Injury control and safety promotion最新文献

A province-wide qualitative study on emergency medical services (EMS) in Alberta was initiated to better understand the extent to which patient billing influences EMS performance. After completing lengthy interviews with 108 EMS-related subjects it was learned through qualitative research methods that billing patients for EMS treatment (ambulatory care) has subtle or determined influences on EMS providers' emergency actions. Furthermore the act of billing patients can and does have an impact on patient care. It often leads to patients and/or their representatives refusing treatment and transportation. Testimony indicates that the final result can be and is troublesome to, patient outcomes. The findings support the generalization that in Alberta the patient's responsibility to pay for needed EMS treatment can be a major obstacle for inclusive injury control.

Background: Community-based models for injury prevention have become an accepted part of the overall injury control strategy. This systematic review of the scientific literature examines the evidence for their effectiveness in reducing pedestrian injury in children 0-14 years of age.

Methods: A comprehensive search of the literature was performed using the following study selection criteria: community-based intervention study; target population was children under 14 years; outcome measure is either pedestrian injury rates or observed child pedestrian or vehicle driver behaviour; and use of a community control or an historical control in the study design. Quality assessment and data abstraction was guided by a standardized procedure and performed independently by two authors. Data synthesis was in tabular and text form with meta-analysis not being possible due to the discrepancy in methods and measures between the studies.

Results: The review found four studies that met all the inclusion criteria. The three studies using injury as their outcome measure found a 12%, 45% and 54% reduction for all childhood injuries with the fourth showing improved traffic control at child pedestrian sites (9% reduction in traffic flow) and sustainable community safety promotion activity.

Conclusion: There is a paucity of research studies in the literature from which evidence regarding the effectiveness of community-based programmes for the prevention of pedestrian injury in children can be drawn. However, the hypothesis that community-based interventions are effective in reducing the incidence of childhood pedestrian injury would appear to be supported, with the degree of success being cumulative depending on the complexity of individual strategies employed.

Problem: Prevention of injuries to child passengers is a significant public health priority, as motor vehicle-related injuries remain a leading cause of death for children in Japan. The purpose of compulsory child restraint seats legislation in April 2000 was to reduce the number of child passengers killed or injured in motor vehicle crashes.

Methods: The objectives of this preliminary evaluation are to measure the effectiveness, benefits and usage of safety seats for child passengers aged 1-5 years by analysing the child casualty data for the period of 1997--2002. Population and vehicle miles travelled based injury and fatality rates were used to compare before and after legislation trends in child casualties.

Results: Despite overall increases in the use of child restraint seats (as observed by different national surveys), overall casualty rates in motor vehicle occupants in the 1-5 year age group did not change (fatalities and serious injuries) or even increased (minor injuries).

Conclusions: Casualties among restrained children have not decreased since the law came to effect in the year 2000, perhaps because of incorrect usage of the seats. Given that exposure to crash environments is increasing, traffic safety advocates and public health community need to be aware of the importance of child restraints as a means of reducing the likelihood of injury. It is necessary to implement effective community-based child safety seat campaigns to disseminate the information on appropriate restraint use and to increase efforts to enforce the existing legislation.

International comparisons of injury data may be useful for examining differences in risk and for suggesting potential interventions or hypotheses for future studies. However important issues to be considered in conducting comparisons are related to both the underlying quality of the data and how the data is collected. The International Collaborative Effort (ICE) on Injury Statistics grew out of concerns over the comparability of international injury data. This article outlines the history behind the development of the injury ICE, brief descriptions of current and past projects, collaborations, and reflections on the value of collaboration.

At surface mining operations throughout the world, loaders and trucks are a primary means of material loading and haulage. As the size, use and technological complexity of these units have increased, so has the concern regarding loader and truck safety. The severity and number of accidents involving loaders and trucks is higher when compared to all other mining accident types. In this paper, an analysis of loader and truck-related fatalities over the last 8 years is performed, the fatality categories and causes of accidents are established and control strategies are discussed and evaluated in an effort to increase hazard awareness by emphasizing safe loading, hauling and maintenance practices, as well as the value of traditional and innovative miner training programmes.

Objective: To assess acute alcohol intoxication among patients presenting with recent injuries at trauma units in Cape Town, Port Elizabeth and Durban from 1999 to 2001.

Design: Cross-sectional surveys were conducted during a four-week period in each of the above sites in 1999, 2000 and 2001. The concept of an 'idealised week' was used to render representative samples. Breath-alcohol concentrations were assessed in a total of 1900 patients using a Lion SD2 alcolmeter.

Results: Over half of all the patients experienced violent injuries. Across sites and for each respective year of the survey, between 35.8% and 78.9% of patients tested positive for alcohol. Between 16.5% and 67.0% had a breath-alcohol concentration greater than or equal to 0.05g/100ml. Port Elizabeth consistently had the highest proportion of patients testing positive for alcohol. Patients injured as a result of violence were more likely to test positive for alcohol than patient who sustained road traffic or other unintentional injuries.

Conclusions: Alcohol involvement among trauma patients remained consistently high for each of the three study periods. Efforts to combat the abuse of alcohol would appear to paramount in reducing the burden of injuries on health care services.

Injuries are a major public health problem worldwide. In the USA, injuries cause 146, 400 deaths annually, with 31 million non-fatal injury visits to emergency departments (EDs). EDs thus represent an important source of injury data. The primary objective of the current study was to describe the epidemiology of injury-related ED visits and assess injury-related utilization of health care resources in an inner-city hospital in Indiana, using data stored in a computerized medical record system. It involved a retrospective review of the records for injury visits to EDs and injury admissions over a 3-year period. The variables extracted and analysed included patients' demographics, external cause of injury, diagnosis, length of stay, ED and hospital charges. A total of 60,470 injury-related ED visits were made, the majority of patients were male (61.6%), uninsured (63.1%), treated in ED and discharged (98.4%). The leading causes of injury were falls (18.8%), motor vehicle crashes (18.4%), assaults (17.6%), being struck (11.2%) and overexertion (10.6). Firearms caused most injury deaths (32.4%; n = 314); motor vehicle crashes were the leading cause of hospitalization (26.6%; n = 642) and also the most expensive to treat as inpatients (mean charge $19,190). The mean charge per patient treated and discharged was $150 compared to $11,116 for patients admitted. These findings demonstrate the value of computerized medical records in capturing and storing E-coded injury data. The system generates data that can be used for epidemiological surveillance and injury prevention at the local level, and for assessment of impact of specific injuries on health care resources.

Cross-sectional studies were conducted in conveniently selected schools in Ghana, Guatemala, and the USA to quantify and compare the percentage of body weight carried by students in their backpacks as well as assess parental knowledge of the backpack weights and contents. Mean backpack weights varied significantly by country and increased significantly with increasing student grade. In the USA, girls significantly carried heavier backpacks (p <.0001). The backpack loads represented an average of 7.7% (95% CI = 7.4-8.0), 9.7% (95% CI = 9.2-10.2), and 9.4% (95% CI = 9.1-9.8) of student body weights in Ghana, Guatemala, and the USA, respectively. No student in Ghana carried a wheeled backpack in contrast to 6% and 2.8%, respectively, in Guatemala and the USA. In Ghana, 4.1 and 73.6% of parents were reported to be aware of their children's backpack weights and contents, respectively, compared to 21.9 and 57.5% in Guatemala, and 7.7 and 55.3% in the USA. Backpack loads respresent a significant percentage of the body weights of students in all three countries. The vast majority of parents are unaware of their child's backpack weight.