action plan to strengthen prevention of · intentional injuries as injuries that are purposely...
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Action Plan toStrengthen Prevention of Unintentional Injuries in Hong Kong
Hong Kong Special Administrative Region of China
Action Plan to Strengthen Prevention of U
nintentional Injuries in Hong Kong
Nov 2014Printed by the Government Logistics Department Hong Kong Special Administrative Region of China
i
Action Plan to Strengthen Prevention
of Unintentional Injuries in Hong Kong
ii
ContentsPage
Abbreviations iii
Preface by Mr Patrick MA Ching-hang, Chairman of the Working Group on Injuries iv
1. Introduction 1
• Developingalocalstrategytostrengthenthepreventionofunintentionalinjuries 2
• Definitionandclassificationofinjuries 4
• Globaldiseaseburdenfrominjuries 5
• Globalactions 9
2. Injury prevention: Hong Kong situation 11
• Epidemiologyofinjuriesanddiseaseburden 12
• Injurysurveillanceeffortandinformationgap 16
• Interventionstopromotepreventionofunintentionalinjuries 17
• Fourpriorityareasidentified 22
• Elaborationofpriorityareas 23
3. Actions to strengthen prevention of unintentional injuries 33
• Goals 34
• Specificactions 35
• Leadactionparties,targetsandtimeframe 45
4. Making it happen 49
Annexes 51
1. Membership of Working Group on Injuries 52
2. Terms of reference of Working Group on Injuries 54
3. DiscussiontopicsinmeetingsoftheWorkingGrouponInjuries 55
iii
Abbreviations
Abbreviation Full name ACLS AdvancedCardiacLifeSupportA&E AccidentandEmergencyAED AccidentandEmergencyDepartmentAMS AuxiliaryMedicalServiceAMSA AsianMedicalStudents’AssociationBLS BasicLifeSupportBRFS BehaviouralRiskFactorSurveyC&ED CustomsandExciseDepartmentCHEP CentreforHealthEducationandHealthPromotionCHEU CentralHealthEducationUnitCHS ChildHealthSurveyCIPRA ChildhoodInjuryPreventionandResearchAssociationCISS CommunityInjurySurveillanceSystemDALYs Disability-AdjustedLifeYearsDH DepartmentofHealthEDB EducationBureauEHCs ElderlyHealthCentresEHS ElderlyHealthServiceFHB FoodandHealthBureauFHS FamilyHealthServiceHA HospitalAuthorityHCPF HealthCareandPromotionFundHHSRF HealthandHealthServicesResearchFundHKMA HongKongMedicalAssociationHKPF HongKongPoliceForceHMRF HealthandMedicalResearchFundICECI InternationalClassificationofExternalCausesofInjuryICHDP IntegratedChildHealthandDevelopmentProgrammeLCSD LeisureandCulturalServicesDepartmentLD LabourDepartmentMCHCs MaternalandChildHealthCentresNCD Non-communicableDiseasesNGOs Non-governmentalOrganisationsOSHC OccupationalSafetyandHealthCouncilPCO Primary Care OfficePHS PopulationHealthSurveyPMH PrincessMargaretHospitalPYLL PotentialYearsofLifeLostRCHEs ResidentialCareHomesfortheElderlySC SteeringCommitteeonPreventionandControlofNon-communicableDiseasesSFH SecretaryforFoodandHealthSHS StudentHealthServiceSHSCs StudentHealthServiceCentresUS UnitedStatesWGAH WorkingGrouponAlcoholandHealthWGDPA WorkingGrouponDietandPhysicalActivityWGI Working Group on InjuriesWHO WorldHealthOrganization
iv
PrefaceInjuriesareaglobalpublichealthproblem. According to theWorldHealth
Organization(WHO),about5.8millionpeopledieeachyearasaresultofinjuries,and
manynon-fatal injuriesresult in life-longdisabilitiesandsuffering. Assuch, injury
preventionisaccordedhighprioritybyWHOandmanycountries.
InHongKong,injurieshaveremainedoneoftheleadingcausesofdeathsincethe
1960s.In2013,injuriesrankedfifthamongtheleadingcausesofdeathandaccounted
for1860deaths. Injuriescouldleadtoprematuredeathanddisability. Theimpactof
injuriesonindividuals,familiesandsocietyshouldnotbeunderestimated.
Traditionally,unintentional injurieshavebeenregardedasrandom,unavoidable
“accidents”.Duringthelastfewdecades,however,abetterunderstandingofthenature
ofinjurieschangedtheseoldbeliefs.Today,unintentionalinjuriesareviewedaslargely
preventableeventsthroughbetterunderstandingoftheirriskfactorsandreductionof
theirlikelihoodandseverity.
InlinewithGovernment’sstrategicframeworkdocument“Promoting Health in Hong
Kong: A Strategy Framework for Prevention and Control of Non-communicable Diseases”
publishedin2008,theWorkingGrouponInjuries(WGI)wassetupin2012toadviseon
priorityactionsforhealthimprovementintheareaofinjuryprevention,andtomake
recommendationsonthedevelopment, implementationandevaluationofanaction
planforthepreventionofinjuries.
v
Fourmeetingsof theWGIwereheldtoexamine,amongotherthings,overseas
evidenceandlocalsituation,beforedrawingupthisActionPlantooutlinethedirection
andstepstotakeintheyearsaheadforeffectivepreventionofinjuriesinHongKong.
AsChairmanoftheWGI,Iwouldliketothankallmembersoftheworkinggroupand
otherswhohavecontributedtodevelopmentofthisActionPlan.
Everyindividualandorganisationhasaroletoplayinthepreventionofinjuries. I
takethisopportunitytoappealforconcertedeffortsfromstakeholdersacrosssectorsin
thisimportantendeavour.Iamconfidentthatinpartnership,wecanbuildahealthier
andsaferplacetolive.
PatrickMAChing-hang,BBS,JP
Chairman
Working Group on Injuries
1
1 Introduction
2
Introduction 1
1. Introduction
Developing a local strategy to strengthen the prevention of unintentional injuries
1.1 Thenumberofpeoplesufferingfromnon-communicablediseases(NCD) is increasing,both
worldwideandinHongKong. TocombatNCD,theDepartmentofHealth(DH)publisheda
strategicframeworkdocumententitled“Promoting Health in Hong Kong: A Strategic Framework
for Prevention and Control of Non-communicable Diseases” inOctober2008,whichprovidedan
armouryofoverarchingprinciplesforthepreventionandcontrolofNCD.
1.2 Tooverseetheimplementationofthestrategicframework,ahigh-levelSteeringCommittee
onPreventionandControlofNCD(SC)wasestablishedinlate2008. TheSCischairedbythe
Secretary forFoodandHealth (SFH),withmembers fromGovernment,publicandprivate
sectors,academiaandprofessionalbodies,industryandotherkeypartners.TheSCendorsedthe
settingupofworkinggroupstoassessandaddressbehaviouralNCDriskfactorsofpublichealth
significance.
1.3 TheWorkingGrouponDietandPhysicalActivity(WGDPA)wasestablishedon16December
2008totackleimminentproblemscausedbyunhealthydietaryhabits,physical inactivityand
obesity. The “Action Plan to Promote Healthy Diet and Physical Activity Participation in Hong Kong”
waslaunchedin2010.
1.4 TheWorkingGrouponAlcoholandHealth(WGAH)was
establishedon23June2009tolookintoproblemsrelated
toalcoholmisuse. The“Action Plan to Reduce Alcohol-
related Harm in Hong Kong”waslaunchedin2011.
3
Introduction1
1.5 As injurypreventionmerits special attention, theWorkingGroupon Injuries (WGI)was
establishedon6February2012toadviseonthepriorityareasforactionandtodrawuptargets
andactionplansrelatedto injuryprevention. TheWGI ischairedbyMrPatrickMAChing-
hangandcomprisesstakeholdersfromthepublicandprivatesectors,representativesfromthe
academia,DistrictCouncils,educationsector,healthcareprofessionals,socialservicessectorand
relevantgovernmentdepartments.ThemembershipandthetermsofreferenceoftheWGIare
listedinAnnexes1and2respectively.
1.6 SinceitsestablishmentinFebruary2012,WGIhasmetfourtimestodiscuss:
i. Globaldevelopmentofinjurypreventionandlocalsituationofinjuries;
ii. PriorityareastostrengtheninjurypreventioninHongKong;
iii. Recommendationstostrengtheninjuryprevention;and
iv. ActionPlantostrengtheninjuryprevention.
ThetopicsdiscussedinthemeetingsarelistedinAnnex3.
1.7 Aftercarefulconsiderationoftheavailableevidenceandthelocalsituation,theWGIproduced
an “Action Plan to Strengthen Prevention of Unintentional Injuries in Hong Kong”,highlighting
fivestrategicdirectionsandninerecommendationstostrengtheninjurypreventioninHong
Kong. TheActionPlanwasendorsedbytheSCinSeptember2014. To implementthenine
recommendationstherein,theWGIproposed16specificactionswhicharesetoutindetail in
Chapter3ofthisdocument.
4
Introduction 1
Definition and classification of injuries
1.8 TheWorldHealthOrganization(WHO)defines injuriesasthephysicaldamagethatresults
whenahumanbodyissuddenlyorbrieflysubjectedtointolerablelevelsofenergy.Itcanbea
bodilylesionresultingfromacuteexposuretoenergyinamountsthatexceedthethresholdof
physiologicaltolerance,oritcanbeanimpairmentoffunctionresultingfromalackofoneor
morevitalelements(i.e.air,water,warmth),asindrowning,strangulation,orfreezing1,2.
1.9 Injuriescanbedividedintointentional injuriesandunintentional injuries. TheWHOdefines
intentionalinjuriesasinjuriesthatarepurposelyinflicted,eitherbythevictimsthemselves(i.e.
suicideandsuicideattempts)orbyotherpersons(i.e.homicide,assault,rape,childabuse,elderly
abuse,andfamilyviolence),andunintentional injuriesas injuriesthatarenot intentionally
inflicted(i.e.roadtrafficinjuries,fallinjuries,sportinjuries,occupationalinjuries,childpoisoning,
burnsanddrowning).2
1.10 Toavoidoverlappingof important injury topicsalreadyreceivingattention fromrelevant
authorities,theWorkingGroup,afterdeliberation,hasdecidedthatthescopeofthis“Action
Plan to Strengthen Prevention of Unintentional Injuries in Hong Kong” shouldbeconfinedto
unintentionalinjuries.
1 Injuries and Violence: The Facts. WHO. 20102 WorldHealthOrganization(2010).TEACH-VIP E-Learning – Foundations and methods.Availableat:http://teach-vip.edc.org/documents/IpGp/InjuryPreve
ntionGeneralPrinciples.pdf,accessed23April2014
5
Introduction1
Global disease burden from injuries
1.11 Injuriesandviolenceareamongthemostprominentpublichealthproblems intheworld.
Everyyear, intentionalandunintentionalinjuriescauseasignificantnumberofdeaths,human
sufferingsanddisabilities,bothgloballyandlocally. Worldwide,injuriesaccountfor5.8million
deathseachyear,comprising10%ofalldeaths.1Thisequatestoalmost15000injurydeathsper
day. Thetopleadingcauseofdeathgloballyfrominjuriesisroadtrafficaccident. Roadtraffic
injuriesalonearepredictedtoincreasein importanceandbecomethefifthleadingcauseof
deathin2030(Figure1andTable1).1
Figure 1: Causes of injury deaths worldwide in 2004
Roadtraffic
23%
Suicide
15%
Homicide
11%
Falls
8%
Drowning
7%
Fires
6%
Poisoning
6%War
3%
Other*
21%
* ”Other”includessmothering,asphyxiation,choking,animalandvenomousbites,hypothermiaand hyperthermia,aswellasnaturaldisasters.
Source:Global burden of disease.WorldHealthOrganization.2004
6
Introduction 1
Total 2004
1. Ischemicheartdisease
2. Cerebrovasculardisease
3. Lowerrespiratoryinfections
4. Chronicobstructivepulmonarydisease
5. Diarrhoealdiseases
6. HIV/AIDS
7. Tuberculosis
8. Trachea,bronchus,lungcancers
9. Roadtrafficcrashes
10. Prematurityandlowbirthweight
11. Neonatalinfectionsandother
12. Diabetesmellitus
13. Malaria
14. Hypertensiveheartdisease
15. Birthasphyxiaandbirthtrauma
16. Suicide
17. Stomachcancer
18. Cirrhosisoftheliver
19. Nephritisandnephrosis
20. Colonandrectumcancers
Total 2030
1. Ischemicheartdisease
2. Cerebrovasculardisease
3. Chronicobstructivepulmonarydisease
4. Lowerrespiratoryinfections
5. Roadtrafficcrashes
6. Trachea,bronchus,lungcancers
7. Diabetesmellitus
8. Hypertensiveheartdisease
9. Stomachcancer
10. HIV/AIDS
11. Nephritisandnephrosis
12. Suicide
13. Livercancer
14. Colonandrectumcancers
15. Oesophagealcancer
16. Homicide
17. Alzheimerandotherdementias
18. Cirrhosisoftheliver
19. Breast cancer
20. Tuberculosis
Table 1: Leading causes of deaths in 2004 and 2030 (predicted) worldwide
Source:World health statistics 2008(www.who.int/whosis/whostat/2008/en/index.html)
1.12 Injuriesandviolencearesignificantcausesofdeathandillhealthinallcountries,buttheyarenot
evenlydistributedaroundtheworldorwithincountries,andsomepeoplearemorevulnerable
than others.1
1.13 Morethan90%ofdeathsthatresultfrominjuriesoccurinlow-andmiddle-incomecountries.
Injurydeathratesare2.5timeshigherinpoorerEuropeancountriesthaninwealthierones.1
1.14 Injuriesarealeadingcauseofdeathamongyoungpeople. Amongpeoplebetweentheages
of5and44years,injuriesareoneofthetopthreecausesofdeath.1Roadtrafficinjuriesarethe
leadingcauseofdeathamongthoseagedbetween15and29years,withhomicideandsuicide
thefourthandfifthleadingcausesofdeathrespectivelyamongthisgroup.1Amongtheelderly,
fallsarethemostcommoncauseofinjurydeath.1
7
Introduction1
1.15 Twiceasmanymenaswomendieeachyearasaresultofinjuries.Thethreeleadingcausesof
deathfrominjuriesformenareroadtrafficinjuries,suicideandhomicide,whileleadingcauses
forwomenareroadtrafficinjuries,suicide,andfire-relatedburns(Figure2).1
Figure 2: Death rates per 100 000 population, by different causes of injury and sex, World, 2004
30
25
20
15
10
5
0Suicide Drowning FallsFires Poisoning RoadtrafficinjuryHomicide
Deathra
tesper100
000
pop
ulation
Men Women
Source:Global burden of disease.WorldHealthOrganization.2004
1.16 Foreverydeathfrominjurytherearemanymoreinjuriesthatresultinhospitalisation,treatment
inemergencydepartments,ortreatmentbypractitionersoutsidetheformalhealthsector.
AccordingtoastudypublishedbyWHO, intheworld’shigh-incomecountriessuchasthe
Netherlands,SwedenandtheUnitedStates(US),foreverypersonkilledbyinjury,approximately
30timesasmanypeoplearehospitalisedandroughly300timesasmanyaretreatedinhospital
emergencyroomsandthenreleased.3Intermsofthenumberofpeoplebeingaffected,deaths
constituteonlyasmallpartofthetotalinjurytoll.Infact,foreveryvictimkilledbyinjury,many
moreareseriouslyandpermanentlydisabledandmanymoreagainsufferminor,short-term
disabilities.4 Themortalityandmorbidityofinjuryeventscanbestberepresentedbyaninjury
pyramid.Fatalinjuriesusuallyrepresentthetipofthepyramid,whichmeanstheyarerelatively
rare. Midwaydownthepyramidareinjuriesresultinginhospitalisations,medicalattentionat
emergencycareunitsoroutpatientclinics,andfurtherdownareinjurieswhichdonotresultin
medicaltreatmentbutmayneverthelesscauseleaveabsencesandproductivityloss.
3 CDC(2005).CDC Injury Surveillance Training Manual Participant Guide 2005.Availableat:http://stacks.cdc.gov/view/cdc/11390,accessed23April20144 HolderY,PedenM,KrugEetal(Eds).Injury surveillance guidelines.Geneva,WHO.2001
8
Introduction 1
Figure 3: Graphic representation of the demand on the health sector caused by injuries
Source:Injuries and Violence: The Facts.WorldHealthOrganization.2010.
Injury pyramidGraphicrepresentationofthedemandonthehealthsectorcausedbyinjuries
Fatal injuries
Injuries resulting in
hospitalizations
Injuries resulting in visits to emergency departments
Injuries resulting in visits to primary care facilities
Injuries treated outside the health system, not treated, or not reported
1.17 Manyoftheinjuredwillbeleftwithdisablingconsequences,andinsomecases,permanent
ones.5 Whendisabilityresultedfrominjuriesisalsotakenintoconsideration,injuriesrepresent
anevenmoresignificantpublichealthproblem,especiallyinlightofthefactthatinjuriesaffect
mainlyyoungpeople,thatistosay,theeconomicallymostproductivesectorofthepopulation.
Injuriescanhaveanimpactatpersonalaswellashouseholdlevels,particularlywhentheinjured
personisthebreadwinner.
1.18 Globally, injuriesaccount for10.4%6ofalldisability-adjusted lifeyears (DALYs),andthis is
expectedtoincreaseto20.1%7by2020. Besideshugephysicalandmentalharmthatinjuries
andviolenceproduceonthoseaffected,considerableeconomiclossesarecausedtovictims,
theirfamilies,andtonationsasawhole,includingproductivitylossesduetoinjurydeathand
disability,combinedwiththecostsoftreatmentandrehabilitationoftheinjured.Theeconomic
costofroadtrafficcrashesgloballyhasbeenestimatedatUS$518billionandcostmostcountries
between1-2%oftheirgrossnationalproduct.1
5 FazlurRahmanAKM.A model for injury surveillance at the local level in Bangladesh: implications for low-income countries.Stockholm,KarolinskaInstitute, 2000.
6 WorldHealthOrganization.2011.Health statistics and health information systems.http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html,accessed30December2011.
7 MurrayCJL,LopezAD.Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study.Lancet,1997,349:1498–1504.
9
Introduction1
1.19 Injuriesandviolencehavenotmadetheirwayintotheglobalhealthagendafora longtime
despitetheirbeingpredictableandlargelypreventable. It isnowbelievedthatmanyinjuries
andmuchviolencecanbeprevented. There isabroadrangeofstrategiesbasedonsound
scientificevidenceshowntobeeffectiveinreducinginjuriesandviolence,andthesestrategies
needtobemorewidelyadopted.Declineininjurieshasbeenobservedmainlyinhigh-income
countriesdue largelytoapplicationof theseeffectivepreventionandtreatmentstrategies
throughconcertedeffortsthatinvolve,butarenotlimitedto,thehealthsector.Theinternational
communityneedstoworkwithgovernmentsandnon-governmentalorganisations(NGOs)
aroundtheworldtoimplementtheseprovenmeasuresandreducetheunnecessarylossoflife
thatoccurseachdayasaresultofinjuriesandviolence.Actionmustbetakennowtodecrease
theadverseimpactcausedbyinjuriesinourcommunity.1
Global actions
1.20 In1996, theForty-ninthWorldHealthAssemblyadoptedResolution49.25. TheResolution
declaredviolencea leadingglobalpublichealthproblem. InresponsetotheOrganization’s
increasingcommitmenttoaddress injuriesandviolence,theWHO’sDepartmentofViolence
andInjuryPreventionandDisability(VIP)wasestablishedinMarch2000.Itactsasafacilitating
authorityfor internationalscience-basedeffortstopromotesafetyandpreventviolenceand
unintentional injuries,tomitigatetheirconsequences,andtoenhancethequalityof lifefor
personswithdisabilitiesirrespectiveofthecauses.8,9
1.21 The World report on violence and healthwasreleasedinOctober2002.Itwasthefirstmostvisible
productofVIP.AsaresultoftheResolutionWHA56.24onImplementingtheRecommendations
of the World Report on Violence and Health(2003),manyMemberStateshavestartedtodevelop
nationalreports,plansofaction,networksandotheractivitiesstemmingfromtheReportand
designedtopreventviolence.TwoguidingdocumentsDeveloping policies to prevent injuries and
violence: guidelines for policy-makers and planners and Preventing injuries and violence: a guide for
ministries of healthwerereleasedin2006and2007respectivelytodescribethenecessarysteps
forcreatinganinjuryandviolencepreventionpolicy. TheWHOWesternPacificRegionalso
releasedaguidingdocumentRegional Framework for Action on Injury and Violence Prevention
2008-2013 Strengthening Injury and Violence Prevention in the Western Pacific Region to assist
countriesindefiningandpreventingavoidabledeathsanddisabilityfromthesecauses.
8 WorldHealthOrganization.2011.Violence and Injury Prevention and Disability (VIP).Availableat:http://www.who.int/violence_injury_prevention/about/en/index.html,accessed24April2014
9 WorldHealthOrganization.2002.Department of Injuries and Violence Prevention Annual Report 2002
10
Introduction 1
1.22 Inrecentyears,WHOhassignificantlysteppedupitsactivitiesintheareaofinjuryandviolence
prevention.TheOrganization’sWorld report on child injury prevention, World report on road traffic
injury preventionandWorld report on violence and healthandtheresolutionsrelatedtothese
reportspassedbytheWorldHealthAssemblyandtheWHORegionalCommitteesspecificallycall
upongovernmentstoidentifyfocalpointsforinjuryandviolencepreventionwithinMinistriesof
Healthtocoordinateandfacilitatenationalefforts.
1.23 In2010,GeneralAssemblyoftheUnitedNationsproclaimed2011–2020theDecadeofActionfor
roadsafety,withaglobalgoalofstabilisingandthenreducingtheforecastedlevelofglobalroad
fatalitiesbyincreasingactivitiesconductedatnational,regionalandgloballevels. TheUnited
NationsRoadSafetyCollaborationhasdevelopedtheGlobal Plan for the Decade of Action for
Road Safety 2011-2020 10asaguidingdocumenttosupporttheimplementationofitsobjectives.
1.24 Manygovernmentsaroundtheworldhavedevelopednational injurypreventionpolicies,
strategiesand/orplansofaction. Althoughtheseinstrumentsvaryinnatureandscope,they
servetoguideanation’seffortstopreventinjury-relateddeathanddisability.Ofthesenational
injurypreventionpolicies,strategiesand/orplans,somearecomprehensivepertainingtoall
injury-relatedmortalityandmorbidity,whileothersfocusonaparticulartypeofinjuriessuch
asroadtrafficinjuriesorviolence-relatedinjuriesoraparticulargroupofintendedbeneficiaries
suchaschildren,youthorwomen.Muchdependsontheburdenposedbythesepublichealth
concernsandthegovernment’spreparednessandabilitytorecognisetheseas issuestobe
addressed.
1.25 Increasingawarenessinthelastfewdecadesthatinjuriesandviolencearepreventablepublic
healthproblemshasledtothedevelopmentofpreventivestrategies.Therewerealreadymany
scientifically-provenmeasurestoreducekeycausesof injury-relateddeaths. Inthe lightof
accumulatingevidence,evidence-basedandeffectiveinterventionsforinjurypreventionmaybe
consideredforadoptionlocally.
1.26 Theultimategoalistopreventinjuriesandviolencefromhappeninginthefirstplace. Atthe
sametime,muchcanbedonetominimisedisabilityandill-healtharisingfrominjuryevents
thatdooccur. Providingqualitysupportandcareservicestovictimsofviolenceandinjuries
canpreventfatalities,reducetheamountofshort-termandlong-termdisabilities,andhelp
thoseaffectedtocopewiththeimpactoftheviolenceorinjuriesontheirlives.Improvingthe
organisation,planningandaccesstotraumacaresystems,includingpre-hospitalandhospital-
basedcare,canhelpreducetheeffectsofinjuries.
10 UnitedNationRoadSafetyCollaboration.2011.Global Plan for the Decade of Action for Road Safety 2011-2020.Availableat:http://www.who.int/roadsafety/decade_of_action/plan/en/#,accessed25June2014
11
Injury prevention: Hong Kong situation2
2 Injury prevention: Hong Kong situation
12
Injury prevention: Hong Kong situation 2
2. Injury prevention: Hong Kong situation
Epidemiology of injuries and disease burden
2.1 Duringtheyears1983-2013,thenumberofregistereddeaths inHongKongdueto injuries
rangedfrom1551to2243peryear(Figure4). In2013,1860registereddeathswerecaused
byinjuries,accountingfor4.3%oftotaldeaths. Injurieswerethefifthleadingcauseofdeath.
Thedeathratesduetoinjuriesformaleandfemalewere36.1and17.1per100000population,
respectively. Intheagegroup1-14years, injurieswerethesecondleadingcauseofdeathin
2013. Itremainedinthesecondplaceconsistently inthepasttenyears,withexceptions in
2009and2010. Inthesetwoyears, injuriesweretheleadingcauseofdeathinthisagegroup
(1-14years).
Figure 4: Number of registered deaths in Hong Kong due to injuries, 1983-2013
5 00
1 000
1 500
2 000
2 500
Year
Num
berofreg
isteredde
aths
1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 201319830
Source:DepartmentofHealth
12
13
Injury prevention: Hong Kong situation2
2.2 Amongthe1860registereddeathsrelatedtoinjuries in2013(Figure5),thecausesofdeath
indescendingorderwereintentionalself-harm(999or53.7%),falls(232or12.5%),transport
accidents(140or7.5%),accidentalpoisoningbyandexposuretonoxioussubstances(137or
7.4%),accidentaldrowningandsubmersion(30or1.6%),assault(27or1.5%),exposuretosmoke,
fireandflames(18or1.0%)andotherexternalcauses(277or14.9%).
Figure 5: Injury mortality by causes of death, 2013 (N=1 860)
Source:DepartmentofHealth
Otherexternalcauses
14.9%
Exposuretosmoke,fireandflames
1.0%
Assault
1.5%
Accidentaldrowningandsubmersion
1.6%
Accidentalpoisoningbyandexposure to noxious substances
7.4%
Transportaccidents
7.5%
Falls
12.5%
Intentionalself-harm
53.7%
2.3 Despitethefactthat injuriesrankedonlythefifthamongleadingcausesofdeath in2013,
potentialyearsoflifelost(PYLL)attributabletoinjuries,thatis,externalcausesofmorbidityand
mortality,rankedsecondamongallcausesofdeath(Figure6). This istosay, injuriesimpose
aheavyburdenonprematuremortality. ThePYLLatage75causedbyinjuriesaccountedfor
15.7%ofthetotalin2013.Itrankedsecondaftertheleadingcausecancer(43.4%ofthetotal)
andwasfollowedbyheartdiseases(10.0%),cerebrovasculardiseases(5.0%).
14
Injury prevention: Hong Kong situation 2
120 000
100 000
80000
60 000
40 000
20 000
0
Malign
antne
oplasm
s
Diseas
esofhe
art
Cerebr
ovascu
lardise
ases
Pneumonia
Nephrit
is,neph
roticsy
ndrom
e
andnep
hrosis
Septica
emia
Chroni
clower
respirat
orydis
eases
Diabet
esmellit
us
Dement
ia
Alloth
ercaus
es
Externa
lcause
sofmo
rbidity
andmo
rtality
Potentialyearsoflife
lostata
ge75
107 006 (43.4%)
38788(15.7%) 24 564
(10.0%) 12281(5.0%)
11389(4.6%) 4 241
(1.7%)3478(1.4%)
3 443(1.4%)
1 717(0.7%)
188(0.1%)
39 346(16.0%)
Figure 6: Potential years of life lost at age 75 by ten leading causes of death in Hong Kong, 2013
CausesofDeathSource:DepartmentofHealth
2.4 Regardingmorbidity,amongallin-patientdischargesanddeathsinallhospitalsin2013,97837
episodeswereduetoinjuries. Injuriesaccountedfor5.1%oftotal in-patientdischargesand
deathsinthatyear. Amongthese97837episodesofinjury-relatedin-patientdischargesand
deaths,fallsaccountedforthelargestshare(39450episodesor40.3%),followedbyaccidental
exposuretootherandunspecifiedfactors(25643episodesor26.2%)andexposuretoinanimate
mechanicalforces(7627episodesor7.8%).
2.5 Amongalldeathsduetoinjuries,theproportionofdeathscausedbyintentional injuries(i.e.
injuriesthatarepurposely inflictedeitherbyvictimsthemselvesorotherpersons)remained
relativelystableduringthepastdecade(Figure7).In2013,55.2%ofthetotalnumberofdeaths
causedbyinjurieswereintentionalinnature.11
11PublicHealthInformationSystem,SurveillanceandEpidemiologyBranch,CentreforHealthProtection,DepartmentofHealth,GovernmentofHongKongSAR.
15
Injury prevention: Hong Kong situation2
Year
Intentional Unintentional2 500
2 000
1 500
1 000
500
02004 20092006 20112005 20102007 20122008 2013
Num
berofreg
isteredde
aths
41.1% 44.9%45.1% 49.0% 49.0% 45.1% 43.9%
46.1% 49.2%44.8%
58.9% 55.1% 54.9% 51.0% 51.0% 54.9% 56.1% 53.9% 50.8% 55.2%
Source:DepartmentofHealth
Figure 7: Number of intentional and unintentional injury deaths, 2004 - 2013
2.6 Apartfromcollectingmortalityandhospitalisationstatistics,DHhadalsoconductedaterritory-
widehouseholdsurvey, the InjurySurvey, in2008tocollectpertinent informationonthe
characteristicsandburdenofunintentional injuries inHongKong. 6.2%oftheHongKong
populationreportedtohavesustainedatleastoneunintentionalinjurythatlimitedtheirnormal
activitiesinthe12monthsbeforeenumeration.Theratewassimilarinbothgendergroupsand
wasfoundtobehighestforelderlypeopleaged75andabove(8.9%).12
2.7 Accordingtothe Injury Survey 2008,thethreecommonestcausesofinjuryepisodeswerefalls
(32.2%),sprain(25.8%)andsports(14.1%).Fallswerefoundtohaveoccurredmorecommonlyin
femalesandattheextremesofage(aged0-14and55andabove).Over80%ofinjuryepisodes
affectedtheextremities.12
2.8 ThePopulationHealthSurvey(PHS),anotherterritory-widehouseholdsurveyconductedin
2003-2004,showedthat14.3%ofpeopleaged15andabovereportedthattheyhadsustained
aninjurythatwasseriousenoughtolimittheirnormalactivities inthe12monthspreceding
thesurvey.13 Asignificantlygreaterproportionofmales(17.4%)thanfemales(11.7%)reported
so.13ThedifferencebetweenthisSurveyandInjury Survey 2008isexplainedbythedifferentcase
definitioninthesetwosurveys.InthePHS (2003/2004),allinjuriesthatwereseriousenoughto
limitone’snormalactivitieswereincluded,regardlessofbeingintentionalorunintentional. In
Injury Survey 2008,onlyunintentional injuriesthatwereseriousenoughtolimitone’snormal
activitieswereincluded.
12DepartmentofHealth(2010).Injury Survey 200813 DepartmentofHealth(2005).Population Health Survey 2003/2004
16
Injury prevention: Hong Kong situation 2
2.9 Accordingtothe Injury Survey 2008, theaveragecostofthetotalmedicalexpenses incurred
ineachinjuryepisodewasHK$1929.0(medianHK$300). Thetotalcostincurredasaresultof
injurieswasestimatedatHK$838.6million(95%CIHK$473.9milliontoHK$1203.4million)in
2008. Thecostincreasedwithageandwasthehighestinpersonsaged65andabove. More
thanhalfofthe injuryepisodes(51.3%)sustainedbyemployedpersonscausedthemtobe
absentfromworktemporarily foranaverageof19.8days(median7.0days). Themeanand
mediannumbersofpaidsickleavestakenwere13.5and5.0days,respectively. Themeanand
mediannumbersofunpaidsickleavestakenwere29.6and7.0days,respectively.36.2%ofthe
injuryepisodescausedthevictimstochangetheirnormaldailyactivitiesand1.4%causedthem
todevelopresidualdisabilitiesfor6monthsorlonger.17.1%oftheinjuryepisodessustainedby
studentscausedthevictimstotakedaysofffromschooltemporarilyforanaverageof11.5days
(median3.0days).12
Injury surveillance effort and information gap
2.10 Aneffectivesurveillancesystemforinjuriescanhelpprovideuseful informationtoassessthe
healthneedsofthepopulationandmonitorpotential impactsofpublichealthinterventions.
Formortalitydata,adeathregistrationsystemmanagedbyImmigrationDepartmentisinplace
toregisterandcollectinformationrelatedtodeaths. Thissystemgathersdeathsreportableto
theCoronerandthosethatarenon-reportable.TheCoronersOrdinancesetsout20categories
ofdeathwhichshouldbereportedtotheCoroner. Deathcausedbyanaccidentor injuryis
oneofthese20categories.Asformorbiditydata,theGovernmentcollectsin-patientdischarge
statisticsfromallpublic,privateandcorrectionalinstitutionhospitals.
2.11 Tofill informationgapscurrentlynotcoveredbymortalityandmorbiditydata,community
surveyscanserveaspopular tools. TheDHhasconductedseveralcommunitysurveys to
collectlocalinformationoninjuryfordifferentagegroups.ThePHS (2003/2004)andtheregular
BehaviouralRiskFactorSurvey(BRFS)obtainedsomeepidemiological informationoninjuries
forsubjectsaged15andoverandadultsaged18-64,respectively. The Injury Survey 2008was
conductedbasedontheWHOInjurySurveillanceGuidelinestocollectpertinent information
aboutthelocalcharacteristicsandburdenofunintentionalinjuriesofallages.TheChildHealth
Survey(CHS)conductedin2005alsocollecteddataoncommontypesofinjuriesinchildren,as
wellasinjurypreventionbehaviours. Inaddition,someNGOsandacademia*alsoconducteda
numberofrelevantcommunitysurveys.
* ExamplesincludetheHongKongChildhoodInjuryPreventionandResearchAssociation(CIPRA)andTheHongKongPolytechnicUniversity
17
Injury prevention: Hong Kong situation2
2.12 In2003,anInjurySurveillanceSystemwassetupintheAccidentandEmergencyDepartment
(AED)ofPrincessMargaretHospital. TheprogramwasfundedbytheOccupationalSafetyand
HealthCouncil(OSHC)andcollaboratedwithTheHongKongPolytechnicUniversity.Underthis
surveillancesystem,detailsofallinjury-relatedcaseswererecorded.Sincethen,thesurveillance
systemhasbeenextendedtotwomorehospitals(CaritasMedicalCentreandTseungKwanO
Hospital).ThisInjurySurveillanceSystemenabledresearcherstoidentifyinjuryblack-spotsand
designpreventivemeasurestoreduceinjuryoccurrenceincommunitysettings.
2.13 Fromavailabledata,wehaveagoodunderstandingonthepatternandburdenofthemajor
typesofinjuries. However,systematiccollationandanalysisofdataisstill lackinginanumber
ofareassuchastheprevalenceofsportsinjuries, injuryepisodesthatrequiremedicalcarein
theAEDandinjuryepisodesthatarenotsevereenoughtorequirehospitalisation.Besides,only
limitedinformationisavailableonattitudeandbarriersofthepopulationtowardsadopting
particularinjurypreventionmeasures.
Interventions to promote prevention of unintentional injuries
Raising public awareness to injury prevention
2.14 Injuriescausesignificantmorbidityandmortalitythatwarrantsourattention.InHongKong,the
Governmentanddifferenthealthadvocateshavetakentheinitiativetoimplementavarietyof
interventionsstrivingtoprovideasafeenvironmentforthegeneralpublictolive,study,work
andplay.Educationisofparamountimportancetoincreasepublicliteracyandinfluencetheir
attitudes,beliefsandbehaviourstowardsinjuryprevention.
2.15 VariouspublicitycampaignshavebeenconductedwithsupportfromtheInformationServices
Departmentbydifferentpolicybureauxanddepartments toarousepublicawarenessof
safetyandinjuryprevention. Examplesofthesecampaignsincludepromotionofroadsafety,
occupationalsafety,againstchildneglectandabuse,etc.Mostofthesecampaignsaresustained
throughouttheyearandsomeofthemare longstandingpromotion,andemployavariety
ofpublicityandadvertisingmeans including information leaflets,media interviews,media
campaigns,publicworkshops,exhibitions,communityinvolvementactivitiesandcounseling.
Someexamplesofmediacampaigns include“Ifyoudrink,don’tdrive!”and“Let’senhance
householdfiresafety”.
18
Injury prevention: Hong Kong situation 2
Encouraging research on injury prevention
2.16 TheGovernmentestablishedseveralhealth-relatedfundstoencouragehealthpromotiongood
practicesandlocalresearchtoinformhealthpolicyformulation.TheHealthCareandPromotion
Fund (HCPF)wasestablished in1995with theaimof improvingeffectivenessofhealth
promotionanddiseasepreventionactions.Anumberofinjury-relatedinterventionshavebeen
subsidisedbythefund.Ontheotherhand,theHealthandHealthServicesResearchFund(HHSRF)
wasestablishedin2002tofacilitatethegenerationofnewknowledgeinareasofhumanhealth
andhealthservicesto improvehealthofthelocalcommunity. Thefundwasmanagedbya
ResearchCouncilchairedbySFH,whichdeterminedtheresearchagendaandfundingcontrol
mechanism. Researchoninjuriesandpoisoningwasmadeasoneofthethematicpriorities.
Asannouncedinthe2011-2012BudgetSpeech,theHHSRF(togetherwithitsfundingambit)
subsumedunderthenew”HealthandMedicalResearchFund(HMRF)”whichcontinuesto
provideaclear,focusedresearchagendaforpublichealthtopicsincludinginjuryprevention.
Interventions to promote injury prevention by the Department of Health
2.17 TheDHhascommittedtosafeguardingthehealthof thecommunity throughpromotive,
preventive,curativeandrehabilitativeservices. Injurypreventionhasbeenpromotedbythe
DHtothegeneralpublicthroughvariouschannels.Thefollowingparagraphssummarisethese
activities.
2.18 TheNon-CommunicableDiseaseDivisionoftheSurveillanceandEpidemiologyBranchofCentre
forHealthProtectionisresponsibleforsurveillanceandcontrolofNCDofpublicimportanceto
HongKongandformulationofstrategiesinrelationtoNCDprevention. Throughconducting
healthsurveys,forexampleInjurySurvey,PHSandBRFS,theDivisionregularlycollects,collates,
analysesanddisseminatessurveillancedataon injuries. The informationcollected isuseful
for formulatinginjurypreventionstrategies;planning, implementingandevaluatinghealth
promotionprogrammes;organisinginjurypreventionandcontrolactions;andconductingrisk
communicationactivitiesthroughtheelectronicpublication“NCD Watch”andthe“ChangeFor
Health”website.
19
Injury prevention: Hong Kong situation2
2.19 Throughanetworkof31MaternalandChildHealthCentres(MCHCs),theFamilyHealthService
(FHS)providesacomprehensiverangeofhealthpromotionanddiseasepreventionservices
forchildrenfrombirthto5yearsofagethroughtheIntegratedChildHealthandDevelopment
Programme(ICHDP). ICHDPaimstoprovideparents-to-beandparentswithanticipatory
guidanceonchildcare,childdevelopmentandparentingissuesthroughinformationleaflets,
audiovisualresources,workshopsandindividualcounselling. Informationrelatedtovarious
aspectsofchildinjuryprevention, includinghomesafety,preventionofdrugpoisoning,risks
of leavingchildunattendedandintroductionofchildcarefacilities,etc.areprovidedtoalert
parentstopossibleinjurytrapsandrisks,andeducatethemonpreventivemeasuresspecificto
children’sdevelopmentalstage.Besides,theFHShastakenastepfurtherbyproactivelyreaching
outtoparents/childcareworkersthroughothere-channels. Videosonhomesafetymeasures
aremadeavailableinthe“FamilyHealthServiceYouTubeChannel”. Throughthe“Parent-Child
e-Link”onlinemembershipprogrammes,e-newslettersonvariousaspectsofparentingandchild
care,includingalertsonhomesafetymeasures,aresenttoparentsaccordingtotheageoftheir
growingchildren.E-newslettersonspecifictopicsarealsosenttoprofessionalusers.Anonline
self-learningparentingprogramme,“ParentingMadeEasy”waslaunchedtofacilitatecarers/
professionalstoaccessevidence-basedandpracticalparenting informationoftheirchoice
throughanimations,videos,interactivegamesandhyperlinks.Importanttopicsonchildinjury
preventionatspecificagesarecovered intheParentingMadeEasywebsite. TheFHSalso
deliverstalksoninjurypreventiontochildcareworkersandconductsmediainterviewtoraise
publicawarenessontheimportanceofchildinjuryprevention.
2.20 TheStudentHealthService(SHS)aimstosafeguardboththephysicalandpsychologicalhealth
ofschoolchildrenthroughcomprehensive,promotiveandpreventivehealthprogrammesto
enablethemtogainthemaximumbenefit fromtheeducationsystemanddeveloptheirfull
potential.TheSHSoperates12StudentHealthServiceCentres(SHSCs),whichprovidesservices
suchashealthassessment,healtheducationandindividualhealthcounsellingforallprimaryand
secondaryschoolstudents.TheSHSprovidesregularhealthtalksoninjurypreventionincluding
sportsafety,homeaccidentpreventionandoutdoorsafetytoprimaryandsecondaryschool
studentsattendingtheirannualhealthcheckattheSHSCs.Healtheducationmaterialsincluding
pamphletsonsportsafety&injurypreventionareavailableandpostedontheSHSwebsite.
20
Injury prevention: Hong Kong situation 2
2.21 TheElderlyHealthService(EHS)providesprimaryhealthcaretotheelderlysoastoimprovetheir
self-careability,encouragehealthylivingandstrengthenfamilysupport inordertominimise
illnessanddisability.VisitingHealthTeamsofEHSconductintegratedassessmentforResidential
CareHomesfortheElderly(RCHEs)throughouttheterritoryeveryyear.Dataonnumberoffalls
ateachRCHEiscollectedtohelpintheplanningoffallpreventionprogrammes. Besides,the
EHSconductshealthtalkssurroundingthesubjectofinjurypreventionatElderlyHealthCentres
(EHCs),socialcentresandRCHEs.Thesetopicsinclude“FallPrevention”,“Homesafety”,“Roadand
Trafficsafety”,“Burn&Scald”and“Choking(Swallowing)”.Theseprogrammesaredevelopedbya
multi-disciplinaryhealthcareteamincludingdoctors,nurses,physiotherapistsandoccupational
therapists,andtailor-madeforcommunitydwellingeldersandthoselivingintheRCHEsaswell
astheircarers(train-the-trainer). Asamodelcentreoffamilymedicinepracticeintheprimary
caresetting,EHCperformsregularholistichealthassessmentforenrolledmemberscoveringfall
riskassessment.Clientsidentifiedwiththeriskoffallareofferedmultidisciplinaryinterventions.
For instance, thesemay involvemedicationmodificationbydoctors,specialeducationand
training,prescriptionofaids(e.g.bedsidecommode)andhomeassessmentandmodification
(e.g. recommendationof installingbedsiderail)etc.andperiodicalreviewsbyalliedhealth
professionalssuchasoccupationaltherapistsandphysiotherapists. TheEHShascollaborated
withprofessionalandcommunityorganisationssuchasNGOs,HongKongMedicalAssociation
(HKMA),andAsianMedicalStudents’Association (AMSA) inorganising large-scalehealth
seminars,trainingworkshopsandexerciseclassesonfallprevention. In2013,atotalof40fall
preventionambassadorsweretrainedincollaborationwithasocialcentrefortheelderlywho
wouldfurtherdisseminatefallpreventionmessagesinthecommunity.
2.22 ThePrimaryCareOffice(PCO)haspublishedtheReferenceFrameworksforcareofdifferent
populationgroups,namelychildrenandolderadults,inprimarycaresettings.TheseReference
Frameworksprovidecommonreference tohealthcareprofessionals for theprovisionof
continuing,comprehensiveandevidence-basedcare inthecommunity,empowerpatients
andtheircarers,andraisepublicawarenessoftheimportanceoftheproperpreventionand
managementofchronicdiseases,aswellashealthpromotionanddiseasepreventionfor
differentpopulationgroups.Adoptionofsafeandhealthybehaviours,includinginjuryandfall
prevention,areamongthehealthissuesbeingpromotedthroughthesereferenceframeworks.
2.23 Selectedhealtheducationalmaterialsonsportsinjurypreventionareavailablefromthewebsite
andpre-recordedtelephoneinformationsystemoftheCentralHealthEducationUnit(CHEU).
21
Injury prevention: Hong Kong situation2
Interventions to promote injury prevention by other government departments and local
organisations
2.24 Foractionstobeeffective,thereisaneedforconcertedeffortsacrossabroadpublichealthfront,
requiringintra-sectoralandinter-sectoralcollaborations. ManyNGOsandcommunitygroups
havebeenimplementinghealthpromotionprogrammestargetingatriskpopulationsubgroups
andindividualstopromotesafetyawarenessandinjuryprevention.
2.25 Tofosterthedevelopmentofasafecommunity,resourcescanbemobilisedacrosssectorsto
implementeffective injurypreventionprogrammesat localcommunity levels. TheAlliance
forHealthyandSafeCitiesplaysanactiveroleinthisarea.DistrictsinthisAllianceorganiseda
varietyoflargescaleactivities, includingrovingexhibitions,publicityprogrammesandHome
SafetyAngeltraining,etc.,topromotesafetywithinthecommunity.
Capacity building for injury prevention
2.26 Capacitybuildingstrengthensthecommunity’sabilitytopreventandtacklehealthproblemsby
increasingpeople’sknowledgeandskills. Increasedsafetyliteracycanhelpextendandsustain
theeffectofinjuryprevention.
2.27 Someorganisationshaveprovidedtrainingonspecificknowledgeandskillsinrescueandinjury
prevention.Forexample,theHongKongLifeSavingSocietyorganisesdifferenttypesandlevels
oftrainingcoursesincludingpoolrescue,openwaterrescue,aswellasaquaticfirstaids,etc.
CoursesforemergencymedicaltrainingsuchasAdvancedCardiacLifeSupport(ACLS)Provider
CourseandBasicLifeSupport (BLS)ProviderCourseareorganisedregularly inHongKong
toprovidetrainingformedicalprofessionals,paramedicsandanyinterestedcitizens. Some
organisationshaveadoptedthetrain-the-trainerapproachtosustaintheeffectofthepromotion
programmes.Forexample,theOSHC,theCentreforHealthEducationandHealthPromotionof
theChineseUniversityofHongKong(CHEP)andtheHongKongChildhoodInjuryPrevention
andResearchAssociation (CIPRA) formanalliance topromotesafeandhealthyschools.
Guidanceisprovidedfortheschoolstodevelopsafetyandhealthypolicyandmanagement
systemstobuildasafeenvironmentforallstudentsandstaff.
22
Injury prevention: Hong Kong situation 2
Four priority areas identified
2.28 Thescopeofinjuriesisverybroad. It isnotpossibletocoveralltypesofinjuries,settingsand
populationgroups.Hencepriorityareasandagenericframeworkoninjurypreventionshould
beconsideredtoguideactions.AccordingtoWHO,insettingprioritiesforinjuryprevention,we
havetoconsideravailableresources,attitudeofthepublic,whethertheinjuryproblemhasbeen
adequatelydefinedandmeasured(i.e.,whoisinjured,how,why,andatwhatrate)andwhether
aneffectivemeasure isavailable.14 Afterdeliberation,WGImembers reachedaconsensus
thattheactionplanshouldfocusoninjurieswithgreatestpublichealthimpact,payparticular
attentiontolarge-scaledsettingsandapproachessuchassportsandhousehold;aswellasdirect
effortstoco-operatewithrelevantstakeholdersinrespectivefields,inordernottoduplicatethe
workalreadycarriedoutbyothergovernmentdepartmentsorparties.
2.29 Basedontheseprinciplesandfollowingseveralroundsofdiscussion,consensuswasreached
inWGItofocusonfourpriorityareas(sportsinjuries,falls,domesticinjuriesotherthanfallsand
drowning).Thesefourareasofunintentionalinjurytypeswillbeelaboratedfurtherinthenext
section.
2.30 WGImembersalsodeliberatedontopicsthatmightnotbesuitabletobecoveredaspriority
areas.Currently,mortalitydataontrafficincidentswerealreadykeptbyDHanddataontraffic
incidentswerekeptbytheHongKongPoliceForce (HKPF). RoadSafetywasanareawell
addressedintheCommissioner’sOperationalPrioritiesofHKPFinrecentyears. HKPFwould
continuetoallocatemanpowerandresourcetopromoteroadsafety. Moreover,thenumber
ofviolentcrimereportedwasnotedtobedecreasinginrecentyears. Asforthenumberof
occupationalinjurycases, ithasbeendecliningoverthepasttenyearsthroughpromotionof
occupationalsafetybytheOSHCandlawenforcementactionsbytheLabourDepartment(LD).
SinceHKPFandLDhavelongbeentacklingtheseinjurymatterssystematically,WGImembers
consideredapttosetthefocusonotherpriorityareas.
14 WorldHealthOrganization(2010).TEACH-VIP E-Learning – Foundations and methods.Availableat:http://teach-vip.edc.org/documents/IpGp/InjuryPreventionGeneralPrinciples.pdf.,accessed23April2014
23
Injury prevention: Hong Kong situation2
Elaboration of priority areas
Sports injuries
2.31 According to the InternationalClassificationofExternalCausesof Injury (ICECI)ofWHO,
sports injury isan injuryepisode inwhichtheperson is injuredwhenhe/she isengagedin
sports-relatedactivity(e.g.competition,recreationalparticipationandwarm-up).
2.32 Asshowninthe Injury Survey 2008,amongthe460000 injuryepisodessustained inthe12
monthsbeforeenumeration,20.8%(or95500) tookplacewhenthe injuredpersonswere
engagedinsports-relatedactivities. Stronggenderdifferencewasdemonstrated insports
injuries,inwhichmalecomprised69.4%ofallepisodesofsportsinjuries. Ahigherproportion
ofsportsinjuriesoccurredamongindividualsaged15to24(accountedfor27.1%)and35to44
(accountedfor19.8%), indicativeofhigherparticipationinsportsactivitybytheseagegroups
(Figure8).
Figure 8: Sports injuries in Hong Kong by age group, 2008
30%
25%
20%
15%
10%
5%
0%
Source:DepartmentofHealth(2010).Injury Survey 2008
15-24 25-34 45-5435-44
Age groups
55-64 65-74 75andabove
5-14
Prop
ortio
nofpop
ulation
sustaining
sportsin
jurie
s(%
)
10.1%
27.1%
12.5%
19.8%16.9%
6.2%2.6%
4.8%
24
Injury prevention: Hong Kong situation 2
2.33 Analysedbythetypeofsportsactivitytheseinjuriesinvolved(Figure9),soccerandbasketball
toppedthelist. Nearlyhalf (49.1%)ofthe95500episodesofsports injurieswererelatedto
soccer(26.8%)andbasketball(22.3%).
Figure 9: Sports injuries in Hong Kong by sports activity, 2008
Source:DepartmentofHealth(2010).Injury Survey 2008
Sportsactivity
30%
25%
20%
15%
10%
5%
0%
Soccer
Basket
ball
Tennis
Badmin
tonHiking
Cycling
Hand
ball
Tracka
ndfiel
d
Volley
ball
Swimm
ing
RunningJog
ging
Yoga
Others
Prop
ortio
nofsportsin
jurie
s(%
) 26.8%
22.3%
6.9% 5.6% 5.1% 4.6% 3.7% 3.2% 2.6% 2.4% 2.3% 1.7% 0.7%
12.2%
2.34 InHongKong,sportsparticipation isactivelypromoted for itshealthbenefit. Morbidity
couldhavebeenunder-estimatedasmostpeoplesufferingfromsports injurieswouldnot
requirehospitalisationormedicalattention. Moreover,statisticsonworkloadofalliedhealth
professionals relatedtosports injurieswerenot routinelycapturedandhencenot readily
available. WGIconsidereditappropriatetofocusonsports injuriessincesports isapopular
undertakingformanypeople.
2.35 Measuresproventobeeffectivetopreventsports injuriesvary innature,andmay include
protectiveequipment,environmentalmodificationandsafetytraining. Theuseofprotective
sportsequipmentcanprotectagainst injuriesforcertainsports(e.g.helmetsforcyclingand
cricket). Theuseofhelmetswhencyclingcanreducetheriskofheadandbrain injuriesby
between63%and88%.15
15 TownerE,DowswellT,MackerethC,JarvisS(2001).What works in preventing unintentional injuries in children and young adolescents? An updated systematic review.PreparedfortheHealthDevelopmentAgency(HAD),London.DepartmentofChildHealth,UniversityofNewcastleuponTyne.
25
Injury prevention: Hong Kong situation2
2.36 Capacitybuildingandskillsdevelopmentare importantpartsofsafesportspromotion. Forinstance,amongpeopleparticipating insports, trainingprogrammeshavebeenused toimproveco-ordination,strengthandtechnique,aswellasincreaseawarenessofinjuryrisksandpreventionstrategies.
2.37 Environmentalmodificationalsoplaysanimportantroleinreducingsportsinjuries. Loweringtheheightofplaygroundequipment,increasingthedepthofimpact-absorbingsurfacesaroundequipmentandmodifyingplayingsurfacesinsportssuchasgymnasium,trackandfield,weredemonstratedtoreducetheseverityoftheimpactfromsportsorleisureinjuries.
Falls
2.38 Falls topthe tollofunintentional injury-relateddeathsandhospitalisations. Agenerallyincreasingtrendisobservedinrecentyears.In2013,fallscaused232deaths(12.5%ofallinjury-relateddeaths),havingincreasedfrom118deaths(5.3%ofall injury-relateddeaths) in2004.Therewere39450fall-relatedhospitalisations(40.3%ofall injury-relatedhospitalisations) in2013,representingan increasefrom30576fall-relatedhospitalisations(41.6%ofall injury-relatedhospitalisations)in2004.
2.39 Fallsdemonstratestrongagerelevance,astheyaremoreprevalentattheextremesoflife(Figure10). Amonginjuriessustainedduetoallcauses,fallsaccountedfor73.0%inindividualsaged65yearsandabove. Itaccountedfor63.9%ofallcausesofinjuriesinindividualsaged0to4.Moreover,fallsdemonstrateanobviousgenderdifference. Intheyoungerextremeofage,i.e.personsaged14andbelow,57.4%offallsoccurredamongmalechildren(versus42.6%infemalechildren). Inpersonsaged65orabove,thepatternisreversed-72.3%occurredinfemaleand27.7%inmale.
Figure 10: Proportion of falls among all causes of injuries by age group and gender, 2008
100%
75%
50%
25%
0%
Age groups
0-4 45-5415-24 65-745-14 55-6425-34 75andabove
35-44 AllAges
Prop
ortio
nsustaining
injurie
s(%
)
Other causes Fall(Male) Fall(Female)
Source:DepartmentofHealth(2010).Injury Survey 2008
26
Injury prevention: Hong Kong situation 2
2.40 Highprevalenceofunintentionalresidentialfallinjurywasobservedamongchildrenandelderly.Themajordiseaseburdenrelatedtofallsalsooccurredamongthesepopulationsubgroups.Forexample,accordingtodatacollected inacollaborativestudybetweenKwaiTsingSafeCommunityandHealthyCityAssociationandPrincessMargaretHospital(PMH),elderlyfallswasidentifiedasoneofthemajorinjurycausesinthatdistrict,andfallsinelderlycarecentreswerenot uncommon.16Accordingtoanotherlocalstudy17,highpopulationdensityisoneoftheriskfactorsforthissituation.Crowdedlivingenvironmentplayedanimportantrolebycontributingtoahighprevalenceoffalls,especiallyinthedomesticsetting.
2.41 Manystudiesshowedthathomemodificationinterventionalonehadnosignificanteffectonelderlyfallsoutcome.Multi-factorialinterventionsincludingexercisetobuildmusclestrength,visioncorrection,homehazardmanagementshowedmorepromisingeffects.18
Domestic injuries (other than falls)
2.42 Homeistheplacewherepeoplespendmostoftheirtime. Domestic injuriesrecordedthehighest injuryrateamongallenvironmentalsettings,accordingtothe InjurySurvey2008.Domesticinjuriesincludeavarietyofinjuriessustainedthroughdifferentmechanisms.Domesticinjurieshavethusbecomeafocusofattentionamongpublichealthprofessionals.
2.43 Aboutone-fifth(20.4%)oftheinjuryepisodestookplaceathome,followedbytransportarea:publichighway,streetorroad(17.8%)andsportsorathleticsarea(13.5%). Itwasestimatedthat94000episodesofdomestic injuriesoccurredin2008. Domestic injuriesaccountedforthelargestshareamongalltypesofinjuriesinelderlyandfemale. Inelderly,domesticinjuriesaccountedfor43.1%amongallinjurytypes.Amongallagegroups,personsaged0-4,65-74and75andabovehadhigherrateofsustainingdomesticinjuriescomparedwithotheragegroups(Figure11).
16 KwaiTsingSafeCommunityandHealthyCityAssociation.Injury Surveillance Report. 2010.17 ChowCB,LuisBP,etal(2003).Unintentional residential child injury surveillance in Hong Kong. J Paediatr Child Health.2003Aug;39(6):420-6.18Modification of the home environment for the reduction of injuries (Review) (2009). Cochrane Collaboration. 2009, Issue 1.
27
Injury prevention: Hong Kong situation2
2.44 Stronggenderdifferencewasdemonstratedindomestic injuries, inwhichfemalecomprised
78%ofallepisodesofdomestic injuries. In female, injuriesoccurringathomeaccounted
for29.8%whichformedthelargestshareamongallsettings,followedbythoseoccurringin
transportareasincludingpublichighways,streetsorroads(19.4%);recreationalareas,cultural
areas,orpublicbuildings(12.1%);andschoolsandeducationalareas(10.7%).
Figure 11: Domestic injuries in Hong Kong by gender and age, 2008
100%
80%
60%
40%
20%
0%
Age groups
0-4 45-5415-24 65-745-14 55-6425-34 75andabove
35-44 AllAges
Prop
ortio
nsustaining
injurie
s(%
)
Other causes DomesticInjuries(Male) DomesticInjuries(Female)
Source:DepartmentofHealth(2010).Injury Survey 2008
2.45 AccordingtotheInjurySurvey2008,domesticinjurieswereduetoseveralmajorcauses,namely
falls,sprain,cutting/piercing,hit/struck,burn,animalbiteandcrush. Causesotherthanfalls
accountedfor60.8%ofalldomesticinjuries(Figure12).
Figure 12: Domestic injuries by causes, 2008
50%
40%
30%
20%
10%
0%Prop
ortio
nofdom
estic
injurie
s(%
)
Falls Animalbite
Cutting/piercing
SportsInjury
OthersSprain CrushHit/struck
Burn
∑ = 60.8%
Source:DepartmentofHealth(2010).Injury Survey 2008
39.1%
25.1%
13.8%9.4%
4.3% 3.1% 2.4% 2.3%0.4%
28
Injury prevention: Hong Kong situation 2
2.46 Measuresproventobeeffectivetoimprovehomesafetyvarywidelyinnature. Thereisgood
evidencefortheeffectivenessofsafetyeducationprogrammesinincreasingsafetybehaviours
andtheuseofsafetydevices.19 Theutilisationofhomesafetyequipmentsuchascupboard
catches,stairgates,windowlocks, fireguards,electricsocketcovers, thermometerstotest
watertemperatures,anti-scalddevicesinhotwatertapsandsmokealarmscanofferprotection
against injuriesoccurring inthehome. Studiesshowedthatwindowsafetymechanismsto
preventchildrenfromopeningwindows,suchasbarsandpositionlockingdevices,areeffective
measurestopreventfalls. Windowbarshavebeenshowntoreducedeathsfromwindowfalls
by35%.20 Securestorageforpoisonsremovesalargerportionofpoisoningriskthanparental
supervisionandmaybeaneffectiveinterventionofpreventingpoisoninginjury.21,22
2.47 On theotherhand,product safety is important to safeguard consumerhealth. With
advancementintechnologyandproductengineering,saferproductsaredesignedtoprevent
injuryoccurrence.Comparativetestscanalertthemtoproducthazards,helpconsumersmake
rationalchoices,andinduceimprovementsinproductqualityandsafety.
2.48 Toachieveahighadoptionofprovensafety interventions, thetwobasicapproachesareto
raiseawarenessandincreaseaccessibilitytothesemeasures.Forsafetyinterventionsinvolving
behaviouralchange,effortshouldbemadetoeducatemembersofthepublictheexistenceof
hazardandeffectivenessofcertainmeasures.
2.49 Althoughmanysectorsarealreadyworkingonthisarea,westillobserveaconsiderablenumber
ofdomesticinjurieseveryyear.Thereisapossibilitythatthosewhoneedtoknowmayfailtoget
themessage.Thisrightlyillustratestheimportanceoftargetedriskcommunication.
19 HarborviewInjuryPreventionandResearchCenter(2001).Best Practices.Seattle,UniversityofWashington.20 SpiefelCN,LindamanFC(1995).Children can’t fly: a programme to prevent childhood mortality from window falls.InjPrev1995:1(3):194-8.21 KrugA,EllisJ,HayI,MokgabudiN,RobertsonJ(1994).The impact of child-resistant containers on the incidence of paraffin (kerosene)ingestion in children. S
AfrMedJ1994;84(11):730-734.22 WoolfAD,SapersteinA,ForjuohS(1992).Poisoning prevention knowledge and practices of parents after a childhood poisoning incident. Pediatrics1992;
90(6):867-870.
29
Injury prevention: Hong Kong situation2
Drowning/near-drowning
2.50 Thenumberofaccidentaldrowningandsubmersiondeathsfluctuatedoverthepasttenyears
(Figure13). Therewere21to56deathsannually. Therewasnoclearincreasingordecreasing
trend.In2013,therewere30deathcasesresultingfromaccidentaldrowningandsubmersion.
Drowning,fromtimetotime,causedsubstantialmortalityinHongKong.
Figure 13: Number of registered death due to accidental drowning and submersion (W65-W74) by
gender in Hong Kong, 2004-2013
60
50
40
30
20
10
0
Year
2004 20092006 20112005 20102007 20122008 2013
Num
berofreg
isteredde
ath
Men WomenSource:DepartmentofHealth
4540
56
3035
3943
29
21
30
80.0%62.9%
76.8%65.1%
81.0%
75.0% 66.7%56.7%
69.0% 83.3%
20.0% 37.1% 23.2% 34.9%19.0%
25.0% 33.3% 43.3% 31.0% 16.7%
30
Injury prevention: Hong Kong situation 2
5-14
1.8
1.6
1.4
1.2
1
0.8
0.6
0.4
0.2
0
Year
2004 20092006 20112005 20102007 20122008 2013
Age
-specificde
athrate(p
er100
000
pop
ulation)
Source:CensusandStatisticsDepartment,DepartmentofHealth
Figure 14: Age-specific death rate due to accidental drowning and submersion (W65 - W74) in
Hong Kong, 2004-2013
Age group 65+45-6415-441-4
2.51 Stronggenderdifferenceisdemonstratedindrowning-relatedmortalitystatistics,inwhichmale
comprisesaround60%to80%ofdeathcasesannually.Besides,obviousagedifferenceisnoted
indrowning-relatedmortalitystatistics.Age-specificdeathrateduetoaccidentaldrowningand
submersionincreaseswithage. Age-specificdeathratewasthehighestfortheagegroup65
andaboveinthepastdecade(Figure14).
31
Injury prevention: Hong Kong situation2
2.52 Amongall501registereddeathsduetodrowninginthepastdecade,133(26.5%)werewater-
transportrelatedand368(73.5%)werenot(Figure15). Amongthese368nonwater-transport
relateddrowningcases,mosthappenedinnaturalwater(e.g.sea,riverandstream)followedby
swimmingpoolandbath-tub.
Figure 15: Number of registered death caused by drowning in Hong Kong, 2004-2013
250
200
150
100
50
0Sea,river,
stream (whilein)
Sea,river,stream (fallinto)
Swimmingpool
Bath-tub Others
206
75
279
51
Numberofregistereddeathcausedbynonwater-transportincidentinHongKong,2004-2013(N=368)
Water-transport
133
Non Water-transport
368
NumberofregistereddeathcausedbydrowninginHongKong,2004-2013(N=501)
Source:DepartmentofHealth
32
Injury prevention: Hong Kong situation 2
2.53 Althoughthenumberofdeathsduetodrowningissmallcomparedwithothermajortypesof
injuries,fatalityrateisexceptionallyhighamongdrowningcases(Figure16).Inthepastdecade,
foreverytenpersonsadmittedtothehospitalduetowater-transportaccident(V90-V94),nine
endedupindeath.Figureswereevenmorealarmingforaccidentaldrowningandsubmersion
(W65-W74). Foreverytenpersonsadmittedtothehospital,seventeenendedupdying. This
wasbecausecasualtieswereusuallysentdirectlytothepublicmortuarywithouttheneed
forhospitaladmission. Thisphenomenonisuniquefordrowning,amongalltypesofinjuries
(V01-Y98)observedinHongKong. Inotherwords,drowning/near-drowningismore lethal
comparedwithothercausesof injuries. Asshown incorrespondingfigures fromthepast
decade,drowninghasoneofthehighestfatalityrateamongallinjuries. Thesignificantpublic
healthimpactshouldnotbeunderestimated.
Figure 16: Causes of injuries by ten leading case fatality rate in Hong Kong, 2012
250%
200%
150%
100%
50%
0%
Casefatalityrate*(%
)
Accidentaldrowningand
submersion
Water transport accidents
Intentionalself-harm
Medicaldevices
associatedwithadverseincidentsin
diagnosticandtherapeutic
use
Pedestrianinjuredintransport accident
Exposureto forces of
nature
Bus occupant injuredintransport accident
Occupant of pick-up truckorvaninjuredintransport accident
Other accidentalthreats to breathing
Accidentalpoisoning by andexposure
to noxious substances
Source:DepartmentofHealth
* Casefatalityratereferredtotheproportionofregistereddeathsinthenumberofin-patientdischargesanddeaths.** Casefatalityrateexceeded100%becausesomecausaltiesweresentdirectlytomortuarywithoutadmittingtohospital.Thesecases
thusdidnotappearinhospitalrecord,i.e.in-patientdischargesanddeaths.
Causes of injuries
193.3%**(W65-W74Accidentaldrowningandsubmersion,involvingbath-tub,swimmingpool,naturalwater)
57.9%(V90-V94Watertransportaccident,involvingwatercraftlikepassengership,fishingboat,yacht,water-skis,canoe)
2.54 Utilisationof lifeguardserviceandswimmingonly inguardedbeachesorpoolsprevent
drowning,withstrongevidence.Theseareareaswhereefforthasbeenmadetocontaintherisk
ofdrowning.Thereareotherareaswhereactionscanbeintroduced.Examplesofneglectedor
hiddenhazardsincludeoutdoorwaterbodies(e.g.streamsandrivers)andindoorwaterbodies
(e.g.washingmachinesfilledwithwaterandnotinoperation).
33
Actions to strengthen prevention of unintentional injuries3
3 Actions to strengthen prevention of unintentional injuries
3434
Actions to strengthen prevention of unintentional injuries 3
3. Actions to strengthen prevention of unintentional injuries
3.1 In2008,DHpublishedastrategicframeworkdocumenttitled“Promoting Health in Hong Kong:
A Strategic Framework for Prevention and Control of Non-communicable Diseases”withtheoverall
goaltoincreasepositivehealthandqualityoflifeofthepeopleofHongKong.
3.2 Toachievetheabovegoal,differentpriorityareaswereidentifiedandthreeworkinggroups
includingthecurrentWGIwereestablished.TheWGIrecognisestheimportanceofconcerted
effortsof theGovernmentanddifferentsectors inthecommunitytocreateasustainable
environmenttostrengtheninjuryprevention. It isofequal importancethat individualstake
responsibilityforhisorherownhealth,aswellasthehealthoftheirfamiliesandcommunities,
bymakinginformedandhealthierchoiceswithregardtoinjuryprevention.
Goals
3.3 Followingcareful reviewofoverseasevidence,examinationof the
local situationandconsultationwithstakeholders, theWGI,after
deliberations, identified fourareasofconcern,namely falls, sports
injuries,domestic injuries (other than falls), anddrowning/near-
drowning.Recommendationsareformulatedwiththefollowinggoals:
1 Tostrengtheninjurysurveillancebybuildingasustainableinjury
surveillancesystem;
2 Toraisepublicawarenessofinjurypreventionbystrengthening
riskcommunication;
3 Toempower thepublic tomake informedchoiceson injury
prevention;and
4 ToreducetheburdenofinjuriesinHongKong.
35
Actions to strengthen prevention of unintentional injuries3
Specific actions
3.4 Toachievethestatedgoals,a totalof16specificactionsareproposed insupportof the9
recommendationsunderpinning5strategicdirections. Table2providesasummaryofthese
actions.
Strategic direction 1: Support new and strengthen existing health promotion activities on injury
prevention
(Recommendation 1A)Developandimplementahealthcommunicationstrategyandadvocacyin
supportofinjuryprevention
3.5 Manyinjuriesandsufferingcanbeavoidedifpreventivemeasuresareproperlytaken.Hence,it
isofutmostimportancethatthepublicisinformedandempoweredwithrespecttopreventive
measures. Effectiveriskcommunicationisafundamentaltooltoassistthepublictorecognise
risksandmake informedchoicesabouttheirhealthand lives. Differentorganisationsare
currentlypromotinginjurypreventionbuttheireffortsarescatteredandnotsystematic.Ifthere
isbettercollaborationandcooperationbetweendifferentparties,synergisticeffectscanbe
generated,thuspropagatinghealthmessagestothepublicmoreeffectively.
Action 1: Devise a health communication strategy to articulate messages positively as safety
promotion and performance enhancement in addition to the traditional ways as injury prevention
and damage minimisation
3.6 Oneimportantaspectofinjurypreventionistodisseminatekeymessagestothepublictoraise
theirawarenessoninjuryprevention. However,thepublic isnotahomogenousgroupand
thereforethemessagesmustbetailor-madetodifferentaudiences. Toachievethis, theDH
shouldtaketheleadtodeviseahealthcommunicationstrategycustomisedtovariousaudiences
onrelevant injurypreventionsubjectsusingappropriatemeans. Throughorganisedand
systematicefforts, injurypreventionmessagescanbeeffectivelycommunicatedwithspecific
targetgroups.Keythemesandideascanbesystematicallystructuredwithinthecommunication
strategy.
(Recommendation 1B)Strengthenexistinghealthpromotionactivitiesoninjurypreventionand
maximisetheutilisationofreadilyavailableresourcesforinjuryprevention
36
Actions to strengthen prevention of unintentional injuries 3
3.7 Small-scaleandshort-termhealthpromotionactivitiesmaygeneratepopulationhealth
impactswhicharebriefandlimitedinscale. Bypoolingresources,thereisahigherchanceto
maximisehealthimprovementeffects. Withclosercollaborationandorganisedeffortsamong
stakeholders,existinghealthpromotionactivitiesoninjurypreventioncanbestrengthenedand
resourcesbetterdeployedforthegoodofsocietyasawhole.
Action 2: Make use of existing and newly obtained mortality and/or morbidity data, credible sources of information and evidence-based practices to develop injury prevention messages in such forms that appeal to varying audiences and to support health promotion activities
3.8 Currently,therearestakeholderspromotinginjurypreventionsuchastheHongKongJockey
ClubSportsMedicineandHealthSciencesCentrewhichfocusesonsportsinjuryprevention.It
isalsonotedthatrecommendationsoninjurypreventionweremadeintheCoroners’ Report
(publishedannuallybytheCoroner’sCourt)andtheReports of the Child Fatality Review Panel
(publishedby theChildFatalityReviewPanelwhich isan independentmulti-disciplinary
non-statutorybodywithmembersappointedby theDirectorofSocialWelfare). These
recommendationsofferedinsightintopopulationgroupsatriskofsustainingfatalinjuries.These
reportsprovideinsightsintopromotionalgapstobeaddressedatpubliceducationlevel. The
DHwillconductregularreviews,forinstance,onanannualbasis, intothesereportstoextract
usefulmessagestocommunicatewiththewiderpublic.
Strategic direction 2: Generate a comprehensive and effective information system to understand the epidemiology of injuries and to provide advice and support on prevention of injuries
(Recommendation 2A)Widenthescopeofinjurysurveillance
3.9 TheWHOdefinedsurveillanceas“systematicongoingcollection,collationandanalysisofdata
andthetimelydisseminationof informationtothosewhoneedtoknowsothatactioncan
betaken”.23 Injurysurveillanceisessential. Withouteffectivesurveillance,itwouldbehardto
identifythetrendsandat-riskgroups,letaloneformulatingspecificpreventivemeasures. The
sustainabilityofaninjurysurveillancesystemisalsocrucialassurveillanceneedstobeongoing
toreflecttimetrends.Moreover,aninjurysurveillancesystemwillneedtorecordtheinjurytype
aswellasthedetailsofeachincident.Asastart,theexistingadministrativestatisticsofrelevant
stakeholdersisagoodsourceofdatatobeusedforsurveillancepurpose.
23 WorldHealthOrganization(2013)Surveillance.Availableat:http://www.who.int/tobacco/surveillance/about_surveillance/en/,accessed11October2013
37
Actions to strengthen prevention of unintentional injuries3
Action 3: Explore the use and systematic analysis of selected data collected in Hospital Authority (HA) hospitals to strengthen knowledge on epidemiology of injury cases requiring Accident and Emergency (A&E) attendance and hospitalisation
3.10 ThisproposedactionfocusesonanalysingthetypesofinjuriesthatrequireA&Eattendanceor
hospitalisation. Areviewofexistingsourcesoflocalsurveillancedataoninjuriesshowedthat
monitoringofmostpartsoftheinjurypyramidisalreadyinplace.Injuriesrangingfromfatalto
untreatedonesarecapturedbytheDeathRegistry,coronerrecords,in-patientdischargerecords
ofHAhospitalsandthevarioussurveys.InjuriesresultinginadmissionstoA&Earecapturedby
thedomesticinjuryinformationsystemsinseveralHAhospitals,asaproxyofthistypeofinjuries.
However,analysisoninjury-relateddatacapturedinA&Eisminimalandthereisnosystematic
disseminationofsuchinformationtothosewhoneedtoknow.WithsurveillanceofA&Edata,
amorecompletepictureoftheburdencausedbyinjuriescanbeobtainedandindicatorsfor
assessingtheburdenofinjuriescanbecalculated.
Action 4: Carry out a review of drowning cases kept by the Coroner’s Court, with a view to
understanding the demographic details, contributory factors of fatal incidents for the development
of injury prevention messages
3.11 Themortality statisticscurrentlymaintainedbyDH isagoodsourceof information for
studyingtheoverallpatternoffataldrowningcases. However, itoffersminimal information
onthedemographiccharacteristicsandmechanismsofthefatalities. Withmorethorough
understandingofthesefactors,appropriatemeasurestopreventfataldrowningcanbepossible.
3.12 Thisproposedactionsuggeststhatareviewshouldbeconductedondrowningcaseskeptbythe
Coroner’sCourt.Astherewerearound30-60casesofdrowningeachyearinthepastdecade,
reviewingfataldrowningaccidentsinthepast5-10yearswouldbeafeasibleandmanageable
exercise.Ifthemomentumofthisexerciseismaintained,thecontentofthereviewwillforma
goodbasisforroutinedrowningsurveillance.
38
Actions to strengthen prevention of unintentional injuries 3
Action 5: Explore a pilot programme to assist schools to implement an injury surveillance
system to identify contributing and precipitating factors for injuries within the school and pinpoint
areas for improvement actions
3.13 Thisproposedactionfocusesonfalls,sportsandotherinjuriesoccurringatschool. According
to the Injury Survey 2008,35.6%ofinjuriessustainedbychildrenaged14andbelowoccurred
inschoolsoreducationalareas.11Thoroughunderstandingoftheepidemiologyofinjuriesisa
prerequisiteforeffectiveinjuryprevention;hencesurveillanceofinjuriesoccurringinschools
isessential.Currentlythereisnostandardisedanduniversallyadoptedinjuryreportingsystem
concerningfalls,sportsinjuriesandotherinjuriesoccurringatschoolsandeachschoolhasits
owninternalproceduresinhandlingsuchincidents.Moreover,itisnotedthatevenifthepractice
ofrecordinginjuriesisinplace,thepurposeismoreonrecordingadministrativemanagementof
incidentsratherthanidentificationofcausationandpreventionofinjuryrecurrence.Thelackof
gooddocumentationofinjuriesandpreventiveactionsalsoputsschoolsinalessadvantageous
positionwhenfacedwithcomplaintsandpossible litigation. Withcollaborationbetween
stakeholdersincludingtheDH,theOSHC,theEducationBureau(EDB),SchoolCouncilsandsome
pilotschools,itishopedthatexistinggoodpracticescanbeharnessedtoformapracticalsystem
torecordandbetterunderstandthenatureofinjuriesoccurringinschools.
Action 6: Explore the possibility of accessing new sources of injury data to enrich the existing
injury surveillance system to alert the public where injuries are more to occur
3.14 TheDHcurrentlymaintainsmortalitydata,whereasmorbiditydatacanbeaccessedfromHA.
Otherformsofmorbiditydatacanbeobtainedfromsourcessuchastheadministrativestatistics
oftheAuxiliaryMedicalService(AMS)regardinginjuriesthatoccuroncyclingtracksetc. This
informationwouldbeusefulforstudyingthecharacteristicsofinjuriesrelatingtocycling,which
isbecomingincreasinglypopular. Withroutinecollection,collationandanalysisofthesedata,
thepubliccanbealertedtothe“blackspots”and“riskbehaviours”whichcommonlyresult in
injuries. Inrespectofthemeansof informationdissemination,bothtraditionalmeanse.g.
settingupwarningsignsatblackspotsandelectronicmeanse.g.websitesormobileapplications
canbeconsidered.
(Recommendation 2B)Strengthentheexisting injurysurveillancesystemtomake itusefuland
sustainable
39
Actions to strengthen prevention of unintentional injuries3
3.15 TheDHhasconductedanumberofsurveyswiththecomponentofinjuriesinthepast.In2003-
2004,theDHconductedthefirstPHStostudythepatternsofhealthstatusandhealth-related
issuesofthegeneralpopulationinHongKongforpersonsaged15yearsandabove.Thesecond
roundofPHS isnowundercommissioning. In2005-2006, theCHSwasconductedamong
childrenaged14andbelowinHongKongtoprovidesupplementaryinformationtothePHSby
includingbaselinedataonthehealthandwell-beingofchildreninHongKong.SinceOctober
2004,theBRFSoftheDHhascontinuouslymonitoredthetrendofhealth-relatedbehaviours
foradultsaged18-64throughaseriesof telephonesurveysconductedsystematicallyand
periodically.In2008,theDHconductedtheInjurySurveytocollectpertinentinformationonthe
characteristicsandtheburdenofunintentionalinjuriesinHongKongpopulation.
Action 7: By conducting in-depth analysis on existing and updated data collected from surveys,
strengthen understanding of the pattern and trend of injuries
3.16 DatafromsurveysconductedbytheNon-CommunicableDiseaseDivisionoftheSurveillance
andEpidemiologyBranchofCentreforHealthProtectionhavebeenusedtopublisharticles
writtenbytheDH,otherorganisationsandresearchers.Tobetterutilisethesesurveydata,more
in-depthanalysismaybeconductedandarticlespublishedandwidelydisseminatedinvarious
mediatoreachdifferentaudiences.
(Recommendation 2C) Promote researchof feasibility, efficiencyandcost-effectivenessof
interventionstopreventinjuries
3.17 Asubstantialamountofstudiesontheeffectivenessandcost-effectivenessofinterventionsto
preventinjurieshavebeenconductedoverseas.Ontheotherhand,localstudiesarelimitedand
itisimportanttoinvestigatethepossibleeffectandfeasibilityofnewandexistingmeasuresto
preventinjuries.Inthisregard,academicinstitutionsandotherNGOsshouldbeencouragedto
submitapplicationsforfundstoconductresearchstudiesrelatingtoinjuryprevention.
Action 8: Encourage more research on the four major types of injuries identified (i.e. sports
injuries, falls, domestic injuries other than falls and drowning)
3.18 TheResearchOfficeof theFoodandHealthBureau (FHB)organisesa forumeveryyear to
encouragerelevantparties,includingacademiaandNGOs,toapplyfortheHCPFandHMRF.In
ordertoencouragepotentialapplicantstoconductresearchoninjuryprevention,theDHcould
highlightthethematicprioritiesoninjurypreventionduringtheforumsorganisedbyFHB.
40
Actions to strengthen prevention of unintentional injuries 3
Strategic direction 3: Strengthen partnership and foster engagement of all relevant stakeholders
(Recommendation 3A) Toworkwithgovernmentbureaux/departments,otherhealthpromotion
partners,NGOs,schools,employeesandemployersofdifferentindustriestodevelopandimplement
measuresthataresensitivetotheneedsofthepublicinachievingpreventionofinjuries
3.19 Healthpromotionanddiseasepreventionrequiretheinvolvementofnotonlythehealthsector
butthewholecommunity.Workinginpartnershipwithallrelevantstakeholdersatcommunity
level iscrucial for thesuccessof injuryprevention. Giventhecomplexityandchallenges
in relation to injuryprevention,healthauthorities,healthcareprofessionals,government
departments,theeducationsector,thehousingsector,thesportssectorandotherNGOshaveto
worktogethertodevelopandimplementmeasuresthataresensitivetotheneedsofthepublic
inachievinginjuryprevention. TheDHwillplayabridgingroleintheseprocesses,bringing
togetherstakeholdersandpromotingthesharingofexperienceandgoodpractices,toenablea
largerpartofthepopulationtobenefit.
Action 9: Support schools to strengthen injury prevention through voluntary participation in
health and safety programmes covering school policy, injury surveillance, first aid training, staff
development, student education, warm-up exercise before sports and parental engagement, with a
long term goal to facilitate the implementation of EDB’s Healthy School Policy.
3.20 Thecomponentof injurysurveillancewillbeimplementedasafirststep. Othercomponents
willbeimplementedconsequentially. Guidelinesforschoolsonsettingupasystemtorecord
injuriesareusefulforprotectingtheschoolsthemselvesanddevelopingstrategiestoprevent
furtherinjuriesamongstaffandthestudentpopulation.SchoolswillbesupportedbyEDBand
DHinstrengtheninginjurypreventionstrategiesandmeasures inschools, includingrecord
keepingoncasesofinjuries.Itmustbeemphasisedthattheaimofkeepinganinjuryrecordisto
helptheschooldesignandimplementpreventivemeasuresratherthanfindingfault.
3.21 Withsurveillancesystemsinplace,patternsof injurieswithrespecttotime,placeandperson
couldbereadilyidentified,studiedandcomparedbeforeandafterinterventions.Interventions
suchasacomprehensiveschoolpolicy,firstaidtraining,staffdevelopment,studenteducation,
warm-upexercisebeforesportsandparentalengagementcouldbecustomisedandpromoted
tomeettheneedsofschoolpopulation.Existingsafeschoolprogrammesandinitiativescould
alsobepromotedforadoptionbyagreaternumberofschools.
41
Actions to strengthen prevention of unintentional injuries3
Action 10: Collaborate with the Leisure and Cultural Services Department (LCSD) to strengthen
sports injury awareness, surveillance and prevention
3.22 It isnotedthatalargenumberofpeopleusethefacilitiesoforparticipateinsportsactivities
organisedbytheLCSD. In2012-13,theLCSDorganisedabout37800recreationalandsports
activities formorethan2136600participantsofallagesandabilities.24 TheLCSDplaysa
significantroleinpreventingsportsinjuries.TheDHwillcollaboratewiththeLCSDtoenhance
effortsonsportsinjuryawareness,surveillanceandprevention.
3.23 Injury-relatedadministrativestatisticsofLCSD'ssportsamenities(e.g.sportscentre,beachand
swimmingpool)mightbeacquiredasaproxyofconductingsurveillanceonsportsinjuries.This
injurysurveillanceinitiativewillbeacontinuousone,andthefrequencyofobtainingdatafrom
LCSDistargetedtobeonceayear. Aggregatedstatisticaltabulationanddescriptionofthese
tableswillbepublishedinareport/articleinprintedorelectronicformforwiderdissemination.
Action 11: Engage stakeholder groups (ranging from service providers to users) and raise their
awareness on injury prevention and safety promotion through briefing(s), sharing session(s) or
seminar(s)
3.24 Seminarswouldbeheldwhentheactionplanoninjurypreventionislaunched,sothatmessages
on injurypreventioncouldbedisseminatedto relevantstakeholders. Dependingonthe
audiencetargeted,thecontentofthesegatheringsshouldbecustomisedtoachievethegreatest
buy-inandimpact.
Strategic direction 4: Build capacity and capability to prevent injuries
(Recommendation 4A)Developpersonal skills toadopt injurypreventivemeasures through
communicationofevidence-basedadvice
3.25 Effectiveriskcommunicationisafundamentaltooltoassistthepublictomakeinformedchoices
abouthealthand living. Many injurieshappenbecausethepublic lacktheknowledgeor
understandingoftheriskofinjuriesandinjurypreventionskills.Withknowledgeandawareness,
safetyliteracyisincreasedandthepublicaremorelikelytotakeactionstopreventinjuries.Thus,
theWGIrecommendsdevelopingevidence-basedadvicetoempowerandenablethegeneral
publictomakeinformedchoicesaboutinjuryprevention.
24 LeisureandCulturalServicesDepartment(2013)Annual Report 2012-2013.Availableat:http://www.lcsd.gov.hk/dept/annualrpt/2012-13/en/leisure/leisure03.html,accessed25October2014
42
Actions to strengthen prevention of unintentional injuries 3
Action 12: Raise awareness and safety literacy of cyclists for them to adopt safe practices and
protective gear while cycling
3.26 CyclingisatypeofphysicalactivitiesthathasgainedpopularityinrecentyearsinHongKong.
However,alargenumberoffatalandseverelyinjuredcasesofcycling-relatedinjurieshavealso
beenrecorded.
3.27 IntheroutinecyclingsafetyworkshopsorganisedbyRoadSafetyCouncil forprimaryand
secondaryschoolstudents,elementsofinjurypreventionandperformanceenhancementwill
berecommendedtothecoachoftheseworkshops. Theseelementsinclude(1)warm-upand
cool-downexercises;(2)updatedlocalsituationofcyclinginjury(e.g.surveillanceresultsfrom
AMSdata);(3)propercyclinggear;and(4)safecyclingskillsandroadmanner.Evaluationofsuch
educationalactivitiesisalsorecommended.
Action 13: Institute community-wide education on interventions proven to be effective in injury
prevention in high risk situations.
3.28 Thisproposedactionfocusesondomesticinjuriesandfalls.TheConsumerCouncilandtheHong
KongCustomsandExciseDepartment(C&ED)havepublicationsonproductsafety,especially
oninstallationsandproductsthatareusedinthedomesticsetting. Suchinformationwillbe
reviewedandleveragedoninrelevantriskcommunicationactivities.
Action 14: Promote knowledge-based interventions to PE teachers and coaches as a means to
raise sports performance and prevent sports injuries using a train-the-trainer approach
3.29 Developingskillsforsportscoachesonsports injurypreventioncouldbemoreefficientthan
teachingindividualplayersasthetrainers,afterbeingequippedwiththeknowledgeandskills
onsportsinjuryprevention,caninturnteachindividualsportsplayersonknowledgeandskills
whileservingasrolemodelsthemselves.TrainingsessionstoPEteachersandcoachesmaybe
organisedwiththehelpoftheEDBandLCSDtocoverconcepts,principlesandpracticesofinjury
preventioninspecificsettingsaswellasexercisesdesignedandtestedtopreventsportsinjuries
andenhancesportsperformance. Expertiseonsports injurypreventionmaybesoughtfrom
relevantsportsexperts.
(Recommendation 4B)Strengthencommunityawarenessandactionstopreventinjuries
43
Actions to strengthen prevention of unintentional injuries3
3.30 TheWGIconsiders it importanttoempowerthegeneralpublicwithskillsandknowledgeof
injuryprevention.Byusingthetrain-the-trainerapproach,messagesofinjurypreventioncanbe
morequicklyandeffectivelydisseminatedtoindividuals.Hence,capacitybuildingprogrammes
targetingteachers,sportscoachesandpeerleadersshouldbeorganisedtogenerateacascading
effectwithinthecommunity.
Action 15: Produce teaching aids to strengthen safety awareness and promote injury prevention
actions by staff and students. Content to be introduced should be tailored to students’ academic
needs
3.31 Schoolsareagoodstartingpoint for theeducationof injurypreventionaschildrencan
benefitdirectlyandalsopropagatethemessagesto their families. TheDHwill studythe
currentcurriculumandteachingresources,andwhereappropriate,makerecommendationsof
age-appropriateinformationandmaterialsoninjurypreventiontobeintroduced.Teachingaids
forprimaryschoolstudentsoninjuryprevention,calledthe“InjuryPreventionProgrammein
PrimarySchools”,werepreparedbytheCIPRA.Inordernottoreinventthewheel,theseteaching
aidswillbereviewedbyteachersbeforeconsideringrevisionandpromotionofuse. After
collectionoftheircomments,changescouldbemadetotheteachingaidsasappropriatebefore
promotionforusebyteachersasteachingaids.
Strategic direction 5: Ensure a health sector that is responsive to the NCD challenges and to improve
the healthcare system
(Recommendation 5A) Engagehealthcareprofessionalsinpromotingmessagesandpracticesthat
preventinjuriesandidentifyingandmanagingat-riskgroups
3.32 Primarycaresettingisanimportantplacetopromotehealthtothepublicincludingthoseat-risk
ofinjuries,asfamilydoctorsandotherprimarycareprovidersareoftenthefirstcontactpointfor
membersofthecommunity.Contactduringconsultationallowsprimarycareproviderstooffer
adviceoninjurypreventionsuchasprovidingsafetytips/self-helpmaterials,briefintervention/
counsellingandreferraltospecificservicesasappropriate. TheWGIrecommendsengaging
healthprofessionalsinreducinginjuries.
44
Actions to strengthen prevention of unintentional injuries 3
Action 16: Engage primary care providers in dissemination of injury prevention information to
increase the accessibility of at-risk groups to community support
3.33 Peoplewith functionaldisabilities,degenerativeconditions,problemofpoly-pharmacyor
childcareproblemsareathigherriskoffallsandothertypesofdomestic injuries. Asprimary
carepractitionersareoftenthefirstpointofcontactfortheseclientgroups,byraisinginjury
awareness, theystandabetterchanceof identifyingandmanagingat-riskgroups. The
Hong Kong Reference Framework for Preventive Care for Children in Primary Care Settingsand
Hong Kong Reference Framework for Preventive Care for Older Adults in Primary Care Settings
provideappropriateguidanceandremindersfordoctorstoinstillconceptsandskillsinat-risk
populationsandtheircarersforpromotinghomesafetyandinjuryprevention.
3.34 SomeNGOsareprovidingcommunitysupporttoelderlyatriskoffalls. Theseconsistofhome
assessmentandmodification,adviceonuseofwalkingframesandassistivedevices,training
ofcarers,etc. Suchservicenetworksshouldbepromotedandextendedtocoverprimarycare
providerssothatpersonsatriskoffallmaybereferredtoaccessalreadyexistingcommunity
supportservices.
45
Actions to strengthen prevention of unintentional injuries3
Table 2: Lead action parties, targets and timeframe
Targets and timeframeStrategic directions Recommendations Actions Lead action parties
(1) Supportnewandstrengthen existing healthpromotionactivitiesoninjuryprevention
(2) Generateacomprehensiveandeffectiveinformationsystemtounderstandtheepidemiologyofinjuriesandtoprovideadviceandsupportonpreventionofinjuries
Startingfrom2015,ahealthcommunication strategy fordifferenttargetgroupswillbedevelopedandimplemented.
From2015,evidence,facts,statisticsandrelevantinformationwillbecollatedandupdatedregularlytosupporthealthpromotionactivities.
By 2015-16, a mechanism willbedevisedtoobtaininjury-relateddatafromHAforanalysis.
In2016,thereviewondrowningcaseskeptbyCoroner’sCourtwillbecompleted.
Startingfrom2015,DHwillengageanumberofprimaryandsecondaryschoolsinapilotprojecttolearnabouttheinjuryreportsoftwareCommunityInjurySurveillanceSystem(CISS)developedbyOSHCandexplorepossibilityofadoptiontoenhanceinjurysurveillanceinschools.
• (1A)Developandimplementahealthcommunication strategyandadvocacyin support of injury prevention
• (1B)Strengthenexistinghealthpromotionactivitiesoninjurypreventionandmaximisetheutilisationofreadilyavailableresourcesforinjuryprevention
• (2A) Widenthescopeofinjurysurveillance
[Action 1]Deviseahealthcommunication strategy to articulatemessagespositivelyassafetypromotionandperformance enhancement inadditiontothetraditionalwaysasinjurypreventionanddamageminimisation
[Action 2] Make use of existingandnewlyobtainedmortalityand/ormorbiditydata,crediblesourcesofinformationandevidence-basedpracticestodevelopinjurypreventionmessagesinsuchformsthatappealtovaryingaudiencesandtosupporthealthpromotionactivities
[Action 3]ExploretheuseandsystematicanalysisofselecteddatacollectedinHospitalAuthority(HA)hospitalstostrengthenknowledgeonepidemiologyofinjurycasesrequiringAccidentandEmergency(A&E)attendanceandhospitalisation
[Action 4] CarryoutareviewofdrowningcaseskeptbytheCoroner’sCourt,withaviewtounderstandingthedemographicdetails,contributoryfactorsoffatalincidentsforthedevelopmentofinjurypreventionmessages
[Action 5]Exploreapilotprogrammetoassistschoolstoimplementaninjurysurveillancesystemtoidentifycontributingandprecipitatingfactorsforinjurieswithintheschoolandpinpointareasforimprovementactions
• DH
• DH• OtherrelevantGovernmentdepartments
• DH• HA
• DH• OtherrelevantGovernmentdepartments
• DH• EDB• Academia• OSHC
46
Actions to strengthen prevention of unintentional injuries 3
Targets and timeframeStrategic directions Recommendations Actions Lead action parties
(3) Strengthenpartnershipandfosterengagementofallrelevantstakeholders
Witheffectfrom2015,DHwillenhancetheinjurysurveillancesystembyacquiringadministrativestatisticsfromdepartmentsandagenciessuchasAMS,whichhavearoleininjurypreventionandmanagement.
Startingfrom2015,in-depthanalysisandinterpretationofinjurydatawillbeconducted,andby2016,articleswillbepublishedtoreachdifferenttargetaudiences.
Thetargetistodesignatethefour major types of injuries in 2015 as thematic priorities for fundingsourcesandpromoteinterest in such research topicsthroughforum/workshop.
The component of injury surveillance(Action5)willbeintroducedinpilotschoolsin2015followedbytargetedactions in response to injury patterns specific to each school.ContinuedsupportfromEDBwillbeenlistedtorolloutarangeofinjurypreventionactionsinschoolsinthe2016/17yearandbeyond.
From2015onwards,DHwillworkwithLCSDtoexploretappingintoinjury-relatedadministrativestatisticsofgovernmentsportsamenities(e.g.sportscentre,beachandswimmingpool)foruseasaproxyforconductingsurveillanceofsportsinjury.InputwillalsobeprovidedtoLCSDforconductingcommunitybasedsurveystorevealtheprevalenceofsportsinjurytoinformpoliciesandactions that promote safe sport.
• (2B)Strengthenthe existing injury surveillancesystemtomakeitusefulandsustainable
• (2C) Promote research offeasibility,efficiencyandcost-effectivenessofinterventionstopreventinjuries
• (3A)Toworkwithgovernmentbureaux/departments,otherhealthpromotionpartners, NGOs, schools,employeesandemployersofdifferentindustriestodevelopandimplementmeasuresthataresensitivetotheneedsofthepublicinachievingpreventionofinjuries
[Action 6] Explorethepossibilityofaccessingnewsourcesofinjurydatatoenrich the existing injury surveillancesystemtoalertthepublicwhereinjuriesaremore to occur
[Action 7]Byconducting in-depthanalysisonexistingandupdateddatacollectedfromsurveys,strengthenunderstandingofthepatternandtrendofinjuries
[Action 8]Encouragemoreresearch on the four major typesofinjuriesidentified (i.e.sportsinjuries,falls,domesticinjuriesotherthanfallsanddrowning)
[Action 9] Supportschoolsto strengthen injury preventionthroughvoluntaryparticipationinhealthandsafetyprogrammescoveringschoolpolicy,injurysurveillance,firstaidtraining,staffdevelopment,studenteducation,warm-upexercisebeforesportsandparentalengagement,withalongtermgoaltofacilitatetheimplementationofEDB’sHealthySchoolPolicy
[Action 10]CollaboratewithLeisureandCulturalServicesDepartment(LCSD)to strengthen sports injury awareness,surveillanceandprevention
• DH• OtherrelevantGovernmentdepartments
• DH
• DH• OtherrelevantGovernmentdepartments/bureau
• EDB• DH
• LCSD• DH
47
Actions to strengthen prevention of unintentional injuries3
Targets and timeframeStrategic directions Recommendations Actions Lead action parties
(4) Buildcapacityandcapabilitytopreventinjuries
(5) EnsureahealthsectorthatisresponsivetotheNCDchallengesandtoimprovethehealthcaresystem
Seminarsforhealthpromotionpartnersandrelevanttargetgroupswillbeorganisedonaregularbasis.Thefirstseminarwillbeconductedforthelaunchingoftheplanin2015.
In anticipation of more injury reportsarisingfromcyclingasanincreasinglypopularactivity,workshopsorganisedbytheRoadSafetyCouncilforprimaryandsecondaryschoolswillbeenrichedwithelementsoninjurypreventionandperformanceenhancement in 2015.
Startingfrom2015,DHwillreviewrecommendationsonproductsafetyissuedbyvariousgovernmentdepartmentsandstatutorybodies,andorganisethemformoretargetedpromotionunderthe4priorityareas.
In2015,DHwillworkwithEDBandLCSDtoenrichtrainingcontentforPEteachersandcoacheswiththefocusonsportsinjuryprevention.The target is to incorporate relevanttrainingcontentfrom2016/17onwards.
Teachingmaterialswillbereviewedtotargetprimarystudents’learningneedsanddisseminatedforteachers’usefrom2016/17onwards.
Startingfrom2015,DHwillliaisewithprimarycareprovidersandNGOstoenhanceaccessofthepublicto community support servicesthataimtopreventandreduceelderlyfall.
• (4A)Developpersonalskillstoadoptinjurypreventivemeasures through communication of evidence-basedadvice
• (4B)Strengthencommunityawarenessandactionstopreventinjuries
• (5A)Engagehealthcareprofessionalsinpromoting messages andpracticesthatpreventinjuriesandidentifyingandmanaging at-risk groups
[Action 11] Engagestakeholdergroups(rangingfromserviceproviderstousers)andraisetheirawarenessoninjurypreventionandsafetypromotionthroughbriefing(s),sharingsession(s)orseminar(s)
[Action 12]Raiseawarenessandsafetyliteracyofcyclistsforthemtoadoptsafepracticesandprotectivegearwhilecycling
[Action 13] Institute community-wideeducationoninterventionsproventobeeffectiveininjurypreventioninhigh risk situations
[Action 14] Promote knowledge-basedinterventionstoPEteachersandcoachesasameanstoraisesportsperformanceandpreventsportsinjuriesusingatrain-the-trainer approach
[Action 15]Produceteachingaidstostrengthensafetyawarenessandpromoteinjurypreventionactionsbystaffandstudents.Contenttobeintroducedshouldbetailoredtostudents’academicneeds
[Action 16]Engageprimarycareprovidersindisseminationofinjurypreventioninformation to increase the accessibilityofat-riskgroupstocommunity support
• DH• NGOs
• RoadSafetyCouncil
• DH• Academia• OtherrelevantGovernmentdepartments
• DH• ConsumerCouncil
• C&ED• NGOs
• EDB• LCSD• DH• Academia
• EDB• DH• OtherrelevantGovernmentdepartments
• DH• Professionalbodies
• NGOs
48
Actions to strengthen prevention of unintentional injuries 3
49
Making it happen4
4 Making it happen
5050
Making it happen 4
4. Making it happen
4.1 TotakeforwardthisActionPlan,DHneedstoactivelyengageindialogueandcollaborative
partnershipswithNGOsandcommunitystakeholders. DHalsoneedstocommunicatethe
purpose,content,progressandachievementsof theActionPlanasaneffectivemeansof
mobilisinginter-sectoralandcross-disciplinarysupport. Adoptingthehealthleadershiprole,
theGovernmentstandsreadytoprovidepeoplewithinformationoninjurypreventionandwork
closelywithallsectorstocreatesupportiveenvironmentsforpeopletomakehealthychoicesfor
themselvesandtheirfamilies.
4.2 TheNCDchallengeahead isgreater thanever. TheWGIdoesnotunderestimatepotential
barriers,difficulties andchallenges. Notwithstanding theabove,we recogniseactive
participationbyeveryoneinthecommunityisamajorkeytosuccess.Byworkingtogether,each
ofuscanmakeHongKongasaferandhealthierplacetolive.
51
Annexes
Annexes
52
Annexes
Annex 1
Membership of Working Group on Injuries
Chairman
MrPatrickMAChing-hang,BBS,JP
Vice Chairman
DrLAMPing-yan,JP
DepartmentofHealth(February2012toJune2012)
DrConstanceCHANHon-yee,JP
DepartmentofHealth(sinceJune2012)
Members
DrCharlesCHANChing-hai
DrPeterCHANHung-chiu
DrCHOWChun-bong,BBS,JP
ProfSianGRIFFITHS,OBE,JP
MsAngieLAIFung-yee,MH
MrLIUAh-chuen,MH
MrNGSze-fuk,GBS,SBS,JP
DrKathleenSOPik-han,BBS,JP
DrPatrickYUNGShu-hang
53
Annexes
Ex-officio Members
DrThomasTSANGHo-fai,JP DepartmentofHealth(February2012toDecember2012)
DrLEUNGTing-hung,JP DepartmentofHealth(sinceDecember2012)
MrVictorHOChun-ip EducationBureau(sinceNovember2013)
MrKONGMan-keung HongKongPoliceForce(February2012toApril2013)
MrDickyLAUCheng-fung HongKongPoliceForce(sinceNovember2013)
MrTSOSing-hin,JP LabourDepartment(February2012toSeptember2012)
MrLIChi-leung LabourDepartment(sinceNovember2012)
MissOliviaCHANYeuk-oi,JP LeisureandCulturalServicesDepartment
(November2013toNovember2014)
MrRichardWONGTat-ming LeisureandCulturalServicesDepartment(sinceNovember2014)
MsCaranWONGKa-wing SocialWelfareDepartment(February2012toAugust2012)
MrFUNGMan-chung SocialWelfareDepartment(sinceNovember2012)
Secretary
DrLEUNGTing-hung,JP
DepartmentofHealth
(February2012toDecember2012)
DrReginaCHINGCheuk-tuen,JP
DepartmentofHealth
(sinceDecember2012)
54
Annexes
Annex 2
Terms of reference of Working Group on Injuries
(a) Toassesstheepidemiology,riskfactorsandsocioeconomicdeterminantsofinjuriesamongthe
localpopulation;
(b) Tomakerecommendationsonthehealthimprovementneedsofthelocalpopulationinrelation
tothepreventionofinjuries;
(c) Toreviewlocalandinternationalgoodpracticesandinterventionstrategiestopreventinjuries;
and
(d) Tomakerecommendationsonthedevelopment, implementationandevaluationofaplanof
actionforthepreventionofinjuriesinHongKong.
55
Annexes
Annex 3
Discussion topics in meetings of the Working Group on Injuries
Date Topics
Firstmeeting
Secondmeeting
Thirdmeeting
Fourthmeeting
6February2012
7January2013
29November2013
24June2014
Global Development of Injury Prevention
(WGIPaperNo.01/2012)
• DefinitionandClassificationofInjuries
• GlobalDiseaseBurdenofInjuries
• WorldHealthOrganization’sCommitmentonInjuries
• Overseasexperienceandscientifically-provenmeasures for injury
prevention
Local Situation of Injuries
(WGIPaperNo.02/2012)
• EpidemiologyandDiseaseburden
• Datacollectionandinjurysurveillance
• Localsituationofhealthpromotionformajortypesofinjuries
Strengthening Injury Prevention in Hong Kong
(WGIPaperNo.03/2013)
• PrinciplestoguidetheworkofWGI
• Identificationofpriorityareas
• TwoPillarsininjuryprevention
Recommendations to Strengthen Injury Prevention in Hong Kong
(WGIPaperNo.05/2013)
Action Plan to Strengthen Injury Prevention in Hong Kong
(WGIPaperNo.06/2014)
Action Plan toStrengthen Prevention of Unintentional Injuries in Hong Kong
Hong Kong Special Administrative Region of China
Action Plan to Strengthen Prevention of U
nintentional Injuries in Hong Kong
Nov 2014Printed by the Government Logistics Department Hong Kong Special Administrative Region of China