At
SPRI, collaboration is an organizational value. For every
project we work hard to bring together chemists, engineers,
epidemiologists, medical sociologists, economists,
biostatisticians, clinicians, survey methodologists, and policy
experts in order facilitate quality research.
Alcohol is Strongly Associated with Lower Mortality
Following an Injury
(Manuscript)
The primary finding from this retrospective analysis of a
registry including all patients treated for traumatic injuries
in level 1 and 2 trauma units in Illinois between 1995 and
2009 is a substantial inverse relationship between in-hospital
mortality and blood alcohol concentration. The study includes
all patients with blood alcohol toxicological examination
levels ranging from below the detectable limit to 500 mg/dl
(N=190,612). The reduction in case fatality rates was
substantial – up to 50% decline. The strength of the
association, the observed dose-response relationship, and the
consistency of the findings across the various multivariable
models indicate that blood alcohol concentration is associated
with a reduction in in-hospital mortality among those that
survive long enough to receive treatment in specialized trauma
units.
Severe Physical Abuse of the Elderly (Manuscript)
This is the first clinical case-control study detailing
clinical outcomes and evaluating risk factors of elderly
persons suffering severe physical abuse. We observed that
victims of severe traumatic elder abuse were more likely to be
female, suffer from a neurological or mental disorder, and
drug and/or alcohol abuse. The victims of abuse were assaulted
by a wide array of weapons and predominately suffered injuries
to the head and torso suggesting an intent to kill -- not
injure. Elderly victims of physical abuse suffer more severe
injuries than their non-abused counterparts. All the key
measures of injury severity—length of hospital stay, treatment
in an ICU, assisted breathing, ISS scores, in-hospital case
fatality rates – were higher in the cases. These measures of
severity are associated with long-term adverse outcomes. In
addition, many of the victims returned to the environment in
which the abuse occurred and were more likely to die during
the first year following the index hospitalization.
Raised Speed Limits on U.S. Roads Result in Higher Road
Fatalities
(Manuscript)
We estimate that between 1995 and 2005, approximately 12,500
people died as a result of repealing the National Maximum
Speed Law. In the 10 states that essentially did not change
their posted speed limits, we observed a substantial decline
in fatalities and injuries in fatal crashes. Therefore, had
the other states not raised their speed limits we expect that
similar declines would have been observed. In our study we
control for differences between the states, vehicle miles
traveled, congestion, and posted speed limits. The repeal of
the National Maximum Speed Law is an example of a policy that
can have a direct life or death impact on its citizens. Our
study clearly shows that policy can directly result in more
deaths. The inverse is true as well -- a well guided policy
can lead to reduction in deaths on roads.
The Impact of OSHA Recordkeeping Regulation Changes on
Occupational Injury And Illness Trends(Manuscript)
The Survey of Occupational Injuries and Illnesses (SOII),
based on OSHA logs, indicates that occupational injuries and
illnesses in the U.S. have steadily declined by 35.8% between
1992-2003. However, major changes to the OSHA recordkeeping
standard occurred in 1995 and 2001. A recent study we
published illustrates that the steep decline in reported
occupational injuries and illnesses during the past 10 years
in the U.S. workforce is an artifact resulting from changes to
the recordkeeping rules and regulations rather than an
improvement in workplace safety.
(Brief Summary)
Conflicts of Interest in Biomedical Research (Manuscript)
We investigate the issue of conflicts of interest (COI) among
researchers whose studies have been published in JAMA and
NEJM. We found that 32.6% of manuscripts published in these
two flagship journals had one or more author with COI. Authors
with conflicts of interest were more likely to present
positive findings. This relationship was noted for studies
investigating drug therapies as well as other
non-pharmeceutical interventions.