Road traffic injuries in the province of Grosseto

Introduction. Road traffic injuries constitute a major public health issue. The Province of Grosseto is one of the territories most affected in the Region of Tuscany. The objective of the study, part of the Road Safety Provincial Council?s project, is to describe the epidemiology of the road accidents in order to contribute to the reduction of the burden of deaths and injuries. Methods. The data relative to road accidents occurring in the Province were drawn from the various sources available: Death Certificates (1991-2005), Police Reports (1991-2003), Hospital Discharge Records (1996-2005), Emergency Room visits (2004-2005). Results. On average, each year road accidents cause 30 deaths, at least 530 hospitalizations, and approximately 3,300 Emergency Room visits. The standardized mortality rate (2003-2005, males: 20.6; females: 6.0), the mortality ratio (2003: 34.6 deaths for every 1,000 accidents), and the severity ratio (2003: 1,432 injured for every 1,000 accidents) are higher than regional figures. Discussion. The greater relative number of fatalities, casualties and crashes can be explained by various physical and social environmental factors such as vast flatland, few greater urban settlements, deprived area. The territory specifically demonstrates an accentuated seasonality in August, a month in which a peak in both the number of accidents and their severity is reported, brought about by the intense volume of commuter and transit traffic, and highlighted by the fact that in that same month approximately half of Emergency Room visits concern non-residents. Conclusion. The complexity of the issue, the number of determinant factors involved, and the disproportionately greater impact on the more disadvantaged and vulnerable segments of society require the development of inter-sectoral strategies and the sharing of responsibility among individuals, groups and communities

Emergency department visits, ambulance calls, and mortality associated with an exceptional heat wave in Sydney, Australia, 2011: a time-series analysis

<p>Abstract</p> <p>Background</p> <p>From January 30-February 6, 2011, New South Wales was affected by an exceptional heat wave, which broke numerous records. Near real-time Emergency Department (ED) and ambulance surveillance allowed rapid detection of an increase in the number of heat-related ED visits and ambulance calls during this period. The purpose of this study was to quantify the excess heat-related and all-cause ED visits and ambulance calls, and excess all-cause mortality, associated with the heat wave.</p> <p>Methods</p> <p>ED and ambulance data were obtained from surveillance and administrative databases, while mortality data were obtained from the state death registry. The observed counts were compared with the average counts from the same period from 2006/07 through 2009/10, and a Poisson regression model was constructed to calculate the number of excess ED visits, ambulance and deaths after adjusting for calendar and lag effects.</p> <p>Results</p> <p>During the heat wave there were 104 and 236 ED visits for heat effects and dehydration respectively, and 116 ambulance calls for heat exposure. From the regression model, all-cause ED visits increased by 2% (95% CI 1.01-1.03), all-cause ambulance calls increased by 14% (95% CI 1.11-1.16), and all-cause mortality increased by 13% (95% CI 1.06-1.22). Those aged 75 years and older had the highest excess rates of all outcomes.</p> <p>Conclusions</p> <p>The 2011 heat wave resulted in an increase in the number of ED visits and ambulance calls, especially in older persons, as well as an increase in all-cause mortality. Rapid surveillance systems provide markers of heat wave impacts that have fatal outcomes.</p

Evaluating the effectiveness of heat warning systems: systematic review of epidemiological evidence

Objectives: To review the existing research on the effectiveness of heat warning systems (HWSs) in saving lives and reducing harm. Methods: A systematic search of major databases was conducted, using "heat, heatwave, high temperature, hot temperature, OR hot climate" AND "warning system". Results: Fifteen articles were retrieved. Six studies asserted that fewer people died of excessive heat after HWS implementation. HWS was associated with reduction in ambulance use. One study estimated the benefits of HWS to be 468millionforsaving117livescomparedto210,000 costs of running the system. Eight studies showed that mere availability of HWS did not lead to behavioral changes. Perceived threat of heat dangers to self/others was the main factor related to heeding warnings and taking proper actions. However, costs and barriers associated with taking protective actions, such as costs of running air conditioners, were of significant concern particularly to the poor. Conclusions: Research in this area is limited. Prospective designs applying health behavior theories should establish whether HWS can produce the health benefits they are purported to achieve by identifying the target vulnerable groups