Injury epidemiology, transport, occupation – IETO

Epidemiology of road traffic crashes and home and leisure injuries. Health-related and human determinants, prevention and innovations in diagnosis, prognosis and care.

Objectives

Non-intentional injuries are among the first causes of mortality and morbidity. The team project is the continuation of the « Injury Prevention and Control » research team project that measured the impact of health-related factors on road safety and improved our knowledge in prognosis and care for mild head injury patients. The project extends its scope to Home and Leisure Injuries. The new project is being developed with the strengthening of a partnership with IFSTTAR, with the ultimate perspective of a complete merger with a research unit located in Lyon, with the aim of building a research group in the domain of injury epidemiology with a European dimension.

The main objectives are:

  •  to describe incidence, causes and consequences of traumas;
  •  to elucidate human factors involved in injury causation;
  •  to propose and validate innovations in prognosis and care.

Details

Centre de recherche INSERM U1219
Université de Bordeaux – ISPED case 11
146 rue Léo-Saignat
33076 BORDEAUX cedex

Tél : +33 (0)5 57 57 15 04



Informations

Research area

The team working hypothesis are derived from results obtained since 2006. First, we hypothesize that human beings exhibit different phenotypes related to attention processes. The way we perceived our environment and the way we use this data in our everyday activities (transportation, leisure, sports, eating …) can be categorized in a finite number of groups of individuals for which prevention and human-machine interaction should be adapted. Second, we plan to test our hypothesis that several debilitating symptoms and condition described several weeks, months following traumatic events are not specific to injury pattern, are described by incomplete nosographic systems among which PTSD plays a key role and are preventable with early interventions.

Our research effort is grounded on a limited number of large data collection tools: a nation-wide linked database (CESIR project on the impact of medication), the setting-up a new cohort on Home and Leisure Injuries (The MAVIE project), the extension of our research project on mild traumatic injury to a broader range of injuries (The SOFTER project).

 

 

 



 Projects

CESIR study:

The research program “CESIR” (a combination of studies on health and road safety) aims at assessing the impact of medicines consumption on the risk of injury in road traffic crashes.
Data from the French health care insurance were matched with the National Police forces data base on physical injuries in road traffic crashes.
The study sample includes all the drivers and pedestrians involved in a personal injury accident. The matching is made possible by identifying the national Social Security number in police records.
Thus, the yearly population of the CESIR study is over 50.000. It is the widest study ever carried out matching data on medicines consumption with data on traffic crashes. CESIR allows significant assessment of the impact of even moderately used molecules.

GAZEL project: Traffic crashes

The Gazel Cohort is a longitudinal study issued by the Inserm in 1989, which aims at studying a sample of 20.000 persons’ health, by that time all formerly employed at the EDF GDF group.A wide and rich variety of available data enable the assessment of the main factors of lifelong health conditions.
In 2000, the IETO team has implemented a specific study on road safety among the participants of the Gazel cohort. The analysis of different questionnaires disclosed innovating results: impact of stressful events, self-reported, description of behavioral changes in driving, drivers’ adaptability to aging.

 

MAVIE project:

Starting November 2014, the IETO team and Calyxis have been coordinating the “Observatoire MAVIE”.
The MAVIE cohort aims at determining both the scope and characteristics of home and leisure injuries in France by exhaustively collecting reported data or observations preceding accidents, such as domestic environment, habits, way of living, state of health of victims…
An over-years prospective follow-up of 100.000 volunteers made it possible to identify combined factors involved in injuries causation (health, ADHD, attentional phenotypes, pharmacoepidemiology…).

Interventional and prevention programs are simultaneously being implemented within the cohort to assess their efficiency. Relevant recommendations on prognosis and care will make it possible to reduce the number of victims and thus respond a major public health issue (in France each year, 11.000.000 injuries and 20.000 deaths).

ATLAS AND PERICLES projects: inattention and risk of accident

Thanks to a privileged partnership with Bordeaux CHU adults’ emergency department, the IETO team has issued an innovating research survey on road safety: assessing the impact of attentional processes on driving.
Data compared the typology of drivers involved in traffic crashes and showing different levels of responsibility. All the volunteer’s samples had been injured, and had come or been driven to the adults’ emergencies.
2.000 volunteers have taken part to the study since 2005. Data has assessed that mind wandering plays a main part thus leading to inattention and crashes.

 

SOFTER project: prevention of long term post traumatism symptoms

When an accident has occurred and couldn’t be avoided, an optimal post-traumatic care should be provided. As a result, over the last years the IETO team has undertaken an ongoing study of long term consequences of accidents.
First the PERICLES project conducted a follow up study of 3.000 patients, all formerly victims of a traumatism, half of them suffering from head trauma.

For the first time data has assessed that, after three months, 20 % of the victims still suffer from a wide range of symptoms with no specific links to the original traumatism, though felt as handicapping: headaches, irritability, lack of mindfulness, vertigo.
These symptoms being closely linked to stress, the IETO team is preparing the SOFTER project which aims at testing, analyzing and assessing the impact of providing stress care for patients within short time after the accident occurred, to help victims go back to normal life.




Main publications

  1. Lagarde E, Salmi LR, Holm LW, Contrand B, Masson F, Ribéreau-Gayon R, Laborey M, Cassidy D. Post-concussion syndrome: neither post-concussion, nor a syndrome, but may be part of posttraumatic stress disorder. JAMA Psy 2014 16 Juil.
  2. Galéra C, Orriols L, M’Bailara K, Laborey M, Contrand B, Ribéreau-Gayon R, Masson F, Bakiri S, Gabaude C, Fort A, Maury B, Lemercier C, Cours M, Bouvard MP, Lagarde E. Mind Wandering and Driving: A responsibility case-control study. BMJ 2012 Dec 13;345:e8105
  3. Avalos M, Adroher ND, Lagarde E, Thiessard F, Grandvalet Y, Contrand B and Orriols L, on behalf of the CESIR research group. Prescription-drug-related risk in driving: comparing conventional and lasso shrinkage logistic regressions. Epidemiology 2012 Sep;23(5):706-12.
  4. Zongo D, Ribéreau-Gayon R, Masson F, Laborey M, Contrand B, Salmi LR, Montaudon D, Beaudeux, JL, Meurin A, Dousset V, Loiseau H, Lagarde E.. S-100B Protein as a screening tool for the early assessment of minor head injury. Ann Emerg Med 2011 Sep 26.
  5. Orriols L, Delorme B, Gadegbeku B, Tricotel A, Contrand B, Laumon B, Salmi LR, Lagarde E, on behalf of the CESIR research group. Prescription medicines and the risk of road traffic crashes: a French registry-based study. PLoS Med 2010;7(11).

partners

logo_ISPED logo_SFR-santepublique-societe logo_CHU-Bordeaux logo_Institut-Bergonie logo_INRIA logo_ANRS logo_HONcode