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5 November 2001
We are unable to provide photocopies of any the articles and reports abstracted below. Where possible, links have been provided to the publisher of the material and contact information for the corresponding author is listed. Please consider asking your library to subscribe to the journals from which these abstracts have been gathered.
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The time course of weather-related deaths.
Ferreira Braga AL, Zanobetti A, Schwartz J. Epidemiology 2001; 12(6): 662-667.
Correspondence: Joel Schwartz, Environmental Epidemiology Program, Harvard School of Public Health, 665 Huntington Avenue, Building I, Rm. 1414, Boston, MA 02115 USA. (email: joel@tiamat.harvard.edu).
BACKGROUND: The association between extremes of temperature and deaths is well known. An excess of deaths is observed during both winter and summer. Extreme high temperatures have been related with deaths among the elderly and young children. In the winter, death rates are usually higher than in the summer.
OBJECTIVES: To estimate both the acute effects and the lagged influence of weather on total daily deaths.
METHODS: The authors carried out time-series analysis in 12 U.S. cities and fit generalized additive Poisson regressions for each city using nonparametric smooth functions to control for long time trend and barometric pressure. They also controlled for day of the week. They estimated the effect and the lag structure of both temperature and humidity on the basis of a distributed lag model.
RESULTS: In cold cities, both high and low temperatures were associated with increased deaths. In general, the effect of cold temperatures persisted for days, whereas the effect of high temperatures was restricted to the day of the death or the immediately preceding day and was twice as large as the cold effect. The hot temperature effect appears to be primarily harvesting. In hot cities, neither hot nor cold temperatures had much effect on deaths. The magnitude of the effect of hot temperature varied with central air conditioning use and the variance of summertime temperatures. No clear pattern for humidity effect was found. These dissimilarities indicate that analysis of the impact of any climatic change should take into account regional weather differences and harvesting (deaths among people very near death who may have lived a few more days if they hadn't been exposed to the temperature extreme).
A comparison of state-specific all-terrain vehicle-related death rates, 1990-1999.
Helmkamp JC. Am J Public Health 2001; 91(11): 1792-1795.
Correspondence: James C. Helmkamp, Center for Rural Emergency Medicine, Robert C. Byrd Health Sciences Center, West Virginia University, P.O. Box 9151, Morgantown, WV 26506-9151 (email: jhelmkamp@hsc.wvu.edu).
BACKGROUND: Despite widespread public education efforts by the ATV industry and the US Consumer Product Safety Commission throughout the 1990s, the average annual ATV-related death rate has increased.
OBJECTIVES: To examine the state-specific ATV-related death rates for any association with the presence of laws that regulate ATV use.
METHODS: Death data from the CPSC were divided into 4 age groups: 1-16 years, 17-49 years, 50-64 years, and 65-84 years. Population-based rates were calculated on the basis of US Census Bureau state-, age-, and sex-specific population estimates. Categories of state safety regulations were: 1) helmet and other safety equipment requirements (21 states); 2) Machine-related requirements but no helmet requirement (23 states); and 3) no requirements (6 states).
RESULTS: States without safety legislation had a collective death rate twice that of the other two groups -- 0.17 deaths per 100,000 vs 0.08 (helmet and machine requirements) and 0.09 (machine requirements only). Detailed tables are provided.
CONCLUSIONS: States with some level of safety legislation have substantially fewer deaths and lower fatality rates than do states that have no ATV safety laws. Associations between adult and child bicycle helmet use.
Twomey JG, Bevis MC, McGibbon CA. MCN Am J Matern Child Nurs 2001; 26(5):272-277.
Correspondence: J.G. Twomey, Graduate Program in Nursing, Institute of Health Professions, Massachusetts General Hospital (MGH), 101 Merrimac Street, Boston, MA 02114, USA. jtwomey2@home.com
BACKGROUND: It is well established that bicycle helmets when properly worn dramatically reduce the occurrence of brain injuries among riders who crash.
OBJECTIVES: To observe the incidence of proper and improper use or non-use of bicycle helmets by children and adults when riding bicycles in groups.
METHODS: The authors used an observational survey of bicycle riders on a recreational bicycle path. In eight half-day sessions, two observers independently rated all riders in groups that consisted of adults and children either wearing or not wearing helmets. Those who wore helmets were then rated as wearing them properly or improperly.
RESULTS: Two-thirds of children wore helmets, but less than one-half wore them properly. One third of the adults wore helmets, and one-half of those wore them properly. Adult helmet use affected child helmet negatively. The strongest correlations were between adult helmet use or non-use and improper or no helmet use in accompanying children.
CONCLUSIONS: Primary care nurses who work with healthy populations should collaborate with other groups involved with families to not only exhort them to wear helmets when riding bicycles but also to instruct those riders how to wear their helmets properly.
Recall bias in injury studies of young people with intellectual disability.
Sherrard J, Tonge BJ, Ozanne-Smith J. Inj Control Safety Promo 2001; 8(2) 83-89.
Correspondence: Jennifer Sherrard, Accident Research Centre, P.O. Box 70A, Monash University, Victoria 3800, Australia. (email: jenny.sherrard@general.monash.edu.au).
BACKGROUND: In the general population, parent report of injury in children is subject to recall bias that can substantially underestimate injury rates derived from medial record data.
OBJECTIVES: This study aimed to assess whether or not carer recall of injury in young people with intellectual disability is also subject to similar recall bias and consequent underestimation of injury incidence rates.
METHODS: In 1996, the Australian CHild and Adolescent Development program collected carer reports of injury during the previous year on 465 subjects with intellectual disability, aged 5-29 years. Medical record injury data for hospital admissions, emergency department presentations, and general practitioner visits were collected for 185 of the parent injury recall records.
RESULTS: The sensitivity and specificity of parent recall of injury for all levels of medical care combined were 57.4% (95% CI 44.1-69.9) and 99.2 (95% CI 95.6-99.9) respectively. The adjusted annual injury incidence rate for the cohort was 55.6/100 subjects.
CONCLUSIONS: When adjusted for recall bias, the carer-reported injury incidence for young people with intellectual disability is approximately double that of the general population and indicates an urgent need for the development, implementation, and evaluation of injury prevention programs for this population. -
Case-crossover studies of occupational trauma: methodological caveats.
Sorock GS, Lombardi DA, Gabel CL, Smith GS, Mittleman MA. Inj Prev 2001; 7(Suppl 1):i38-i42.
Correspondence: Gary Sorock, Liberty Mutual Research Center for Safety and Health, 17 Frankland Road, Hopkinton, MA 01748, USA. (e-mail gary.sorock@libertymutual.com).
BACKGROUND: The case-crossover methodology is gaining increasing acceptance as a means of investigating the risk associated with transient exposures for disease. It was developed to examine triggers for the onset of myocardial infarction.
OBJECTIVES: This paper seeks to examine selected methodological issues when applying the case-crossover method to the study of traumatic injuries in the work environment.
METHODS: Researchers known to be working on occupational case-crossover studies were invited to present at a workshop held at the National Occupational Injury Research Symposium in October 2000. Data from ongoing studies were used to illustrate various methodological issues involved in case-crossover studies of occupational injury.
RESULTS: To utilize the case-crossover design, investigators must clearly define the time during which a worker is at risk of injury, the period of time during which a particular transient exposure could cause an injury and carefully select control time periods that estimate the expected frequency of exposure. Other issues of concern are changing work tasks over time, correlated exposures over time and information bias.
CONCLUSIONS: More case-crossover studies of occupational injury are needed to compare results from multiple studies. The validation of the timing of transient exposures relative to injury onset, whether done in a laboratory or field setting, should be conducted. Nested case-crossover designs in other epidemiological studies (case-control or cohort) can examine both transient and fixed risk factors for occupational injury, and should be attempted.
See report on ATV safety legislation under Recreation and Sports
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The influence of stimulants, sedatives, and fatigue on tunnel vision: risk factors for driving and piloting.
Mills KC, Spruill SE, Kanne RW, Parkman KM, Zhang Y. Hum Factors 2001; 43(2):310-327.
Correspondence: K.C. Mills, Profile Associates, Chapel Hill, North Carolina 27514, USA. (e-mail profiler@intrex.net).
BACKGROUND: The use of fatigue, alcohol and other drugs impairs drivers and pilots through several mechanisms.
OBJECTIVES: To assess the influence of fatigue, alcohol and other drugs upon peripheral vision.
METHODS: A computerized task was used in two studies to examine the influence of stimulants, sedatives, and fatigue on single-target and divided-attention responses in different parts of the visual field. The drug effects were evaluated over time with repeated behavioral and subjective measures against ascending and descending drug levels.
RESULTS: In the first study, 18 fully rested participants received placebo, alprazolam (0.5 mg), and dextroamphetamine (10 mg). Alprazolam impairs performance, whereas dextroamphetamine induces enhancement and tunnel vision. Study 2 exposed 32 participants to fatigue and no fatigue with a repeated-measures crossover design. Four independent groups subsequently received placebo, dextroamphetamine (10 mg), caffeine (250 mg), or alcohol (.07%). Under fatigue, stimulants have no performance-enhancing effects, whereas impairment from alcohol is severe. Under no fatigue, alcohol has a modest effect, caffeine has no effect, and dextroamphetamine significantly enhances divided-attention performance coincident with tunnel vision. Participants rate all drug effects more stimulating and less sedating while fatigued.
CONCLUSIONS: Actual or potential applications of this research include driver and pilot training.
Law enforcement officers' opinions about gun locks: anchors on life jackets?
Coyne-Beasley T, Johnson RM. Inj Prev 2001; 7(3): 200-204.
Correspondence: Tamera Coyne-Beasley, Injury Prevention Research Center and Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, 27599-7225, USA. (e-mail coybea@med.unc.edu).
BACKGROUND: It has been suggested that young people's easy access to firearms is a major contributor to suicide, and homicide in that population. One way law enforcement officers support firearm safety is by promoting the use of gun locks.
OBJECTIVES: This investigation examined law enforcement officers' willingness to use gun locks on their own guns, as well as their opinions regarding gun locks in general.
METHODS: Free keyed cable gun locks were distributed to all law enforcement officers in one agency (urban city in the southern region of the United States) who wanted one, and then an anonymous questionnaire survey was conducted about their subsequent use of, and attitudes toward, these devices.
RESULTS: About half of the 207 officers collected gun locks (n=103). Nearly three quarters (73%) completed and returned the questionnaire. Two thirds reported that they were not using the gun lock they collected (65%), and over half disagreed that gun lock use should be required (56%). Very few cited any actual or potential technical problems with the device. An important reason given for non-use of gun locks related to being able to access the weapon quickly in case of an emergency.
CONCLUSIONS: The findings highlight the need for further investigation into law enforcement officers' attitudes toward gun locks, the degree to which their attitudes affect their firearm safety counseling, and the need to develop a gun safety device that can be disengaged quickly.
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