A Systematic Review of the Risks of Motor Vehicle Crashes Associated with Psychiatric Disorders

Differences in shift and work-related patterns between metropolitan and regional/rural healthcare shift workers and the occupational health and safety risks

OBJECTIVES

To explore if there are differences in shift patterns and work-related factors between metropolitan and regional/rural healthcare shift workers and their risk of poor sleep and mental health. Furthermore, explore whether these factors impact on medical errors, workplace and car/near car accidents.

DESIGN

A cross-sectional study.

SETTING

An anonymous online survey of healthcare shift workers in Australia.

PARTICIPANTS

A total of 403 nurses, midwives and paramedics completed the survey.

MAIN OUTCOME MEASURES

Sample characteristics, employment location, shift work-related features, sleep and mental health measurements, workplace accidents, medical errors and car/near car accident post shift.

RESULTS

Regional/rural healthcare shift workers were significantly older, had more years' experience, worked more nights, on-call and hours per week. Those in metropolitan areas took significantly longer (minutes) to travel to work, had higher levels of anxiety, increased risk of shift work disorder, reported significantly more workplace accidents and were more likely to have a car/near car accident when commuting home post shift. Both groups reported ~25% having a medical error in the past year. Workplace accidents were related to more on-call shifts and poor sleep quality. Medical errors were associated with fewer years' experience, more evening shifts and increased stress. Car accidents were associated with metropolitan location and increased depression.

CONCLUSION

Differences in work-related factors between metropolitan and regional/rural healthcare shift workers were observed. Some of these factors contributed to occupational health and safety risks. Further exploration is needed to understand how to reduce occupational health and safety risks, and improve employee and patient safety both in both regional/rural and metropolitan areas.

Subjective and Objective Improvement in a 39-Year-Old Male Suffering From Severe Chronic Pain and Disability Using Chiropractic BioPhysics® Protocols Following Rear-Impact Motor Vehicle Crash With a 10-Month Long-Term Follow-Up

We present the case of a patient receiving structural rehabilitation following a rear-impact motor vehicle collision (MVC). Medications did not alleviate the symptoms of the crash injuries. Resolution of injury-caused pain and disability was found following postural and structural rehabilitation treatment. A 39-year-old male was injured in a rear-impact collision between two very large vehicles. Severe migraine headaches, neck pain, and radiculopathy, as well as lower back pain, were the result of the crash. Patient-reported outcomes (PROs) demonstrated that the symptoms were causing severe disability and poor health-related quality of life (HRQoL) measures. Radiographs found spine alignment abnormalities consistent with rear impact MVC. Chiropractic Biophysics® (CBP®) structural rehabilitation was performed. Following a treatment regimen involving strengthening weakened and damaged muscles, postural and spinal traction, postural spinal manipulative therapy (SMT), and home therapies resulted in the resolution of the symptoms. All outcome measures demonstrated improvement, including Short-Form 36 question health questionnaire (SF-36), quadruple visual analog scale (QVAS), headache disability index (HDI), neck disability index (NDI), revised Oswestry disability index (RODI), as well as significant measured improvements found on radiographs. Spine pain and altered alignment are frequent results of MVCs. If left uncorrected, these abnormalities increase the likelihood of chronic pain and disability. Combined low back pain (LBP), neck pain (NP), headache (HA), and radiculopathy, as found in our subject, significantly pre-dispose the individual to poor HRQoL, years lived with disability (YLDs) and increased the global burden of disease (GBD). Physicians who treat injured patients should have a repeatable, reliable, valid, and efficacious method to reduce pain, increase range of motion (ROM), improve spine alignment, and improve the performance of activities of daily living (ADLs). Further, larger studies of injured patients are necessary to determine if the CBP® protocol reduces GBD caused by MVC injuries.