Injury control and safety promotion最新文献

Drowning is a leading cause of injury related death in many countries. Strategies to prevent these deaths depend upon characteristics of the victim and the specific circumstances surrounding the event. One preventive strategy that may be beneficial for persons of all ages and under nearly all circumstances is increased swimming ability, through some form of swimming instruction. However, a clear protective relationship between increased swimming ability and the risk of drowning has never been demonstrated. Studies focused on children, suggest that swimming ability may confer some protection, although the data are far from conclusive. This paper (1) reviews the current evidence regarding the relationship between swimming ability, swimming lessons and the risk of drowning, (2) reviews the past and present recommendations for swimming instruction and (3) outlines future research needs.

A number of routes can be followed towards the prevention of drowning, such as educating on water safety, installing barriers between non-intended users and water, mitigating the consequences of submersion incidents, and design. The human factor approach to safety is that design should always be the primary route. Human factors can be applied to the design of personal protective equipment such as buoyancy aids, barriers such as pool fencing, ancillary equipment such as swimming pool covers through to information and organisational factors such as safety signs and swimming campaigns. Design should consider all potential drowning scenarios and accommodate the characteristics of those at risk. A framework is presented with examples on how human factor principles can be applied to the design of potential drowning sites and products, with suggestions for methods and techniques that can be used in the key stages of predicting potential hazards and assessing risk.

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.

Injury prevention efforts often focus on reducing the risk of potentially dangerous activities, facilities or equipment, such as diving, swimming pools or flotation devices. This paper aims to clarify the concepts of risk assessment and risk perception. Statistically, risk denotes the probability of an untoward event, often expressed in terms of potential financial loss. Subjectively, though, risk denotes an individual's perception of the likelihood and the seriousness of an undesirable event. Individual perception appears to be strongly influenced by personal traits and socio-cultural parameters. Risk assessment helps to form the basis for public health interventions. The implementation and effectiveness of these are influenced by individual risk perception. Therefore, preventive efforts need to incorporate and hopefully influence the determinants of risk perception among the target populations. Considering drowning, both hazard and incidence of submersion injuries are underestimated, whereas treatment options are usually overestimated. Consequently, individual risk alertness needs to be improved--drowning remains a ubiquitous risk.