The major problem in enforcing the zero BAC limit is ensuring that
the province or territory enacts accompanying legislation authorizing the
police to demand a breath sample from drivers subject to this limit. There
has been no problem with drivers testing positive with exceedingly small
amounts of alcohol in their breath samples, because of natural processes
or diet. Presumably, the machines have thresholds to eliminate...
The major problem in enforcing the zero BAC limit is ensuring that
the province or territory enacts accompanying legislation authorizing the
police to demand a breath sample from drivers subject to this limit. There
has been no problem with drivers testing positive with exceedingly small
amounts of alcohol in their breath samples, because of natural processes
or diet. Presumably, the machines have thresholds to eliminate this
problem.
How easy is it to enforce zero limit in the face of possiblity of
physicigical sources of alcohol and uses of other dietry and household
sources of alcohol? There might be a lot or few false positive cases as a
result. Is there anything of in the scientific evidence base?
Reading the article, The effects of provincial bicycle helmet
legislation on helmet use and bicycle ridership in Canada (ref 1), it
appears the conclusions reached were ill considered and unreliable for a
number of reasons.
The article concludes that helmet legislation is not associated with
changes in ridership. This statement is somewhat misleading. Fig 3 in the
article shows trends of recreational bicycle u...
Reading the article, The effects of provincial bicycle helmet
legislation on helmet use and bicycle ridership in Canada (ref 1), it
appears the conclusions reached were ill considered and unreliable for a
number of reasons.
The article concludes that helmet legislation is not associated with
changes in ridership. This statement is somewhat misleading. Fig 3 in the
article shows trends of recreational bicycle use and the mean number of
times cycled in Alberta and Prince Edward Island. Alberta youth data 2001
shows approximately 58% use bikes, 30 times a year, a combined product of
17.4 may indicate the level of cycling activity. In 2007, 58% also used
bicycles but only 16 times per year, indicating a product of 9.28 and
suggesting a reduced level of cycling activity by 47%. For PEI by similar
calculation, in 2001, 73% x 38 = 27.7 and in 2007, 66% by 39 = 25.74,
reduced cycling 8%. The articles does not provide data on the helmet
wearing rates in either Alberta of PEI and therefore it lacks essential
data to make reliable judgements, except possibly to say youth cycling has
been discouraged. No information is provided on enforcement levels for
helmet use, police data on fines for example, whereas in Victoria,
Australia they issued more than 19000 fines in the first 12 months of
their helmet law.
Fig 2 shows a wearing rate of 32.9% for youth in Saskatchewan and it
is of interest because the head injury rate quoted by Macpherson et al
2002 (ref 2) was 9.78 for children 5-19 years in Saskatchewan, compared to
an average for provinces with helmet legislation of 9.96. Ontario is
similar with a low head injury rate but the wearing rate from before
legislation to after was similar at about 46% (ref 3). Both results
indicates helmets may have little bearing on the head injury rates and
other aspects could be involved, taking more care when cycling for
example.
The article mentions national response rates of 84.7%, 80.7%, and
78.9%, respectively, indicating a reduction and could this reflect people
who may cycle less due to having a legal requirement not responding?
People may also be less inclined to admit not wearing a helmet and thus
breaking the law, so is the telephone survey process a reliable guide
compared with road surveys for example.
The article contains no data on the accident rates, enforcement rates
or head injury rate changes but advocates helmet legislation. It refers to
a meta-analysis of five case control studies of cyclists seen in emergency
departments found that helmets significantly reduced the risk of head,
brain, and severe brain injuries by 63- 88% among cyclists of all ages.
However, the 5 reports included in the meta -analysis were primarily
comparing cyclists who had chosen to wear helmets and research suggests
the accident rates and injury rates can change for various types of
cyclists significantly.
The article mentions, bicycling is among the top five physical
activities practiced by Canadians; however, benefits to physical health
and to the environment must be considered in light of the risks of injury.
Between 1994 and 2004, 44 577 hospitalisations occurred due to cycling
incidents in Canada, representing 2% of all hospitalised injuries. The
health benefit of cycling are not discussed in detail that would have
helped to promote a balanced view, e.g. In 2001, deaths in Canada (ref 4)
due to all circulatory disease were approximately 60,000 compared to 63
from cycling. Type 2 diabetes is one of the fastest growing diseases in
Canada with more than 60,000 new cases yearly (ref 5). Per million
population, approximately two cyclist deaths occur annually compared with
2000 from circulatory diseases. Exercise helps to avoid depression and
annually about 3665 individuals commit suicide, including a youth category
of approximately 500 (ref 6). Exercise also helps to avoid stroke leading
to brain damage. During 2003/04, 26,676 patients were admitted for
ischaemic stroke (ref 7). Physical inactivity, high blood pressure,
obesity and diabetes continue to contribute to heart disease and stroke in
Canada and cycling helps to avoid all these problems. Dr Hillman from the
UK's Policy Studies Institute calculated the life years gained by cycling
outweigh life years lost in accidents by a factor of 20 to 1(ref 8).
The UK's National Children's Bureau (NCB) provided a detailed review
(ref 9) of cycling and helmets in 2005 stating the case for helmets is far
from sound, the benefits of helmets need further investigation before even
a policy supporting promotion can be unequivocally supported,. the strong
claims of injury reduction made by helmet proponents have not been borne
out for fatalities (which this paper argues is the most methodologically
sound test of effectiveness) in real-life settings with large populations.
(page 46).
The case for helmets is not conclusive because several reports
contain details which raise serious doubts whether helmet wearing improves
safety overall. Data from Canada also indicates that the accident rate can
increase by wearing a helmet.
My report, Evaluating bicycle helmet use and legislation in Canada (ref 3)
shows why helmet legislation and helmet promotion is not justified and it
is important to fully consider all of the evidence. Additional information
is provided in an assessment of the USA and their state bicycle helmet
laws (ref 10).
Jessica Dennis, Beth Potter, Tim Ramsay, Ryan Zarychanski.
The effects of provincial bicycle helmet legislation on helmet use and
bicycle ridership in Canada.
Inj Prev 2010 16: 219-224 originally published online June 29, 2010
2 Macpherson AK, To TM, Macarthur C, et al. Impact of mandatory
helmet legislation on bicycle-related head injuries in children: a
population-based study. Pediatrics 2000;110:e60.
3 Clarke CF, Evaluating bicycle helmet use and legislation in Canada
http://www.cycle-helmets.com/canada-helmet-assessment.doc
4 Health indicators, January 2005, Statistics Canada , Catalogue no.
82-221, Vol 2005 No1.
5 Health Canada, It's Your Health, Type 2 Diabetes http://www.hc-
sc.gc.ca/iyh-vsv/diseases-maladies/diabete_e.html accessed 17.02.2008
6 Kutcher SP, Szumilas M, Youth suicide prevention, CanMedAssocJ, 29
Jan ,178,(3) 2008
7 Medical News Today, Weekend Hospital Admission Increases Fatality
Risk Of Stroke, http://www.medicalnewstoday.com/articles/64884.php ,
accessed 18.02.2008
8 Hillman M, CYCLE HELMETS the case for and against Policy studies
Institute, London 1993
9 Gill T, Cycling and Children and Young People, A review, National
Children's Bureau, 2005. http://www.cycle-
helmets.com/cyclingreport_timgill.pdf
10 Health and safety assessment of state bicycle helmets laws in the
USA
http://www.ctcyorkshirehumber.org.uk/USA_helmet_laws.pdf
The story of seatbelts has ever been one of success - at least for
government bodies and the motor industry. However, seatbelts have an
unfortunate side effect owing to the dissipation of the kinetic and
vestibular discomfort associated with acceleration and deceleration: in
effect, faster and more erratic driving is encouraged.
Moreover, any savings in casualties among motor vehicle occupants
must be weighed...
The story of seatbelts has ever been one of success - at least for
government bodies and the motor industry. However, seatbelts have an
unfortunate side effect owing to the dissipation of the kinetic and
vestibular discomfort associated with acceleration and deceleration: in
effect, faster and more erratic driving is encouraged.
Moreover, any savings in casualties among motor vehicle occupants
must be weighed against the obvious failure of seatbelts to assist
vulnerable road-users such as pedestrians and cyclists - and hence public-
transport users, since walking and cycling are generally the most
practible modes for accessing public transport. The official attitude to
this issue - at least in the UK - has often been one of oversight, even if
the value of walking and cycling are recognised. The limited provision of
paths for the (sometimes) exclusive use of these vulnerable groups is
hardly compensation.
There is plenty of evidence to show that speeds on urban and suburban
streets - when the density of traffic permits - have steadily increased
[1], an issue for which seatbelt use cannot be absolved. Indeed, the link
between seatbelt use and increased speed was recognised by at least one
state: German seatbelt-fitted buses were permitted higher speeds than
buses without seatbelts [2].
So, happy-with-reservations 50th birthday...
References
[1] UK Department for Transport (2008). Road Safety Compliance
Consultation. London: TSO.
Jeffrey et al's [1] evidence of a serious underestimation of road
injuries is worrying for the year-by-year comparisons that are taken as
evidence for the state of road safety. The UK figures for death and
serious injury are reported to have followed a downward trend for forty
years or so, which has generally been taken as evidence - if no more than
implicitly - that a culture of safety on the roads i...
Jeffrey et al's [1] evidence of a serious underestimation of road
injuries is worrying for the year-by-year comparisons that are taken as
evidence for the state of road safety. The UK figures for death and
serious injury are reported to have followed a downward trend for forty
years or so, which has generally been taken as evidence - if no more than
implicitly - that a culture of safety on the roads is steadily developing
[2]. However, Jeffrey et al's study raises the issue of just how much
change there has been in the standards of recording casualties over the
years. It follows also that the proposing of explanations for the reported
changes must be guarded.
Even overlooking this last point, the safety-culture argument is
itself unconvincing. We well know that there are persistent problems
concerning, for example, speeding, drink-driving and "jumping" level
crossings, along with more recent issues of drugs and mobile-phone use.
Regarding speeding, it is estimated that 50% of drivers exceed the limit
on urban and suburban roads [3].
Alternative factors to explain the falling casualties include the
following: (a) NHS spending on trauma care, by which the consequences of a
given level of trauma are less serious than previously; (b) increasing
cases of road congestion, which lowers speed and the incidence of
overtaking, and hence the severity of crashes; (c) the avoidance of the
road by vulnerable road users [4]. This last issue is coupled with the
high rates of reported pedestrian casualties in Britain [3]; evidence from
Scotland suggests that children in the lowest socio-economic classes are
particularly at risk [5]. In the light of Jeffrey et al's evidence that
casualties among cyclists have been most affected by underestimation, with
pedestrians also notable in this regard, vulnerable road-users seem to be
getting a worse deal than the official figures suggest. Furthermore, there
are the health issues of a society that has become inactive through its
heavy dependence on cars.
If walking and cycling are really to be developed to the level that
applies for example in the Netherlands and Denmark - and bearing in mind
the importance of walking and cycling for accessing public transport -
there is much work to be done in Scotland, and by extrapolation across the
UK as a whole.
References
1. Jeffrey S, Stone D H, Blamey A, et al. An evaluation of police
reporting of road casualties. Injury Prevention 2009; 15: 13-18.
2. Donneley R R (2008). Scottish road strategy: Consultation
document. Edinburgh: The Scottish Government.
3. Department for Transport (2008). Road safety compliance
consultation. London: TSO.
4. Reinhardt-Rutland A H, Thomson J, Foot H, Elliott M (2008).
Response to the Scottish Government consultation: Scottish road safety
strategy. Leicester: British Psychology Society.
5. White D, Raeside R, Barker D (2000). Road accidents and children
living disadvantaged areas. Edinburgh: The Scottish Government.
As noted in the recently released WHO and UNICEF World Report on
Child Injury Prevention, globally, road traffic injuries (RTI) are the
leading cause of death among 10-19 year-olds with more than 260,000
children dying from RTIs each year. (1) In addition, an estimated 10
million more children are non-fatally injured. Africa has the world's
highest RTI mortality rate at 28.3 per 100,000 (2), yet relatively few
resources...
As noted in the recently released WHO and UNICEF World Report on
Child Injury Prevention, globally, road traffic injuries (RTI) are the
leading cause of death among 10-19 year-olds with more than 260,000
children dying from RTIs each year. (1) In addition, an estimated 10
million more children are non-fatally injured. Africa has the world's
highest RTI mortality rate at 28.3 per 100,000 (2), yet relatively few
resources and attention are given to the prevention of RTI in Africa; the
dearth of information regarding the impact and cost-effectiveness of
injury-prevention interventions on the continent is staggering.
Amend.org is a non-governmental organization that focuses on road
traffic safety for children in sub-Saharan Africa. Programs include media
outreach, the distribution of reflective material to school children, and
the teaching of road traffic safety courses in primary schools. The
results of pre- and post-program evaluative tests in five sample primary
schools in Ghana showed improved levels of student understanding of road
safety strategies. This education initiative, called Be Seen, Be Safe, has
been introduced to over 30,000 school children in Ghana and plans are
underway to introduce it in Tanzania in the coming months. An additional
program included a seminar on RTI issues conducted for the media in the
Ghanaian capital, Accra. Journalists and editors from 28 newspapers,
representing approximately half of the country's newspapers attended.
Comparison of newspaper articles on road traffic safety collected three
weeks prior to the workshop compared with six weeks after the workshop
showed an increase of 20% for numbers of commentaries and informational
stories relating to RTIs. Clearly, the need for greater public education
and awareness was recognized by the journalists and editors.
As the evidence mounts about the major public health epidemic
resulting from RTIs, especially in Africa and other developing countries,
promising efforts such as those undertaken by Amend.org must be encouraged
and expanded. However, we urge that all programs be developed in
collaboration with local stakeholders and undergo rigorous evaluation to
assure their effectiveness.
1 In: Peden M, Oyegbite K, Ozanne-Smith J, et al, eds. World report
on child injury prevention. 2008.
http://www.who.int/violence_injury_prevention/child/injury/world_report/en/index.html.
(accessed Jan 8, 2009).
2. In: Peden, M; Scurfield, R; Sleet, D; Mohan, D; Hyder, AA. World
report on road traffic injury prevention. Geneva: World Health
Organization; 2004. Available:
http://www.who.int/violence_injury_prevention/publications/road_traffic/world_report/en/.
(accessed Jan 8, 2009).
Several analyses of the results of bibliographic databases have shown
that--for several health fields and subjects--the number of databases
searched influences the number of papers found. Library and information
scientists seem to use certain methods and outcomes in their analyses. I
am curious whether this study used the same methods and measures.
The article of Dr. Stevenson's is very interesting. This article showed
that intervention increasing the use of safe belt. Traumatic brain injury
is one of the most leading causes of death and disability in developing
countries. In Indonesia, there are numerous reports that showed high
mortality is correlated with unsafe practice of driving or motorcycling.
Previous report showed that the use of safety belts is the single...
The article of Dr. Stevenson's is very interesting. This article showed
that intervention increasing the use of safe belt. Traumatic brain injury
is one of the most leading causes of death and disability in developing
countries. In Indonesia, there are numerous reports that showed high
mortality is correlated with unsafe practice of driving or motorcycling.
Previous report showed that the use of safety belts is the single most
effective means of reducing fatal and nonfatal injuries in motor-vehicle
crashes. Previous review from Shults et.al. showed that primary safety
belt laws and enhanced enforcement programs tend to result in greater
increases in usage rates for target groups with lower baseline rates.
Previous reviews also showed that interventions which combine education
with either incentives or distribution of free booster seats have a
beneficial effect on acquisition and use of booster seats for children.
This is a simple way for saving more lives.
References
Shults RA,Nichols JL, Zarr DC, Sleeta DA, Eldera RW, Effectiveness of
primary enforcement safety belt laws and enhanced enforcement of safety
belt laws: A summary of the Guide to Community Preventive Services
systematic reviews, Journal of Safety Research, 2004, 35(2;)189-196
Magnussen L, Emusu D, King W, Osberg JS. Interventions for promoting
booster seat use in 4–8 year olds traveling in motor vehicles. The
Cochrane Database of Systematic Reviews 2006, Issue 1.
The article documenting the successful seat belt intervention and
attributable increase in wearing in Guanghzhou, China is a substantial
contribution to road safety in middle-income and low-income countries. The
reported increase in seat belt wearing is particularly significant in the
context of documented declines over 3 years (2005-2007) in two other
eastern seaboard Chinese cities, Nanjing, Jiangsu Province and Zhousha...
The article documenting the successful seat belt intervention and
attributable increase in wearing in Guanghzhou, China is a substantial
contribution to road safety in middle-income and low-income countries. The
reported increase in seat belt wearing is particularly significant in the
context of documented declines over 3 years (2005-2007) in two other
eastern seaboard Chinese cities, Nanjing, Jiangsu Province and Zhoushan,
Zhejiang Province. The baseline Nanjing results were described in Injury
Prevention (Dec 2007), the 3 year 2 city results are currently available
on line.[1,2] The minimal wearing of rear seat belts (consistently below 1%)
is an additional noteworthy outcome measure of this latter series of
surveys. Considering the substantially documented injury prevention
benefits of seat belt wearing and that in China fitting has been required
in front seats from 1993 and in rear seats of new vehicles since 2004 (and
that laws and regulations are in place), interventions that promote
community awareness of the effectiveness of seat belts together with
sustained enforcement should be actively encouraged.
References
1. Routley V, Ozanne-Smith J, Li D, et al. "Patterns of seat belt wearing
in Nanjing, China." Inj. Prev, 2007, 13(6): 388-393.
2. Routley,V, Ozanne-Smith J, Li D et al. China belting up or down? Seat
belt wearing trends in Nanjing and Zhoushan. Accid Anal Prev (in press).
Available online 4 September 2008.
First I want to thank the authors for an excellent study. As the
authors discuss, the benefit of using photoelectric technology to reduce
smoke alarm disablement and thereby fire deaths has never been adequately
communicated to the public. (Note: This author has made repeated
requests, accompanied by extensive research, to the National Fire
Protection Association (NFPA), Underwriters Laboratories...
First I want to thank the authors for an excellent study. As the
authors discuss, the benefit of using photoelectric technology to reduce
smoke alarm disablement and thereby fire deaths has never been adequately
communicated to the public. (Note: This author has made repeated
requests, accompanied by extensive research, to the National Fire
Protection Association (NFPA), Underwriters Laboratories (UL) and the
Consumer Product Safety Commission (CPSC) to inform the public but no
action has been taken.)
The authors may be interested to know that the following language has
been contained in the Massachusetts State Building Code since 1998.
"Section 919.3 - Where required: single and multiple station smoke
detectors or household fire warning systems shall be installed and
maintained in full operating condition in the locations described in 780
CMR 919.3.1 through 919.3.3. Any smoke detector located within 20 feet of
a kitchen or within 20 feet of a bathroom containing a tub or shower shall
be a photoelectric type smoke detector."
This decision was based on research submitted by this author that is
not available in the public health literature.
From a study published in NFPA’s Fire Journal, “ ... We favor
photoelectric detectors to reduce rates of nuisance alarms from cooking
and to provide optimal protection from cigarette related fires. Electrical
detectors with battery back-up are the detectors of choice, except in
communities such as remote villages in Alaska, where alternating current
is non-existent or unreliable. If ionization detectors are installed, they
should be located at least 20 feet, and preferably 25 feet, from stoves
and at least 10 feet from bathroom doors if possible." (KuKlinski, Diana,
Berger, Lawrence, and Weaver, John, "Smoke Detector Nuisance Alarms - A
Field Study in a Native American Community", Fire Journal (Sept/Oct 1996)
pp. 65-72.)
In a study in Woodlands, Texas, 90% (115/126) of the total number of
false alarms were recorded by the ionization detectors, 86% (83/95) of the
non-malfunction alarms were caused by cooking. This study clearly shows
that the most common source of false alarms in a residential setting is
cooking and that ionization detectors are clearly more susceptible to
these types of false alarms. (Moore, D.A., "Remote Detection and Alarm for
Residences: The Woodlands System", U.S. Fire Administration, Emmitsburg,
Md., May 1980.)
In a manual published by one manufacturer titled "A Method For
Improving Smoke Detector Codes In The United States, the manufacturer
recommends using photoelectric detectors in, "Existing small apartments
where kitchens or open flame heaters are adjacent to sleeping area." This
manufacturer also recommends using a photoelectric detector if you have to
place a detector within 20 ft of a furnace or heater. ("A Method for
Improving Smoke Detector Codes In the United States", prepared by BRK
Electronics, (1987).)
The authors have contributed valuable research to the previous work.
I have already forwarded it to the various boards and committees that I am
dealing with which type of smoke alarm to require.
If I may add some additional comments on the following topics
discussed by the authors.
1. The authors cite 2 studies showing that, "smoke alarms are
effective interventions for injuries from residential fires."
Comment
I agree that smoke alarms are better than nothing but this
information has to be put in context. The authors conclude that having a
smoke alarm is better than not having a smoke alarm. This is almost self
evident. But neither investigated whether or not one type was better than
another or if there were scenarios were it should have made a difference
but didn’t. Neither author was probably aware, because it was never
publicized, that in the late 80's UL and the smoke alarm manufacturers
decided to de-sensitize smoke alarms, i.e. ionization smoke alarms, to
help reduce the nuisance alarm problem. Since this de-sensitization has
taken place the % of fire fatalities with working alarms has doubled. (US
Fire Administration Data)
A 2004 Report issued by the NFPA, after this de-sensitization, found
that smoke alarms reduced the risk of dying in a fire by only 7% for
apartment dwellers. This report also estimated that the reduction risk for
all residential occupancies was only 21%. (Ahrens, M., “U. S. Experience
with Smoke Alarms and Other Fire Detection Alarm Equipment,” National Fire
Protection Association, Quincy, MA November 2004.) In any case,
researchers cannot identify how much of the reduction in risk is not due
to the effectiveness of the detector but rather due to occupant
characteristic that go along with owning a smoke detector: higher income,
newer construction, better evacuation plans etc? All of these factors
would contribute to a reduction in fire risk. As a consequence, the
actual reduction in risk due to the effectiveness of the detector is
probably much less that 21%. Smoke alarms do reduce risk but do they
reduce it as much as we think they do?
Since, according to the CPSC, approximately 90% of the smoke alarms
in use are ionization, then these statistics refer to the effectiveness of
ionization alarms. This relatively small amount of risk reduction is due
to the failure of the ionization alarm to adequately sense smoke created
by smoldering fires, such as those started by smoking. "NIST officials
told the Boston City Council's Public Safety Committee in August that
"ionization alarms may not always alarm, even when a room is filled with
smoke from a smoldering fire." Scientists have reached similar conclusions
in Norway, Australia and England." ("Smoke Detector Alarming Limits,"
Roylance, F., Baltimore Sun, March 4, 2008.)
2. The authors discuss the cost of different technologies and list
the following prices: ionization - $10, photoelectric $15, and dual
sensors for $25.
Comment
The Boston Fire Department has provided photoelectric smoke alarms in
our free give-away program for approximately ten years. The last pricing
information that we received was $5.75 for ionization and $8.00 for
photoelectric. It appears that much of the price differential at the
retail level is due to marketing as opposed to manufacturing cost
differences. It is not unreasonable to assume that if photoelectric
alarms captured 90% of the market that benefits of "economies of scale"
would change the price differential. In addition, in new construction the
total price included wiring and labor so the total price differential is
negligible.
Let me conclude with the following information:
Due to this author’s research the Massachusetts Board of Fire
Prevention Regulations approved the following language. (It will become
effective on October 1, 2008.)
32.02: Definitions
Approved monitored battery power smoke detector, shall consist of a
working device, as defined in M.GL.c148, s. 26D. However such device shall
not include a device that employs ionization technology as the sole means
of smoke detection.
Approved primary power smoke detector, shall consist of a working
device, as defined in M.GL.c148, s. 26D. However such device shall not
include a device that employs ionization technology as the sole means of
smoke detection.
32.03 Installation of Smoke Detectors In the Vicinity of a
Kitchen, Bathroom or Other Areas.
No smoke detector employing ionization technology shall be installed
within 20 feet of an entryway to a kitchen, or bathroom containing a
bathtub or shower or any other room or area which features any item which
produces steam or moisture. The 20 foot measurement shall include and
extend into common areas of a multi-family dwelling, if applicable.
Due to this author’s research the Governor of Vermont will sign the
following legislation. (It will become effective on January 1, 2009.)
(a) A person who constructs a single-family dwelling shall install
one or more photoelectric-only-type smoke detectors in the vicinity of any
bedrooms and on each level of the dwelling, …
(b) Any single-family dwelling when transferred by sale or exchange
shall contain one or more photoelectric-only-type smoke detectors in the
vicinity of any bedrooms and on each level of the dwelling installed in
accordance with the manufacturer's instructions …
This research paper is additional evidence supporting my efforts to
educate the public regarding the differences in smoke alarm technology and
I appreciate the authors’ thoroughness. Hundreds of lives can be saved
each year if the public is provided with this type of information.
The major problem in enforcing the zero BAC limit is ensuring that the province or territory enacts accompanying legislation authorizing the police to demand a breath sample from drivers subject to this limit. There has been no problem with drivers testing positive with exceedingly small amounts of alcohol in their breath samples, because of natural processes or diet. Presumably, the machines have thresholds to eliminate...
How easy is it to enforce zero limit in the face of possiblity of physicigical sources of alcohol and uses of other dietry and household sources of alcohol? There might be a lot or few false positive cases as a result. Is there anything of in the scientific evidence base?
Conflict of Interest:
None declared
Reading the article, The effects of provincial bicycle helmet legislation on helmet use and bicycle ridership in Canada (ref 1), it appears the conclusions reached were ill considered and unreliable for a number of reasons.
The article concludes that helmet legislation is not associated with changes in ridership. This statement is somewhat misleading. Fig 3 in the article shows trends of recreational bicycle u...
The story of seatbelts has ever been one of success - at least for government bodies and the motor industry. However, seatbelts have an unfortunate side effect owing to the dissipation of the kinetic and vestibular discomfort associated with acceleration and deceleration: in effect, faster and more erratic driving is encouraged.
Moreover, any savings in casualties among motor vehicle occupants must be weighed...
Dear Editor
Jeffrey et al's [1] evidence of a serious underestimation of road injuries is worrying for the year-by-year comparisons that are taken as evidence for the state of road safety. The UK figures for death and serious injury are reported to have followed a downward trend for forty years or so, which has generally been taken as evidence - if no more than implicitly - that a culture of safety on the roads i...
As noted in the recently released WHO and UNICEF World Report on Child Injury Prevention, globally, road traffic injuries (RTI) are the leading cause of death among 10-19 year-olds with more than 260,000 children dying from RTIs each year. (1) In addition, an estimated 10 million more children are non-fatally injured. Africa has the world's highest RTI mortality rate at 28.3 per 100,000 (2), yet relatively few resources...
Several analyses of the results of bibliographic databases have shown that--for several health fields and subjects--the number of databases searched influences the number of papers found. Library and information scientists seem to use certain methods and outcomes in their analyses. I am curious whether this study used the same methods and measures.
The article of Dr. Stevenson's is very interesting. This article showed that intervention increasing the use of safe belt. Traumatic brain injury is one of the most leading causes of death and disability in developing countries. In Indonesia, there are numerous reports that showed high mortality is correlated with unsafe practice of driving or motorcycling. Previous report showed that the use of safety belts is the single...
The article documenting the successful seat belt intervention and attributable increase in wearing in Guanghzhou, China is a substantial contribution to road safety in middle-income and low-income countries. The reported increase in seat belt wearing is particularly significant in the context of documented declines over 3 years (2005-2007) in two other eastern seaboard Chinese cities, Nanjing, Jiangsu Province and Zhousha...
Dear Editor
First I want to thank the authors for an excellent study. As the authors discuss, the benefit of using photoelectric technology to reduce smoke alarm disablement and thereby fire deaths has never been adequately communicated to the public. (Note: This author has made repeated requests, accompanied by extensive research, to the National Fire Protection Association (NFPA), Underwriters Laboratories...
Pages