Injury prevention

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Injury prevention is an effort to prevent or reduce the severity of bodily injuries caused by external mechanisms, such as accidents, before they occur. Injury prevention is a component of safety and public health, and its goal is to improve the health of the population by preventing injuries and hence improving quality of life. Among laypersons, the term "accidental injury" is often used. However, "accidental" implies the causes of injuries are random in nature. [1] Researchers use the term "unintentional injury" to refer to injuries that are nonvolitional but preventable. Within the field of public health, efforts are also made to prevent or reduce "intentional injury." Data from the U.S. Centers for Disease Control, for example, show unintentional injuries are the leading cause of death from early childhood until middle adulthood. During these years, unintentional injuries account for more deaths than the next nine leading causes of death combined.[ citation needed ]

Contents

Injury prevention strategies cover a variety of approaches, many of which are classified as falling under the "3 E’s" of injury prevention: education, engineering modifications, and enforcement/enactment. Some organizations, such as Safe Kids Worldwide, have expanded the list to six E's adding: evaluation, economic incentives and empowerment.

Measuring effectiveness

Researching is challenging, because the usual outcome of interest is deaths or injuries prevented, and it is nearly impossible to measure how many people did not get hurt who otherwise would have. Education efforts can be measured by changes in knowledge, attitudes, beliefs and behaviors, before and after the intervention, however tying these changes back into reductions in morbidity and mortality is often problematic.

Examining trends in morbidity and mortality in the population is usually not difficult and may provide some indication of the effectiveness of injury prevention interventions. However, this approach suffers from the potential of ecological fallacy, where the data shows an association between an intervention and a change in the outcome, but there is actually no causal relationship.

Common types

Traffic and automobile safety

Traffic safety and automobile safety are a major component of injury prevention because it is the leading cause of death for children and young adults into their mid 30s. Injury prevention efforts began in the early 1960s when activist Ralph Nader, exposed the automobiles as being more dangerous than necessary with his book Unsafe at Any Speed. This led to engineering changes in the way cars are designed to allow for more crush space between the vehicle and the occupant. The Centers for Disease Control and Prevention (CDC) also contributes much to automobile safety. The CDC Injury Prevention Champion, David Sleet, illustrated the importance of lowering the legal blood alcohol content limit to 0.08 percent for drivers; requiring disposable lighters to be child resistant; and using evidence to demonstrate the dangers of airbags to young children riding in the front seat of vehicles. [2]

Engineering: vehicle crash worthiness, seat belts, airbags, locking seat belts for child seats.

Education: promote seat belt use, discourage impaired driving, promote child safety seats.

Enforcement and enactment: passage and enforcement of primary seat belt laws, speed limits, impaired driving enforcement.

Pedestrian safety

Pedestrian safety is the focus of both epidemiological and psychological injury prevention research. Epidemiological studies typically focus on causes external to the individual such as traffic density, access to safe walking areas, socioeconomic status, injury rates, legislation for safety (e.g., traffic fines), or even the shape of vehicles which affects the severity of injuries resulting from a collision. Epidemiological data show children aged 1–4 are at greatest risk for injury in driveway and sidewalks. Children aged 5–14 are at greatest risk while attempting to cross streets.

The body of psychological research on pedestrian safety is currently much smaller than that in the epidemiological field, but is rapidly growing. Psychological pedestrian safety studies extend as far back as the mid-1980s when researchers began examining behavioral variables in children. Behavioral variables of interest include selection of crossing gaps in traffic, attention to traffic, the number of near hits or actual hits, or the routes children chose when crossing multiple streets such as while walking to school. Behavioral studies often collect such variables which imply risk of injury; e.g., children engaging in risky behaviors may be assumed to be at greater risk if actually crossing a street alone. The most common technique used in behavioral pedestrian research is the pretend road, in which a child stands some distance from the curb and watches traffic on the real road. The child then walks to the edge of the street when a crossing opportunity is chosen. Research is gradually shifting to more ecologically valid virtual reality techniques. Leading scientists in psychological pedestrian safety research are Dr. Benjamin Barton, Dr. David Schwebel and Dr. James Thomson.

Home safety

Home accidents including burns, drownings, and poisonings are the most common cause of death in industralized countries. [3] Efforts to prevent accidents such as providing safety equipment and teaching about home safety practices may reduce the rate of injuries. [3]

Other

The following is an abbreviated topic list of some common focus areas of injury prevention efforts:

Research

Further evidence is required to determine the most effective approach for community-based educational initiatives to prevent burns and scalds in children, [5] and school-based programs for injury prevention. [6]

See also

Related Research Articles

Personal protective equipment Equipment designed to help protect an individual from hazards

Personal protective equipment (PPE) is protective clothing, helmets, goggles, or other garments or equipment designed to protect the wearer's body from injury or infection. The hazards addressed by protective equipment include physical, electrical, heat, chemicals, biohazards, and airborne particulate matter. Protective equipment may be worn for job-related occupational safety and health purposes, as well as for sports and other recreational activities. "Protective clothing" is applied to traditional categories of clothing, and "protective gear" applies to items such as pads, guards, shields, or masks, and others. PPE suits can be similar in appearance to a cleanroom suit.

Road traffic safety Methods and measures for reducing the risk of death and injury on roads

Road traffic safety refers to the methods and measures used to prevent road users from being killed or seriously injured. Typical road users include pedestrians, cyclists, motorists, vehicle passengers, horse riders, and passengers of on-road public transport.

Pressure ulcer Chronic ulcer of skin where the ulcer is an ulceration of tissue deprived of adequate blood supply by prolonged pressure

Pressure ulcers, also known as bedsores, are localized damage to the skin and/or underlying tissue that usually occur over a bony prominence as a result of usually long-term pressure, or pressure in combination with shear or friction. The most common sites are the skin overlying the sacrum, coccyx, heels, and hips, though other sites can be affected, such as the elbows, knees, ankles, back of shoulders, or the back of the cranium.

Seat belt legislation requires the fitting of seat belts to motor vehicles and the wearing of seat belts by motor vehicle occupants to be mandatory. Laws requiring the fitting of seat belts to cars have in some cases been followed by laws mandating their use, with the effect that thousands of deaths on the road have been prevented. Different laws apply in different countries to the wearing of seat belts.

Traumatic brain injury Injury of the brain from an external source

A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity, mechanism or other features. Head injury is a broader category that may involve damage to other structures such as the scalp and skull. TBI can result in physical, cognitive, social, emotional and behavioral symptoms, and outcomes can range from complete recovery to permanent disability or death.

Trachoma Human disease

Trachoma is an infectious disease caused by bacterium Chlamydia trachomatis. The infection causes a roughening of the inner surface of the eyelids. This roughening can lead to pain in the eyes, breakdown of the outer surface or cornea of the eyes, and eventual blindness. Untreated, repeated trachoma infections can result in a form of permanent blindness when the eyelids turn inward.

The National Traffic and Motor Vehicle Safety Act was enacted in the United States in 1966 to empower the federal government to set and administer new safety standards for motor vehicles and road traffic safety. The Act was the first law to establish mandatory federal safety standards for motor vehicles. The Act created the National Highway Safety Bureau. The Act was one of a few initiatives by the government in response to an increasing number of cars and associated fatalities and injuries on the road following a period when the number of people killed on the road had increased 6-fold and the number of vehicles was up 11-fold since 1925.

National Safety Council nonprofit, nongovernmental public service organization promoting health and safety in the USA

The National Safety Council (NSC) is a 501(c)(3) nonprofit, public service organization promoting health and safety in the United States of America. Headquartered in Itasca, Illinois, NSC is a member organization, founded in 1913 and granted a congressional charter in 1953. Members include more than 55,000 businesses, labor organizations, schools, public agencies, private groups and individuals.

A needlestick injury is the penetration of the skin by a hypodermic needle or other sharp object that has been in contact with blood, tissue or other body fluids before the exposure. Even though the acute physiological effects of a needlestick injury are generally negligible, these injuries can lead to transmission of blood-borne diseases, placing those exposed at increased risk of infection from disease causing pathogens, such as the hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Among healthcare workers and laboratory personnel worldwide, more than 25 blood-borne virus infections have been reported to have been caused by needlestick injuries. In addition to needlestick injuries, transmission of these viruses can also occur as a result of contamination of the mucous membranes, such as those of the eyes, with blood or body fluids, but needlestick injuries make up more than 80% of all percutaneous exposure incidents in the United States. Various other occupations are also at increased risk of needlestick injury, including law enforcement, laborers, tattoo artists, food preparers, and agricultural workers.

Walking bus concept

A walking bus is a form of student transport for schoolchildren who, chaperoned typically by two adults, walk to school along a set route, with some similarities to a school bus route. Like a real bus, walking buses have a fixed route with designated "bus stops" and "pick up times" at which they pick up and "drop off" children.

A health professional may provide health care treatment and advice based on formal training and experience. The field includes those who work as a physician, surgeon, physician assistants, nurse, physiotherapist, dentist, midwife, psychologist, psychiatrist, or pharmacist or who perform services in allied health professions. A health professional may also be a public health or community health practitioner.

Safe Kids Worldwide is a global non-profit organization working to prevent childhood injury through research, community outreach, legislative advocacy and media awareness campaigns. Safe Kids Worldwide has over 400 coalitions in 49 states, and has partners in over 30 countries. The proclaimed mission of Safe Kids Worldwide is "protecting kids from unintentional injuries, the number one cause of death for children in the United States." It is a 501(c) organization.

Traffic collision When a vehicle collides with another object

A traffic collision, also called a motor vehicle collision (MVC) among other terms, occurs when a vehicle collides with another vehicle, pedestrian, animal, road debris, or other stationary obstruction, such as a tree, pole or building. Traffic collisions often result in injury, disability, death, and property damage as well as financial costs to both society and the individuals involved.

Preventable causes of death Causes of death that could have been avoided

The World Health Organization has traditionally classified death according to the primary type of disease or injury. However, causes of death may also be classified in terms of preventable risk factors—such as smoking, unhealthy diet, sexual behavior, and reckless driving—which contribute to a number of different diseases. Such risk factors are usually not recorded directly on death certificates, although they are acknowledged in medical reports.

Prevention of HIV/AIDS prevent and minimize the occurrence of HIV and AIDS

HIV prevention refers to practices that aim to prevent the spread of the Human Immunodeficiency Virus (HIV). HIV prevention practices may be undertaken by individuals to protect their own health and the health of those in their community, or may be instituted by governments and community-based organizations as public health policies.

Work-related road safety in the United States

People who are driving as part of their work duties are an important road user category. First, workers themselves are at risk of road traffic injury. Contributing factors include fatigue and long work hours, delivery pressures, distractions from mobile phones and other devices, lack of training to operate the assigned vehicle, vehicle defects, use of prescription and non-prescription medications, medical conditions, and poor journey planning. Death, disability, or injury of a family wage earner due to road traffic injury, in addition to causing emotional pain and suffering, creates economic hardship for the injured worker and family members that may persist well beyond the event itself.

Safe-In-Sound award

The Safe-in-Sound Excellence in Hearing Loss Prevention Award is an occupational health and safety award that was established in 2007 through a partnership between the National Institute for Occupational Safety and Health (NIOSH) and the National Hearing Conservation Association (NHCA). In 2018, the partnership was extended to include the Council for Accreditation in Occupational Hearing Conservation (CAOHC).

Symptoms and discomforts of pregnancy are those presentations and conditions that result from pregnancy but do not significantly interfere with activities of daily living or pose any significant threat to the health of the mother or baby, in contrast to pregnancy complications. Still, there is often no clear separation between symptoms versus discomforts versus complications, and in some cases the same basic feature can manifest as either a discomfort or a complication depending on the severity. For example, mild nausea may merely be a discomfort, but if severe and with vomiting causing water-electrolyte imbalance it can be classified as a pregnancy complication.

Childhood blindness

Childhood blindness is an important cause contributing to the burden of blindness. Blindness in children can be defined as a visual acuity of <3/60 in the eye with better vision of a child under 16 years of age. This generally means that the child cannot see something three feet away, that another child could see if it was 60 feet away.

David A. Sleet is an American scientist recognized for championing the application of behavioral science to unintentional injury prevention and helping to establish injury prevention as a global public health concern. He has published hundreds of articles and book chapters and was co-editor of the Handbook of Injury and Violence Prevention.; Injury and Violence Prevention: Behavioral Science Theories; Derryberry’s Educating for Health; and the international prize-winning World Report on Road Traffic Injury Prevention.

References

  1. "Is There Such Thing As Accidental Injury?" . Retrieved 22 March 2003.
  2. "CDC Injury Prevention Champion David Sleet Receives 2015 Elizabeth Fries Health Education Award". CDC Foundation. 24 April 2015. Archived from the original on 5 September 2016. Retrieved 6 September 2016.
  3. 1 2 Kendrick, Denise; Young, Ben; Mason-Jones, Amanda J.; Ilyas, Nohaid; Achana, Felix A.; Cooper, Nicola J.; Hubbard, Stephanie J.; Sutton, Alex J.; Smith, Sherie; Wynn, Persephone; Mulvaney, Caroline (2012). "Home safety education and provision of safety equipment for injury prevention". The Cochrane Database of Systematic Reviews (9): CD005014. doi:10.1002/14651858.CD005014.pub3. ISSN   1469-493X. PMID   22972081.
  4. PLOS ONE Staff (2018-09-06). "Correction: Towards a deeper understanding of parenting on farms: A qualitative study". PLOS ONE. 13 (9): e0203842. Bibcode:2018PLoSO..1303842.. doi:10.1371/journal.pone.0203842. PMC   6126865 . PMID   30188948.
  5. Turner, C.; Spinks, A.; McClure, R.; Nixon, J. (2004). "Community-based interventions for the prevention of burns and scalds in children". The Cochrane Database of Systematic Reviews (3): CD004335. doi:10.1002/14651858.CD004335.pub2. ISSN   1469-493X. PMC   6464795 . PMID   15266531.
  6. Orton, Elizabeth; Whitehead, Jessica; Mhizha-Murira, Jacqueline; Clarkson, Mandy; Watson, Michael C.; Mulvaney, Caroline A.; Staniforth, Joy Ul; Bhuchar, Munish; Kendrick, Denise (2016). "School-based education programmes for the prevention of unintentional injuries in children and young people". The Cochrane Database of Systematic Reviews. 12: CD010246. doi:10.1002/14651858.CD010246.pub2. ISSN   1469-493X. PMC   6473192 . PMID   28026877.

Further reading

Research journals covering injury prevention include: