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.
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.
Results of radioactivity measurements in Bratislava aerosols following the Fukushima accident showed that at least three radioactive plumes arrived to Bratislava as indicated by 131I/137Cs activity ratios. When compared with the Chernobyl results available for the Bratislava station, the Fukushima radionuclide levels were almost five orders of magnitude lower, with the maximum values for 131I and 137Cs of 0.5 and 0.07 mBq/m3, respectively. The 131I and 137Cs vs. 7Be aerosol activity records showed that the increases in 131I and 137Cs activity concentrations were accompanied by 7Be increases, indicating that both the horizontal and vertical transports of radionuclides were responsible for observed radionuclide concentrations. The 134Cs/137Cs activity ratio was close to 1, as has also been reported by other investigators.
•The HFACS-Railway Accidents framework for the railway system in China was proposed.•The organizational and supervision deficiencies and human errors were disclosed.•The quantitative correlation analysis was conducted to identify the key causes.•The dynamic process of the accident is presented based on the casual diagram. Accidents continue to be the major concern in the railway industry, and human factors have been proved to be the prime causes to railway accidents. In this paper, the Human Factors Analysis and Classification System-Railway Accidents (HFACS-RAs) framework is proposed to identify and classify human and organizational factors involved in railway accidents. To establish an applicable HFACS-RAs framework, large amount of incident and accident data are collected and the existing safety flaws are identified by safety experts, manufactures and railway managers who have attended the HFACS workshop. To find out the leading accident casual factors, the Analytical Network Process (ANP) method combined with Fuzzy Decision Making Trail and Evaluation (DEMATEL) method is adopted to analyze the influence relationships of human and organization factors classified by HFACS-RAs framework after its reliability is demonstrated. The expert judgement is required in most phases in this study for the uncertainty and complexity of the human and organizational factors and the proposed method to identify the main casual factors is elaborated in the case study. The relevant preventative measures can be raised to avoid the recurrence of similar accidents after the investigation. Finally some considerations on further work are discussed.