Protective Devices: Types, Uses and Safety

SAFETY AND RISK IN SOCIETY SERIES

PROTECTIVE DEVICES TYPES, USES AND SAFETY

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SAFETY AND RISK IN SOCIETY SERIES Chemical Safety Board Robert W. Talford (Editor) 2009. ISBN 978-1-60692-586-7 Consumer Product Safety Issues Peter A. Varga and Mate D. Pinter 2009. ISMN 978-1-60456-826-4 Fire Safety Ingmar Søgaard and Hans Krogh (Editors) 2009. ISBN: 978-1-60741-490-2 Fire In The United States: A Reference Work on the Nation's Fire Problem Ciro Bouchard and Marco Fortin (Editors) 2009. ISBN: 978-1-60741-746-0 Accidents: Causes, Analysis and Prevention Henri Bédard and Geraud Delashmit (Editors) 2009. ISBN 978-1-60741-712-5 Accidents: Causes, Analysis and Prevention Henri Bédard and Geraud Delashmit (Editors) 2009. ISBN 978-1-61668-510-2 (Online book) Protective Devices: Types, Uses and Safety Victor E. Argosyan (Editor) 2010. ISBN: 978-1-60876-223-1 Risk Management Benigno Jordão and Emilio Sousa (Editors) 2010. ISBN: 978-1-60876-011-4 Consumer Product Safety Commission Issues Isaac E. Bowman (Editor) 2010. ISBN:978-1-60876-766-3

SAFETY AND RISK IN SOCIETY SERIES

PROTECTIVE DEVICES TYPES, USES AND SAFETY

VICTOR E. ARGOSYAN EDITOR

Nova Science Publishers, Inc. New York

Copyright © 2010 by Nova Science Publishers, Inc. All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means: electronic, electrostatic, magnetic, tape, mechanical photocopying, recording or otherwise without the written permission of the Publisher. For permission to use material from this book please contact us: Telephone 631-231-7269; Fax 631-231-8175 Web Site: http://www.novapublishers.com NOTICE TO THE READER The Publisher has taken reasonable care in the preparation of this book, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained in this book. The Publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers‘ use of, or reliance upon, this material. Independent verification should be sought for any data, advice or recommendations contained in this book. In addition, no responsibility is assumed by the publisher for any injury and/or damage to persons or property arising from any methods, products, instructions, ideas or otherwise contained in this publication. This publication is designed to provide accurate and authoritative information with regard to the subject matter covered herein. It is sold with the clear understanding that the Publisher is not engaged in rendering legal or any other professional services. If legal or any other expert assistance is required, the services of a competent person should be sought. FROM A DECLARATION OF PARTICIPANTS JOINTLY ADOPTED BY A COMMITTEE OF THE AMERICAN BAR ASSOCIATION AND A COMMITTEE OF PUBLISHERS. LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA Protective devices : types, uses and safety / editor, Victor E. Argosyan. p. cm. Includes index. ISBN 978-1-61122-438-2 (eBook) 1. Safety appliances. I. Argosyan, Victor E. T55.P785 2009 620.8'6--dc22 2009042896

Published by Nova Science Publishers, Inc.  New York

CONTENTS Preface Chapter 1

Chapter 2

Chapter 3

vii Head Restraints and Whiplash: The Past, Present and Future Ediriweera Desapriya, Marc White, Giulia Scime, Khairun Jivani, Shelina Babul, John Holland and Ian Pike Mouthguards: The Effects and the Solutions for Underlying Problems Tomotaka Takeda, Keiichi Ishigami, Kazunori Nakajima and Katsuhide Kurokawa Particulate Respiratory Protection – Overview, Emerging Issues and Research Needs Samy Rengasamy, Ziqing Zhuang, Raymond Roberge and Ronald E. Shaffer

Chapter 4

Neurodevelopmental Treatment Approach in Cerebral Palsy Maria Teresa Botti Rodrigues dos Santos, Felipe Scalco Manzano and Renata de Oliveira Guare

Chapter 5

Performance Assessment and Limitations of Distal Protection Filters for Carotid Artery Stenting Gail M. Siewiorek and Ender A. Finol

1

61

131

161

181

Chapter 6

Use of Seat Belt by Mini-Bus Drivers in Nigeria Abiodun Olukoga, Kehinde Oluwadiya, Tinu Olukoga and Olusola Odu

199

Chapter 7

Motorcycle Helmet Use in Mar del Plata, Argentina Rubén Daniel Ledesma, Raquel Peltzer, Fernando Poó and Mariana Cremonte

215

Chapter 8

Hip Protector Devises to Prevent Hip Fractures of Older Adults Pekka Kannus and Jari Parkkari

225

vi

Contents

Chapter 9

Traffic Accidents and Helmets: A Research Overview Viroj Wiwanitkit

233

Chapter 10

The Use of the Laryngeal Mask Airway in Rabbits George M. Kazakos, Ioannis Savvas, Tilemachos Anagnostou, Irene M. Kazakou and Dimitris Raptopoulos

239

Chapter 11

Research and Reports on Medical Protective Devices in Thailand Viroj Wiwanitkit

Index

245 249

PREFACE This book explores various protective devices utilized in the fields of medicine, automobile and motorcycle safety, and sports. This new and important work gathers the latest research from around the globe in the study of this field and highlights such topics as: head restraints and whiplash, mouthguards, particulate respiratory protection, distal protection filters for cartoid artery stenting, motorcycle helmet use in Argentina, hip protector devices, and others. Chapter 1 - While fatalities due to rear impacts are lower than in other collision types, injuries represent a much larger percentage (approx. 26% of all injuries) and typically occur as neck strain (e.g. whiplash). Whiplash injuries occur when the sudden movement between the head and torso results in injuries to the soft tissues of the neck. This mainly occurs in rearend collisions. The effectiveness of vehicle seats has been tested over the last 35 years and previous research shows that head restraints could reduce injuries by 14 to 18%. Vehicle seats have seen an evolution in terms of their characteristics and design since the 1970s from bucket seats to yielding seats to high retention seats, and more recently, energy absorbing anti-whiplash seats. Anti-whiplash seats were developed to absorb as much energy as possible while reducing the occupant acceleration and minimizing the movements of the neck. Other restraints that have been tested to be effective are active head restraints and restraints with better geometry. Research shows that serious neck injuries arising primarily from low impact rear-end motor vehicle collisions can be effectively prevented by the use and proper adjustment of head restraints with better static geometry. The major issue is that the public is not properly adjusting their head restraint. In 2008, the World Congress on Neck Pain highlighted that PREVENTION IS POSSIBLE, concluding that it was possible to reduce the risk of serious neck injuries arising from motor vehicle collisions by 35% if people purchased vehicles with good head restraints and adjusted them appropriately. This chapter provides: 1) a review the history, evolution, and scientific literature surrounding head restraints and whiplash-related injury; 2) the risk factors, and prevalence of inappropriate use of head restraints 3) the need to educate drivers, occupants, fleet owners, and policy-makers concerning the importance of head restraints that have obtained a rating of ―good‖ or higher and the efficacy of the proper adjustment of head restraints for prevention of serious neck injuries; 4) new strategies addressing the three E‘s of injury prevention including education, engineering, and enforcement, with a particular focus on social marketing and occupational health strategies that increase proper head restraint adjustment for preventing whiplash-

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related injuries and associated impairments and disability. Gaps in the literature and future directions surrounding the prevention of neck injury and whiplash are also provided. Chapter 2 - A basic athletic mouthguard (or a mouthpiece, a gum shield) is a resilient device placed on the upper jaw to reduce orofacial injuries particularly to the teeth and surrounding structures. Several types of mouthguards are available (Figure I-1, 2). Like other protective devices, a mouthguard is essential to protect the body from sports-related dental injuries, which are not rare and are costly, disfiguring, and emotionally distressing (Figure I-3 to 7). Recently, mouthguard usage has been spreading gradually. Nevertheless, many sportsrelated dental and oro-facial injuries can still occur regardless of whether a mouthguard is worn or not. This is because, not only the level of comfort [1], but also the safety and so on of mouthguards is strongly influenced by the types available and the quality of manufacturing (Figure I-7 to 9). So it is dangerous to assume that all types of mouthguards offer the same level of protection. But most athletes have not recognized these problems. Thus, in order to solve them, we have conducted a series of studies. Chapter 3 - This chapter is a brief review of respiratory protective devices for harmful airborne particulates. Particles in the breathing air present serious health hazards to civilians and workers in occupational settings. To reduce the inhalation of particles, respiratory protection is required when other control measures are not feasible or not yet implemented. For many years respiratory protection devices were used in industrial workplaces to minimize particulate exposures, then extended to other workplaces including healthcare. Respirators are required to reduce the exposure to airborne infectious diseases, including severe acute respiratory syndrome (SARS), pandemic influenza and multi-drug resistant diseases because implementation of administrative and engineering controls is not always feasible. Similarly, bioterrorism incidents involving viruses, bacteria and spores require respiratory protection. Another emerging area of concern is the recent technological developments in the nanotechnology industry for producing engineered nanomaterials. Nano-sized particles may potentially be more toxic than equal quantities of larger-sized particles. The exposure to harmful nonbiological and biological aerosols can be addressed by proper selection of air-purifying respirators (APRs) recommended by regulatory agencies and other organizations. The National Institute for Occupational Safety and Health (NIOSH) and other standards organizations have developed performance standards for APRs. The NIOSHcertified APRs will provide expected protection levels when properly used. However, these devices do not fit all wearers equally well and impose varying levels of discomfort when fitted to the face. Poor fit of a respirator causes face seal leakage and compromises the respiratory protection levels. To address this issue, NIOSH has recently characterized face sizes and shapes characteristic of the current U.S. work force and developed new respirator fit test panels. Advanced respirator design for different facial features could improve respirator fit leading towards consistent protection. Also, the physiological impact of some forms of respiratory protective equipment upon wearers has not been adequately examined. Re-use of disposable equipment is also an issue of recent importance given that supplies of disposable respirators may be insufficient in a pandemic-like setting. Recent technological developments have produced nanofibers which can be employed for producing efficient filters. Similarly, antimicrobial components can be incorporated into the filter media used for respirators to kill/ inactivate the microorganisms, as they pass through or are captured in the filter. The need for further research and developments in the different areas of respiratory protection are discussed.

Preface

ix

Chapter 4 - Background: Cerebral palsy (CP) describes a group of movement and posture developmental disorders causing activity limitation, caused by nonprogressive disturbances occurring in the developing fetal or infant brain. Complex limitations in self-care functions, such as feeding, dressing, bathing, mobility and the ability to coordinate muscle action to maintain normal posture and to perform normal movements, may also occur. The goal in providing treatment for disabled individuals is to treat the patient in the safest and most efficient manner possible. For some disabled people, comprehensive dental services would be impossible without the more restrictive management techniques. The classic neurodevelopmental treatment (NDT), focus on sensorimotor components of muscle tone, reflexes and abnormal movement patterns, postural control, sensation, perception and memory. Objective: Describe some methods opening facilitates access to internal surfaces of the maxillary molars, important for dental treatment as well as for preventive care procedures in disabled patients, such as cryotherapy and botulinum toxin A injection. And evaluate the electromyographic (EMG) activity of right and left anterior temporalis and masseter muscles during mandibular resting position in individuals with CP on dental chair, before and after assistive stabilization (NDT). Method and Materials: A group of 32 spastic CP individuals of both genders, aged 8 to 14 years old (10.1 ± 3.6), were evaluated. The EMG signals of electric activity were obtained using a 8-channel module (EMG System do Brasil Ltda ®, Sao Jose dos Campos, SP, Brazil) from the bilateral anterior temporalis and masseter muscles in two stages (S1 and S2), stored and analyzed as root-mean-square with values expressed in microvolts. The individuals were firstly positioned on dental chair in their usual seating position with no assistive stabilization or head control (S1). After one week the same individuals were evaluated and positioned according to the NDT (S2). The nonparametric Wilcoxon t test, with significance level of 95%, was used to compare the EMG activity of the muscles on two stages. Results: The right and left anterior temporalis muscles showed a statistically significant reduction in EMG activity (p100 mL of dead space cause a compensatory increase in the depth of respiration (Hinds and Bellin 1993). Wearing a FFR adds its dead space (VD resp) to the anatomical VD of the respiratory tract, functionally resulting in the creation of significantly augmented physiological VD and the associated increased physiological burden and compensatory requirements. Human respiratory VD averages 1 mL per pound of body weight. Average VD resp of a FFR is dependent upon its configuration (e.g., cup, duck bill, flat fold) and the facial anthropometic features of the wearer. The resultant compensatory increase in VT ranges from 50% - 90% of the VD resp (for respirators having a VD resp of 100 mL or more) (James 1976). Duck bill and cup-shaped FFR have greater VD resp than flat fold N95, but the VD resp differences of these various FFR upon the physiological burden of wearers has not been evaluated in depth. For example, it is theoretically possible that the lower VD resp associated with flat fold FFR might offer physiological benefit when worn over extended periods or during intense physical activity.

Respirator Dead Space (VD RESP) Gases The VD resp of FFR serves as a repository for exhaled and inhaled gases and houses mixtures that are significantly different from the ambient atmosphere (Caretti and Coyne 2008). Inhalation of CO2 that is higher, or O2 that is lower, than ambient levels results in compensatory mechanisms to maintain the body‘s acid-base status within its normally tight boundaries. OSHA ambient workplace standards for CO2 are