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PubMedDate not supplied

Use of mouthguards and headgear in organized sports by school-aged children.

Sports-related orofacial trauma is a serious problem that can be prevented by wearing protective mouthguards and headgear. While this equipment is available, few studies have been done of wearing practices. This study assesses the wearing practices using data from the Child Health Supplement of the 1991 National Health Interview Survey. Results indicate that football was the only sport in which the majority of children used mouthguards and headgear. While statistically significant differences (p<.05) were found in use of the equipment in all sports by grade level, gender, parent's education, ethnicity, and by region of the the country, these differences were not consistent across sports. Healthy People 2000 calls for extending requirements for use of orofacial protective devices to all organizations sponsoring sports that pose risk to injury. Given the complex nature of the findings, multifaceted initiatives that include the promulgation of rules must be developed and tested to determine what approaches are effective in ensuring consistent use.

Adolescent↗

PubMed1997

Effects of weight and center of gravity location of head-supported devices on neck loading.

A comprehensive study of the effect of Head-Supported Devices (HSDs) on neck loading during helicopter accidents is presented. The new Articulated Total Body (ATB) model which treats the neck as a deformable segment was used for crash simulation. Different categories of human and manikin subjects were considered under several crash scenarios. Simulations were theoretically designed to include a wide range of HSDs by changing their weights and center of gravity (CG) locations relative to the head, and studying the effects of these changes. Since HSDs were only theoretically included in the model, detachment of specific detachable devices used in most military applications was not modeled in the study. Hence, two typical detachable devices were modeled and selected simulations were repeated and compared not only to provide a measure of accuracy for the original results but also to see the effect of separation of these devices from the helmet.

Accidents, Aviation↗

PubMed2002

The avoidability of head and neck injuries in ice hockey: an historical review.

The number of minor traumatic brain injury (mTBI), cerebral concussions, is increasing and cannot be eliminated by any kind of equipment. Prevention strategies, such as the introduction of "checking from behind" rules have become effective in decreasing the number of severe spinal injuries. A new "head checking" rule should reduce mTBI in the same way in the following years. Mouthguards should be mandatory as an effective device for the prevention of dental and orofacial injuries, as well as reducing the incidence and severity of mTBI. A new internet database system, the International Sports Injury System (ISIS) should improve epidemiological analysis of head, face, and spinal injuries worldwide. ISIS should provide an internationally compatible system for continuous monitoring of risk factors, protective effects of equipment, and protective effects of equipment and effects of changes in rules through the years.

Craniocerebral Trauma↗

PubMed1975

Effects of a welding helmet and dust respirators on respiration at rest and during exercise.

The influence of welders' protective devices on respiration at rest and during exercise was studied under laboratory conditions. During exercise the devices caused increased ventilation and increased arterial carbon dioxide tension. In the case of the welding helmet the increase was probably a consequence of increased dead space. It is concluded that the physiological affects on respiration are of minor importance in themselves, but they should be taken into account when the degree of exposure to welding fumes is evaluated.

Adult↗

PubMed2001

Mild hypothermia induced by a helmet device: a clinical feasibility study.

STUDY OBJECTIVE: To test the feasibility and the speed of a helmet device to achieve the target temperature of 34 degrees C in unconscious after out of hospital cardiac arrest (CA). METHODS: Patients with cardiac arrest due to asystole or pulseless electrical activity (PEA) who remained unconscious after restoration of spontaneous circulation (ROSC) were enrolled in the study and randomised into two groups: a normothermic group (NG) and a hypothermic group (HG). Bladder and tympanic temperature were monitored every 15 min. A helmet device was used to induce mild hypothermia in the HG. Later on, the effect of mild hypothermia on the haemodynamics, electrolytes, lactate, arterial pH, CaO2, CvO2 and O2 extraction ratio were analysed and compared to the values obtained from the NG. RESULTS: Thirty patients were eligible for the study, 16 were randomised into the HG and 14 were randomised into the NG. The median tympanic temperature at admission in both groups was 35.5 degrees C (range: 33.3-38.5 degrees C) and the median tympanic temperature after haemodynamic stabilisation was 35.7 degrees C (range: 33.6-38.2 degrees C). In the HG, the core and the central target temperature of 34 degrees C were achieved after a median time of 180 and 60 min, respectively after ROSC. At the start of the study, no significant differences between the NG and HG were seen. At the end of the study, lactate concentration and O2 extraction ratio were significantly lower in the HG; however the CvO2 was significantly lower in the NG. CONCLUSIONS: Mild hypothermia induced by a helmet device was feasible, easy to perform, inexpensive and effective, with no increase in complications.

Body Temperature↗

PubMed1976

Chrome alloy welding fume study.

Breathing zone samples obtained at a production arc welding operation employing approximately 90 welders demonstrated excessive exposure to chromium from the welding of high chromium alloy steel. Breathing zone samples were collected inside welding helmets. Methods considered for reducing employee exposure included local exhaust ventilation and the use of air-supplied helmets. Air-supplied helmets were chosen as best suited for the production scheme and suitable devices were subsequently developed that reduced breathing zone contaminant levels well below applicable standards.

Air Pollutants↗

PubMed1998

Fatalities from non-use of seat belts and helmets in Greece: a nationwide appraisal. Hellenic Road Traffic Police.

It has been established that seat belt use by car occupants and helmet use by motorcycle riders substantially reduces the risk of serious and fatal injuries following accidents. No study, however, has evaluated the motor vehicle deaths that could be prevented in Greece by general use of these devices, even though this country has the highest mortality from motor vehicle accidents in the European Union. We have estimated the odds ratios (OR) for death rather than injury in a motor vehicle accident by seat belt use among occupants of passenger cars or helmet use among motorcycle riders, using a nationwide database in which persons killed or injured in road traffic accidents in 1985 and 1994 were recorded. The study base included 910 dead and 19,511 injured persons for 1985 and 1203 dead and 22,186 injured persons for 1994. The OR and 95% confidence intervals (CI) for death rather than injury was 0.69 (CI: 0.58 to 0.81, p < 10(-5)) for seat belt users versus non-users and 0.64 (CI: 0.51 to 0.81; p < 10(-3)) for helmet users versus non-users. There was evidence that the protective effect of these passive safety devices increased from 1985 to 1994 probably reflecting technological improvements. The proportion of all deaths that could have been avoided if all car occupants used seat belts was estimated to 27%, whereas 38% of motorcycle deaths could have been avoided if all motorcycle riders used helmets. These proportions translate to about 500 deaths per year, mostly deaths among young men.

Accidents, Traffic↗

PubMed2001

The association between risk-taking behavior and the use of safety devices in adolescents.

The purpose of this research study was to measure the association between risk taking behavior in adolescents and their use of safety devices. The study focused on three safety devices: seat belts, motorcycle helmets, and bicycle helmets. This is a secondary data analysis using data from the Youth Risk Behavior Survey conducted by the Centers for Disease Control and Prevention. The results of this study indicate that risky behavior in adolescents is associated with their non-use of safety devices. In general, risky behavior was more associated with the non-use of seatbelts than the use of other safety devices. The results of this study suggest that a comprehensive approach to reducing risky behaviors in adolescent should be considered when planning injury prevention programs.

Adolescent↗

PubMed2004

Pressure on the face while in the prone position: ProneView versus Prone Positioner.

STUDY OBJECTIVE: To measure the surface pressure on the face of a patient placed in the prone position with the most commonly used prone positioning devices, a non-face-contoured positioner (PP) and a new face-contoured device (PV). DESIGN: Prospective, randomized comparison. SETTING: Operating room in an American academic medical center. SUBJECTS: 35 randomly recruited adult volunteers. INTERVENTIONS: Surface pressure on the face was measured in awake subjects placed in the prone position, with the head and neck in the position of most comfort, using both the PP and PV devices. MEASUREMENTS: Surface pressure was obtained using an array of small transducers imbedded in a thin cushion that was interfaced between the face and positioning device. The amount of extension or flexion of the head on the neck was estimated using an angular measurement of eye-ear line and horizontal line. MAIN RESULTS: The average surface pressure on the face was less with the PV than with the PP (21 +/- 3 mmHg vs. 27 +/- 5 mmHg; p < 0.0001). The number of areas where pressure exceeded 30 mmHg and 50 mmHg was lower for the PV than the PP (15 +/- 7.5 areas vs. 19 +/- 7.2 areas > 30 mmHg; p < 0.05; 5.2 +/- 3.3 areas vs. 9.0 +/- 5.0 areas > 50 mmHg; p < 0.0001). Pressure on the chin increased with extension of the head or neck (p < 0.05) with both devices. CONCLUSIONS: Surface pressure on the face in the prone position is 29% higher with the non-face-contoured PP than with the face-contoured PV. The number of areas on the face where the surface pressure is greater than 50 mmHg is 80% higher with the PP than the PV. Small degrees of head extension increases pressure on the chin. Both devices produce areas of pressure, typically over the chin, which may be associated with local skin damage. Keeping the head and neck in a non-flexed, non-extended position may minimize pressures.

Equipment Design↗

PubMedDate not supplied

Traffic-related injury prevention interventions for low-income countries.

Traffic-related injuries have become a major public health concern worldwide. However, unlike developed or high-income countries (HICs), many developing or low-income countries (LICs) have made very little progress towards addressing this problem. Lack of the progress in LICs is attributable, in part, to their economic situation in terms of their governments' lack of resources to invest in traffic safety, cultural beliefs regarding the fatalism of injuries, competing health problems particularly with the emergence of HIV/AIDS, distinctive traffic mixes comprising a substantial number of vulnerable road users for whom less research has been done, low literacy rates precluding motorists to read and understand road signs, and peculiar political situations occasionally predominated by dictatorship and non-democratic governments. How then can LICs tackle the challenge of traffic safety from the experiences of HICs without reinventing the wheel? This paper reviews selected interventions and strategies that have been developed to counter traffic-related injuries in HICs in terms of their effectiveness and their applicability to LICs. Proven and promising interventions or strategies such as seat belt and helmet use, legislation and enforcement of seat belt use, sidewalks, roadway barriers, selected traffic-calming designs (e.g., speed ramps/bumps), pedestrian crossing signs combined with clearly marked crosswalks, and public education and behavior modification targeted at motorists are all feasible and useable in LICs as evidenced by data from many LICs. While numerous traffic-related injury policy interventions and strategies developed largely in HICs are potentially transferable to LICs, it is important to consider country-specific factors such as costs, feasibility, sustainability, and barriers, all of which must be factored into the assessment of effectiveness in specific LIC settings. Almost all interventions and strategies that have been proven effective in HICs will need to be evaluated in LICs and particular attention paid to the effectiveness of enforcement measures. It behooves LIC governments, however, to ensure that only standard, approved safety devices like helmets are imported into their countries. Additionally, LICs may need to improvise and innovate in the traffic safety technology transfer.

Accidents, Traffic↗

PubMed2006

Continuous positive airway pressure with modified helmet for treatment of hypoxemic acute respiratory failure in infants and a preschool population: a feasibility study.

OBJECTIVE: To analyze the feasibility of using continuous positive airway pressure (CPAP) delivered via a modified helmet to treat children with hypoxemic acute respiratory failure. DESIGN: A single-center, prospective, clinical study. SETTING: Pediatric intensive care unit in a university hospital. PATIENTS: Fifteen consecutive children (from 1 month to 5 yrs of age) with hypoxemic acute respiratory failure (defined as Pao2/Fio2 <300). INTERVENTIONS: CPAP was delivered via a modified helmet (CaStar, Starmed, Italy) of reduced size, fastened by a device we call a "baby-body." The feasibility of CPAP with the helmet was the primary end point. The improvement of gas exchange was the secondary one. MEASUREMENTS AND MAIN RESULTS: Ten of 15 children had multiple organ failure. Nine of 15 children were </=1 yr old. The helmet was well tolerated by all the children. Additional sedation was provided to four patients. No children developed significant complications (skin lesion, gastric distension, conjunctivitis, epistaxis, or loss of invasive devices) or lethal, helmet-related events. Oxygenation improved above baseline after 2 hrs of CPAP with the helmet; no significant variation of hemodynamic variables was detected. CONCLUSIONS: The helmet is a suitable device for delivery of CPAP to infants and preschool children with hypoxemic acute respiratory failure. It was well tolerated and improved oxygenation.

Acute Disease↗

PubMed1999

Occupant injury protection in automobile collisions.

Modern technology has produced automotive vehicles that have become both a luxury and a necessity in modern civilization. They have become highly useful, even more varied in form and function, and capable of high speeds on crowded roadways. One unfortunate consequence is the high frequency of accidents and the greater severity of injuries when collisions do occur. In response, modern technology has produced a variety of safety and health features, devices and designs intended for better occupant protection on in high speed vehicles. Injury reduction has become a prime design objective, but there are residual risks, which, as technology evolves, require effective communication to those risk. There can be little risk avoidance behavior without awareness of the hazards and effective communication to the vehicle occupant, as to what could and should be done for self-protection. For example, one out of three drivers apparently fails to understand the function of head restraints, few understand the 'safe zone' posture required for air bags and many believe safety features should be adjusted only for comfort. Some of the current residual injury producing problems in occupant systems are specifically described here in order to illustrate what is needed in terms of both design remedies and health promotion activities.

Accidents, Traffic↗

PubMed1987

The prevention of injury secondary to motor vehicle accidents.

Motor vehicle accidents are a common cause of death for all age groups but are the most serious threat to life for patients aged one to 34 years. Major progress has been made in reducing these losses through improved highway design, improved laws, adjudication of laws controlling the drunk driver, and the advent of vehicle safety design standards. A federal law enacted in 1966 established the National Highway Traffic Safety Administration (NHTSA) and the Federal Motor Vehicle Safety Standards (FMVSS). Motor vehicles, particularly passenger cars, now provide effective protection for occupants because of vehicle safety design features required by the FMVSS. Safety belts are the single most effective safety device available and are required equipment in virtually all motor vehicles sold in the United States. Passive protection for nonusers of safety belts is rapidly improving with the availability of air bags and automatic belt systems, improved windshields, steering wheels, dashboards, and seats, and other vehicle crashworthiness features. Motorcyclists, bicyclists, and pedestrians are also provided with improved protection because of the FMVSS.

Accidents, Traffic↗

PubMed1993

Analysis of biomechanical and ergonomic aspects of the cervical spine in F-16 flight situations.

With the help of a biomechanical neck model, several normal postures of an F-16 pilot were analysed. Measurements of accelerations and head positions were obtained during four flights, including simulated air combat. With the help of a model, muscle forces and joint reaction forces in the neck were estimated. Although at the present stage of research results of calculations must be interpreted carefully, conclusions can be drawn with respect to sitting posture, head position and helmet devices. The backward inclined back rest of the F-16 chair decrease the lordosis of the cervical spine, resulting in reduced calculated forces in the lower cervical spine. In high load situations, calculated maximal forces are of the same order of magnitude as failure loads of vertebrae and estimations of maximum muscle forces. The calculated neck load is increased substantially by the helmet and helmet-mounted devices. This load can be reduced by lightening the helmet or shifting the centre of mass of the helmet backwards.

Acceleration↗

PubMed2003

Influence of seat foam and geometrical properties on BioRID P3 kinematic response to rear impacts.

As the primary interface with the human body during rear impact, the automotive seat holds great promise for mitigation of Whiplash Associated Disorders (WAD). Recent research has chronicled the potential influence of both seat geometrical and constitutive properties on occupant dynamics and injury potential. Geometrical elements such as reduced head to head restraint, rearward offset, and increased head restraint height have shown strong correlation with reductions in occupant kinematics. The stiffness and energy absorption of both the seating foam and the seat infrastructure are also influential on occupant motion; however, the trends in injury mitigation are not as clear as for the geometrical properties. It is of interest to determine whether, for a given seat frame and infrastructure, the properties of the seating foam alone can be tailored to mitigate WAD potential. Rear impact testing was conducted using three model year 2000 automotive seats (Chevrolet Camaro, Chevrolet S-10 pickup, and Pontiac Grand Prix), using the BioRID P3 anthropometric rear impact dummy. Each seat was distinct in construction and geometry. Each seat back was tested with various foams (i.e., standard, viscoelastic, low or high density). Seat geometries and infrastructures were constant so that the influence of the seating foams on occupant dynamics could be isolated. Three tests were conducted on each foam combination for a given seat (total of 102 tests), with a nominal impact severity of Delta V = 11 km/h (nominal duration of 100 msec). The seats were compared across a host of occupant kinematic variables most likely to be associated with WAD causation. No significant differences (p < 0.05) were found between seat back foams for tests within any given seat. However, seat comparisons yielded several significant differences (p < 0.05). The Camaro seat was found to result in several significantly different occupant kinematic variables when compared to the other seats. No significant differences were found between the Grand Prix and S-10 seats. Seat geometrical characteristics obtained from the Head Restraint Measuring Device (HRMD) showed good correlation with several occupant variables. It appears that for these seats and foams the head-to-head restraint horizontal and vertical distances are overwhelmingly more influential on occupant kinematics and WAD potential than the local foam properties within a given seat.

Accidents, Traffic↗

PubMed2004

Child and family safety device affordability by country income level: an 18 country comparison.

OBJECTIVE: To compare availability, urban price, and affordability of child/family safety devices between 18 economically diverse countries. DESIGN: Descriptive: urban price surveys by local safety organisations or shoppers. SETTING: Retail stores and internet vendors. MAIN OUTCOME MEASURES: Prices expressed in US dollars, and affordability measured by hours of factory work needed to buy a child safety seat, a belt-positioning booster seat, a child bicycle helmet, and a smoke alarm. RESULTS: Prices of child and family safety devices varied widely between countries but the variation for child safety seats and bicycle helmets did not relate strongly to country income. Safety devices were expensive, often prohibitively so, in lower income countries. Far more hours of factory work were required to earn a child safety device in lower income than middle income, and middle income than higher income, countries. A bicycle helmet, for example, cost 10 hours of factory work in lower income countries but less than an hour in higher income countries. Smoke alarms and booster seats were not available in many lower income countries. CONCLUSIONS: Bicycles and two-axle motor vehicles were numerous in lower and middle income countries, but corresponding child safety devices were often unaffordable and sometimes not readily available. The apparent market distortions and their causes merit investigation. Advocacy, social marketing, local device production, lowering of tariffs, and mandatory use legislation might stimulate market growth. Arguably, a moral obligation exists to offer subsidies that give all children a fair chance of surviving to adulthood.

Child↗

PubMed2005

Preventing head and neck injury.

A wide range of head and neck injury risks are present in sport, including catastrophic injury. The literature since 1980 on prevention of head and neck injury in sport was reviewed, focusing on catastrophic and brain injury and identifying the range of injury prevention methods in use. There have been few formal evaluations of injury prevention methods. Approaches that are considered, or have been proven, to be successful in preventing injury include: modification of the baseball; implementation of helmet standards in ice hockey and American football and increased wearing rates; use of full faceguards in ice hockey; changes in rules associated with body contact; implementation of rules to reduce the impact forces in rugby scrums. Helmets and other devices have been shown to reduce the risk of severe head and facial injury, but current designs appear to make little difference to rates of concussion. Research methods involving epidemiological, medical, and human factors are required in combination with biomechanical and technological approaches to reduce further injury risks in sport.

Athletic Injuries↗

PubMed2000

Study for verification testing of the helmet-mounted display in the Japanese Experimental Module.

Our purpose is to propose a research and development project in the field of telemedicine. The proposed Multimedia Telemedicine Experiment for Extra-Vehicular Activity will entail experiments designed to support astronaut health management during Extra-Vehicular Activity (EVA). Experiments will have relevant applications to the Japanese Experimental Module (JEM) operated by National Space Development Agency of Japan (NASDA) for the International Space Station (ISS). In essence, this is a proposal for verification testing of the Helmet-Mounted Display (HMD), which enables astronauts to verify their own blood pressures and electrocardiograms, and to view a display of instructions from the ground station and listings of work procedures. Specifically, HMD is a device designed to project images and data inside the astronaut's helmet. We consider this R&D proposal to be one of the most suitable projects under consideration in response to NASDA's open invitation calling for medical experiments to be conducted on JEM.

Data Display↗