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Exploring the Determinants of the Severity of Pedestrian Injuries by Pedestrian Age: A Case Study of Daegu Metropolitan City, South Korea.

ABSTRACT: Pedestrian-vehicle crashes can result in serious injury to pedestrians, who are exposed to danger when in close proximity to moving vehicles. Furthermore, these injuries can be considerably serious and even lead to death in a manner that varies depending on the pedestrian's age. This is because the pedestrian's physical characteristics and behaviors, particularly in relation to roads with moving vehicles, differ depending on the pedestrian's age. This study examines the determinants of pedestrian injury severity by pedestrian age using binary logistic regression. Factors in the built environment, such as road characteristics and land use of the places where pedestrian crashes occurred, were considered, as were the accident characteristics of the pedestrians and drivers. The analysis determined that the accident characteristics of drivers and pedestrians are more influential in pedestrian-vehicle crashes than the factors of the built environmental characteristics. However, there are substantial differences in injury severity relative to the pedestrian's age. Young pedestrians (aged under 20 years old) are more likely to suffer serious injury in school zones; however, no association between silver zones and injury severity is found for elderly pedestrians. For people in the age range of 20-39 years old, the severity of pedestrian injuries is lower in areas with more crosswalks and speed cameras. People in the age range of 40-64 years old are more likely to be injured in areas with more neighborhood streets and industrial land use. Elderly pedestrians are likely to suffer fatal injuries in areas with more traffic signals. This study finds that there are differences in the factors of pedestrian injury severity according to the age of pedestrians. Therefore, it is suggested that concrete and efficient policies related to pedestrian age are required to improve pedestrian safety and reduce pedestrian-vehicle crashes.

SUBMITTER: Park SH

PROVIDER: S-EPMC7177641 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Exploring the Determinants of the Severity of Pedestrian Injuries by Pedestrian Age: A Case Study of Daegu Metropolitan City, South Korea.

Park Seung-Hoon SH Bae Min-Kyung MK

International journal of environmental research and public health 20200331 7

Pedestrian-vehicle crashes can result in serious injury to pedestrians, who are exposed to danger when in close proximity to moving vehicles. Furthermore, these injuries can be considerably serious and even lead to death in a manner that varies depending on the pedestrian's age. This is because the pedestrian's physical characteristics and behaviors, particularly in relation to roads with moving vehicles, differ depending on the pedestrian's age. This study examines the determinants of pedestria ...[more]

PMID: 32244336

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Project description:BackgroundA coronavirus disease 2019 (COVID-19) outbreak started in February 2020 and was controlled at the end of March 2020 in Daegu, the epicenter of the coronavirus outbreak in Korea. The aim of this study was to describe the clinical course and outcomes of patients with COVID-19 in Daegu.MethodsIn collaboration with Daegu Metropolitan City and Korean Center for Diseases Control, we conducted a retrospective, multicenter cohort study. Demographic, clinical, treatment, and laboratory data, including viral RNA detection, were obtained from the electronic medical records and cohort database and compared between survivors and non-survivors. We used univariate and multi-variable logistic regression methods and Cox regression model and performed Kaplan-Meier analysis to determine the risk factors associated with the 28-day mortality and release from isolation among the patients.ResultsIn this study, 7,057 laboratory-confirmed patients with COVID-19 (total cohort) who had been diagnosed from February 18 to July 10, 2020 were included. Of the total cohort, 5,467 were asymptomatic to mild patients (77.4%) (asymptomatic 30.6% and mild 46.8%), 985 moderate (14.0%), 380 severe (5.4%), and 225 critical (3.2%). The mortality of the patients was 2.5% (179/7,057). The Cox regression hazard model for the patients with available clinical information (core cohort) (n = 2,254) showed the risk factors for 28-day mortality: age > 70 (hazard ratio [HR], 4.219, P = 0.002), need for O₂ supply at admission (HR, 2.995; P = 0.001), fever (> 37.5°C) (HR, 2.808; P = 0.001), diabetes (HR, 2.119; P = 0.008), cancer (HR, 3.043; P = 0.011), dementia (HR, 5.252; P = 0.008), neurological disease (HR, 2.084; P = 0.039), heart failure (HR, 3.234; P = 0.012), and hypertension (HR, 2.160; P = 0.017). The median duration for release from isolation was 33 days (interquartile range, 24.0-46.0) in survivors. The Cox proportional hazard model for the long duration of isolation included severity, age > 70, and dementia.ConclusionOverall, asymptomatic to mild patients were approximately 77% of the total cohort (asymptomatic, 30.6%). The case fatality rate was 2.5%. Risk factors, including older age, need for O₂ supply, dementia, and neurological disorder at admission, could help clinicians to identify COVID-19 patients with poor prognosis at an early stage.

Project description:BackgroundData regarding the association between preexisting cardiovascular risk factors (CVRFs) and cardiovascular diseases (CVDs) and the outcomes of patients requiring hospitalization for coronavirus disease 2019 (COVID-19) are limited. Therefore, the aim of this study was to investigate the impact of preexisting CVRFs or CVDs on the outcomes of patients with COVID-19 hospitalized in a Korean healthcare system.MethodsPatients with COVID-19 admitted to 10 hospitals in Daegu Metropolitan City, Korea, were examined. All sequentially hospitalized patients between February 15, 2020, and April 24, 2020, were enrolled in this study. All patients were confirmed to have COVID-19 based on the positive results on the polymerase chain reaction testing of nasopharyngeal samples. Clinical outcomes during hospitalization, such as requiring intensive care and invasive mechanical ventilation (MV) and death, were evaluated. Moreover, data on baseline comorbidities such as a history of diabetes, hypertension, dyslipidemia, current smoking, heart failure, coronary artery disease, cerebrovascular accidents, and other chronic cardiac diseases were obtained.ResultsOf all the patients enrolled, 954 (42.0%) had preexisting CVRFs or CVDs. Among the CVRFs, the most common were hypertension (28.8%) and diabetes mellitus (17.0%). The prevalence rates of preexisting CVRFs or CVDs increased with age (P < 0.001). The number of patients requiring intensive care (P < 0.001) and invasive MV (P < 0.001) increased with age. The in-hospital death rate increased with age (P < 0.001). Patients requiring intensive care (5.3% vs. 1.6%; P < 0.001) and invasive MV (4.3% vs. 1.7%; P < 0.001) were significantly greater in patients with preexisting CVRFs or CVDs. In-hospital mortality (12.9% vs. 3.1%; P < 0.001) was significantly higher in patients with preexisting CVRFs or CVDs. Among the CVRFs, diabetes mellitus and hypertension were associated with increased requirement of intensive care and invasive MV and in-hospital death. Among the known CVDs, coronary artery disease and congestive heart failure were associated with invasive MV and in-hospital death. In multivariate analysis, preexisting CVRFs or CVDs (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.07-3.01; P = 0.027) were independent predictors of in-hospital death after adjusting for confounding variables. Among individual preexisting CVRF or CVD components, diabetes mellitus (OR, 2.43; 95% CI, 1.51-3.90; P < 0.001) and congestive heart failure (OR, 2.43; 95% CI, 1.06-5.87; P = 0.049) were independent predictors of in-hospital death.ConclusionBased on the findings of this study, the patients with confirmed COVID-19 with preexisting CVRFs or CVDs had worse clinical outcomes. Caution is required in dealing with these patients at triage.

Project description:BackgroundDespite concerns regarding increasingly frequent and intense heat waves due to global warming, there is still a lack of information on the effects of extremely high temperatures on the adult abundance of mosquito species that are known to transmit vector-borne diseases. This study aimed to evaluate the effects of extremely high temperatures on the abundance of mosquitoes by analyzing time series data for temperature and mosquito abundance in Incheon Metropolitan City (IMC), Republic of Korea, for the period from 2015 to 2020.MethodsA generalized linear model with Poisson distribution and overdispersion was used to model the nonlinear association between temperature and mosquito count for the whole study area and for its constituent urban and rural regions. The association parameters were pooled using multivariate meta-regression. The temperature-mosquito abundance curve was estimated from the pooled estimates, and the ambient temperature at which mosquito populations reached maximum abundance (TMA) was estimated using a Monte Carlo simulation method. To quantify the effect of extremely high temperatures on mosquito abundance, we estimated the mosquito abundance ratio (AR) at the 99th temperature percentile (AR99th) against the TMA.ResultsCulex pipiens was the most common mosquito species (51.7%) in the urban region of the IMC, while mosquitoes of the genus Aedes (Ochlerotatus) were the most common in the rural region (47.8%). Mosquito abundance reached a maximum at 23.5 °C for Cx. pipiens and 26.4 °C for Aedes vexans. Exposure to extremely high temperatures reduced the abundance of Cx. pipiens mosquitoes {AR99th 0.34 [95% confidence interval (CI) 0.21-0.54]} to a greater extent than that of Anopheles spp. [AR99th 0.64 (95% CI 0.40-1.03)]. When stratified by region, Ae. vexans and Ochlerotatus koreicus mosquitoes showed higher TMA and a smaller reduction in abundance at extreme heat in urban Incheon than in Ganghwa, suggesting that urban mosquitoes can thrive at extremely high temperatures as they adapt to urban thermal environments.ConclusionsWe confirmed that the temperature-related abundance of the adult mosquitoes was species and location specific. Tailoring measures for mosquito prevention and control according to mosquito species and anticipated extreme temperature conditions would help to improve the effectiveness of mosquito-borne disease control programs.

Project description:ObjectivesThis study examined hypertension prevalence, awareness, treatment and control and their determinants among adults attending health facilities in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape.DesignA cross-sectional analytical study.SettingsThe three largest outpatient clinics in BCMM.ParticipantsAmbulatory adults (aged 18 years and over) attending the study settings during the study period (n=998).Primary outcome measureThe prevalence of hypertension (systolic blood pressure (BP) of ≥140 mm Hg and/or a diastolic BP of ≥90 mm Hg or current medication for hypertension), the awareness of it (prior diagnosis of it) and its treatment and control (Eighth Joint National Committee Criteria of BP <140/90/90 mm Hg).Secondary outcome measureAssociated factors of hypertension, hypertension unawareness and uncontrolled hypertension.ResultsOf the 998 participants included, the prevalence of hypertension was 49.2%. Hypertension unawareness was reported by 152 participants (23.1%) with significant gender difference (p=0.005). Male sex, age <45 years, higher level of education, single status, current employment, higher monthly income, current smoking, alcohol usage, absence of diabetes and non-obese were significantly associated (p<0.05) with hypertension unawareness.Of the participants who were aware of having hypertension (n=339), nearly all (91.7%, n=311) were on antihypertensive medication and only 121 participants (38.9%) achieved the BP treatment target. In the multivariate logistic regression model analysis, ageing (95% CI 1.9 to 4.4), being married (95% CI 1.0 to 2.0), male sex (95% CI 1.2 to 2.3), concomitant diabetes (95% CI 1.9 to 3.9), lower monthly income (95% CI 1.2 to 2.2), being unemployed (95% CI 1.0 to 1.9) and central obesity (95% CI 1.5 to 2.8) were the significant and independent determinants of prevalent hypertension.ConclusionThe prevalence and awareness of hypertension was high in the study population. In addition, the suboptimal control of BP among treated individuals, as well as the significant cardiovascular risk factors, warrant the attention of health authorities of BCMM and the country.

Dataset Information

Exploring the Determinants of the Severity of Pedestrian Injuries by Pedestrian Age: A Case Study of Daegu Metropolitan City, South Korea.

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Exploring the Determinants of the Severity of Pedestrian Injuries by Pedestrian Age: A Case Study of Daegu Metropolitan City, South Korea.

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