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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.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.
An accident, also known as an intentional act, is an undesirable, incidental, and an unplanned event that could have been prevented had circumstances leading up to the accident been recognized, and acted upon, prior to its occurrence. Most scientists who study unintentional injury avoid using the term "accident" and focus on factors that increase risk of severe injury and that reduce injury incidence and severity.
Safety is the state of being "safe", the condition of being protected from harm or other non-desirable outcomes. Safety can also refer to the control of recognized hazards in order to achieve an acceptable level of risk.
Public health has been defined as "the science and art of preventing disease, prolonging life and promoting human health through organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the health of a population and the threats it faces is the basis for public health. The public can be as small as a handful of people or as large as a village or an entire city; in the case of a pandemic it may encompass several continents. The concept of health takes into account physical, psychological and social well-being. As such, according to the World Health Organization, it is not merely the absence of disease or infirmity.
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.
Education is the process of facilitating learning, or the acquisition of knowledge, skills, values, beliefs, and habits. Educational methods include storytelling, discussion, teaching, training, and directed research. Education frequently takes place under the guidance of educators, however learners may also educate themselves. Education can take place in formal or informal settings and any experience that has a formative effect on the way one thinks, feels, or acts may be considered educational. The methodology of teaching is called pedagogy.
Engineering is the study of using scientific principles to design and build machines, structures, and other things, including bridges, roads, vehicles, and buildings.The discipline of engineering encompasses a broad range of more specialized fields of engineering, each with a more specific emphasis on particular areas of applied mathematics, applied science, and types of application. See glossary of engineering.
Enforcement is the process of ensuring compliance with laws, regulations, rules, standards, or social norms. By enforcing laws and regulations, governments attempt to effectuate successful implementation of policies.
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.
Mortality rate, or death rate, is a measure of the number of deaths in a particular population, scaled to the size of that population, per unit of time. Mortality rate is typically expressed in units of deaths per 1,000 individuals per year; thus, a mortality rate of 9.5 in a population of 1,000 would mean 9.5 deaths per year in that entire population, or 0.95% out of the total. It is distinct from "morbidity", which is either the prevalence or incidence of a disease, and also from the incidence rate.
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.
An ecological fallacy is a formal fallacy in the interpretation of statistical data that occurs when inferences about the nature of individuals are deduced from inferences about the group to which those individuals belong. Ecological fallacy sometimes refers to the fallacy of division, which is not a statistical issue. The four common statistical ecological fallacies are: confusion between ecological correlations and individual correlations, confusion between group average and total average, Simpson's paradox, and confusion between higher average and higher likelihood.
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.
Ralph Nader is an American political activist, author, lecturer, and attorney, noted for his involvement in consumer protection, environmentalism and government reform causes. The son of Lebanese immigrants to the United States, Nader was educated at Princeton and Harvard and first came to prominence in 1965 with the publication of the bestselling book Unsafe at Any Speed, a critique of the safety record of American automobile manufacturers that became known as one of the most important journalistic pieces of the 20th century. Following the publication of Unsafe at Any Speed, Nader led a group of volunteer law students—dubbed "Nader's Raiders"—in a groundbreaking investigation of the Federal Trade Commission, leading directly to that agency's overhaul and reform. In the 1970s, Nader leveraged his growing popularity to establish a number of advocacy and watchdog groups including the Public Interest Research Group, the Center for Auto Safety, and Public Citizen.
The Centers for Disease Control and Prevention (CDC) is the leading national public health institute of the United States. The CDC is a United States federal agency under the Department of Health and Human Services and is headquartered in Atlanta, Georgia.
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.
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 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.
Epidemiology is the study and analysis of the distribution and determinants of health and disease conditions in defined populations.
A driveway is a type of private road for local access to one or a small group of structures, and is owned and maintained by an individual or group.
A sidewalk or pavement, also known as a footpath or footway, is a path along the side of a road. A sidewalk may accommodate moderate changes in grade (height) and is normally separated from the vehicular section by a curb. There may also be a median strip or road verge either between the sidewalk and the roadway or between the sidewalk and the boundary.
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.
The following is an abbreviated topic list of some common focus areas of injury prevention efforts:
A seat belt is a vehicle safety device designed to secure the occupant of a vehicle against harmful movement that may result during a collision or a sudden stop. A seat belt functions to reduce the likelihood of death or serious injury in a traffic collision by reducing the force of secondary impacts with interior strike hazards, by keeping occupants positioned correctly for maximum effectiveness of the airbag and by preventing occupants being ejected from the vehicle in a crash or if the vehicle rolls over.
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.
Risk compensation is a theory which suggests that people typically adjust their behavior in response to the perceived level of risk, becoming more careful where they sense greater risk and less careful if they feel more protected. Although usually small in comparison to the fundamental benefits of safety interventions, it may result in a lower net benefit than expected.
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.
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 a 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.
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 needle or other sharp object, which 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 contracting infectious diseases, such as hepatitis B (HBV), hepatitis C (HCV), and the 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.
An occupational hazard is a hazard experienced in the workplace. Occupational hazards can encompass many types of hazards, including chemical hazards, biological hazards (biohazards), psychosocial hazards, and physical hazards. In the United States, the National Institute for Occupational Safety and Health (NIOSH) conduct workplace investigations and research addressing workplace health and safety hazards resulting in guidelines. The Occupational Safety and Health Administration (OSHA) establishes enforceable standards to prevent workplace injuries and illnesses. In the EU a similar role is taken by EU-OSHA.
Most seat belt laws in the United States are left to the states. However, the first seat belt law was a federal law, Title 49 of the United States Code, Chapter 301, Motor Vehicle Safety Standard, which took effect on January 1, 1968, that required all vehicles to be fitted with seat belts in all designated seating positions. This law has since been modified to require three-point seat belts in outboard-seating positions, and finally three-point seat belts in all seating positions. Initially, seat belt use was voluntary. New York was the first state to pass a law which required vehicle occupants to wear seat belts, a law that came into effect on December 1, 1984. New Hampshire is the only state that has no enforceable laws for the wearing of seat belts in a vehicle.
Driving in the United States is a frequent occurrence, with the majority of Americans using private automobiles as their primary form of transportation to their workplace. Each state has the authority to set its own traffic laws and issue driving licenses, although these laws are largely the same and licenses from other states are respected throughout the country. Americans drive on the right side of the road. There are numerous regulations on driving behavior, including speed limits, passing regulations, and seat belt requirements. Driving while intoxicated with alcohol is illegal in all jurisdictions within the U.S.
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 500 chapters and coalitions in all 50 states, and has partners in 25 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.
Falling is the second leading cause of accidental death worldwide and is a major cause of personal injury, especially for the elderly. Falls in older adults are an important class of preventable injuries. Builders, electricians, miners, and painters are occupations with high rates of fall injuries.
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, death, and property damage.
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.
Luchemos por la Vida is a nonprofit organization whose purpose is to help prevent traffic accidents in Argentina. It promotes road traffic safety and focuses its efforts in contributing to safe behavior in the traffic system. The organization does not receive financial support from government agencies and is mainly held by the effort of volunteers, help from private firms, and services provided to the community. In 2010 there were 21 deaths per day in Argentina, more than 100,000 injured people, and severe material losses due to traffic accidents.
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.
National Safety Month (NSM) is an annual month-long observance in the United States each June.
Research journals covering injury prevention include:
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