Summary The link between sleepiness and the risk of motor vehicle accidents is well known, but little is understood regarding the risk of home, work and car accidents of subjects with insomnia. An international cross‐sectional survey was conducted across 10 countries in a population of subjects with sleep disturbances. Primary care physicians administered a questionnaire that included assessment of sociodemographic characteristics, sleep disturbance and accidents (motor vehicle, work and home) related to sleep problems to each subject. Insomnia was defined using the International Classification of Sleep Disorders (ICSD‐10) criteria. A total of 5293 subjects were included in the study, of whom 20.9% reported having had at least one home accident within the past 12 months, 10.1% at least one work accident, 9% reported having fallen asleep while driving at least once and 4.1% reported having had at least one car accident related to their sleepiness. All types of accident were reported more commonly by subjects living in urban compared to other residential areas. Car accidents were reported more commonly by employed subjects, whereas home injuries were reported more frequently by the unemployed. Car accidents were reported more frequently by males than by females, whereas home accidents were reported more commonly by females. Patients with insomnia have high rates of home accidents, car accidents and work accidents related to sleep disturbances independently of any adverse effects of hypnotic treatments. Reduced total sleep time may be one factor explaining the high risk of accidents in individuals who complain of insomnia.
Objective: Powered mobility devices (PMDs) are commonly used as aids for older people and people with disabilities, subgroups of vulnarable road users (VRUs) who are rarely noted in traffic safety contexts. However, the problem of accidents involving PMD drivers has been reported in many countries where these vehicles have become increasingly popular. The aim of this study is to extract and analyze national PMD-related accident and injury data reported to the Swedish Traffic Accident Data Acquisition (STRADA) database. The results will provide valuable insight into the risks and obstacles that PMD drivers are exposed to in the traffic environment and may contribute to improving the mobility of this group in the long term. Methods: The current study is based on data from 743 accidents and 998 persons. An analysis was performed on a subset of data (N = 301) in order to investigate the development of accidents over a period of 10 years. Thereafter, each accident in the whole data set was registered as either single (N = 427) or collision (N = 315). Results: The results show that there was a 3-fold increase in the number of PMD-related accidents reported to STRADA during the period 2007-2016. With regard to single accidents, collisions, as well as fatalities, the injury statistics were dominated by males. Single accidents were more common than collisions (N = 427 and N = 316, respectively) and the level of injury sustained in each type of accident is on par. The vast majority of single accidents resulted in the PMD driver impacting the ground (87%), due to either PMD turnover (71%) or the driver falling out of the PMD (16%). The reason for many of the single accidents was a difference in ground level (34%, typically a curb). Cars, trucks, or buses were involved in 67% of collision events; these occured predominantly at junctions or intersections (70%). Abbreviated Injury Scale (AIS) 3+ injuries were dominated by hip and head injuries in both single accidents and collision events. Conclusions: The present study shows that further research on PMD accidents is required, with regard to both single accidents and collision events. To ensure that appropriate decisions are made, future work should follow up on injury trends and further improve the quality of PDM-related accident data. Improved vehicle stability and design, increased usage of safety equipment, proper training programs, effective maintenance services, and development of a supporting infrastructure would contribute to increased safety for PMD drivers.
Abstract Objectives Root canal treatment forms an essential part of general dental practice. Sodium hypochlorite (NaOCl) is the most commonly used irrigant in endodontics due to its ability to dissolve organic soft tissues in the root canal system and its action as a potent antimicrobial agent. Although NaOCl accidents created by extrusion of the irrigant through root apices are relatively rare and are seldom life-threatening, they do create substantial morbidity when they occur. Methods To date, NaOCl accidents have only been published as isolated case reports. Although previous studies have attempted to summarise the symptoms involved in these case reports, there was no endeavour to analyse the distribution of soft tissue distribution in those reports. In this review, the anatomy of a classical NaOCl accident that involves facial swelling and ecchymosis is discussed. Results By summarising the facial manifestations presented in previous case reports, a novel hypothesis that involves intravenous infusion of extruded NaOCl into the facial vein via non-collapsible venous sinusoids within the cancellous bone is presented. Conclusions Understanding the mechanism involved in precipitating a classic NaOCl accident will enable the profession to make the best decision regarding the choice of irrigant delivery techniques in root canal débridement, and for manufacturers to design and improve their irrigation systems to achieve maximum safety and efficient cleanliness of the root canal system.
The number of accidents and victims in the construction sector has not decreased significantly despite the increasingly stricter laws and regulations. The analysis of accidents, as well as their root causes and determinants can certainly contribute to the development of more effective preventive interventions. The present study proposes a methodology for the analysis and synthesis of data provided by accidents statistics with the goal of defining specific risk profiles based on the accidents determinants, their variables, and how they interact with one another in influencing the occurrence of an accident. For this purpose, a procedure capable of extracting this type of information from the European Statistics on Accidents at Work (ESAW) database was developed. In particular, data processing and aggregation are performed by means of the synergic use of the Matrix of Descriptors (MoD) and cluster analysis. To validate such a procedure, the analysis of fatalities due to electrical shocks was carried out. The results achieved allowed us to elicit valuable information for both safety managers and decision makers. The proposed methodology can facilitate a systemic analysis of accidents databases reducing the difficulties in managing reports and accident statistics.
▶ Two main causes are motorcycle's poor conspicuity and motorist's speed/distance judgment error. ▶ Riders/surroundings brightness contrast may be a more crucial determinant of conspicuity. ▶ Speed/distance judgment error is more common among older motorists. ▶ Motorcycle being less threatening than cars also contributes to speed/distance judgment error. The most typical automobile–motorcycle collision take places when an automobile manoeuvres into the path of an approaching motorcycle by violating the motorcycle's right of way (ROW). The present paper provides a comprehensive review of past research that examined motorcycle ROW accidents. Articles and publications were selected for relevance and research strength through a comprehensive search of major databases such as Transportation Research Information Services (TRIS), Compendex, and Medline. Two major causes of such a crash scenario are the lack of motorcycle conspicuity and motorist's speed/distance judgment error, respectively. A substantial number of studies have manipulated physical characteristics of motorcycles and motorcyclists to enhance conspicuity, along with research addressing motorists’ gap-acceptance behaviours and arrival time judgments when confronting motorcycles. Although various conspicuity aids have proven effective, some researchers reported that motorcyclist's/motorcycle's brightness per se may be less important as a determinant of conspicuity than brightness contrast between the motorcyclists and the surroundings. Larger vehicles tended to be judged to arrive sooner than motorcycles. Such a speed/distance judgment error is likely attributable to some psychological effects such that larger automobiles appear more threatening than motorcycles. Older motorists particularly have difficulties in accurately estimating the distance and the speed of an approaching motorcycle. Research examining the effects of conspicuity measures on motorists’ speed/distance judgments when confronting motorcycles has been rather inconclusive. Past research offers valuable insight into the underlying motorcycle ROW crash mechanisms. However, with ageing society and a rapid change in traffic composition (e.g., more larger motorcycles) in recent years, prior research findings should be updated. The present study finally provides recommendations for future research on motorcycle ROW accidents.
ABSTRACT Aim To analyze the severity of automotive injuries associated with blood alcohol concentration (BAC) in increments of 0.01%. Design/setting Epidemiological study using the Fatality Analysis Reporting System. Participants All people in US fatal automotive accidents, 1994–2008 (n = 1 495 667). Measurements The ratio of serious: non‐serious injuries for drivers, by BAC. Findings Accident severity increases significantly even when the driver is merely ‘buzzed’, a finding that persists after standardization for various confounding factors. Three mechanisms mediate between buzzed driving and high accident severity: compared to sober drivers, buzzed drivers are significantly more likely to speed, to be improperly seatbelted and to drive the striking vehicle. In addition, there is a strong ‘dose–response’ relationship for all three factors in relation to accident severity (e.g. the greater the BAC, the greater the average speed of the driver and the greater the severity of the accident). Conclusions The severity of life‐threatening motor vehicle accidents increases significantly at blood alcohol concentrations (BACs) far lower than the current US limit of 0.08%. Lowering the legal limit could save lives, prevent serious injuries and reduce financial and social costs associated with motor vehicle accidents.
•Three single bicycle accident simulations were performed with and without a helmet.•All three helmeted cases showed a reduction of the risk of concussion by up to 54%.•The risk of fracture was reduced by up to 98% when including a helmet. There is some controversy regarding the effectiveness of helmets in preventing head injuries among cyclists. Epidemiological, experimental and computer simulation studies have suggested that helmets do indeed have a protective effect, whereas other studies based on epidemiological data have argued that there is no evidence that the helmet protects the brain. The objective of this study was to evaluate the protective effect of a helmet in single bicycle accident reconstructions using detailed finite element simulations. Strain in the brain tissue, which is associated with brain injuries, was reduced by up to 43% for the accident cases studied when a helmet was included. This resulted in a reduction of the risk of concussion of up to 54%. The stress to the skull bone went from fracture level of 80MPa down to 13–16MPa when a helmet was included and the skull fracture risk was reduced by up to 98% based on linear acceleration. Even with a 10% increased riding velocity for the helmeted impacts, to take into account possible increased risk taking, the risk of concussion was still reduced by up to 46% when compared with the unhelmeted impacts with original velocity. The results of this study show that the brain injury risk and risk of skull fracture could have been reduced in these three cases if a helmet had been worn.
•According to police officers, mobile phone use is under-reported in traffic accident records.•Drug and alcohol use may also be under-reported in road accident records.•Some factors contributing to accidents (e.g., inattention, dangerous driving) are not included in reporting procedures.•Police officer’s views about accident causation may influence their memory recall. What are the main contributing factors to road accidents? Factors such as inexperience, lack of skill, and risk-taking behaviors have been associated with the collisions of young drivers. In contrast, visual, cognitive, and mobility impairment have been associated with the collisions of older drivers. We investigated the main causes of road accidents by drawing on multiple sources: expert views of police officers, lay views of the driving public, and official road accident records. In Studies 1 and 2, police officers and the public were asked about the typical causes of road traffic collisions using hypothetical accident scenarios. In Study 3, we investigated whether the views of police officers and the public about accident causation influence their recall accuracy for factors reported to contribute to hypothetical road accidents. The results show that both expert views of police officers and lay views of the driving public closely approximated the typical factors associated with the collisions of young and older drivers, as determined from official accident records. The results also reveal potential underreporting of factors in existing accident records, identifying possible inadequacies in law enforcement practices for investigating driver distraction, drug and alcohol impairment, and uncorrected or defective eyesight. Our investigation also highlights a need for accident report forms to be continuously reviewed and updated to ensure that contributing factor lists reflect the full range of factors that contribute to road accidents. Finally, the views held by police officers and the public on accident causation influenced their memory recall of factors involved in hypothetical scenarios. These findings indicate that delay in completing accident report forms should be minimised, possibly by use of mobile reporting devices at the accident scene.
Industrial accidents triggered by natural events (NaTech accidents) are a significant category of industrial accidents. Several specific elements that characterize NaTech events still need to be investigated. In particular, the damage mode of equipment and the specific final scenarios that may take place in NaTech accidents are key elements for the assessment of hazard and risk due to these events. In the present study, data on 272 NaTech events triggered by floods were retrieved from some of the major industrial accident databases. Data on final scenarios highlighted the presence of specific events, as those due to substances reacting with water, and the importance of scenarios involving consequences for the environment. This is mainly due to the contamination of floodwater with the hazardous substances released. The analysis of process equipment damage modes allowed the identification of the expected release extents due to different water impact types during floods. The results obtained were used to generate substance-specific event trees for the quantitative assessment of the consequences of accidents triggered by floods.
Highlights • especially atypical traffic accidents need to be investigated directly at the crash site. • interdisciplinary teamwork is necessary to match all autopsy results with damages of the car and findings at collision scene. • technical software (e.g. PC-crash®) can be used to visualize the results of reconstruction. • the body was hit upright by the car and landed in the trunk after flew over the car.