Effect of Obstructive Sleep Apnea on the Risk of Injuries—A Nationwide Population-Based Cohort Study

Obstructive sleep apnea (OSA) has been reported to increase the risk of motor vehicle accidents. However, only few studies have investigated the effects of OSA on overall risk injury. The aim of study is to investigate whether OSA increases the risk of overall injury. The data were collected during 2000–2015 from Taiwan’s National Health Insurance Research Database. A total of 8901 individuals diagnosed with OSA were inpatients, or outpatients at least three times were enrolled. Finally, 6915 participants with OSA were included as the study cohort. We matched the study cohort with a comparison cohort, at a ratio of 1:4. Cox proportional hazards regression was used to analyse the association between OSA and overall injury. Patients with OSA had 83.1% increased risk of overall injury, compared to non-OSA individuals [adjusted hazards ratio (HR) = 1.831, confidence interval (CI) = 1.674–2.020, p < 0.001]. In the stratified age group, patients aged ≧65 years had the highest risk of injury (adjusted HR= 2.014; CI = 1.842–2.222, p < 0.001). Patients with OSA were at a higher risk of falls, traffic injury, poisoning, suffocation, suicide, and abuse or homicide than non-OSA individuals, with falls and traffic injury as the leading causes of injuries. The data demonstrated that patients with OSA have a higher risk of overall injury. The study results can be a reference for developing injury prevention strategies in the future. The general population and clinicians should have more awareness regarding OSA and its negative effects on injury development.

Exploring Women’s Experience of Gender-Based Violence and Other Threats to Safety on Public Transport in Bangladesh

Equal access to safe transport is increasingly conceptualised as a fundamental right for women, with demonstrated impact on health outcomes, social and economic mobility, and societal participation. This study analysed qualitative and quantitative data to examine travel patterns and experiences among 200 women (aged between 18-64 years) using paid transport for work or educational purposes in Bangladesh. Results showed that the women faced multiple threats to their safety, including gender-based violence, harassment and crime, and traffic and non-traffic injury and that the use of paid transport was associated with high levels of anxiety and fear. Despite these circumstances, the women were captive travellers, forced to make transport choices based on price, availability, and ease of travel rather than safety. Unable to choose safe transports, the women attempted to mitigate risks by changing their travel pattern and behaviour, and by restricted their travel frequency. These findings are discussed within the context of women’s rights and mobility justice.

The spectrum of body injuries of the driver and passenger in the case of a lethal traffic injury in a frontal collision in the interior of class E cars

The article discusses the state of examination of a lethal automobile injury to a driver and a passenger in a frontal collision in the passenger compartment of class E cars. Aim of the work. Investigate the injuries of the driver and passenger in the passenger compartment of an E class car and highlight the signs of being in the passenger compartment in the driver’s or passenger’s seat for practical use in forensic medical research. Materials and methods. The objects of the study were 179 «Acts of forensic medical examination of corpses» and «Conclusions of an expert» on road accidents accompanied by injury and death of people obtained from the archives of the Zhytomyr Regional Bureau of Forensic Medical Examination, accompanied by the death of persons inside car. The damage to the driver and passenger in a frontal collision in the passenger compartment of class E cars was carefully considered. A set of proven reliable methods was used in the work: anthropometric, morphometric, photographic, forensic, statistical analysis. Results. As a result of the registration of damages, the features inherent in damages received in the passenger compartment of an E-class car in a frontal collision were revealed. In particular: injuries to the soft tissues of the left leg prevailed among the front seat passengers, and not among the drivers, as is commonly believed; fractures of the bones of the lower extremities were found only in drivers; fractures of the bones of the right upper limb were observed only in front seat passengers; damage to the soft tissues of the left hand was characteristic only of drivers; the drivers had pelvic fractures on the right and left; the drivers had rib fractures on the left in combination with ruptures of the lungs on the side of the injury; the passengers had injuries to the ribs on the right, but no right-sided ruptures of the lungs were recorded. Conclusions. It has been established that the spectrum of damage to a driver and a passenger in a fatal car injury in a frontal collision in the passenger compartment of class E cars is characterized by a sufficient variety. Fractures of the right and left lower extremities and fractures of the thoracic spine are among the features that distinguished the driver from the passenger in a frontal collision in the passenger compartment of class E cars.

Identification of Factors Affecting Road Traffic Injuries Incidence and Severity in Southern Thailand Based on Accident Investigation Reports

Thailand has the second-highest rates of road traffic mortality globally. Detailed information on the combination of human, vehicle, and environmental risks giving rise to each incident is important for addressing risk factors holistically. This paper presents the result of forensic road traffic investigation reports in Thailand and determines risk factor patterns for road traffic injuries. Detailed forensic reports were extracted for 25 serious traffic accident events. The Haddon matrix was used to analyze risk factors in three phases stratified by four agents. The 25 events analyzed involved 407 victims and 47 vehicles. A total of 65.8% of victims were injured, including 14.5% who died. The majority (66.1%) of deaths occurred at the scene. Human-error-related factors included speeding and drowsiness. Passenger risks included not using the seat belt, sitting in the cargo area and the cab of pickups. Overloaded vehicles, unsafe car modifications, no occupant safety equipment and having unfixed seats were vehicular risks. Environmental risks included fixed objects on the roadside, no traffic lights, no guard rails, no traffic signs, and road accident black spots. At present, traffic accidents cause much avoidable severe injury and death. The outcome of this paper identifies a number of preventable risk factors for traffic injury, and importantly examines them in conjunction. Road traffic safety measures need to consider how human, vehicle, and environmental risks intersect to influence injury likelihood and severity. The Haddon matrix is useful in identifying these pre- and post-accident risk factors. Furthermore, the sustainable preventions of road traffic injury need to address these risks together with active law enforcement.