Road traffic crashes with fatal and non-fatal injuries in Arkhangelsk,Russia in 2005–2010

The study investigated trends in traffic crashes with fatal and non-fatal injuries in Arkhangelsk, Russia in 2005–2010. Data were obtained from the road police. Negative binomial regression with time regressor was used to investigate trends in monthly incidence rates (IRs) of crashes, fatalities, and non-fatal injuries. During the six-year period, the police registered 4955 crashes with fatal and non-fatal injuries, which resulted in 217 fatalities and 5964 non-fatal injury cases. The IR of crashes with fatal and non-fatal injuries per total population showed no evident change, while the IR per increasing total number of motor vehicles decreased on average by 0.6% per month. Pedestrian crashes constituted 51.8% of studied crashes, and pedestrians constituted 54.6% of fatalities and 44.5% of non-fatal injuries. The IRs of pedestrian crashes and non-fatal pedestrian injuries per total population decreased on average by 0.3% per month, and these were the major trends in the data.     

Estimating the costs of non-fatal consumer product injuries in the United States

This paper describes a data-driven injury cost model (ICM) developed to estimate the costs associated with non-fatal consumer product injuries. The modeling effort combines information by diagnosis from the US Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) and 17 other large data sets. The ICM contains four aggregated cost components: (1) medical costs, (2) work losses, (3) quality of life and pain and suffering costs, and (4) product liability insurance administration and litigation costs. The ICM estimates societal costs, which are broader than costs to any individual group, such as victims, insurers, or product manufacturers. Costs associated with consumer product injuries are estimated to be approximately $500 billion in 1996, accounting for nearly one-third of the total annual injury costs. We examine injury costs in several ways, including by major product category, by sex and age of victims, by body part injured, by injury diagnosis, and by highest level of medical treatment received. We also rank the 10 leading consumer products that account for injury costs overall and within different age groups. Products such as stairs and floors are among the top 10 for all age groups. Other products, however, are more closely tied to injuries at particular stages of life (e.g., infant/toddler, child, young adult, elderly). These cost estimates are useful in assessing which products and types of injuries impose the greatest costs on society and for identifying areas for focused injury prevention efforts.     

Prevention of drowning in home pools – lessons from Australia

As an affluent and warm weather country, Australia faced an epidemic of drowning in children under five as the popularity of home pools increased in the late 1960s and early 1970s. In one state child drowning rose by 6.62 per 100,000 in the five years from 1968. Variation across jurisdictions in actions to regulate domestic pools has resulted in Australia representing an unfortunate natural experiment in interventions to prevent child drowning in pools. Mechanisms adopted by various authorities were analysed in detail to identify factors that contributed to success and failure in regulating domestic pools. Despite early identification of the problem and development of what were later demonstrated to be effective interventions, best practice solutions were not established in any jurisdiction until 2002, 25 years after identification of the problem. Key failures in intervention were found to be: failure to act in a timely way, flawed regulation, blockage of timely action and repeal of effective state regulation under political pressure, and blockage of effective standards. Lessons are identified as: inherent weaknesses in the standard setting process, failure of interventions to address major risk categories, failure to act before the hazard grew, failure to consider lesser interventions for tactical reasons, failure to pay attention to advocates, and the need for continuing effort. The paper argues that analysis of the identification of the problem, development of interventions and implementation of mechanisms of prevention illustrate where systemic changes are required and indicate lessons that should be applied in developing and implementing future interventions.     

Epidemiology of unintentional child injuries in the South-East Asia Region: a systematic review

All the 11 members of the South-East Asia Region (SEAR) of the World Health Organization are categorised as low- and middle-income countries. This region has over a quarter of the world's total population but comprises about one-third of the world's unintentional injury-related deaths. There is a paucity of good-quality mortality and morbidity data from most of these countries. This is the first systematic review of community-based surveys on child injuries that summarises evidence from child injury studies from the SEAR countries. The included papers reported varying estimates of overall non-fatal unintentional injury rates across the countries, from 15/1000 children in Thailand to as high as 342/1000 children in India. The fatal injury rates were also found to be varying. This review revealed a need for strengthening child injury research using standard methodologies across the region and for promoting the dissemination of the results.     

An analysis of stratagems to reduce drowning deaths of young children in private swimming pools and spas in Victoria,Australia

This population-based retrospective case series study examined the frequency and distribution of protective stratagems (legislatively compliant safety barrier, adequate caregiver supervision, water familiarisation and early administration of cardiopulmonary resuscitation [CPR]) amongst drowning deaths of young children (0–4 years) in private swimming pools or spas in Victoria, Australia. In 65.0% (52/80) of deaths, none of the four protective stratagems were known to be present and there was only one case where all four were known to be present. This indicates that if the presence of all four stratagems is increased, this may reduce drowning in this age group and setting. While these results are positive, further examination of the presence and interaction of these stratagems for effectiveness is required. Further research is also warranted to explore the impact of enforcement of pool fencing legislation and potential associations between water familiarisation and drowning risk. In addition, a consensus on the definition of adequate supervision in needed.     

学龄前儿童意外伤害流行病学特征及预防对策研究

伤害使儿童、青少年早死或残疾,给家庭和社会带来巨大负担,早死人数的多寡直接影响到人口平均期望寿命的高低.为了解学龄前儿童意外伤害流行病学特征并提出预防干预对策,对武汉市部分城区学龄前儿童意外伤害的发生进行了现场调查研究.经统计分析,儿童的行为特点与意外伤害的发生均存在密切联系;伤害的类型以摔碰伤、车祸、坠落伤及切割伤居前四位.在调研基础上提出了干预和控制学龄前儿童意外伤害的对策.     

Incidence and characteristics of unintentional injuries among children in a resource limited setting in Kampala,Uganda

ABSTRACT

Given that little is known about the epidemiology of unintentional injuries in children in low-income countries, this study sought to determine the incidence and characteristics of unintentional injuries among children aged ≤18 years in a slum community in Uganda. From a household survey, the incidence and odds ratios for factors associated with unintentional injury characteristics were calculated. Of 1583 children, 706 had suffered 787 unintentional injuries yielding an annual incidence rate of 497 injuries per 1000 children. Commonest injuries were cuts, bites or open wounds (30.6%) and bruises or superficial injuries (28.6%) with majority (75.5%) occurring at home. Boys were more likely to be injured at school (AOR 4.34; 95% CI 1.22–15.54) and to be injured from falls (AOR 1.41; 95% CI 1.01–1.96). Older children (12–18 years) were more likely to suffer from fractures (AOR 2.37; 95% CI 1.26–4.43), concussions and organ system injuries (AOR 3.58; 95% CI 1.03–12.39) and cuts, bites or open wounds (AOR 2.05; 95% CI 1.21–3.48). Older children were less likely to suffer burns or scalds as compared to the young children (AOR: 0.23; 95% CI 0.11–0.50). Unintentional injury incidence rate was high among children with most occurring in the homes.     

Community safety promotion at local,regional, and national levels. Summary report from a workshop on local organizing and societal contributions with regard to the development of Safe Communities,held at the Third International Conference on Safe Communities,June 6-8, 1994, Harstad,Norway

Aim The aim of this review was to determine the extent to which the effectiveness of countermeasures for preventing alpine skiing injuries has been evaluated. Methods The methodology involved a critical review based on the available international literature and sports equipment standards, as well as consultation with experts in the field. Where possible, the review focused on controlled trials. Results Key injury countermeasures in skiing identified in this review include physical conditioning programmes, ski-bindings and their timely release, professional adjustment of ski-bindings and the use of mechanical testing devices for this, design of ski pole handles, helmets for children (and adults), ski patrollers, skier education, speed control on the slopes and safe lifting equipment. A tabular categorisation of the types of evidence for the effectiveness of injury countermeasures is presented. This demonstrates that the weight of evidence is generally based on a combination of data-based or biomechanical testing evidence and informed opinion/anecdotal evidence. There is minimal evidence based on controlled trials in the field. The most evaluated countermeasures are ski bindings and ski pole handles. Properly adjusted ski bindings have the potential for a 3.5-fold reduction in lower extremity injuries, particularly knee injuries. Ski pole handle design needs further innovation and attention. An immediate concern is the generally poorer standard of children’s equipment, ski bindings and their adjustment. Conclusion Skiing is a sport that is growing in popularity, but with a need for controlled trials of its injury prevention countermeasures. This review provides a basis for further action in injury prevention research, development and implementation.     

Prevention of childhood poisoning in the home: overview of systematic reviews and a systematic review of primary studies

Unintentional poisoning is a significant child public health problem. This systematic overview of reviews, supplemented with a systematic review of recently published primary studies synthesizes evidence on non-legislative interventions to reduce childhood poisonings in the home with particular reference to interventions that could be implemented by Children's Centres in England or community health or social care services in other high income countries. Thirteen systematic reviews, two meta-analyses and 47 primary studies were identified. The interventions most commonly comprised education, provision of cupboard/drawer locks, and poison control centre (PCC) number stickers. Meta-analyses and primary studies provided evidence that interventions improved poison prevention practices. Twenty eight per cent of studies reporting safe medicine storage (OR from meta-analysis 1.57, 95% CI 1.22–2.02), 23% reporting safe storage of other products (OR from meta-analysis 1.63, 95% CI 1.22–2.17) and 46% reporting availability of PCC numbers (OR from meta-analysis 3.67, 95% CI 1.84–7.33) demonstrated significant effects favouring the intervention group. There was a lack of evidence that interventions reduced poisoning rates. Parents should be provided with poison prevention education, cupboard/drawer locks and emergency contact numbers to use in the event of a poisoning. Further research is required to determine whether improving poison prevention practices reduces poisoning rates.     

Identifying the factors behind fatal and non-fatal road crashes: a case study of Lahore,Pakistan

ABSTRACT

The study identifies the factors behind fatal and non-fatal road crashes in Lahore, Pakistan, by investigating 461 reported cases to Traffic Police Lahore that occurred during January–November 2014. Road crashes are categorized into fatal and non-fatal crashes and, because of the binary nature of the dependent variable, logistic regression is used to identify the factors behind these crashes. As a follow-up, discriminant analysis is employed to classify the factors related to fatal and non-fatal crashes. The logistic regression results reveal that females are at higher risk of fatalities than male drivers. Among vehicle types, rickshaws and cars are more involved in fatal accidents because both are growing at large on roads. Long trucks and trailers are also involved in fatal accidents, mainly because of their huge size and drivers’ risky driving behaviours. It is also noted that risk of fatalities is higher in case where two vehicles bumped each other. Speeding and overloading are the common behaviours resulting in fatal crashes. Better urban transport systems and strict compliance with traffic rules and regulations may improve road safety in Pakistan.     

中国残疾预防的转折机会和预期分析

残疾社会负担迅速增加是推动我国尽快开展残疾预防工作的重要原因,而现代医学科技的发展使绝大部分残疾可防可控是开展残疾预防的必要条件。系统回顾了近30年来我国主要的残疾预防政策行动,总结了取得的成效和存在的问题,分析了我国残疾预防工作面临的新形势以及新的政策动向,提出了下一步残疾预防工作的四个重点,即提高认识、完善政策、加强行动、强化支持。     

Prevalence and predictors of bicycle helmet use in a southeastern,US city

Fatalities and head injuries from bicycle-related crashes remain a concern in the United States. Despite legislation in many states, helmet use remains low. This observational study examined the helmet use and related factors in a North Carolina city. The sample consisted of 2088 observations of bicyclists. The objectives were to (1) determine helmet use; (2) describe other safe bicycling practices; and (3) examine the relationship of demographic variables and safe riding practices with helmet use. Helmet use was observed for 25% of the sample. Demographic factors related to helmet use were being female (OR = 1.32), 26 years old or older (OR = 4.94), and White (OR = 2.17). Bicyclists riding on the road with traffic were more likely to wear a helmet than bicyclists riding on the sidewalk (OR = 2.04). Findings indicate that helmet use remains low in the city. Research to monitor, better understand, and promote helmet use is needed.     

A preliminary investigation of factors affecting seafood consumption behaviour in the inland and coastal regions of Victoria,Australia

This paper examines whether there are any substantial differences in factors influencing seafood consumption (at‐home) behaviour of consumers from two different regions of Victoria, Australia. We have used the logit modelling procedure and found that there exist noticeable regional differences in seafood consumption behaviour. In the case of the inland region, it is found that the variables price, distance, taste, quality and season are significant at the conventional level. For the coastal region, the factors quality, age and number of persons employed (at the 5% level) and size of households (at the 10% level) significantly influence the seafood consumption behaviour.     

Analysis of the mechanism of injury in non-fatal vehicle-to-pedestrian and vehicle-to-bicyclist frontal crashes in Sweden

The aim of this paper is to analyse and compare injuries and injury sources in pedestrian and bicyclist non-fatal real-life frontal passengercar crashes, considering in what way pedestrian injury mitigation systems also might be adequate for bicyclists. Data from 203 non-fatal vehicle-to-pedestrian and vehicle-to-bicyclist crashes from 1997 through 2006 in a city in northern Sweden were analysed by use of the hospitals injury data base in addition to interviews with the injured. In vehicle-to-pedestrian crashes (n = 103) head and neck injuries were in general due to hitting the windscreen frame, while in vehicle-to-bicycle crashes (n = 100) head and neck injuries were typically sustained by ground impact. Abdominal, pelvic and thoracic injuries in pedestrians and thoracic injuries in bicyclists were in general caused by impacting the bonnet. In vehicle-to-pedestrian crashes, energy reducing airbags at critical impact points with low yielding ability on the car, as the bonnet and the windscreen frame, might reduce injuries. As vehicle-to-bicyclist crashes occurred mostly in good lighting conditions and visibility and the ground impact causing almost four times as many injuries as an impact to the different regions of the car, crash avoidance systems as well as separating bicyclists from motor traffic, may contribute to mitigate these injuries.     

Knowledge,attitudes, and practices of family physicians and nurses regarding unintentional injuries among children under 15 years in Cairo,Egypt

Unintentional injuries are a leading cause of death among children, especially in developing countries. Lack of reliable data regarding primary health care professionals' role in childhood unintentional injury prevention hinders the development of effective prevention strategies. A survey of 99 family physicians and nurses from 10 family health centres sought to develop insight into their knowledge, attitudes, and practices regarding unintentional injury prevention for children <15 in Cairo, Egypt. Approximately, 60% were familiar with the terms unintentional injuries and injury prevention. Falls and road traffic crashes were identified as primary causes of childhood injuries by 54.5%. While >90% agreed injury prevention counselling (IPC) could be effective, only 50.5% provided IPC. Lack of time and educational materials were the leading barriers to provision of IPC (91.9% and 85.9%, respectively), while thinking counselling is not part of their clinical duties was the least perceived barrier (9.1%). There is a large disconnect between providers' knowledge, attitudes and practices regarding IPC, more training and provision of counselling tools are essential for improving IPC by Egyptian medical providers.     

Costs of unintentional injuries among children in an urban slum community in Kampala city,Uganda

Abstract

Unintentional injuries cause deaths, disabilities, productivity and financial losses and disproportionately affect children in low-income settings yet their cost remains under studied. This study determined the household out-of-pocket expenditure and missed school attendance due to unintentional childhood injuries in a Ugandan slum. We used a cross-sectional household survey design. Data were collected on occurrence and associated costs of unintentional injuries during a one-year period from July 2014 to June 2015. A total of 706 (44.7%) children who had suffered from injuries were reported in the one year period. More male children (N?=?415, 58.7%) suffered injuries than females (N?=?291, 41.2%). The average out-of-pocket expenditure on treating an injury was US $24.1 [standard deviation (SD)?=?±$62.8] and mean school days lost were 25 days (SD?=?±51.8). Road traffic injuries (RTIs) resulted in higher costs [mean difference was US $51.1 (95% CI: $11.4–$90.8)] compared to injuries that, for example, occurred at school. In a Ugandan slum community, unintentional childhood injuries resulted in high out-of-pocket expenditures and missed school attendance. The costs varied widely depending on external causes of the injury. These findings highlight the need to invest in population level injury prevention interventions to reduce injury costs by households.     

School safety assessment in Bengaluru and Kolar districts,India

Abstract

Ensuring optimum safety in schools to prevent injuries and promote safety of children is a mandate by the Constitution of India. However, there is limited evidence regarding safety and injury prevention in schools. This safety appraisal was conducted on a sample of 131 schools, selected by stratified random sampling in Bengaluru and Kolar districts in India. Trained investigators collected data using smart phone-assisted interview, observational methods and record review between 1 January and 31 March 2019. Safety was assessed across the domains of macro areas (policy, guidelines, committee, budget, coordination and training), physical infrastructure, road and transport safety, fire safety and first-aid services. Safety level (%) at each school was computed based on scores obtained in each domain. Overall safety level was at 50.8% of the assessment criteria and was relatively better in private schools (54%). Most schools scored less than 30% in domains of transport safety, fire safety and macro areas. Results highlight the need for implementing and augmenting safety measures in schools.