Aim To investigate the epidemiology of unintentional fall-related injuries at home among young and middle-aged adults (25 to 59 years) and to investigate the contribution of alcohol to these injuries. Methods Routinely collected national fall injury data were analysed to describe the incidence and characteristics of falls at home resulting in death or hospital inpatient treatment among this age group in New Zealand. A systematic review of the published literature evaluated the epidemiological evidence quantifying the risk of falls associated with acute and usual alcohol consumption in this age group. A population-based case-control study was conducted in Auckland, New Zealand over a 12-month period. Cases were 335 people aged 25 to 59 years who were admitted to hospital or died as a result of unintentional non-occupational falls at home. Controls were 352 people randomly selected from the electoral roll from the same age group as the cases. The participants or next-of-kin completed a structured interview to ascertain data on personal and lifestyle factors including alcohol consumption. Findings The review of national injury data found that almost a third of unintentional falls resulting in an in-patient admission among working-age people were recorded as occurring at home. For every death there were about 150 in-patient hospital admissions. The systematic review identified only a small number of studies but showed an increased risk of unintentional falls in this age group with increasing exposure to alcohol use. The magnitude of this risk varied considerably across studies with most estimates being relatively imprecise. There was modest evidence of a dose-response relationship with acute alcohol use. The association between usual alcohol use and fall risk was inconclusive. The case-control study revealed that after controlling for confounding, the consumption of two or more standard alcoholic drinks in the preceding six hours relative to none is associated with a significantly increased risk of fall-related injury. Approximately 21% of unintentional non-occupational falls at home in this population was attributed to this risk. No association between hazardous drinking as a usual pattern and falls was found when the analyses were adjusted for confounders. Conclusion A significant proportion of unintentional fall-related injuries among the working-aged New Zealanders occur at home. Consuming two or more drinks in the previous six hours was strongly associated with unintentional non-occupational falls at home that result in admission to hospital or death in this age group. This largely unrecognised problem should be addressed in further research and in falls prevention programmes.

<p>The aim of this study was to understand injury mechanisms behind fractures of the upper extremities in car accidents. Volvo Car Corporation initiated this project based on the fact that no safety system today focuses on preventing injuries to the upper extremity. A literature study was undertaken focusing on the basic anatomy of the upper extremity, different fracture types and fracture mechanisms. Three subsets, from 1998 – January 2009, were selected from Volvo’s statistical accident database: 1) all occupants involved in an accident 2) all occupants with a MAIS2+ injury 3) all occupants with an upper extremity fracture. These subsets were used in a comparison, using frequency analyses. The comparison analysis showed that frontal impact is the dominating accident type for all three subsets. The comparison analysis also indicated that the risk for upper extremity fractures follows the pattern of MAIS2+ injury risk. An in-depth study using 92 selected cases, including 80 occupants, was also performed. All available information, such as medical records, questionnaires completed by the occupants and photographs from the accident scene was collected and analysed. The analysis of the in-depth study, together with knowledge retrieved from the literature study, resulted in six different mechanism groups that were used to categorise fractures. The groups were then analysed individually in regard to accident type and fractured segment of the upper extremity. Analysis of the mechanism groups showed that frontal impact is the dominating accident type in these subsets as well. It could also be seen that the fractures occurring in the in-depth study are quite evenly distributed along the upper extremities. Upper extremity injuries are relatively infrequent in car accidents but may result in long-term disability, including chronic deformity, pain, weakness and loss of motion. More attention is therefore necessary in order to develop a safer environment for car occupants.</p>

The incidence of falls is common in older adults and becomes more frequent with advancing age. Falls and injuries associated with falls are among the most debilitating and traumatic medical problems encountered by the elderly. There is evidence that indicates there may be a cause and effect relationship between specific gait parameters and falling. If a simple gait test can predict fallers, it could become a valuable tool for identifying individuals at high risk of falling. The purposes of this study were 1) to determine whether performance on the Functional Ambulation Profile (FAP) could accurately predict fallers and non-fallers in a prospective manner and 2) to identify gait parameters within the FAP that would best classify fallers. My hypothesis for this study include 1) the Functional Ambulation Profile (FAP) will accurately predict subjects as fallers and non-fallers and 2) of the five variables that comprise the FAP walking velocity, right and left step length:leg length ratio, step width will be the most powerful predictors of fall status. Two hundred twenty six subjects were evaluated using the GAITRite electronic walkway. Falls surveillance was conducted for 8 months after each participant's specific GAITRite testing date. Average height, weight and BMI were 161.9 �� 8.7 cm, 68.1 �� 16.7 kg, and 25.9 �� 4.1 kg/m��, respectively. Men and women were analyzed separately using analysis of variance, logistic regression and relative operating characteristic curves. There was no difference between fallers and non-fallers for any of the FAP variables for both the men and women. Regression results indicated the overall model for FAP to predict fallers was not statistically significant for either men or women, (p=0.706 and p=0.543, respectively). In addition, none of the five variables that make up the FAP was significant enough to be included in a stepwise logistic model, thus we were unable to develop an alternative model for predicting fallers based on gait variables. A secondary analysis found that the FAP was unable to distinguish multiple fallers (3 or more) from occasional and non-fallers in this same study population. The results of this study indicate that the FAP does not predict falls in independently living men and women over the age of 70. Further, none of the five gait variables that compose the FAP was a significant independent predictor of falls in this same population. Based on the results of this study we conclude that the FAP alone is not sufficient to predict risk of falling among older adults. Because of the complexity of all the physical, psychological and environmental elements that can lead to falling, tests based on only spatial and temporal gait characteristics do not appear to be good fall predictors for independent older adults. / Graduation date: 2003

The Commercial Vehicle Safety Alliance (CVSA) is an association of industry representatives, and state, territorial, provincial, and federal government officials in the United States, Canada, and Mexico. The CVSA's goal is to improve commercial vehicle safety. The CVSA concentrates its safety focus on three areas; driver, vehicle, and hazardous materials. Since 1981, the CVSA has developed a set of criteria for each of the three areas that define conditions which are so unsafe that a truck and/or driver should not be allowed to operate. These criteria are known as out of service (OOS) criteria. To check the compliance of motor carriers with the CVSA criteria, a series of road side inspections is conducted by state and local governments. If the driver and/or vehicle are found in violation of the CVSA OOS criteria, they are placed "out of service" until the conditions are completely remedied. Due to criteria growth, the CVSA wanted to examine the OOS criteria in the vehicle and hazardous materials areas. This study, focused on the vehicle portion of the OOS criteria, attempted to correlate commercial vehicle defects to commercial vehicle accidents. For a major portion of this project, actual accident reports from six states of the United States were evaluated. The states and reports were selected via a stratified two stage cluster sampling system. The results were used to form estimates of the proportion and number of commercial vehicle accidents in the United States with a mechanical defect as a contributing factor. In addition to the accident report sampling, other sources were used to establish a correlation between vehicle defects and commercial vehicle accidents. They include literature, national databases, and post-crash inspections. Results from this study show that approximately 4.6% of all commercial vehicle accidents have a mechanical defect as a factor contributing to the accident. Of these, brakes (1.66%), tires (0.45%), couplings (0.38%), load securement (0.37%), and wheels (0.33%) accounted for the majority. A comparison was also made between the OSU study results and the information gathered from other sources. A cost factor was also used to rank the accidents. The sampled accidents accrued $22.7 million in damage to people and property. The underlying assumption is vehicle defects that are strongly represented in accidents and accident damage estimates should have a strong representation in the out-of-service criteria. / Graduation date: 1997

Thesis (Ph. D.)--University of Tennessee, Knoxville, 2005. / Includes bibliographical references (p. 120-126). Also available online via the University of Tennessee ETD website (http://web.utk.edu/~thesis/etd.shtml).

Every year, drivers throughout the world are killed or injured in road traffic, particularly in developing countries. Young drivers run a greater risk everywhere, and this problem is still largely unsolved. Better understanding of the underlying processes could, however, be a useful tool in preventive endeavours. The aim of this thesis is to elucidate some of the accident problem among young car drivers. The focus is on understanding how lifestyle and other social and demographical factors influence the health of young people in terms of mobility and safety. Better knowledge of these factors makes it possible to design safety measures specially tailored for different subgroups. This is expected to help make the measures more effective and reduce the conflict between mobility and safety. The thesis is based on five studies, the first of which focuses on the factors that influence young people in their decision concerning whether or not to obtain a driving licence (Paper I). In the second study, focus lies on how groups with different lifestyles and socio-economic background start practice driving and the benefit derived from the opportunity to practise from the age of 16 (Paper II). The third study aims at visualising accident patterns during driving practice (Paper III) while the fourth evaluates the effects of a reform that lowered the age limit for practice driving to 16 (Paper IV). The last study aims at analysing the relation between the lifestyles of young drivers and accidents (Paper V). The results of the five studies underlines the complexity of the young driver problem. Many factors such as financial means, time and norms influence how many people take their licence and consequentially, safety and health (I). Socio-economic background together with lifestyle influences the possibility of obtaining a driving licence and of accumulating extensive driving practice (II), which is relevant as regards safety on the road for newly qualified drivers (IV). Paper III shows the prevalent accident pattern during driver training and Paper V shows that the accident risk is different in different lifestyle groups. The combined results presented in the five papers offers the possibility of developing different countermeasures for the selective influencing of different groups under different conditions. If this is adapted as closely as possible to target groups and situations, it should be possible to significantly enhance safety without losing much of young drivers’ mobility, both during driving practice and afterwards. / On the day of the public defence of the doctoral thesis the status of the articles I was: Under review and article II was: Submitted. The titel of article III was "Typical accident patterns during driver training in Sweden – an explorative study using correspondence analysis". Aricle I and III are published in full text.

The aim of this study was to understand injury mechanisms behind fractures of the upper extremities in car accidents. Volvo Car Corporation initiated this project based on the fact that no safety system today focuses on preventing injuries to the upper extremity. A literature study was undertaken focusing on the basic anatomy of the upper extremity, different fracture types and fracture mechanisms. Three subsets, from 1998 – January 2009, were selected from Volvo’s statistical accident database: 1) all occupants involved in an accident 2) all occupants with a MAIS2+ injury 3) all occupants with an upper extremity fracture. These subsets were used in a comparison, using frequency analyses. The comparison analysis showed that frontal impact is the dominating accident type for all three subsets. The comparison analysis also indicated that the risk for upper extremity fractures follows the pattern of MAIS2+ injury risk. An in-depth study using 92 selected cases, including 80 occupants, was also performed. All available information, such as medical records, questionnaires completed by the occupants and photographs from the accident scene was collected and analysed. The analysis of the in-depth study, together with knowledge retrieved from the literature study, resulted in six different mechanism groups that were used to categorise fractures. The groups were then analysed individually in regard to accident type and fractured segment of the upper extremity. Analysis of the mechanism groups showed that frontal impact is the dominating accident type in these subsets as well. It could also be seen that the fractures occurring in the in-depth study are quite evenly distributed along the upper extremities. Upper extremity injuries are relatively infrequent in car accidents but may result in long-term disability, including chronic deformity, pain, weakness and loss of motion. More attention is therefore necessary in order to develop a safer environment for car occupants.

One of the primary reasons of the escalating rates of injuries and fatalities in the construction industry is the ever so complex, dynamic and continually changing nature of construction work. Use of cranes has become imperative to overcome technical challenges, which has lead to escalation of danger on a construction site. Data from OSHA show that crane accidents have increased rapidly from 2000 to 2004. By analyzing the characteristics of all the crane accident inspections, we can better understand the significance of the many variables involved in a crane accident. For this research, data were collected from the U.S. Department of Labor website via the OSHA database. The data encompass crane accident inspections for all the states. The data were divided into categories with respect to accident types, construction operations, degree of accident, fault, contributing factors, crane types, victim’s occupation, organs affected and load. Descriptive analysis was performed to compliment the previous studies, the only difference being that both fatal and non-fatal accidents have been considered. Multinomial regression has been applied to derive probability models and correlation between different accident types and the factors involved for each crane accident type. A log likelihood test as well as chi-square test was performed to validate the models. The results show that electrocution, crane tip over and crushed during assembly/disassembly have more probability of occurrence than other accident types. Load is not a significant factor for the crane accidents, and manual fault is more probable a cause for crane accident than is technical fault. Construction operations identified in the research were found to be significant for all the crane accident types. Mobile crawler crane, mobile truck crane and tower crane were found to be more susceptible. These probability models are limited as far as the inculcation of unforeseen variables in construction accidents are concerned. In fact, these models utilize the past to portray the future, and therefore significant change in the variables involved is required to be added to attain correct and expedient results.

Texte remanié de: Th. doct.--Droit privé--Nantes, 2004. / Bibliogr. p. 668-723. Index.

Thesis (Ph.D.)--York University, 2007. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 161-190). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:NR39040