Injury incidence,risk perception and product-related safety behavior among 18- and 45-year-olds

Abstract

Adolescents generally have twice the injury incidence of adults. This increased risk of injury may partly be a consequence of the types of activities performed, the level of exposure to products and the safety behavior. The purpose of this paper was to identify possible predictors for the increased injury risk of adolescents compared to adults. To this end, all 18- and 45-year-olds in a major city in Norway received a questionnaire asking for information on injury experience, level of use and risk perceptions concerning 14 specific products, and the adoption of safety measures; 686 18-year-olds and 81 o 45-year-olds answered the questionnaire. The adolescents reported a higher injury incidence as compared to adults for all the listed products. The difference was significant even after controlling for level of use. Adolescents also had higher levels of risk perception and decreased adoption of safety measures as compared to adults. Females reported less injuries but higher levels of risk perception than males. Females also adopted more safety measures. An important finding from this study was that adolescents, as compared to adults, also expose themselves to increased risk levels when ‘ordinary’ products are concerned, and not only in terms of well-known high-risk activities (driving fast, skiing downhill, etc.). This tends to support the idea that more general factors or dimensions of risk-related behaviors may exist which should be accounted for in the planning of injury prevention activities.     

Perceptions of risk among children with and without attention deficit/hyperactivity disorder

Traditionally, health professionals have positioned injury prevention strategies from their own perspective with little acknowledgement or understanding of the perspective of those who experience risk taking: specific populations of children with differing approaches to risk perception and problem-solving. The present study addresses this oversight by engaging children with and without attention deficit/hyperactivity disorder (ADHD) to explore the meaning of risk from their perspective. Although both groups of children reported similar processes of assessing risk, unique to children with ADHD was the overestimation of their physical abilities, intentional risk taking and anticipation of positive or no consequences of their risk taking. These findings also advance our knowledge of potentially appropriate strategies to effect change in risk taking that could influence risk of injury. Specifically, findings suggest that prevention efforts that incorporate both cognitive and social interventions are the most promising approaches. Integrating this understanding of children's perception of risk builds our knowledge about the contribution of risk perception to injury events and may help to inform future injury prevention initiatives with children with ADHD.     

The roles of child,parent and environmental factors in pedestrian supervision

Pedestrian injuries are a significant health risk to children, particularly those 5–9 years of age. Surprisingly, few studies have explored parent-related factors that may moderate this risk. We examined parental supervision choices in the context of child pedestrian experience, parent perceptual factors and varying levels of environmental risk. A series of street crossing scenarios were used to examine the roles of child, parent and environmental factors in determining parents’ supervision choices. Parents recognised differing levels of risk across environmental conditions and altered their supervision choices accordingly. Child age and parental risk perception were significantly predictive of supervision choices. Our results demonstrate that parents assess multiple factors when determining the intensity of supervision necessary for their children. Notably, parents adjust their supervision in direct relation to changes in the physical environment. Implications of these findings for injury prevention and future research are discussed.     

The roles of child, parent and environmental factors in pedestrian supervision

Pedestrian injuries are a significant health risk to children, particularly those 5-9 years of age. Surprisingly, few studies have explored parent-related factors that may moderate this risk. We examined parental supervision choices in the context of child pedestrian experience, parent perceptual factors and varying levels of environmental risk. A series of street crossing scenarios were used to examine the roles of child, parent and environmental factors in determining parents' supervision choices. Parents recognised differing levels of risk across environmental conditions and altered their supervision choices accordingly. Child age and parental risk perception were significantly predictive of supervision choices. Our results demonstrate that parents assess multiple factors when determining the intensity of supervision necessary for their children. Notably, parents adjust their supervision in direct relation to changes in the physical environment. Implications of these findings for injury prevention and future research are discussed.     

Latino families report lower child injury rates than white families

Latino children have lower visit rates to emergency departments and primary care physicians than white children in the USA. Using a nationally representative household survey, this study asked whether parental report of injury was also lower for Latino children, after adjusting for demographic, socioeconomic, health status and health care access factors. Data were obtained on injuries for which medical advice or treatment was received from the National Health Interview Survey (NHIS) from 1997 to 2003. Using the multistage probability design of NHIS, annual rates and adjusted odds of childhood injury report by race and ethnicity were calculated. Respondents reported lower rates of injury for Latino children (6.0 (95% CI 5.3-6.8)/100 person-years) than white children (13.4 (12.7-14.2)/100 person-years). Lower injury rates were mainly due to lower rates of sports injuries and accidental falls. Latino children had lower odds of reported injury than white children, even after adjusting for multiple factors (odds ratio 0.7; 95% CI 0.6-0.8). Lower odds of injury report among Latino children are independent of direct measures of demographic, socioeconomic, health status and health care access factors and indirect measures of acculturation including respondent language and country of origin. Potential explanations include lower exposure to risk, greater child supervision, reporting bias, differences in cultural attitudes toward seeking of health care and reduced health care access that cannot be explored in NHIS due to the form of the current questions. Further research is needed to investigate cultural differences in risk exposure, child supervision and seeking of injury care.     

Childhood and adolescent injuries in elementary schools in north-western Uganda: extent,risk and associated factors

Childhood injuries remain understudied in Uganda. The objective of this study was to determine the extent, nature and determinants of school-related childhood injury risk in north-western Uganda. A cohort of 1000 grade fives from 13 elementary schools was followed-up for one term. Survival and multi-level modelling techniques compared the risk rates across gender, schools and locations. Childhood injuries are common in north-western Uganda. Most of them occur during travel, breaks, practical classes and gardening, while walking, playing, learning and digging. Most injuries result from collisions with objects, sports and falls. Two-thirds of children receive first aid and hospital care. Times to injury were 72.1 and 192.9 person days (p = 0.0000). Gender differences in time to event were significant (p = 0.0091). Girls had better survival rates: cumulative prevalence of childhood injury was 36.1%; with significant gender differences (p = 0.007). Injury rate was 12.3/1000 person days, with a hazard ratio of 1.4. Compared to girls, boys had a 37% higher injury rate (p = 0.004). Rates varied among schools. Associated factors include sex and school. Rural–urban location and school differences do influence childhood injury risk. Childhood injuries are common: the risk is high, gender- and school-specific. Determinants include gender and school. Location and school contexts influence injury risk.     

Incidence,patterns and risk factors for injuries among Ugandan children

There is limited epidemiological data on childhood injuries in developing countries. This study assessed the incidence, patterns and risk factors for injuries among children aged 0–5 years in Wakiso District, Uganda. To determine differences, chi-square and Wilcoxon rank sum tests were used. Risk factors were assessed using Poisson regression. Overall, information from 359 children of mean age 32 months (SD: 18.4) was collected. Annual incidence of injuries was 69.8 per 1000 children/year (95% CI 58.8–80.8). One fatal injury due to burns was reported. Incidence of injuries was less associated with being female (IRR: 0.56, 95% CI 0.34–0.90) and increasing age of the caretaker (IRR: 0.96, 95% CI 0.92–0.99). The high incidence of childhood injuries necessitates the need for interventions to reduce injuries among children.     

The legal framework and initiatives for promoting safety in the United Arab Emirates

Injury is a leading cause of morbidity and mortality in the United Arab Emirates (UAE). The UAE is a rapidly developing country with fast economic growth, demographical and environmental changes that are associated with new hazards emerging at a similar pace. The UAE as a federal entity has federal and local systems responsible for safety policy, regulations and enforcement. To set priorities for safety promotion and injury prevention, it is necessary to have data on the most frequent external causes of injury and the main individual, equipment and environmental risk factors that contribute to injury. However good quality data for injury prevention are scarce. The aim of this paper is to describe the scale of injury as a public health problem in the UAE, and the development of safety policies, regulations and promotion efforts with special emphasis on traffic, occupational and child safety.     

Seating position and patterns of severely injured body parts among child passengers in motor vehicle crashes: Japan as a distinct case

ABSTRACT

This study describes injury patterns and outcomes related to the seating position of child passengers involved in motor vehicle crashes in Japan. Using data obtained from a national trauma registry database, we compared the occurrence of injuries by body parts, length of hospital stay and in-hospital deaths between front-seating and rear-seating among children. We analysed 166 children aged 0–5 years and 205 children aged 6–12 years. No significant differences were observed between front- and rear-seating for injured body parts, length of hospital stay or in-hospital deaths in the 0–5-year-old victims. Among those aged 6–12 years, rear-seating was associated with a higher incidence of head and chest injuries but the length of stay or in-hospital deaths did not differ. These findings contrast those of previous studies, which found that rear-seating reduces injury risk, possibly attributed to low age-appropriate restraint use among school-aged children in Japan.     

Consumers' Needs for Public Education and Corporate Participation Regarding Child Internet Addiction: Based on the Risk Perception Attitude Framework

Internet addiction, which causes physical, behavioral, and psychological problems, especially in children, is becoming an increasingly common disorder in contemporary society. This study investigated the needs of consumers for public education and corporate participation in South Korea to prevent or reduce the risk to young children becoming addicted to the Internet, and classified consumers into four groups according to their risk perception and efficacy beliefs using the Risk Perception Attitude framework. The expressed consumer need for public education was higher for groups with low efficacy beliefs, whereas the expressed need for corporate participation was higher for groups with high efficacy beliefs. These results indicate that consumers who perceive the risk as out of their control feel a higher need for a public approach, while those with high efficacy beliefs feel a higher need for corporate efforts.     

Child injury prevention in Vietnam: achievements and challenges

As with other South Asian countries, injury is becoming a leading cause of death and morbidity among children in Vietnam. In response to the increasing burden of child injury, government and non-government agencies in Vietnam have combined efforts during the last decade to develop and implement various child injury prevention strategies and programmes. This article provides, through a review of relevant documents and interviews with major stakeholders, an overview of these efforts and highlights major challenges to child injury prevention in the country. The findings point to notable achievements in terms of increasing awareness of injury facing children at all levels in the community and developing a sound injury prevention policy framework in a relatively short period of time. However, much needs to be done to implement necessary environmental and legislative changes, strengthen child injury surveillance and injury prevention research; and to improve access to health services. The insight into the experience of Vietnam could benefit other low- and middle-income countries with a high burden of child injury.     

Child injury prevention in Vietnam: achievements and challenges

As with other South Asian countries, injury is becoming a leading cause of death and morbidity among children in Vietnam. In response to the increasing burden of child injury, government and non-government agencies in Vietnam have combined efforts during the last decade to develop and implement various child injury prevention strategies and programmes. This article provides, through a review of relevant documents and interviews with major stakeholders, an overview of these efforts and highlights major challenges to child injury prevention in the country. The findings point to notable achievements in terms of increasing awareness of injury facing children at all levels in the community and developing a sound injury prevention policy framework in a relatively short period of time. However, much needs to be done to implement necessary environmental and legislative changes, strengthen child injury surveillance and injury prevention research; and to improve access to health services. The insight into the experience of Vietnam could benefit other low- and middle-income countries with a high burden of child injury.     

Beyond Environmental Regulations: Exploring the Potential of “Eco-Islam” in Boosting Environmental Ethics Within SMEs in Arab Markets

The recent global increase in environmental regulation does not necessarily signal improvement in firms’ ecological imprints. Like many markets, the Arab world is struggling to implement environmental compliance measures among local firms. For Arab countries, the reliance solely on formal policies to improve local firms’ ecological footprints may be risky given the evident institutional challenges to enforce environmental regulations, specially post the Arab Spring. Drawing from the literature highlighting the merits of combining formal and informal controls to ensure successful implementation of a strategy, we argue that the emphasis for regulation must be accompanied by an emphasis for developing environmental ethics of individuals, who are the expected implementers of any environmental policy. In that light, we propose that the Eco-Islam phenomenon can serve as an influential and effective foundation for building organizational cultures with stronger environmental ethics among local small and medium enterprises (SMEs). We explain the underlying maxims of Eco-Islam then conduct qualitative research among experts preaching or practicing the concept to gain better insights into the potential of leveraging it in Muslim-majority Arab countries. Finally, we conclude with insightful implications for local SMEs in the region.     

Adolescents as victims of familial violence: a hospital based surveillance

Adolescent abuse is an important and understudied issue in society. The objective of this study was to examine the epidemiology of physical injuries due to maltreatment among adolescents aged 10-19 years. Subjects came from seven hospitals/trauma centres in Washington DC that were involved in the Washington DC Initiative to Reduce Infant Mortality and Prevention of Childhood Injuries Study. From 1996-1998, information was gathered about all injuries to adolescents aged 10-19 years that resulted in a visit to a participating emergency department. This paper focuses on the subset 178 adolescents aged 10-19 years who presented with physical injuries due to maltreatment. It was found that 55% of victims of abuse were female. Abuse victims were more likely to be female than those with unintentional injury. The most common injuries were contusions to the extremities (29%). Mothers were the most common perpetrators (48%). A total of 64% of victims were assaulted with an object/weapon and the most common object used was a belt. There are some similarities and some important differences between patterns of maltreatment in adolescents vs. younger children. Increased awareness of maltreatment among older children is a critical step in increasing and improving screening and prevention practices among health-care professionals.     

Characteristics and risk factors for accident injury in Canada from 1986 to 1996: an analysis of the Canadian Accident Injury Reporting and Evaluation (CAIRE) database

This study analyzed the database of Canadian Accident Injury Reporting and Evaluation (CAIRE) for the injuries reported from January 1986 to March 1996 in seven provinces at children's or general hospitals in Canada. In order to describe the characteristics of injuries, we compared the different categories of injuries by sex and by age groups, identified patterns of injuries, and detected the products causing injury to Canadian people. The results showed that there were 130,489 injury cases in Canada during the 10 years from 1986 to 1996. The 10–19 year age group had 57,582 cases, representing 44.13% of total injuries, and making it the group with the highest occurrence of injuries. The male injury rate (69.75%) was significantly higher than the female rate (30.25%) (P = 0.0001). Six areas were identified as priorities for intervention: 1) injuries occurring on playgrounds among children and youth; 2) sports and playground apparatus injuries and injuries sustained in transit among young people; 3) the top five causes of injuries; 4) diagnosis and treatment of injuries; 5) consumer products and safety; and 6) nature and physical sites of injuries. Further work is needed in: evaluating injury causes, comparing the results with reports from other countries and the necessary approaches and prevention measures to reduce and control injury occurrences to improve the quality of consumer products, and to protect the health of the population in Canada.     

The epidemiology of non-fatal injuries among 11-, 13- and 15-year old youth in 11 countries: findings from the 1998 WHO-HBSC cross national survey

The primary objective was to present a cross-country comparison of injury rates, contexts and consequences. The research design was the analysis of data from the 1998 cross-national Health Behaviour in School-aged Children survey and 52955 schoolchildren from 11 countries, aged 11, 13 and 15 years, completed a self-administrated questionnaire. A total of 41.3% of all children were injured and needed medical treatment in the past 12 months. Injury rates among boys were higher than among girls, 13.3% reported activity loss due to injury and 6.9% reported severe injury consequences. Most injuries occurred at home and at a sport facility, mainly during sport activity. Fighting accounted for 4.1% of injuries. This paper presents the first cross-national comparison of injury rates and patterns by external cause and context. Findings present cross-country similarities in injury distribution by setting and activity. These findings emphasize the importance of the development of global prevention programmes designed to address injuries among youth.     

Keeping our children safe in motor vehicles: knowledge,attitudes and practice among parents in Kuwait regarding child car safety

Child safety restraints can reduce risk of death and decrease injury severity from road traffic crashes; however, knowledge about restraints and their use in Kuwait is limited. A cross-sectional, self-administered survey about child car safety was used among a convenience sample of parents of children aged 18 years or younger at five Kuwaiti university campuses. Of 552 respondents, over 44% have seated a child in the front seat and 41.5% have seated a child in their lap while driving. Few parents are aware of and fewer report using the appropriate child restraint; e.g., 36% of parents of infants recognised an infant seat and 26% reported using one. Over 70% reported wearing seat belts either “all of the time” (33%) or “most of the time” (41%). This new information about parents' knowledge and practice regarding child car seat use in Kuwait can inform interventions to prevent child occupant injury and death.     

Car child safety seats use among Iranian children in Mashad

Despite the strong evidence of child safety seats (CSSs) effectiveness in reducing injuries, it is still rarely used in some societies. The purpose of this study was to determine prevalence and predictors of CSS use in Mashad, Iran. Five hundred ninety kindergarten children whose parents owned a car were enrolled in the study. Parents were asked about using CSS for their children, reasons for CSS use/non-use, demographics, history of road traffic injuries and receiving any advice on CSS. Of families, 25.5% expressed that they used CSS for their child at present or any time in the past, but only 6.3% of children travelled restrained in CSS at the time of study. Age-appropriate CSS use was reported in 14.5% of infants and 2.3% of 1–5-year-old children. A significant relationship was observed between lower child age, higher maternal education and high family income with CSS use. The main reasons for CSS none-use were reported as not feeling the need (42%), followed by its high price (22%). Use of CSS was uncommon. The financial concerns and information gap about the essential need for CSS should be considered as priorities for action especially among lower socio-economic groups of society.     

How childhood ADHD-like symptoms predict selection into entrepreneurship and implications on entrepreneurial performance

This study advances research on mental health and entrepreneurship through the examination of Attention Deficit Hyperactivity Disorder (ADHD)-like symptoms, associated with hyperactivity/impulsivity and inattention. We examine the impact of these symptoms at age 10 on entrepreneurial performance as an adult. We find that while ADHD-like symptoms in childhood may have a positive impact on entrepreneurial selection, they negatively impact on survival and performance, with a variant effect by each symptom, predominantly among males. We find that high levels of inattention predict business failure and lower take-home income, while high levels of hyperactivity/impulsivity contribute to overall negative earnings' growth.     

Bicycle-related injuries: Injury,hazard, and risk patterns

Abstract

This paper provides the results of a U.S. Consumer Product Safety Commission (CPSC) study to determine the circumstances involved in bicycle-related injuries treated in U.S. hospital emergency rooms. It also includes information from a CPSC exposure survey of the U.S. population of bicycle users and their patterns of bicycle and helmet use. Together, these data were used to identify and evaluate risk factors currently associated with bicycle use in the United States

Risk models identified factors specifically associated with injuries to children and to adults. Children were at particular risk of injury, and appeared to be especially vulnerable to head injury. In addition, the risk of injury for children was significantly increased when riding in non-daylight conditions. For both adults and children, there was a higher risk of injury on streets than in such areas as bike paths or unpaved surfaces. While some problems associated with bicycle assembly, operation, and maintenance were observed, the data did not suggest that any mechanical remedy is likely to reduce injuries substantially.