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At least 253 records · Page 14Linked to original sources
PubMed1996

Temporomandibular disorders, headaches, and neck pain following motor vehicle accidents and the effect of litigation: review of the literature.

A literature review concerning the relationships between motor vehicle accidents and temporomandibular disorders, whiplash, headache, neck pain, and litigation was undertaken. The review shows that many patients recover or resume work prior to settlement, but most unsuccessfully treated patients do not generally recover following the settlement of legal claims; the postinjury problems are not strictly psychologic. Litigating patients and nonlitigating patients are often not dramatically different in most important regards (including pain and return to work), with litigating patients deserving the same treatment as other patients with chronic pain. It was found that postinjury neck symptoms and headaches can be persistent. Employment appears to be a better predictor of long-term outcome than compensation and litigation. In addition, limited consensus is available concerning prognostic factors. Patients with postinjury temporomandibular disorders tend to respond less well to treatment than do noninjury patients with temporomandibular disorders, as do litigating compared to nonlitigating temporomandibular disorders patients, but a cause and effect relationship is not known. The incidence of temporomandibular disorders following motor vehicle accidents may not be as high as has been claimed in whiplash cases. More research is required in the area of temporomandibular disorders, motor vehicle accidents, and litigation.

Accidents, Traffic↗
PubMed1979

Multiple cardiovascular injuries and motor vehicle accidents.

A patient sustained blunt chest trauma in a motor vehicle accident. Cardiovascular trauma was initially obscured by more obvious orthopedic injuries. Thoracic aortic transection with false aneurysm formation was discovered incidentally during cardiac catheterization for traumatic tricuspid insufficiency. Successful repair of both lesions was subseqeuntly performed. This case demonstrates the difficulty in recognizing cardiovascular trauma in survivors of motor vehicle accidents and emphasizes the need for an aggressive diagnostic approach with consideration of coexisting injuries in patients who have sustained blunt chest trauma.

Accidents, Traffic↗
PubMedDate not supplied

[Road safety in Italy: epidemiology of two-wheeled motor vehicles accidents. National statistics 2000].

OBJECTIVE: to describe road accidents occurred in Italy focusing, in particular, on two-wheeled motor vehicles. DESIGN: Analysis of road accidents based on current data referring to year 2000. SETTING: Italy. RESULTS: In Italy, 67,127 two-wheeled motor vehicle accidents occurred in 2000. Two crash types account for 75% of the accidents: side impact and front-side impact. Per one million kilometres travelled 0.4 cars and 1.3 two-wheeled vehicles are involved (0.7 motorcycles and 2.2 mopeds). In 2000 there were 1,229 deaths and 69,543 injured riders. Males up to forty years old are the most represented. The masculinity ratio presents a decreasing trend from motorcycles to mopeds and to cars both for killed people and for injured people. The lethality rate increases with age for all types of vehicles but for mopeds this trend is much more evident. Most of the accident occur in urban road while most of the deaths happen in extra-urban road. CONCLUSION: Mopeds and motorcycles, which are a small subset of all motor vehicles (approximately 20%), are greatly overrepresented in crashes. Considering the kilometres travelled, the risk to be involved in a crash for mopeds is estimated to be 32.6 times higher than the comparable risk for cars and for motorcycles it is 17 times higher. The risk of death for riders is two times the risk for cars.

Accidents, Traffic↗
PubMed1992

Severity and outcome of intracranial lesions in pedestrians injured by motor vehicles.

To evaluate the type and severity of intracranial lesions and the prognosis after closed head trauma in pedestrians injured by motor vehicles, we reviewed the cases of 225 consecutive patients who suffered major head injuries in collisions with motor vehicles. Patients in this series were comatose, had intracranial hematomas requiring surgical removal, or both. The initial Glasgow Coma Scale (GCS) score was 9-15 in 24% of patients, 6-8 in 32%, and 3-5 in 43%. Intracranial hypertension occurred in 40%. Diagnostic studies showed subdural hematomas in 45% of patients, epidural hematomas in 8%, intracerebral hematomas in 10%, and cerebral contusions in 9%. Clinically significant mass lesions were evacuated, and intracranial pressure was monitored and treated aggressively if elevated. After 6 months, 51% of the patients had died, 13% were vegetative or severely disabled, and 35% had a good outcome or moderate disability. These major head injuries in pedestrians struck by motor vehicles were usually severe, included a high incidence of intracranial hematomas and increased intracranial pressure, and frequently had poor outcomes.

Accidents, Traffic↗
PubMed1981

Death and injury from motor vehicle crashes in Israel: epidemiology, prevention and control.

Death and motor vehicle crash (MVC) rates per 1000 vehicles and kilometres travelled in Israel (1977) exceed those of all western countries, despite low numbers of young and intoxicated drivers. Increased casualties have resulted from expansion of driver and vehicle populations offsetting a decline in crash risk. Time data indicate casualty crash trends reflect trends in traffic volume, and that night time case fatality rates (CFR) are high. Place data indicate that more than three quarters of all crashes occur in cities, mostly involving pedestrians, but the majority of deaths result from higher speed inter-urban crashes, mostly of 2-vehicle type, and not as intersections. The rates for deaths per 100 crashes are 4- and 8-fold higher in inter-urban than urban crashes for occupants and pedestrians, respectively. Vehicle data indicate high MVC risk from careless driving, probably speeding in taxis, and point to the need for occupant protection standards in light weight trucks and pick up vans. Human data indicate that 92% of drivers in MVCs are male. The risk of involvement is high for drivers aged 18 and drops at aged 55. Pedestrian accidents resulted in 48.1% of all dead, and included large numbers of young and elderly. Reduction in inter-urban private motor vehicle travel and in speeds at which crashes occur are suggested as swift and effective measures to reduce death and injury. Low cost strategies include air bags and other occupant protection standards and more seat belts. Prevention of pedestrian accidents requires a variety of measures to reduce vehicle-pedestrian conflicts.

Accidents, Traffic↗
PubMed2006

Motor vehicle contributions to ambient PM10 and PM2.5 at selected urban areas in the USA.

A source apportionment study was carried out to estimate the contribution of motor vehicles to ambient particulate matter (PM) in selected urban areas in the USA. Measurements were performed at seven locations during the period September 7, 2000 through March 9, 2001. Measurements included integrated PM(2.5) and PM(10) concentrations and polycyclic aromatic hydrocarbons (PAHs). Ambient PM(2.5) and PM(10) were apportioned to their local sources using the chemical mass balance (CMB) receptor model and compared with results obtained using scanning electron microscopy (SEM). Results indicate that PM(2.5) components were mainly from combustion sources, including motor vehicles, and secondary species (nitrates and sulfates). PM(10) consisted mainly of geological material, in addition to emissions from combustion sources. The fractional contributions of motor vehicles to ambient PM were estimated to be in the range from 20 to 76% and from 35 to 92% for PM(2.5) and PM(10), respectively.

Air Pollution↗
PubMed2003

Is body mass index a risk factor for motor vehicle driver injury? A cohort study with prospective and retrospective outcomes.

OBJECTIVE: To investigate the association between risk of motor vehicle driver injury and body mass index (BMI). METHODS: In a cohort study of 10 525 New Zealand men and women, BMI was assessed in 1992-1993 (baseline), and data on deaths and hospitalizations for motor vehicle driver injury were obtained by record linkage to national health databases for the period 1988-1998. Hazard ratios (HR) and CI were estimated by Cox regression. RESULTS: During a mean 10.3 years of follow-up, 139 fatal and non-fatal driver injury cases occurred (85 before baseline and 54 after). A U-shaped association was observed between driver injury risk and BMI, both crudely and after adjustment for covariates, which included age, sex, driving exposure, and alcohol intake (P-values for quadratic trend </=0.02). Participants in the highest (>/=28.7 kg/m(2); HR = 2.00, 95% CI: 1.18-3.39) and lowest (<23.5 kg/m(2); HR = 2.17, 95% CI: 1.27-3.73) quartiles of BMI were twice as likely to have experienced a driver injury during the follow-up period as participants in the reference quartile (25.9-28.6 kg/m(2); HR = 1.00). CONCLUSION: Further research is needed to corroborate or refute the hypothesis that BMI is a risk factor for serious motor vehicle driver injury.

Accidents, Traffic↗
PubMedDate not supplied

Long-term outcome of motor vehicle accident injury.

OBJECTIVE: To define the psychological outcome at 5 years of a sample of non-head-injured motor vehicle accident victims and identify baseline predictors. METHODS: Self-report questionnaires were completed by 111 consecutive subjects who had been injured in a motor vehicle accident 5 years earlier and who had been assessed previously in a prospective 1-year study. RESULTS: Although most subjects reported a good outcome, a substantial minority described continuing social, physical, and psychological difficulties and a quarter of those studied suffered phobic anxiety about travel as a driver or passenger. There was little change in quality of life outcome and effects on travel between assessments at 3 months, 1 year, and 5 years. The prevalence of posttraumatic stress disorder remained approximately 10% throughout the follow-up; most early cases had remitted by 5 years, and a similar number of delayed new onsets had occurred between 1 year and 5 years. PTSD at 5 years was predicted by physical outcome and by postaccident intrusive memories and emotional distress. Compensation proceedings were initiated by 66 subjects and were often prolonged and a cause of distress. There were no significant associations with outcome. Trends for a poor outcome in claimants, especially those not settled at 5 years, may be due to their having more serious physical problems. CONCLUSION: Psychological complications are important and persistent after injury in a motor vehicle accident, are associated with adverse effects on everyday activities, and pose a challenge for consultation-liaison psychiatry.

Accidents, Traffic↗
PubMed2000

Motor-vehicle injury patterns in emergency-department patients in a south-European urban setting.

The objectives are to identify the main injury patterns in the various types of user (of cars, motorcycles/mopeds, bicycles and pedestrians) injured in traffic crashes and treated in hospital emergency services, along with their main demographic characteristics. One-year cumulative survey all of patients attended to emergency departments in Barcelona, Spain, over a 12-month period (1998) for injuries due to motor vehicle crashes. Bivariate descriptive analyses were conducted to identify the different profiles of motor-vehicle injury patients by age, sex, user type, injured body region and type of injuries. ISS scoring was used to determine injury severity. Of the nearly 17,000 injured traffic victims during 1998, 62% were men. Young people between 15 and 39 (71.6%) were most affected. 42% were users of two-wheeled motor vehicles, followed by car occupants (32%) and pedestrians (24%). Neck sprain (33%) was the most common injury among car occupants, multiple contusion and contusion of lower limbs among two-wheeled motor vehicles (23.5% and 14% respectively) and pedestrians (17.3% and 14.4% respectively) and upper limb fractures (20%) among cyclists. Motorcycle and moped users, mainly young males, have the highest probability of suffering injuries, with lower limbs being the most affected anatomical region. Elderly pedestrians sustaining injuries to the lower limbs and the head contribute substantially to the overall injury situation.

Accidents, Traffic↗
PubMedDate not supplied

Chronic pain and posttraumatic stress symptoms in litigating motor vehicle accident victims.

OBJECTIVE: There has been little research examining chronic pain and posttraumatic stress symptoms in persons injured in motor vehicle accidents. The purpose of this study was to evaluate differences in physical injury and impairment, psychological distress, and pain coping strategies in litigating chronic pain patients low and high in motor vehicle accident-related posttraumatic stress symptoms. DESIGN: A total of 160 consecutive chronic pain patients referred for psychological-legal assessment underwent semistructured interview and testing. The testing battery included the Minnesota Multiphasic Personality Inventory-2, the Multidimensional Pain Inventory, the Sickness Impact Profile, and the Coping Strategies Questionnaire. Using the sample-specific median split of 18 posttraumatic stress symptoms on the Minnesota Multiphasic Personality Inventory-2 Posttraumatic Stress Disorder scale, chronic pain patients were categorized as evidencing low or high levels of posttraumatic stress symptoms. RESULTS: The findings indicate that participants evidencing high posttraumatic stress symptoms had more physical impairment, psychological distress, and maladaptive pain coping strategies and were more likely to be treated with antidepressants, other medications, and psychological management than participants evidencing low posttraumatic stress symptoms. A discriminant function analysis was performed using the full combination of physical injury and impairment, psychological distress, and pain coping variables in the prediction of posttraumatic stress symptom-defined group membership. The resulting discriminant function accounted for 61% of the between-group variance and correctly classified 92% of participants who were low in posttraumatic stress symptoms and 88% of participants who were high in posttraumatic stress symptoms. CONCLUSIONS: Chronic pain and posttraumatic stress symptoms in litigating motor vehicle accident victims are associated with increased physical and psychological morbidity.

Accidents, Traffic↗
PubMed2004

Mesothelioma and lung cancer among motor vehicle mechanics: a meta-analysis.

We conducted a systematic review and analysis of the epidemiological literature that examines the risk of lung cancer and mesothelioma among motor vehicle mechanics who may have been engaged in brake repair and, thus, were potentially exposed to asbestos. All relevant studies were classified into three tiers according to their quality. Tier III (lowest quality) studies were cited for completeness, but were not included in the meta-analysis. Meta relative risks (meta-RRs) were calculated for mesothelioma and lung cancer using both fixed and random effects models for Tiers I and II, separately, followed by stratified analyses based on study design or exposure characterization (garage workers versus brake workers) and, for lung cancer studies, based on adequate adjustment for smoking. The meta-analysis for Tier I (higher quality) and Tier II (lower quality) studies of mesothelioma yielded RR estimates of 0.92 (95% CI 0.55-1.56) and 0.81 (95% CI 0.52-1.28), respectively. Further stratification according to exposure characterization did not affect the results. The meta-analysis for lung cancer produced RR estimates of 1.07 (95% CI 0.88-1.31) for Tier I and 1.17 (95% CI 1.01-1.36) for Tier II. When the lung cancer analysis was limited to studies that used adequate control for smoking, the resulting RR estimate was 1.09 (95% CI 0.92-1.28). Based on these findings, we conclude that employment as a motor vehicle mechanic does not increase the risk of developing mesothelioma. Although some studies showed a small increase in risk of lung cancer among motor vehicle mechanics, the data on balance do not support a conclusion that lung cancer risk in this occupational group is related to asbestos exposure.

Asbestos↗
PubMed2004

Fetal intracranial injuries in a preterm infant after maternal motor vehicle accident: a case report.

OBJECTIVE: To present a case of fetal intracranial injuries in a preterm infant after maternal motor vehicle accident and to review the relevant literature. DESIGN: Case report. SETTING: Neonatal and pediatric intensive care unit of a children's hospital. PATIENT: Preterm infant (gestational age, 30-6/7 wks) with intracranial injuries after maternal motor vehicle accident. RESULTS: Whereas the mother had only a closed femur fracture, her infant sustained subdural, subarachnoid, and intracerebral hemorrhages in the left parietal and temporal lobes most likely attributable to direct fetal trauma. Massive fetomaternal hemorrhage may have led additionally to hypoxia-ischemia contributing indirectly to the injury. At the last follow-up visit (chronological age, 20 months; corrected age, 18 months), there was evidence of a persistent right-sided hemiparesis in an otherwise normally developed infant. CONCLUSIONS: Motor vehicle accidents during pregnancy can be associated with fetal mortality and significant morbidity, even in the absence of severe maternal injuries. Direct (hemorrhagic) and indirect (hypoxic-ischemic) intracranial injuries should be actively sought with appropriate imaging studies.

Accidents, Traffic↗
PubMed2000

Lead loading of urban streets by motor vehicle wheel weights.

This study documents that lead weights, which are used to balance motor vehicle wheels, are lost and deposited in urban streets, that they accumulate along the outer curb, and that they are rapidly abraded and ground into tiny pieces by vehicle traffic. The lead is so soft that half the lead deposited in the street is no longer visible after little more than 1 week. This lead loading of urban streets by motor vehicle wheel weights is continuous, significant, and widespread, and is potentially a major source of human lead exposure because the lead is concentrated along the outer curb where pedestrians are likely to step. Lead deposition at one intersection in Albuquerque, New Mexico, ranged from 50 to 70 kg/km/year (almost 11 g/ft(2)/year along the outer curb), a mass loading rate that, if accumulated for a year, would exceed federal lead hazard guidelines more than 10,000 times. Lead loading of major Albuquerque thoroughfares is estimated to be 3,730 kg/year. Wheel weight lead may be dispersed as fugitive dust, flushed periodically by storm water into nearby waterways and aquatic ecosystems, or may adhere to the shoes of pedestrians or the feet of pets, where it can be tracked into the home. I propose that lead from wheel weights contributes to the lead burden of urban populations.

Dust↗
PubMed1996

Alcohol, the elderly, and motor vehicle crashes.

To document the prevalence of alcohol or drug use among elderly drivers admitted to a Level 1 trauma center after motor vehicle crashes, charts from 180 drivers age 60 years or older who were admitted to an urban Level 1 trauma center after motor vehicle crashes were retrospectively reviewed. Overall, 14% of the patients had a positive blood alcohol screen; among men, 21% had a positive screen. Only 55% of the patients were discharged to home. Only one patient ( < 1%) had a toxicology screen positive for another drug abuse. Alcohol/drug abuse counselling was offered to only one patient. These results suggest a relatively of high prevalence of alcohol use in elderly drivers involved in motor vehicle crashes, particularly men. However, abuse of other drugs was uncommon. Physicians treating intoxicated drivers should consider referral for alcohol counselling.

Accidents, Traffic↗
PubMed1987

Geographic variations in mortality from motor vehicle crashes.

Using a new technique to study the mortality associated with motor vehicle crashes, we calculated population-based death rates of occupants of motor vehicles during the period 1979 through 1981 and mapped them according to county for the 48 contiguous states of the United States. Mortality was highest in counties of low population density (r = 0.57; P less than 0.0001) and was also inversely correlated with per capita income (r = 0.23; P less than 0.0001). Death rates varied more than 100-fold; for example, Esmeralda County, Nevada, with 0.2 residents per square mile (2.6 km2), had a death rate of 558 per 100,000 population, as compared with Manhattan, New York, with 64,000 residents per square mile and a death rate of 2.5 per 100,000. Differences in road characteristics, travel speeds, seat-belt use, types of vehicles, and availability of emergency care may have been major contributors to these relations.

Accidents, Traffic↗
PubMed2006

Anti-diabetic drug use and the risk of motor vehicle crash in the elderly.

BACKGROUND: Studies of the risk of motor vehicle crash associated with diabetes have produced conflicting results. OBJECTIVES: To assess whether the use of anti-diabetic drugs among the elderly increases the risk of motor vehicle crash. METHODS: The computerized databases of the various universal insurance programs of Québec were linked to form a cohort of all 224,734 elderly drivers that was followed from 1990-1993. Using a nested case-control approach, all 5,579 drivers involved in an injurious crash (cases) and a random sample of 13,300 control subjects were identified. Exposure to anti-diabetic drugs was assessed in the year preceding the index date, namely the date of the crash for the cases and a randomly selected date during follow-up for the controls. RESULTS: The adjusted rate ratio of an injurious crash was 1.4 (95% CI: 1.0-2.0) for current users of insulin monotherapy relative to non-users and 1.3 (95% CI: 1.0-1.7) for sulfonylurea and metformin combined. Monotherapy, using either a sulfonylurea or metformin, was not associated with an increased risk. There was a dose-response effect in subjects using high doses of combined oral therapy (RR 1.4; 95% CI: 1.0-2.0). For users of insulin monotherapy or of high doses of combined oral therapy, the increase corresponds to an excess rate of 32 crashes per 10,000 elderly drivers per year. CONCLUSIONS: L Elderly drivers treated with insulin monotherapy or a combination of sulfonylurea and metformin, especially at high doses, have a small increased risk of injurious crashes. There is no increased risk associated with any regimen of oral monotherapy.

Accidents, Traffic↗
PubMed1995

Fatalities from motor-vehicle collisions with trains--Kansas, 1990-1994.

During 1983-1992, a total of 5831 deaths in the United States were attributed to motor-vehicle collisions with trains. During that same period, Kansas had the third highest death rate in the United States from motor-vehicle collisions with trains, and the annual rate for the state (0.8 per 100,000 persons) was approximately four times the national rate (0.2 deaths per 100,000 persons). To identify approaches for preventing such collisions, the Kansas Department of Health and Environment (KDHE) characterized all fatal motor-vehicle collisions with trains at highway-rail grade crossings in the state from 1990 through 1994. This report summarizes the results of that study.

Accidents↗
PubMed2006

Characterization of metals emitted from motor vehicles.

A systematic approach was used to quantify the metals present in particulate matter emissions associated with on-road motor vehicles. Consistent sampling and chemical analysis techniques were used to determine the chemical composition of particulate matter less than 10 microm in aerodynamic diameter (PM10*) and particulate matter less than 2.5 microm in aerodynamic diameter (PM2.5), including analysis of trace metals by inductively coupled plasma mass spectrometry (ICP-MS). Four sources of metals were analyzed in emissions associated with motor vehicles: tailpipe emissions from gasoline- and diesel-powered vehicles, brake wear, tire wear, and resuspended road dust. Profiles for these sources were used in a chemical mass balance (CMB) model to quantify their relative contributions to the metal emissions measured in roadway tunnel tests in Milwaukee, Wisconsin. Roadway tunnel measurements were supplemented by parallel measurements of atmospheric particulate matter and associated metals at three urban locations: Milwaukee and Waukesha, Wisconsin, and Denver, Colorado. Ambient aerosol samples were collected every sixth day for one year and analyzed by the same chemical analysis techniques used for the source samples. The two Wisconsin sites were studied to assess the spatial differences, within one urban airshed, of trace metals present in atmospheric particulate matter. The measurements were evaluated to help understand source and seasonal trends in atmospheric concentrations of trace metals. ICP-MS methods have not been widely used in analyses of ambient aerosols for metals despite demonstrated advantages over traditional techniques. In a preliminary study, ICP-MS techniques were used to assess the leachability of trace metals present in atmospheric particulate matter samples and motor vehicle source samples in a synthetic lung fluid.

Colorado↗