bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of external cause of injury codes reported in Washington State hospital discharge records
Authors: LeMier M , Cummings P , West T A 
Published: October 2002

Objective—To evaluate the accuracy of external cause of injury codes (E codes) reported in computerized hospital discharge records.Methods—All civilian hospitals in Washington State submit computerized data for each hospital discharge to a file maintained by the Department of Health. In 1996, 32 hospitals accounted for 80% of the injury related discharges in this file; from these hospitals, we sampled 1260 computerized records for injured patients in a stratified, but random, manner. An expert coder then visited the 32 study hospitals, reviewed the medical records that corresponded to each computerized record, and assigned an E code for that hospitalization. The computerized E code information was compared with codes provided by the expert reviewer.Results—The incidence of hospitalization for injury based upon computerized hospital discharge data was very similar to that based upon chart review: incidence rate ratio 1.0 (95% confidence interval 1.00 to 1.02). Computerized hospital discharge data correctly ranked injuries in regard to both mechanism and intent. Overall agreement on coding was 87% for mechanism of injury, 95% for intent of injury, and 66% for the complete E code. The sensitivity of computerized hospital discharge data for identification of falls, motor vehicle traffic injuries, poisonings, and firearm injuries was 91% or better. The predictive value positive of coding for these four categories of injury ranged from 88% for motor vehicle traffic injuries to 94% for poisonings. The amount of agreement for intent coding ranged from 84% for firearm injuries to 99% for falls. Agreement on coding of the complete E code ranged from 57% for firearm injuries to 72% for poisonings.Conclusions—Computerized hospital discharge data can be used with confidence to determine how many injuries are treated in a hospital setting and the relative magnitude of various categories of injury. E codes reported in hospital discharge data are a reliable source of information on the mechanism and intent of injury, the two types of information most often used for injury related analyses and priority setting. The detail codes (complete E codes) reported in hospital discharge codes are less reliable and must be used with caution.
Non-fatal occupational injuries and illnesses treated in hospital emergency departments in the United States
Authors: Jackson L L 
Published: October 2002

Objectives—To estimate the number and rate of occupational injuries and illnesses treated in hospital emergency departments and to characterize the nature, event, and source of injury and illness.Setting—Twenty four hour emergency departments in hospitals in the United States.Methods—Surveillance for occupational injuries and illnesses was conducted in a national probability based sample of hospital emergency departments through the National Electronic Injury Surveillance System (NEISS). Worker demographics, nature of injury and disposition, and incident circumstances were abstracted from emergency department medical records, typically within 24–72 hours of treatment.Results—Approximately 3.6 million occupational injuries and illnesses were treated in emergency departments in 1998. Younger workers, particularly males, continue to have the highest rates of work related injuries. Together, lacerations, punctures, amputations, and avulsions represented one fourth of the emergency department treated injuries, mostly to hand and fingers. Sprains and strains, largely to the trunk, also accounted for one fourth of the injuries. The three leading injury events were contact with objects, bodily reactions and exertions, and falls.Conclusions—Despite apparent decreases in rates, youth continue to have a high burden of injury in the workplace. However, three fourths of all emergency department treated injuries occur to workers 20–44 years of age. Emergency department surveillance is particularly amenable to capture of young worker injuries and provides a wealth of injury details to guide prevention efforts—efforts that will likely reduce occupational injuries as these workers age. Emergency department surveillance also provides injury estimates with few demographic or employer constraints, other than the medical venue used.
The Fatality Assessment and Control Evaluation program's role in the prevention of occupational fatalities
Authors: Higgins D N , Casini V J , Bost P , Johnson W , Rautiainen R 
Published: October 2002

Objectives—The objective of the Fatality Assessment and Control Evaluation (FACE) program is to prevent traumatic occupational fatalities in the United States by identifying and investigating work situations at high risk for injury and formulating and disseminating prevention strategies to those who can intervene in the workplace.Setting—The FACE program is a research program located in the Division of Safety Research, a division of the National Institute for Occupational Safety and Health (NIOSH). NIOSH is an agency of the United States government and is part of the Centers for Disease Control and Prevention. NIOSH is responsible for conducting research and making recommendations for prevention of work related illnesses and injuries. FACE investigators conduct traumatic occupational fatality investigations throughout the United States and provide technical assistance to 15 state health or labor departments who have cooperative agreements with NIOSH to conduct traumatic fatality surveillance, targeted investigations, and prevention activities at the state level.Methods—Investigations are conducted at the worksite using the FACE model, an approach derived from the research conducted by William Haddon Jr. This approach reflects the public health perspective that the etiology of injuries is multifactorial and largely preventable. FACE investigators gather information on multiple factors that may have contributed to traumatic occupational fatalities. Information on factors associated with the agent (energy exchange, for example, thermal energy, mechanical energy, electrical energy, chemical energy), host (worker who died), and the environment (the physical and social aspects of the workplace), during the pre-event, event, and post-event time phases of the fatal incident are collected and analyzed. Organizational, behavioral, and environmental factors contributing to the death are detailed and prevention recommendations formulated and disseminated to help prevent future incidents of a similar nature.Results—Between 1982 and the present, more than 1500 fatality investigations have been conducted and reports with prevention recommendations distributed. Findings have been published in scientific and trade journals; safety professionals and policy makers have used FACE findings for prevention efforts; and working partnerships have been formed to address newly emerging safety concerns.Conclusions—FACE investigations identify multiple factors contributing to fatal occupational injuries, which lead to the formulation and dissemination of diverse strategies for preventing deaths of a similar nature.
Fire incidents involving regulators used in portable oxygen systems
Authors: Washenitz F , Stoltzfus J , Newton B , Kubinski L 
Published: October 2002

Objectives—To address the causes and prevention of fire incidents involving aluminum bodied oxygen regulators used by firefighters or emergency medical technicians.Methods—The National Institute for Occupational Safety and Health, the United States Food and Drug Administration, and an independent forensic investigator examined several incidents involving injury to firefighters and emergency medical technicians to determine why regulators in these incidents flashed.Results—Data and test results from investigations revealed that aluminum was a contributing factor, and there were a number of safe handling techniques which firefighters and emergency medical technicians could use to reduce the risk of regulator fires. A provisional test method was proposed by the American Society for Testing and materials (ASTM) in late 2000 to identify designs that would have a propensity for flashing. Results of the test method show good correlation with actual fire incidents.Conclusion—Development of the ASTM standard and associated testing will be helpful to oxygen regulator designers to design safer oxygen regulator systems. As well, there are a number of additional safe handling procedures that firefighters and emergency medical technicians can follow to reduce the risk of a regulator fire.
Height, surface firmness, and visual reference effects on balance control
Authors: Simeonov P , Hsiao H 
Published: October 2002

Objectives—To investigate the effects of height, surface firmness, and visual reference on standing balance in construction workers.Design—Controlled laboratory study with balanced repeated measures.Participants—Twenty four construction workers.Setting—Test subjects performed standing tasks at ground level as well as at 3 m and 9 m high balconies on firm or deformable surfaces with close visual references included or excluded from their visual field.Methods—Standing balance was determined from center of pressure as measured by a force platform. Dependent variables were root mean square of sway in medial-lateral and anterior-posterior directions, area of sway, and velocity of sway.Results—Heights without close visual references significantly increased all sway parameters. The effect of height in conditions without close visual references increased dramatically on deformable surfaces.Conclusions—Elevated work environments and deformable work surfaces negatively affect balance and may be associated with increased risk of fall incidents. Appropriate close visual references increase the ability to maintain balance.
Evaluation of a child safety program based on the WHO Safe Community model
Authors: Lindqvist K , Timpka T , Schelp L , Risto O 
Published: October 2002

Objectives: To evaluate the outcome of the World Health Organization (WHO) Safe Community model with respect to child injuries.Study design: A population based quasiexperimental design was used. Cross sectional pre-implementation and post-implementation data were collected in intervention (Motala municipality) and control (Mjölby municipality) areas, both in Östergötland county, Sweden.Results: The total relative risk of child injury in the intervention community decreased more (odds ratio 0.74; 95% confidence interval (CI) 0.68 to 0.81) than in a control community exposed only to national level injury prevention programs (0.93; 95% CI 0.82 to 1.05). The relative risk of moderately (abbreviated injury scale (AIS) 2) severe injury in the study area was reduced to almost a half (odds ratio 0.49; 95% CI 0.41 to 0.57), whereas the risk of minor (AIS 1) injuries decreased only slightly (odds ratio 0.89; 95% CI 0.80 to 0.99). The risk of severe or fatal (AIS 3–6) injuries remained constant.Conclusions: After introduction of an injury prevention program based on the WHO Safe Community model, the relative risk for child injury in the intervention community decreased significantly more than in a control community exposed only to national injury prevention programs.
State level estimates of the incidence and economic burden of head injuries stemming from non-universal use of bicycle helmets
Authors: Schulman J , Sacks J , Provenzano G 
Published: October 2002

Objective: To develop national and state level estimates for preventable bicycle related head injuries (BRHIs) and associated direct and indirect health costs from the failure to use bicycle helmets.Methods: Information on the effectiveness and prevalence of use of bicycle helmets was combined to estimate the avoidable fraction, that is, the proportion of BRHIs that could be prevented through the use of bicycle helmets. The avoidable fraction multiplied by the expected number of BRHIs gives an estimate of the number of preventable cases. Direct and indirect health costs are estimated from a social perspective for the number of preventable BRHIs to assess potential cost savings that would be achieved if all riders wore helmets.Results: Approximately 107 000 BRHIs could have been prevented in 1997 in the United States. These preventable injuries and deaths represent an estimated $81 million in direct and $2.3 billion in indirect health costs. Estimates range from 200 preventable BRHIs and $3 million in health costs in Wyoming (population 480 000) to 13 700 preventable BRHIs and $320 million in health costs in California (population 32.3 million).Conclusions: A number of successful approaches to increasing bicycle helmet use exist, including mandatory use laws and community based programs. The limited use of these strategies may be related to the fact that too little information is available to state agencies about the public health and economic burden of these preventable injuries. In conjunction with information on program costs, our estimates can assist state planners in better quantifying the number of preventable BRHIs and the costs and benefits of helmet promotion programs.
Understanding the knowledge and attitudes of commercial drivers in Ghana regarding alcohol impaired driving
Authors: Asiamah G , Mock C , Blantari J 
Published: October 2002

Objectives: The knowledge and attitudes of commercial drivers in Ghana as regards alcohol impaired driving were investigated. This was done in order to provide information that could subsequently be used to develop antidrunk driving social marketing messages built upon the intrinsic values and motivation of these drivers.Methods: Focus group discussions were held with 43 bus and minibus drivers in the capital city, Accra. A structured discussion guide was used to capture information related to values, risk perceptions, leisure time activities, and attitudes on alcohol impaired driving.Results: The majority of drivers expressed an understanding that drunk driving was a significant risk factor for crashes. There was a significant under-appreciation of the extent of the problem, however. Most believed that it was only rare, extremely intoxicated drivers who were the problem. The drivers also had a minimal understanding of the concept of blood alcohol concentration and related legal limits. Despite these factors, there was widespread support for increased enforcement of existing antidrunk driving laws.Conclusions: In Ghana, commercial drivers understand the basic danger of drunk driving and are motivated to assist in antidrunk driving measures. There are misconceptions and deficits in knowledge that need to be addressed in subsequent educational campaigns.
Changes in injury mortality by intent and mechanism in Taiwan, 1975–98
Authors: Lu Tsung-Hsueh 
Published: October 2002

Background: Most official mortality publications do not present the mechanism of injury (for example, cut/pierce, drowning, fall, poisoning, or suffocation) for intentional injuries (for example, suicide or homicide).Objectives: To determine if the presentation of mechanism of injury for intentional injuries had different mechanism profiles.Methods: Age adjusted injury mortality rates by intent and mechanism of injury for Taiwan were calculated for the years 1975 to 1998. TheInternational Classification of Diseasecodes for the matrix by intent and mechanism groupings were based on recommendations of the US Centers for Disease Control and Prevention.Results: If rates for both groups (intentional and unintentional) are combined, the importance of poisoning and suffocation increase relative to their contribution for unintentional injuries alone. Given the same mechanism of injury, different intents showed different patterns of change during the study period and given the same intent, the changes over time differed for different mechanisms of injury.Conclusions: It is important to include the mechanism of injury within intentional injuries because it provides different profiles of injury problems. Thus the simultaneous tabulation of injury mortality data by both intent and mechanism is a necessary step for identifying and prioritizing injury problems. The argument that good preventive measures could prevent both unintentional and intentional injuries was also confirmed.
Association between state level drinking and driving countermeasures and self reported alcohol impaired driving
Authors: Shults R A , Sleet D A , Elder R W , Ryan G W , Sehgal M 
Published: October 2002

Objectives:In 1999, alcohol related motor vehicle crashes in the United States claimed 15 786 lives and injured more than 300 000 persons. Drinking and driving behavior is shaped by individual and environmental level influences. In this study, the association between each state's driving under the influence of alcohol (DUI) countermeasures and self reported alcohol impaired driving was explored.Methods:Mothers Against Drunk Driving's (MADD's)Rating the States 2000survey, which graded states on their DUI countermeasures from 1996–99, was used as an index of each state's comprehensive DUI prevention activities. Information on alcohol impaired driving from residents of each state was obtained from the 1997 Behavioral Risk Factor Surveillance System (BRFSS) survey. The association between the MADD state grades and alcohol impaired driving was assessed using multiple logistic regression.Results:Of the 64 162 BRFSS respondents who reported drinking any alcohol during the past month, 2.1% of women and 5.8% of men reported at least one episode of alcohol impaired driving in the past month. Those living in states with a MADD grade of “D” were 60% more likely to report alcohol impaired driving than those from states with a MADD grade of “A” (odds ratio 1.6, 95% confidence interval 1.3 to 2.1). The association existed for men and women.Conclusion:These findings suggest that stronger state level DUI countermeasures are associated with lower rates of self reported alcohol impaired driving.
Personal and situational influences on drink driving and sober driving among a cohort of young adults
Authors: Morrison L , Begg D J , Langley J D 
Published: October 2002

Objectives:To compare personal and situational influences on incidents involving drink driving with those involving sober driving.Methods:Information on a range of road safety practices was sought in face to face interviews conducted with 969 members of the Dunedin Multidisciplinary Health and Development Study cohort at age 26 years. A total of 750 study members reported an incident that involved the opportunity to consume alcohol and also travel by motor vehicle. Of these, 87 were classified as “drink drive incidents” and 663 as “sober drive incidents”.Results:Study members who were male, of lower socioeconomic status, had no school qualifications, or were dependent on alcohol or marijuana at age 21 were significantly more likely to report a drink drive incident at age 26. Compared with the sober drive incidents, the drink drive incidents were more commonly associated with driving alone, drinking at bars, and no advanced planning. For drink drive incidents the amount of alcohol consumed was influenced by the conviviality of the occasion, whereas for sober drive incidents it was the need to drive. One quarter of those reporting drink drive incidents stated they had used marijuana and/or LSD at the event at which they drank.Conclusions:Drink drive and sober drive incidents differed, particularly with regard to decisions made before the event. Prevention efforts could usefully be targeted toward these decisions.
Sperm donor suffers years later from inherited disease
Authors: Gebhardt D O E 
Published: October 2002

A case is described of a man who discovered years after donating sperm for artificial insemination, that he had a serious genetic disease, autosomal dominant cerebellar ataxia (ADCA). This manifests itself only years after puberty and occurs in 50% of the progeny. The sperm had been used for the conception of 18 children in 13 women. The parents were only told three years after the insemination. This long time interval was unavoidable since many of the parents had to be found and the hospital director wished first to discuss the matter with his legal advisors and other experts.In future, in agreement with the new law only 10 inseminations will take place with sperm from one donor. This will reduce still further the availability of donor sperm.
A study on the ethics of microallocation of scarce resources in health care
Authors: Fortes P A C , Zoboli E L C P 
Published: October 2002

Objectives:This study attempts to analyse the ethical dilemmas arising from the microallocation of scarce health care resources, in terms of deontology and utilitarianism.Methods:A group of 395 people were interviewed in the region of Diadema, greater San Paulo, Brazil, while visiting patients in the only state hospital in town. Each interviewee was given a list of eight simulated emergencies (see appendix). In each of the eight cases the interviewee had to choose which of the two patients described, both of whom suffered from exactly the same problem, should receive the only hospital bed currently available. The differences between the hypothetical patients were as follows: age, gender, family dependency, and lifestyle. Each interviewee was asked to justify one of their responses. These responses were then analysed.Results:The results pointed to the co-existence of deontological and utilitarian orientations among the people interviewed. A tendency to give priority to the destitute was revealed throughout the research, contradicting the idea that society, valuing only productive people, wishes only such people to receive the most resources, thus maximising the benefits to be gained from resources. The results showed that people’s disapproval of the alcoholic was stronger than that of the nicotine abuser.
Use of the phenylalanine:tyrosine ratio to test newborns for phenylketonuria in a large public health screening programme
Authors: Eastman J.W. , Sherwin J.E. , Wong R. , Liao C.L. , Currier R.J. , Lorey F. , Cunningham G. 
Published: October 2002

Objective To assess the benefits of using the phenylalanine:tyrosine ratio to screen newborns for phenylketonuria (PKU). Setting Data were collected from all newborns in California during a ten month period (n = 404 381). Methods Dried blood spot specimens were analysed at nine laboratories. To assure that the results reported from multiple sites were matched accurately, an automated methodology was chosen that included sample processing, analysis, telecommunications, reporting, and information technology. Phenylalanine and tyrosine concentrations were measured independently by continuous flow fluorometry, for which precision, recovery, detection limits, carryover, chemical specificity, reportable range, and number of repeats are reported. Results In this study, 37% of the newborns were tested at less than 24 hours of age. For this population, using a phenylalanine only cut off of 200 μmol/l, there were 48 recalled infants per case of classic PKU. Using the phenylalanine:tyrosine ratio with a cut off of 1.50, screen positives could be reported with phenylalanine as low as 150 μmol/l and with only 12 recalls per case. Conclusions The phenylalanine:tyrosine ratio can be measured accurately at multiple laboratories using two channel chemical analyses. Having applied the methods to the routine clinical screening of a large population, it was confirmed that the clinical sensitivity and specificity of the PKU screening test are higher when the phenylalanine:tyrosine ratio is incorporated into the cut off than when the cut off is based on the phenylalanine concentration alone.