Accident; analysis and prevention
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Comparative Study
Systematic review of unintentional injury prevention economic evaluations 2010-2019 and comparison to 1998-2009.
Health economic evaluation studies (e.g., cost-effectiveness analysis) can provide insight into which injury prevention interventions maximize available resources to improve health outcomes. A previous systematic review summarized 48 unintentional injury prevention economic evaluations published during 1998-2009, providing a valuable overview of that evidence for researchers and decisionmakers. The aim of this study was to summarize the content and quality of recent (2010-2019) economic evaluations of unintentional injury prevention interventions and compare to the previous publication period (1998-2009). ⋯ Most economic evaluations of unintentional injury prevention interventions address just two injury causes. Better adherence to health economic evaluation reporting standards may enhance comparability across studies and increase the likelihood that this type of evidence is included in decision-making related to unintentional injury prevention.
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Attributions of fault are often associated with worse injury outcomes; however, the consistency and magnitude of these impacts is not known. This review examined the prognostic role of fault on health, mental health, pain and work outcomes after transport injury. A systematic search of five electronic databases (Medline, Embase, CINAHL, PsycINFO, Cochrane Library) yielded 16,324 records published between 2000 and January 2018. ⋯ However, the evidence of negative associations between fault-based compensation claims and work-related outcomes was limited. Lawyer involvement and fault-based compensation claims were associated with adverse mental health outcomes six months post-injury, but not beyond 12 months. The most consistent associations between fault and negative outcomes were not for fault attributions, per se, but were related to fault-related procedures (e.g., lawyer engagement, fault-based compensation claims).
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Canada's freight rail system moves 70% of the country's surface goods and almost half of all exports (RAC, 2016). These include dangerous goods. Anonymous survey of freight rail operating employees conducted by the Teamsters Canada Rail Conference (TCRC, 2014) revealed that many do not report getting enough sleep because of their work schedules, and that fatigue may be affecting their performance at work. ⋯ Exploration of accident themes suggests that management of fatigue and shift scheduling in the freight rail industry is a complex issue that is often not conducive to employee circadian rhythms and sleep requirements. It also suggests that current shift scheduling and fatigue management practices may be insufficient to mitigate the associated safety risk. Railway fatigue management systems that are based on the principles of modern sleep science are needed to improve scheduling practices and mitigate the ongoing safety risk.
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Review Meta Analysis
Recommend or mandate? A systematic review and meta-analysis of the effects of mandatory bicycle helmet legislation.
If all cyclistswere wearing helmets, significant numbers of head injuries might theoretically be prevented. Mandatory bicycle helmet legislation increases helmet use but is a controversial measure. Results from 21 studies of the effects of mandatory bicycle helmet legislation on injuries among crash involved cyclists were investigated by means of meta-analysis and the effects of several potential biases were investigated. ⋯ Some adverse effects may occur, but will not necessarily be large or long-lasting. People who may be deterred from cycling, are among those with the highest injury risk and the smallest health effects from cycling. If the overall goal is to improve safety for all cyclists and to increase cycling, mandatory bicycle helmet legislation should be supplemented by other measures, especially improved bicycle infrastructure.
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Review Meta Analysis
Recommend or mandate? A systematic review and meta-analysis of the effects of mandatory bicycle helmet legislation.
If all cyclistswere wearing helmets, significant numbers of head injuries might theoretically be prevented. Mandatory bicycle helmet legislation increases helmet use but is a controversial measure. Results from 21 studies of the effects of mandatory bicycle helmet legislation on injuries among crash involved cyclists were investigated by means of meta-analysis and the effects of several potential biases were investigated. ⋯ Some adverse effects may occur, but will not necessarily be large or long-lasting. People who may be deterred from cycling, are among those with the highest injury risk and the smallest health effects from cycling. If the overall goal is to improve safety for all cyclists and to increase cycling, mandatory bicycle helmet legislation should be supplemented by other measures, especially improved bicycle infrastructure.