Respiratory distress syndrome

TLDR: The importance of studying the human factors in the causation of accidents was particularly evident from the deliberations of the working party set up by the Royal College of Surgeons under the chairmanship of Mr. Norman Capener to study the factors predisposing to accidents of all kinds and their prevention.

Abstract: deplorable state of affairs are, first, minimum and maximum speed limits, which would reduce the velocity of impact in collisions, and, secondly, segregation of lorries and vans from other vehicles, perhaps by prohibiting heavy vehicles from using the fast lane. They draw attention to a \" dangerous combination of youth, high-performance cars, long journeys -particularly at week-ends-going to sleep at the wheel \"; and point to the curious fact that about two-thirds of the fatal accidents were in south-bound traffic. More motorways have been built since the M. 1 and more are on the way. But nobody who has driven on one is likely to dissent from Gissane and Bull's conclusion that \" motorways demand new standards of driving skills and user behaviour.\" A very different aspect of \"user behaviour\" was the subject of an investigation by Dr. Kaare Solheim, who reports at page 81 of the B.M.7. on the deaths of 168 pedestrians killed in Oslo. In contrast to a motorway the streets of a city are usually thronged with pedestrians, and two features of those in Solheim's series are worth noting. These are, first, that 55% of them were aged 60 or older, and, secondly, that 20% of those aged 20 or older were intoxicated (that is, had a blood-alcohol concentration higher than 0.05%). Tests of the amount of alcohol consumed by people involved in road accidents are likely to come into practical use in Great Britain, and the report by T. B. Begg and his colleagues in the B.M.J. last week showed how efficient measuring alcohol in the breath can be with both the breathalyzer and the Kitagawa-Wright apparatus. As Dr. Solheim rightly concludes, \" the pedestrian must be educated in road safety as well as the motorist,\" though the many elderly people among the killed suggests that education of this sort is only a small part of the problem. That children need the protection of crossings patrolled by an adult is now well recognized from experience in the neighbourhood of schools, but the vulnerability of old people with failing senses is something for which the community is not yet making sufficient allowance on the road. While the main effort of the Road Research Laboratory has been directed into engineering technology, there is surely a case for greatly increasing the amount of research into the human factors causing road accidents One little-studied factor is the taking of risks. The presence of a single factor by itself rarely produces an accident. A combination of two factors is rather more likely to do so; and in general the greater the number of factors the more certain it is that an accident will occur. In principle it is possible to compute from their separate occurrences the frequency with which one or more factors will be present simultaneously. The way to prevent a combination of factors, and hence an accident, is to reduce the frequency of all the individual factors, not merely those directly related to the nature of the road. This means studying levels of risk taking. It is clear from the statistics of insurance companies that people differ in the average level of risk which they will accept. But it is possible that variability in the accepted level of risk may be more important in the causation of accidents. A person who consistently takes very slight risks may be less of a menace than a person who normally never takes a risk at all but occasionally has lapses when he does something stupid. Lapses may occur spontaneously, but may also be related to alcohol and other drugs, to lack of sleep, and so on. As in the field of traffic engineering, research will be necessary before methods of reducing the taking of risks can be worked out, but it is a line worth following. The importance of studying the human factors in the causation of accidents was particularly evident from the deliberations of the working party set up by the Royal College of Surgeons under the chairmanship of Mr. Norman Capener to study the factors predisposing to accidents of all kinds and their prevention. The working party's meetings culminated in a public convention at the Royal College last May, which was reported in this journal at the time,' I when many speakers emphasized the need to provide good training for young people in the proper performance of the many complicated tasks, including driving, that are now a part of our daily lives. The same theme of individual responsibility for safe and skilled action is readily discernible in the working party's report, recently published.4 In its discussion of road accidents the report emphasizes, as have others, the interaction of many factors in the causation of motor accidentsand \" a reduction in road traffic accidents is unlikely to take place suddenly as the result of any one action.\" But in addition to the varieties of mechanical risk and their elimination to which the report draws attention it pin-points such well-known bases of safe driving as sobriety, good manners, mental alertness, and a sense of responsibility. There is indeed an urgent need, as was said in these columns earlier,' \"to rouse the community to a sense of its own responsibility for safety of life and limb and for avoiding habits that are deadly.\