Dorotéia Fátima Pelissari de Paula Soares

The new Brazilian traffic code and some characteristics of victims in southern Brazil

Objective—The aim was to study characteristics of traffic accident victims before and after the implementation of the new Brazilian traffic code, in January 1998. Subjects and methods—The study population was car and motorcycle occupants seen in a pre-hospital care service in Londrina, Paraná State (Brazil) before the introduction of the new Brazilian traffic code, from 22 January to 21 July 1997, and after its implementation during the same period in 1998. Victims were analyzed over the time periods according to helmet and seat belt use, gender, underage driving, and alcohol on the breath. Results—Use of seat belts increased from 45% to 62.6% and of helmets from 31.2% to 66.2% after the introduction of the new Brazilian code. The proportion driving under age 18 and with perceptible alcoholic breath declined significantly only among motorcycle riders. There was a 20% decline in car occupant injuries along with a 9% reduction in motorcycle related injuries after the change of the law. Conclusion—Results favor the hypothesis that rigorous legislation increases safer practices in traffic, at least during the first months of its implementation.

Characteristics of mortality in traffic accidents in an area of southern Brazil

OBJECTIVE The mortality by traffic accidents is discussed by means of the characterization of residents who died as a result of accidents in 1992. MATERIAL AND METHOD The study population was made up of all the victims of accidents which occurred in 1992 and who died in the same year. RESULTS AND CONCLUSIONS The majority of victims were males between the ages of 20 and 49 years who were pedestrians (29%), motorcycle riders (34%) or cyclists (18%). The accidents occurred mostly in the early afternoon and evening at crossroads of the busiest avenues. It may be concluded that even in the interior towns the consequences of traffic accidents constitute one of the principal hazards to the populations health and reveal a distinct pattern that calls for measures specific prevention.

Perfil do trabalho e acidentes de trânsito entre motociclistas de entregas em dois municípios de médio porte do Estado do Paraná, Brasil

This cross-sectional study focused on motorcycle couriers (work profile, work conditions, and traffic accidents) in Londrina and Maringá, Paraná State, Brazil. Data were collected from self-completed questionnaires in 2005-2006. In Londrina and Maringá, respectively, 377 and 500 motorcycle couriers completed the questionnaire, with mean ages of 28 and 29 years. Londrina showed a higher proportion of couriers that earned per delivery, worked both day and night or on night shifts only, and who worked more than 10 hours a day (p < 0.05). Despite greater exposure to hazardous work and traffic conditions in Londrina, there was no significant difference in the accident rates during the 12 months prior to the survey in Londrina and Maringá (2.89 and 2.80 per 100 person-months, respectively). The study detected precarious work conditions, high exposure to hazardous traffic conditions, and high accident rates among motorcycle couriers.

Fatores associados ao risco de internação por acidentes de trânsito no Município de Maringá-PR

OBJETIVO: Analisar os fatores associados ao risco de internacao da coorte constituida pelas vitimas dos acidentes de trânsito ocorridos no Municipio de Maringa - PR, no ano 2000. METODO: A coorte foi composta pelas vitimas que tiveram registro no Servico Integrado de Atendimento ao Trauma em Emergencia (SIATE) ou em Boletim de Ocorrencia Policial (BO). Foi feita vinculacao dos bancos gerados com os dados do SIATE, do BO, da Autorizacao de Internacao Hospitalar (AIH-SUS) e da Comunicacao de Internacao Hospitalar (CIH). Foram realizadas analises univariadas e de regressao multipla de Cox para identificar, entre as variaveis relacionadas a vitima, ao acidente e ao condutor do veiculo, os fatores de risco para internacao. RESULTADOS: Foram identificadas 3.468 pessoas vitimadas em 2.725 acidentes. O risco medio de internacao foi de 19,4/100 vitimas (673 internacoes). A analise de regressao multipla identificou como categorias de maior risco de internacao: vitimas pedestres, ciclistas e motociclistas; com idade acima de 50 anos; vitimadas em colisao com transporte pesado ou onibus; em acidentes ocorridos de madrugada e de tarde, em algumas regioes da cidade; e sendo o condutor do veiculo residente no proprio municipio. CONCLUSAO: Conclui-se que os programas de reducao dos acidentes de trânsito devem considerar os subgrupos mais vulneraveis a acidentes graves e que as multiplas determinacoes do risco apontam para a necessidade de acoes articuladas dos diversos setores de governo e segmentos da sociedade nesses programas.

Qualidade da informação sobre causas externas no Sistema de Informações Hospitalares

OBJECTIVE To analyze the coverage and quality of the data on hospitalizations due to external causes in the Hospital Information System of the Brazilian National Health System. METHODS Hospitalizations recorded in the Hospital Information System of 11 hospitals in two municipalities (Londrina and Maringá, Southern Brazil), in 2004, were compared with hospitalizations identified as consequences of external causes through investigating medical records, complemented with mortality and pre-hospital data. The crude agreement rate, sensitivity and positive predictive value were calculated. The profile of groups of hospitalization causes recorded in the System was compared with that obtained from investigations. RESULTS In Londrina, 3,002 hospitalizations due to external causes were recorded in the System and, in Maringá, 1,403. The investigations found 4,018 and 2,370, respectively. The System presented high positive predictive values for hospitalizations due to external causes in both municipalities: 97.7% in Londrina and 98.6% in Maringá. However, the sensitivity was low: 57.3% in Maringá and 73% in Londrina, thus denoting underrecording of these causes. Comparison between the profiles of the types of causes revealed that there was underestimation of some causes in the System, especially regarding accidents due to exposure to inanimate mechanical forces, assaults and intentional self-harm. CONCLUSIONS Underrecording of hospitalizations due to external causes and some distortions regarding the types of causes occurred in the Hospital Information System in both municipalities. Detection of these deficiencies may contribute towards the process of improving the quality of the information in this System.OBJETIVO: Analisar a cobertura e a qualidade das informacoes sobre internacoes por causas externas no Sistema de Informacoes Hospitalares do Sistema Unico de Saude. METODOS: As internacoes ocorridas no Sistema de Informacoes Hospitalares de 11 hospitais, em 2004, em dois municipios (Londrina e Maringa, PR), foram comparadas com aquelas identificadas como consequencias de causas externas por pesquisa em laudos medicos, complementadas por dados de mortalidade e de servico pre-hospitalar. Foram calculados indicadores de concordância bruta, sensibilidade e valor preditivo positivo. Comparou-se o perfil de agrupamentos de causas das internacoes registradas no Sistema com o obtido na pesquisa. RESULTADOS: Foram registradas no Sistema 3.002 internacoes por causas externas em Londrina e 1.403 em Maringa, enquanto a pesquisa detectou 4.018 e 2.370, respectivamente. O Sistema apresentou alto valor preditivo positivo para internacoes por causas externas em ambos os municipios (97,7% em Londrina e 98,6% em Maringa). Porem, a sensibilidade foi baixa: 57,3% em Maringa e 73% em Londrina, denotando sub-registro dessas causas. A comparacao dos perfis de tipos de causas externas revelou que ha subestimacao de algumas causas no Sistema, especialmente por acidentes por exposicao a forcas mecânicas inanimadas, agressoes e lesoes autoprovocadas. CONCLUSOES: Ha sub-registro de internacoes por causas externas e algumas distorcoes em relacao aos tipos de causas no Sistema de Informacoes Hospitalares nos dois municipios estudados. A deteccao dessas deficiencias pode contribuir para o processo de qualificacao da informacao desse Sistema.

Road Injury-Related Mortality in a Medium-Sized Brazilian City After Some Preventive Interventions

Objective. Some measures have been put into practice in Brazil over the last few years, to reduce the mortality due to road traffic–related injuries. The present study had the aim of evaluating the trends and characteristics of mortality due to this cause among the inhabitants of a medium-sized Brazilian city that has good-quality mortality data. Method. This was a time series study carried out using consolidated data from the Ministry of Health, covering 1994 to 2005. Results. The results indicate that the obligatory use of seat belts in urban areas (starting in September 1995), implementation of speed control radar at some strategic points (end of 1995 and 1996), and introduction of prehospital attention for victims of road traffic events (starting in June 1996) had a small impact on mortality among victims of road traffic injuries, which continued at a high rate (more than 35 per 100,000 population). In 1999, the year after a new national road traffic code had been implemented, a larger reduction in mortality levels was observed (to 27.2 per 100,000). However, this downward trend was not maintained over subsequent years, with mortality levels continuing to be around 23 to 29 per 100,000 population. Pedestrians, motorcyclists, elderly people, and men were the victims at highest risk of death. Conclusion. This study shows that, despite the general reduction in mortality rate after the new road traffic code was introduced, this trend was not maintained over subsequent years. This shows the need for new strategies aimed at reducing road traffic deaths in towns, particularly among pedestrians and motorcyclists.

Motorcycle couriers: characteristics of traffic accidents in southern Brazil

OBJECTIVE This study aimed at understanding characteristics of traffic accidents with motorcycle couriers in the cities of Londrina and Maringá, in the State of Paraná (Brazil). METHODS A total of 327 couriers who reported, in 2005/2006, motorcycle accident in the previous 12 months took part in the study (147 in Londrina and 180 in Maringá). RESULTS Of all the interviewed, 39.6% reported more than one traffic accident. The accidents were perceived as serious by 21.4% of them and 56.3% reported knowing a convalescing courier due to a traffic accident. Most injuries (82.9%) occurred during work hours. Significant differences were observed between the cities concerning climatic conditions (p=0.013), time of the day (p=0.002), pre-hospital care (p=0.032) and hospital admission (p<0.001). CONCLUSION The high incidence and the recurrence of traffic accidents highlight the susceptibility of motorcycle couriers to these events and the need for strategies and specific prevention policies.

Elderly victims of falls seen by prehospital care: gender differences

OBJECTIVE To identify elderly who are victims of falls, according to gender, who received care from prehospital services of Maringá, Paraná. METHODS A cross-sectional exploratory study carried out with 1,444 elderly patients who suffered falls in Maringá in the period from 2006 to 2008. Data were gathered from prehospital care services, typed and processed using the Epi Info 6.04d®. The χ² test was used to compare the falls in relation to gender (significance level = 0.05). RESULTS The number of falls according to gender presented similar percentages, 51.0% for males and 49.0% for females. Significant differences between genders were observed regarding age (p < 0.001), presence of alcohol breath (p < 0.001), type of fall (p < 0.001), place of fall (p < 0.001), treatment at hospital (p = 0.023), number of injuries (p = 0.014), type of injury (p < 0.001) and injury location (p <0.001). CONCLUSION These results show that falls happen differently among the elderly when considering gender. It highlights the importance of understanding these differences in detail and the circumstances in which the fall occurred, since this knowledge is key to plan preventive actions.

Factors Associated with Road Accidents among Brazilian Motorcycle Couriers

The objective of the study was to identify factors associated with reports of road accidents, among motorcycle couriers in two medium-sized municipalities in southern Brazil. A self-administered questionnaire was answered by motorcycle couriers that had worked for at least 12 months in this profession. The outcomes analyzed were reports on accidents and serious accidents over the 12 months prior to the survey. Bivariate and multivariate analyses by means of logistic regression were carried out to investigate factors that were independently associated with the outcomes. Seven hundred and fifty motorcycle couriers, of mean age 29.5 years (standard deviation = 8.1 ), were included in the study. Young age (18 to 24 years compared to ≥25 years, odds ratio [OR] = 1.77) speeding (OR = 1.48), and use of cell phones while driving (OR = 1.43) were factors independently associated with reports of accidents. For serious accidents, there was an association with alternation of work shifts (OR = 1.91) and speeding (OR = 1.67). The characteristics associated with accidents—personal (young age), behavioral (use of cell phones while driving and speeding), and professional (speeding and alternation of work shifts)—reveal the need to adopt wide-ranging strategies to reduce these accidents, including better work conditions for these motorcyclists.

Quality of external-cause data in the Hospitalization Information System

OBJECTIVE To analyze the coverage and quality of the data on hospitalizations due to external causes in the Hospital Information System of the Brazilian National Health System. METHODS Hospitalizations recorded in the Hospital Information System of 11 hospitals in two municipalities (Londrina and Maringá, Southern Brazil), in 2004, were compared with hospitalizations identified as consequences of external causes through investigating medical records, complemented with mortality and pre-hospital data. The crude agreement rate, sensitivity and positive predictive value were calculated. The profile of groups of hospitalization causes recorded in the System was compared with that obtained from investigations. RESULTS In Londrina, 3,002 hospitalizations due to external causes were recorded in the System and, in Maringá, 1,403. The investigations found 4,018 and 2,370, respectively. The System presented high positive predictive values for hospitalizations due to external causes in both municipalities: 97.7% in Londrina and 98.6% in Maringá. However, the sensitivity was low: 57.3% in Maringá and 73% in Londrina, thus denoting underrecording of these causes. Comparison between the profiles of the types of causes revealed that there was underestimation of some causes in the System, especially regarding accidents due to exposure to inanimate mechanical forces, assaults and intentional self-harm. CONCLUSIONS Underrecording of hospitalizations due to external causes and some distortions regarding the types of causes occurred in the Hospital Information System in both municipalities. Detection of these deficiencies may contribute towards the process of improving the quality of the information in this System.OBJETIVO: Analisar a cobertura e a qualidade das informacoes sobre internacoes por causas externas no Sistema de Informacoes Hospitalares do Sistema Unico de Saude. METODOS: As internacoes ocorridas no Sistema de Informacoes Hospitalares de 11 hospitais, em 2004, em dois municipios (Londrina e Maringa, PR), foram comparadas com aquelas identificadas como consequencias de causas externas por pesquisa em laudos medicos, complementadas por dados de mortalidade e de servico pre-hospitalar. Foram calculados indicadores de concordância bruta, sensibilidade e valor preditivo positivo. Comparou-se o perfil de agrupamentos de causas das internacoes registradas no Sistema com o obtido na pesquisa. RESULTADOS: Foram registradas no Sistema 3.002 internacoes por causas externas em Londrina e 1.403 em Maringa, enquanto a pesquisa detectou 4.018 e 2.370, respectivamente. O Sistema apresentou alto valor preditivo positivo para internacoes por causas externas em ambos os municipios (97,7% em Londrina e 98,6% em Maringa). Porem, a sensibilidade foi baixa: 57,3% em Maringa e 73% em Londrina, denotando sub-registro dessas causas. A comparacao dos perfis de tipos de causas externas revelou que ha subestimacao de algumas causas no Sistema, especialmente por acidentes por exposicao a forcas mecânicas inanimadas, agressoes e lesoes autoprovocadas. CONCLUSOES: Ha sub-registro de internacoes por causas externas e algumas distorcoes em relacao aos tipos de causas no Sistema de Informacoes Hospitalares nos dois municipios estudados. A deteccao dessas deficiencias pode contribuir para o processo de qualificacao da informacao desse Sistema.