In 1988 and 1990, respectively, Norway and Sweden adopted legal reforms including abandonment of mandatory jail sentences for persons driving with BACs above specific limits. Interrupted time-series analysis finds that in both countries traffic deaths diminished simultaneously with the reforms, consistent with the understanding that Scandinavian success in reducing impaired driving does not depend upon mandatory jail.
The purpose of this investigation is to evaluate the value of postmortem computerized tomography (CT) for Abbreviated Injury Scale (AIS) scoring and Injury Severity Scoring (ISS) of traffic fatalities.
This is a prospective investigation of a consecutive series of 52 traffic fatalities from Southern Denmark that were CT scanned and autopsied. The AIS and ISS scores based on CT and autopsy (AU) were registered in a computer database and compared. Kappa values for reproducibility of AIS-severity scores and ISS scores were calculated.
On an average, there was a 94% agreement between AU and CT in detecting the presence or absence of lesions in the various anatomic regions, and the severity scores were the same in 90% of all cases (range, 75-100%). When different severity scoring was obtained, CT detected more lesions with a high severity score in the facial skeleton, pelvis, and extremities, whereas AU detected more lesions with high scores in the soft tissues (especially in the aorta), cranium, and ribs. The kappa value for reproducibility of AIS scores confirmed that the agreement between the two methods was good. The lowest kappa values (>0.6) were found for the facial skeleton, cerebellum, meninges, neck organs, lungs, kidneys, and gastrointestinal tract. In these areas, the kappa value provided moderate agreement between CT and AU. For all other areas, there was a substantial agreement between the two methods. The ISS scores obtained by CT and by AU were calculated and were found to be with no or moderate variation in 85%. Rupture of the aorta was often overlooked by CT, resulting in too low ISS scoring.
The most precise postmortem AIS and ISS scorings of traffic fatalities was obtained by a combination of AU and CT. If it is not possible to perform an AU, then CT may be used as an acceptable alternative for AIS scoring. We have identified one important obstacle for postmortem ISS scoring, namely that aorta ruptures are not easily detected by post mortem CT.
One hundred sixty-three fatal road traffic accidents (RTAs) resulting in 178 deaths occurring from 1983-1987 in a Danish county have been studied from a preventive perspective. Alcohol was an important factor in 41% of all fatal RTAs. Other factors such as high speed, the use of seat belts and helmets, and technical defects are mentioned. Also, the material has been analyzed according to types of accidents. Prospects for the local prevention of RTAs are discussed with particular emphasis on accidents related to alcohol and high speed. Examples are given of preventive activities where experience gained through the present study have been useful.
BACKGROUND: According to the WHO, insufficient attention is devoted to the problem of accident while more than one half of the death in children of 1 to 14 years of age in industrialized countries are caused by accidents. METHODS AND RESULTS: Nationwide statistical data from the Czech Republic have been evaluated and compared with those of selected European countries and the USA. In the years 1991-1993 average of 151 children died in the Czech Republic in the age group of 5- to 9-year olds. In 68 of them the cause of death was an injury that in almost half of the cases was due to a traffic accident. The trend in the mortality of children of the same age was assessed comparing the averages for 1950-1952 and 1991-1993. The overall mortality decreased by 68% while the greatest decline was in non-accident causes (75%). Mortality due to accidents decreased by 55% and that caused by motor vehicles by only 19%. The lowest mortality due to accidents was found in Sweden. CONCLUSIONS: The results show that mortality due to accidents and poisonings in younger school children in the Czech Republic is higher than, e.g. in Austria and Sweden. In order to be able to elaborate a draft of appropriate and effective preventive measures, it is necessary to obtain further information on accidents and poisonings in children that have not ended fatally.
[A comparative analysis of the incidence of the occurrence of injuries to the soft tissues, bones and internal chest organs in trauma from a fall from a height and from the collision of a moving car with a pedestrian].
The author compares the incidence of injuries to soft tissues, bones, and thoracic organs in two types of traumas: falling from height and collision of a pedestrian with a moving car. A total of 100 corpses of subjects who died from such traumas were examined. The incidence of the detected injuries is shown on figures. Comparison of the graphic images indicates that trauma from falling from height results in more massive and numerous injuries to the chest than from collision with a moving car. Fractures of the spine, bleedings to the pleural cavity, mediastinum, and the heart coating, and ruptures of the aorta, lungs, and heart more often result from falling from height. Collision of a pedestrian with a moving car more often leads to fractures of the clavicle, sternum at the level of the third or fourth sternocostal joining, and punctate hemorrhages under the lung pleura.
Causes of pedestrian accidents (N = 534) were investigated for patients treated for injuries at the emergency unit of a hospital. Accidents in collisions with motor vehicles were the main cause (87.8%). Young children (0-9 years old) and the elderly (above 60 years of age) are the most vulnerable in terms of mortality rates observed in these age groups. Preponderance of males in pedestrian accidents was observed in the accident categories of collisions with motor vehicle and bicycle, whereas a slight preponderance of females was found in collisions with other traffic. The predominant age groups were located in the range from 0 through 19 years.
This population-based study examines patterns of fatal motor vehicle traffic crashes (MVTCs) by age group (16-24, 25-64, 65+) among Canadian drivers. The Canadian Traffic Accident Information Databank (TRAID) provided information about fata MVTCs between 1984 and 1993. Distribution of risk factors was compared by age group. Crude odds ratios and 95% CIs were calculated for both young and elderly drivers compared with middle-aged drivers. The middle-age group was selected as reference population since it demonstrates the lowest risk of fatality. Compared to the middle-aged group, young drivers demonstrated excess risk for (1) risk-taking behaviours and conditions, specifically alcohol and illicit drug use, speeding, non use of seat belts, fatigue and falling asleep, and inexperience; (2) crashes during the summer, during weekends and at night; and (3) single-vehicle collisions and on performing overtaking manoeuvres. Excess risk among elderly drivers was noted for (1) medical and physical conditions, inattention and inexperience; (2) driver actions, for example, improper turning, failure to yield right-to-way; (3) occurrence on weekdays and during the day; and (4) collisions at intersection and vehicle--vehicle sideswipes. The results show notable differences in risk factors by age group and confirm the need for preventive efforts that incorporate age-specific strategies.