3 Feb, 14 | by Bridie Scott-Parker
I had a conversation recently with a colleague who is a tireless worker in the safety of pedestrians, and his comment regarding policy response resonated with me so much that I thought I would share it with you. He likened policy response to road safety to the Hindenburg Disaster of 1937 (see www.airships.net/hindenburge/disaster for more information), such that improvements in safety only occur after tragic, highly-visible critical events. This policy response, which certainly is an important one, is frequently characterised by ‘too little, too late’. My colleague found this particularly frustrating when policy based in sound risk assessments and a plethora of evidence-based research can prevent – or at least minimise – the damage from catastrophe in the first place.
Whilst myself and my colleague are lucky enough to live, work, and indeed use the road environment in a developed country, evidence-based policy and practical responses are never more urgently needed than now in developing countries. The plight of these countries was highlighted in a recent The Economist article (read more at http://www.economist.com/news/international/21595031-rich-countries-have-cut-deaths-and-injuries-caused-crashes-toll-growing). What we in ‘rich countries’ refer to as vulnerable road users such as pedestrians and motor and pedal cyclists are never more vulnerable than when using the road networks of the developing world.
Interestingly, cost cannot be the only obstacle, with The Economist article stating that
“iRAP has helped to build fences to separate pedestrians from traffic in Bangladesh, at a cost of just $135 to avert a death or serious injury; and installed rumble strips on hard shoulders in Mexico to alert drivers when they are veering from their lane ($920). Telling people about safety laws—and then making those laws stick—can be surprisingly affordable and effective, too. The share of people wearing seat belts in Ivanovo, Russia, rose from 48% in 2011 to 74% in 2012, after a police crackdown and social-media campaign partly paid for by Bloomberg Philanthropies, the foundation of Michael Bloomberg, New York’s former mayor and one of the few big aid donors to spend heavily on road safety. Dan Chisholm of the WHO calculates that enforcing speed limits and drunk-driving laws in South-East Asia would cost just 18 cents per person per year.”
I would argue that a part of our role as injury prevention practitioners, professionals and researchers in ‘rich countries’ is to help in the journey to identify, then remove or ameliorate, obstacles to developing nations maximising the benefits of our knowledge and experiences.
More on guns… There was a really interesting paper titled “Gun Violence Trends in Movies” recently published in Pediatrics.
This study examined the presence of gun related violence in top grossing major motion pictures and concluded that gun violence in films has grown substantially. Not a huge surprise but what was interesting is that the rate of growth in PG-13 (age 13+) films outpaced both PG (Parental Guidance Suggested) and R (age 17+) rated films. So much so, that in recent years the study found that there is actually more gun violence in PG-13 then in R rated movies. Why is this important?
The article also does a nice job of summarizing relevant research that outlines why this might be bad. The authors drew two conclusions from this research that can be outlined to some extant with these statements: 1. exposure to violence can lead to increased aggressive attitudes and behavior and 2. exposure to guns independent of violent behavior can lead to increased aggression. The authors went on to describe the combined gun violence in PG-13 movies as a “double whammy” that may be contributing to increased aggressive behavior in youth. I’ll confess that increased aggressive behavior due to simply being exposed to a gun (the “weapons effect”) was news to me.
Other research has shown that exposure to things like smoking and drinking in movies increases engagement in those activities among youth and at least for smoking there is a push by some public health advocates to assign an R rating to movies when smoking is present. Maybe an R rating should also be considered for movies that contain some lower threshold level of gun violence?
13 Jan, 14 | by Barry Pless
Anna Lacey, reporter for the BBC Health Check, notes that the basic idea behind cycle helmets is to create a mini crumple zone to absorb some of the impact energy and give your skull and brain more time to slow down before coming to a stop. Those extra few milliseconds can reduce the amount of compression in the brain and potentially make the difference between brain damage and a mild case of concussion. Most helmets are now made of polystyrene but a safety engineeer, Anirudha Surabhi, in London wasn’t convinced it’s the best choice. He looked to the natural world for inspiration and noted that the woodpecker pecks at about ten times per second and each peck involves the same amount of force as crashing at 50 miles per hour. “It’s the only bird in the world where the skull and the beak are completely disjointed, and there’s a soft corrugated cartilage in the middle that absorbs all the impact and stops it from getting a headache.“ To mimic the woodpecker’s crumple zone, Anirudha turned to a cheap and easily accessible source – paper and engineered it into a double-layer of honeycomb that could then be cut and constructed into a functioning helmet. “What you end up with is tiny little airbags throughout the helmet,” he says. “So when you have a crash, what these airbags do is they go pop, pop, pop, pop, pop – and they go all the way to the bottom, without the helmet cracking. That’s what absorbs the energy. ” The paper design has been tested to European standards, and when compared to a standard polystyrene helmet, the results are impressive.
”If you crash at 15 miles per hour in a normal helmet, your head will be subjected to around 220G [G-force], whereas the new design absorbs more of the impact and means you experience around 70G instead,” says Surabhi. To put that into context, international safety standards recognise that to avoid serious brain damage, a person must not be exposed to impact forces above 300G. This means that while a polystyrene helmet helps you to avoid fatal or serious head injury, the paper helmet will give your head more time to slow down and potentially lower the risk of even less serious injuries like concussion. Anirudha’s paper helmet is already in the shops. Among his new ideas is a flat-pack version suitable for cyclists use by city bike hire schemes. Of course, debate still rages over whether helmets really help protect cyclists at all – with arguments ranging from the ineffectiveness of polystyrene to the mere act of wearing a helmet encouraging cyclists to take more risks and drivers to be less cautious. But an independent review by the Transport Research Laboratory in 2009 found that assuming they are worn correctly, cycle helmets should be effective. Still, wearing cycle helmets is not compulsory in the UK.
Authors note: This was recently brought to my attention by one of our sons. When I googled the inventor I discovered that Ani Surabhi Rao is head of Design at Kranium Designs, a London based company created by owner Brian Krane to serve as a test site for new designs and as a resume. Surabhi writes, “I am actively involved in designing and bringing designs to production which involves rapid brain storming, 3d development, design thinking and material led innovation.” If you have any doubts about this near-miracle, marketed as Kranium Revolution (L80 or $129), go to this link, http://anirao.com/videos.php, and then click on Kranium Demo and the ‘waterproof’ video as well. I am, as you may be able to tell, gob-smacked!! And, no, I get no commissions, darn it!
PS.. for the record, we blogged about the woodpecker mystery previously!
7 Jan, 14 | by Barry Pless
The Guardian carried a story about a ban on toy guns in the federal district of Brazil. The law was intended to help reduce violent crime. The penalties for selling such replicas are steep: from $2000 to 44,000; closed for 30 days; or loss of trading license. The rising homicide rate in Brazil is part of what lies behind this initiative. Time will tell if it yields any positive results. But it is clearly a step in the right direction, though I suspect the NRA would not agree.
6 Jan, 14 | by Bridie Scott-Parker
I hope you said ‘no’ in response to that question! If you didn’t, maybe you shouldn’t be sharing the road with the rest of us sane people!
To me, driving whilst distracted is just like driving blindfolded. In either scenario, you cannot and do not see the road in front, to the side, or behind you. You cannot detect or react appropriately to driving hazards that you would otherwise be able to avoid. Yet a simple drive/walk/cycle down any busy street is likely to mean that you will encounter someone who is distracted, that is, someone who is effectively driving whilst blindfolded.
Here in Australia, distracted and inattentive driving is recognised as one of our Fatal Five (e.g., see http://www.police.qld.gov.au/News+and+Alerts/campaigns/fatalfive.htm). Sources of distraction include external mechanisms both inside the vehicle such as mobile phones and in-car navigation devices or outside the vehicle such as roadside advertising, but may also include oft-unrecognised internal mechanisms such as extreme emotions. Whilst distracted driving is not unique to the young driver, by virtue of their driving inexperience they are at increased risk of harm as a result of distracted driving. Naturalistic driving research recently published in The New England Journal of Medicine (see http://www.nejm.org/doi/full/10.1056/NEJMsa1204142?query=featured_home) revealed that the risk of a crash/near-crash among young drivers increased significantly if drivers were
* dialling or reaching for a cell phone,
* sending or receiving text messages,
* reaching for an object other than a cell phone,
* looking at a roadside object, or
Crash risk increased significantly for experienced drivers who were dialling a cell phone (risks associated with accessing internet and texting were not measured). The Authors noted that “The secondary tasks associated with the risk of a crash or near-crash all required the driver to look away from the road ahead.” Effectively driving blindfolded. This suggests that efforts should address the ‘blindfolded driving’ not only of young drivers through interventions such as graduated driver licensing programs as recommended by the Authors, but blindfolded driving by all drivers of all ages and driving experiences.
31 Dec, 13 | by Barry Pless
Also in the New York Times a short while ago was a piece describing what advocates of gun control have to contend with when even mental health checks are challenged. This is an edited version of that article:
Last April, workers at Middlesex Hospital in Connecticut called the police to report that a psychiatric patient named Mark Russo had threatened to shoot his mother if officers tried to take the 18 rifles and shotguns he kept at her house. Mr. Russo, who was off his medication for paranoid schizophrenia, also talked about the recent elementary school massacre in Newtown. The police seized the firearms, as well as seven high-capacity magazines, but Mr. Russo, 55, was eventually allowed to return to the trailer where he lives alone. As for his guns, Mr. Russo is scheduled to get them back in the spring, as mandated by Connecticut law.
The Russo case highlights a central, unresolved issue in the debate over balancing public safety and the Second Amendment right to bear arms: just how powerless law enforcement can be when it comes to keeping firearms out of the hands of people who are mentally ill. Connecticut’s law giving the police broad leeway to seize and hold guns for up to a year is actually relatively strict. Most states only ban gun possession after someone is involuntarily committed to a psychiatric facility or designated as mentally ill or incompetent after a court proceeding or other formal legal process. As a result, the police often find themselves grappling with legal ambiguities when they encounter mentally unstable people with guns, unsure how far they can go in searching for and seizing firearms and then, in particular, how they should respond when the owners want them back.
In each of three recent shootings the gunman had been recognized as mentally disturbed but had not been barred from owning a firearm. After the Newtown killings a year ago, state legislatures across the country debated measures that would have more strictly limited the gun rights of those with mental illness. But most of the bills failed amid resistance from both the gun lobby and mental health advocates concerned about unfairly stigmatizing people. The New York Times obtained records from more than 1,000 cases in which guns were seized in mental-health-related episodes. A systematic review of these cases underscores how easy it is for people with serious mental health problems to have guns. Moreover, in many of the cases examined, the authorities said they had no choice under the law but to return the guns after an initial seizure for safekeeping. And nothing prevents the mentally ill from buying new guns. Adding to the uncertainty for law enforcement, federal courts have ruled that an emergency involuntary psychiatric evaluation is not grounds to bar someone from possessing firearms. Following the Newtown shooting the mental health debate in state legislatures focused largely on two areas: requiring mental health professionals to report dangerous people to the authorities and expanding the mental health criteria for revoking gun rights.
As for Mark Russo, the Middletown man who is looking forward to reclaiming his 18 guns in April, he acknowledged that public records indicated that he had made threats of violence, but he said they were untrue. He said he had had difficulty getting doctors to understand the real nature of his problem, which is not mental illness but paranormal activities that have afflicted him since his youth, including objects disappearing from his home and a bird once flying out of his forehead. “I’ve offered to take a lie-detector test to prove what I’m saying is true,” he said. “But psychiatrists, they don’t want to hear about God and demons and all that.”
Editors note: I have removed many, many examples of what appear to me to be incredibly bizarre behavior protected by the gun lobby. How unbelievably disturbing all this is. On a lighter note, and harking back to an editorial I wrote many years ago, you should now go to YouTube and see the 3 episodes from the Daily Show in which John Oliver compares Australia’s gun control laws with those of the U.S. The link is: (John Oliver Australia Gun Control)
31 Dec, 13 | by Barry Pless
A federal judge ruled on Tuesday that New York’s expanded ban on assault weapons and high-capacity magazines was constitutional, but struck down a provision forbidding gun owners from loading their firearms with more than seven rounds.
Gov. Andrew M. Cuomo and lawmakers passed the new legislation, among the most restrictive in the country, in January in response to the mass shooting last December at an elementary school in Newtown, Conn. The judge, William M. Skretny of Federal District Court in Buffalo, called the seven-round limit “an arbitrary restriction” that violated the Second Amendment.
Editors comment: A small step indeed but keep in mind what gun control advocates are up against. See the blog that follows.
27 Dec, 13 | by Barry Pless
I am struggling with trying to decide what the most effective preventive strategy might be to help control the epidemic of driver crashes associated with cell phone use. One possibility is more Public Service Announcements like this one:
Go to it and tell me what you think.
24 Dec, 13 | by Bridie Scott-Parker
I thought as my final blog for 2013 that I would ponder the question: the festive season or the injury season?
I recall spending a Christmas Eve some 20 years ago in hospital as my then fiancée had to be treated for dreadful scalds on his stomach. Needless to say, despite the sweltering heat and ridiculously-high humidity, he has never again cooked a Christmas brisket wearing only shorts!
A representative of St George Hospital in the Australian state of New South Wales recently advised “Our emergency department usually experiences an increase in presentations of up to 40 per cent during the Christmas and New Year period.”
Common injuries to be on the lookout for including
* those involving water (and especially pools in the hot Australian summer);
* breaks, sprains and strains which may result from using Christmas presents such as scooters and trampolines;
* burns (see above);
* and cuts (especially when opening gifts with knives).
Apparently hanging Christmas decorations is particularly risky (read more about this injury prevention issue at http://www.medicaldaily.com/holiday-decorating-injuries-rise-when-stringing-christmas-lights-lands-you-er-264564), with injuries ranging from slips and falls from ladders (and make-shift ladders like tables), electrocutions from faulty wiring and watering trees whilst lights are still plugged in, and children biting into baubles.
I have really enjoyed blogging this year, sharing my thoughts and experiences with you.
I hope you and yours have a happy and safe break as 2013 draws to a close, Bridie : )
22 Dec, 13 | by Barry Pless
Mother Jones recently posted a fascinating but disturbing map of US states showing the number of deaths by cars vs deaths by guns. In light of the Newtown anniversary I wanted to share it with blog readers. The lead was the Bloomberg News study “ suggesting that by 2015, guns would kill more Americans than traffic accidents do.” As the piece notes, “A number of states have already hit this grisly milestone.” You will need to go to the website of the original piece to see the map but here is the salient comment Mother Jones makes: “It’s little surprise that many of these states—including Alaska, Arizona, Colorado, Indiana, Utah, and Virginia—are notorious for lax gun laws. What’s more, the numbers aren’t driven just by “bad guys with guns.” Nationally, close to two-thirds of gun deaths are suicides, and the split is much higher in states such as Alaska, which reported more than twice as many gun suicides as traffic deaths in 2010. Utah, Nevada, Oregon, and Washington are also seeing more gun suicides than traffic fatalities. Idaho, Montana, and others are close behind.” Sorry to spring this on blog readers at this time of year but I feel we owe it to Sandy Hill families to do so.