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Biomedical subjects

E C Wigglesworth

Publications and source records attributed to E C Wigglesworth.

At least 19 recordsLinked to original sources

Towards an Australian Institute of Trauma Research: learning the lessons of history.

Although medical research in Australia in the 20th century has resulted in a reduction of approximately 95% in the death rate from the infectious and parasitic diseases, there has been no such beneficial outcome in road traffic accidents which, it is here suggested, were out of control from 1948 until 1970. In 1970 several concerned community groups (spearheaded by the Royal Australasian College of Surgeons) campaigned for the introduction of mandatory seat belt wearing. As a consequence of that initiative, and the virtual plethora of subsequent research activities, the road traffic accident rate has declined substantially in the last three decades. The death rate from drownings to toddlers (children under 5) was essentially unchanged until the 1970s when research into toddler pool deaths and the implementation of those research findings resulted in a downturn in toddler drownings in the last two decades. These two examples demonstrate the value of accident research and the implementation of research findings. By analogy with the contributions of the large medical research institutes, the creation of an Australian Institute of Trauma Research seems desirable and is here proposed.

Accidents, Traffic↗

The current hiatus in occupational injury research in Australia.

OBJECTIVE: In late 1999, the Safety Institute of Australia (SIA) noted the difficulty of accessing and reviewing Australian research into occupational injuries and asked for a register of research in this field to be created. It offered the use of its website as a continuing location for a possible register. The creation of the initial database was the primary objective of this work. METHOD: Data collection was by survey form, which was distributed by mail to relevant organisations and individuals and was also downloadable from the SIA website. Responses were accepted by mail, fax and e-mail. RESULTS: By April 2000, responses which included publications in peer-reviewed journals since 1995 totalled just 154. This seemed to support the Institute's opinion that the amount of research in progress was inadequate to reduce the incidence of workplace injuries in Australia. CONCLUSIONS AND IMPLICATIONS: The small number of responses was partly due to the 1996 restructuring of the National Occupational Health and Safety Commission. Additionally, present arrangements give no role for investigator-initiated and investigator-driven research which has been the essential prerequisite for success in other areas of public health. The Australian workforce is now disadvantaged in contrast to overseas competitors who have national occupational injuries research organisations. To remedy this situation, a new science-based research grant organisation, with annual funds of about $25 million, administered by a new Occupational Injuries Research Council is proposed.

Accidents, Occupational↗

Motor vehicle crashes and spinal injury.

Accident reports for 67 patients admitted to 3 spinal cord injury units in Australia in 1987 as a result of motor vehicle accidents were examined. Two thirds of the accidents occurred during the Friday-Saturday-Sunday leisure period and about 60% occurred during the November-February Australian summer holiday season. This conforms to the general Australian pattern of road trauma which is predominantly a consequence of leisure travel. The likelihood of a road traffic injury resulting in damage to the spinal cord was highest for motorcyclists whose average age was 22.7, lower than that for vehicle drivers (33.7) and vehicle passengers (38.1). However the most important finding is that most car occupants received their injuries when the motor vehicle overturned. As vehicle rollovers are relatively rare in the total spectrum of traffic crashes this distribution is thought not to have been previously reported. Some possible mechanisms of spinal cord injury are reviewed and engineering solutions to prevent future injuries are recommended. The paper also emphasises the unique opportunity for Australia to collect meaningful data on the causes of spinal injury and advocates the creation of an Australian Spinal Cord Injury Registry.

Accidents, Traffic↗

Serious occupational injuries in Australia: some deficiencies of the existing data collections.

This study examines the incidence in Australia of "serious" occupational injuries, arbitrarily defined as those which resulted in absence from work for six months or more. The raw data were contained in computer print-outs specially prepared by the State offices of the Australian Bureau of Statistics (ABS) and the study includes analyses by age, sex, occupation and industry of the injured person. The unexpectedly large total of 14,281 high-severity injuries cannot be supported with confidence since the principal finding was the large and consistent variation in injury rates between the States. For males, the overall injury rates (per 10,000 persons) for Victoria, South Australia and Tasmania were in the range 11 to 16: those for Queensland and Western Australia were in the high 30s; whilst that for New South Wales exceeded 50. A similar ranking of injury rates prevailed in almost every subset. The highest rates arose in New South Wales, Queensland and Western Australia in six of the seven occupation groups, in nine of the ten industry groups and in all eleven age groups. It is difficult to find any scientific explanation for these variations in terms of levels or extent of exposure to risk. In the opinion of this author, these variations should be attributed to differences in the institutional arrangements for the coverage, collection and/or compilation of compensation data.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Occupational↗

Towards prevention of spinal cord injury: the role of a national register.

The Menzies Foundation in Australia recently sponsored two technical meetings designed to reduce the incidence of spinal cord injury in the Australia-New Zealand area. From these meetings came unanimous support for the creation of a national Register to develop data and programmes for the prevention of spinal cord injury. The Foundation has since provided further funds for a Planning Committee to bring the Register into being. These developments are described.

Australia↗

Data needs for research in road trauma.

This paper laments the existence of widespread "instant" expertise on road trauma; postulates the need for multidisciplinary epidemiological research teams to produce a more scientific approach to this problem, based on authoritative information and analysis; and suggests that any such teams will require accessible, comprehensive, compatible data. The paper describes some problems of existing data collections associated with the source of the data, the lack of compatibility and comprehensiveness, and the absence of data on exposure and on severity of injury. It is suggested that, in the context of these deficiencies, extensive development of new data is unrealistic. Instead, the paper concludes by recommending gradual expansion of currently available data on a national basis, under the control of the Australian Bureau of Statistics. It is suggested that Section 51 of the Constitution provides the necessary head of power for this development.

Accidents, Traffic↗

The need for epidemiological research in road trauma.

This paper discusses the application of epidemiological methods to the public health problem of road trauma. The complex nature of the system is stressed, and some consequent difficulties in the formulation of appropriate hypotheses are outlined. Examples are given. To solve these problems, the paper proposes the formation of multidisciplinary full-time epidemiological research teams.

Accidents, Traffic↗

The fault doctrine and injury control.

An analogy is drawn between the fourteenth-century conceptualization of infectious disease and the twentieth-century conceptualization of trauma. In both cases, causality is associated with faulty human behavior which acts as a handicap to progress. It is suggested that the practice of attributing accident causality to faulty behavior restricts the development of preventive activities in three ways: it implies that allocation of culpability is synonymous with identification of cause; it inhibits countermeasure implementation directly; and it concentrates on behavior instead of environmental hazards. A more useful and more appropriate approach is outlined and discussed.

Accidents, Occupational↗

Road trauma: who should be counted?

Fatalities associated with the use of road vehicles, as reported in two separate data series, are compared. The customarily used collection, Road Traffic Accidents Including Casualties, underreported the actual total of road trauma deaths in Australia for the decade 1965 to 1974 by almost 2000 cases (5.8%). Of this total, approximately half were attributable to duration of survival exceeding 30 days; the remainder could be accounted for by a quirk of definition which excluded "off-road" accidents (in car parks, domestic and farm premises, factories and shopping centres). Cases excluded increased from 1.7% in 1965 to 8.4% in 1974. In the interests of accurate countermeasure evaluation, some revisions are recommended.

Accidents, Traffic↗

Injury control: a state-of-the-art review.

There is a growing body of new knowledge suggesting that trauma should no longer be conceptualized as a behavioural phenomenon with the associated connotations of chance, unexpectedness and blame worthiness. Instead, it should be regarded as a public health problem amenable to scientific, research-based strategies of the type that have been successfully introduced in the fight to conquer infectious disease. If progress is to be made in reducing the toll of accidental mortality and morbidity, the current need is for the increased allocation of resources to develop, extend and disseminate this new knowledge.

Accident Prevention↗