Life-threatening motor vehicle crashes in bright sunlight.
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ABSTRACT:
SUBMITTER: Redelmeier DA
PROVIDER: S-EPMC5228668 | biostudies-literature | 2017 Jan
REPOSITORIES: biostudies-literature
Publications
Life-threatening motor vehicle crashes in bright sunlight.
Redelmeier Donald A DA Raza Sheharyar S
Medicine 20170101 1
Bright sunlight may create visual illusions that lead to driver error, including fallible distance judgment from aerial perspective. We tested whether the risk of a life-threatening motor vehicle crash was increased when driving in bright sunlight.This longitudinal, case-only, paired-comparison analysis evaluated patients hospitalized because of a motor vehicle crash between January 1, 1995 and December 31, 2014. The relative risk of a crash associated with bright sunlight was estimated by evalu ...[more]
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Project description:BackgroundMotor vehicle crashes are a leading cause of serious trauma during pregnancy, but little is known about their relationships with pregnancy outcomes.PurposeTo estimate the association between motor vehicle crashes and adverse pregnancy outcomes.MethodsA retrospective cohort study of 878,546 pregnant women, aged 16-46 years, who delivered a singleton infant in North Carolina from 2001 to 2008. Pregnant drivers in crashes were identified by probabilistic linkage of vital records and crash reports. Poisson regression modeled the association among crashes, vehicle safety features, and adverse pregnancy outcomes. Analyses were conducted in 2012.ResultsIn 2001-2008, 2.9% of pregnant North Carolina women were drivers in one or more crashes. After a single crash, compared to not being in a crash, pregnant drivers had slightly elevated rates of preterm birth (adjusted rate ratio [aRR]=1.23, 95% CI=1.19, 1.28); placental abruption (aRR=1.34, 95% CI=1.15, 1.56); and premature rupture of the membranes (PROM; aRR=1.32, 95% CI=1.21, 1.43). Following a second or subsequent crash, pregnant drivers had more highly elevated rates of preterm birth (aRR=1.54, 95% CI=1.24, 1.90); stillbirth (aRR=4.82, 95% CI=2.85, 8.14); placental abruption (aRR=2.97, 95% CI=1.60, 5.53); and PROM (aRR=1.95, 95% CI=1.27, 2.99). Stillbirth rates were elevated following crashes involving unbelted pregnant drivers (aRR=2.77, 95% CI=1.22, 6.28) compared to belted pregnant drivers.ConclusionsCrashes while driving during pregnancy were associated with elevated rates of adverse pregnancy outcomes, and multiple crashes were associated with even higher rates of adverse pregnancy outcomes. Crashes were especially harmful if drivers were unbelted.
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Project description:Anxiety-inducing life events increase the risk of motor vehicle crashes. We test the hypothesis that earthquakes, known to increase anxiety in the population, also increase the incidence of motor vehicle crashes. Our study took place in Oklahoma, USA where wastewater injection resulted in increased induced seismicity between 2010 and 2016. We identified dates of earthquakes???magnitude 4 (a level felt by most people) with data from the U.S. Geologic Survey. The Oklahoma Highway Safety Office provided county-level monthly vehicle crash counts. We defined high, medium, and low earthquake exposure counties based on the location of earthquake epicenters. Using time-series analyses, we evaluated the association between monthly counts of ?magnitude 4 earthquakes and motor vehicle crashes by exposure group. Earthquakes???magnitude 4 took place in 38 of 84 study months, and a monthly average of 5813 (SD?=?384) crashes occurred between 2010 and 2016. In high-exposure counties, we observed an additional 39.2 motor vehicle crashes per each additional???magnitude 4 earthquake in the prior month (SE?=?11.5). We found no association between the timing of ?magnitude 4 earthquakes and motor vehicle crashes in the medium or low exposure counties. With a binary earthquake exposure variable, we found a 4.6% (SE?=?1.4%) increase in motor vehicle crashes in the high exposure counties in the month following 1 or more ?magnitude 4 earthquakes. Consistent with our hypothesis, there was no association between earthquakes of magnitude???2.5 and motor vehicle crashes in the high-exposure counties. This novel evidence of an association between induced earthquakes in Oklahoma and motor vehicle crashes warrants future research given the high economic and social costs of such vehicle crashes.
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Project description:IntroductionRoadside sobriety checkpoints are an intervention in which law enforcement officers stop passing vehicles to check whether drivers are impaired. There is clear evidence that a program of roadside sobriety checkpoints is an effective approach to reducing alcohol-involved motor vehicle crashes, likely because of general deterrent effects across the entire population of drivers. The aim of this study is to assess the duration of time over which individual roadside sobriety checkpoints are associated with alcohol-involved motor vehicle crashes, within the context of a broader checkpoint program.MethodsIn August 2018, the authors accessed incident-level data for alcohol-involved motor vehicle crashes and roadside sobriety checkpoints for the City of Los Angeles, California, 2013-2017. Counts of crashes and checkpoints were computed within three different temporal units: days (n=1,826), weeks (n=260), and months (n=60). The number of checkpoints were then calculated at different lagged periods (up to 7 days, up to 4 weeks, and up to 3 months). Autoregressive integrated moving average analyses related counts of checkpoints over these lagged periods to subsequent crashes.ResultsFewer alcohol-involved motor vehicle crashes occurred when there were more roadside sobriety checkpoints over the previous 4 days, 5 days, 6 days, 7 days, and 1 week.ConclusionsIndividual roadside sobriety checkpoints affected alcohol-involved motor vehicle crashes in Los Angeles, California for approximately 1 week. The temporal configuration of individual checkpoints is an important consideration when designing an overall roadside sobriety checkpoint program.
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Project description:BackgroundThere is growing evidence that a range of pre-injury, injury related and post-injury factors influence social and health outcomes across the injury severity spectrum. This paper documents health related outcomes for people with mild, moderate and severe injury after motor vehicle crash (MVC) injuries in New South Wales, Australia.MethodsThis inception cohort study followed 2019 people injured in MVCs, for 6 and 12 months post-injury. We categorised moderate injury as hospital length-of-stay (LOS) of 2-6 days and Injury Severity Score (ISS) of 4-11, while severe injury as LOS ≥7 days or ISS ≥ 12. We examined differences in paid work status, 12-Item Short Form Survey (SF12), EQ-5D and World Health Organisation Disability Assessment Schedule II (WHODAS) outcomes longitudinally from baseline to 12 months between levels of injury severity using linear mixed models for repeated measures. We first considered minimally sufficient adjustment factors (age, sex, crash role, perceived danger in crash, pre-injury health, pre-injury EQ-5D, recruitment source), and then more extensive adjustments including post-injury factors. The presence of mediating pathways for SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) via post-injury factors was evaluated.ResultsBased on hospital length of stay (LOS), 25 and 10% of participants sustained moderate and severe injuries, respectively, while 43 and 4% had these injuries based on ISS. Twelve months post-injury LOS ≥7 days versus ≤1 day was associated with an estimated 9 units lower mean SF12 PCS using a minimally sufficient adjustment model, and LOS ≥ 7 days was associated with a 3 units lower mean SF12 MCS score. Mediation analyses (LOS ≥ 7 days vs ≤1 day) found for SF12 MCS outcomes, effects of injury severity were small and mostly indirect (direct effect - 0.03, indirect effect - 0.22). Whereas for SF12 PCS outcomes the effect of having a more severe injury rather than mild were both direct and indirect (direct effect - 0.50, indirect effect - 0.38).ConclusionsIndividuals with severe injuries (those with LOS ≥ 7 days and ISS 12+) had poorer recovery 12 months after the injury. In addition, post-injury mediators have an important role in influencing long-term health outcomes.Trial registrationAustralia New Zealand Clinical trial registry identification number - ACTRN12613000889752 .
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Project description:ObjectiveTo investigate the risk and injury severity on the regional body (head, neck, and chest) of obese children in frontal motor vehicle crashes (MVCs).MethodsNo physical surrogates (i.e., crash dummies) for obese children were available, and experiments on pediatric cadavers were generally not feasible. Therefore, computational models of obese children using medical imaging processing and state-of-the-art modeling techniques were developed. A hybrid modeling technique was used to integrate the finite element model for torso fat layer into the standard multibody model to represent various levels of obese children for 3- and 6-year-old age groups. The models were used to investigate injury severity under various crash scenarios through model simulations.ResultsThe head injury criterion and chest acceleration were observed to increase as body mass index (BMI) increased. Meanwhile, no such correlations were found between BMI and neck injury and chest deformation. Forward head and torso excursions were observed to increase as obesity increased, owing to the momentum effect of greater body mass.ConclusionsObese children appeared to have greater risks for head and chest injuries than do their non-obese counterparts in frontal MVCs, owing to higher head and chest accelerations induced by greater body excursion.
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Project description:Legal medical marijuana has been commercially available on a widespread basis in Colorado since mid-2009; however, there is a dearth of information about the impact of marijuana commercialization on impaired driving. This study examined if the proportions of drivers in a fatal motor vehicle crash who were marijuana-positive and alcohol-impaired, respectively, have changed in Colorado before and after mid-2009 and then compared changes in Colorado with 34 non-medical marijuana states (NMMS).Thirty-six 6-month intervals (1994-2011) from the Fatality Analysis Reporting System were used to examine temporal changes in the proportions of drivers in a fatal motor vehicle crash who were alcohol-impaired (?0.08 g/dl) and marijuana-positive, respectively. The pre-commercial marijuana time period in Colorado was defined as 1994-June 2009 while July 2009-2011 represented the post-commercialization period.In Colorado, since mid-2009 when medical marijuana became commercially available and prevalent, the trend became positive in the proportion of drivers in a fatal motor vehicle crash who were marijuana-positive (change in trend, 2.16 (0.45), p<0.0001); in contrast, no significant changes were seen in NMMS. For both Colorado and NMMS, no significant changes were seen in the proportion of drivers in a fatal motor vehicle crash who were alcohol-impaired.Prevention efforts and policy changes in Colorado are needed to address this concerning trend in marijuana-positive drivers. In addition, education on the risks of marijuana-positive driving needs to be implemented.
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Project description:Uber, the world's largest ridesharing company, has reportedly provided over 2 billion journeys globally since operations began in 2010; however, the impact on motor vehicle crashes is unclear. Theoretically, ridesharing could reduce alcohol-involved crashes in locations where other modes of transportation are less attractive than driving one's own vehicle while under the influence of alcohol. We conducted interrupted time-series analyses using weekly counts of injury crashes and the proportion that were alcohol-involved in 4 US cities (Las Vegas, Nevada; Reno, Nevada; Portland, Oregon; and San Antonio, Texas). We considered that a resumption of Uber operations after a temporary break would produce a more substantial change in ridership than an initial launch, so we selected cities where Uber launched, ceased, and then resumed operations (2013-2016). We hypothesized that Uber's resumption would be associated with fewer alcohol-involved crashes. Results partially supported this hypothesis. For example, in Portland, Uber's resumption was associated with a 61.8% reduction (95% confidence interval: 38.7, 86.4) in the alcohol-involved crash rate (an absolute decrease of 3.1 (95% confidence interval: 1.7, 4.4) alcohol-involved crashes per week); however, there was no concomitant change in all injury crashes. Relationships between ridesharing and motor vehicle crashes differ between cities over time and may depend on specific local characteristics.
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Project description:Study objectivesHeart attacks and motor vehicle crashes are the leading causes of death in US firefighters. Given that sleep disorders are an independent risk factor for both of these, we examined the prevalence of common sleep disorders in a national sample of firefighters and their association with adverse health and safety outcomes.MethodsFirefighters (n = 6,933) from 66 US fire departments were assessed for common sleep disorders using validated screening tools, as available. Firefighters were also surveyed about health and safety, and documentation was collected for reported motor vehicle crashes.ResultsA total of 37.2% of firefighters screened positive for any sleep disorder including obstructive sleep apnea (OSA), 28.4%; insomnia, 6.0%; shift work disorder, 9.1%; and restless legs syndrome, 3.4%. Compared with those who did not screen positive, firefighters who screened positive for a sleep disorder were more likely to report a motor vehicle crash (adjusted odds ratio 2.00, 95% CI 1.29-3.12, p = 0.0021) and were more likely to self-report falling asleep while driving (2.41, 2.06-2.82, p < 0.0001). Firefighters who screened positive for a sleep disorder were more likely to report having cardiovascular disease (2.37, 1.54-3.66, p < 0.0001), diabetes (1.91, 1.31-2.81, p = 0.0009), depression (3.10, 2.49-3.85, p < 0.0001), and anxiety (3.81, 2.87-5.05, p < 0.0001), and to report poorer health status (p < 0.0001) than those who did not screen positive. Adverse health and safety associations persisted when OSA and non-OSA sleep disorders were examined separately.ConclusionsSleep disorders are prevalent in firefighters and are associated with increased risk of adverse health and safety outcomes. Future research is needed to assess the efficacy of occupational sleep disorders prevention, screening, and treatment programs in fire departments to reduce these safety and health risks.
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