Mortality in the motor vehicle and motor vehicle parts industry.
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Cause of Death↗
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When "buckle up" is not enough: enhancing the safety of children in motor vehicles.
Motor vehicle crashes are the leading cause of death and acquired disability in children over age 1 in the United States. In 1998 alone, 697 children under age 6 died as occupants in motor vehicles, and nearly 100,000 were injured. This Issue Brief describes findings from Partners for Child Passenger Safety, the nation's largest surveillance system of children in car crashes, and points to improvements in child restraints that can reduce the risk of serious injury in the event of a crash.
Accidents, Traffic↗
Motor vehicle inspection and motor vehicle accident mortality.
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Accidents, Traffic↗
Children's use of motor vehicle restraints: maternal psychological distress, maternal motor vehicle restraint practices, and sociodemographics.
OBJECTIVE: To determine the relative contribution of maternal psychological distress, maternal restraint use, and sociodemographic characteristics to the likelihood that a child would not be restrained in a motor vehicle. METHODS: We examined data on 6251 children aged 0-17 years from the 1998 National Health Interview Survey. The level of children's motor vehicle restraint use (low vs high) was examined by maternal psychological distress and motor vehicle restraint use. Multivariate regression analyses were used to model the odds of children's low use of motor vehicle restraints, controlling for potential confounders. RESULTS: According to maternal reports, more than 10% of children and nearly 13% of mothers reported low use of motor vehicle restraints. Multivariate analyses revealed that maternal use of restraints and psychological distress were both independently related to children's use of restraints, with maternal low use as the stronger correlate. Older children were more likely than younger children to be low users of motor vehicle restraints if the mother reported that she was a low user of restraints. Families with male children, black and Hispanic mothers, and 4 or more members reported lower use of restraints for their children. CONCLUSIONS: Children's low use of motor vehicle restraints was associated with low levels of maternal motor vehicle restraint use and maternal psychological distress. Moreover, maternal motor vehicle restraint practices become increasingly important as children age. Health care providers should consider maternal motor vehicle restraint use, maternal psychological distress, and child age in addition to sociodemographics when assessing children's motor vehicle safety.
Adolescent↗
The prevention of injury secondary to motor vehicle accidents.
Motor vehicle accidents are a common cause of death for all age groups but are the most serious threat to life for patients aged one to 34 years. Major progress has been made in reducing these losses through improved highway design, improved laws, adjudication of laws controlling the drunk driver, and the advent of vehicle safety design standards. A federal law enacted in 1966 established the National Highway Traffic Safety Administration (NHTSA) and the Federal Motor Vehicle Safety Standards (FMVSS). Motor vehicles, particularly passenger cars, now provide effective protection for occupants because of vehicle safety design features required by the FMVSS. Safety belts are the single most effective safety device available and are required equipment in virtually all motor vehicles sold in the United States. Passive protection for nonusers of safety belts is rapidly improving with the availability of air bags and automatic belt systems, improved windshields, steering wheels, dashboards, and seats, and other vehicle crashworthiness features. Motorcyclists, bicyclists, and pedestrians are also provided with improved protection because of the FMVSS.
Accidents, Traffic↗
Injuries associated with mandible fractures sustained in motor vehicle collisions.
Motor vehicle collisions are second only to altercations as the most common cause of mandible fractures. This article details in a retrospectively studied group the incidence of isolated mandible fractures and associated injuries in patients who were involved in motor vehicle collisions. This group consisted of 148 patients with mandible fractures listed in the University of Mississippi's trauma registry during the past 5 years. In almost all patients, associated injuries occurred with mandible fractures that were caused by motor vehicle collisions, with an incidence of 99.3 percent. Facial and head lacerations and facial fractures were the leading associated injuries, occurring in more than half of the patients who had a mandible fracture. Closed head injury is the major life-threatening associated injury and cause of mortality. The life-threatening injuries occurred in 64.8 percent of patients in this study. The mortality rate in this group of patients was 8.1 percent. These data suggest that mandible fractures from motor vehicle collisions should never be viewed as an isolated injury but rather as part of a spectrum of significant and sometimes life-threatening injuries that require thorough trauma evaluation at the time of presentation.
Accidents, Traffic↗
Extensive fetal intrathoracic injuries sustained in a motor vehicle accident.
Motor vehicle accidents are the primary nonobstetric cause of maternal and subsequent fetal mortality. We present a case in which blunt abdominal trauma sustained by a pregnant woman in a motor vehicle accident caused extensive intrathoracic fetal injuries consisting of bilateral hemothorax, severe bilateral interstitial pulmonary hemorrhages, hemopericardium, and subepicardial hemorrhages, in addition to fetal cranial injuries. To the best of our knowledge, this is the first report of fetal intrathoracic injuries sustained with blunt maternal trauma. The underlying mechanism of intrathoracic trauma was thought to be similar to that of blast injury with transmission of excessive hydrostatic forces throughout the amniotic fluid with severe impact on the elastic fetal chest. This case supports the concept of in utero blast injury to the fetus as a possible cause for fetal soft tissue trauma associated with blunt trauma to the maternal abdomen.
Accidents, Traffic↗
Capacity of screening questionnaires to predict psychiatric morbidity 18 months after motor vehicle accidents.
Motor vehicle accidents are one of the most common causes of trauma-related psychiatric morbidity. Previous studies have suggested that symptom screening instruments may be useful in predicting risk of longer-term psychiatric morbidity, but results have varied. The present study is based on 83 of an eligible 102 consecutive hospital-admitted survivors of road trauma who completed a structured clinical interview at baseline and 18-month follow-up. A subsample returned symptom questionnaires within 2 weeks of the accident, with between 60 and 66 completing the questionnaire. Receiver Operator Characteristic curve analyses were applied to obtain optimal predictive scores on each screening measure. Combining the derived cutoff scores on the Impact of Event Scale (measuring posttraumatic stress disorder symptoms) and the Beck Depression Inventory yielded an odds ratio of 82.9 in predicting any psychiatric morbidity at 18 months, with a specificity of 95%, and high positive (89%) and negative (91%) predictive indices. If these exploratory findings are confirmed by future studies, the case will be strengthened for routine screening of motor vehicle accident survivors to allow ongoing monitoring and selective early interventions for the high-risk subgroup. Compliance with completing and returning questionnaires remains a major challenge in this population, however, as indicated by the level of attrition in our study.
Accidents, Traffic↗
Seat belt use before and after motor vehicle trauma.
BACKGROUND: Motor vehicle crashes cause significant morbidity and mortality annually. Seat belt use has partially been associated with a decreased risk of morbidity and mortality among those involved in motor vehicle crashes. Persons injured in motor vehicle crashes and not wearing seat belts have an increased risk of admission to trauma centers for motor vehicle crash-related injury. The purpose of this study was to measure changes in seat belt use after discharge among patients admitted to a Level I trauma center for injuries sustained in motor vehicle crashes. METHODS: Patients admitted to a Level I trauma center for injuries sustained in motor vehicle crashes during 1998 were eligible for participation. A telephone interview was conducted with a random sample of 136 eligible patients regarding patterns of seat belt use before and after their collision. Demographic data and clinical characteristics were also collected. The frequency of seat belt use before and after crash involvement was compared for all patients and stratified by age, gender, race, and Injury Severity Score (ISS). RESULTS: Slightly over half (54%) of patients reported "always" wearing a seat belt before their collision compared with 85% afterward. Younger age groups, male subjects, and whites had the largest increases in the frequency of seat belt use after collision (45%, 37%, and 44% increases, respectively). With respect to injury severity, the largest increase in the frequency of seat belt use was among those with ISS of 15 to 25 (82% increase). Significant concordance between patient- and emergency medical service-reported use of seat belts was observed. Among subjects reported by emergency medical service personnel to have been restrained, nearly 90% reported belt use at the time of the telephone interview. The most frequently cited occasion for failure to use seat belts (30%) was when taking short trips. Other reported reasons were forgetting to fasten belts (29%), discomfort (10%), being in a rush (8%), riding in the back seat (4%), and that seat belts were unnecessary when riding with a good driver (3%). CONCLUSION: Involvement in a motor vehicle crash results in increased seat belt use. Prevention efforts should be directed toward those patients who report infrequent use. Patient "converts" to seat belt use after collisions may be useful in public awareness and prevention campaigns.
Accidents, Traffic↗
Elemental investigation of some Egyptian vehicle motor alloys using neutron activation analysis.
Six samples of different Egyptian motor vehicle alloys have been investigated by neutron activation analysis to estimate the concentrations of their elemental constituents, which affect their quality. A single high resolution hyper-pure germanium HPGe gamma-ray detector and a multichannel analyzer are used to collect the gamma-ray spectra. A HPGe-HPGe coincidence spectrometer was also used to confirm the identity of certain peaks. Thirteen trace elements (Sc, Cr, Fe, Co, Zn, Sn, Sb, La, Sm, Eu, Hf, Pt and Au) were observed in the spectra and their concentrations were determined. A comparative study on the element concentrations for the six samples is given.
Journal Article↗
Matching fatal accident reporting system cases with National Center for Health Statistics motor vehicle deaths.
Motor vehicle traffic fatalities in the United States are described by two major data sources, the Fatal Accident Reporting System (FARS) and the National Center for Health Statistics Multiple Cause of Death data (NCHS). Certain data, such as the age and sex of the fatality, are reported by both sources. However, each source contains data absent from the other. For example, only the FARS describes the precise circumstances of injury, and only the NCHS identifies the anatomic injuries listed on the death certificate. Thus, it would be useful to have a single file that offers for each case all of the data provided in each of the separate files. Creation of such a file is impeded by the fact that neither file contains personal identifiers for the cases listed. The present paper describes a method of matching cases from the two files based on simultaneous agreement of several variables common to both files (age, sex, date of death, role in the crash, and state in which the injury occurred). Using this method, 85% of the FARS cases can be uniquely matched with a case in the NCHS data.
Accidents, Traffic↗
Stature and seat position as factors affecting fractionated response time in motor vehicle drivers.
Motor vehicle accident fatalities are a cause for concern internationally; all drivers need to selectively attend to environmental changes, and to react swiftly and appropriately. The focus of the present paper was to investigate the effect of stature and seat positioning on fractionated response time. Eighty four young South African adults spanning a range of statures from 1.48 m to 2.00 m were tested in two extreme seat positions (near and far) using a European designed car-shell. Significant differences (p < 0.05) in knee flexion angle, but not in reaction or movement times were identified. Separation of tallest (X 1.93 m) and shortest (X 1.56 m) subjects (n = 20) revealed no significant stature-related differences in response times. However, the tall group showed significantly improved results when seated in the far position and the short group when seated in the near position. The results indicate that correct seat positioning will exert a significant effect on the overall response time of the driver, which in turn will affect the braking distance whilst driving.
Journal Article↗
Assessing technologies for preventing injuries in motor vehicle crashes.
Motor vehicle crashes are a leading cause of morbidity and mortality. In the Haddon matrix, crashes are divided into three phases and factors affecting each phase. In the context of this matrix, the effectiveness, use, and legislation of safety belts and airbags are discussed, using process, injury, and economic outcome measures.
Accidents, Traffic↗
Accidental poisoning due to motor vehicle exhaust.
Motor vehicle exhaust contains a mixture of poisonous gases mainly the carbon monoxide. Exposure to this exhaust can be lethal in a closed space. One such case occurring in a young male is described.
Adult↗
Fractures of the mandible in motor vehicle accidents.
Motor vehicle accidents are a common cause of fractures of the mandible and are the most common cause of serious and multiple fractures. The usual mechanism of injury is outlined. The common fractures that occur are through the anterior alveolar process, condylar necks, or edentulous areas of the body and symphysis. There is high incidence of other injuries associated with jaw fractures in these patients. Treatment of the mandibular fracture must wait until the patient's general condition is stabilized. Obstruction of the airway demands emergency treatment by keeping the tongue forward and repeated suction of blood and mucus from the mouth and nasopharynx. Emergency tracheostomy is rarely necessary because of mandibular fractures. The methods for immobilizing a fractured jaw are outlined. The majority of accident victims are young and therefore have teeth. When there are teeth that occlude immobilization of the mandible must include intermaxillary fixation by wiring the teeth into occlusion. Interosseus wiring is used to support unstable fragments. Intramedullary Kirschner wires are a simple and effective method for immobilizing fractures through the body and symphysis of edentulous patients.
Accidents, Traffic↗
[The neurologist and patients driving motor vehicles].
Driving motor vehicles is a complex visuomotor task that challenges normal nervous system functioning. Indemnity of sensory organs and intact alertness are essential. In addition, safe driving is extremely sensitive to disturbances of attention as well as to some forms of cortical dysfunction. Epilepsy, cognitive impairment, Parkinson's disease, stroke and sleep disorders, among other conditions, may interfere with driving through different mechanisms. The individual rights to maintain important privileges such as having a driver's license may enter in conflict with a society demanding safer regulations. Current trends favor more liberal restrictions and may provide specific limits on an individual basis to patients with impairments caused by neurological diseases. So far, there is no information on the consequences in terms of rate of accidents following newly introduced changes in driver license regulations for neurological patients.
Accidents, Traffic↗
Upper cervical trauma in motor vehicle collisions.
Motor vehicle collisions can cause a variety of injuries in pedestrians and vehicle occupants. Fatal and nonfatal trauma to the upper cervical spine, that is, atlanto-occipital junction, atlas and axis, can be part of this spectrum. Certain distinctive injuries (for example, "hangman's fracture") which occur result from the unique anatomic structure of this area and the various disruptive forces such as extension, distraction (tension), compression (axial loading), shear, and inertia generated during collision. Correlation of autopsy findings or radiological information of these cervical injuries or both with scene investigation can be informative not only in the determination of morbidity and mortality, but also in the assessment of injury mechanisms and improvements in occupant protection.
Accidents, Traffic↗
[Motor vehicle accidents with entrapment. A medical and technical investigation of crash mechanism, injury pattern and severity of entrapment of motor vehicle occupants between 1983 and 2003].
AIM: Crash mechanisms, injury patterns, and severity of injury of entrapped motor vehicle occupants were analysed by the Accident Research Unit's scientific teams between 1983 and 2003. RESULTS: Of the 1281 vehicle passenger entrapments in our study, 18.3% happened on highways, 25.6% on federal roads, 35.9% on country roads, and 18.3% on city roads. Of those involved, 69.9% were drivers, 19.4% were front passengers, and 8.5% were rear passengers. Coinvolved objects in car collisions were: other cars 30.9%, trucks 50.2%, objects 18.6%, and motorbikes 0.3%. Coinvolved objects in truck collisions were: other trucks 61.8% and objects 38.2%. The mean Delta-V was 42 km/h (cars 46.2, trucks 32.2). Maximum AIS levels were 31% I, 25.2% II, 19.4% III, 7.8% IV, 7.8% V, and 8.6% VI. Of injuries, 68.7% were to the head, 23.5% to the neck, 50.8% to the chest, 43.6% to upper extremities, 15.4% to the abdomen, 16.4% to the pelvis, and 52.9% to lower extremities. The incidence of multiple injuries (ISS>16) was 23.7%, and mortality was 15.9%. CONCLUSION: Car drivers are more at risk of accidents with entrapment on rural streets, and truck drivers are more at risk on highways. In most cases car occupants crash with trucks or other cars, and truck drivers collide more frequently with other trucks or objects. Besides a high degree of severe single injuries, there is also a high incidence of multiple injury victims and high mortality. Of the fatalities, 74.5% occur during the preclinical course and 24.5% during the clinical course.
Abbreviated Injury Scale↗