Tag: safety

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Is it Safe for Pregnant Women to Drive?

A lonely tree at Police Point Park, Medicine Hat, Alberta. (Dr. Noorali Bharwani)
A lonely tree at Police Point Park, Medicine Hat, Alberta. (Dr. Noorali Bharwani)

I found an interesting article in the Canadian Medical Association Journal (CMAJ July 8, 2014) regarding the above subject. Dr. Donald Redelmeier and his colleagues author the research paper titled, “Pregnancy and the risk of traffic crash.”

When a woman is pregnant there are a number of changes occurring in the body. These changes may contribute to increased driving error. The authors of the CMAJ article compared the risk of a serious motor vehicle crash during the second trimester to the baseline risk before pregnancy.

The authors analyzed women who gave birth in Ontario between April 1, 2006, and March 31, 2011. Certain groups of women were excluded from the study. The primary outcome was a motor vehicle crash resulting in a visit to an emergency department.

After analyzing all the data from the study, the conclusion was that pregnancy is associated with a substantial risk of a serious motor vehicle crash during the second trimester. The authors further suggested that this risk merits attention for prenatal care.

In a commentary associated with the article under the title, “High risk of traffic crashes in pregnancy: Are there any explanations?” Stephen J. McCall, and Sohinee Bhattacharya say that the World Health Organization classifies maternal deaths due to traffic crashes as coincidental and not related to the state of pregnancy. Others have argued that pregnancy is the root cause of such deaths, because pregnant women are more susceptible to crashes.

McCall and Bhattacharya make the following key points in their CMAJ commentary:
-Normal physiologic changes during pregnancy may increase sleep deprivation and stress, which may increase the likelihood of human error.
-Epidemiologic studies have shown an increased risk of motor vehicle crashes among women in their second trimester of pregnancy; these studies should be interpreted with caution because data on duration and frequency of driving, and on shared responsibility for crashes, were lacking.
-Further research into the biological mechanisms that may link pregnancy to car crashes is warranted.

So, like many things in medicine the jury is still out debating whether we should allow pregnant women to drive, especially during second trimester. Suffice to say whether you are male or female, pregnant or not, just drive carefully.

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Chlamydia, Gonorrhea and Syphilis on the Rise

Recent memo from Alberta Health Services’ South Zone office warns physicians about the significant rise of sexually transmitted diseases (STD) in Southern Alberta. In 2009, Alberta reported the highest STD rates across the country. Most significant is the increase in syphilis.

In 2008, a report in the Canadian Medical Association Journal (CMAJ August 12, 2008) said that Alberta launched a $2 million campaign to combat the rise of sexually transmitted disease a day after releasing figures indicating skyrocketing rates of gonorrhea and chlamydia among young people in the province. The ads were meant to encourage condom use and regular testing for the disease. But the incidence of STD continues to rise.

STD is also on the rise in other western countries. In the United Kingdom, cases of syphilis among people aged 45 to 64 increased 139 per cent between 2002 and 2006. Cases of chlamydia rose 51 per cent.

In March 2008, U.S. Centers for Disease Control and Prevention reported that one in four teenage girls in the U.S. has a STD. An estimated 3.2 million teenage girls in that country are at risk for health problems such as infertility and cervical cancer because they have chlamydia, trichomoniasis, herpes simplex virus or human papillomavirus (causes genital warts).

Cases of syphilis have particularly increased among men having sex with men. In this group, there is also a high incidence of HIV. If a person has sex with someone who has STD then the risk of contracting the disease is extremely high. It does not matter whether a person is heterosexual or homosexual.

You are at risk of having STD if you ever had sex, if you had many sex partners, if you had sex with someone who has had many sex partners and/or you had sex without using condom.

Long term consequences of STD can be serious and sometime life threatening. Chlamydia and gonorrhea can cause pelvic inflammatory disease in women and infection of testicular area in men. This may render a person sterile. Viral warts can cause cancer of the cervix or penis. Syphilis can cause infection of the nervous system, mental problems, blindness and death. Other illnesses related to STD are hepatitis, genital herpes and AIDS.

You can lower the risk of STD by having sex with someone who is not having sex with anyone else – a monogamous relationship, who does not have STD and by always using a condom until your relationship has been established with your partner.

Primary prevention of STD can be achieved by preventing exposure by identifying at-risk individuals, performing a thorough assessment accompanied by patient-centred counselling and education and immunization when appropriate, says one of the CMAJ articles.

Secondary prevention is aimed at preventing or limiting further spread by decreasing the prevalence of STDs through detection in at-risk populations, counselling, conducting partner notification and treating infected individuals and contacts.

Practicing safe sex is the best way to stay out of trouble. Same rules apply to men and women, whether they are homosexual or heterosexual.

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All-Terrain Vehicles Are Dangerous

Last week, I read two articles on all-terrain vehicles (ATVs). One was in the Bulletin of the American College of Surgeons (November 2008 issue) and the second article was in Westworld magazine (November 2008 issue). Then I went to the Canada Safety Council website (www.safety-council.org) to see what they had to say.

ATVs first appeared in Canada in the 1970s. They are used in the farming, forestry, natural resource and law enforcement industries. They are also popular for adventure tourism, recreational trail riding and camping. More than 2.5 million Canadians now ride ATVs and at least 850,000 own one.

According to the U.S. Consumer Product Safety Commission (CPSC), the number of estimated injuries treated in the emergency room has almost tripled over the most recent 10-year period – from 53,000 to 150,000. There is a threefold increase in the deaths – from 267 to 870. Twenty per cent of these deaths were amongst children younger that 16 years of age.

CPSC says that ATVs are one of the deadliest products under their jurisdiction. Most of the fatalities are due to rider error. With increased exposure has come a rise in injuries — most of them preventable. Speed, inexperience, improper apparel, non-use of helmets and alcohol are common factors. ATV injuries are more likely to happen to boys aged 15 to 19 than any other group. A US study found that only four per cent of the drivers involved in injury incidents reported having had any training, says the Canada Safety Council website.

The provinces with the largest increases in ATV-related injuries were New Brunswick (90 per cent) and Alberta (89 per cent).

The Alberta Centre for Injury Control and Research examined the 20 ATV-related deaths that occurred in the province between July 1999 and June 2002. Among its findings:
-The majority (55 per cent) occurred in the summer, between July and September.
-Eighty-five per cent of the deceased were the drivers of the ATV.
-At least 60 per cent of the fatalities were due to head injuries.
-Children and teens represented 45 per cent of those killed, including two passengers and seven drivers. The deceased drivers were all from 10 to 15 years old.
-Alcohol was involved in 45 per cent of the deaths.

Across Canada, regulations vary. The New Brunswick task force has made the following recommendation:

That youth between the ages of 14 and 16 years be required to obtain an all-terrain vehicle learner’s permit, for which they must have parental permission. The learner’s permit should only be obtained under the following conditions:
-must successfully complete a mandatory Canada Safety Council approved training course;
-must be supervised at all times by a parent or legal guardian who has successfully completed a Canada Safety Council approved training course and has a valid driver’s licence; and
-the size of the all-terrain vehicle being operated cannot exceed the size recommended for their age by the manufacturer.

What are the valuable precautions one can take when riding ATV?

Keep the vehicle off paved roads, avoid tandem rides, wear a helmet, do not drive under the influence of alcohol, and do not allow children to operate adult-sized ATVs. It is also suggested by the American Association of Pediatrics that no children younger than 16 years drive ATVs regardless of the model and whether an automobile driver’s license is required to operate one. The Canada Safety Council offers a hands-on training program led by certified instructors. It may be worth looking into that.

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