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Federal Regulations Written to Help Prevent Truck Crashes

Because of their size and weight, commercial trucks are capable of causing extremely serious injuries should an accident occur. As a result, the federal government has passed various laws holding semitruck drivers, as well as trucking companies, responsible when they fail to comply with applicable federal regulations. While the standards may be high, the public’s safety is important enough to warrant the heightened standards.

Federal Trucking Laws That Promote Safety

Federal law prohibits the use of alcohol and other controlled substances while driving a semi-truck. Under 49 CFR 382, employers are required to implement and follow alcohol and controlled substance testing in compliance with federal law. Semi-truck drivers are restricted from driving or performing any safety-sensitive function if their alcohol concentration is at or above .04. While this BAC is lower than many states’ DUI/DUII laws, the risks associated with impaired truck drivers warrants a more stringent guideline.

In January 2012, a federal law was amended by the Federal Motor Carrier Safety Administration to prohibit truckers from texting, dialing, or even holding a phone while operating a truck. However, drivers are allowed to use hands-free mobile devices if they require only a single touch to operate. Operators who violate this law may face over $2000 in fines and the loss of their license. According to an ABC7.com report, the legislation came as a response to a Kentucky truck accident that killed 11 people after the truck driver was using his cell phone while driving.

Promoting Safety

While trucking companies must ensure that their fleet of trucks is well maintained and their drivers are disciplined when safety violations occur, the public should also be vigilant drivers. Defensive driving techniques such as slowing down in work zones, keeping a safe following distance, and being aware of “no-zones” can help avoid trucking accidents and fatalities.  It’s our collective responsibility to help keep the country’s roadways safer for all motorists, including truck drivers.

Traumatic Brain Injury: Am I Ever Going to be 100 Percent Again?

Traumatic brain injury is appropriately named traumatic, as it is an extremely serious injury from which there is no predictable recovery time. The best answer to the question, “How long will it take me to get better?” is “It depends.”

In the early stages of a head injury, it is impossible to predict what lies ahead. Each doctor will likely give you a different estimate of how long your recovery will take. Some may say your recovery is maximized six to nine months after the injury, and others may say you have several years to improve.  However, traumatic brain injury victims will likely have made significant improvements in certain skills and learned to cope with what can’t be improved in that length of time.

Although it is rare for someone to say she’s recovered 100 percent from a head injury, many will return to work, resume a normal family life, and function well socially. But he may still say he feels different.

The Brain’s Potential for Recovery

According to CNN, the brain is extremely resilient and has the capacity to restore some functions after traumatic injury, a phenomenon called plasticity, which is enhanced by rehabilitation.

Plasticity is the brain’s ability to change. We now know that it is possible to form new brains cells (neurons) even as adults, and by undergoing rehabilitation to relearn basic tasks, a traumatic brain injury patient may be able to form new brain connections that allow him to make a more complete recovery. The goal of rehabilitation is to stimulate the brain to reform lost circuits, but how well a patient recovers depends on the severity of the injury. Generally, the more improvement shown in the early stages of traumatic brain injury, the more potential there is for improvement long term.

Change is a hard part of life, and the reality is traumatic brain injury or not, we are always changing. Although the aging process is gradual, a head injury causes sudden change, which makes it all the more difficult. But the good news is that people do get better. It just takes time and persistence.

Sports Head Injuries Gaining National Recognition

The prevalence of head injuries in sports and their devastating lasting effects is well documented. Football players’ head injuries have been a prevalent news topic in the past few months. As the face of football, the National Football League is being blamed for keeping this epidemic buried for so long. Despite claims by former professional football players of the post-career effects of repeat head trauma, the NFL continually discredited research associated with analysis of deceased football players’ brains. It wasn’t until 2009 that any league official publicly acknowledged any long-term effects of concussions.

According to the Center for BrainHealth, long term effects of concussions include memory problems, intense anger and/or aggression, personality changes, lack of concentration, problems organizing and planning, difficulty problem solving, and language impairment. Particularly troubling is the number of former NFL athletes struggling with mental health problems. Just in the past 4 years, there have been 10 recorded suicides among former NFL players.

Along with the depression, dementia is another significant mental health problem for former NFL players. A 2012 study by National Institute for Occupational Safety and Health (NIOSH) showed that players who spent at least five seasons playing in the NFL were four times more likely than the general population to die with dementia or amyotrophic lateral sclerosis, also known as Lou Gehrig’s Disease. Former Bears quarterback  Jim McMahon has been an outspoken advocate for retired players suffering from dementia. He says that while he “doesn’t have thoughts of killing himself anymore” he still has the dementia and “doesn’t think they [NFL] were looking out for our best interests” while he played.

Fortunately, President Obama recently hosted a sports summit  highlighting the concerns of head injuries in sports. This gathering brought together more than 200 sports officials, medical experts, parent activists and young athletes, with a goal of finding new ways to treat and prevent serious head injuries, particularly in youth sports. In addition, the NCAA and Pentagon have launched a $30 million clinical study of concussion and head impact exposure among college students.


Rise in Construction Injuries

Construction work is known for being dangerous. With the seventh-highest rate of non-fatal injury among all occupations in 2009 alone, construction workers died on the job almost three times the rate that all other workers in the US did. Additionally, while overall workplace fatalities decreased by over 6% in 2012, construction site fatalities actually increased by 11%.

With the technology available today, there is no defensible reason why fatalities should be increasing for construction workers. The construction industry has an obligation to take note of these staggering statistics and make a commitment to ensuring the safety of its workers.  If production is prioritized over the lives of employees, both injuries and fatalities will only increase.  The variety of hazards construction workers face at their workplace is shared by few other occupations. Workers are already at greater risk than any other industry to suffer a disabling injury due to falls, equipment malfunctions, and pinch point crush injuries.  However, lead poisoning and respiratory problems also affect these workers. From 2002 to 2008 construction workers made up 15% of all cases reporting lead blood levels exceeding 25 ug/dl. And in regards to dangerous levels of exposure to asbestos, construction workers are at the greatest risk of all occupations. Over 1.3 million construction workers are exposed to asbestos on the job each year.

Unfortunately, the mental toll this industry demands from its workers is often overlooked as a major hazard.  Researchers at Harvard School of Public Health (HSPH) found that construction workers are frequently stressed about work-related injuries and pain and often fail to seek help, putting themselves at risk for more injuries and mental health issues, including depression, anxiety, and even suicide. Because the construction industry employs over 11 million people in the US, this data suggests that a large portion of our workforce is not getting the support they desperately need. Essentially, the mental burden brought on by a workplace injury is too much for many construction workers.  Another 2012 study of over 350,000 construction workers found that injured workers were 45% more likely to be diagnosed with depression than non-injured workers.

To combat their mental and physical suffering, it is paramount that the workers have treatment options, and more importantly, are made aware of them. It is critical that an injured worker understand he or she may be entitled to receive workers’ compensation benefits to cover their lost wages and medical bills.  In cases where a third party is involved, the injured workers may also be eligible for compensation for pain and suffering, whether physical or emotional. In conclusion, it is important that more people are educated about the risks and dangers of the construction industry so that we can prevent both harm to the workers through a commitment to safer practices and better treatment.


New Hope For Those With Spinal Cord Injuries

Each day car accidents and other tragic events leave victims paralyzed for the rest of their life. There are 250,000 Americans who have a spinal cord injury and 37% are caused by motor vehicle accidents each year. Of these injured individuals, half  are paraplegic. With average lifetime costs for paraplegics being $400,000 and an estimated 48% of spinal cord injury (SCI) victims being uninsured, the impact of this debilitating injury is magnified. Unfortunately, 63% of SCI (spinal cord injured) individuals are unemployed 8 years after the injury so making a living to cover those expenses is difficult.

Until now, these victims have had very little to hope for in terms of regaining their mobility lost to the injury. However, new breakthroughs in electrical stimulation therapy for paraplegics have shown promise. University of Louisville neuroscientist Susan Harkema oversaw a recent study in applied electrical stimulation and its effect on nerve pathways after injury. Over five years, Harkema’s team applied electrical stimulation to paralyzed men with broken spinal cords. Amazingly, all four patients were able to develop movement. This marked the first time electrical stimulation allowed patients to move voluntarily after a paralyzing spinal cord injury. The level of regained movement varied – participants went from being paralyzed to being able to wiggle their big toes, lift and swing their legs, and move their ankles up and down without support. Currently, the stimulation can only activate one muscle group at a time. Yet, patients are already showing dramatically improved bladder, bowel and sexual function.  While things like lifting a leg may seem insignificant to able-bodied people, these simple movements give spinal cord injury victims a sense of freedom and independence that is incredibly meaningful.

An important takeaway from this research is the hope it has given people paralyzed from a spinal cord injury. Knowing there is a reasonable chance that they can regain their mobility may give them the motivation to walk an extra 10 steps in physical therapy or do an extra hour of leg lifts. And hopefully, this research has merely scratched the surface of what is possible.



Recent Trucking Regulations Impact Safety

Driver fatigue is often overlooked as a cause for traffic accidents. Truck drivers are especially affected by fatigue given the nature of their job and work schedules.  Previous studies have shown that a truck driver remaining awake for 17 hours results in response times 50% slower than that of a well-rested driver. Another factor that impacts response time by 50%: BAC of .04%.  Fatigued drivers are as dangerous to other motorists as drunk or drinking drivers. A driver who has gone 21 hours without sleep will show effects equivalent to having .1% BAC, which is definitely considered drunk driving.  Hopefully there are not many truck drivers on the roads that have gone 21 hours without sleep, but any lack of sleep will have a negative effect on the driver’s ability.

Fortunately, last July the U.S. Department of Transportation’s Federal Motor Carrier Safety Administration (FMCSA) implemented new hours-of-service rules. The new rules limit the maximum average work week for truck drivers to 70 hours, an approximate 14.6% decrease from the prior limit of 82 hours per week.  After reaching 70 hours, drivers must rest for at least 34 consecutive hours before resuming driving. Finally, truck drivers must take a 30 minute driving break during the first 8 hours of a shift.

As part of the Moving Ahead for Progress in the 21st Century Act (MAP-21), Congress mandated that research be conducted on driver fatigue.   Washington State University Sleep and Performance Research Center looked at 100 truck drivers’ levels of fatigue and amount of sleep over two 7/8 day work cycles and the mandatory rest breaks between shifts. The researchers compared the level of fatigue in drivers that had one mandatory nighttime period break between shifts with drivers that had two or more nighttime period breaks between shifts. Researchers found that when drivers had two or more nighttime periods between driving shifts, they did not experience as many lapses of attention, maintained their lane position better, and reported less sleepiness while on duty than those with only one nighttime period between driving shifts.

Principal study investigator Professor Hans Van Dongen said that the study confirmed prior research findings: “Earlier laboratory studies we have done for FMCSA suggested that the old provision did not provide sufficient sleep opportunity for nighttime drivers whose restart break included only one nighttime period.” The study included 106 truck drivers, who submitted data from two duty cycles between January and July 2013.  While it is satisfying to see quantitative results showing the beneficial effects modifying work shift and rest period requirements for drivers, it remains to be seen if the new regulations will make the roads safer for both truck drivers and other drivers on the road.

Revisiting Safety Standards in Buses

Many have called for a review of safety standards for both trucks and buses in light of the tragic crash between a Fed Ex truck and a charter bus that killed 10 people in Northern California earlier this month. While the National Traffic and Safety Board (NTSB) has pushed for “seatbelts, emergency exits and fire-safety rules to protect bus passengers” for years, legislation at the federal level is a slow-moving process. According to National Highway Traffic Safety Administration (NHTSA) data, “requiring seatbelts could reduce fatalities by up to 44 percent and reduce the number of moderate to severe injuries by up to 45 percent” in relation to the number of large bus passengers that are killed and injured every year . However, it wasn’t until just this past November that the NHTSA issued a new federal rule requiring lap and shoulder belts for each passenger and driver seat on tour or charter buses manufactured after November 2016. While this rule is a substantial advancement for safety standards, it should be the first step of many.

Legislation requiring safety features be incorporated into design of tour and charter buses is important, but perhaps the bigger issue to tackle is having passengers make use of existing valuable safety features.  In the recent tragedy in Northern California, passengers were found dead and thrown from the bus despite the fact that the Silverado Stages’ charter bus was a brand new 2014 model and did have seat belts. NTSB member Mark Rosekind points out that it is tough to ensure passengers consistently use seatbelts on any bus unless it is federally mandated, which could be a great next step for the NHTSA.

The second aspect of this tragic crash that needs to be examined is the massive flames engulfing both truck and bus following the crash. As of now, there are conflicting reports regarding whether the Fed Ex truck was on fire prior to the collision.  Either way, the accident must be investigated thoroughly to ensure that safety features in the charter bus worked properly, allowing the passengers enough time to escape before being killed by the fire. The government is considering implementing mandatory fire-suppression systems in 2015. However, these systems are designed to suppress fires started in wheels and engines and aren’t equipped to handle the huge blazes that follow collisions. While it is almost impossible to put out fires of such immense size, the focus should be on making these larger buses easier to escape to reduce casualties. Hopefully we can learn from this truly heartbreaking event and prevent another calamity like this from occurring.

Important Facts about Strokes and Increased Danger for Women

Most of us know how dangerous strokes are. While strokes can and often are lethal, they also can cause varying degrees of brain damage, paralysis, and severe cognitive deficits. Often the amount of time that elapses between the stroke and treatment determines the patient’s recovery or permanent damage.

Stroke is currently the fourth leading cause of death in the United States today, and surprisingly affects approximately 55,000 more women than men each year, according to the Centers for Disease Control and Prevention. Because women are at greater risk for strokes than men, it is crucial that women are able to recognize stroke symptoms and know that rapid medical response is essential. It’s also important for anyone with stroke risk factors such as high blood pressure (hypertension), diabetes, high cholesterol and being overweight to make sure their spouse or families are also aware what to do in an emergency or if they suspect stroke.

According to the American Heart Association’s journal Stroke, women should be aware of medications or medical conditions that may affect their stroke risk. First, women who are considering using birth control pills should get screened for high blood pressure, because oral contraceptives can increase the risk of blood clots and stroke. Pregnant women who have a history of high blood pressure should ask their doctor about their risk, as there may be increased risk of developing preeclampsia or stroke during pregnancy or post-partum. There are simple treatments that may reduce risk such as taking low-dose aspirin or calcium supplements while pregnant. Women over 75 should be screened for atrial fibrillation, an abnormal heart rhythm. Atrial fibrillation increases the risk of stroke and can be treated with medication or surgery. Finally, as with most health problems, quitting smoking, regular exercise and healthful eating are the best ways to reduce risk overall, for women and men.

While prevention and reducing risk factors for stroke is important, sometimes strokes are inevitable. A recent study found that 1 in 5 women can’t identify a single warning sign of stroke. The classic symptoms of a stroke are a drooping face, speech difficulty, or weakness or numbness in one of the arms. But, lesser-known and more ambiguous symptoms can include a sudden onset of dizziness, severe headache or vision loss. New guidelines suggest using the mnemonic FAST to remember the symptoms: Face drooping, Arm weakness, Speech trouble, and Time to call 911 immediately. According to Dr. Larry Goldstein, a neurologist and the director of the Duke Comprehensive Stroke Center, the most important thing to remember and watch for is “an abrupt change neurologically – any abrupt change. That could be a stroke and that needs to be taken seriously.”

So, if someone is exhibiting stroke symptoms, what should be done? You should call 9-1-1 immediately. Also try and pinpoint the time that symptoms began and relay this critical information to medical professionals. Any details you can give are invaluable in the immediate treatment of a stroke.

Improving the “Standard” Way of Thinking

The number of cars on the road has increased by leaps and bounds since the invention of roads. The highway engineers now focus on creating wider, faster roads to allow for the increased traffic. However, many engineers have lost sight of what is most important: Safety. As described by engineer Charles Marohn, ”First comes speed; then traffic volume, then safety; then cost.” See http://www.theatlanticcities.com/neighborhoods/2013/08/what-happens-when-town-puts-people-cars/6600/ for the full story.

Following these guidelines, engineers have begun creating “highways” through the middle of towns.  People living in these towns criticized the loss of vegetation, space, and safety as cars sped by their homes. Marohn’s response to these complaints is simple:  “these standards have been shown to work across the world”. Realizing the emptiness of this response, Marohn evaluated the human consequences of this type of thinking. As he wrote in his blog, “Taking highway standards and applying them to urban and suburban streets, and even county roads, costs us thousands of lives every year”. Thankfully, Marohn decided to act on this epiphany and now goes across America explaining that things can be done differently –  “that America’s towns and cities can build streets that are safe and operate at a human scale, the old-fashioned way, and that they can save money and bolster their economies in the process.”

Marohn’s epiphany is a great reminder that just because doing something “according to standards” is satisfactory, we should always look to improve those standards even if it means rethinking an established mentality.  Our standards for safety on the road should constantly evolve and improve with time.

How Pediatric Corporate Dentistry May Affect Your Child

One of the most celebrated provisions of the Affordable Care Act has been mandated coverage for pediatric dental benefits. With the expansion of Medicaid, there has also been a sizable population of newly insured children as well. Unfortunately not all dental providers will accept Medicaid and parents may have few options when choosing a pediatric dentist that accepts Medicaid benefits.  Many of the dental clinics that accept Medicaid are corporately owned, rather than privately owned. But just because the child is on Medicaid and the parents may not be able to afford to choose another provider, doesn’t mean that these children deserve sub-par care.

In the December 2013 issue of American Association for Justice’s Trial magazine, an article titled “The Evils of Corporate Dentistry”, brought to light many unfortunate circumstances, including children who were restrained while being treated at a corporate dental chain office.  These offices were found to be performing unnecessary and unsafe procedures on the children as well. According to an article from PBS’s website, another corporate dental group was investigated by Medicaid, who found “crowns that didn’t fit, decay left untreated under a crown and nerves left exposed”.  See the article here: http://www.pbs.org/wgbh/pages/frontline/health-science-technology/dollars-and-dentists/complaints-about-kids-care-follow-kool-smiles/ 

Not only were the procedures unnecessary and unsafe, there were an exorbitant number of them being performed, all to increase the clinics’ revenue. Often times the dental groups offered bonuses to the dentists who billed above a certain amount. Some would even fire dentists who weren’t meeting the “production standards.”

So how can parents protect their child? First, they should know that no matter what the dental staff says, the parents are allowed to be with their child through every procedure. They have every right to be near their child in the treatment room, and there are no health guidelines that state otherwise. See http://www.aapd.org/media/Policies_Guidelines/G_Protective.pdf

Second, if they see or feel that a treatment is not in the best interest of their child, they should speak up. Both articles cited examples where parents said they trusted the dentists and the corporate dental chain to care for their children. But if a parent feels something isn’t right, they have the right to stop treatment and seek a second opinion.

Doing some research on the dentist or dental chain doesn’t hurt either. With so much information on the internet these days, it’s worth the extra investigation for the parent to have peace of mind when choosing a pediatric dentist.