Research on safety supervision and management system of China railway based on association rule and DEMATEL

Safety management is a key issue in the railroad industry that needs to be continuously focused on. And it is essential to study causes of accidents for preventing accidents. However, there is a limited academic discussion on the systematic study of organizations and accidents, as well as their safety-related interactions and accidents, as opposed to human-caused disasters. Thus, the model of China's railway safety supervision and management system by sorting out the existing organizations involved in management in China is established in this paper. Firstly, social forces and auxiliary enterprises are specifically added to the model. And then, the relationship between organizations and accidents, as well as the relationship between safety interactions among organizations and accidents are explored by analyzing 224 accident reports, which led to 4 principles for accident prevention. Finally, based on these principles, measures to secure organizational nodes, as well as measures to promote safe interactions among organizations are proposed. The results showed that: (1) China Railway node is not only the most critical node in the safety supervision and management system but also the most vulnerable to the influence of other nodes. (2) The accident occurred due to the simultaneous occurrence of an accident at the China Railway node and the social force node. (3) When there are often safety risks in auxiliary enterprises and social forces simultaneously, the government's management is likely to be defective. The findings in this study can provide helpful references not only for improvement of safety management system structure and supervision and management mechanism but also for the formulation of safety supervision and management policies in China and other countries.

Educational technologies for accident prevention due to falls in childhood: a scoping review

OBJECTIVES

to map evidence on educational technology use for accident prevention due to falls in childhood.

METHODS

a scoping review, carried out in October and November 2022, in the MEDLINE, Web of Science, BDENF and CINAHL databases and LILACS bibliographic index. There was no delimitation of language or time. Data were extracted and analyzed descriptively by two independent researchers. The research protocol was registered in the Open Science Framework.

RESULTS

twenty-six studies were selected. Booklets, pamphlets and leaflets were the most used technologies, presenting health services as the most frequent environment to develop research on fall prevention. The technologies developed were important outcomes: increased knowledge of children, family members, caregivers, health and education professionals.

CONCLUSIONS

educational technology use makes it possible to increase knowledge, adopt safe practices and reduce falls.

Evaluating the citywide Edinburgh 20mph speed limit intervention effects on traffic speed and volume: A pre-post observational evaluation

OBJECTIVES

Traffic speed is important to public health as it is a major contributory factor to collision risk and casualty severity. 20mph (32km/h) speed limit interventions are an increasingly common approach to address this transport and health challenge, but a more developed evidence base is needed to understand their effects. This study describes the changes in traffic speed and traffic volume in the City of Edinburgh, pre- and 12 months post-implementation of phased city-wide 20mph speed limits from 2016-2018.

METHODS

The City of Edinburgh Council collected speed and volume data across one full week (24 hours a day) pre- and post-20mph speed limits for 66 streets. The pre- and post-speed limit intervention data were compared using measures of central tendency, dispersion, and basic t-tests. The changes were assessed at different aggregations and evaluated for statistical significance (alpha = 0.05). A mixed effects model was used to model speed reduction, in the presence of key variables such as baseline traffic speed and time of day.

RESULTS

City-wide, a statistically significant reduction in mean speed of 1.34mph (95% CI 0.95 to 1.72) was observed at 12 months post-implementation, representing a 5.7% reduction. Reductions in speed were observed throughout the day and across the week, and larger reductions in speed were observed on roads with higher initial speeds. Mean 7-day volume of traffic was found to be lower by 86 vehicles (95% CI: -112 to 286) representing a reduction of 2.4% across the city of Edinburgh (p = 0.39) but with the direction of effect uncertain.

CONCLUSIONS

The implementation of the city-wide 20mph speed limit intervention was associated with meaningful reductions in traffic speeds but not volume. The reduction observed in road traffic speed may act as a mechanism to lessen the frequency and severity of collisions and casualties, increase road safety, and improve liveability.

Human reliability analysis in de-energization of power line using HEART in the context of Z-numbers

Investigation reveals that a high percentage of incident causes are ascribed to some forms of human error. To effectively prevent incidents from happening, Human Reliability Analysis (HRA), as a structured way to represent unintentional operator contribution to system reliability, is a critical issue. Human Error Reduction and Assessment Technique (HEART) as a famous HRA technique, provides a straightforward method to estimate probabilities of human error based on the analysis of tasks. However, it faces varying levels of uncertainty in assigning of weights to each error producing condition (EPC), denoted as assessed proportion of affect (APOA), by experts. To overcome this limitation and consider the confidence level (reliability or credibility) of the experts, the current study aimed at proposing a composite HEART methodology for human error probability (HEP) assessment, which integrates HEART and Z-numbers short for, Z-HEART. The applicability and effectiveness of the Z-HEART has been illustrated in the de-energization power line as a case study. Furthermore, a sensitivity analysis is fulfilled to investigate the validity of the proposed methodology. It can be concluded that Z-HEART is feasible for assessing human error, and despite the methodological contributions, it offers many advantages for electricity distribution companies.

A study on ship collision conflict prediction in the Taiwan Strait using the EMD-based LSSVM method

Ship collision accidents are the primary threat to traffic safety in the sea. Collision accidents can cause casualties and environmental pollution. The collision risk is a major indicator for navigators and surveillance operators to judge the collision danger between meeting ships. The number of collision accidents per unit time in a certain water area can be considered to describe the regional collision risk However, historical ship collision accidents have contingencies, small sample sizes and weak regularities; hence, ship collision conflicts can be used as a substitute for ship collision accidents in characterizing the maritime traffic safety situation and have become an important part of methods that quantitatively study the traffic safety problem and its countermeasures. In this work, an EMD-QPSO-LSSVM approach, which is a hybrid of empirical mode decomposition (EMD) and quantum-behaved particle swarm optimization (QPSO) optimized least squares support vector machine (LSSVM) model, is proposed to forecast ship collision conflicts. First, original ship collision conflict time series are decomposed into a collection of intrinsic mode functions (IMFs) and a residue with EMD. Second, both the IMF components and residue are applied to establish the corresponding LSSVM models, where the key parameters of the LSSVM are optimized by QPSO algorithm. Then, each subseries is predicted with the corresponding LSSVM. Finally, the prediction values of the original ship collision conflict datasets are calculated by the sum of the forecasting values of each subseries. The prediction results of the proposed method is compared with GM, Lasso regression method, EMD-ENN, and the predicted results indicate that the proposed method is efficient and can be used for the ship collision conflict prediction.

Impact of adaptive cruise control (ACC) system on fatality and injury reduction in China

OBJECTIVES

The road traffic safety situation around the world is not optimistic. The development of intelligent vehicles has become an ideal way to reduce road traffic crashes. The adaptive cruise control (ACC) system is an effective intelligent vehicle active safety system for avoiding certain types of collisions. This study aimed to assess the safety benefits of ACC in China, including the potential maximum impact and realistic impact.

METHODS

This study applies a national-level safety impact evaluation model to assess the safety benefits of ACC in China, including the potential maximum impact and realistic impact. Road traffic fatality and severe injury trends in China, proportion of different collision types in China, effectiveness of collision avoidance, and market penetration rate of ACC are considered in the potential maximum impact scenario. Furthermore, the ACC activation rate and the technology's technical limitations, including its effectiveness in different weather, light, speed, and road conditions, are discussed in the realistic scenario.

RESULTS

With a 100% market penetration rate, fatalities could be reduced by 5.48%, and injuries could be reduced by 4.91%. With a large increase in market penetration rate of ACC in the coming future, the reductions in fatalities and severe injuries are 324-957 and 1,035-2,737 in 2025 and 531-1,579 and 1,604-4,242 in 2030. Considering ACC's activation rate and its 4 main limitations, the adjusted realistic result is approximately one-third of the potential maximum result.

CONCLUSIONS

The result clearly shows that the ACC system can improve road traffic safety in China. Technical limitations have a great impact on ACC's safety benefits. Of all of the limiting factors, the turn-on rate provides the most room for improvement, and improving the suitability of the ACC system on curved and sloped roads provides the smallest effect.

Effectiveness of front crash prevention systems in reducing large truck real-world crash rates

Objective: Forward collision warning (FCW) and automatic emergency braking (AEB) have the potential to prevent or mitigate many large truck crashes. While these systems are known to be effective in passenger vehicles, less is known about their effectiveness in large trucks. The objective of this study was to estimate the effectiveness of these systems in reducing real-world crash rates of large trucks.Methods: Data on Class 8 trucks operating on limited-access highways during 2017-2019 were obtained from SmartDrive Systems. Detailed data on exposure measures and crash circumstances were extracted from video footage by both automated means and manual coding. Crash rates were compared by front crash prevention technology (FCW, AEB, neither), both for all police-reportable crashes overall and for relevant crash types.Results: FCW was associated with a statistically significant 22% reduction in the rate of police-reportable crashes per vehicle miles traveled, and a significant 44% reduction in the rear-end crash rate of large trucks. AEB also was associated with significant reductions-12% overall and 41% for rear-end crashes. Warnings were issued in 31% of rear-end crashes for FCW-equipped trucks. AEB intervened in 43% of rear-end crashes; about two thirds of these interventions involved autobrake activations. On average, speed was reduced by over half between the time of the intervention and impact for both systems. Observed reductions in same-direction sideswipe and roadway departure crashes per mile traveled were smaller in magnitude than those of rear-end crashes; these were consistent with other crash avoidance technologies suspected to be bundled with FCW/AEB in some cases, and very few front crash prevention interventions occurred in these types of crashes.Conclusions: FCW and AEB are effective countermeasures for crashes in which large trucks rear-end other vehicles. Large truck safety is expected to improve as new trucks are increasingly equipped with these systems. FCW has the advantage that some of these systems can be retrofitted to existing trucks, so benefits can be realized sooner and with less investment.

Human error in motorcycle crashes: A methodology based on in-depth data to identify the skills needed and support training interventions for safe riding

OBJECTIVE

Human error by either rider or other vehicle driver is the primary contributing factor in crashes involving powered-two-wheelers. A human-factor-based crash analysis methodology is key to enhancing the road safety effectiveness of rider training interventions. Our aim is to define a methodology that uses in-depth data to identify the skills needed by riders in the highest risk crash configurations to reduce casualty rates.

METHODS

The methodology is illustrated through a case study using in-depth data of 803 powered-two-wheeler crashes. Seven types of high-risk crash configuration based on pre-crash trajectories of the road-users involved were considered to investigate the human errors as crash contributors. Primary crash contributing factor, evasive maneuvers performed, horizontal roadway alignment and speed-related factors were identified, along with the most frequent crash configurations and those with the greatest risk of severe injury.

RESULTS

Straight Crossing Path/Lateral Direction was the most frequent crash configuration and Turn Across Path/Opposing Direction was identified as that with the highest risk of serious injury. Multi-vehicle crashes cannot be considered as a homogenous category of crashes to which the same human failure is attributed, as different interactions between motorcyclists and other road users are associated with both different types of human error and different rider reactions. Human error in multiple-vehicle crashes differed between those configurations related to crossroads and those related to rear-end and head-end crashes. Both single-vehicle crashes and multi-vehicle head-on crashes frequently occur along curves. The involved collision avoidance maneuvers of the riders differed significantly among the highest risk crash configurations. The most relevant lack of skills are identified and linked to their most representative context. In most cases a combination of different skills was required simultaneously to avoid the crash.

CONCLUSIONS

The results contribute to understand the motorcyclists' responses in high-risk crash scenarios. The findings underline the need to group accident cases, beyond the usual single-vehicle versus multi-vehicle collision approach. The different interactions with other road users should be considered to identify the competencies of the motorcyclists needed to reduce crash risks. Our methodology can be applied to increase the motorcyclists' safety by supporting preventive actions based on riders' training and eventually ADAS design.

Fight or flight? Behaviour and experiences of laypersons in the face of an incipient fire

Within minutes, an incipient fire can develop into a life-threatening full fire. Consequently, it should be fought as early as possible. But are laypersons capable of doing this? In such a situation, how do they behave and feel? These questions are addressed in the current study. Persons without any professional firefighting training (N = 64) were confronted in two experimental runs with a real incipient fire in the form of a burning pillow. The results show that most participants were motivated and able to extinguish the fire successfully. However, most of them made a number of mistakes. Of central importance for extinguishing the fire was self-efficacy. Furthermore, participants improved greatly in the second round, especially regarding reaction time span and various psychological variables (e.g. stress, mood). Particularly on the basis of these exercise effects, we can derive a number of practical implications. Practitioner Summary: Laypersons are willing and able to successfully fight an incipient fire. Yet, their behaviour is not optimal and could lead to self-endangerment. Thus, it is critically important that people perform practical exercises as part of fire safety trainings and repeat them after some time. Abbreviatons: TPB: theory of planned behaviour; CIT: critical incident technique; MANOVA: multivariate analysis of variance.

Lethal Means Counseling, Distribution of Cable Locks, and Safe Firearm Storage Practices Among the Mississippi National Guard: A Factorial Randomized Controlled Trial, 2018-2020

Objectives. To examine whether lethal means counseling and provision of cable locks prompt safe firearm storage relative to control among firearm-owning members of the Mississippi National Guard.Methods. This randomized controlled trial utilized a 2 × 2 factorial design (lethal means counseling vs control, provision of cable locks vs no cable locks). Follow-up assessments took place at 3 and 6 months after baseline. Data were collected (n = 232; 87.5% male; mean age = 35.01 years; 77.2% White) from February 2018 through July 2020.Results. Relative to control, lethal means counseling and provision of cable locks resulted in greater adoption of several safe storage methods over time. Lethal means counseling outperformed control (3 months: 55.0% vs 39.0%; odds ratio [OR] = 1.91). Cable locks outperformed control at 3 and 6 months on number of storage methods (1.41 vs 1.11; d = 0.29 and 1.34 vs 1.16; d = 0.15, respectively) and locking devices (59.8% vs 29.9%; OR = 3.49 and 58.4% vs 35.8%; OR = 2.52, respectively)Conclusions. Lethal means counseling and cable locks can result in sustained changes in firearm storage.Public Health Implications. The military may benefit from lethal means counseling, perhaps administering at point of entry.Trial Registration. Clinical Trials.gov identifier: NCT03375099.

Analysis method for revealing human and organisational factors of occupational accidents with movement disturbance (OAMDs)

Slips, trips and other movement disturbances account for 20 to 30% of recorded occupational accidents (OAs). The causal representations of these accidents hamper their prevention. An analysis method dedicated to occupational accidents with movement disturbance (OAMDs) has been developed to change these representations. In France, the causal tree method (CTM) is very commonly used for analysing OAs. An initial version of an OAMD analysis method, which overcomes the problems encountered when analysing these accidents using the CTM, has been developed. This OAMD analysis method was reviewed by six targeted prevention officers and as a result some proposals have been discarded and this initial version has been transformed into three additional CTM modules. The purpose of these modules is to identify human and organisational factors and provide a formal representation of damage caused, beyond bodily injuries. Practitioner summary: A method for analysing occupational accidents triggered by a slip, a trip or any other movement disturbance has been developed in consideration of the practices and constraints in companies. In particular, this method allows us to highlight the human and organisational factors involved in the accident situation. Abbreviations: OA: occupational accident; OAMD: occupational accident with movement disturbance; CTM: causal tree method.

Severe Fireworks-Related Injuries: Demographic Characteristics, Injury Patterns, and Firework Types in 294 Consecutive Patients

OBJECTIVES

The relationship between fireworks and patient characteristics is not known. Our objective was to examine how severe fireworks-related injuries in children and teens compare to adults.

METHODS

We conducted a retrospective case series (2005-2015) study of patients who sustained consumer fireworks-related injuries requiring hospital admission and/or operation at a single level 1 trauma/burn center. The distribution of race, use behavior, injury type, body region injured, and firework type was examined by age groups, 1 to 10 years, 11 to 17 years, and 18 years or older.

RESULTS

Data from 294 patients 1 to 61 years of age (mean, 24 years) were examined. The majority (91%) were male. The proportion of injuries from different firework types varied by age, with rockets causing the highest proportion in children aged 1 to 10 years, homemade fireworks in those aged 11 to 17 years, and shells/mortars in adults 18 years or older. Compared with adults, children aged 1 to 10 years were more frequently American Indian/Alaska Native, Hispanic, or Asian than White. Compared with adults, children aged 1 to 10 years and 11 to 17 years were more frequently bystanders than active users. Compared with adults, children aged 1 to 10 years and 11 to 17 years had a greater proportion of burn and face injuries. Children aged 1 to 10 years had a decreased proportion of hand injuries. Three patients, 2 adults and 1 child aged 11 to 17 years, died.

CONCLUSIONS

Children, teens, and adults experience severe fireworks-related injuries differently, by demographic characteristics, injury patterns, and firework types. Tailored public health interventions could target safety messaging and injury prevention outreach efforts to reduce firework injuries among children and adolescents.

Hazard Perception and Prediction test for walking, riding a bike and driving a car: "Understanding of the global traffic situation"

To "put oneself in the place of other road users" may improve understanding of the global traffic situation. It should be useful enabling drivers to anticipate and detect obstacles in time to prevent accidents to other road users, especially those most vulnerable. We created a pioneering Hazard Perception and Prediction test to explore this skill in different road users (pedestrians, cyclists and drivers), with videos recorded in naturalistic scenarios: walking, riding a bicycle and driving a car. There were 79 participants (30 pedestrians, 14 cyclists, 13 novice drivers and 22 experienced drivers). Sixty videos of hazardous traffic situations were presented, divided into 2 blocks of 30 videos each: 10 walking, 10 riding a bicycle, 10 driving a car. In each situation presented, we evaluated the performance of the participants carrying out the task of predicting the hazard and estimating the risk. In the second block, after they had carried out the task, we gave them feedback on their performance and let them see the whole video (i.e., checking what happened next). The results showed that the holistic test had acceptable psychometric properties (Cronbach's alpha = .846). The test was able to discriminate between the different conditions manipulated: a) between traffic hazards recorded from different perspectives: walking, riding a bicycle and driving a car; b) between participants with different user profiles: pedestrians, cyclists and drivers; c) between the two test blocks: the first evaluation only and the second combining evaluation with this complex intervention. We found modal bias effects in both Hazard Perception and Prediction; and in Risk Estimation.

Management of the pregnant trauma patient in the emergency department

This supplement reviews the evidence regarding important considerations in pregnant trauma patients, including the primary and secondary survey as well as the possibility for Rh exposure, placental abruption, uterine rupture, and the need for a prompt perimortem cesarean section in the moribund patient. Because ionizing radiation is a concern in pregnancy, the circumstances in which benefits of testing outweigh risks to the fetus are discussed. Emergency clinicians are encouraged to advocate for trauma prevention, including proper use of safety restraints in motor vehicles and screening for domestic violence, as these measures have been shown to be effective in reducing morbidity and mortality in this patient population. Recommendations for monitoring, admission, discharge, and follow-up are also provided.

Association Between Characteristics of Injurious Falls and Fall Preventive Interventions in Acute Medical and Surgical Units

BACKGROUND

Hospital falls remain common and approximately 30% of falls in hospital result in injury. The aims of the study were the following: (i) to identify the association between fall interventions present at the time of the injurious fall and injurious faller characteristics and (ii) to identify the association between fall preventive interventions present at the time of the injurious fall and the injurious fall circumstances.

METHODS

Secondary data analysis of deidentified case series of injurious falls across 24 acute medical/surgical units in the United States. Variables of interest were falls prevention interventions (physical therapy, bed alarm, physical restraint, room change, or a sitter) in place at the time of fall. Data were analyzed using logistic regression and hazard ratios.

RESULTS

There were 1,033 patients with an injurious fall, occurrence peaked between Day 1 and Day 4, with 46.8% of injurious falls having occurred by Day 3 of admission. Injurious fallers with a recorded mental state change 24 hours prior to the fall were more likely to have a bed alarm provided (adjusted odds ratio [OR] 2.56, 95% confidence interval [CI] 1.61, 4.08) and receive a physical restraint as fall prevention interventions (adjusted OR 6.36, 95% CI 4.35, 9.30). Injurious fallers restrained fell later (stay Day 6) than those without a restraint (stay Day 4) (p = .007) and had significantly longer lengths of stay (13 days vs 9 days).

CONCLUSIONS

On medical/surgical units, injurious falls occur early following admission suggesting interventions should be commenced immediately. Injurious fallers who had a physical restraint as an intervention had longer lengths of stay.

Geometric road design factors affecting the risk of urban run-off crashes. A case-control study

Objective

Single vehicle run-off crashes in urban areas constitute a growing problem that deserves more attention from authorities and researchers. This study aims to detect geometric road design risk factors characterizing places where urban run-off crashes might happen.

Methods

A case-control study was performed in the urban area of Valladolid (Spain) with data corresponding to a four-year period. Logistic regression models were used to analyze data, considering different variables related to design parameters in the models: type of intersection, radius of curvature, width of the pavement, width of the traffic lane, number of lanes for traffic in the same direction, direction of the traffic, length of the previous straight section, distance to the previous traffic light, slope, and finally, priority regulation. Two different scenarios were investigated: intersections and curves.

Results

The Adjusted Odds-Ratio of a run-off crash was five times higher in double direction roads with median strip than in one-way urban roads, for both curves and intersections, and almost nine times higher on road sections with previous straight lengths greater than 500 meters. Specific risk factors for intersections are “number of lanes for traffic in the same direction” (the odds of a run-off crash are more than five times higher on a road with two or more lanes), “length of preceding straight section” (the odds on road sections with lengths greater than 500 meters are more than nine times that of road sections with a length of less than 150 meters). For curves, specific factors are “width of the traffic lane” (the odds of a run-off crash on curves with lanes wider than 3.75m are more than six times higher) and “priority regulation” (the odds of a run-off crash increases more than twelve times on road sections with traffic light regulation over those without any regulation).

Conclusions

The current study identifies urban road configurations that might require redesigning with the aim of decreasing the odds of a run-off crash, or the implementation of passive protective systems to mitigate their consequences. Specifically, intersections in two direction roads with median strip, more than two lanes per direction and a long preceding straight section, as well as curves with wide lanes and traffic light regulation, are the places that require attention.

An improved vehicle-pedestrian near-crash identification method with a roadside LiDAR sensor

PROBLEM

Potential conflicts between pedestrians and vehicles represent a challenge to pedestrian safety. Near-crash is used as a surrogate metric for pedestrian safety evaluations when historical vehicle-pedestrian crash data are not available. One challenge of using near-crash data for pedestrian safety evaluation is the identification of near-crash events.

METHOD

This paper introduces a novel method for pedestrian-vehicle near-crash identification that uses a roadside LiDAR sensor. The trajectory of each road user can be extracted from roadside LiDAR data via several data processing algorithms: background filtering, lane identification, object clustering, object classification, and object tracking. Three indicators, namely, the post encroachment time (PET), the proportion of the stopping distance (PSD), and the crash potential index (CPI) are applied for conflict risk classification.

RESULTS

The performance of the developed method was evaluated with field-collected data at four sites in Reno, Nevada, United States. The results of case studies demonstrate that pedestrian-vehicle near-crash events could be identified successfully via the proposed method. Practical applications: The proposed method is especially suitable for pedestrian-vehicle near-crash identification at individual sites. The extracted near-crash events can serve as supplementary material to naturalistic driving study (NDS) data for safety evaluation.

Cycling on the edge: the effects of edge lines, slanted kerbstones, shoulder, and edge strips on cycling behaviour of cyclists older than 50 years

To prevent single-bicycle crashes, this study is the first to evaluate effects of slanted kerbstones, edge lines, shoulder strips, and edge strips on cycling behaviour of cyclists ≥50 years. In Experiment 1, 32 participants cycled on a control path and paths with edge lines, slanted kerbstones, and three types of 0.5 m wide shoulder strips (with grey artificial grass, green artificial grass, or concrete street-print). In Experiment 2, 30 participants cycled a different route including a control path and paths with edge lines or 0.3 m white edge strips. Cyclists rode closer to the main cycle path's edge in the shoulder strips conditions, although the presence of these strips resulted in a larger total distance to the verge compared to the control condition. Furthermore, cyclists cycled further from the verge in the edge strip condition than the control condition. Safety implications of the shoulder and edge strips are considered to be positive. Practitioner Summary: Older cyclists have a high risk for single-bicycle crashes (e.g. riding into the verge). In two experiments, cyclists ≥50 years cycled a route where different treatments were applied on a cycle path. Shoulder and edge strip treatments were related to more efficient path use and safer distances from the verge. Abbreviations: AGS: artificial grass strip; CL: control location; CSS: concrete street-print strip; ELC: edge line continuous; ELI: edge line intermittent; LP: lateral position; SDLP: standard deviation of the lateral position; SK: slanted kerbstones; WCES: white chippings edge strip.

Identifying a gap in drowning prevention: high-risk populations

INTRODUCTION

Some populations have been less susceptible to reductions in drowning than others. It has been hypothesised that this is due to prevention strategies failing to account for the influence of social determinants (such as ethnicity, socioeconomic status). Populations such as ethnic minorities have been over-represented in injury statistics, however this is not well explored in drowning. This study aims to identify high-risk populations for drowning, risk factors and prevention strategies.

METHODS

A literature review undertaken systematically using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach was conducted of peer-reviewed literature in English, published between 1990 and 2018 from high-income countries. Search terms included drowning, water safety, ethnic minority, migrant, and culturally diverse.

RESULTS

In total, 35 articles were included. High-risk populations identified were: ethnic minorities, First Nations/Aboriginal people, migrants and rural residents. Over half (51%) focused on children (0-18 years). Risk factors included social determinants, swimming ability and knowledge, attitudes and behaviour. Four intervention studies were found; two focused on upskilling adults from high-risk populations to increase employment opportunities within the aquatic industry; an evaluation of a 10-year rock fishing safety education project and a learn-to-swim programme for minority children. Proposed prevention strategies included education, practical skills, research, policy and engagement.

DISCUSSION

Limited literature exists pertaining to drowning among adults from high-risk populations. There is a need to increase the sophistication of drowning prevention strategies addressing the disparities in drowning from a culturally appropriate perspective. Acknowledging the role of the social determinants of health in drowning prevention is essential in order to improve drowning outcomes for high-risk populations globally.

Knowledge transfer for occupational health and safety: Cultivating health and safety learning culture in construction firms

Within the last decades the incidence of workspace injuries and fatalities in the UK construction industry has declined markedly following the developments in occupational health and safety (OHS) management systems. However, safety statistics have reached a plateau and actions for further improvement of OHS management systems are called for. OHS is a form of organizational expertise that has both tacit and explicit dimensions and is situated in the ongoing practices. There is a need for institutionalization and for the transfer of knowledge across and along construction supply chains to reduce OHS risks and facilitate cultural change. The focus of this article is the factors that facilitate OHS knowledge transfer in and between organizations involved in construction projects. An interpretative methodology is used in this research to embrace tacit aspects of knowledge transfer and application. Thematic analysis is supported by a cognitive mapping technique that allows understanding of interrelationships among the concepts expressed by the respondents. This paper demonstrates inconsistency in OHS practices in construction organizations and highlights the importance of cultivating a positive safety culture to encourage transfer of lessons learnt from good practices, incidents, near misses and failures between projects, from projects to programmes and across supply chains. Governmental health and safety regulations, norms and guidelines do not include all possible safety issues specific to different working environments and tied to work contexts. The OHS system should encourage employees to report near misses, incidents and failures in a 'no-blame' context and to take appropriate actions. This research provides foundation for construction project practitioners to adopt more socially oriented approaches towards promoting learning-rich organizational contexts to overcome variation in the OHS and move beyond the current plateau reached in safety statistics.

Utilization of driving and other transportation rehabilitation in the National Health and Aging Trends Study

BACKGROUND

As people age, their mobility begins to decrease. In an effort to maintain mobility, this population can seek out rehabilitation services with the goal of improving their driving. However, it is unclear who has sought out rehabilitation for this purpose.

OBJECTIVE

To better understand, identify, and describe the characteristics of older adults who utilize rehabilitation with the purpose of improved driving.

METHODS

Data was analyzed from the fifth round of the National Health and Aging Trends study (NHATS), which is made up of Medicare beneficiaries over the age of 65 that are community-dwelling. Rehabilitation utilization specifically for improved driving and other transportation was analyzed. Adjusted weighted logistic regression was conducted to better understand and identify the characteristics of the study population that received rehabilitation services for the purpose of improved driving ability.

RESULTS

Nineteen percent (N = 1,335) of this cohort received rehabilitation in the past year. Of those, 10% (N = 128) received rehabilitation to specifically improve driving and 2% (N = 25) did so to improve other transportation. Older adults who were single, separated, or never married were less likely to use rehabilitation for improving driving ability, compared to older adults who were married (OR: 0.29; 95% CI: 0.11-0.80).

CONCLUSION

Older adults who are married were more likely to report they wanted to improve their driving ability with rehabilitation. The role of rehabilitation services to improve driving among older adults will play a key role in the coming years as older adults strive to maintain their independence.

Empirical study of gap and correlation between philosophies Safety-I and Safety-II: A case of Beijing taxi service system

In contrast to the conventional safety philosophy (Safety-I) which focuses on 'what goes wrong', a newborn one (Safety-II) focusing on 'what goes right' endows people with more opportunities to realize productive safety in complex socio-technical systems. Yet, it is challenging to make the best of both the philosophies in a period of knowledge transition when they may have to coexist. This work investigates how Safety-II may resemble, differ from, and correlate to Safety-I. From individual, environmental and organizational aspects, 9 impacting factors are identified and expounded comparatively in the two philosophies. To examine impact of the factors on accidents and resilience respectively, an empirical approach is presented in the context of Beijing taxi service system (BTSS). Multiple means such as questionnaire surveys, semi-structured interviews, and statistical analysis with bi-method (Correlation Analysis, and Data Envelopment Analysis) cross-checking are utilized comprehensively to support the empirical study. The results show that: a) individual factors play a dominant role in system risk/performance management, in respect to views of both Safety-I and II; and b) organizational factors are more influential in creating and maintaining system resilience. Based on the findings, possible patterns of integrating the two philosophies are instantiated through mutually complementary application to BTSS. Despite the context of BTSS, this work provides a feasible way of comparing between Safety-I and Safety-II, for beneficial reference of other socio-technical systems.

A dual perspective on risk perception and its effect on safety behavior: A moderated mediation model of safety motivation, and supervisor's and coworkers' safety climate

Previous studies have acknowledged the impact of risk perception on safety behavior, but were largely controversial. This study aims to clarify this conflict and the mechanism through which risk perception can have an impact on safety behavior. From the perspective of the dual attribute of the job demand concept in job demands-resources theory, we posit that risk perception can be considered as a job hindrance or a job challenge depending on the context, thereby resulting in a negative or positive impact on safety behavior, respectively. The current research context is the construction industry and the hypotheses were tested using hierarchically nested data collected from 311 workers in 35 workgroups. Risk perception was demonstrated to be a job hindrance exerting a negative impact on safety behavior and safety motivation mediated this effect. In addition, two dimensions of group-level safety climate--supervisor's and coworkers'--were expected to alleviate or even reverse the detrimental effects of hindrance risk perception on safety motivation and on safety behavior via motivation. A moderation model and a first-stage moderated mediation model were established, respectively, for testing the moderating roles of safety climate in the relationship between risk perception and safety motivation, and in the indirect relationship of risk perception with safety behavior via motivation. Surprisingly, contrary to the hypotheses, when supervisor's safety climate changed from a low level to a high level, the impact of risk perception on safety motivation changed from positive to negative, and the negative effect of risk perception on safety behavior via safety motivation was not alleviated but worsened. As expected, for workers in a positive coworkers' safety climate, the negative effect of risk perception on motivation and the indirect negative effect of risk perception on behavior were both reversed to the positive. This indicates that coworkers' safety climate helped to change perceived risk from a job hindrance to a challenge. This research contributes to workplace risk perception and safety behavior research by theoretically viewing risk perception as a dual job hindrance-challenge concept and proposing two competing hypotheses concerning the impact of risk perception on safety behavior. The empirical investigation confirmed the hindrance attribute of risk perception in the construction context. It provides a theoretical framework and empirical evidence for future research to synthesize the conflict risk perception-safety behavior relationship. We also contribute to the literature by pointing out the potential negative role of certain supervisor safety activities such as paternalistic leadership in influencing employee safety.

Getting mixed signals: Connotations of teamwork as performance shaping factors in network controller and rail driver relationship dynamics

Signal passed at danger (SPAD) events have been a perennial issue in rail and requires continued scholarship. Much of the literature has tended to focus on activities within the train cab, placing the spotlight on "error" within the rail driving role; however a train is not propelled by a single person but by a team. This study set out to understand how network controllers perceive the relationship dynamic between the network controller and rail driver, and how these views shape system performance. Using a phenomenological approach underpinned by Joint Cognitive Systems theory, interviews were conducted with network controllers (N = 55) across 8 rail organisations in Australia and New Zealand to examine how they related to signals and to drivers. Sixteen different perspectives were identified ranging in type and varying by frequency, each with implications for coupling strength between the controller and driver roles and on system performance. Key dimensions of teamwork in train movement were emphasised, illustrating how the underlying values and philosophies in different network controlling cultures influence risk perception. The findings may be used to develop a more informed understanding of the 'controller-signal-driver-train' system and pave the way for strategies that can embrace diversity in different perspectives whilst optimizing system safety and performance.

Monitoring complexity and resilience in construction projects: The contribution of safety performance measurement systems

Although complexity and resilience are key inter-related characteristics of construction projects, little is known on how to monitor these characteristics and their implications for safety management. This study investigates the contribution of Safety Performance Measurement Systems (SPMS) as a means for monitoring and understanding of sources of complexity and resilience in construction. It is based in three empirical studies carried out in construction projects, two in Chile and one in Brazil. Two main tools were applied in these studies: (i) the Technical, Organizational and Environmental (TOE) framework, focused on complexity; and (ii) the Resilience Assessment Grid (RAG), focused on resilience. Improvement opportunities were identified for existing SPMS. Also, a set of guidelines for the design of SPMS emerged from these studies as well as a model that explains the connections between the main constructs encompassed by the guidelines.

Exploring the Impact of Unsafe Behaviors on Building Construction Accidents Using a Bayesian Network

Unsafe behavior is a critical factor leading to construction accidents. Despite numerous studies supporting this viewpoint, the process by which accidents are influenced by construction workers’ unsafe behaviors and the extent to which unsafe behaviors are involved in this process remain poorly discussed. Therefore, this paper selects cases from Chinese building construction accidents to explore the probabilistic transmission paths from unsafe behaviors to accidents using a Bayesian network. First, a list of unsafe behaviors is constructed based on safety standards and operating procedures. Second, several chains of unsafe behaviors are extracted from 287 accident cases within four types (fall, collapse, struck-by and lifting) to form a Bayesian network model. Finally, two accidents are specifically analyzed to verify the rationality of the proposed model through forward reasoning. Additionally, critical groups of unsafe behaviors leading to the four types of accidents are identified through backward reasoning. The results show the following: (i) The time sequence of unsafe behaviors in a chain does not affect the final posterior probability of an accident, but the accident attribute strength of an unsafe behavior, affects the growth rate of the posterior probability of an accident. (ii) The four critical groups of unsafe behaviors leading to fall, collapse, struck-by, and lifting are identified. This study is of theoretical and practical significance for on-site behavioral management and accident prevention.

[Analysis of the determinants of cost savings in traffic accidents on interurban roads in Spain]

OBJECTIVE

The increase in traffic accidents depends on multiple factors; it generates an economic and public health problem that must be analyzed jointly by agents involved in road safety. The aim of the work was to quantify the effect of various factors in the cost savings due to traffic accidents on interurban roads in Spain.

METHODS

It was analyzed, through a lineal regression with panel data model and in the period 2000-2017, how different factors affected cost savings due to the risk of mortality or injury avoided on Spanish interurban roads.

RESULTS

A 1% increase in traffic volume led to a reduction in costs per MVKT (million vehiclekilometres travelled) of €162.46 referring to the risk of mortality, €115.32 for serious injuries and €10.10 for mild injuries. This increase in unemployment caused a cost reduction of €31.43, €10.76 and €0.98, respectively. The same increase in the investment in replacement implied a reduction of these costs of €11 for any risk. A 1% increase in the ageing index led to an increase in costs of €276.83 in terms of mortality risk and €257.49 in terms of injury. Foreign tourism generated a cost of more than €40 for any risk. A 1% increase in GDP per capita led to an increase in costs of €155.50, €138.09 and €8.21 for defined risks. The points driving license led to an increase in costs of €785.50 per MVKR when referring to mortality risks.

CONCLUSIONS

Determining factors for cost savings: motorization rate, unemployment rate and investment in replacement interurban roads. Determining factors that increased costs: expiry of the effect of the penalty - points driving licence, ageing index of the population, increase in GDP or proportion of foreign travelers.

Surgical fires: Still a burning issue in England and Wales

A significant number of surgical fires occur each year and can have devastating effects on patients. The National Reporting and Learning System database identified 37 reports of surgical fires in England and Wales between January 2012 and December 2018 - over 52% resulting in some degree of harm. Surgical fires remain preventable adverse events that can be avoided by adherence to effective preventative strategies and improved education. This article surveys the existing literature, addressing the fire triad and how to effectively manage and prevent a surgical fire.

A six-year review of patients admitted to hospital with injuries related to quad bike use

AIM

To describe quad bike injury-related hospitalisations in the Midland region over a six-year period.

METHOD

A retrospective review of anonymised, prospectively-collected trauma registry data from 1 July 2012 to 30 June 2018 was undertaken. Cases include patients hospitalised with quad bike-related injuries. Non-major injuries are included to provide a clearer picture of the trauma burden.

RESULTS

Three hundred and forty-six injuries resulted in hospitalisation with 70.2% of events occurring on a farm. Males outnumbered females 3.7:1. Forty-six children (<16 years) were hospitalised, of which 23 were injured on-farm and seven on a road. Over six years there was an annual average increase of 7.3% for all events occurring on a farm, 2.6% for injuries occurring during a farming activity and 4.7% for off-farm recreational injuries.

CONCLUSION

Despite continued public debate and education on the safe use of quad bikes, injuries severe enough to require hospitalisation continue to occur. Children continue to be injured, both as riders and passengers. Ageing farmers are a developing area for concern. While workplace safety garners most of the safety attention, two other areas also deserve injury prevention consideration; injuries that occur on-farm but not during farming activities and those occurring off-farm to recreational riders.

Expediting cataract surgery in New Zealand is cost-effective for falls prevention and improving vision-so what might be the next steps?

Multifactorial individual assessment with interventions tailored to the individual's risk factors can reduce the rate of falls and risk of fractures. Assessment of vision is one key aspect of multifactorial assessment and first eye cataract surgery reduces the rate of falls. We recently modelled the impact of expediting first eye cataract surgery in New Zealand for falls prevention (Boyd et al Injury Prevention). The model used was the same model used for previous modelling of home safety assessment and modification and community exercise programmes. This study found that expedited cataract surgery was highly cost-effective by generating a quality-adjusted life-year (QALY) for NZ$10,600 (95%UI: NZ$6,030-15,700). Routine cataract surgery itself (relative to no such surgery being available) was even more cost-effective at $4,380 per QALY gained, when considering vision benefits and falls prevention benefits. In this viewpoint article, we discuss the potential next steps for expediting cataract surgery and further improving its cost-effectiveness in the New Zealand setting.

Integration of hazard rectification efficiency in safety assessment for proactive management

OBJECTIVE

Safety assessment is crucial for the development of continuous improvement strategies. However, most studies assess construction safety with cross-sectional information and thus management tends to be passive. This study proposes an evidence-based methodology incorporating hazard rectification efficiency for project safety assessment.

METHOD

First, we theoretically introduced hazard rectification efficiency as a proxy for hazard exposure. Later, based on set-pair analysis, we proposed a safety assessment model that incorporates hazard occurrence and rectification efficiency. Subsequently, we collected site investigation records from seven building projects in Qingdao, Shandong. The data were used to develop a safety performance index (SPI) with the proposed model and a default model. The results were compared and discussed according to industrial practices for validation purposes.

RESULTS

The proposed model provides conservative indications of project safety performance; more importantly, the index calculated with the model provides advance warning when necessary. In the proposed method, in terms of the SPI, hazard and rectification indicators provide actionable information to address failures and improve safety conditions.

IMPLICATIONS

This research describes a new perspective (rectification efficiency) for safety assessment, which supplements the current body of knowledge on safety assessment. The proposed index, SPI, promotes the adoption of proactive hazard identification, monitoring, and control in construction.

On the relationship between road safety research and the practice of road design and operation

How do the findings of road safety research affect the practice by which the road infrastructure is built and operated? The question is seldom asked. I discuss the complexities of the research-practice symbiosis in the light of two historical anecdotes. These allow me to point out several issues of concern. My general conclusion is that the relationship, as it evolved over time, is unpremeditated and occasionally dysfunctional. Issues of concern are the lightness with which decisions affecting road-user safety can be based on opinion that is unsupported by evidence, that such opinions can trump inconvenient evidence, that research findings can be willfully distorted or disregarded, that questionable results can be given a ring of consensual truth, and that the questions which research asks and what findings get published are at times influenced by external interest. In sum, the concern is that practice is not sufficiently evidence-based. Road users have a right to expect that decisions substantially affecting their safety take into account fact-based expectation of safety consequences. It is therefore time to endow the research-practice relationship with a premeditated and purposeful structure.

Taking the Fall for Kids: A Journey to Reducing Pediatric Falls

PURPOSE

To reduce harm related to pediatric falls, a quality improvement project was conducted at a children's hospital.

DESIGN AND METHODS

An interprofessional team designed and implemented evidence-based interventions to align with the hospital's journey to reduce patient harm. These interventions included selection and implementation of a fall risk assessment tool, implementation of fall bundle elements, and implementation of fall prevention education to patients and families. Surveys, audits, and rate of falls were used to evaluate the project.

RESULTS

Fall bundle compliance increased from 27% to 88% and there were zero patient falls in five out of the six months after implementation a comprehensive pediatric fall prevention program.

CONCLUSIONS

Implementing pediatric-specific, evidence-based interventions can help to reduce patient falls. There was a substantial increase in fall bundle compliance and a decrease in falls and falls with injury.

PRACTICE IMPLICATIONS

Engagement and empowerment of clinical nurses in the quality improvement process design and implementation can substantially improve patient outcomes and patient safety while reducing harm. Future research is needed to determine factors that promote enhanced reporting needed to determine the true incidence of patient falls in pediatric inpatient and outpatient settings.

Net-societal and net-private benefits of some existing vehicle crash avoidance technologies

Most light-duty vehicle crashes occur due to human error. Many of these crashes could be avoided or made less severe with the aid of crash avoidance technologies. These technologies can assist the driver in maintaining control of the vehicle when a possibly dangerous situation arises by issuing alerts to the driver and in a few cases, responding to the situation itself. This paper estimates the societal and private benefits and costs associated with three crash avoidance technologies, blind-spot monitoring, lane departure warning, and forward-collision warning, for all light duty passenger vehicles in the U.S. for the year 2015. The three technologies could collectively prevent up to 1.6 million crashes each year including 7200 fatal crashes. In this paper, the authors estimated the net-societal benefits to the overall society from avoiding the cost of the crashes while also estimating the private share of those benefits that are directly affecting the crash victims. For the first generation warning systems, net-societal benefits and net-private benefits are positive. Moreover, the newer generation of improved warning systems and active braking should make net benefits even more advantageous.

Speech Analysis for Fatigue and Sleepiness Detection of a Pilot

BACKGROUND: Mental fatigue and sleepiness are well recognized determinants of human-error related accidents and incidents in aviation. In Brazil, according to the Center for Investigation and Prevention of Aeronautical Accidents (CENIPA), the rate of accidents in the aerial modal is 1 per 2 d. Human factors are present in 90% of these accidents.CASE REPORT: This paper describes a retrospective study of the communication between a pilot and an air traffic control tower just before a fatal accident. The objective was the detection of fatigue and sleepiness of a pilot, who complained of these signs and symptoms before the flight, by means of voice and speech analysis. The in-depth accident analysis performed by CENIPA indicated that sleepiness and fatigue most likely contributed to the accident. Speech samples were analyzed for two conditions: 1) nonsleepy data recorded 35 h before the air crash (control condition), which were compared with 2) data from samples collected about 1 h before the accident and also during the disaster (sleepy condition). Audio recording analyses provided objective measures of the temporal organization of speech, such as hesitations, silent pauses, prolongation of final syllables, and syllable articulation rate.DISCUSSION: The results showed that speech during the day of the accident had significantly low elocution and articulation rates compared to the preceding day, also indicating that the methodology adopted in this study is feasible for detection of fatigue and sleepiness through speech analysis.de Vasconcelos CA, Vieira MN, Kecklund G, Yehia HC. Speech analysis for fatigue and sleepiness detection of a pilot. Aerosp Med Hum Perform. 2019; 90(4):415-418.

Green wave for cyclists: Users' perception and preferences

Several innovative measures in traffic control applied in Europe have successfully improved the comfort and safety of cycling, among which is the green waves for cyclists. Consecutive traffic lights are synchronised to create a green wave, increasing comfort and decreasing waiting times and related deliberate red-light running. This study focused on exploring the user acceptance of green wave systems and the user evaluation of six distinct interface designs (i.e. numeric-based countdown, dot-based vertical countdown, dot-based clockwise countdown, LED line, LED road surface, on-bike speed indicator). Results indicate a preference for three systems: numeric-based countdown, LED line and LED road surface. Results also show a significant influence of nationality on the evaluation of the interfaces. Based on our findings, we argue that the numeric-based countdown represents the most promising option for future adaptive green wave implementations. The outcomes of the present study represent a useful evidence and guidance for researchers, designers and decision makers in the field of green waves, mobility and traffic safety.

Research on complex air leakage method to prevent coal spontaneous combustion in longwall goaf

Spontaneous combustion of coal is one of the major hazards threatening production safety during longwall mining. Mining-induced voids, which provide passages for air leakage, are the key factor triggering spontaneous combustion of coal in longwall goafs. In this study, a comprehensive method, which combined pressure balance, grouting injection, and filling fissures, was proposed to prevent spontaneous combustion of coal in longwall goafs with complex air leakage. Field engineering practice was carried out in Sitai Coal Mine in China. The results demonstrated that with the application of the proposed method, in the working face, the concentration of CO was decreased from 31ppm to 0 and the air leakage quantity was decreased from 261 to below 80 m³min^-1. The gas samples analysis from the gob areas also indicated that concentrations of O₂ and CO were successively decreased, indicating that the risk of spontaneous combustion of coal in goafs was eliminated. The above mentioned analysis indicates that, the method proposed in this study is useful and efficient. Successful application of this technology could provide reference for the treatment of other coal mines.

The impact of vessel speed reduction on port accidents

Reduced-speed zones (RSZs) have been designated across the world to control emissions from ships and prevent mammal strikes. While some studies have examined the effectiveness of speed reduction on emissions and mammal preservation, few have analyzed the effects of reduced ship speed on vessel safety. Those few studies have not yet measured the relationship between vessel speed and accidents by using real accident data. To fill this gap in the literature, this study estimates the impact of vessel speed reduction on vessel damages, casualties and frequency of vessel accidents. Accidents in RSZ ports were compared to non-RSZ ports by using U.S. Coast Guard data to capture the speed reduction effects. The results show that speed reduction influenced accident frequency as a result of two factors, the fuel price and the RSZ designation. Every $10 increase in the fuel price led to a 10.3% decrease in the number of accidents, and the RSZ designation reduced vessel accidents by 47.9%. However, the results do not clarify the exact impact of speed reduction on accident casualty.

Evaluating Targeted Intervention on Coal Miners' Unsafe Behavior

Miners’ unsafe behavior is the main cause of roof accidents in coal mines, and behavior intervention plays a significant role in reducing the occurrence of miners’ unsafe behavior. However, traditional behavior intervention methods lack pertinence. In order to improve the intervention effect and reduce the occurrence of coal mine roof accidents more effectively, this study proposed a targeted intervention method for unsafe behavior. The process of targeted intervention node locating was constructed, and based on the analysis of 331 coal mine roof accidents in China, three kinds of targeted intervention nodes were located. The effectiveness of targeted intervention nodes was evaluated by using structural equation model (SEM) through randomly distributing questionnaires to miners of Pingdingshan coal. The results show that, in preventing roof accidents of coal mines, the targeted intervention nodes have a significant positive impact on the intervention effect. The method can also be applied to the safety management of other industries by adjusting the node location and evaluation process.

Applicability of accident analysis methods to Chinese construction accidents

INTRODUCTION

It is necessary to clearly understand construction accidents for preventing a rise in Chinese construction accidents and deaths. Better analysis methods are required for Chinese construction sector accidents.

METHODS

Choosing and analyzing a typical construction accident based on four popular contemporary accident causation models: STAMP, AcciMap, HFACS, and the 2-4 Model. Then we evaluated the models' applicability to construction accidents, including their usability, reliability, and validity.

RESULTS

STAMP addressed how complexity within the accident system influenced the accident development, and its output makes the responsibilities clearer for the accident. AcciMap described the entire system's failure, the entire accident's trajectory, and the relationship between them. AcciMap showed that the accident was a dynamic developing process, and this method has a high usability. The taxonomic nature of HFACS is an important feature that provides it with a high reliability. In the accident reviewed here, we found that poor management was a critical factor rather than the individual factor in the accident. The 2-4 Model provided detailed causes of the accident and established the relationship among the accident causes, the safety management system, and the safety culture. It also avoided capturing all of the complexity in the large sociotechnical system and revealed a dynamic analysis and developing process. We confirmed that it has a high usability and validity. Therefore, the 2-4Model is recommended for future Chinese construction accident analysis efforts.

PRACTICAL APPLICATIONS

The study provides a useful, reliable, and effective analysis method for Chinese construction accidents.

Perceptions of falls and falls prevention interventions among Personal Alert Victoria clients

This paper explores the perceptions and experiences of falls among Personal Alert Victoria (PAV) clients and identifies barriers and enablers to engagement in falls prevention interventions. Data were collected via semistructured telephone interviews (n = 12) and a client survey with open-ended and closed-ended questions (n = 46). Descriptive statistics and thematic analysis was guided by the COM-B model (capability, opportunity, and motivation) for behaviour change. The interview and survey explored experiences of falls, falls risk factors, access and participation in falls prevention interventions, access to health and support services, and experiences using the PAV service. Capability barriers identified included poor health, lack of time, low health literacy, and perceived high intensity of exercise classes. Opportunity barriers were lack of transport, high cost, and long waiting times for falls prevention interventions. Motivation barriers were the belief that falls are inevitable and a perceived lack of relevance of falls prevention interventions. Enablers identified were a focus on broader health and well-being benefits (capability), hospitalisations or rehabilitation that incorporates falls prevention in recovery (opportunity), and raising awareness of falls risk (motivation). Findings suggest that further research is required to inform the tailoring of positive health messages to improve the uptake of falls prevention interventions by PAV clients.

Forward collision warning system impact

OBJECTIVE

The objective of this research is to use historical crash data to evaluate the potential benefits of both high- and low-speed automatic emergency braking (AEB) with forward collision warning (FCW) systems.

METHODS

Crash data from the NHTSA's NASS-General Estimates System (GES) and Fatality Analysis Reporting System (FARS) databases were categorized to classify crashes by the speed environment, as well as to identify cases where FCW systems would be applicable.

RESULTS

Though only about 19% of reported crashes occur in environments with speeds greater than 45 mph, approximately 32% of all serious or fatal crashes occur in environments with speeds greater than 45 mph. The percentage of crashes where FCW systems would be relevant has remained remarkably constant, varying between about 21 and 26% from 2002 to 2015. In 2-vehicle fatal crashes where one rear-ends the other, the fatality rates are actually higher in the struck vehicle (33%) than the striking vehicle (26%). The disparity is even greater when considering size-class differences, such as when a light truck rear-ends a passenger car (15 vs. 42% fatality rates, respectively).

CONCLUSIONS

NHTSA and the Insurance Institute for Highway Safety (IIHS) proposed the Automatic Emergency Braking Initiative in 2015, which is intended to make AEB (also called crash-imminent braking) with FCW systems standard on nearly all new cars by September 2022. Twenty automakers representing 99% of the U.S. auto market voluntarily committed to the initiative. Though the commitment to safety is laudable, the AEB component of the agreement only covers low-speed AEB systems, with the test requirements set to 24 mph or optionally as low as 12 mph. The test requirements for the FCW component of the agreement include 2 tests that begin at 45 mph. Only 21% of relevant serious injury or fatal accidents occur in environments at speeds under 24 mph, whereas about 22% of serious or fatal crashes occur in environments with speeds greater than 45 mph. This means that the AEB with FCW systems as agreed upon will cover only 21% of serious or fatal crashes and will not cover 22% of serious or fatal crashes. Because these systems are protective not only for the occupants of the vehicle where they are installed but also other vehicles on the roads, the data indicate that these systems should be a standard feature on all cars for high-speed as well as low-speed environments for the greatest social benefit.

Use of evidential reasoning and AHP to assess regional industrial safety

China’s fast economic growth contributes to the rapid development of its urbanization process, and also renders a series of industrial accidents, which often cause loss of life, damage to property and environment, thus requiring the associated risk analysis and safety control measures to be implemented in advance. However, incompleteness of historical failure data before the occurrence of accidents makes it difficult to use traditional risk analysis approaches such as probabilistic risk analysis in many cases. This paper aims to develop a new methodology capable of assessing regional industrial safety (RIS) in an uncertain environment. A hierarchical structure for modelling the risks influencing RIS is first constructed. The hybrid of evidential reasoning (ER) and Analytical Hierarchy Process (AHP) is then used to assess the risks in a complementary way, in which AHP is hired to evaluate the weight of each risk factor and ER is employed to synthesise the safety evaluations of the investigated region(s) against the risk factors from the bottom to the top level in the hierarchy. The successful application of the hybrid approach in a real case analysis of RIS in several major districts of Beijing (capital of China) demonstrates its feasibility as well as provides risk analysts and safety engineers with useful insights on effective solutions to comprehensive risk assessment of RIS in metropolitan cities. The contribution of this paper is made by the findings on the comparison of risk levels of RIS at different regions against various risk factors so that best practices from the good performer(s) can be used to improve the safety of the others.

Workplace Accident Prevalence and Associated Factors among Tobacco Farm in São Lourenço do Sul-RS, Brazil

Agriculture has the highest risk of accidents. In Brazil the reality of this situation is unknown owing to scarcity of studies and underreporting of workplace accidents in rural areas. This article aims to evaluate workplace accident prevalence and associated factors among tobacco farm in Sao Lourenco do Sul-RS, Brazil. Cross-sectional study with 488 tobacco farmers, assessing sociodemographic, behavioural, labour characteristics and association with workplace accidents occurring in their lifetime. The injury prevalence was 24%. Being male (PR 1.62; 95%CI 1.04-2.52), and tenant farmer (PR 1.87; 95%CI 1.29-2.72), bundling tobacco leaves (PR 2.00; 95%CI 1.14-3.52) and having minor psychiatric disorders (PR 1.58; 95%CI 1.06-2.35) were positively associated with accidents. 46% of serious injuries caused superficial lesions and 26% caused fractures. Rural workplace accident prevention policies need to be established, particularly for tobacco farming. Larger studies are needed to understand work process-related aspects that increase the risk of accidents.

Comparison of recidivism rates for a teenage trauma prevention program after the addition of high-fidelity patient simulation

OBJECTIVES

We evaluated the benefits of adding high-fidelity simulation to a teenage trauma prevention program to decrease recidivism rates and encourage teens to discuss actionable steps toward safe driving.

METHODS

A simulated pediatric trauma scenario was integrated into an established trauma prevention program. Participants were recruited because they were court-ordered to attend this program after misdemeanor convictions for moving violations. The teenage participants viewed this simulation from the emergency medical services (EMS) handoff to complete trauma care. Participants completed a postsimulation knowledge assessment and care evaluation, which included narrative data about the experience. Qualitative analysis of color-coded responses identified common themes and experiences in participants' answers. Court records were reviewed 6 years after course completion to determine short- and long-term recidivism rates, which were then compared to our program's historical rate.

RESULTS

One hundred twenty-four students aged 16-20 years participated over a 2-year study period. Narrative responses included general reflection, impressions, and thoughts about what they might change as a result of the course. Participants reported that they would decrease speed (30%), wear seat belts (15%), decrease cell phone use (11%), and increase caution (28%). The recidivism rate was 55% within 6 years. At 6 months it was 8.4%, at 1 year it was 20%, and it increased approximately 5-8% per year after the first year. Compared with our programs, for historical 6-month and 2-year recidivism rates, no significant difference was seen with or without simulation.

CONCLUSIONS

Adding simulation is well received by participants and leads to positive reflections regarding changes in risk-taking behaviors but resulted in no changes to the high recidivism rates This may be due to the often ineffectiveness of fear appeals.

Fall Prevention Hits Stumbling Blocks

Implementation of efforts to screen older people for fall risk-and to intervene before falls occur-have been scattershot at best. Ongoing studies of fall prevention called STRIDE (Strategies to Reduce Injuries and Develop Confidence in Elders) might change that. The studies look at whether clinicians can implement a fall-prevention program across rural, urban, and suburban treatment settings.

Drowning Prevention in Pediatrics

Drowning contributes significantly to morbidity and mortality in the pediatric population but it is largely preventable through judicious use of safety measures. To affect outcomes surrounding drowning, pediatricians need to understand the most updated terminology, the basic resuscitation protocols, and the assessment and management of a drowning victim. Most importantly, pediatricians must appreciate the importance of properly counseling patients and families about drowning prevention. Effective preventive measures supported by the literature include constant and reliable adult supervision, swim instruction for most children older than age 4 years, pool isolation fencing, and the proper use of personal floatation devices. [Pediatr Ann. 2018;47(3):e112-e117.].

Vehicular Hyperthermia-A Highly Preventable and Potentially Fatal Problem

A child dying of heat injury due to being left unattended in a motor vehicle is a needless tragedy. Each year in the United States an average of 38 children mostly younger than age 2 years die of vehicular hyperthermia, frequently the result of a parental lapse of attention and not intentional neglect. Serious illness results quickly from exposure to rising heat within the passenger compartment, even on days when the temperature is fairly moderate. Prevention is paramount in addressing this problem and can best be accomplished by a combination of technological means, such as passive warning systems, laws that make leaving a child in a car alone illegal, and public education campaigns. [Pediatr Ann. 2018;47(3):e88-e90.].

Evaluating the impact of a falls prevention community of practice in a residential aged care setting: a realist approach

BACKGROUND

Falls are a major socio-economic problem among residential aged care (RAC) populations resulting in high rates of injury including hip fracture. Guidelines recommend that multifactorial prevention strategies are implemented but these require translation into clinical practice. A community of practice (CoP) was selected as a suitable model to support translation of the best available evidence into practice, as it could bring together like-minded people with falls expertise and local clinical knowledge providing a social learning opportunity in the pursuit of a common goal; falls prevention. The aims of this study were to evaluate the impact of a falls prevention CoP on its membership; actions at facility level; and actions at organisation level in translating falls prevention evidence into practice.

METHODS

A convergent, parallel mixed methods evaluation design based on a realist approach using surveys, audits, observations and semi-structured interviews. Participants were 20 interdisciplinary staff nominating as CoP members between Nov 2013-Nov 2015 representing 13 facilities (approximately 780 beds) of a RAC organisation. The impact of the CoP was evaluated at three levels to identify how the CoP influenced the observed outcomes in the varying contexts of its membership (level i.), the RAC facility (level ii.) and RAC organisation (level iii.).

RESULTS

Staff participating as CoP members gained knowledge and awareness in falls prevention (p < 0.001) through connecting and sharing. Strategies prioritised and addressed at RAC facility level culminated in an increase in the proportion of residents supplemented with vitamin D (p = 0.002) and development of falls prevention education. At organisation level a falls policy reflecting preventative evidence-based guidelines and a new falls risk assessment procedure with aligned management plans were written, modified and implemented. A key disenabling mechanism identified by CoP members was limited time to engage in translation of evidence into practice whilst enabling mechanisms included proactive behaviours by staff and management.

CONCLUSIONS

Interdisciplinary staff participating in a falls prevention CoP gained connectivity and knowledge and were able to facilitate the translation of falls prevention evidence into practice in the context of their RAC facility and RAC organisation. Support from RAC organisational and facility management to make the necessary investment in staff time to enable change in falls prevention practice is essential for success.