bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seatbelt legislation in Japan: high risk driver mortality and seatbelt use
Authors: Nakahara S , Ichikawa M , Wakai S 
Published: March 2003

Objectives:To clarify why seatbelt legislation did not achieve the expected reduction in mortality in Japan.Location and background:Seatbelt legislation was enacted in Japan in September 1985 and penalties were introduced in November 1986.Methods:The driver deaths per vehicle km traveled (D/VKT) were calculated to adjust for changes in traffic volume. Decreases in D/VKT were compared with the reduction expected after legislation. The association between percentage changes of driver D/VKT, seatbelt use rate, and seatbelt non-use rate were explored. Deaths of passengers, pedestrians, and cyclists were also examined. Mortality data were obtained from vital statistics, traffic volume figures from the Ministry of Land, Infrastructure, and Transport, and seatbelt use rates from the National Police Agency.Results:Although the decrease in D/VKT after the law was enforced was larger than the absolute number of deaths, it was far less than predicted. The percentage decrease in seatbelt non-use rate showed the strongest correlation with the percentage decrease in driver mortality. Mortality did not increase among other road users after the law was enacted.Conclusion:Accurate evaluation of the effect of seatbelt legislation must take into account changes in traffic volume. The selective recruitment hypothesis—that high risk drivers were less responsive to seatbelt legislation—fits well with the findings. There was no conclusive evidence supporting risk compensation—that is, an increase in injuries among other road users.
Socioeconomic variation in injury in children and older people: a population based study
Authors: Lyons R A , Jones S J , Deacon T , Heaven M 
Published: March 2003

Objectives:To compare hospital admission rates for all causes and specific causes of injury in children and the elderly by a measure of economic deprivation.Study design:All emergency admissions for Welsh residents from 1997–99 were located to one of 865 electoral tracts, which were grouped into fifths using a measure of socioeconomic deprivation. Standardised admission rates for all ages and 0–14, 15–75, and 75+ year groups for each quintile were calculated with 95% confidence intervals.Results:There were 90 935 admissions in a population of 2.84 million yielding a crude admission rate of 1601/100 000/year and a standardised rate of 1493/100 000. The ratio of admissions in deprived and affluent areas varied with category of injury and age group. In general, socioeconomic variations in injury rates were much smaller in older people than in children with the exception of pedestrian related injuries where the rates were similar. The largest variations were for injuries sustained in assaults or self inflicted.Conclusions:The relationship between socioeconomic position and injury varies by cause and age group. This should be considered when developing area based preventive interventions or monitoring the effectiveness of policies to reduce inequalities in injury occurrence.
Discrepancy between actual and estimated speeds of drivers in the presence of child pedestrians
Authors: Harré N 
Published: March 2003

Objectives:First, to measure the speeds of vehicles with and without children on the footpath, and second to compare these with drivers’ estimates of how fast they would go in these conditions.Design:The speeds of vehicles in three conditions: control (no children present), children playing with a ball on the footpath, and children waiting to cross the road, were measured using speed tubes during two 55 minute sessions. Drivers’ estimates of their speeds were measured with a questionnaire.Setting:Speeds were measured on a main road in Auckland, New Zealand. The questionnaire was conducted at another time with drivers stopping for petrol approximately 500 metres from the measurement site.Subjects:A total of 1446 speed measurements were taken and 93 drivers‘ questionnaire responses were analysed.Results:The mean free speed of vehicles in the control condition was 55.60 kph, with drivers‘ estimates being 56.37 kph. When children were playing with a ball the measured speed was 54.29 kph and the estimated speed 39.27 kph. When children were waiting to cross the measured speed was 52.78 kph, estimated speed 34.02 kph. Analyses indicated that there were significant differences between measured and estimated speeds.Conclusions:New Zealand drivers make inadequate speed adjustments in the presence of children, despite probably believing they do so. Establishing specific rules about appropriate speeds around children and highlighting to drivers the discrepancy between their attitudes and behaviour are two intervention strategies suggested.
Injury prevention attitudes and awareness in New Zealand
Authors: Hooper R , Coggan C A , Adams B 
Published: March 2003

Objectives:This study was designed to obtain New Zealand data on beliefs related to a broad spectrum of injuries and their prevention.Methods:A cross sectional phone survey was conducted of approximately 400 randomly selected households from each of 13 territorial local authorities across New Zealand, giving a total of 5282. Respondents were asked questions on awareness and attitudes to injury prevention, ownership and use of safety equipment, safety behaviours, and incidence of self reported injury.Results:84% agreed with the statement that “Most injuries are preventable” and 91% rated their homes as “very safe” or “reasonably safe”. A high proportion of homes had smoke alarms (81%) and first aid kits (81%), and more than half (56%) had turned down the temperature of their hot water to 55°C or lower. However, less than half of the respondents said that they practised the other safety behaviours. Significant associations were found between the practise of safety behaviours and respondents’ home safety ratings. There was a significant association between home safety ratings and the incidence of injury occurring in all settings (p<0.0001), however there was no discernable association between home safety ratings and injury occurring in the home.Conclusions:Although this survey found that most respondents believed that injuries are preventable and considered their homes to be safe, the public need to be further encouraged to adopt common safety practices and behaviours in the home.
Association between handgun purchase and mortality from firearm injury
Authors: Grassel K M , Wintemute G J , Wright M A , Romero M P 
Published: March 2003

Objective:To determine the association between mortality from violent or firearm related injury and previous handgun purchase.Methods:Case-control study of 213 466 Californians ages 21 and older who died in 1998; cases were the 4728 violent or firearm related injury deaths, with subsets by specific cause and means of death, and controls were the 208 738 non-injury deaths. The exposure of interest was the purchase of a handgun during 1996–98. The main outcome measure was the odds ratio for handgun purchase, adjusted for age, sex, race, education, and marital status.Results:Handgun purchase was more common among persons dying from suicide (odds ratio (OR) 6.8; 95% confidence interval (CI) 5.7 to 8.1) or homicide (OR 2.4, 95% CI 1.6 to 3.7), and particularly among those dying from gun suicide (OR 12.5; 95% CI 10.4 to 15.0) or gun homicide (OR 3.3; 95% CI 2.1 to 5.3), than among controls. No such differences were seen for non-gun suicide or homicide. Among women, those dying from gun suicide were much more likely than controls to have purchased a handgun (OR 109.8; 95% CI 61.6 to 195.7). Handgun purchasers accounted for less than 1% of the study population but 2.4% of gun homicides, 14.2% of gun suicides, and 16.7% of unintentional gun deaths. Gun suicide made up 18.9% of deaths among purchasers but only 0.6% of deaths among non-purchasers.Conclusion:Among adults who died in California in 1998, those dying from violence were more likely than those dying from non-injury causes to have purchased a handgun.
Studying “exposure” to firearms: household ownershipvaccess
Authors: Ikeda R M , Dahlberg L L , Kresnow M-j , Sacks J J , Mercy J A 
Published: March 2003

Background:Firearm ownership has often been used to measure access to weapons. However, persons who own a firearm may not have access to it and conversely, persons who do not own a firearm may be able to access one quickly.Objectives:To examine whether using firearm ownership is a reasonable proxy for access by describing the demographic characteristics associated with ownership and access.Methods:Data are from the 1994 Injury Control and Risk Survey, a national, random digit dial survey. Information about household firearm ownership and ready access to a loaded firearm were collected and weighted to provide national estimates. Adjusted odds ratios for three separate models were calculated using logistic regression.Results:A total of 1353 (27.9%) respondents reported both having a firearm in the household and ready access to one. An additional 313 respondents (8.1%) reported having a firearm, but were not able to access these weapons. Another 421 respondents (7.2%) did not have a firearm in or around their home, yet reported being able to retrieve and fire one within 10 minutes. Based on the logistic regression findings, the demographic characteristics of this latter group are quite different from those who report ownership. Those who do not have a firearm, but report ready access to one, are more likely to be ethnic minorities, single, and living in attached homes.Conclusions:Asking only about the presence of a firearm in a household may miss some respondents with ready access to a loaded firearm. More importantly, those who do not own a firearm, but report ready access to one, appear to be qualitatively different from those who report ownership. Caution should be exercised when using measures of ownership as a proxy for access.
Family characteristics and pedestrian injury risk in Mexican children
Authors: Celis A , Gomez Z , Martinez-Sotomayor A , Arcila L , Villaseñor M 
Published: March 2003

Background:Family characteristics have been described as risk factors for child pedestrian and motor vehicle collision. Research results come mainly from developed countries, where family relationships could be different than in developing ones.Objective:To examine family characteristics as risk factors for pedestrian injury in children living in Guadalajara City, Mexico.Methods:Case-control study of injuries among children 1–14 years of age involved in pedestrian-motor vehicle collisions. Cases resulting in death or injuries that required hospitalization or medical attention were included and identified through police reports and/or emergency room registries. Two neighborhood matched controls were selected randomly and compared with cases to estimate odds ratios (OR) and 95% confidence intervals (CI).Results:Significant risk factors were: male (OR 2.3, 95% CI 1.2 to 4.4), number of siblings in household (two siblings, OR 3.2, 95% CI 1.4 to 6.6; three siblings, OR 4.5, 95% CI 1.9 to 11.0; four or more siblings, OR 3.7, 95% CI 1.1 to 12.9), and number of non-siblings/non-parents in household (four or more, OR 6.2, 95% CI 1.5 to 26.6). Children of a sole mother, working mother, or grandmother living in house did not show increased risk after adjusting for socioeconomic conditions.Conclusion:Household size has implications for child pedestrian and motor vehicle collision prevention efforts and is relatively easy to identify. Also, the lack of risk association with working mothers may indicate that grandmothers are not part of the social support network that cares for children of working mothers.
Seismic, structural, and individual factors associated with earthquake related injury
Authors: Peek-Asa C , Ramirez M , Seligson H , Shoaf K 
Published: March 2003

Background:Earthquakes cause thousands of deaths worldwide every year, and systematic study of the causes of these deaths can lead to their prevention. Few studies have examined how multiple types of risk factors are related to physical injury during an earthquake.Methods:A population based case-control study was conducted to examine how individual characteristics, building characteristics, and seismic features of the 1994 Northridge, California, earthquake contributed to physical injury. Cases included fatal and hospital-admitted injuries caused by the earthquake. Controls were drawn from a population based phone survey of county residents. Cases were individually matched to two sets of controls: one matched by age and gender and one matched by location at the time of the earthquake.Results:Individuals over age 65 had 2.9 times the risk of injury as younger people (95% confidence interval (CI) 1.2 to 7.4) and women had a 2.4 times greater risk than men (95% CI 1.2 to 5.1). Location in multiple unit residential and commercial structures each led to increased injury risk compared with single unit residential structures, but the exact estimate varied depending on the control group used. With every increase in ground motion of 10%g, injury risk increased 2.2 times (95% CI 1.6 to 3.3).Conclusions:Controlling for other factors, it was found that individual, building, and seismic characteristics were independently predictive of increased injury risk. Prevention and preparedness efforts should focus on each of these as potential points of intervention.
Suicide among North Carolina women, 1989–93: information from two data sources
Authors: Runyan C W , Moracco K E , Dulli L , Butts J 
Published: March 2003

Objectives:To characterize the events and examine suicide precursors among women and to examine gaps in surveillance.Setting:A statewide study in North Carolina.Methods:Suicides of women age 15 and older for the time period 1989–93, as identified from the Office of the Chief Medical Examiner, were included. All case files were reviewed by hand and telephone interviews were attempted with investigating law enforcement officials for every case in 1993.Results:Altogether 882 suicides met the case definition, for an age adjusted rate that fluctuated between 5.53 and 7.26 per 100 000 women across the period. Interviews with law enforcement officials were completed for 135 of the 177 cases from 1993. White women had rates nearly three times those of racial minorities. Women under age 45 were proportionally more likely than older women to have recently experienced the breakup of an intimate relationship. Information about precursors was not as consistently reported as had been hoped. Medical examiner records were variable in completeness. Law enforcement interviews frequently did not yield information about the factors we had hoped to examine, probably because the investigations were conducted primarily to rule out homicide.Conclusions:This study suggests somewhat different precursor patterns by age group. It also points to the need for reconsidering how suicide surveillance is accomplished as a strategy to guide intervention.
Validity of self reported home safety practices
Authors: Chen L-H , Gielen A C , McDonald E M 
Published: March 2003

Objectives:To examine the validity of self reported data on parents’ home safety practices of using smoke alarms and stair gates, and having syrup of ipecac.Setting:Families from a pediatric continuity clinic in a large, urban teaching hospital with infants from birth to 6 months were enrolled in the study.Methods:As part of a randomized controlled trial to promote home safety, parents’ responses to personal interviews were compared to observations made in the respondents’ homes two to four weeks after the interview. Positive and negative predictive values, sensitivity, and specificity were computed and compared between the intervention and control group families.Results:Sensitivities were high among the four safety practices. Specificities were much lower and fell into a much wider range than sensitivities. The positive predictive values were low and the negative predictive values were high. No differences in these indicators of validity were found between intervention and control group families.Conclusions:If the main interest in an evaluation is on therelativedifference between study groups, rather than theabsolutevalue of the outcome measure, our results suggest that self reported data may be of acceptable validity. However, when assessing a patient’s risk, clinicians need to recognize the problem of over-reporting of safety practices.
Injuries and death of children in rollover motor vehicle crashes in the United States
Authors: Rivara F P , Cummings P , Mock C 
Published: March 2003

Context:There is an increased awareness of the problem of rollover crashes, but few data on children involved in rollover crashes in the United States.Objective:To determine: (1) the rates of rollover crashes involving children and the incidence of fatal injury; (2) the characteristics of crashes involving children; (3) the risk factors for children being in a rollover compared with a non-rollover crash; and (4) whether the risk of death is greater for children involved in crashes in sport utility vehicles (SUVs) or passenger cars.Design:Retrospective cohort study.Data:1993 through 1998 crashes involving children younger than 16 years included in the Crashworthiness Data System or reported to the Fatality Analysis Reporting System.Results:During the study period, 100.4 children per 100 000 person-years were involved in a rollover crash, accounting for 10% of all children involved in crashes. The incidence of fatal injuries in rollover crashes was 3.4 per 100 000 person-years. Sixty percent of children involved in rollovers were riding in SUVs. Among vehicles carrying children and involved in a crash, the adjusted relative risk of the crash being a rollover was 11.1 (95% confidence interval (CI) 9.3 to 13.3) for SUVs compared with passenger cars. The adjusted relative risk of death was 1.8 (95% CI 1.1 to 2.8) in a rollover crash and the relative risk of injury was 2.1 (95% CI 1.1 to 3.8) compared with non-rollover crashes. However, the relative risk of death for children in SUVs which crashed was 0.4 (95% CI 0.1 to 2.5) compared with passenger cars which crashed.Conclusions:Crashes involving children in SUVs were more likely to be rollover crashes than those involving passenger cars, and rollover crashes were associated with an increased risk of death and injury. However, the overall risk of death for children in a crash was not higher for children who crashed in an SUV compared to children who crashed in a passenger vehicle. Whether children are safer overall in SUVs compared with other cars cannot be answered with the data used.
Predictors and severity of injury in assaults with barglasses and bottles
Authors: Coomaraswamy K S , Shepherd J P 
Published: March 2003

Background:Although glasses and bottles are frequently used as weapons in assaults, there is little knowledge on which prevention strategies can be based.Design:Scrutiny of a random sample of 1288 criminal injury compensation applications.Objective:To identify predictors and relative severity of glass and bottle injury.Method:Injury site, severity, treatment, and demographic characteristics of victims and assailants were studied with reference to awards from the UK national Criminal Injuries Compensation Authority (CICA).Main outcome measures:Gender of victims and assailants, injury sites, treatment, and award (UK pounds) as indices of injury severity.Results:Annual CICA awards to all victims of assaults in licensed premises during 1996–98 amounted to £4.08 million (for all glass/bottle assaults: £1.15 million = 28%). The mean cost of 746 glass assaults was £2347, compared with £2007 for 542 injuries from bottle assaults (mean difference £340; p<0.01). This difference largely reflected more eye injuries with glasses (26 cases: 3% of all glass assaults) than with bottles (eight cases: 1% of all bottle assaults).Bottle assault was significantly associated with unidentified assailants and scalp injuries; whereas glass injury was significantly linked to pub opening hours (midday to midnight), Thursdays, eye and face injuries, and treatment requiring sutures.Mean age of bottle assault victims (26.1 years) was lower than of glass victims (27.3 years; p<0.01), and same gender assaults were more frequent than between gender assaults for both bottle (p<0.001) and glass (p<0.001) assaults. Female victims were allocated to lower compensation awards more frequently than male victims; this was the case for both bottle (p<0.05) and glass (p<0.01) assaults.Conclusions:Assaults with bottles caused less serious injury and resulted in lower compensation costs. Injury distribution was linked to victim gender and weapon choice, but not to assailant gender. Prevention strategies should focus on both bottle and glass assaults and should take account of the setting and time in which drinking occurs.
An investigation of child restraint/seatbelt usage in motor vehicles by Maori in Northland New Zealand
Authors: Brewin M , Peters T 
Published: March 2003

Objective:To investigate child restraint/seatbelt use by the indigenous (Maori) population in Northland New Zealand.Method:Observational surveys were conducted at the two main car parks (McDonald’s and the largest supermarket) to determine the number of passengers restrained, the type of restraints, and correct use. Observations were restricted to those who were obviously Maori, based upon the local knowledge of the observer. In addition, face to face questionnaires were administered to Maori whanau/caregivers involved in the care of two or more children for more than three days a week.Results:A total of 788 participants were observed. Babies were those most likely to have all occupants restrained correctly (97%), followed by toddlers (66%), adults (56%), and school age children (48%); 138 interviews were conducted. Females (86%) were significantly more likely to ensure that all passengers were restrained on short journeys compared to males (67%; p<0.05). Respondents under 45 (80%) were significantly less likely to restrain child passengers compared to people aged 45 or older (91%; p<0.05).Discussion:This study highlights the problem that larger families in this study had in providing correct child restraints for all their children.
Children’s response to a commercial back-up warning device: Figure 1
Authors: Sapien R E , Widman Roux J , Fullerton-Gleason L 
Published: March 2003

Objective:To determine preschool children’s response to a commercial back-up warning alarm in a mock setting of an automobile backing up.Setting:Preschool parking lot in Albuquerque, New Mexico, USA.Methods:With subjects acting as their own controls, 33 preschoolers were asked to walk behind a stationary vehicle twice. The first time, the control, no warning sound was emitted from the vehicle. The second time, the vehicle was placed in reverse gear triggering an alarm. Children’s responses were recorded by a hidden video camera. Avoidance behavior by the child was considered a positive response. Location and distance to where the response occurred was measured.Results:Thirty three children, 38–61 months, were studied. None responded to the alarm with avoidance behavior but 18 looked toward the vehicle or hesitated in their gait.Conclusion:Although over half of the children acknowledged the warning alarm, the device did not elicit avoidance behavior. Mere acknowledgment of the warning device would not prevent injury.