RESUMO
INTRODUCTION: Outcomes from trauma at the major referral hospital [Hospital Nacional de San Benito (HNSB)] in El Petén, Guatemala, have not been analyzed. Empirical evidence demonstrated a high number of motorcycle accidents (MAs). We hypothesized a large incidence of head trauma with poor outcomes in MAs compared to all other forms of blunt trauma. METHODS: Our hypothesis was tested by performing a community observational study and a retrospective chart review in El Petén, Guatemala. An independent observer catalogued 100 motorcycle riders on the streets of El Petén for riding practices as well as helmet utilization. HNSB does not have electronic medical records. For this study, we performed a retrospective chart review of randomly selected nonconsecutive trauma admission at HNSB between March 2018 and June 2023. Blunt trauma was compared between MAs versus all others. Variables were examined by parametric and nonparametric tests as well as contingency table analyses. RESULTS: Most motorcycles riders involved multiple individuals (2.61 ± 0.79/motorcycle). Seventy riders included children (median = 1.0 [Q1-Q3 range = 1.0-3.0]/motorcycle). Overall, only three riders were wearing helmets. Forty-one were women. Of patients presenting to HNSB with trauma, 91 charts were reviewed (33.0 [20.0-37.0] y old; male 89%), 76.7% were blunt, and 23.3% were penetrating trauma. Within blunt trauma, 57.1% were MAs versus 42.9% all others; P = 0.13. MAs were younger (29.5 [20.0-37.0] versus 34.0 [21.8-45.8] y old; P < 0.05) and of similar gender (male 82.5% versus 96.6%; P = 0.1). More MAs had a computed tomography (70.0% versus 30.0%; P < 0.01) and they were more likely to present with head trauma (72.5% versus 46.7%; P = 0.04) but similar Glasgow Coma Scale (15.0 [13.5-15.0] versus 15.0 [12.5-15.0]; P = 0.7). MAs were less likely to require surgical intervention (37.5% versus 56.7%; P = 0.05) but had similar hospital length of stay (4.0 [2-6] versus 4.0 [2-10.5] d; P = 0.5). CONCLUSIONS: Unsafe motorcycle practices in El Petén are staggering. Most trauma at HNSB is blunt, and likely from MAs. More patients with MAs presented with head trauma. However, severe trauma might be transferred to higher level hospitals or mortality might occur on scene, which will need further investigations. Assessment of mortality from trauma admissions is ongoing. These findings should lead to enforcement of safe motorcycle practices in El Petén, Guatemala.
Assuntos
Acidentes de Trânsito , Dispositivos de Proteção da Cabeça , Motocicletas , Humanos , Motocicletas/estatística & dados numéricos , Estudos Retrospectivos , Masculino , Feminino , Guatemala/epidemiologia , Adulto , Acidentes de Trânsito/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Criança , Pré-Escolar , Incidência , Traumatismos Craniocerebrais/epidemiologia , Traumatismos Craniocerebrais/etiologia , Ferimentos não Penetrantes/epidemiologia , Ferimentos não Penetrantes/etiologia , LactenteRESUMO
OBJECTIVE: To outline the profile of patients with facial trauma, victims of motorcycle accidents, treated at the Hospital da Restauração, Recife/PE, Brazil, from December 2020 to July 2021. METHODS: The collection was carried out through questionnaire and analysis of medical records. Data were analyzed descriptively, as well as Pearson's chi-square test or Fisher's exact test. RESULTS: Among the patients, 88.6% were male, 47.5% were between 18 and 29 years old, and 59.6% lived in rural areas; 72.15% of the victims used the motorcycle for work and 43.52% were working at the time of the accident. Most victims did not have a national motorcycle license (62%) and were not wearing a helmet at the time of the accident (60%), with 37.6% wearing a full-face helmet, 16.5% an open helmet, and 5.9% an articulated full-face helmet. Soft tissue injuries were the most prevalent. Zygomatic complex fractures were the most common facial fractures and were significantly associated with helmet use and type. CONCLUSIONS: Most victims of motorcycle accidents are young adult men, without a regular driver's license and residing in rural areas. Preventive and educational actions and continuous traffic inspections are necessary to minimize these accidents.
Assuntos
Acidentes de Trânsito , Traumatismos Faciais , Dispositivos de Proteção da Cabeça , Motocicletas , Humanos , Masculino , Acidentes de Trânsito/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Adulto , Feminino , Estudos Prospectivos , Adolescente , Traumatismos Faciais/epidemiologia , Brasil/epidemiologia , Adulto Jovem , Pessoa de Meia-Idade , Inquéritos e Questionários , Lesões dos Tecidos Moles/epidemiologiaRESUMO
OBJECTIVE: In Bogotá, Colombia, motorcyclists represent a concern as the proportion of motorcycle users between 2013 and 2018 has increased from 18% to 35%. Despite available risk reduction strategies, the fatality rates are also growing, notably in young adults (15-29 years old). This study aims at identifying correct helmet use patterns and its relationship with official records of injuries and casualties in the city over time. METHODS: Between 2015 and 2018, semiannual observational studies of motorcycle users in six randomly selected sites in Bogotá were conducted. Data was collected and analyzed on the number of occupants per vehicle (driver and passengers), gender, approximate age, type of helmet, and whether it was correctly used (strapped) or not. Bivariate and multivariate analyses were performed to identify the determinants of correct helmet use. Additionally, a spatial analysis was conducted to estimate the relationship between motorcycle's casualties and correct use of the helmet (full-face helmet use) prevalence. RESULTS: A total of 77,932 motorcycles were observed, showing a high prevalence of helmet use (99% for drivers and passengers), but only 88% use it correctly (89% drivers and 82% passengers). The presence of enforcement (camera or police personnel) increases the correct use of the helmet, especially in principal roads. Female, adults, and single riders are more likely to correctly wear the helmet. Finally, there is a relationship between the concentration of the fatalities and the incorrect helmet use in 80% of the observational sites. CONCLUSIONS: Incorrect helmet use has been found by the study to be related to higher mortality among motorcycle occupants in Bogotá. Our data shows that enforcement increases correct helmet use with the potential to reduce deaths among motorcycle occupants.
Assuntos
Acidentes de Trânsito/mortalidade , Falha de Equipamento/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Aplicação da Lei , Motocicletas/legislação & jurisprudência , Adolescente , Adulto , Cidades/epidemiologia , Colômbia/epidemiologia , Feminino , Humanos , Masculino , Adulto JovemRESUMO
OBJECTIVE: To analyze the effect of helmet use on injury severity among motorcyclists and passengers involved in traffic accidents. METHODS: Cross-sectional study of traffic accidents involving motorcyclists attended at the emergency healthcare units participating in the Violence and Accidents Survey Conducted in Sentinel Emergency Departments (Viva Survey) 2017. RESULTS: There was a predominance of individuals aged 18 to 29 years old (46.6%), black (75.2%), with high school education (50.6%). Alcohol use was observed in 14.1% of cases. Helmet use was associated with a 76% reduction in the occurrence of head trauma and a 28% reduction in the referral, hospitalization or death. CONCLUSION: Young, male, black individuals and those with low education were the most frequent victims of accidents. Helmet use was protective for severe injuries.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Fatores Socioeconômicos , Inquéritos e Questionários , Índices de Gravidade do Trauma , Ferimentos e Lesões/prevenção & controle , Adulto JovemRESUMO
RESUMO: Objetivo: Analisar o efeito do uso de capacete na gravidade de lesões em condutores e passageiros de motocicletas envolvidos em acidentes de trânsito. Métodos: Estudo de corte seccional sobre vítimas de acidentes de transporte terrestre envolvendo motociclistas, atendidos nos serviços de urgência e emergência e participantes do Inquérito de Vigilância de Violências e Acidentes (Viva Inquérito) 2017. Resultados: Verificou-se predomínio de indivíduos na faixa de 18 a 29 anos (46,6%), negros (75,2%) e com ensino médio (50,6%). Em 14,1% dos acidentes houve relato de uso de álcool. O uso do capacete reduziu em 76% a ocorrência de trauma cranioencefálico e em 28% a ocorrência de encaminhamento para outro hospital, internação ou óbito. Conclusão: Motociclistas jovens, negros, de baixa escolaridade e do sexo masculino apresentaram-se mais vulneráveis aos acidentes. O uso do capacete mostrou-se protetor para lesões graves.
ABSTRACT: Objective: To analyze the effect of helmet use on injury severity among motorcyclists and passengers involved in traffic accidents. Methods: Cross-sectional study of traffic accidents involving motorcyclists attended at the emergency healthcare units participating in the Violence and Accidents Survey Conducted in Sentinel Emergency Departments (Viva Survey) 2017. Results: There was a predominance of individuals aged 18 to 29 years old (46.6%), black (75.2%), with high school education (50.6%). Alcohol use was observed in 14.1% of cases. Helmet use was associated with a 76% reduction in the occurrence of head trauma and a 28% reduction in the referral, hospitalization or death. Conclusion: Young, male, black individuals and those with low education were the most frequent victims of accidents. Helmet use was protective for severe injuries.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Ferimentos e Lesões/epidemiologia , Motocicletas , Acidentes de Trânsito/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Fatores Socioeconômicos , Ferimentos e Lesões/prevenção & controle , Brasil/epidemiologia , Índices de Gravidade do Trauma , Estudos Transversais , Inquéritos e QuestionáriosRESUMO
Objective: Road traffic accidents (RTAs) are the number one cause of traumatic brain injuries (TBIs) worldwide. This study examines RTA-related TBIs in the Dominican Republic, a country in the Caribbean with the highest RTA fatality rate in the Western Hemisphere. Methods: We interviewed 117 adult patients or medical guardians of patients admitted to Hospital Traumatológico Dr. Ney Arias Lora in Santo Domingo following an RTA. Information regarding the type of accident, patient demographics, and injuries sustained was collected for each patient. Results: Most study participants were males (79.5%), and the most common method of transportation was motorized 2-wheeled vehicle (MTW; 74.4%). Of the 69 patients who suffered a TBI, 66.7% were classified as moderate-severe TBIs and 30.3% were classified as mild TBIs. The most common types of intracranial hemorrhage were subdural hemorrhage (12%) and subarachnoid hemorrhage (9.4%). Helmet use among admitted MTW riders was reported at 22.4%, and none of the 9 MTW riders who died in the hospital were wearing a helmet. Only 58.1% of patients lived in an area that offered 911 emergency response services at the time of the study. At 66.2%, the majority of people living within the 911 service area utilized emergency response services following an RTA. Multiple logistic regression determined that the utilization of 911 emergency response services was associated with a decrease in the likelihood of presenting with a moderate/severe TBI by a factor of 0.78 (adjusted odds ratio [OR]; P < .008; 95% confidence interval [CI], 0.65, 0.93). Nonuse of a helmet was associated with a 1.22 times increased risk of presenting with a moderate/severe TBI (adjusted OR; P < .04; 95% CI, 1.01, 1.61). Age and gender were not statistically significant in this model. Conclusions: The results of this study support 2 important avenues for reducing the burden of RTA-associated neurologic disease in the Dominican Republic. As with many other middle-income countries, MTWs represent an economical and efficient mode of transportation. Therefore, increasing helmet use may be the most effective way to reduce RTA-associated TBIs. In addition, continuing the expansion of postcrash emergency response services may mitigate the severity of RTA-associated neurologic disease.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Lesões Encefálicas Traumáticas/epidemiologia , Adulto , Lesões Encefálicas Traumáticas/terapia , República Dominicana/epidemiologia , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Humanos , Masculino , Fatores de RiscoRESUMO
Currently in Jamaica, motorcyclists account for the largest group of fatalities among all road users. Between 2016 and 2018, a cross sectional study was conducted at the Saint Ann's Bay Regional Hospital involving 155 participants. There were 98.7% males, ages ranged from 14-64 years and more than two thirds of the motorcyclists were under 40 years. Only 29.4% wore helmets, and of those motorcyclists, 52.8% indicated they were only riding for a short distance. Increasing age correlated with increased helmet compliance. Persons with motorcycles greater than 150 cubic centimetres were also more likely to wear a helmet. Interventions to promote increased helmet compliance should take these factors into account in conjunction with enhancing law enforcement.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Traumatismos Craniocerebrais/epidemiologia , Estudos Transversais , Educação/estatística & dados numéricos , Feminino , Humanos , Seguro/estatística & dados numéricos , Jamaica/epidemiologia , Licenciamento/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Motocicletas/legislação & jurisprudência , Sistema Musculoesquelético/lesões , Adulto JovemRESUMO
Objective: The objective of this study was to analyze the association between consumption of alcoholic drinks and adoption of other risky forms of behavior in traffic among motorcyclists involved in accidents. Methods: This was an exploratory cross-sectional study among injured motorcyclists who were hospitalized in the traumatology department of the "Governador Paulo Guerra" Restoration Hospital (Hospital da Restauração Governador Paulo Guerra), Recife, Pernambuco, Brazil. A questionnaire containing items relating to sociodemographic, occupational, and behavioral factors and aspects of the accident and road conditions was applied. Descriptive and bivariate analyses were performed and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The significance level was set at 5%. Results: One hundred seventy individuals were investigated. Consumption of alcohol prior to the accident was reported by 32.9% of motorcyclists. This behavior was positively associated with the following risky forms of behavior in traffic: speeding (OR = 4.08; 95% CI, 1.15-9.48); failure to use a helmet (OR = 2.41; 95% CI, 1.15-5.02); and not having a motorcycle driver's license (OR = 2.68; 95% CI, 1.31-5.45). Conclusion: This study showed that, in the population studied, riding a motorcycle under the effects of alcoholic drinks was associated with other risky forms of behavior in traffic: speeding, not using a helmet, and not having a motorcycle driver's license. We believe that the interaction between these behaviors may lead to greater occurrence and greater severity of accidents.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Dirigir sob a Influência/psicologia , Motocicletas , Assunção de Riscos , Adolescente , Adulto , Idoso , Brasil , Cidades , Estudos Transversais , Feminino , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Humanos , Licenciamento/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
INTRODUCTION: Land transport accidents (LTA) are the second cause of death in schoolchildren aged 13 to 17 years. The study aims to describe the risk factors for LTA in schoolchildren from the National School Health Survey (PeNSE) of 2015 and to evaluate the trend of selected indicators in the last three editions of PeNSE. METHODOLOGY: A descriptive study on risk factors for LTA in 2015, with PeNSE data and time series trends analysis, with age-adjusted regression tests of the 2009, 2012 and 2015 editions, in Brazilian capitals. RESULTS: In 2015, 26.3% of ninth grade schoolchildren, mostly between 13 and 15 years of age, reported having been in a motor vehicle driven by someone who consumed alcohol and 32.4% had driven a motor vehicle; 30.7% of adolescents did not use seat belts in the back seat; and 16.8% of schoolchildren who ride motorcycles did not wear helmets. There was also a worsening of the indicators between 2009 and 2015, regarding driving a motor vehicle (1.0 percentage points) and having been driven by vehicle for consumption of alcoholic beverages (1.1 percentage points). DISCUSSION: The LTA occurrence results from the interaction between roads, vehicles and users, and has a strong correlation with behavior. CONCLUSIONS: The results show the need to invest in educational measures, associated with supervision, the improvement of road infrastructure, research and improvement of legislation. The monitoring of risk factors in schoolchildren substantially contributes to support intersectoral public policies interventions to reduce morbidity and mortality in traffic.
INTRODUÇÃO: Os acidentes de transporte terrestre (ATT) são a segunda causa de morte em escolares de 13 a 17 anos. O presente estudo visou descrever os fatores de risco para ATT em escolares da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2015 e avaliar a tendência de indicadores selecionados nas três últimas edições da PeNSE. METODOLOGIA: Estudo descritivo sobre fatores de risco para ATT no ano de 2015, com dados da PeNSE e análise de tendência das séries temporais, com testes de regressão ajustados por idade, das edições de 2009, 2012 e 2015, nas capitais brasileiras. RESULTADOS: Em 2015, 26,3% dos escolares do nono ano, na maioria entre 13 e 15 anos, relataram terem sido conduzidos em veículo motorizado dirigido por alguém que consumiu bebida alcoólica e 32,4% relataram terem dirigido veículo motorizado; 30,7% dos adolescentes não usaram cinto de segurança no banco de trás; e 16,8% dos escolares usuários de motocicleta não usaram capacetes. Observou-se ainda tendência de piora dos indicadores entre 2009 e 2015, referentes a dirigir veículo motorizado (1,0 pontos percentuais) e ter sido conduzido em veículo por alguém que consumiu bebida alcoólica (1,1 pontos percentuais). DISCUSSÃO: A ocorrência de ATT resulta da interação entre vias, veículos e usuários, tendo forte correlação com o comportamento. CONCLUSÕES: Os resultados apontam a necessidade de investir em medidas educativas, associadas a fiscalização, a melhoria das vias, pesquisas e aprimoramento da legislação. O monitoramento dos fatores de risco em escolares contribui substancialmente para apoiar intervenções das políticas públicas intersetoriais para a redução de morbimortalidade por trânsito.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Comportamento do Adolescente/psicologia , Inquéritos Epidemiológicos/normas , Acidentes de Trânsito/tendências , Adolescente , Condução de Veículo/psicologia , Condução de Veículo/estatística & dados numéricos , Brasil , Dirigir sob a Influência/psicologia , Dirigir sob a Influência/estatística & dados numéricos , Feminino , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Inquéritos Epidemiológicos/tendências , Humanos , Masculino , Motocicletas/estatística & dados numéricos , Fatores de Risco , Cintos de Segurança/estatística & dados numéricos , Distribuição por Sexo , Fatores SocioeconômicosRESUMO
OBJECTIVE: To estimate lives saved during 2008-2023 by traffic safety laws passed in six developing countries while participating in the Bloomberg Road Safety Program (BRSP). METHODS: BRSP-funded local staff identified relevant laws and described enforcement to the study team. We analyzed road crash death estimates for 2004-2013 from the Global Burden of Disease and projected estimates absent intervention forward to 2023. We amalgamated developing country and US literature to estimate crash death reductions by country resulting from laws governing drink driving, motorcycle helmets, safety belt use, and traffic fines. RESULTS: BRSP helped win approval of traffic safety laws in Brazil, China, Kenya, Mexico, Turkey, and Vietnam. In 2008-2013, those laws saved an estimated 19,000 lives. Many laws only took effect in 2014. The laws will save an estimated 90,000 lives in 2014-2023. Of the 109,000 lives saved, drink driving laws will account for 84%, increased motorcyclist protection for 13%, increased fines and penalty points for 2%, and safety belt usage mandates for 1%. Drink driving reductions in China will account for 56% of the savings and reduced drink driving and motorcycling deaths in Vietnam for 35%. The savings in China will result from a narrow intervention with just 4% estimated effectiveness against drink driving deaths. As a percentage of deaths anticipated without BRSP effort, the largest reductions will be 11% in Vietnam and 5% in Kenya. CONCLUSIONS: Viewed as a public health measure, improving traffic safety provided large health gains in developing nations.
Assuntos
Acidentes de Trânsito/prevenção & controle , Condução de Veículo/legislação & jurisprudência , Países em Desenvolvimento , Regulamentação Governamental , Motocicletas/legislação & jurisprudência , Segurança/legislação & jurisprudência , Acidentes de Trânsito/legislação & jurisprudência , Acidentes de Trânsito/mortalidade , Brasil , China , Dirigir sob a Influência/legislação & jurisprudência , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Humanos , Quênia , Aplicação da Lei , México , Equipamentos de Proteção/estatística & dados numéricos , Turquia , VietnãRESUMO
OBJECTIVES: This study aimed to determine the factors associated with the incorrect use of a helmet retention system (loose or open) and how often this happens. METHODS: This was an observational transversal study conducted in Curitiba, Brazil. Trained observers positioned at traffic lights collected information about the helmet fixation mode, the helmet model (full-face, open-face, modular, half), and the helmet retention system model (micrometric, double-D, fast-release). Additional data including position on the motorcycle, gender, and function of the motorcycle (as a work vehicle) were collected. The observers, collection site, and periods were randomly selected by lots. RESULTS: From a total of 3,050 motorcyclists, 1,807 (59.2%) had their helmets fastened correctly, 907 (29.7%) had the retention system fastened loosely, and in 336 (11.0%), the retention system was completely open. Increased odds of incorrect use were observed for the fast-release and double-D buckles compared to the micrometrics buckles, with a fixed odds ratio (OR) of 4.62 (95% confidence interval [CI], 3.89-5.51) and 3.54 (95% CI, 2.46-5.09), respectively (P <.0001). Full-face helmets had a higher chance of incorrect use (P <.0001), and passengers had a higher incidence of incorrect use of the helmet than drivers (P <.0001). CONCLUSION: An important risk factor related to the incorrect use of the helmet was the type of retention system. The helmet model and being a passenger had a secondary influence on incorrect use of helmets.
Assuntos
Queixo , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas , Brasil , Desenho de Equipamento , Feminino , Humanos , Masculino , Fatores de RiscoRESUMO
RESUMO: Introdução: Os acidentes de transporte terrestre (ATT) são a segunda causa de morte em escolares de 13 a 17 anos. O presente estudo visou descrever os fatores de risco para ATT em escolares da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2015 e avaliar a tendência de indicadores selecionados nas três últimas edições da PeNSE. Metodologia: Estudo descritivo sobre fatores de risco para ATT no ano de 2015, com dados da PeNSE e análise de tendência das séries temporais, com testes de regressão ajustados por idade, das edições de 2009, 2012 e 2015, nas capitais brasileiras. Resultados: Em 2015, 26,3% dos escolares do nono ano, na maioria entre 13 e 15 anos, relataram terem sido conduzidos em veículo motorizado dirigido por alguém que consumiu bebida alcoólica e 32,4% relataram terem dirigido veículo motorizado; 30,7% dos adolescentes não usaram cinto de segurança no banco de trás; e 16,8% dos escolares usuários de motocicleta não usaram capacetes. Observou-se ainda tendência de piora dos indicadores entre 2009 e 2015, referentes a dirigir veículo motorizado (1,0 pontos percentuais) e ter sido conduzido em veículo por alguém que consumiu bebida alcoólica (1,1 pontos percentuais). Discussão: A ocorrência de ATT resulta da interação entre vias, veículos e usuários, tendo forte correlação com o comportamento. Conclusões: Os resultados apontam a necessidade de investir em medidas educativas, associadas a fiscalização, a melhoria das vias, pesquisas e aprimoramento da legislação. O monitoramento dos fatores de risco em escolares contribui substancialmente para apoiar intervenções das políticas públicas intersetoriais para a redução de morbimortalidade por trânsito.
ABSTRACT: Introduction: Land transport accidents (LTA) are the second cause of death in schoolchildren aged 13 to 17 years. The study aims to describe the risk factors for LTA in schoolchildren from the National School Health Survey (PeNSE) of 2015 and to evaluate the trend of selected indicators in the last three editions of PeNSE. Methodology: A descriptive study on risk factors for LTA in 2015, with PeNSE data and time series trends analysis, with age-adjusted regression tests of the 2009, 2012 and 2015 editions, in Brazilian capitals. Results: In 2015, 26.3% of ninth grade schoolchildren, mostly between 13 and 15 years of age, reported having been in a motor vehicle driven by someone who consumed alcohol and 32.4% had driven a motor vehicle; 30.7% of adolescents did not use seat belts in the back seat; and 16.8% of schoolchildren who ride motorcycles did not wear helmets. There was also a worsening of the indicators between 2009 and 2015, regarding driving a motor vehicle (1.0 percentage points) and having been driven by vehicle for consumption of alcoholic beverages (1.1 percentage points). Discussion: The LTA occurrence results from the interaction between roads, vehicles and users, and has a strong correlation with behavior. Conclusions: The results show the need to invest in educational measures, associated with supervision, the improvement of road infrastructure, research and improvement of legislation. The monitoring of risk factors in schoolchildren substantially contributes to support intersectoral public policies interventions to reduce morbidity and mortality in traffic.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Acidentes de Trânsito/estatística & dados numéricos , Inquéritos Epidemiológicos/normas , Comportamento do Adolescente/psicologia , Cintos de Segurança/estatística & dados numéricos , Fatores Socioeconômicos , Condução de Veículo/psicologia , Condução de Veículo/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Brasil , Acidentes de Trânsito/tendências , Fatores de Risco , Inquéritos Epidemiológicos/tendências , Distribuição por Sexo , Dirigir sob a Influência/psicologia , Dirigir sob a Influência/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricosRESUMO
With the objective of analyzing fatal and non-fatal road traffic injuries in cyclists and to document helmet use in this road user to inform sustainable mobility policies, a descriptive analysis of four secondary official information sources was conducted at the national level: mortality, Ministry of Health's hospital discharges, Unintentional and Violence Registry System (SIS-SS-17-P) and the 2012 National Health and Nutrition Survey (ENSANUT). Only SIS-SS-17-P and ENSANUT document helmet use. Except for ENSANUT information analyzed is of 2014.A total of 190 cyclists died in Mexico during 2014 and 392 were hospitalized; head was the anatomical region most frequently affected (63% and 32%, respectively). Only 0.75% of the 667 cases registered in SIS-17 reported helmet use and 24% suffered head injuries. Of the 165,348 non-fatally injured cyclists from ENSANUT <10% used helmet, 24% had head injuries and more than 16,000 suffered permanent injuries. Whereas cyclist-friendly infrastructure is an effective intervention to prevent injuries in the long term, helmet use could potentially reduce the frequency and severity of head injuries in the short run while bicycle use widespread as a means of transportation providing "safety in numbers".
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Ciclismo/lesões , Traumatismos Craniocerebrais/epidemiologia , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Idoso , Ciclismo/estatística & dados numéricos , Criança , Estudos Transversais , Feminino , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Inquéritos Epidemiológicos , Hospitalização/estatística & dados numéricos , Humanos , Masculino , México , Pessoa de Meia-Idade , Sistema de Registros , Índices de Gravidade do Trauma , Ferimentos e Lesões/mortalidade , Adulto JovemRESUMO
OBJECTIVE: To analyze the type of injuries and the characteristics and geographical distribution of road accidents where motorcycles were involved in Mexico. METHODS: A descriptive analysis of second-hand information sources was conducted, including the number of accidents (N = 41,881), total number of injured people (N = 13,916) and medical expenses (N = 9,111) associated to motorcycle accidents during 2014. RESULTS: Motorcycles represent 13.14% of the total number of deaths in road accidents in Mexico, and the Southeast region of Mexico registers the highest proportion of fatal injuries. Of the total number of motorcycles, 1.84% (95% confidence interval [CI]: 1.83-1.86) were involved in a collision. 3.64 (95% CI: 3.39-3.89) people died and 105.5 (95% CI: 104.1-106.8) were injured in every 10,000. Out of the total number of injuries, 76.6% were male and 53.74% were women. 55.1% of deaths were caused by intracranial trauma. Only 16.6% wore a helmet at the time of the accident, and those not wearing a helmet had a 2.11 (odds ratio [OR]: 2.1; CI 95%: 1.8-2.4) higher chance of head injury. Regarding the severity of the crash, those occurred in suburban areas (OR: 6.58; CI 95%: 5.69-7.60), in unpaved surfaces (OR: 4.13; CI 95%: 3.04-5.61), after low alcohol consumption (OR: 1.89; CI 95%: 1.46-2.44), at night (OR: 2.24; CI 95%: 1.95-2.57) and on weekends (OR: 1.65; CI 95%: 1.44-1.90), had the highest chance of turning into a fatal accident. CONCLUSIONS: In spite of the progress made in terms of road safety, motorcycle accidents are still increasing, and the use of a helmet is still proportionally low. More information on these groups and risk factors needs to be available so people are better informed. Also, regulations need improvements regarding the use of security equipment like helmets in order to reduce injuries and fatal accidents.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Traumatismos Craniocerebrais/epidemiologia , Motocicletas/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Traumatismos Craniocerebrais/mortalidade , Feminino , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Humanos , Lactente , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Ferimentos e Lesões/mortalidade , Adulto JovemRESUMO
Globally, 49% of deaths from traffic crashes occur among vulnerable road users, including pedestrians, bicyclists, and motorcyclists. Approximately, a quarter of those killed are motorcyclists. The authors carried out a systematic review of the literature to evaluate the effectiveness of interventions to prevent motorcycle crashes and the associated morbidity and mortality. The studies included in this review provide evidence for the effectiveness of helmet use, protective clothing, training, and penalties for alcohol consumption and speeding in preventing injury and death to motorcyclists. The use of helmets is effective, especially if it is universally required by law for drivers and passengers. Training to obtain a license also has positive effects but not when it is totally voluntary. There is limited but consistent evidence that strengthening laws for penalties related to alcohol consumption or speeding has an impact on risk. Traffic calming interventions could help reduce crashes in urban areas. In jurisdictions where there is limited regulation or adherence to effective measures, such as the use of helmets, efforts should be directed primarily at expanding such practices. In other areas, efforts can focus on approaches based on alternative effective measures or on more innovative interventions adapted to local conditions.
Assuntos
Acidentes de Trânsito/prevenção & controle , Dirigir sob a Influência/legislação & jurisprudência , Licenciamento/normas , Motocicletas , Segurança , Ferimentos e Lesões/prevenção & controle , Dirigir sob a Influência/prevenção & controle , Desenho de Equipamento , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Humanos , Motocicletas/legislação & jurisprudência , Motocicletas/normas , Roupa de Proteção/estatística & dados numéricosRESUMO
OBJECTIVE: The purpose of this article is to describe a public school-based educational intervention (EI) designed to increase knowledge, improve attitudes, and change practices related to road safety. METHODS: We used a mixed-methods evaluation of a road traffic safety baseline diagnosis conducted in 4 public schools, 2 primary and 2 secondary. Research was organized into 4 phases: (1) diagnosis, (2) EI design, (3) implementation, and (4) evaluation. We used convenience sampling (n = 219 students) across schools and applied a pre-/posttest design based on quantitative and qualitative data. The former related to surveys on road safety experiences, knowledge, attitudes, and practice and the latter to observation checklists, community mapping, ethnography, and focus groups. To compare pre-post scores, we used multilevel mixed-effect ordinal logistic regressions. We developed data matrices, field notes, and systematized community mapping. We also transcribed focus group discussions, generated categories, and carried out thematic analysis. RESULTS: Ethnography indicated poor sidewalk conditions, no helmet or seat belt use, overcrowded public transportation, and no traffic lights or proper signals. Pedestrians did not use sidewalks and crossed streets unsafely. Subsequent to the intervention, however, the study population showed significant changes in their knowledge, practices, and attitudes. They identified road traffic incidents (RTIs) as the first cause of death among children and youth, and most understood that the solution to the problem was incumbent upon each and every individual. They also displayed increased perceptions of danger in practices such as traveling on overcrowded public transportation, failing to wear seat belts in cars and helmets on motorcycles, crossing the street while using mobile phones or playing with friends, and riding with drunk drivers. Changes varied according to gender, and students reported being able to carry out safe practices only when they were in control of the situation; for instance, as pedestrians. CONCLUSIONS: Because safe practices depend not only on children and youth but on the adults and social environment surrounding them, it is essential to engage parents, teachers, and decision makers in efforts to reduce RTIs. This will improve the establishment of commitments to impact social reality through consistent changes and mobilize greater resources for creating more secure communities in matters of road safety.
Assuntos
Acidentes de Trânsito/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Pedestres , Gestão da Segurança , Ferimentos e Lesões/prevenção & controle , Adolescente , Comportamento do Adolescente , Adulto , Criança , Comportamento Infantil , Feminino , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Humanos , Masculino , México , Cintos de Segurança/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
Injuries resulting from motorcycle road traffic accidents are an important public health issue in Brazil. This study aimed to describe the characteristics of motorcyclists involved in traffic accidents attended in public urgent and emergency services in the state capitals and the Federal District. This is a cross-sectional study based on data from the Violence and Accident Surveillance System (VIVA Survey) in 2014. Data were analyzed according to sociodemographic, event and attendance characteristics. Proportional differences between genders were analyzed by chi-square test (Rao-Scott) with 5% significance level. Motorcyclist-related attendances (n = 9,673) reported a prevalence of men (gender ratio = 3.2), young people aged 20-39 years (65.7%), black / brown (73.6%), paid work (76.4%). Helmet use was reported by 79.1% of the victims, 13.3% had consumed alcohol in the six hours prior to the accident, 41.4% of the events were related to the victim's work. Accidents were more frequent on weekends, in the morning and late afternoon. These characteristics can support the development of public accident prevention policies and health promotion.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Serviços Médicos de Emergência/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/epidemiologia , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores de Tempo , Adulto JovemRESUMO
This study aimed to describe the profile of motorcycle users and determine the prevalence of use. Also, to evaluate the reason for using a motorcycle, users' perceived risk of traffic accident, pattern of helmet wearing and number of accidents related to motorcycle use in the last 12 months. This cross-sectional study was conducted in the city of Pelotas, Southern Brazil. Sampling process was carried out in two stages, with the primary unit being the census track and the secondary the house. The study included 3,004 individuals aged 10 to 59 years, which answered a structured questionnaire. The outcome of the study was the use of motorcycle. The prevalence of motorcycle use was 25%. The majority of the riders were composed by males (79%). Individuals aged from 18 to 35-years-old comprised 42% of the total number of users, mainly as riders (24%). Forty percent of the users were not using properly the helmet strap. The major part of the users (76%) had a perception of high risk for accidents. The prevalence of accidents was 8%; it was higher among males and among those individuals aged from 18 to 35 years. The use of motorcycle was widespread in the population. Users were aware of the risk of accident, even though they reported to not wear correctly the helmet.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Brasil/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
The aim of this study was to identify the prevalence and some characteristics associated with the use of motorcycle helmets in two Colombian cities. The researcher used quantitative and qualitative techniques. The prevalence of the use of a motorcycle helmet among motorcyclists was greater in Ibague (98.1%) than in Valledupar (82.4%); among passengers in the city of Valledupar, it did not reach 2%. Men were 2.1 times more likely to wear helmets than women (IC 95:1.6-2.7). Using qualitative techniques, the factors explaining the reasons for use/non-use of helmets (being hygienic, climatic, esthetic and safety reasons) were identified for Valledupar. The use of the helmet is a protective measure in the event of traffic accidents; however, the prevalence of usage is not ideal. It is important for traffic and health authorities as well as the civil society to organize, in order to design and implement measures aimed at strengthening the use of this road safety gear.
Assuntos
Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Adolescente , Adulto , Cidades , Colômbia , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Adulto JovemRESUMO
There is no clear consensus for the optimal treatment of sagittal craniosynostosis; however, recent studies suggest that improved neurocognitive outcomes may be obtained when surgical intervention imparts active cranial expansion or remodeling and is performed before 6 months of age. The authors consider spring-mediated cranioplasty (SMC) to optimally address these imperatives, and this is an investigation of how helmet orthoses before or after SMC affect aesthetic outcomes.The authors retrospectively evaluated patients treated with SMC and adjunct helmeting for sagittal synostosis. Patients were stratified into 4 cohorts based on helmet usage: preop, postop, both, and neither. The cephalic index (CI) was used to assess head shape changes and outcomes. Twenty-six patients met inclusion criteria: 6 (23%) had preop, 11 (42%) had postop, 4 (15%) had preop and postop, and 5 (19%) had no helmeting. Average age at surgery was 3.6 months. Overall, CI improved from a mean 69.8 to 77.9 during an average 7-month course of care. Mean preoperative change in CI showed greater improvement with preop helmet (1.3) versus not (0.0), (Pâ=â0.029), despite similar initial CI in these cohorts (70.4 and 69.6 respectively, Pâ=â0.69). Nonetheless, all patient cohorts regardless of helmeting status achieved similar final CIs (range 76.4-80.4; Pâ=â0.72).In summary, preoperative molding helmet therapy leads to improved CI at the time of spring-mediated cranioplasty. However, this benefit does not necessarily translate into overall improved CI after surgery and in follow-up, calling into question the benefits of molding helmet therapy in this setting.