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PubMed2002

Asphyxial deaths caused by automobile exhaust inhalation not attributable to carbon monoxide toxicity: study of 2 cases.

The authors report two suicides that resulted from the intentional inhalation of automobile exhaust gases in which death occurred without the formation of physiologically significant amounts of carboxyhemoglobin. These circumstances are correlated with measurements of the involved vehicles' exhaust gases, which showed reduced concentrations of carbon monoxide present, reflecting improvements in automobile engine technology. In the absence of carbon monoxide toxicity, the authors attribute death in these cases to asphyxia caused by carbon dioxide intoxication and diminished atmospheric oxygen concentrations.

Aged↗
PubMed1983

Effect of acute ethanolism on the hospital course and outcome of injured automobile drivers.

Acute ethanolism in automobile drivers is purported to be both protective and detrimental in susceptibility to injury from an accident. The potential influence of acute intoxication (serum ethanol greater than 100 mg/dl) on pattern and severity of injury, hospital course, and long-term outcome, including mortality, was examined in 182 consecutive automobile drivers requiring admission to a regional university trauma center during 1980. Significantly more drivers were intoxicated than not, 61% vs. 39%. Similarly, more than 75% of the intoxicated drivers were young males and more than 80% of the intoxicated drivers were felt to be negligent and at cause for the accident. However in this series, the patterns and severity of injuries, hospital course, and late outcome were unaffected by the patient's blood alcohol level. Acute alcohol intoxication apparently neither protected nor hindered the response to injury in these motor vehicle drivers.

Accidents, Traffic↗
PubMed2006

Active involvement and intervention in patients exposed to whiplash trauma in automobile crashes reduces costs: a randomized, controlled clinical trial and health economic evaluation.

STUDY DESIGN: To examine and compare the costs and consequences in a partial economic evaluation of two competing interventions in patients exposed to whiplash trauma in automobile crashes. The interventions were an active involvement and intervention using early mobilization and a standard intervention of rest, recommended short-term immobilization in a cervical collar and a cautious, gradual self-exercise program according to a leaflet. The study was randomized and controlled. OBJECTIVES: The aim of the study was to compare the costs of an active involvement and intervention versus a standard intervention and to relate them to the clinical benefits in patients exposed to whiplash trauma in automobile crashes to facilitate decision-making regarding intervention and resource allocation. SUMMARY OF BACKGROUND DATA: There is very little known about the health economic aspects of various interventions in the target treatment group of patients. METHODS: Based on a prospective, randomized, clinical trial, data on clinical effectiveness and resources used for the active involvement and intervention and standard intervention were collected for a comparative analysis of the costs related to physical therapy treatment and sick leave. A cost-consequence analysis consisting of a modified cost-effectiveness analysis was used. RESULTS: The costs were significantly lower after 6 and 36 months with an active involvement and intervention as compared with the standard intervention. The active involvement and intervention were significantly superior in reducing experienced pain and reducing sick leave. CONCLUSIONS: For patients exposed to whiplash trauma in a motor vehicle collision, an active involvement and intervention were both less costly and more effective than a standard intervention.

Accidents, Traffic↗
PubMed2003

The effects of airbags on orbital fracture patterns in frontal automobile crashes.

PURPOSE: To investigate orbital fractures that occurred in frontal automobile crashes and to determine the effects of frontal airbags on injury incidence and severity. METHODS: The National Automotive Sampling System database files from 1993 to 2000 were examined. Frontal crashes were selected that included drivers and front-seat passengers only and excluded ejected occupants and rollover crashes. Orbital fractures could be closed, open, displaced, or any combination of these and were identified by using the Abbreviated Injury Scale codes. RESULTS: The analysis included 12,429,580 front-seat occupants from 25,464 cases. Of all occupants who were exposed to an airbag deployment, 0.09% sustained an orbital fracture. In contrast, occupants who were not exposed to an airbag deployment were more than twice as likely to sustain an orbital fracture (0.22%). In addition to reduction in incidence, airbags were also shown to decrease the severity of orbital fractures that occupants sustained. Occupants exposed to airbag deployment mostly sustained closed, less severe fractures (61.9%), whereas occupants not exposed to airbag deployment sustained the majority as more severe, open, displaced, or comminuted fractures (61.3%). CONCLUSIONS: This article presents the most comprehensive study of orbital fractures in automobile crashes to date. It is shown that both the incidence and the overall severity of orbital fractures decreases considerably with exposure to airbag deployment. This is accomplished because the airbag minimizes occupant contact with the windshield and steering wheel, which are the two leading sources of orbital fractures for occupants not exposed to airbag deployment.

Accidents, Traffic↗
PubMed1998

Prevalence of occupational asthma among automobile and furniture painters in the center of Eskisehir (Turkey): the effects of atopy and smoking habits on occupational asthma.

BACKGROUND: Occupational asthma (OA) is a respiratory disorder characterized by airway hyperreactivity caused by agents present in the workplace. For determination of the prevalence of OA among car and furniture painters exposed to isocyanate in the center of Eskisehir, Turkey, a clinical and epidemiologic prospective study in three phases was done, incorporating 312 (89.4%) of the painters. METHODS: Of these subjects, 190 (61%) were furniture painters and 122 (39%) automobile painters. In the first phase of the study, a modified questionnaire and pulmonary function test (PFT) were done. During the second phase, peak expiratory flow rate (PEFR) was monitored in 52 subjects whose complaints were confirmed and who agreed to a month of such monitoring. In the third phase, nonspecific bronchial provocation tests (NSBPT) with histamine were done on 23 of the PEFR-monitored workers. RESULTS: Finally, through questionnaire, typical history, PFT, PEFR monitoring, and NSBPT, 30 workers (9.6%) were diagnosed as having OA. Smoking habits and atopy in the OA-diagnosed workers were found to be statistically significantly high in comparison to the other workers. CONCLUSIONS: It was concluded that OA is a common disorder among automobile and furniture painters, and smoking habits and atopy were seen to have a significant effect on OA occurrence.

Adolescent↗
PubMed2004

Long term effects of exposure to automobile exhaust on the pulmonary function of female adults in Tokyo, Japan.

AIMS: To investigate the chronic effects of air pollution caused mainly by automobiles in healthy adult females. METHODS: Respiratory symptoms were investigated in 5682 adult females who had lived in the Tokyo metropolitan area for three years or more in 1987; 733 of them were subjected to pulmonary function tests over eight years from 1987 to 1994. The subjects were divided into three groups by the level of air pollution they were exposed to during the study period. The concentrations of nitrogen dioxide and suspended particulate matter were the highest in group 1, and the lowest in group 3. RESULTS: The prevalence rates of respiratory symptoms in group 1 were higher than those in groups 2 and 3, except for wheezing. Multiple logistic regression analysis showed significant differences in persistent phlegm and breathlessness. The subjects selected for the analysis of pulmonary function were 94, 210, and 102 females in groups 1, 2, and 3, respectively. The annual mean change of FEV(1) in group 1 was the largest (-0.020 l/y), followed by that in group 2 (-0.015 l/y), and that in group 3 (-0.009 l/y). Testing for trends showed a significant larger decrease of FEV(1) with the increase in the level of air pollution. CONCLUSIONS: The subjects living in areas with high levels of air pollution showed higher prevalence rates of respiratory symptoms and a larger decrease of FEV(1) compared with those living in areas with low levels of air pollution. Since the traffic density is larger in areas with high air pollution, the differences among the groups may reflect the effect of air pollution attributable to particulate matter found in automobile exhaust.

Adult↗
PubMed1998

Patterns of injury associated with automobile airbag use.

The wide use of automobile airbags has undoubtedly reduced the mortality and the incidence of serious injuries from motor vehicle accidents. However, automobile airbags appear to be associated with a variety of injuries including fatal injuries, ocular injuries, upper limb and chest injuries. Further improvements in airbag design together with education of the general public in their use should help reduce airbag-related injuries.

Accidents, Traffic↗
PubMed1988

Automobile accidents involving patients with obstructive sleep apnea.

Although patients with obstructive sleep apnea often report falling asleep while driving, the frequency of auto accidents involving these patients has not been rigorously studied. Therefore, we compared the driving records of 29 patients with obstructive sleep apnea with those of 35 subjects without sleep apnea. The patients with sleep apnea had a sevenfold greater rate of automobile accidents than did the subjects without apnea (p less than 0.01). The percentage of persons with one or more accidents was also greater in the patients with apnea than in the control subjects without apnea (31% versus 6%, p less than 0.01). The percentage of persons having one or more accidents in which they were at fault was also greater in the patients with apnea than in the control subjects (24% versus 3%, p less than 0.02). The automobile accident rate of the patients with sleep apnea was 2.6 times the accident rate of all licensed drivers in the state of Virginia (p less than 0.02). In addition, 24% of patients with sleep apnea reported falling asleep at least once per week while driving. We conclude that patients with obstructive sleep apnea have a significantly higher frequency of auto accidents than do subjects without apnea. Impaired drivers with sleep apnea may cause many preventable auto accidents.

Accidents, Traffic↗
PubMed2000

Environmental and biological monitoring of benzene during self-service automobile refueling.

Although automobile refueling represents the major source of benzene exposure among the nonsmoking public, few data are available regarding such exposures and the associated uptake of benzene. We repeatedly measured benzene exposure and uptake (via benzene in exhaled breath) among 39 self-service customers using self-administered monitoring, a technique rarely used to obtain measurements from the general public (130 sets of measurements were obtained). Benzene exposures averaged 2.9 mg/m(3) (SD = 5.8 mg/m(3); median duration = 3 min) with a range of < 0.076-36 mg/m(3), and postexposure breath levels averaged 160 microg/m(3) (SD = 260 microg/m(3)) with a range of < 3.2-1,400 microg/m(3). Log-transformed exposures and breath levels were significantly correlated (r = 0.77, p < 0.0001). We used mixed-effects statistical models to gauge the relative influences of environmental and subject-specific factors on benzene exposure and breath levels and to investigate the importance of various covariates obtained by questionnaire. Model fitting yielded three significant predictors of benzene exposure, namely, fuel octane grade (p = 0.0011), duration of exposure (p = 0.0054), and season of the year (p = 0.032). Likewise, another model yielded three significant predictors of benzene concentration in breath, specifically, benzene exposure (p = 0.0001), preexposure breath concentration (p = 0.0008), and duration of exposure (p = 0.038). Variability in benzene concentrations was remarkable, with 95% of the estimated values falling within a 274-fold range, and was comprised entirely of the within-person component of variance (representing exposures of the same subject at different times of refueling). The corresponding range for benzene concentrations in breath was 41-fold and was comprised primarily of the within-person variance component (74% of the total variance). Our results indicate that environmental rather than interindividual differences are primarily responsible for benzene exposure and uptake during automobile refueling. The study also demonstrates that self-administered monitoring can be efficiently used to measure environmental exposures and biomarkers among the general public.

Adult↗
PubMed2004

Sample characterization of automobile and forklift diesel exhaust particles and comparative pulmonary toxicity in mice.

Two samples of diesel exhaust particles (DEPs) predominate in health effects research: an automobile-derived DEP (A-DEP) sample and the National Institute of Standards Technology standard reference material (SRM 2975) generated from a forklift engine. A-DEPs have been tested extensively for their effects on pulmonary inflammation and exacerbation of allergic asthmalike responses. In contrast, SRM 2975 has been tested thoroughly for its genotoxicity. In the present study, we combined physical and chemical analyses of both DEP samples with pulmonary toxicity testing in CD-1 mice to compare the two materials and to make associations between their physicochemical properties and their biologic effects. A-DEPs had more than 10 times the amount of extractable organic material and less than one-sixth the amount of elemental carbon compared with SRM 2975. Aspiration of 100 micro g of either DEP sample in saline produced mild acute lung injury; however, A-DEPs induced macrophage influx and activation, whereas SRM 2975 enhanced polymorphonuclear cell inflammation. A-DEPs stimulated an increase in interleukin-6 (IL-6), tumor necrosis factor alpha, macrophage inhibitory protein-2, and the TH2 cytokine IL-5, whereas SRM 2975 only induced significant levels of IL-6. Fractionated organic extracts of the same quantity of DEPs (100 micro g) did not have a discernable effect on lung responses and will require further study. The disparate results obtained highlight the need for chemical, physical, and source characterization of particle samples under investigation. Multidisciplinary toxicity testing of diesel emissions derived from a variety of generation and collection conditions is required to meaningfully assess the health hazards associated with exposures to DEPs. Key words: automobile, diesel exhaust particles, forklift, mice, pulmonary toxicity, SRM 2975.

Animals↗
PubMed1982

Chromosome changes in workers (smokers and nonsmokers) exposed to automobile fuels and exhaust gases.

The incidence of chromosome changes in men occupationally exposed to automobile fuels and exhaust gases was investigated. Blood samples were taken from the following four groups of 12 men: drivers of diesel-engine trucks, drivers of gasoline-engine trucks, automobile inspectors, and a reference group. The men in the groups were matched with respect to age, smoking habits, and length of time in their respective jobs. Chromosome preparations from lymphocytes were made and analyzed by standardized routine methods, and the frequencies of gaps, breaks, and sister chromatid exchanges were recorded. Statistical analysis of the results gave no evidence for a marked occupational effect, though there remains a grave suspicion that working with diesel motors may cause an increased level of chromosome changes. Smokers showed a significant or near significant increase in breaks, total aberrations, and sister chromatid exchanges over the nonsmokers in three of the groups. An analysis of the data revealed a weak positive correlation between the frequencies of chromosome breaks and sister chromatid exchanges in an individual.

Adult↗
PubMed1982

Medicare program; services covered under automobile, liability, and employer group health insurance--Health Care Financing Administration. Proposed rule.

The Health Care Financing Administration is proposing regulations dealing with services covered under automobile medical, no-fault, or liability insurance and services to end-stage renal disease beneficiaries who are also insured under employer group health plans. These rules are required by sections 953 of the Omnibus Reconciliation Act of 1980 which excludes from Medicare coverage any services for which payment has been made or can reasonably be expected to be made under an automobile or liability insurance policy or plan or under no-fault insurance, and section 2146 of the Omnibus Budget Reconciliation Act of 1981 which makes medicare benefits secondary to benefits payable under an employer group health plan for services furnished to end-stage renal disease beneficiaries during a specified period of up to 12 months. The intent is to conserve Medicare funds and prevent duplicate payments by Medicare.

Acute Kidney Injury↗
PubMed1983

Medicare program, services covered under automobile medical, no-fault, or liability insurance; services furnished to ESRD beneficiaries who are covered under employer group health insurance--Health Care Financing Administration. Final rule.

These regulations set forth policies and procedures on coverage of services that are reimbursable under automobile medical, no-fault, or liability insurance, and services to end-stage renal disease (ESRD) beneficiaries who are also covered under employee group health plans. The regulations are necessary to implement section 953 of the Omnibus Reconciliation Act of 1980 and section 2146 of the Omnibus Budget Reconciliation Act of 1981. The first of these sections excludes from Medicare coverage any services for which payment has been made or can reasonably be expected to be made under an automobile or liability insurance policy or plan or under no-fault insurance. The second section makes Medicare benefits secondary to benefits payable under an employer group health plan for services furnished to ESRD beneficiaries during a specified period of up to 12 months. The intent is to conserve Medicare funds and prevent duplicate payments by Medicare.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2006

Acute coronary occlusion and myocardial infarction secondary to blunt chest trauma from an automobile airbag deployment.

Automobile airbags have been universally installed to save lives in motor vehicle accidents, but have also been linked with facial and thoracic burns and chest trauma during rapid deployment. Blunt trauma to the chest may result in electrical and mechanical injuries to the heart and great vessels. We report a case of a 19-year-old man who presented with acute myocardial infarction following a blunt chest trauma from an automobile airbag deployment. Although mechanical complications resulting from airbag injury have been reported in the past, this is the first report of an acute thrombotic coronary occlusion triggered by the rapid airbag deployment. The case underscores the importance of systematic clinical evaluation to guide management in patients with confounding clinical presentation.

Acute Disease↗
PubMedDate not supplied

Exposure to nitrogen oxides and other air pollutants from automobiles.

We have conducted an epidemiological study to investigate the association between exposure to automobile exhaust and respiratory health. Three zones were selected in Tokyo according to expected exposure levels. Zone A is within 20 meters from the roadside of major roads with heavy traffic. Zone B is 20-150 meters away from the roadside of the same road. Zone C is the residential district in a suburb of Tokyo. Zone A, which was nearest to the roads, had the highest mean levels of personal exposure to nitrogen dioxide for housewives, followed by Zone B and Zone C. Ambient levels of nitrogen oxides, and mass concentrations, polycyclic aromatic hydrocarbons and mutagenicity of suspended particulate matter were higher at the roadside within Zone A. A cross-sectional study of respiratory symptoms and repeated examinations of pulmonary function were also performed in each zone. These results suggest that exposure to automobile exhaust may be associated with respiratory symptoms. Nevertheless, pulmonary function didn't show consistent differences over all examinations. We should have further analyses about a decline of pulmonary function with age.

Adult↗
PubMed1979

A case of automobile trauma during pregnancy.

Accidental injury is an important complication of pregnancy. In North Carolina the rate of maternal deaths secondary to accidents has remained constant since 1966; however, because of a reduction in other causes, the percentage of maternal deaths due to accidents has doubled (11.4%). As a result, it is appropriate to reassess the evaluation of injuries sustained in automobile accidents. A case of automobile trauma to a pregnant woman at term is presented, and a plan of management involving fetal monitoring is recommended.

Accidents, Traffic↗
PubMed1976

Investigations on the carcinogenic burden by air pollution in man. XIV. Effects of automobile exhaust condensate on the Syrian golden hamster lung.

Syrian golden hamsters were intratracheally instilled with 5 or 2.5 mg/animal of automobile exhaust condensate at two weekly intervals. Moribund animals were fixed by intravascular perfusion. Samples of lobar and segmental bronchi, as well as of peripheral lung tissue, were taken for electron microscopical examination. In addition, all organs were examined histologically. After a survival time of 30 to 60 weeks all animals developed multiple pulmonary adenomas, thus indicating a marked carcinogenic effect of automobile exhaust condensate.

Adenoma↗