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Press releases Saturday 24 June 2006
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(1) PEOPLE KEEP DRIVING EVEN WHEN SLEEPY
(2) 4x4 DRIVERS MORE LIKELY TO FLOUT MOBILE PHONE AND SEAT BELT LAWS
(4) NHS SHOULD BE REMOVED FROM DIRECT GOVERNMENT CONTROL
(5) MORE EFFORT NEEDED TO PREVENT HUMAN RIGHTS ABUSES
(6) DON’T USE MOBILE PHONE DURING STORMS, WARN DOCTORS
(1) PEOPLE KEEP DRIVING EVEN WHEN SLEEPY
Online First
(Awareness of driving while sleepy and road traffic accidents: prospective
study in GAZEL cohort)
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38863.638194.AE
People continue to drive even when they know they are sleepy, suggests a large study published on bmj.com today. This has important implications for public safety, say the researchers.
Studies have shown that sleepiness in drivers is an important factor contributing to the burden of traffic related injury and death. Estimates of the proportion of car crashes attributable to sleepiness range from 3% to 33%, but little is known about the extent to which drivers are able to assess that they are sleepy while driving.
Researchers in France examined the association between self reported driving while sleepy and the risk of serious road traffic accidents (RTAs) in 13,299 middle aged drivers.
They collected data on sleepiness and other driving behaviours in 2001, and serious RTAs in 2001-3. Socioeconomic status was recorded, and a range of other factors that could affect the results were taken into account.
In answer to the question “in the past 12 months, have you ever driven while sleepy?” 63% of participants responded never, 36% a few times in the year, 0.8% about once a month, 0.3% about once a week, and 0.2% more than once a week.
There was a strong association between self assessed driving while sleepy and the risk of serious road traffic accidents over the next three years. This risk increased with reported frequency of driving while sleepy.
For example, participants who reported driving while sleepy “a few times in the year” were 1.5 times more likely to have been involved in a serious RTA compared with those who reported not driving while sleepy over the same period. And those who reported doing so “once a month or more often” were nearly three times more likely to have been involved in a serious RTA.
Further analysis did not change this association and follow-up questionnaires in 2004 also found a similar trend.
These results clearly show that self assessed driving while sleepy is a powerful predictor of serious road traffic accidents, and suggest that drivers are aware that they are sleepy when driving but do not act accordingly, say the authors. Drivers may either underestimate the impact of sleepiness on their driving performance or overestimate their capacity to fight sleepiness.
Messages on prevention should therefore focus on convincing sleepy drivers to stop driving and sleep before resuming their journey, they conclude.
Contacts:
Emmanuel Lagarde, Senior Researcher,
INSERM U593, Université Victor Segalen, Bordeaux Cedex, France
Email: emmanuel.lagarde@isped.u-bordeaux2.fr
Séverine Ciancia, Media Relations,
INSERM, Paris, France
Email: severine.ciancia@tolbiac.inserm.fr
(2) 4x4 DRIVERS MORE LIKELY TO FLOUT MOBILE PHONE AND SEAT BELT LAWS
Online First
(Unsafe driving behaviour and four wheel drive vehicles: observational
study)
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38848.627731.2F
Drivers of four wheel drive vehicles are more likely to flout laws regarding mobile phones and seat belts than drivers of other cars, finds a study published on bmj.com today.
This is a major public health concern and greater efforts are needed to educate the public and enforce these laws, argue the authors.
The study took place at three different sites in Hammersmith, West London. Private passenger vehicles were observed Monday to Friday for one hour in the morning (9-10 am), afternoon (1-2 pm), and early evening (4-5 pm).
The first observations were carried out in February 2004, within the “grace” period regarding use of hand held mobile phones, during which police only cautioned offenders. Observations were repeated one month later, after police began to impose penalties for non-compliance with the new law.
A total of 38,182 normal cars and 2,944 four wheel drive vehicles were included in the analysis. Overall, almost one in six drivers (15.3%) was not wearing a seat belt and one in 40 (2.5%) was using a hand held mobile phone while he or she passed the observer.
Drivers of four wheel drive vehicles were almost four times more likely than drivers of other cars to be seen using hand held mobile phones. They were also more likely not to comply with the law on seat belts.
Levels of non-compliance with both laws were slightly higher in the penalty phase of observation than during the grace period, and breaking one law was associated with an increased likelihood of breaking the other.
“Our data show a worryingly high level of non-compliance with laws on seat belts and hand held mobile phones by drivers in London, and almost no effect of the end of the grace period on the use of a mobile phone while driving,” write the authors. “Our observation that almost one in six drivers was not wearing a seatbelt is a major public health concern,” they add.
The findings also support the theory of risk compensation, which predicts that drivers of four wheel drive vehicles feel safer and therefore take more risks when driving.
Although four wheel drive vehicles are safer in a crash, their owners may be placing themselves and other road users at increased risk of injury, warn the authors.
Contact:
Lesley Walker, Research Associate,
Department of Primary Care and Social Medicine, Imperial College, London,
UK
Email: lemorph@hotmail.com
(3) INJURY RATES ON ENGLAND’S ROADS REMAIN HIGH, DESPITE GOVERNMENT CLAIMS THAT THEY HAVE FALLEN SUBSTANTIALLY
Online First
(Changing safety on England’s roads: analysis of hospital statistics)
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38883.593831.4F
The number of serious injuries on England’s roads is much higher than Government figures suggest, says a paper published on bmj.com today.
Government targets for England look to reduce by 40% overall the number of serious injuries and deaths on the nation’s roads by 2010, (compared with a starting point - baseline - of the 1994-8 average figures). The target for those aged 15 or under is higher, at 50% reduction.
But when researchers compared police statistics (which the Government uses for its figures), and hospital statistics between 1996 and 2004, they found large discrepancies.
Police figures showed that by 2004, numbers of those killed or seriously injured had dropped by almost a third (from 86 per 100,000 population, to 59 per 100,000). However, the police statistics showed a much smaller decline in the number of people killed than the number seriously injured.
Police statistics showed a 32% drop in serious but non-fatal injuries. However, the researchers found that hospital figures for non-fatal road injuries showed that rates had hardly changed between 1996 and 2004.
The authors suggest the discrepancies are probably down to an increase in under-reporting of injuries in the police statistics and that, if there has been a decline in injuries, it is probably only in those considered by the police to have been minor.
More investigation is needed, say the authors, since the findings cast doubt on whether there has been much progress on the Government’s target to date - and on its likelihood of being met by 2010. In practical and policy terms, much more needs to be done to ensure that there are real and substantial reductions in serious injuries on England’s roads.
Contacts:
Dr Mike Gill, Regional Director of
Public Health, South East Regional Public Health Group, Guildford GU1 4GA
Email: mike.gill@dh.gsi.gov.uk
Professor Michael Goldacre, Department
of Public Health, Old Road Campus, University of Oxford, UK
Email: michael.goldacre@dphpc.ox.ac.uk
(4) NHS SHOULD BE REMOVED FROM DIRECT GOVERNMENT CONTROL
(Personal View: It is time
to separate the NHS from direct government involvement)
http://bmj.com/cgi/content/full/332/7556/1518
Only an NHS free of direct government control, managed by an all-party body with clinical and health service experts, will save the NHS from being used as a political football, says a leading public health consultant in this week’s BMJ.
Dr Layla Jader, a member of the British Medical Association’s Public Health Committee Wales, argues that the NHS has seen valuable resources wasted in “constant structural changes.” She proposes that an independent body, made up of those working in the sector and patients - rather than government advisors - is the best hope to sustain an NHS fit for the 21st century.
With an independent management structure, “the pressure of constant media attention and the threat of political retribution - which drive many politicians to short term solutions that won’t solve long term problems and mean they never learn from past mistakes - will be eased”, says Dr Jader.
The NHS is a huge and complex organisation, and the current modernisation programme makes this the perfect opportunity to reconsider its management structure - however radical a move that may appear. Delegating responsibility for inflation control to the independent Bank of England seemed a similarly ambitious step, but has “greatly contributed to the country’s economic stability”, argues Dr Jader.
“The NHS is too vital to our future prosperity to be governed by any specific party”, says Dr Jader. It needs a system that “replaces political dogma with clinically driven decisions, confrontation with consensus, unaccountability with democracy, and short term decision making with long term stability”, she concludes.
Contact:
Dr Layla Jader, Consultant in Public
Health Medicine, Committee for Public Health Medicine and Community Health,
British Medical Association Wales
Email: layla.jader@nphs.wales.nhs.uk
(5) MORE EFFORT NEEDED TO PREVENT HUMAN RIGHTS ABUSES
(Editorial: Doctors, interrogation,
and torture)
http://bmj.com/cgi/content/full/332/7556/1462
More effort is needed to prevent human rights abuses, argues a senior doctor from Argentina in this week’s BMJ.
In the past month, several medical associations have spoken out about the role of doctors in interrogation. These statements should bring medical debate on human rights to the forefront, but they are not enough, writes Professor Luis Justo.
One of the main reasons for reopening the discussion about the duties of health workers in the “war on terror” and its ethical implications is the existence of the so called biscuit teams (behavioural science consultation teams or BSCT). These teams operate in US military prisons and comprise psychologists, psychiatrists, and other health workers.
Last year, a US report on interrogation techniques in Guantanamo Bay, Afganistan, and Iraq, acknowledged that biscuit teams assisted in interrogations.
Professor Justo believes that biscuit teams’ advice to interrogators should be questioned. “Regulations about what is considered “humane” for the Department of Defense may change over time, but it is clear that its criterion for “humanity” has dire ethical flaws,” he says.
Fortunately many medical associations are speaking out against these practices. Last month, the World Medical Association (which has more than 80 national medical associations as members) revised its Tokyo declaration on torture. The American Medical Association and the American Psychiatric Association have also made statements about the role of doctors in interrogation.
There is also an urgent need to make clear to all health workers that participation in torture or abuse of prisoners is against the ethical core of healthcare professions, says the author.
Health students should be educated explicitly on active engagement with human rights, going beyond simply considering health to be a human right and ensuring abstention from participating in any behaviour which demeans human rights.
He suggests a proposal put forward 10 years ago for an international court to judge the behaviour of physicians and other health workers and to keep records on complicity in human rights violations merits further discussion.
Such a body could initially act by making public statements denouncing doctors who have committed documented violations of human rights, he says, but could also use its influence to urge national medical associations to revoke such doctors’ licence to practice. “It would be a demanding task, but it would be worth the international effort to do it,” he concludes.
Contact:
Luis Justo, Professor of Bioethics,
Universidad Nacional del Comahue, Catamarca, Cipolletti, Argentina
Email: justo@maipue.com
(6) DON’T USE MOBILE PHONE DURING STORMS, WARN DOCTORS
(Letter: Injury from lightning
strike while using mobile phone)
http://bmj.com/cgi/content/full/332/7556/1513
Three doctors in this week’s BMJ warn of the risk of using mobile phones outdoors during stormy weather.
They describe the case of a 15 year old girl who was witnessed being struck by lightning while using her mobile phone in a large park in London during stormy weather. She was successfully resuscitated, but one year later she suffered complex physical, cognitive, and emotional problems.
If someone is struck by lightning, the high resistance of human skin results in lightning being conducted over the skin without entering the body, explain the authors. This is known as flashover and has a low death rate. Conductive materials such as liquids or metallic objects disrupt the flashover and result in internal injury with greater death rates.
To their knowledge, no similar cases have been reported in the medical literature. They found three cases reported in newspapers in China, Korea, and Malaysia, all resulting in death.
“This rare phenomenon is a public health issue, and education is necessary to highlight the risk of using mobile phones outdoors during stormy weather to prevent future fatal consequences from lightning strike injuries related to mobile phones,” say the authors.
“The Australian Lightning Protection Standard recommends that metallic objects, including cordless or mobile phones, should not be used (or carried) outdoors during a thunderstorm,” they add. “We could not find any advice from British telecommunication companies.”
Contact:
Swinda Esprit, Senior House Officer
in Otorhinolaryngology, Northwick Park Hospital, Middlesex, UK
Email: swinda@runbox.com
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