Last data update: May 13, 2024. (Total: 46773 publications since 2009)
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Head injuries (TBI) to adults and children in motor-vehicle crashes
Viano DC , Parenteau CS , Xu L , Faul M . Traffic Inj Prev 2017 18 (6) 0 PURPOSE: This is a descriptive study. It determined the annual, national incidence of head injuries (TBI) to adults and children in motor-vehicle crashes. It evaluated NASS-CDS (National Automotive Sampling System-Crashworthiness Data System) for exposure and incidence of various head injuries in towaway crashes. It evaluated three health databases for emergency department (ED) visits, hospitalizations and deaths due to TBI in motor-vehicle occupants. METHODS: Four databases were evaluated using 1997-2010 data on adult (15+ years old) and child (0-14 years old) occupants in motor-vehicle crashes: 1) NASS-CDS estimated the annual incidence of various head injuries and outcomes in towaway crashes, 2) NHAMCS (National Hospital Ambulatory Medical Care Survey) estimated ED visits for TBI, 3) NHDS (National Hospital Discharge Survey) estimated hospitalizations for TBI and 4) NVSS (National Vital Statistics System) estimated TBI deaths. The four databases provide annual, national totals for TBI related injury and death in motor-vehicle crashes based on differing definitions with TBI coded by AIS in NASS-CDS and by ICD in the health data. RESULTS: Adults: NASS-CDS had 16,980 +/- 2,411 (risk = 0.43% +/- 0.06%) with severe head injury (AIS 4+) out of 3,930,543 exposed adults in towaway crashes, annually. There were 49,881 +/- 9,729 (risk = 1.27% +/- 0.25%) hospitalized with AIS 2+ head injury, without death. There were 6,753 +/- 882 (risk = 0.17% +/- 0.02%) fatalities with a head injury cause. The public health data had 89,331 +/- 6,870 ED visits, 33,598 +/- 1,052 hospitalizations and 6,682 +/- 22 deaths with TBI. NASS-CDS estimated 48% more hospitalized with AIS 2+ head injury without death than NHDS occupants hospitalized with TBI. NASS-CDS estimated 29% more deaths with AIS 3+ head injury than NVSS occupant TBI deaths, but only 1% more deaths with a head injury cause. Children: NASS-CDS had 1,453 +/- 318 (risk = 0.32% +/- 0.07%) with severe head injury (AIS 4+) out of 454,973 exposed children, annually. There were 2,581 +/- 683 (risk = 0.57% +/- 0.15%) hospitalized with AIS 2+ head injury, without death. There were 466 +/- 132 (risk = 0.10% +/- 0.03%) fatalities with a head injury cause. The public health data had 19,251 +/- 2,803 ED visits, 3,363 +/- 255 hospitalizations and 488 +/- 6 deaths with TBI. NASS-CDS estimated 24% fewer hospitalized children with AIS 2+ head injury without death than NHDS hospitalization with TBI. NASS-CDS estimated 31% more deaths with AIS 3+ head injury than NVSS child deaths, but 5% fewer deaths with a head injury cause. CONCLUSIONS: The annual, national incidence of motor-vehicle related head injury (TBI) was estimated using 1997-2010 NASS-CDS from the Department of Transportation and NHAMCS (ED visits), NHDS (hospitalizations) and NVSS (deaths) from the Department of Health and Human Services. The transportation and health databases use different definitions and coding, which complicate direct comparisons. Future work is need where ICD to AIS translators are used if comparisons of serious head injuries in NASS and health datasets are to be made. |
Motor vehicle injury prevention
Sleet DA , Viano DC , Dellinger A . Oxford Bibliographies, Public Health 2013 One hundred years after the first self-propelled vehicle was invented, the world’s first recorded traffic death occurred when Mary Ward was thrown from the passenger seat of her cousin’s steam-powered car and rolled underneath the vehicle traveling 3-4 mph in Ireland on August 31, 1869. The first traffic fatality in the United States reportedly occurred in New York City in 1899 when Henry H. Bliss stepped off a streetcar and was struck by a passing electric-powered taxicab at the corner of Central Park West and 74th Street. By 1900 the yearly traffic death toll in the United States was up to thirty-six, and by 1972 a staggering 54,000 people were killed in traffic, and 2 million maimed. In 2009, traffic injuries were the leading cause of death of Americans aged 10–14, 15–19, and 20–24. The annual cost of motor vehicle–related fatal and nonfatal injuries is $99 billion in medical expenses and lost productivity, which is nearly the equivalent of $500 for each licensed driver in the United States. Motor vehicle travel is the most common form of transportation in the United States, although pedestrians, motorcyclists, and bicyclists are also injured in traffic. The number of registered automobiles in the United States grew from 8,000 in 1900 to 250 million in 2010, yet deaths per 100 million vehicle miles traveled actually declined by 77 percent between 1966 and 2010. Advances in the safety of vehicles, improved roads, and changes in driver behavior have led to this improvement. The conceptualization of this approach was fostered by William Haddon Jr., who developed models for exploring countermeasures to reduce or prevent injuries involving elements in the causal sequence related to the host (driver and passenger), agent (vehicle), and environment (roads and highways). Still, in 2009, the United States lost 33,808 people in traffic crashes. The major risk factors include non-use of seat belts and child restraints, alcohol, speed, non-use of helmets, and distracted driving. According to Rumar (The role of perceptual and cognitive filters in observed behavior, in Human behavior and traffic safety, Edited by L. Evans and R. Schwing. New York: Plenum, 1985) only 3 percent of crashes are due solely to the roadway environment, 2 percent solely to vehicles, and 27 percent to the combination of road environment and drivers. Globally, 1.3 million people die each year from road traffic injuries, or about 3,000 each day. Around 90 percent of those deaths occur in low- and middle-income countries. By 2020, traffic-related injuries will be the third leading contributor to the global burden of disease and injury, up from the eighth leading cause in 2009. This article describes the science of motor vehicle injury prevention and control, and identifies resources on the history, development, and application of principles of injury control to reduce traffic injury. |
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