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Biomedical subjects

J F Kraus

Publications and source records attributed to J F Kraus.

At least 55 records · Page 3Linked to original sources
PubMed1995

The impact of two related prevention strategies on head injury reduction among nonfatally injured motorcycle riders, California, 1991-1993.

Although the traumatic injury death rate in the United States decreased during the last 20 years, the percent of all injury deaths attributable to brain injuries has remained steady. Head injuries are a leading cause of injury among motorcycle riders in crashes, and the helmet is an effective measure to reduce these injuries. To reduce the burden and cost of motorcycle injuries, many states have increased helmet use by introducing mandatory helmet legislation. This report presents evidence on the effects of the motorcycle helmet and helmet use legislation--two interrelated prevention strategies which decrease traumatic brain injury among motorcycle riders. Nonfatally injured motorcyclists were included if they crashed between January 1, 1991 and December 31, 1993 and were treated in one of 18 hospitals in 10 California counties. Medical records for all injured motorcyclists admitted to these 18 hospitals and those treated in the emergency department and released in eight of these hospitals were individually reviewed. Complete lists of injury diagnoses for each rider were coded according to the 1990 Abbreviated Injury Severity Scale by trained clinical staff. Before the universal helmet law was introduced (when only a third of injured riders wore helmets) 38.2% of riders sustained head injuries. When helmet use increased to over 85% of injured riders following the law, less than 25% of riders sustained head injuries. Both the severity and the number of head injuries per individual rider decreased after the mandatory helmet use law led to increased helmet use. Riders wearing helmets suffered fewer skull fractures, fewer intracranial injuries, had less frequent and shorter periods of loss of consciousness, more favorable GCS scores, and shorter hospital stays. Mandatory motorcycle helmet use laws are an effective mechanism to increase helmet use among riders and thus prevent head and brain injuries resulting from motorcycle crashes.

Accidents, Traffic↗
PubMed1995

Occupational injury in female aerospace workers.

We conducted a population-based case-control study in women in high-risk manufacturing occupations to examine occupational injury and its association with possible risk factors inside and outside the work place. The primary hypothesis was that women with young children are at greater risk of occupational injury than are women without young children, owing to the responsibility and fatigue associated with raising young children. The odds of reported injury was 2.9 times greater in women with a child less than 6 years of age than in women without children less than age 6 [odds ratio (OR) = 2.9; 95% confidence interval (CI) = 1.5-5.6]. The same effect was not observed for women with older children. Other predictors of injury were a history of previous injury (OR = 2.7; 95% CI = 1.8-3.9) and a body mass index greater than or equal to 25 (OR = 1.6; 95% CI = 1.08-2.4). We found small or zero effects for age, years of work experience, total number of children at home, ethnicity, marital status, and shift worked. These findings indicate that factors outside the work place, such as the presence of young children at home, may increase the risk of occupational injury for women employed in manufacturing jobs.

Accidents, Occupational↗
PubMed1995

Fatal injuries in motorcycle riders according to helmet use.

OBJECTIVE: Helmets have been shown to be effective in preventing head injuries in motorcyclists, but some studies have suggested that helmets may cause injury to parts of the head or neck because they add mass to the head. DESIGN: This study examined patterns of fatal injuries in helmeted and unhelmeted motorcyclists. MATERIALS AND METHODS: Coroner reports, hospital records, and police reports for motorcyclists fatally injured in crashes from July 1, 1988 through October 31, 1989 were examined. All injury diagnoses were abstracted and coded to the 1990 version of The Abbreviated Injury Scale and the International Classification of Diseases, 9th revision. MAIN RESULTS: Cerebral injury, intracranial hemorrhage, face, skull vault, and cervical spine injuries were more likely to be found in fatally injured unhelmeted motorcyclists than in helmeted motorcyclists. CONCLUSIONS: These results expand earlier reports showing that helmets provide protection for all types and locations of head injuries, and show that they are not associated with increased neck injury occurrence.

Abdominal Injuries↗
PubMed1995

Incidence, risk factors and prevention strategies for work-related assault injuries: a review of what is known, what needs to be known, and countermeasures for intervention.

This review organizes available data to address current epidemiological understanding of injuries from workplace assaults. We describe the incidence and general populations at risk for fatal and nonfatal work-related injury, and assess available information on risk factors and countermeasures considered important in reducing injury occurrence. Overall rates of occurrence of work-related homicides and nonfatal injuries are estimated, and those factors that appear to be consistent across studies are explored. Much of what is known about occupations at high risk for assaults and injuries comes from a small number of documents and special studies within subsets of workplaces. Unfortunately, the potency of specific countermeasures for prevention of violence-related injury in work settings continues to be largely unknown. Numerous fundamental questions remain to be answered: Critical is a full assessment of risk, identification of situations and circumstances amenable to intervention, and evaluations to demonstrate effectiveness.

Female↗
PubMed1995

Compliance with the 1992 California motorcycle helmet use law.

To evaluate helmet use in California before and after the introduction of an unrestricted helmet use law on January 1, 1992, observations of motorcycles and their riders were made at 60 locations in seven California counties, twice before and four times after the law was introduced. Helmet use increased from about 50% in 1991 to more than 99% throughout 1992. Compliance was achieved despite variations in helmet use by motorcycle design and road type. Seven percent of riders used nonstandard helmets after the law. With adequate enforcement, unrestricted helmet use laws can achieve almost 100% compliance and reduce the number of people riding motorcycles.

California↗
PubMed1994

The effect of the 1992 California motorcycle helmet use law on motorcycle crash fatalities and injuries.

OBJECTIVE: To determine the effects of the California motorcycle helmet use law on statewide fatalities and a large sample of nonfatal injuries before and after law implementation. DESIGN: Police reports and death certificates were collected for motorcycle crash fatalities in California for 1991 (prelaw) and 1992 (postlaw). Official counts of registered motorcycles provided a statewide basis for exposure to a motorcycle crash. Autopsy results were collected for fatalities in 11 counties. Hospital records were reviewed for nonfatal injuries in 28 hospitals in 10 of the 11 counties. Police reports were linked to injury data for the riders. SUBJECTS AND PATIENTS: A total of 850 fatalities and injury data for 547 fatally injured riders and 3252 nonfatally injured patients. MAIN OUTCOME MEASURES: Changes in number and rates among statewide fatalities were estimated. The number and pattern of head injuries in fatally and nonfatally injured motorcycle riders were evaluated. RESULTS: After implementation of the helmet use law, statewide motorcycle crash fatalities decreased by 37.5%, from 523 fatalities in 1991 to 327 in 1992, more than 37%, and an estimated 92 to 122 fatalities were prevented. Motorcycle fatality rates were reduced by 26.5%, from 70.1 per 100,000 registered motorcycles in 1991 to 51.5 per 100,000 in 1992. Head injuries decreased significantly among both fatally and nonfatally injured motorcyclists. CONCLUSION: Enactment of an unrestricted helmet law significantly reduces the incidence of motorcycle crash fatalities and the number and severity of head injuries.

Accidents, Traffic↗
PubMed1994

Lower extremity injuries from motorcycle crashes: a common cause of preventable injury.

Lower extremity injuries are among the most common injuries sustained by motorcycle riders in crashes and often lead to extended and costly medical treatment and permanent disability. This study characterizes lower extremity injuries in a group of 700 motorcycle riders in crashes in Los Angeles County from July 1, 1988, through October 31, 1989. Motorcycle crash fatalities (n = 163) were identified through the Los Angeles County Coroner's office, and nonfatally injured riders (n = 537) were identified at four of the ten level I and level II trauma centers in the county. Lower extremity injuries were diagnosed in 301 (56%) of nonfatally injured and in 75 (46%) of fatally injured riders. Fractures were the most common lower extremity injury and were diagnosed in 52% and 42% of riders with nonfatal and fatal injuries, respectively. Over a third of all fractures were to the tibia or fibula. Drivers and passengers did not differ in their risk for lower extremity injuries. Multiple-vehicle collisions resulted in a higher risk of lower extremity injuries than did single-vehicle collisions. The highest risk for lower extremity fractures was observed among riders in broadside collisions in which another vehicle struck the motorcycle (risk ratio = 2.7). Modifications in vehicle design and rider apparel may prevent some lower extremity injuries in motorcycle crashes.

Abbreviated Injury Scale↗
PubMed1994

Effect of immediate resuscitation on children with submersion injury.

STUDY OBJECTIVE: To determine the effect of immediate resuscitative efforts on the neurological outcome of children with submersion injury. DESIGN: A case-control study was designed to determine if immediate resuscitation by rescuers or bystanders reduces the frequency of severe neurological damage or death in children with a documented submersion event. Logistic regression was used calculate an adjusted odds ratio. PARTICIPANTS: The study group consisted of 166 children, aged zero to 14 years, having a submersion event during May 1984 through August 1992, and admitted through various emergency departments to Huntington Memorial Hospital in Pasadena, California. MEASUREMENTS AND MAIN RESULTS: All study subjects had an observed and documented episode of apnea at the time of submersion. Outcomes were evaluated on the basis of neurological impairment or death. Exposure was verified from historical accounts of postsubmersion events provided by family, friends, and/or paramedical personnel. The study factors included age and gender, duration of submersion, hypothermia, presence of apnea, resuscitative efforts, and clinical outcome. Children with a good outcome were 4.75 (adjusted odds ratio (OR)) times more likely to have a history of immediate resuscitation than children with poor outcome (95% confidence interval: 3.44 < OR < 6.06, P = .0001). Various types of resuscitative efforts and potential confounding factors were also evaluated. CPR and mouth-to-mouth resuscitation were the most effective types for the prevention of death or severe anoxic encephalopathy. CONCLUSION: Immediate resuscitation before the arrival of paramedical personnel is associated with a significantly better neurological outcome in children with submersion injury.

Adolescent↗
PubMed1993

Acute traumatic injuries in underground bituminous coal miners.

Using injury information from the 1986 Mine Safety and Health Administration database, and demographic information from a 1986 sample survey of the miner population, acute traumatic injury rates for male workers in underground bituminous coal mines were computed by age, current job experience, and total mine work experience. Three groups of workers assessed in this study showed the highest injury rates: workers aged 15-30 years; workers with between 2 and 3 years of experience; and workers with 10 or more years of experience in the current job. Injury rates decline with age in each time-interval of current job category and each total mine working experience category. Experience per se does not appear to be related to lower injury rates independent of age, which is paradoxical. The interaction of worker age with length of current or total mining experience is complex. The potential for catastrophic multiple fatalities and severe injuries suggests that additional work is needed to study, simultaneously, factors such as training and job task, and those that describe specific work exposures and mining hazards.

Accidents, Occupational↗
PubMed1993

Epidemiological aspects of fatal and severe injury urban freeway crashes.

Two types of crashes are common on urban freeways: in-lane rear-end impacts with stopped or slowed vehicles and those where a vehicle leaves the roadway (and road shoulder) and impacts with obstacles outside traffic lanes. Crashes resulting in a fatal or severe injury to a vehicle occupant were identified from crash records in the regional office of the California Department of Transportation for the 1,500 miles of freeways in Los Angeles, Ventura, and Orange counties, California, for 1984 and 1985. Selected road characteristics were assessed and traffic-volume data obtained for these freeways to determine the relationship of these types of crashes to freeway features. Fatal- or severe-injury crash rates were highest for off-road crashes compared with in-lane crashes, with certain lanes having more frequent in-lane collisions and with a higher rate of in-lane crashes in freeway segments without a left shoulder. Off-road collisions were significantly more frequent in the absence of a right shoulder and on freeways with two or three lanes. Multivariate analyses that control for selected confounding factors such as traffic volume show similar findings including strong association with hour of crash.

Accident Prevention↗
PubMed1993

The occurrence and epidemiologic features of alcohol-related occupational injuries.

This paper presents a review of published literature on alcohol-related occupational injuries. Based on the information presented the true magnitude of the problem of alcohol- and work-related injuries has not been accurately assessed and the epidemiologic features of this problem have not been properly evaluated. There is some evidence, albeit incomplete, that alcohol contributes to work-related injuries, but the extent is not known. Further, the risk of injury by specific industry and occupation has not yet been elucidated. Analytic studies which include control groups and which assess confounding variables are needed so as to aid in the design of effective countermeasure strategies. Even when alcohol is detected, its role in the causal pathway from the worker-energy interaction to injury onset (or exacerbation) has not been studied.

Accidents, Occupational↗
PubMed1992

Standard definitions for childhood injury research: excerpts of a conference report.

As awareness of the huge human and other costs of injury has grown, research has expanded. There has not been any standard set of terminology for use in this research. As a result, research and surveillance data are too often difficult to interpret and compare. To overcome this impediment to gains in needed knowledge about childhood injuries, a conference was held in 1989 by the National Institute of Child Health and Human Development to develop a set of standard definitions. The full conference report is available from the US Government Printing Office. This report presents excerpts, emphasizing those--core--variables likely to be of use to the largest number of investigators. The conference recommendations presented address cross-cutting factors (age, race/ethnicity, location, socioeconomic status, and biopsychosocial development), effect modifiers (exposure, medical risk factors, substance abuse, time, injury severity, and social risk factors), and specific injuries (motor vehicle injuries, central nervous system injuries, falls, fire/burns, drowning, and violence). It is expected that childhood injury investigators will strive to meet the recommendations of this conference and that use of these definitions will lead to improvements in research and, ultimately, to revision of the definitions.

Child↗
PubMed1991

Motorcycle licensure, ownership, and injury crash involvement.

The interrelationships among motorcycle licensure, ownership, and injury crash involvement were investigated in a sample of 2,723 motorcycle drivers severely or fatally injured in California in 1985-86. Owners of motorcycles in such crashes ("driver-owners") were less likely to have valid licenses than a random sample of motorcycle owners who had not been in crashes (42 vs. 57 percent). Thirty-three percent of the crash-involved drivers had valid motorcycle driver's licenses; 39 percent were operating motorcycles they did not own ("driver-nonowners"). Driver-nonowners were less likely to be validly licensed than driver-owners (20 percent vs. 44 percent). The licensing rate of crash-involved driver-nonowners was 15 percent if the owner was also unlicensed. Rates of valid licensure were lowest among the youngest drivers. Virtually no crash-involved driver-nonowners under age 21 were licensed in cases in which the owner was also young and unlicensed.

Accidents, Traffic↗
PubMed1991

Variation in suicide occurrence by time of day, day of the week, month, and lunar phase.

Previous studies suggest that suicide occurrence varies by month and day of the week, but not by lunar phase. Variation by time of day has never before been adequately examined; to our knowledge, all previous studies have failed to obtain time-of-death information for a large percentage of cases. We examined suicide occurrence among residents of Sacramento County, CA, during the period from 1925 to 1983. Data were abstracted from coroner's autopsy and investigative reports. In contrast to previous studies, data on time of death were available for a large percentage of cases. 4,190 suicide deaths were identified during the study period. Suicide occurrence varied substantially by time of day; for both sexes and for ages under 65 years, the fewest suicide deaths occurred during the early morning hours, from 0401 to 0800. For recent years of the study, suicides occurred most frequently on Monday for both males and females and for most age groups. Variation by month followed no consistent pattern by gender, age, years of the study, or combinations of these factors. Contrary to popular belief, suicide occurrence did not vary by lunar phase.

California↗
PubMed1990

Brain injuries among infants, children, adolescents, and young adults.

Blunt and penetrating force injuries to the brain constitute an enormous public health problem. If a child or young adult survives a moderate or severe brain injury, there is a strong likelihood of a lifetime of physical and mental impairment as well as tremendous economic and social impact on the family. The magnitude of this problem has only been recently appreciated, yet many questions on the causes and short- or long-term outcomes remain unanswered. One conclusion is clear: prevention is the best solution, but information on the nature of the brain injury, exposure factors, and effectiveness of countermeasures is incomplete. We sought to summarize certain basic epidemiological data on brain injuries in infants, children, adolescents, and young adults as well as findings on incidence of brain injury and current data on demographics and risk factors. We also estimated disability and person-years of life lost from brain injuries and highlight the value of helmets as a countermeasure for several exposures to head injury.

Accident Prevention↗