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Detailed case reports of incidents of suicide and attempted suicide on the London Underground railway system between 1985 and 1989 were examined for the presence of suicide notes. The incidence of note-leaving was 15%. Notes provided little insight into the causes of suicide as subjectively perceived, or strategies for suicide prevention.
A case of post-traumatic stress disorder (PTSD) following a road traffic accident in which the onset of symptoms was delayed for 18 months until a widely reported major disaster occurred is described. A severe major depressive episode was precipitated, requiring treatment in its own right. During psychotherapy sessions, extreme emotions, heightened sensations, and 'organic memories' relating to the original accident were experienced.
BACKGROUND: Post-traumatic stress disorder is a well recognised condition which can have long-term consequences. A rail accident to commuter trains in south London provided an opportunity, within the context of a Psychological Therapies Service, to study the prevalence and associations of the condition in a follow-up study. METHOD: Postal questionnaires were completed by 187 survivors (52% response rate) 10 to 22 months after the accident, and their symptoms were compared with a commuter control group. RESULTS: The accident group scored significantly higher on the Impact of Events scale (IES) than the control group. Severity of physical injury was significantly associated with high IES scores. Thirty per cent of those moderately or severely injured showed high levels of intrusion or avoidance symptoms (sub-scores of 20 or more). Thirty per cent of those nearest the accident focus had high sub-scores, associated variables being the accident experience of risk of death, feeling trapped and seeing death. For those less directly involved the proportions with symptoms were similar to those of controls. CONCLUSIONS: It is recommended that disaster services should provide for long-term psychological effects, particularly for those survivors who are injured, who experience risk of death, feeling trapped or who witness death.
Electromagnetic fields (EMF) reduce the signal quality of electrocardiograms and may lead to the misinterpretation by automated external defibrillators (AED). We designed this investigation as a prospective study, with a randomized sequence of AED applications on healthy volunteers. We chose busy public places where public access defibrillation was possible as test locations. Strong EMF were sought and found at train stations next to accelerating and decelerating trains. The primary outcome variable was the absolute number of shocks advised in the presence of sinus rhythm by five commonly used AED in Austria. For data analysis, the statistician was blinded in regard to the AED models tested. Data analysis was based on a per protocol evaluation. Of 390 tests run, 0 cases of false positive results occurred (95% CI: 0-0.77). AED can be regarded as safe, even with the interference of EMF present at train stations.
A patient presented to the authors with unilateral sensorineural hearing loss after falling asleep with his ear tightly pressed against a window of a moving train. This study set out to determine whether a train could generate sound levels of sufficient intensity to cause such a hearing loss. A sound level meter was used to measure the sound levels produced at the window of a moving train. Further measurements were made with a rubber attachment on the microphone, that simulated the effect of the ear stuck to the window. The sound levels were found to be amplified by the attachment but not to levels that could cause a hearing loss over a short period. In a second experiment eight healthy volunteers all perceived an increase in sound levels when their ears were pressed against a train window. It seems unlikely that sleeping with an ear against a train window can cause hearing loss, but it cannot be ruled out.
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One hundred and twenty-seven autopsy cases of rail traffic accidents received from South Delhi were studied during the period from 1996-2002. Data for the study was gathered from autopsy reports and hospital records. The cases represented approximately 1.41% of all autopsy cases received from South Delhi at the All India Institute of Medical Sciences, New Delhi (India). Data was analysed with regard to the age and sex of the victim, the part of the body involved and the pattern of injuries in different body regions. Death occurred at the scene of the fatal event in twenty-eight cases; another twenty-eight cases were brought in dead to the hospital. Seventy-one cases died after being admitted to the hospital. Ethanol was detected in the blood of 17.4% of cases.
The Government published its long-awaited draft Bill on the creation of a new criminal offence of corporate manslaughter shortly before the May 2005 general election. The Bill was included in the Queen's Speech after the general election and, with a Labour government back in power, the new offence could be on to the statute book as early as 2006. The Home Affairs Committee and the Work and Pensions Committee announced ajoint inquiry to consider and report on the Bill. This is expected to be completed by the end of 2005. Pressure for reform of the law relating to manslaughter and corporate killing arose out of a series of high profile fatal accidents, including several rail crashes. There has been said to be an increasing concern amongst the public that companies and organisations are not being held sufficiently accountable for deaths caused by their criminal negligence. The author acted in the first of the major cases, representing the directors accused of manslaughter following the Herald of Free Enterprise capsize disaster in 1987.
In Italy, railway-related deaths give rise to extensive inquiries because it is mandatory for the public prosecutor to investigate the circumstances of death. For the railway embankment, normal traffic rules are not valid and the guilt of the engine driver usually cannot be proven. Consequently, these cases are very often declared as suicides without adequate evidence. Furthermore, there is a potential risk of confusion with homicide, body dismemberment or mutilation. Our medico-legal institutes are increasingly engaged with expert opinions on questions of accident, suicide or homicide because they lead to complications in the fields of insurance, criminal and civil law.
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The change in concentration of suspended particulate matter (SPM) in indoor and outdoor air in the Tokyo metropolitan area was studied using a new portable sampler (SPMP-sampler). The relationship between the airborne particle concentration in indoor and outdoor air varied with the aerodynamic diameters of the particles. The concentration of the SPM in indoor air increased in proportion to that in outdoor air. The polycyclic aromatic hydrocarbon (PAH) concentration in SPM also varied with the aerodynamic diameters of the particles. Fine particles with diameters of less than 2 microns contained high concentrations of PAH. The PAH concentration in indoor air increased in proportion to that in outdoor air. There were significant correlations between the concentrations of B(k)F, B(a)P, and B(ghi)P in indoor air. The mutagenic activities in the airborne particles also varied with the aerodynamic diameters of the particles. Fine particles with diameters of less than 2 microns had high mutagenic activities.
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Beginning approximately 4 years after the Chernobyl nuclear accident a steady increase in the incidence of thyroid cancer was observed in children and adolescents of the Bryansk Oblast, which received the highest level of radionuclide contaminants in Russia. We examined the spatial relationship between the residence location of patients with identified thyroid cancer (0-18 years old at the time of the accident) and a number of geographic parameters to better account for the etiology of thyroid cancer spatial distribution. Geographic parameters analyzed included spatial distribution of 137Cs and 131I in soil, population demographics, measurements and reconstructions. of absorbed thyroid 131I doses in the population, and maps of major transportation arteries. An interesting finding is the lack of a consistent correlation between the spatial distribution of radionuclides in the soil and thyroid cancer incidence. Instead, most of the thyroid cancer cases were diagnosed in settlements situated on major railways and roads. Correlating population with thyroid cancer cases and transportation arteries reveals a much higher cancer rate on or near major roads and railways than at a distance from them, again independent of radionuclide soil concentration. There are other important factors, of course, that must be considered in future evaluations of this phenomenon. These include the influence of iodine endemic zones, genetic predisposition to thyroid cancer, and duration of residence time in contaminated areas. The feasibility of radionuclide transport on railways and roads is discussed, together with the vectors for transfer of the contaminants to the human population. Developing a model to reconstruct the radiation dose to the thyroid over time in this geographic region is proposed in light of the impact of transportation arteries. Specific studies are outlined to provide the data necessary to develop this model as well as to better characterize the feasibility and scientific validity of the contribution to human health effects of this transport factor. Transport factor refers to the transport of radionuclides on transportation arteries and the transfer of these agents to the human population residing in the vicinity of these arteries. If the impact on thyroid cancer of the transport of radionuclides on major railways and roads is indeed significant, a major reappraisal of the risk of large-scale radioactive release into the environment is necessary.
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This study analyzes the economics of transshipping biomass from truck to train in a North American setting. Transshipment will only be economic when the cost per unit distance of a second transportation mode is less than the original mode. There is an optimum number of transshipment terminals which is related to biomass yield. Transshipment incurs incremental fixed costs, and hence there is a minimum shipping distance for rail transport above which lower costs/km offset the incremental fixed costs. For transport by dedicated unit train with an optimum number of terminals, the minimum economic rail shipping distance for straw is 170 km, and for boreal forest harvest residue wood chips is 145 km. The minimum economic shipping distance for straw exceeds the biomass draw distance for economically sized centrally located power plants, and hence the prospects for rail transport are limited to cases in which traffic congestion from truck transport would otherwise preclude project development. Ideally, wood chip transport costs would be lowered by rail transshipment for an economically sized centrally located power plant, but in a specific case in Alberta, Canada, the layout of existing rail lines precludes a centrally located plant supplied by rail, whereas a more versatile road system enables it by truck. Hence for wood chips as well as straw the economic incentive for rail transport to centrally located processing plants is limited. Rail transshipment may still be preferred in cases in which road congestion precludes truck delivery, for example as result of community objections.
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This study was designed to assess the after effects of sarin exposure on the nervous system in victims of the Tokyo Subway Sarin Attack, which occurred on 20 March, 1995. We performed a similar study 3 yr after the disaster. This time, we newly enrolled 36 staff of the Teito Rapid Transit Authority (Tokyo Eidan subway) to assess the 7 yr after effects on the nervous system, and merged previous data including unpublished data to enhance statistical power. New subjects consisted of 23 male exposed subjects and 13 referent subjects matched for age and working types. Neurobehavioral tests for psychomotor function and memory, stabilometry, and Benton visual retention test were performed. As reported previously, the exposed group performed significantly less well in the psychomotor function test (tapping) than the referent group (117.8 +/- 1.2 vs. 105.6 +/- 1.2 msec). Using merged data, this phenomenon was also observed in a dose-dependent manner and the exposed group performed significantly less well in the backward digit span test (4.47 +/- 1.17 vs. 5.11 +/- 1.65 digits). These results indicate that chronic decline of psychomotor function and memory function still exist 7 yr after the sarin exposure.
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