CHP 200: Community Health Program-lMohamed M. B. Alnoor

SAFETY and INJURY PREVENTION

Characterize injury as a public health problem

Detail the impact of injury Identify control strategies Highlight the key elements of effective

programs Address obstacles and catalogue

resources Identify provider’s role in prevention

Purpose

Injury: Physical damage due to transfer of energy

kinetic thermal chemical electrical radiant Over a period of time, “exposure”

that is either acute or chronic

Definition:

KSA Traffic accidents > 275,000 persons (men,

women and children) 6,000 deaths ( 16 per day )

- 60% : reckless driving- 34 % : speeding

1/3 of all hospital beds SR26 billion

The toll:

In USA 80% blunt, 20% penetrating Motor vehicle, gunshot, falls etc.. Drowning, poisonings 5th leading cause of death (1996) First, age 1 through 44 (1996)

Mechanism, Outcomes

Disability far exceeds death rate

First, age 1- 44 “Years of life lost” (YLL) concept:

-Life expectancy for young shortened by death from injury

-Comparable with heart disease and cancer

-Young and productive members of society!

Disability, Outcomes

Accident: An unexpected occurrence, happening by chance

Injury: A definable, correctable event, with specific risks for occurrence

A result of risk poorly managed “Disease of injury” concept Injury can be prevented!

Injury, Not Accident!

Epidemiologic Triangle

“Prevention is the vaccine for the disease of injury”.

Environment Host

AGENT

A causalrelationship

!

The 4 E’s: Education Enactment/Enforcement Engineering Economic incentives/ penalties

General Principles

ENVIRONMENT VEHICLE HUMAN

VISIBILITYPAVEMENTSIGNALSCONSTRUCTION

DEFECTSBREAKSTIRESAVOIDANCE SYSTEMS

AGEEXPERIENCEALCOHOL DRUGSSPEED

PRE EVENT

GUARD RAILSMEDIANSBREAKAWAY POSTS

AIR BAGSAUTOMATIC BELTSCRASHWORTHINESS

BELT USE HELMET USETOLERANCE

EVENT

EMS SYSTEMFIRST RESPONDERBYSTANDER CARE

FUPOST-CRASH FIRE

EL LEAKS

AGE PHYSICAL CONDITION

POST EVENT

Factors influencing Road Injuries ,The Haddon Matrix

Public Health ApproachFive steps:

What is the problem?SurveillanceWhat is the cause?Risk

identificationWhat works?Intervention

How do you do it?Implementation

Did it work? Outcome measurement

Categories of injury prevention:

Primary prevention:

Secondary prevention:

Tertiary prevention:

Eliminate the event

Diminish effect

Improve outcomes

Examples of effective injury prevention: National highway speed limits

Apartment window guards

Smoke detectors

Child passenger restraint laws

“Cycle” helmet laws

Strategies of injury prevention:

Direct Costs• Medical Costs (including worker’s comp)• Indemnity Payments

Indirect Costs• Time Lost (by worker and supervisor)• Schedule delays• Training new employees• Cleanup time / equipment repairs• Legal fees

Cost of Accidents

The Iceberg Effect

Cost of Accidents

On average, the indirect costs of accidents exceed the direct costs by a 4:1 ratio

Causes of AccidentAccidents are caused by:

Unsafe conditions Unsafe acts

Unsafe Conditions Easiest to correct (and very cost

effective) Easiest to prevent

• Safety audits• Safety inspections• Maintenance schedules for equipment

• Encouraging employee reporting• Good housekeeping

Causes of Accident

Unsafe Acts Most difficult to address

• Changing behavior isn’t easy Best prevented by developing a “safety culture”

Causes of Accident

Establish accountability for safety

Define safety responsibilities

Safety Cultures

Establish accountability for safety

Employees should be evaluated on their safety performance Doing a job correctly includes doing it safely

Safety Cultures

Define safety responsibilities Employee responsibilities include

Safety Cultures

Maintaining good housekeeping Recognizing and reporting safety hazards

Using personal protective equipment (PPE)

Define safety responsibilities

Employer responsibilities include

Safety Cultures

Providing access to information Providing personal protective

equipment Providing training

Preventing Sports InjuriesEquipment / Field Changes

Rule Changes / Coaching

Individual Preparation

Equipment Changes to prevent injuriesAdd equipment :

Chin protectors

Field/Equipment Changes

Helmets

Preventing Sports Injuries

Field modifications to prevent injuries Avoid :

Potholes

grates Anchoring soccer goals

Field/Equipment Changes

Preventing Sports Injuries

Rule Changes/Coaching Rule changes to adjust for injury

patternsExample = “spearing” in football

Officials Must enforce the established rules

Coaches Teach the appropriate techniques

Preventing Sports Injuries

Learn about the game prior to signing up Is this sport appropriate for your child? Does your child wish to participate? Who will be supervising practices/games?

Purchase the recommended equipment

Pre-participation physical examPreseason conditioning

Individual Preparation Prior to Participation

Preventing Sports Injuries

Practice within your limitsStay well-hydratedKnow and follow the rules of the

game

Preventing Sports InjuriesIndividual Preparation

At Participation

If injured Seek medical attention prior to

returning to play Adequate rehabilitation is essential

Preventing Sports InjuriesIndividual Preparation

At Participation

ENVIRONMENT VEHICLE HUMAN

PRE EVENT

EVENT

POST EVENT

Factors influencing Road Injuries ,The Haddon Matrix