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Biomedical subjects

Mark R Stevenson

Publications and source records attributed to Mark R Stevenson.

11 recordsLinked to original sources

The prevalence of, and factors associated with, serious crashes involving a distracting activity.

The study's objectives were to determine the prevalence and types of distracting activities involved in serious crashes, and to explore the factors associated with such crashes. We interviewed 1367 drivers who attended hospital in Perth, Western Australia between April 2002 and July 2004 following a crash. A structured questionnaire was administered to each driver and supplementary data were collected from ambulance and medical records. Over 30% of drivers (433, 31.7%) cited at least one distracting activity at the time of crashing and driver distraction was reported to have contributed to 13.6% of all crashes. The major distracting activities were conversing with passengers (155, 11.3%), lack of concentration (148, 10.8%) and outside factors (121, 8.9%). Using logistic regression, a distracting activity at the time of a crash was significantly more likely among drivers with shorter driving experience (0-9 years, 38.3% versus >or=30 years, 21.0%, p<0.001). Distracting activities at the time of serious crashes are common and can cause crashes, and the types of activities reported are varied. Increased driver awareness of the adverse consequences of distracted driving with a focus on novice drivers, enforcement of existing laws (e.g. those requiring a driver to maintain proper control of a vehicle), and progress on engineering initiatives (such as collision warning systems) are needed to reduce injury.

Accidents, Traffic↗

Injury profiles of Indigenous and non-Indigenous people in New South Wales.

OBJECTIVES: To compare the injury profiles of the Indigenous population in New South Wales with that of the non-Indigenous population. DESIGN AND SETTING: Descriptive analysis of NSW Health data obtained from the Health Outcomes Information and Statistical Toolkit (HOIST) database. Hospitalisation data were collected for the period 1 July 1999 to 30 June 2003. Mortality data were collected for the period 1 January 1999 to 31 December 2002. MAIN OUTCOME MEASURES: Hospitalisation and death rates due to injury by age, sex, injury mechanism and Indigenous status. Rate ratios for comparison between Indigenous and non-Indigenous populations. RESULTS: Rates of death from injury were higher for all age groups in the Indigenous population, except people older than 65 years. Indigenous people aged 25-44 years were twice as likely to be hospitalised as their non-Indigenous counterparts (rate ratio [RR], 2.09; 95% CI, 2.03-2.14), and five times as likely to be hospitalised for interpersonal violence (RR, 5.19; 95% CI, 4.98-5.40). CONCLUSION: The higher rates of injury-related hospitalisation and death in the Indigenous population in NSW are consistent with data reported for other parts of Australia. Of particular concern is the number of Indigenous deaths and hospitalisations due to interpersonal violence.

Accidental Falls↗

Estimating population-based injury prevention practices.

This study piloted a survey suitable to generate statewide prevalence estimates for injury prevention practices and/or behaviours. A number of prevalence estimates of injury prevention practices and/or behaviours were generated in the pilot. For example, the prevalence of a household smoke alarm was high (732/1000 households) and yet only 44% of households had tested the functionality of the alarm in the 12 months preceding the survey. Findings of this kind point to an increasing need for primary care practitioners to play a leading role in targeting preventive strategies for injury. In addition, the survey methods and approach highlight the value of such information to health departments and non-government agencies in terms of targeting priority injury risk behaviours and the evaluation of injury-related intervention programmes. The survey has been designed so the methods can be applied nationally and internationally.

Adult↗

Role of mobile phones in motor vehicle crashes resulting in hospital attendance: a case-crossover study.

OBJECTIVES: To explore the effect of drivers' use of mobile (cell) phones on road safety. DESIGN: A case-crossover study. SETTING: Perth, Western Australia. PARTICIPANTS: 456 drivers aged > or = 17 years who owned or used mobile phones and had been involved in road crashes necessitating hospital attendance between April 2002 and July 2004. MAIN OUTCOME MEASURE: Driver's use of mobile phone at estimated time of crash and on trips at the same time of day in the week before the crash. Interviews with drivers in hospital and phone company's records of phone use. RESULTS: Driver's use of a mobile phone up to 10 minutes before a crash was associated with a fourfold increased likelihood of crashing (odds ratio 4.1, 95% confidence interval 2.2 to 7.7, P < 0.001). Risk was raised irrespective of whether or not a hands-free device was used (hands-free: 3.8, 1.8 to 8.0, P < 0.001; hand held: 4.9, 1.6 to 15.5, P = 0.003). Increased risk was similar in men and women and in drivers aged > or = 30 and < 30 years. A third (n = 21) of calls before crashes and on trips during the previous week were reportedly on hand held phones. CONCLUSIONS: When drivers use a mobile phone there is an increased likelihood of a crash resulting in injury. Using a hands-free phone is not any safer.

Accidents, Traffic↗

Evaluating the effectiveness of a participatory ergonomics approach in reducing the risk and severity of injuries from manual handling.

Manual handling is the greatest contributor to non-fatal injury and disease in the workplace, commonly accounting for one-third of national injury counts. Interventional strategies that have focused on selecting or modifying the worker have been ineffective in reducing injury risk. In recent times, participatory ergonomics has been widely adopted as a process to reduce the risk of injury from manual handling but it is not well validated as an intervention. This study evaluated the effectiveness of a participatory ergonomics risk assessment approach in reducing the rate and severity of injuries from manual and non-manual handling sustained by a cohort of 137 cleaners within a hospital setting. The date of injury and the workers' compensation claim cost and hours lost from work were obtained for each injury incurred during the 4-year pre-intervention and 3-year intervention period. The age, gender and hours worked were ascertained for every cleaner whether injured or not. Using generalized linear mixed modelling analysis, reductions of rate of injury by two-thirds, workers' compensation claim costs by 62% and hours lost by 35% for manual handling injuries were found to be associated with the intervention period. Although the cleaners experienced a significant intervention period reduction in non-manual handling injury rate, the corresponding changes in severity of injury were not significant. The success of the intervention supports the adoption of a participatory ergonomics approach in reducing the rate and consequence of injuries in the workplace.

Adult↗

Modelling bivariate count series with excess zeros.

Bivariate time series of counts with excess zeros relative to the Poisson process are common in many bioscience applications. Failure to account for the extra zeros in the analysis may result in biased parameter estimates and misleading inferences. A class of bivariate zero-inflated Poisson autoregression models is presented to accommodate the zero-inflation and the inherent serial dependency between successive observations. An autoregressive correlation structure is assumed in the random component of the compound regression model. Parameter estimation is achieved via an EM algorithm, by maximizing an appropriate log-likelihood function to obtain residual maximum likelihood estimates. The proposed method is applied to analyze a bivariate series from an occupational health study, in which the zero-inflated injury count events are classified as either musculoskeletal or non-musculoskeletal in nature. The approach enables the evaluation of the effectiveness of a participatory ergonomics intervention at the population level, in terms of reducing the overall incidence of lost-time injury and a simultaneous decline in the two mean injury rates.

Accidents, Occupational↗

Childhood drowning: barriers surrounding private swimming pools.

OBJECTIVE: To investigate the causes of child drowning and determine the need for changes in the legislation as well as improvements to the inspection and enforcement of current legislation related to barriers surrounding private swimming pools. METHODS: There were 3 stages to the study: a retrospective review of coroner's data, an audit of swimming pool inspections, and in-depth interviews with swimming pool inspectors in Western Australia. The incidence of childhood drowning (per population) and compliance rates of swimming pools (per 1000 swimming pools) to the legislation were measured. RESULTS: During the 12-year observational period (1988-2000) 50 children younger than 5 years drowned in private swimming pools in Western Australia with an overall incidence of drowning of 4.4 per 100 000 children per year. Sixty-eight percent of drownings occurred in pools that did not have 4-sided fencing with an almost 2-fold increased risk (incidence rate ratio: 1.78; 95% confidence interval: 1.40-1.79) of a child's drowning in a swimming pool with 3-sided versus 4-sided fencing. The compliance rate of swimming pools (compliance to the current legislation) at first inspection was approximately 400 per 1000 swimming pools. CONCLUSIONS: Almost two thirds of the swimming pools in which children drowned had only 3-sided fencing. With a combination of a change in legislation, enhanced inspection processes, and public education, the incidence of drowning in private swimming pools in Western Australia could be reduced in the coming years.

Architectural Accessibility↗

Modeling young driver motor vehicle crashes: data with extra zeros.

Much of the data collected on motor vehicle crashes is count data. The standard Poisson regression approach used to model this type of data does not take into account the fact there are few crash events and hence, many observed zeros. In this paper, we applied the zero-inflated Poisson (ZIP) model (which adjusts for the many observed zeros) and the negative binomial (NB) model to analyze young driver motor vehicle crashes. The results of the ZIP regression model are comparable to those from fitting a NB regression model for general over-dispersion. The findings highlight that driver confidence/adventurousness and the frequency of driving prior to licensing are significant predictors of crash outcome in the first 12 months of driving. We encourage researchers, when analyzing motor vehicle crash data, to consider the empirical frequency distribution first and to apply the ZIP and NB models in the presence of extra zeros due, for example, to under-reporting.

Accidents, Traffic↗

Phone use and crashes while driving: A representative survey of drivers in two Australian states.

OBJECTIVE: To explore the use and effects of using mobile phones while driving. DESIGN: Cross-sectional survey. SETTING: New South Wales and Western Australia, 20 October to 7 November 2003. PARTICIPANTS: 1347 licensed drivers aged 18 to 65 years. Data were weighted to reflect the corresponding driving population in each state. MAIN OUTCOME MEASURES: Mobile phone use while driving (hand-held, hands-free and text messaging); adverse effects of use. RESULTS: While driving, an estimated 57.3% +/- 1.5% of drivers have ever used a mobile phone and 12.4% +/- 1.0% have written text messages. Men, younger drivers and metropolitan residents were more likely to use a phone while driving and to report a higher frequency of use. Enforcement of hand-held phone restrictions was perceived to be low (69.0% +/- 1.5%) and an estimated 39.4% +/- 2.1% of people who phone while driving use a hand-held phone. Half of all drivers (50.1% +/- 1.6%) did not agree with extending the ban to include hands-free phones. Among drivers aged 18-65 years in NSW and WA, an estimated 45 800 +/- 16 466 (0.9% +/- 0.3%) have ever had a crash while using a mobile phone and, in the past year, 146 762 +/- 26 856 (3.0% +/- 0.6%) have had to take evasive action to avoid a crash because of their phone use. CONCLUSIONS: Phone use while driving is prevalent and can result in adverse consequences, including crashes. Despite legislation, a significant proportion of drivers continue to use hand-held mobile phones while driving. Enhanced enforcement is needed.

Accidents, Traffic↗