Introduction. The ever-increasing global road traffic accidents is caused by several risk factors: human factors, vehicle factors, and road environmental factors. In the Philippines, 12,000 road users die annually due to road crashes and almost one-third are alcohol-related crashes.

Objectives. This study aims to investigate the effects of suspected alcohol intoxication on the severity of injuries among drivers and passengers in a major urban region in the Philippines using the Metro Manila Accident Recording and Analysis System (MMARAS) of the Metropolitan Manila Development Authority from 2005 to 2020.

Methods. The Metro Manila Accident Recording and Analysis System (MMARAS) was used to determine the data on trends and association for alcohol-related road crashes, while descriptive and inferential statistics such as logistic and multinomial regression were used to determine trends and associations.

Results. Suspected alcohol intoxication road crash cases in Metro Manila have decreased from 45 cases in 2005 to 31 cases in 2020. The year 2011 recorded the highest cases of alcohol-suspected road crashes. The years 2010, 2011, and 2012 recorded the highest number of driver's death while 2005, 2006, 2014, and 2019 recorded higher deaths for passengers. Cars and motorcycles are the most commonly involved vehicles in alcohol-suspected road crashes, while Quezon City (n=307) and Marikina City (n=267) are the common places of incidence for drunk-driving accidents. On the other hand, alcohol intoxication increases the risk of driver's death (OR=9.16; 95% CI [5.388-15.574]) and injury (OR=5.22; 95% CI [4.487-6.074]). While intoxicated, hitting an object (OR = 12.557; 95% CI [1.478-106.694]) and truck collisions (OR=7.176; 96% CI [1.261-40.817]) can increase the risk for driver's death. Meanwhile, side swipe (OR=2.330; 95% CI [1.029-5.277]) and angle impact (OR= 7.972; 95% CI [1.804-35.227]), increase the odds for driver injuries.

Conclusion. Suspected alcohol intoxication road crashes can be prevented; however, a collaborative effort is needed. The government is responsible for road safety education as well as effectively enforcing road safety-related laws, while the road users shall use the roadways responsibly.

BACKGROUND: eHealth in the Philippines is poised to take off but adoption of eHealth applications in the country's public health sector is limited in scale.

OBJECTIVE: This paper examines the context and status of eHealth policy in the Philippines. The aim is to lay out the domains of policy issues that should be addressed for the successful implementation of eHealth in the Philippines.

METHODS: The themes and issues of policies on eHealth cited by Khoja, Durrani, Nayani and Fahim (2012) were used to describe and analyze the status of eHealth policy context in the Philippines. These are: (1) networked care, (2) interjurisdictional practice, (3) diffusion of eHealth/digital divide, (4) eHealth integration with existing systems, (5) response to new initiatives, (6) goal-setting for eHealth policy, (7) evaluation and research, (8) investment, and (9) ethics in eHealth. Documents and policies in the form of enacted laws, memoranda, implementing rules and regulations were retrieved and reviewed to answer whether or not policy themes and issues are addressed currently.

RESULTS AND CONCLUSION: Current policies in the status quo do not adequately address the issues that enable effective implementation of eHealth in the Philippines. While preconditions for eHealth to flourish such as strategic frameworks for ICT and eHealth have been established, they are inadequate in addressing licensing, diffusion of innovation, handling innovation, evaluation and research, and investment.

BACKGROUND AND OBJECTIVE: Road safety in the Philippines has been increasingly significant with the increasing level of industrialization and urbanization over the last decade. The main objective of the study was to determine the road safety performance for Metro Manila by computing for an index based on data and variables of road traffic over the past years.

METHODOLOGY: The variables for index calculation included speed, alcohol, infrastructure, vehicle defect, and other unsafe driver behavior were drawn from the Metro Manila Development (MMDA) database complemented with literature review from several sources. Equal Weighting method was utilized, as this is the simplest, yet, least biased measurement suitable for the data at hand.

RESULTS AND CONCLUSION: The Road Safety Performance Index for Metro Manila remains more or less constant over a five-year period, increasing and decreasing from 0.45 to 0.59 which means that Metropolitan Manila has fared poorly in all indicators. Metro Manila has a poor road safety performance as evidenced by the road safety index. There is a need to improve on all components of road safety identified in this study for the safety of road users. 

Introduction: In the Philippines, data on road traffic injuries show that road injury is the 11th leading cause of premature deaths in the Philippines. The World Health Organization estimates that 1.24 million die globally due to road traffic crashes. Objectives: This study aimed to show the trend of the road crash situation in Metro Manila, Philippines, over eleven years (2005–2015) and to analyze human error and other associated hazard factors for road crashes. Methods: This study is a secondary analysis of an 11-year database culled from 2005–2015, for Metro Manila, Philippines. The variables included road crash classification, incidence over months and time of the day, road crash disaggregated by location, region, and city, and type of vehicle. Descriptive statistics were used to describe the incidence of a road crash, road crash fatalities, and risk factors associated with a road crash in Metro Manila. Results: The incidence of road crashes in Metro Manila has increased from 65,111 in 2005 to 95,615 in 2015. Fatalities also increased from 348 to 536. The most predominant type of vehicle involved in road crashes were cars from 46% to 67%, followed by jeepneys, vans, and motorcycles. The most commonly reported human errors were speeding, inattentive and bad turning. The reported percentage of speeding from 2005–2010 ranged between 32% and 58%. In 2014, speeding (96%) was the most reported human error among the other reported errors; such as inattentiveness (range, 28 to 41%) and bad turning (0.6% and 33%). Fatigue and traffic violation made up 0.02% to 0.45% of the reported human factors of road crash-related hospitalization cases in Metro Manila for the period. Suspected alcohol use accounted for 0.04% to 4.57% of the human errors reported. For non-fatal and fatal crashes, the associated human errors were suspected alcohol use, inattentiveness, and speeding. The highest adjusted residual for both fatal and non-fatal (injurious) crashes was for inattentiveness. Human error was associated with years, suggesting that for some years, the number of crashes caused by human errors is significantly higher than expected. Alcohol-suspected crashes are significantly higher than expected for 2005 and 2011, with 2011 having the highest adjusted residual. Inattentiveness-caused crashes were significantly higher than expected for years 2005 to 2010, with 2007 having the highest adjusted residual. Bad turning was significantly higher from 2005 to 2007; while disobedience was significantly higher for 2005 to 2008. Speeding was significantly higher than expected from 2005 to 2010. Conclusion There is a need to address the public health concern posed by road crashes in Metro Manila, as well as to rectify the ergonomically related risk factors and human error components in a road crash.
Risk Factors

Introduction: Small-scale mining (SSM) has been in the Philippines since the early 1900s and significant contributor to the local economy. SSM has contributed 14% of the country's total Gross Domestic Product and has a revenue share of about 19 billion pesos (380 million USD). Objectives: This study aims to document mining occupational safety and health in SSM in the Philippines and identify best practices among miners and communities to reduce toxic chemical use in mining. It also aims to evolve laws and legislative measures on mining in the country as the basis for more aggressive policies and programs for SSM in the Philippines. Methods: The data were based on gray literature, peer-reviewed journals, databases, government statistics, and secondary literature. Data were analyzed through critical appraisal on the impacts of mining in terms of occupational safety, mining issues, hazards, and disasters, environmental and health impact, as well as documentation of best practices in mining to reduce the use of toxic chemicals, and the current laws and legislations on mining in the Philippines. Results: SSM or artisanal mining is categorized as part of the informal sector of the market economy. In the Philippines, the leading types of accidents in the mines are being hit by falling objects, suffocation from chemical fumes, and crushing injuries, exposure to intense heat, poor ventilation, vibration, dust, fumes, repetitive stress injury, intense noise, manual handling (e.g., lifting) of heavy machinery, and biological and chemical hazard. Occupational illnesses include skin diseases, emphysema, chronic obstructive lung disease, and hearing loss. Due to these risks, the Philippines has adopted mercury-free mining, cyanide reduction, and green and climate-smart mining. The use of borax in recovering gold from ore instead of mercury originated in the Philippines, which is now widely known as the mercury-free gravity-borax method adopted in Africa and Asia. The Philippines also has a plethora of laws covering mining as a whole. Developmental directives include enacting specific SSM laws and regulations, including a separate set of safety rules, and decentralizing the issue and control of SSM permits and licenses through local government units. Some noted legislative measures, Presidential Decrees, and Administrative Orders have been crafted to cover the safety net, equity, safety, and health for small-scale miners, among the most vulnerable working populations. Discussion: Hazards and risks have been documented in SSM in the Philippines. However, the policies, legislation, and protective measures on SSM warrant more comprehensive coverage, implementation, and provision of social safety nets. Conclusion The study concludes that mining in the Philippines continues to be a problem as it produces adverse effects on workers' health, the community, and the environment. It is crucial to ensure the health and safety of mining workers, and all players and stakeholders must fulfill their respective roles. Governments and communities need to perform their regulatory and monitoring functions dutifully to build up their capacities to benefit mining communities that contribute much to the local economy.
Occupational Injuries ; Mining

Introduction: Road traffic accidents are a growing public health burden, especially in the low- and middle-income countries (LMICs). With resource scarcity, road traffic injuries may lead to poor quality of life among survivors, or deaths at worst. Victims of crashes involving transportations are gendered; therefore, there may be differences in the trends and characteristics of injuries sustained by men and women related to road crash. Objectives: This study aimed to determine the factors related to severity of road crashes among women road users in the Philippines from 2008 to 2017. Methods: We conducted a retrospective review of clinical records of women patients involved in road crash at the Trauma Division, Department of Surgery of the Philippine General Hospital (PGH) for the ten-year period, January 1, 2008 to December 31, 2017. Data were extracted from the electronic patient records in Integrated Surgical Information System (ISIS). Results: From 2008 to 2017, 926 of the road crash victims brought to PGH were women. There was an increasing trend, with the years 2015 to 2017 accounting for half of the total cases (55.62%). The highest cases of women patient admissions were also recorded during the months of June and July (5.61%). The CALABARZON region (11.23%) and National Capital Region (8.21%) had the highest admissions. The patients were most commonly pedestrians (12.20%) and involved in collisions (13.50%) or vehicle involvement (13.17%). The most common vehicle involved was a motorcycle (9.72%) followed by car and vans (1.62%). Only a small proportion of women patients used helmets (3.33%) and seatbelts (0.12%). The median length of hospital stay of women patients was 5 days. The most commonly sustained injuries among patients were multiple (83.65%), external (43.72%), extremity (33.15%), head and neck (23.47%), and face (21.58%) injuries. Among these, injuries to the extremity had the highest average length of hospital stay (16.04 ± 31.28 days) while external and head and neck injuries had the shortest (10.81 ± 33.42 days). Multinomial regression showed that women patients who suffered from head and neck, and abdominal injuries had increased odds of dying by 4.94 times (CI: 2.158-11.302, p < 0.05), and 3.33 times (CI:1.235-9.02, p < 0.05), respectively, compared to those who did not suffer said injuries. Conclusion There is a significant number of women involved in road crashes in the Philippines, and therefore, there is a need for directed policies on female road users as vulnerable road users.
Accidents ; Women ; Motor Vehicles ; Length of Stay ; Hospitalization

Introduction: Companies and hospitals in the healthcare industry, like other businesses, are not exempted from the rising labor costs and growing dissatisfaction among employees. The assessment and optimization of total rewards management (TRM) are important since TRM consists of monetary and non-monetary rewards given to employees in exchange for their time, talents, and efforts. Objective: This study assessed the TRM in Philippine healthcare companies. This study also looked into the organizational structure of various health-service companies and their TRM, and the difference between companies with TRM and without TRM in terms of pay, benefits, work-life balance, career development, and performance recognition. Method: A total of 74 human resource personnel were randomly sampled from healthcare companies in the Philippines. A survey questionnaire was administered with items on TRM philosophy divided into five parts – pay, benefits, work-life balance, career development, and performance recognition. High mean scores per TRM component correspond to higher levels of agreement to positive statements to the corresponding TRM component. Chi-square test was used to determine the association between various demographic variables and the existence of a TRM philosophy in a company. T-test was used to determine whether the differences in the mean scores per TRM component were statistically significant or not. Results: Less than half (44%) of the included companies have TRM and companies in Metro Manila were more likely to have an existing TRM philosophy. Companies in the healthcare sector usually disseminate information on TRM during town hall meetings, and not during onboarding. Employees in the healthcare companies had strict work schedules as most employers did not allow flexi-time arrangements. This may have contributed to burnout and stress that are common in most companies. Lastly, employees working in companies with a TRM philosophy do not experience significantly better pay, benefits, work-life balance, career development, and performance recognition than those working in companies without TRM. Conclusion These findings suggest that even companies with an established TRM philosophy need significant improvement in their TRM processes for TRM to translate to better pay, benefits, work-life balance, career development, and performance recognition.
Work-Life Balance

INTRODUCTION: Metro Manila, the metropolitan center and seat of the national government, is composed of 16 cities and 1 municipality, and considered as the second-most populous region in the Philippines. Transport is a key sector that is needed for accessibility and economic progress. Yet, the question on safety of the roads of Manila remains as road crashes continue to be reported. OBJECTIVE: The study aims to determine the trend of road crashes in Metro Manila, and the factors associated with both fatality and injury among three types of road users – the drivers, the passengers, and the pedestrians. METHODS: A retrospective analysis of 523,059 road crash data between 2016 to 2020 was done. Using descriptive statistics, the road crash variables analyzed in the study were (1) crash classification according to damage to property, fatal, and non-fatal crash, (2) road user type according to driver, passenger, and pedestrian, (3) vehicle type, (4) junction type, and (5) risky road user behavior. Logistic and multinomial regression models were used to determine whether these variables were significant with road user fatality and injury. RESULTS: The analysis of the MMARAS database (n=523,059) showed an increasing trend of road crashes occurred since 2016 and peaked in 2019, and declined in 2020. Majority (436,367, 83.426%) were damage to property, followed by non-fatal or injurious cases (84751, 16.203%) and fatal outcomes (1941, 0.371%). Drivers have the greatest number of fatalities and injuries compared to passengers and pedestrians. Cars (513482 52.322%) and motorcycles (136641, 13.923%) remain the major types of vehicles involved in road crashes. The factors that were significantly associated with increased odds ratio for driver death were involvement of pedicabs (OR=10.937, p=0.000), motorcycles (OR=55.061, p=0.000), bus (OR=5.835, p=0.000), truck (OR=7.073, p=0.000), hit object (OR=11.007, p=0.000), self-accident (OR=6.149, p=0.000), and collisions in bridges/flyovers (OR=2.713, p=0.010)). The factors that were significantly associated with increased odds ratio for passenger fatality were the involvement of motorcycle (OR=3.75, p=0.021), angle impact (OR=42.01, p=0.002), multiple collision (OR=18.42, p=0.040), self-accident (OR=32.66, p=0.010), and lost control (OR=82.98, p=0.001). The factors significantly associated with pedestrian fatality were hit and run (OR=56.04, p=0.000), hit pedestrian (OR=1085.17, p=0.000), and crashes in bridges/flyover (OR=4.20, p=0.025). Meanwhile, multinomial regression showed that classification of crash and vehicle type were significantly associated with fatal and non-fatal crashes. CONCLUSION The study showed the trend of fatality and injury among drivers, passengers, and pedestrians from 2016-2020, and factors of road crashes in Metro Manila including vehicle type, road behaviors, collision type and junction type.

Introduction: Road traffic injuries are among the leading causes of preventable death, claiming around 7000 lives every year. Furthermore, road traffic can injure or disable thousands more every year in the Philippines. Objectives: This study determined the hospital length-of-stay patterns and risk factors for a prolonged length of stay in a tertiary hospital after road traffic injury. Methods: A retrospective cohort study was conducted to determine the determinants of the length of stay in the Philippine General Hospital (PGH) among road traffic injury victims for the year 2016. Length of stay was recorded according to the median. The other variables were cross-tabulated against the length of stay, and each of their crude odds ratios along with corresponding p-values were presented. Continuous variables were analyzed using Wilcoxon Mann-Whitney U-test. The predictor model for the determinants of prolonged length of stay in the hospital was built using forward selection. Likelihood-ratio test was used to compare the model with and without the exposure variable. Results: A total of 427 road traffic injury victims were admitted to the Philippine General Hospital in 2016. The mean age of the patients was 31.55 years (±14.97) with a median age of 29 years. The majority of patients were males (82.4%) and single (60.8%). Most patients were riding a motorcycle during the time of the accident (64.2%) while 20% were pedestrians. The majority of the victims were intoxicated (74.3%) and were not using helmets (57.1%) at the time of the accident. Most of the victims received first aid (69.2%) and the mean time of admission was 3.03 (±13.31) days while the median time to admission was 12 hours. Receiving first aid (p<0.01), availed services (p<0.01), and married civil status (p=0.04) were found to be strongly associated with length of hospital stay. Without controlling for any confounders, pay patients (OR = 3.46, 95% CI: 1.3, -9.87), elective patients (OR = 7.88, 95% CI: 2.64, 31.61), and those in non-trauma wards (OR=2.07, 95% CI: 1.29, 3.36) had higher odds for longer hospitalization stay. On the other hand, those who did not receive first aid (OR = 0.55, CI:0.35, 0.85) had lower odds for prolonged hospitalization. Those who suffered face injury and did not suffer external injuries had a higher mean rank, suggesting a longer length of hospital stay. On the other hand, upon controlling variables found to be associated with previous studies, those with low Glasgow coma scale (GCS) scores were 2.77 times (95% CI: 1.13, 6.91) more likely to stay longer in the hospital. Conclusion The type of victim, mortality status, age, and sex were found to be important determinants of prolonged hospitalization. To lessen the number of fatalities and road trauma injuries, laws on road safety should be strictly and properly implemented. Shared responsibility of all road users is also important in improving the safe usage of roads.
Length of Stay ; Accidents, Traffic ; Wounds and Injuries

Introduction: Globally, the number of people who die from road crashes continues to rise, reaching a high of 1.35 million in 2016. Due to this continued increase in fatalities and injuries within the road transport system, especially in low- and middle-income countries, 2011 to 2020 was declared by the United Nations General Assembly in 2010 as the Decade of Action for Road Safety. Objectives: This study looked into the epidemiology of road crashes and injuries in Metro Manila over ten years, from 2008-2017, from data gathered at the Department of Surgery of the Philippine General Hospital (PGH). Method: A retrospective review of patients’ clinical records was conducted to describe the epidemiology of road crash cases in the Trauma Division, Department of Surgery of the PGH. Clinical records of the road crash patients admitted to the division over the ten years, January 1, 2008, to December 31, 2017, were extracted from the Integrated Surgical Information System (ISIS). Results: A total of 422 patients were admitted to the PGH Department of Surgery and recorded in the ISIS database, from 2008 to 2017, who suffered from road crashes in Metro Manila. Most of these patients (80.8%) were male. The mean age of patients was 32.4 years. The highest number of admissions (27.5%) and road crash deaths (6.9%) were in 2016; the highest number was from the city of Manila (26.7%), and most happened at nighttime (61.8%) between 6:00 PM and 5:59 AM. Throughout the years, motorcycle (52.8%) was the vehicle type involved. Among patients with helmet use information, 65.4% were not wearing helmets, 91.2% had a history of alcohol intake. The majority incurred multiple injuries (82.7%), with the external region (53.8%) as the most common. Patients who sustained injuries to their head and neck region were five times more likely to die and six times more likely to have an unchanged patient outcome than those who did not have these injuries. Patients who had a GCS of 8 and below or those who had severe brain injuries were eight times more likely to die and six times more likely to have an unchanged patient outcome. Conclusion This study looked into the epidemiology of road crash cases admitted to the Surgery Department of the PGH. Road crash injuries and deaths remain a growing concern among the citizens of Metro Manila. It is hoped that the results of this study will provide policymakers with an objective and data-driven perspective on road crashes.
Accidents ; Patients