Fatalities Fatality Trends

Age The number of strangulation fatalities was greatest among children under one, who accounted for approximately half (45%) of the childhood strangulation fatalities. The fatality trend declined until age seven, after which it rose until dropping again at age 13. 

Percentage of fatalities trend (increase or reduction) over time Medium Acceptable Objective... 

Statistical reviews—serious injury and fatality trending... 

Partyka, S.C. 1984. Simple models of fatality trends using employment and population data. Accident Analysis and Prevention, 16, 211-222. 

Partyka, S. C. (1991). Simple models of fatality trends revisited seven years later. Accid. Anal Prev., 23, 423-430. 

Lyman, S., S. A. Ferguson, E. R. Braver and A. F. Williams (2002). Older driver involvement in police reported crashes and fatal crashes trends and projections. Traffic InJ. Prev., 8, 116-120. 

Nichols, J. L., D. Glassbrenner and R. P. Compton (2005). The impact of a nationwide effort to reduce airbag-related deaths among children An examination of fatality trends among younger and older age groups. J. Safe. Res. 36, 309-320. 

This chapter provides a summary of the major issues so far. It identifies the hazards posed by railroads, assesses the casualty rates, looks at trends in those rates, makes comparisons with comparable hazards in other industries or elsewhere in society, and reflects on how people react to the hazards. The five major railroad hazards considered are (in no particular order) fatalities to highway users at grade crossings trespasser fatalities, fatalities to train crews in collisions and derailments and during coupling operations occupational injuries to maintenance employees and releases of hazardous materials. 

Given the leadmg role which trends in the fatal accident rate played in the hearings which precipitated modern traffic safety policy it is remarkably how little effort has been made within the Department of Transportation to understand fatality trends. The record at NHTSA is dismal. An exchange between the GAO and NHTSA illustrates the agency s recalcitrance toward comprehensive analysis of accident rates, llie GAO reviewed several safety programs and commented on the lack of analysis of fatality rates. The reply from NHTSA was ... 

Only recently has NHTSA devoted resources to monitoring fatality trends. Useful as this effort may be, it does little to improve understanding of the causes for changes in trends. Consider the foUowing statement from NHTSA s First Annual Highway Traffic Safety Trend Report ... 

For an analysis of the mystery plunge, see James Hedlund, Robert Arnold, Ezio Cerrelli, Susan Partyka, Paul Hoxie and David Skinner An Assessment of the 1982 Traffic Fatality Dearease Accident Analysis and Prevention (August 1984) 247-262. Also see Susan C. Partyka Simple Models of Fatality Trends Using Employment and Population Data Accident Analysis and Prevention (June 1984) 211-222 and P. P. Scott Modelling Time-Series of British Road Accident DdXsP Accident Analysis and Prevention (April 1S>86) 109-117. 

LaneJD, Stinson FS, Bertolucci D Trends in alcohol-related fatal traffic crashes, United States, 1977-95 (Surveillance Report No 42). Rockville, MD, National Institute on Alcohol Abuse and Alcoholism, 1997... 

As of the early 1990s, annual worker fatalities ran about 9 per 100,000 employees annual lost-time disabling injuries ran about 4,000 per 100,000 employees (1). Property losses increased fourfold from the 1970s (2). The trends in fatalities and property losses can probably be ascribed to the increasing complexity and productivity of the highly automated chemical plants, where personnel are isolated from processes. Whereas exposure to health and safety hazards maybe reduced, the ability of experienced operating personnel to sense process problems and to correct these problems frequently is decreased. Another aspect of process management which has tended to increase hazards is the effort to reduce the formation of wastes and undesired by-products. This effort requires dose approach to temperature and pressure limits, at which points loss of control can be catastrophic (see Process control). Process and plant safety issues have been discussed (3—8). 

In view of the perceived benefit of aspirin in the secondary prevention of stroke and myocardial infarction, two large trials involving physicians as subjects were initiated to study the effect of aspirin in the primary prevention of arterial thrombosis. In the American study, 22,000 volunteers (age 40 to 84 years) were randomly assigned to take 325 mg of aspirin every other day or placebo. The trial was halted early, after a mean follow-up of 5 years, when a 45% reduction in the incidence of myocardial infarction and a 72% reduction in the incidence of fatal myocardial infarction were noted with aspirin treatment. However, total mortality was reduced only 4% in the aspirin group, a difference that was not statistically significant, and there was a trend for a greater risk of hemorrhagic stroke with aspirin. Thus, the prophylactic use of aspirin in an apparently healthy population is not recommended at this time, unless there are risk factors for cardiovascular disease. 

However, the use of antidepressants in completed suicide showed an upward trend, while the use of more violent methods (gassing, hanging) fell During this time prescription of moclobemide and two SSRIs (citalopram and fluoxetine) increased, while that of tricyclics (mainly doxepin and amitriptyline) remained steady. The mean annual fatal toxicity index was highest for tricyclics, such as doxepin, trimipramine, and amitripyline, and lowest for SSRIs. 

The most recent studies of time trends in stroke incidence do suggest that age-specific incidence is now falling (Sarti et al. 2003 Rothwell et at. 2004 Anderson et al. 2005 Hardie et al. 2005). Between the periods 1981-1984 and 2002-2004, a 40% reduction in the incidence of fatal and disabling stroke was found in Oxfordshire, UK (Rothwell et al. 2004), although this reduction was less marked in the oldest old (Fig. 1.3). High-quality population-based studies of time trends in TIA and minor stroke are lacking. However, moderate rises in TIA incidence were reported in Oxfordshire, UK, between the periods... 

Stegmayr B, Asplund K, Wester PO (1994). Trends in incidence, case fatality rate, and severity of stroke in Northern Sweden, 1985-1991. Stroke 25 1738-1745 Sudlow CLM, Warlow CP (1996). Comparing stroke incidence worldwide. What makes studies comparable Stroke 27 550-558 Sudlow CLM, Warlow CP (1997). Comparable studies of the incidence of stroke and its pathological types. Results from an international collahoration. Stroke 28 491-499... 

Dermal Exposure. A single topical dose of 2,273 mg/kg Aroclor 1254 was fatal to hairless mice within 24 hours (Puhvel et al. 1982). It was not specified whether all three treated mice died or whether the Aroclor was administered in pure acetone or in acetone-mineral oil emulsion. Median lethal doses for single dermal applications of PCBs to rabbits were between 794 and 1,269 mg/kg for Aroclors 1242 and 1248, between 1,260 and 3,169 mg/kg for Aroclors 1221 and 1262, and between 1,260 and 2,000 mg/kg for Aroclors 1232 and 1260 (Fishbein 1974 Nelson et al. 1972). These PCBs were applied undiluted except for Aroclors 1260 and 1262, which were administered in corn oil. Other details regarding the exposure protocol were not provided. Cause of death was not reported, and there was no clear trend of toxicity with degree of chlorination. Lethality data for other species or durations of exposure were not located. The lethal dose from the Puhvel et al. (1982) study is recorded in Table 3-3. 

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