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C W Runyan

Publications and source records attributed to C W Runyan.

At least 37 records · Page 2Linked to original sources
PubMed1998

Partner homicide-suicide involving female homicide victims: a population-based study in North Carolina, 1988-1992.

Homicide-suicide is a form of fatal violence in which an individual commits homicide and subsequently kills him- or herself. One hundred and sixteen homicide-suicide events involving 119 female homicide victims in North Carolina from 1988-1992 were identified through state medical examiner files. Case files were reviewed retrospectively to identify event characteristics, precursors, and typologies. In 86% of cases the perpetrator was the current or former partner of the victim. During the study period, 24% of men who killed their female partners in North Carolina subsequently committed suicide and another 3% attempted suicide but survived. Victim separation from the perpetrator was the most prevalent precursor (41%), followed by a history of domestic violence (29%). In nearly half of the cases with a history of domestic violence, the victim had previously sought protection from the perpetrator in the form of an arrest warrant, restraining order, or intervention by a law enforcement officer. Children of the victim (and/or perpetrator) witnessed the homicide-suicide, were in the immediate vicinity, found their parents' bodies, or were killed, in 43% of cases. The prevalence of separation and domestic violence suggests several potential points of intervention, including stronger domestic violence legislation. Future research should place priority on assessing the impact of partner homicide-suicides on the families in which they occur. Such studies are essential for the informed development of preventive and therapeutic interventions for the families of both the victims and perpetrators of these fatal events. In addition, research focused on assisting men in coping with issues of control and separation is needed.

Adolescent↗
PubMed1997

Fatal occupational injuries in a southern state.

Fatal occupational injuries were studied using data from medical examiners' reports in North Carolina for the years 1977-1991. Cases were defined as deaths due to accidents or homicide at the workplace, and populations at risk were estimated from the 1980 and 1990 US Censuses. Mortality rate ratios and proportionate mortality ratios were used as measures of association, and the population attributable risk percentage was used as an indicator of the burden of injury. Standard weights for direct age-adjustment of rates were obtained from the total state workforce. There were 2,524 eligible deaths-83 percent from unintentional traumatic injuries, 14 percent from homicide, and the remainder from other causes. This report focuses on unintentional trauma deaths, which were strongly associated with the wood production, fishing, and transportation industries. Elderly, African-American, and self-employed workers had higher fatality rates than members of other groups. Among male workers, motor vehicle crashes were the principal cause of death on the job, followed by falling objects, machinery, and falls. The industries contributing the largest proportions of these deaths were construction, trucking, agriculture, and logging (population attributable risk percentages were 16.8%, 8.8%, 7.9%, and 6.9%, respectively). The fatality patterns of female workers were different: Numbers of deaths from homicide and unintentional trauma were equal, and 27% of the latter deaths occurred in one catastrophic fire. Decentralized and rural industries were the most hazardous, but many deaths were outside the current jurisdiction of occupational safety and health agencies. These patterns suggest that greater scrutiny of such industries, through both research and intervention, is warranted.

Accidents, Occupational↗
PubMed1997

Farm work is dangerous for teens: agricultural hazards and injuries among North Carolina teens.

Children who work in agriculture suffer more than 23,000 injuries and 300 fatalities on American farms every year. Using survey data collected from a random sample of working teens (ages 14 to 17) in North Carolina, the authors analyze the farm-based hazard exposure and injury experiences of teens who work on farms. The group of farmworking teens (N = 141) is 72 percent male, has a mean age of 16.6 years, and is, on average, in the 10th grade. The data show that teens working on farms in North Carolina are exposed to significant safety hazards throughout their farmworking careers. A majority of the respondents in this group of farmworkers reported exposure to tractors, large animals, all-terrain vehicles, farm trucks, and rotary mowers, and more than one-third reported exposure to pesticides and tobacco harvesters. Common reported injuries include insect stings, cuts, burns, and falls. The researchers find that gender, age, and farmwork experiences are related to variations in types of hazards to which teens are exposed and in the types of injuries they suffer. These variables also are related to the overall complexity of the teens' farmwork experiences and the burden of injury endured by teens.

Accidents, Occupational↗
PubMed1997

Pediatric injury prevention counseling priorities.

OBJECTIVE: Child health care providers have a unique opportunity to conduct injury prevention counseling but limited empirical evidence for choosing prevention strategies. Efficient use of time requires that prevention strategies of higher priority be discussed before lower priority strategies. Our aim was to assess consensus among experts about the prioritization of prevention strategies for office based injury prevention counseling for parents of children under age two. DESIGN: We used a modified Delphi technique with 23 childhood injury prevention experts nationwide. Participants were blinded to the identities of each other. MEASURES: The first questionnaire, distributed via facsimile transmission, consisted of open ended questions about prevention strategies participants believe should be included and their prioritization methods. The second questionnaire was closed ended and based on the results of the first. RESULTS: Seventeen injury problems and 21 prevention strategies were suggested for counseling. Participants emphasized environmental strategies over more active, educational ones. Motor vehicle occupant injuries and car seats were given high priority scores by all participants. Smoke detectors, lowering the hot water heater temperature, and pool fencing also received high priority ratings. Participants based their decisions on the severity of the injury, the frequency with which the injury occured, and the availability of environmental strategies. However, they disagreed about the relative importance of these factors. Time constraints and parents' inability to absorb information led them to suggest limiting, to fewer than four, the number of prevention strategies addressed at any one visit. CONCLUSIONS: This study illustrates areas of consensus as well as unresolved dilemmas about pediatric injury prevention counseling. A rational decision making approach to prioritizing elements of clinical counseling is needed. Meanwhile, clinicians can use the findings of this study to derive their own judgments.

Accident Prevention↗
PubMed1996

A statewide survey of hazards in child care centers.

OBJECTIVES: The purpose of this study was to determine adherence to selected recommended safety standards in North Carolina child care centers. METHODS: A self administered questionnaire eliciting information about safety practices in child care was mailed to a randomly selected sample of 409 North Carolina child care centers. RESULTS: One hundred and ninety five usable questionnaires were returned from child care centers in 75 counties. Results indicated that all of the standards included in the state's child regulations were being adhered to by at least 80% of the centers. However, adherence to recommended standards not included in the state's regulations was quite variable, with one standard implemented by less than 5% of the centers. The lowest rates of adherence were found for standards specifying that resilient surface material be used under playground equipment (4%) and that certain foods that may present a choking hazard to small children not be served (27%). CONCLUSIONS: Many hazards not addressed in North Carolina child care regulations are present in child care centers. Some safety standards are not adhered to due to lack of knowledge or limited resources. Inclusion of national standards in state child care regulations appears to reduce, but not eliminate, the likelihood of hazards being reported. Further research should include on-site inspections and attention to safety in family child care.

Child↗
PubMed1996

Work patterns and occupational hazard exposures of North Carolina adolescents in 4-H clubs.

OBJECTIVES: This study documents sex differences in work patterns, injuries, and hazard exposures among adolescents in homes, farms, and other work sites. METHODS: 14 to 17 year old 4-H club members were asked to complete self administered questionnaires regarding their lifetime experience of work, hazard exposure, and injuries. RESULTS: Of 323 respondents, more than two thirds had ever worked paid jobs. Fifty seven per cent were injured during non-farm work and hazards were part of the non-farm work environment for 54% of the respondents. Males were more likely to work in hazardous conditions, including operating heavy equipment on farms or construction sites. Almost three quarters of the teens who worked on farms reported being injured there and 100% were exposed to at least one farm hazard. CONCLUSIONS: Adolescents perform jobs at homes, farms, or other work sites where they are exposed to numerous safety hazards. Prevention efforts should target specific hazards youths are exposed to rather than the general work site.

Accidents, Occupational↗
PubMed1995

Injuries to women in the United States: an overview.

This review summarizes the descriptive epidemiology of injuries among women in the United States, highlighting major problems as well as needs and opportunities for intervention and research. Injury mortality rates for 1984-88 were calculated from the National Center for Health Statistics mortality data tapes. Additional injury mortality and all injury morbidity information were derived from existing literature. Studies providing gender-specific U.S. injury information during the last ten years were reviewed. Injuries are the leading causes of death for females to age 34 and are responsible for more years of potential life lost than any other cause of death. The lifetime cost of injuries to females is approximately 50 billion dollars annually. Motor vehicle related injuries, falls, and violence are the most significant injury problems for women. Although morbidity is far greater than mortality, access to information about nonfatal injuries is extremely limited. What evidence does exist points to the importance of domestic assault as a major, underrecognized source of preventable injury. Though the greater magnitude of injury among men frequently eclipses the significance of injury as a problem for women, this paper presents evidence that injury is a problem which should feature prominently in the women's health agenda for the nation. There are pressing research needs to understand the changing trends in injuries to females and to identify appropriate intervention strategies. In addition, the study points to the needs for improvement in data systems to document injury morbidity.

Accidental Falls↗
PubMed1994

American Public Health Association/American Academy of Pediatrics Injury Prevention Standards.

Injury prevention is an integral part of quality child-care programs. National standards relating to injury prevention have been published by the APHA and the AAP. The majority of these standards are preventive in nature and stress injury prevention in the development of policies and procedures and in the implementation of daily practices in child-care programs. Although it may not be possible to prevent all injuries in child-care settings, it is important for care givers, parents, and health professionals to identify potential hazards in the child-care environment. Once these hazards are identified, preventive corrective actions directed toward both environmental modifications and individual behaviors can be promoted to keep the incidence of injuries as low as possible.

Accident Prevention↗
PubMed1994

Practices of county medical examiners in classifying deaths as on the job.

Although annual United States occupational injury fatalities range between 7,000 and 10,400, consistent rules to determine which deaths are "occupational" do not exist. Fifty-seven North Carolina county medical examiners (MEs), responsible for more than 50% of all medical examiner cases in 1990, received our questionnaire. Fifty-three (93%) responded, classifying 22 scenarios as on-the-job deaths and indicating usual classification practices and information sources. Agreement varied among the scenarios, but those involving transportation and nonpaid workers elicited particularly inconsistent responses. Fifty-six percent of medical examiners have a general rule for determining on-the-job status, but deaths associated with motor vehicles, farming, and occupations other than the decedent's usual job were classified most inconsistently. The lack of standard definitions of "job," "work," and "on-the-job" is apparent in classification decisions. Certain work situations need special consideration.

Accidents, Occupational↗
PubMed1993

Deaths at work among children and adolescents.

OBJECTIVE: To identify and describe all nonmilitary on-the-job injury fatalities in North Carolina among persons younger than 20 years over 10 years, with special attention to potential violations of the Fair Labor Standards Act. DESIGN AND SETTING: Historical, population-based case series, with cases identified by the computerized files of the North Carolina Office of the Chief Medical Examiner. CASES: Persons younger than 20 years who died of injuries received on the job in North Carolina between January 1, 1980, and December 31, 1989. RESULTS: We identified 71 cases. Decedents ranged in age from 11 to 19 years, with 41% aged 17 years or younger. Cases were disproportionately male (90%), white (80%), and injured during June, July, and August (44%). Farm or field was the most frequent place of injury (27%). More than 50% of injuries involved a motorized vehicle, frequently a tractor. Similar to studies in adults, homicide was the leading cause of fatal occupational injury for females. At the time of injury, 86% of workers younger than 18 years were involved in activities that appeared to violate the Fair Labor Standards Act of 1938. CONCLUSIONS: This study raises questions about the adequacy of federal child labor policies as minors continue to work under conditions that place them at risk for fatal injuries.

Accidents, Occupational↗
PubMed1992

Risk factors for fatal residential fires.

BACKGROUND: Residential fires are the most important cause of fire-related mortality in the United States. Previous research has concentrated on fatal fires in urban areas; considerably less is known about fatal fires in rural areas. METHODS: We studied fatal and nonfatal residential fires in predominantly rural areas. Using a case-control design, we compared all 151 fatal fires (cases) in single-family dwellings in North Carolina during a 13-month period with a sample of nonfatal fires (controls). Case fires were identified through the medical-examiner system, and control fires that occurred within a few weeks of the case fires were chosen from the records of randomly selected fire departments statewide. For each fire, fire officials were interviewed about the dwelling, the fire, the people involved, and the fire-response system. RESULTS: Although heating incidents were the leading cause of fires, fatal fires were more likely to have been caused by smoking (31 percent of fatal fires vs. 6 percent of nonfatal fires). Mobile homes posed a higher risk of death if a fire occurred (odds ratio, 1.7; 95 percent confidence interval, 1.1 to 2.6), as did the absence of a smoke detector (odds ratio, 3.4; 95 percent confidence interval, 2.1 to 5.6). Smoke detectors were more protective against death in fires involving young children and when no one present was impaired by alcohol or drugs or had a physical or mental disability. The presence of an alcohol-impaired person was the strongest independent risk factor for death in the case of a fire (odds ratio, 7.5; 95 percent confidence interval, 4.4 to 12.7). CONCLUSIONS: Residential fires are most likely to be caused by heating equipment or smoking materials. The risk of death is greatest in fires in mobile homes, in those involving alcohol-impaired persons, and in those in houses without smoke detectors.

Adolescent↗
PubMed1992

Emergency department record keeping and the potential for injury surveillance.

Successful design of injury prevention measures relies on understanding the occurrence and circumstances of injuries, which, in turn, necessitates that good quality data be collected about injured persons. The emergency department (ED) is an important source of injury information. This paper reports the results of a survey of all 129 hospital emergency departments in North Carolina to examine record-keeping practices and determine what information is collected and stored in the EDs. The findings demonstrate that there is considerable variability in the types of data that would be available to a researcher attempting to use ED records. Of special note is the absence of information about the external cause of injury.

Data Collection↗
PubMed1992

Newspapers: a source for injury surveillance?

Newspapers have not been extensively evaluated as an injury surveillance source. We compared clippings with medical examiner records for 45 residential fire deaths and 58 drownings of children to assess extent, completeness, and accuracy of newspaper coverage. Newspapers covered 96% of the fire fatalities and 78% of the drownings and contained more information than medical examiner records on several factors, including fire cause and smoke detector presence, pool fences, warning signs, and supervision of children.

Child↗