Tuesday, January 27, 2009

Estimating Road Transport trauma in the Australian indigenous population

First, road crashes account for a greater proportion of all deaths in the Indigenous population than the non-Indigenous population. Secondly, based on the Australian Indigenous road death estimates the road death rate in the Indigenous population may be three times higher than that of the non-Indigenous population.

Since 1994, the Australian Bureau of Statistics has published data on the causes of death in the Indigenous populations of Western Australia, South Australia and the Northern Territory. Over the period 1994 to 1997, road crashes represented 5.6% of all deaths in the combined Indigenous populations of these jurisdictions. This is comparable to diabetes (6.7%) and stroke (6.3%) as a major cause of death. In contrast, road crashes are the lowest ranking of the main causes of death for the non-Indigenous populations in the same jurisdictions, making up only 1.7% of all causes of death.

The number of deaths for every 100,000 population is a measure of public health risk associated with road use. The available mortality data is used in conjunction with population data to generate road death rates for the Indigenous and non-Indigenous populations in Western Australia, South Australia and the Northern Territory. The total road crash death rate over the four years is 39 deaths per 100,000 Indigenous persons and 12 deaths per 100,000 non-Indigenous persons.

The available road death data and the estimated Indigenous population for each of Australia’s States and Territories were then used to estimate the number of Indigenous road deaths Australia-wide. Two methods were employed. The first is a simple pro-rata method and the second (preferred method) takes into account possible differences in the road death rates between each of the States and Territories.

Using the second method it is estimated that in 1997 there were 31 Indigenous deaths per 100,000 population. This is three times the estimate for the non-Indigenous population (10 deaths per 100,000 population). The simple pro-rata method results in a slightly higher estimate of Indigenous deaths (35 deaths per 100,000 population).

Reliable data on the extent of road trauma are required to develop adequate road safety countermeasures. There is a clear need for improved information on the extent of involvement of Indigenous people in serious road crashes. The Commonwealth is currently supporting an initiative which should assist in meeting this goal. The National Coronial Information System, under development by Monash University, will allow the identification Australia-wide of injury deaths involving Indigenous people.

Tuesday, January 20, 2009

Bicycle helmets and Injury Prevention of road Transport

Bicycle helmet efficacy is quantified using a formal meta-analytic approach based on peer-reviewed studies. Though several reviews have already been published advocating the use of helmets, this approach provides summary estimates of efficacy in terms of head injury, brain injury and facial injury based on studies of cyclists involved in crashes in which injury and helmet information is available for each individual. It also provides evidence concerning neck injury and fatal injury. These topics have only been partially addressed previously due to the small numbers of cases involved.

The results are based on studies conducted in Australia, the USA, Canada and the United Kingdom, published in the epidemiological and public health literature in the period 1987- 1998. The summary odds ratio estimate for efficacy is 0.40 (95% confidence interval 0.29, 0.55) for head injury, 0.42 (0.26, 0.67) for brain injury, 0.53 (0.39, 0.73) for facial injury and 0.27 (0.10, 0.71) for fatal injury. This indicates a statistically significant protective effect of helmets. Three studies provided neck injury results that were unfavourable to helmets with a summary estimate of 1.36 (1.00, 1.86), but this result may not be applicable to the lighter helmets currently in use.

In conclusion, the evidence is clear that bicycle helmets prevent serious injury and even death. Despite this, the use of helmets is sub-optimal. Helmet use for all riders should be further encouraged to the extent that it is uniformly accepted.

Sunday, January 11, 2009

Transport drivers using Alcohol fatalities

Over the past 18 years, the incidence of drink driving has substantially reduced. Table 1 shows that during 1981, 44 per cent of all drivers and motorcycle riders killed in road crashes had a blood alcohol concentration (BAC) of 0.050 gm/100ml or greater. This has reduced to 26 per cent in 1998. This reduction in alcohol-related road trauma has come about as a result of strengthened legislation and enforcement in conjunction with high profile media and public education activities. These efforts have had a significant impact on public attitudes towards drink driving. The result for 1998 represents a substantial improvement on the previous year (28%). It comes after a long period in the 1990s where further reductions in the incidence of alcohol related road fatalities appeared to have stalled.

Sunday, January 4, 2009

Sleep and Car driving in young adults

Sleepiness is a significant contributor to car crashes and sleepiness related crashes have higher mortality and morbidity than other crashes. Young adult drivers are at particular risk for sleepiness related car crashes. It has been suggested that this is because young adults are typically sleepier than older adults because of chronic sleep loss, and more often drive at times of increased risk of acute sleepiness. This project aimed to determine the relationship between sleep and driving patterns in young adult drivers. Three estimates of the risk of driving while sleepy were calculated from the data:

1) a model incorporating known circadian and sleep factors influencing sleepiness,
2) time-of-day accident statistics;
3) self-reported sleepiness.

Monday, December 29, 2008

Improved shock absorbing liner for car driver helmets

This report presents the findings of the project 'Improved Shock Absorbing Liner for Helmets'. A special tool was developed to produce flat samples of foam made of either the new design or the current design. A total of 161 flat foam samples were manufactured and tested to the Australian Standard for motorcycle and bicycle helmets. This included 100 samples with new design and 61 samples with current design. The newly designed shock absorbing foam liner, when compared with the current liner, displayed significantly more crushing, greater timeduration (interaction), less slab-cracking and recorded peak decelerations less than the required 300 g's (g-force).

Monday, December 22, 2008

Benchmarking general aviation fatal Car accidents in Australia

General aviation broadly comprises all civil aviation activity other than scheduled airline operations and is a major component of total aviation activity in Australia. This monograph provides an analysis of fatal accident trends in Australia and compares these with similar trends for the USA and Canada.

Benchmarking measures

The analysis focuses on fatal accidents and fatalities rather than all accidents as benchmarking measures. This is because the definition of general aviation accidents and the frequency of reporting varies substantially from country to country. In order to benchmark Australia’s general aviation safety record it is necessary to find a common definition of accidents across countries.

Currently fatal accidents are the only type of accidents that have a common definition and are equally reported in Australia, the US and Canada. Reported fatal accidents and fatalities are therefore used as a measure of overall general aviation safety.

Main points
  • Australia’s general aviation fatal accident rate has declined from 1.41 fatal accidents per 100 000 flight hours in 1990 to 1.00 fatal accidents per 100 000 flight hours in 2000

  • Australia’s general aviation fatal accident rate per 100 000 flight hours for the year 2000 was the lowest of the three countries reported.

  • Australia’s general aviation fatal accident rate per 100 000 flight hours has been below the Canadian and US rate for all years except for 1994 and 1998.

  • Australia’s general aviation fatality rate per 100 000 flight hours has been below the Canadian and US rate for all years except for 1990 and 1999.

  • In recent years the Canadian and US rates have improved and are closer to Australia’s rates.

Tuesday, December 16, 2008

Heavy Vehicle exposure limits and guidelines

The guidelines for health effects of whole-body vibration are well documented in Australian and International Standards. However, there is still much to be learnt about vibration dose/response relationships. In terms of health criteria, the current International Standard is an improvement on the Australian Standard which was based on the 1985 International Standard. The new standard should provide a truer indication of injury risk due to vibration than the older standard.

The various State Occupational Health and Safety Regulations apply to truck drivers and under these Regulations employers are required to ensure that the systems of work and the working environment of the employee are without risks to health and safety. This would also apply to vibration exposure. However, the Australian Standard for whole-body vibration is not cited in State OH&S Regulations. This means that employers and employees would need to comply with guidelines from the most appropriate Standard available. Being the most recent standard, ISO 2631-1997 is likely to be considered most appropriate.

The fatigue limits in the current Australian Standard have been abandoned in the current International Standard because they were not supported by research. Further research is required to establish realistic fatigue limits.

The guidelines for comfort in the International Standard seem to be reasonably well founded (Griffin 1990) and could be useful in rating truck drivers vibration exposures especially if the contribution of vibration in all axes is included in the assessment. Comfort levels could possibly form the basis for fatigue limits although extensive research would be necessary to confirm such a link.