay was 6 days (1–192). The overall case fatality was 3.7%. Although the incidence of WRI in Qatar is quite substantial, its mortality rate is relatively low in comparison to other countries of similar socioeconomic status. Prolonged hospital stay and treatment exert a significant socioeconomic burden on the nation's and families' resources. Focused and efficient injury prevention strategies are mandatory to prevent future WRI.

Effect of health education intervention on the awareness and use of personal protective equipments among small scale electric arc welders in Ilorin, Nigeria.

Introduction:Welding is associated with workplace hazards that can affect the health of those who engaged in it as they are exposed to harmful dust.Subjects and Methods:This was a health education intervention study carried out among self-employed electric arc welder. Data were collected using an interviewer administered questionnaire and health education intervention was carried out between the preintervention and postintervention stages. Epi-info version 3.5.1 software package was used for data analysis and Chi-square analysis was used to determine the statistical significance of observed differences between the study and control groups before the intervention and after intervention. Level of significance was set at a P < 0.05.Results:At the preintervention phase, 285 respondents were interviewed in each of the study and control groups, while 280 study respondents and 275 control respondents were available for the postintervention phase of the study. Before the intervention, 279 (97.9%) of the respondents in the study group were aware of eye goggles as a means of protection, 20 (7%) were aware of welding helmet, 206 (72.3%) were aware of hand gloves and 4 (1.4%) were aware of face mask. All showed a significant increase in awareness postintervention (P < 0.05) while there was no significant increase in awareness in the control group.Conclusion:Health education brought about a significant increase in awareness and use of personal protective equipment among the welders. There is a need for proper education of welders on workplace hazards, the types and use of different protective devices in other to safeguard their health.

Injuries from falling objects in the United Arab Emirates

Our aim was to study the demography, anatomical regions injured, severity, and outcome of hospitalised trauma patients who were injured by falling objects in order to give recommendations regarding their prevention in the UAE. All trauma patients who were injured by falling objects and were admitted to Al Ain Hospital for more than 24 hours, or died after arrival to the hospital were studied for over 3 years. One hundred forty nine patients having a mean age (SD) > 34 (12.1) years were studied. The annual incidence of hospitalisation was 10.7/100,000 persons per year. Majority (97.3%) were males and 73.2% from the Indian subcontinent. The most common location for injury was work (88.6%), followed by home (9.4%). Patients injured at home were younger (p < 0.0001), and were more females (p < 0.0001). Extremities and head/neck were the most common injured regions; 1.3% of patients died. Males from the Indian subcontinent are at a higher risk of being injured by falling objects especially at work. Safety education and programs, environmental changes, use of protective devices including helmets or special shoes, and proper enforcement of the safety guidelines could reduce hospitalisations, disability, and death from these injuries.

Roll-in Experience from the Cardiovascular Outcomes with Renal Atherosclerotic Lesions (CORAL) Study

PurposeTo describe the experience and results from the roll-in phase of the Cardiovascular Outcomes with Renal Atherosclerotic Lesions (CORAL) study. Materials and MethodsThe CORAL roll-in database was used to describe the baseline characteristics of the patients in the roll-in cohort, all of whom underwent renal artery stent placement; to evaluate CORAL site performance; to compare estimates of lesion (stenosis) severity made by site interventionalists with the central CORAL angiographic core laboratory readings; and to report outcomes after renal artery stent placement. During the roll-in phase, 239 patients (mean age, 70.2 y ± 9.0; 49% male) underwent renal artery stent procedures. Angiographic core laboratory analysis of renal arteriograms was done, and participants were followed at 1 month and 9 months. ResultsMajor angiographic complications were identified in 28 (13%) subjects. Kidney function remained unchanged at the short (2–4 weeks) follow-up interval. Improvement in systolic blood pressure with use of distal embolic protection devices (n = 161) did not show any clinical benefit over nonuse of such devices (n = 78) in this small series. At 9 months, there were significantly more endpoints reported by site in subjects with bilateral renal artery stenosis (P = .01) and prior history of stroke (P = .03). ConclusionsIn the roll-in phase of the CORAL study, a significant number of angiographic complications were identified. No effect was seen on estimated glomerular filtration rate after renal artery stent placement, but systolic blood pressure decreased significantly.

Holdups, Renegotiation, and Deal Protection in Mergers

We examine the contracting and negotiation process in mergers using an incomplete contracts framework. Our multi-period model allows for the arrival of new information and renegotiation after the signing of an initial merger agreement but before deal completion or termination. A properly designed initial contract solves the holdup problem during renegotiation and induces higher deal-specific effort, including the due diligence assessment of the deal. The contract grants an option to the target to terminate the merger, where the strike on the option compensates the acquirer’s deal-specific effort without imposing excessive costs on the target for pursuing non-merger alternatives. The option strike can be implemented by the use of deal protection devices, such as a target termination fee and/or an acquirer lockup. Employing a large sample of stock mergers, we find evidence supporting model predictions for the renegotiation of contracts, deal outcomes and the use of deal protection devices.

Magnitude of ocular trauma in a tertiary care hospital of western Nepal

Background: Ocular injury is one of the major causes of monocular visual impairment and blindness worldwide, with significant socioeconomic impact. The present study was done to establish the incidence and identify the common causes of ocular trauma in a tertiary care hospital of western Nepal. Methods: This is a cross-sectional study, conducted at a teaching hospital in western Nepal from January 2012 to January 2013. All ocular trauma cases attending emergency and eye OPD were included in the study. A complete history and detailed ophthalmological evaluation was done. Results: Total number of cases was two hundred and nine. The incidence of ocular trauma was 1.74%. Average age of patients was 28.89±19.06 years. Maximum patients were from third decade of life and were males (66.5%). Majority of ocular trauma occurred in right eye and were sustained at the workplace. Only 2.4% of patients used protective agents. The cases presented to the hospital within 48 hours of injury were 71.8%. Maximum subjects didn’t use any medication before they presented to this hospital. Road traffic accident (RTA) was the commonest cause of ocular trauma followed by wood stick and fall injury. Conclusion: Males are more prone to ocular trauma. As the commonest cause is RTA and very few patients used protective devices so public awareness about eye health program and strict legislation for the use of protective devices may help to reduce the magnitude of ocular injury. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 140-143 DOI: http://dx.doi.org/10.3126/njms.v2i2.8964

Asthma and exposure to cleaning products - a European Academy of Allergy and Clinical Immunology task force consensus statement

Professional and domestic cleaning is associated with work-related asthma (WRA). This position paper reviews the literature linking exposure to cleaning products and the risk of asthma and focuses on prevention. Increased risk of asthma has been shown in many epidemiological and surveillance studies, and several case reports describe the relationship between exposure to one or more cleaning agents and WRA. Cleaning sprays, bleach, ammonia, disinfectants, mixing products, and specific job tasks have been identified as specific causes and/or triggers of asthma. Because research conclusions and policy suggestions have remained unheeded by manufactures, vendors, and commercial cleaning companies, it is time for a multifaceted intervention. Possible preventive measures encompass the following: substitution of cleaning sprays, bleach, and ammonia; minimizing the use of disinfectants; avoidance of mixing products; use of respiratory protective devices; and worker education. Moreover, we suggest the education of unions, consumer, and public interest groups to encourage safer products. In addition, information activities for the general population with the purpose of improving the knowledge of professional and domestic cleaners regarding risks and available preventive measures and to promote strict collaboration between scientific communities and safety and health agencies are urgently needed.

The Relationship between Serum Osteopontin Levels and Isolated Coronary Artery Ectasia

Aims: Occupational head exposure of radiation was suggested to be associated with brain tumors in interventional cardiologists. The brain is of particular interest, because it is one of the least protected organs during interventional procedures. Our aim was to investigate the efficacy of the lead cap in radiation protection of the head and compare it with that of a ceiling mounted lead glass screen in a real life setting. Our secondary goal was to test the comfort and convenience of the lead cap when worn on a regular daily basis. Methods-Results: Radiation dose to the operator was recorded by the three dosimeters placed outside the lead cap, inside the cap and outside the apron at the level of trunk for a total of 18 months. Only the lead cap (Burkhart Roentgen International, St Petersburg, Florida, USA) but not the ceiling suspended protective glass screen was used during the first three months of measurement of radiation dose to the head. Later concomitant use of both protection devices was analyzed. The dosimeter outside the cap recorded a dose of 2.77 mSv radiation when the ceiling mounted screen was not used during the first 3 months. The doses were 2.4 to 12.5 times higher in comparison to the measurements that were recorded when the ceiling suspended screen was used. However, a remarkable dose of radiation (ranged between 1.16-0.22 mSv) was received by the operators head despite the use of ceiling mounted screen. Yet, even without the protection of the ceiling mounted screen, the dose recorded by the dosimeter inside the lead cap during the first period was <0.1 mSv (Table). As expected, the doses to the head recorded by the dosimeter inside the cap during the next 15 months period were also less than 0.1 mSv with the use of the ceiling mounted screen. Therefore, a cap with only 0.5 mm lead equivalence reduced the dose to the head to ignorable levels regardless of the use of the screen. Conclusions: A cap with only 0.5 mm lead equivalence was much more protective than the mounted screen and reduced the dose to the head to ignorable levels regardless the use of the mounted screen. Although being a subjective conclusion, the operator regularly wearing the lead cap reported that the lead cap is reasonably comfortable and offers an acceptable wearing comfort when used on daily practice.

Results of the Retrospective Analysis of Renal Artery Stenting for the Salvage of Renal Function Study

Renal artery stenting is expected to improve or stabilize renal function. However, the efficacy of renal artery stenting in severely reduced renal function is unclear. We evaluated 23 patients with class IV or V renal dysfunction who were treated for renal artery stenosis between 2004 and 2009. Improvement in renal function was found in 7 (30%) patients, all of whom were treated with distal protection device. Deterioration of renal function was found in 4 (17%) cases. In these 4 cases, distal protection device could not be used for anatomical reasons. The use of distal protection device was associated with significantly less renal deterioration after the procedure (P < .05, odds ratio 0.21 [confidence interval 0.09-0.50]). Renal artery stenting can stabilize or improve renal function in patients with severe renal dysfunction. Distal protection devices may be beneficial in patients who require renal artery stenting due to severely reduced renal function.

Cerebral protection devices for transcatheter aortic valve implantation: is better the enemy of good?

Transcatheter aortic valve implantation is a widely performed procedure for treatment of symptomatic severe aortic stenosis. According to the current literature, major stroke has been reported as occurring in 3-6% of patients during the first 30 days following valve implantation. Several pathological mechanisms may be involved in the development of periprocedural ischaemic stroke with the majority being due to thromboembolism and atheroembolism. One approach to reduce the incidence of procedural cerebral thromboembolic events is the use of cerebral protection devices, either deflecting (Embrella, TriGuard) or capturing (Claret, Embol-X) embolic material. We decided to review the current evidence on this important issue focusing on the four cerebral protection devices currently available.

A review of mercury exposure among artisanal small-scale gold miners in developing countries

Extraction of gold using mercury has been a way out of poverty for millions of people in developing countries. Artisanal small-scale gold mining (ASGM) has expanded during the last decades and is often carried out under primitive conditions. Thus, workers in this industry may be exposed to high levels of mercury and suffer from toxic effects from mercury exposure. The objective of this review was to provide an outline of the studies available on elemental mercury exposure among artisanal small-scale gold miners. Searching the PubMed and Embase databases, 26 studies with a total of 3,005 exposed subjects and 442 controls across 14 different developing countries were found. Urine mercury levels were used as biomarkers of exposure. In general, the urine mercury levels were elevated and a considerable proportion of workers had urine mercury levels above existing guidelines. Exposed subjects were stratified into residents, miners, millers, smelters, and refiners, who by work task content were expected to be increasingly exposed to mercury. This group order did show a clear trend of increasing mercury levels. Mercury levels differed substantially between studies. Possible explanations include dissimilarities in gold extraction methods, use of protective devices, and selection of participants. This review provides evidence that artisanal gold miners and residents of the mining sites are exposed to mercury vapour to an extent where acute and long-term toxic effects of mercury are likely. Interventions aimed at reducing exposure and emission of mercury from ASGM are needed.

Results of carotid angioplasty and stenting are equivalent for critical versus high-grade lesions in patients deemed high risk for carotid endarterectomy

BackgroundTo examine outcomes of carotid angioplasty and stenting (CAS) in patients with critical carotid stenosis who are deemed high risk for carotid endarterectomy. MethodsMedical records were retrospectively analyzed for patients undergoing CAS between September 2002 and March 2011 at a single institution. Patients were classified as having either critical (≥90%) or high-grade (70%–89%) carotid stenosis based on angiography. The primary composite end point was stroke, myocardial infarction, or death from any cause during the periprocedural period or any ipsilateral stroke during the follow-up period. ResultsA total of 245 patients underwent 257 CAS procedures during the study period. Fifty-one percentage (n = 130) of cases involved critical stenosis (66.2% male; mean age, 71 ± 10 y), with the remaining group (n = 127) involving high-grade stenosis (67.7% male; mean age, 71 ± 9 y). Symptomatic carotid disease was present in 25% of the critical stenosis and 31% of the high-grade stenosis groups (P = 0.33). Chronic obstructive pulmonary disease was more commonly found in the high-grade stenosis group (20% versus 8%, P = 0.01). No difference was observed between the groups relative to other baseline demographic characteristics, presence of contralateral carotid occlusion, stent diameter or length, maximum balloon diameter or length, use of embolic protection device, or procedural duration. Technical success was achieved in all cases. There was no difference in the need to predilate before the introduction of the filter or stent based on the degree of stenosis. We found no difference in the primary composite end point between the high-grade or critical stenosis groups (7.1% versus 7.7%, P = 0.74), or there were no differences between the individual components of the composite end point. Mid-term survival was similar between the two groups at a mean follow-up period of 2.4 y. ConclusionsDespite concerns regarding the potential for increased neurologic complications, our data demonstrate that patients with high-grade and critical stenosis are able to safely undergo CAS and achieve similar periprocedural outcomes and mid-term prognosis.

The protective effect of clopidogrel and atorvastatin in patients undergoing carotid stenting

Over the last few years, the advance in operator’s experience, the improvement in technology and the strong demand from patients for a less-invasive alternative to surgery has made carotid artery stenting (CAS) an equally efficient and safe procedure to carotid endarterectomy for the treatment of carotid artery stenosis [1–3]. The introduction of mechanical cerebral protection systems can be considered the cornerstone in the evolution of CAS; these devices aim to prevent emboli from reaching the brain, and their introduction in the majority of procedures is responsible for better outcomes reported in recent clinical trials and registries. Therefore, guidelines strongly recommend the use of embolic protection devices in all procedures [4]. Despite progress in CAS, periprocedural stroke rate remains significant, and has an important physical, mental and social impact on patients’ lives. Therefore, indication for treatment of asymptomatic patients is one of the most debatable issues in the literature. In particular, incidence of microembolization, during and after CAS, persists despite the use of cerebral protection devices. Diffusion-weighted MRI (DW-MRI) has been shown to be a sensitive tool in identifying new ischemic cerebral lesions that are caused by emboli during CAS. Cerebral ischemic lesions are observed by DW-MRI in 15–78% of patients after CAS, and most of them are not associated with acute neurological symptoms [5–7]. Clinical implication and impact on prognosis of asymptomatic cerebral microembolism is still debated. Recently, a large study analyzing the role of asymptomatic cerebral ischemic lesions after CAS on prognosis in terms of major adverse cardiac and cerebrovascular event (death, stroke and myocardial infarction) demonstrated that a positive DW-MRI after CAS was not an

Radiation Protection in Interventional Radiology: Survey Results of Attitudes and Use

PurposeTo assess attitudes of interventional radiologists toward personal radiation protection and the use of radiation protection devices. Materials and MethodsInvitations to an anonymous online survey that comprised eight questions focused on operator attitudes toward radiation protection devices were sent via e-mail to the active membership of the Society of Interventional Radiology (SIR): a total of 3,158 e-mail invitations. A single reminder e-mail was sent. ResultsThere were 504 survey responders (16% response rate). Reported radiation safety device use included lead apron (99%), thyroid shield (94%), leaded eyeglasses (54%), ceiling-suspended leaded shield (44%), rolling leaded shields (12%), ceiling-suspended/rolling lead-equivalent apron (4%), radiation-attenuating sterile surgical gloves (1%), and sterile lead-equivalent patient-mounted drape (4%). Reasons commonly cited for not using certain devices were comfort (eyewear), ease of use (mounted shields), and lack of availability (rolling/hanging shields and patient-mounted shields). ConclusionsInterventionalists have an array of tools from which to choose for personal radiation protection; however, for a variety of reasons related to lack of availability or choice, these tools are not universally employed. Further study may be of value to clarify why comfort was cited most often as the primary barrier to the use of protective eyewear and difficulty of use was cited as the primary barrier to use of mounted shields (despite reporting that concern for radiation-induced injury to the eye is paramount). It may also be of interest to further study why certain devices with demonstrable protection effects are not readily available, such as rolling/hanging and patient-mounted shields.

Carotid Revascularization: A Systematic Review of the Evidence

The aim of this study is to provide an evidence-based review of the periprocedural safety and long-term effectiveness of carotid artery stenting (CAS) compared to carotid endarterectomy (CEA), with particular attention paid to the use of embolic protection devices and patients at high risk for CEA. Electronic databases (Ovid Medline, Cochrane central register of controlled trials, Pubmed, and Embase) were searched to identify: (1) randomized controlled trials (RCT) comparing outcomes of CEA and CAS, and (2) prospective clinical trials assessing the safety of CAS in patients at high surgical risk. Pooled incidence rates and one-sided 95% confidence interval for the periprocedural and long-term composite end-point of stroke, myocardial infarction, or death among high surgical risk patients were generated and compared to objective performance criteria (OPC) reported by previous trials. Six RCTs and 14 prospective clinical trials met our search criteria. Selected RCTs showed inconsistency in reported periprocedural and long-term outcome rates. Pooled incidence rates of the periprocedural and long-term composite end-point of stroke, myocardial infarction or death in high surgical risk candidates were 5.59% and 7.92%, respectively. These results were noninferior to selected OPCs (P-value <0.001). CAS represents a safe and effective stroke prevention strategy in high surgical risk patients when compared with CEA. The inconsistent results from the RCTs and the improved outcomes in the prospective clinical trials are likely related to variability in operator experience, use of embolic protection devices, and patient selection strategies.

An Analysis of the Factors Influencing Radiation Dose and Fluoroscopic Time During Renal Artery Stent Placement

To determine the factors that affect mean absorbed dose and fluoroscopic times during renal artery stent placement. After institutional review board approval, the HI-IQ database was queried for patients undergoing renal artery stent placement only from January 2007 to June 2010. Procedures that were performed as part of other procedures such as iliac artery stents were excluded. The HI-IQ data included fluoroscopy time (f) and radiation dose (mGy). Demographic, medical history, procedural details, and advanced preprocedural renal artery stent imaging were obtained. Variables (number of stents, average body mass index , number of stents placed per year and number of years' service of an interventional physician, pre-procedural imaging, and use of embolic protection device) were analyzed using a t test after log transformation and testing for variance with an F test. A total of 134 patients (75 males, 70.6 ± 10.5 years old) underwent the placement of 177 renal artery stents (unilateral [n = 95], average stent per patient = 1.3). Mean fluoroscopy time was 15.6 minutes and mean absorbed dose to the patient was 1729 mGy. The average fluoroscopic time and absorbed dose was significantly higher with bilateral stent placement compared to unilateral placement (13.8 vs 19.7 minutes, P = .002; 1803 vs 2380 mGy, P = .03). The average fluoroscopic time was significantly higher in patients undergoing abdominal aortogram prior to renal artery selection and stent placement. The placement of more than 1 stent with an abdominal angiogram prior to renal artery stent placement results in increased fluoroscopic time and mean absorbed dose.

Change in Lung Function over Time in Male Metropolitan Firefighters and General Population Controls: A 3‐year Follow‐up Study

Previous studies in firefighters have been contradictory regarding their course of lung function over time. The aim of this ongoing study is to investigate how changes in lung function over time in male metropolitan firefighters compare with those in population controls, and to explore associations between firefighters' use of personal respiratory protection devices during occupational exposures and their risk of accelerated lung function decline. A prospective comparison of FEV1 (forced expiratory volume in 1 second) and FVC (forced vital capacity) was performed between 281 firefighters and 933 population controls. Logistic regression models were used to compare changes from baseline of FEV1 and FVC after 3 years and risk of accelerated decline between the cohorts. Within the firefighter cohort, risk of accelerated decline was compared between subgroups based on use of respiratory protection devices. Controls showed similar mean annual declines for FEV1 and FVC across age categories, whereas firefighters aged <45 years showed increasing values over time (p=0.040). Firefighters had a lower odds of accelerated FEV1 decline compared with controls (OR=0.60, 95%CI 110.44; 0.83), but firefighters who never or rarely used respiratory protection during fire knockdown had a higher odds of accelerated FEV1 decline compared with those who used it often or frequently (OR=2.20, 95%CI 1.02; 4.74). Younger generations of firefighters showed an increase in lung function relative to older colleagues, while population controls consistently showed decline of lung function across all ages. Firefighters who reported to be incompliant in using respiratory protection showed an increased risk of accelerated FEV1 decline.

The Association between Facial Fracture Patterns and Traumatic Head Injury in Injured Motorcycle Riders According to Helmet Use Status

ObjectiveThis study was undertaken to identify the association between facial fracture patterns and traumatic head injury in injured motorcycle riders.MethodsRetrospective study design. We reviewed the medical records of patients who underwent facial bone computed tomography (CT) and brain CT simultaneously among the injured motorcycle riders between May 2009 and July 2011. Data collected included age, sex, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), facial fracture patterns, head protective device (helmet) use, alcohol intake, time of accident and seat position. Facial fracture patterns were grouped as upper, mid, and lower face. Traumatic head injury (THI) included skull fracture, brain haemorrhage and diffuse axonal injury.ResultsOf the 154 patients included, 138 (89.6%) were male, 57 (37%) had facial fracture, 69 (44.8%) wore helmets and 30 (19.5%) had THI. Their mean age was 29.0+15.0 years. After multivariate logistic regression analysis, THI was associated with GCS, seat position of riders and accident time. THI was correlated with the combination of upper and midfacial fractures in helmeted group and isolated upper facial fracture or the combination of upper and midfacial fractures in unhelmeted group. The rest of facial fracture patterns were not correlated with THI regardless of helmet.ConclusionsThe combination of upper and midfacial fractures are the risk factor of THI regardless of helmet. The patients with the combination of upper and midfacial fractures should be further evaluated for head injury regardless of helmet.