Community-based injury prevention: effects on health care utilization.

BACKGROUND: Worldwide, an estimated 78 million people are disabled each year because of unintentional injuries and about 3 million die. The WHO Safe Community model is a framework for community-based injury prevention programmes. The aim of this study is to evaluate the outcome on health care utilization of a Safe Community programme. METHODS: The incidence of injuries treated at health care facilities in an intervention municipality (pop. 41,000) was compared to the injury incidence in a control municipality (pop. 26,000). The incidence was recorded immediately before and one year after programme implementation from registrations made during all first-contact health care visits and from examination of hospital discharge registers. RESULTS: The incidence of health care treated injuries in the intervention area had decreased by 13% (95% CI: 9-16%) from 119 (95% CI: 115-122) per 1000 population-years to 104 (95% CI: 101-107). In the control area, the corresponding injury incidences were 104 (95% CI: 100-108) and 106 (95% CI: 102-109). The hospital-treated injuries in the intervention area decreased by 15% (95% CI: 7-24%) from 19 (95% CI: 17-20) per 1000 population-years to 16 (95% CI: 15-17), while in the control area, the incidences remained at 13 (95% CI: 11-14) per 1000 population-years. Utilization of acute care in the intervention area for reasons other than injuries increased by 8% (95% CI: 6-10%), while in the control area, the number of visits did not show significant change. CONCLUSION: This first controlled evaluation showed that an injury prevention programme based on local action groups can significantly reduce injuries requiring health care in a community. Local prevention can provide a complement to national level campaigns.     

Impact of social standing on injury prevention in a World Health Organization Safe Community--intervention outcome by household employment contract

BACKGROUND: Although social inequality in health has been an argument for community-based injury prevention programmes, intervention outcomes with regard to differences in social standing have not been analysed. The objective of this study was to investigate rates of injuries treated in health-care among members of households at different levels of labour market integration before and after the implementation of a WHO Safe Community programme. METHODS: A quasi-experimental design was used with pre- and post-implementation data collection covering the total populations <65 years of age during one year in the programme implementation municipality (population 41 000) and in a control municipality (population 26 000). Changes in injury rates were studied using prospective registration of all acute care episodes with regard to social standing in both areas during the study periods. RESULTS: Male members of households categorized as not vocationally active displayed the highest pre-intervention injury rates. Also after the intervention, males in households classified as not vocationally active displayed notably elevated injury rates in both the control and study areas. Households in the study area in which the significant member was employed showed a post-intervention decrease in injury rate among both men (P < 0.001) and women (P < 0.01). No statistically significant change was observed in households in which the significant member was self-employed or not vocationally active. In the control area, only an aggregate-level decrease (P < 0.05) among members of households in which the significant member was employed was observed. CONCLUSIONS: The study displayed areas for improvement in the civic network-based WHO Safe Community model. Even though members of non-vocationally active households, in particular men, were at higher pre-intervention injury risk, they were not affected by the interventions. This fact has to be addressed when planning future community-based injury prevention programmes.     

The global burden due to occupational injury

BACKGROUND: Occupational injuries are a public health problem, estimated to kill more than 300,000 workers worldwide every year and to cause many more cases of disability. We estimate the global burden of fatal and non-fatal unintentional occupational injuries for the year 2000. METHODS: The economically active population (EAP) of about 2.9 billion workers was used as a surrogate of the population at risk for occupational injuries. Occupational unintentional injury fatality rates for insured workers, by country, were used to estimate WHO regional rates. These were applied to regional EAP to estimate the number of deaths. In addition to mortality, the disability-adjusted life years (DALYs) lost, which measure both morbidity and mortality, were calculated for 14 WHO regions. RESULTS: Worldwide, hazardous conditions in the workplace were responsible for a minimum of 312,000 fatal unintentional occupational injuries. Together, fatal and non-fatal occupational injuries resulted in about 10.5 million DALYs; that is, about 3.5 years of healthy life are lost per 1,000 workers every year globally. Occupational risk factors are responsible for 8.8% of the global burden of mortality due to unintentional injuries and 8.1% of DALYs due to this outcome. CONCLUSIONS: Occupational injuries constitute a substantial global burden. However, our findings greatly underestimate the impact of occupational risk factors leading to injuries in the overall burden of disease. Our estimates could not include intentional injuries at work, or commuting injuries, due to lack of global data. Additional factors contributing to grave underestimation of occupational injuries include limited insurance coverage of workers and substantial under-reporting of fatal injuries in record-keeping systems globally. About 113,000 deaths were probably missed in our analyses due to under-reporting alone. It is clear that known prevention strategies need to be implemented widely to diminish the avoidable burden of injuries in the workplace.     

Injury status and perspectives on developing community safety promotion in China

The objective of this paper is to introduce the epidemiology of injuries in China, and then consider the development of safe communities in regard to injury prevention and safety promotion. The disease spectrum has changed in recent decades in the People's Republic of China. Both in cities and rural areas, injury has become the fifth leading cause of death. At least 800 000 people die from injury each year, and 50 million non-fatal injuries occur, of which 2.3 million lead to disability of varying degrees of severity. The average injury-related death rate in China from 1990 to 1997 was 66 per 100 000, which accounts for 11% of total deaths. The potential years of life lost (PYLL) of injury accounts for 24% of the total, and disability-adjusted life years (DALYs) account for 17%. Main injury causes of death, in descending order, are: suicide, traffic accident, drowning, falling, poisoning, homicide, burn and scald, and iatrogenic injury. Considering China's current injury status and its rapid societal change, injury prevention and safety promotion need to be strengthened further, and there is a special need for the development of Safe Communities programmes. The prevention of injuries through safety promotion has been increasingly focussed on over recent decades. The WHO Safe Community model is recognized as representing an effective and long-term approach to the prevention of injuries at a local level, and has been beneficially applied all over the world. A programme may cover several aspects of injury prevention and safety promotion simultaneously, or only include one or two aspects. In a Safe Community programme in China, children, the elderly, cyclists and their passengers, and farmers should be among the prioritized target populations. However, multi-focussed inter-sectoral programmes have been shown to have additional effects to distinct sectoral programmes.     

Effect of transfer, lifting, and repositioning (TLR) injury prevention program on musculoskeletal injury among direct care workers

Musculoskeletal injuries among health care workers is very high, particularly so in direct care workers involved in patient handling. Efforts to reduce injuries have shown mixed results, and strong evidence for intervention effectiveness is lacking. The purpose of our study was to evaluate the effectiveness of a Transfer, Lifting and Repositioning (TLR) program to reduce musculoskeletal injuries (MSI) among direct health care workers. This study was a pre- and post-intervention design, utilizing a nonrandomized control group. Data were collected from the intervention group (3 hospitals; 411 injury cases) and the control group (3 hospitals; 355 injury cases) for periods 1 year pre- and post-intervention. Poisson regression analyses were performed. Of a total 766 TLR injury cases, the majority of injured workers were nurses, mainly with back, neck, and shoulder body parts injured. Analysis of all injuries and time-loss rates (number of injuries/100 full-time employees), rate ratios, and rate differences showed significant differences between the intervention and control groups. All-injuries rates for the intervention group dropped from 14.7 pre-intervention to 8.1 post-intervention. The control group dropped from 9.3 to 8.4. Time-loss injury rates decreased from 5.3 to 2.5 in the intervention group and increased in the control group (5.9 to 6.5). Controlling for group and hospital size, the relative rate of all-injuries and time-loss injuries for the pre- to post-period decreased by 30% (RR = 0.693; 95% CI = 0.60-0.80) and 18.6% (RR = 0.814; 95% CI = 0.677-0.955), respectively. The study provides evidence for the effectiveness of a multifactor TLR program for direct care health workers, especially in small hospitals.     

Community Based Assessment of Unintentional Injuries in a Community Development Block of Purba Bardhaman District,West

BackgroundInjuries are a focus of public health practice because they pose a serious health threat and are preventable. Currently, injury accounts for 14% of all Disability Adjusted Life Years (DALYs) losses for the world''s entire population. In India, unintentional injuries within the home environment have not so far been recognized to the same extent as traffic and work-related injuries among all age groups. With this background, a community based epidemiological study was conducted with the aim to find out the prevalence and epidemiology of unintentional injuries.MethodsA cross-sectional study was conducted during July 2018 - June 2019 in Bhatar block of Purba Bardhaman District. Cluster random sampling was applied to select required sample of 555 individuals from 24 villages. The study tools used were a predesigned and pretested schedule developed by the researchers with the help of Guidelines for conducting community surveys on injuries by World Health Organization (WHO) and a checklist for assessing household level injury hazard. The study had approval from Institutional Ethics Committee. Chi square test and multivariable logistic regression were performed using SPSS V16.ResultsPrevalence of unintentional injury was 8.8 % in the preceding three months. Multivariable logistic regression revealed that those who were below 18 years of age, severely vulnerable to unintentional injuries and belonged to nuclear families had significantly higher odds of developing unintentional injuries at home.ConclusionUnintentional injury is prevalent in West Bengal. Dissemination of injury prevention information with special focus on household modification is an effective strategy to prevent unintentional injuries.     

National survey of the injury prevention activities of children's centres

Children's centres were established across England to provide a range of services including early education, social care and health to pre‐school children and their families. We surveyed children's centres to ascertain the activities they were undertaking to prevent unintentional injuries in the under fives. A postal questionnaire was sent to a sample of children's centre managers (n = 694). It included questions on current activities, knowledge and attitudes to injury prevention, health priorities and partnership working. Responses were received from 384 (56%) children's centres. Overall, 58% considered unintentional injury prevention to be one of the three main child health priorities for their centre. Over half the respondents (59%) did not know if there was an injury prevention group in their area, and 21% did not know if there was a home safety equipment scheme. Knowledge of how child injury deaths occur in the home was poor. Only 11% knew the major cause of injury deaths in children under five. Lack of both staff time and funding were seen as important barriers by children's centre staff to undertake injury prevention activities. Nearly all stated that training (97%) and assistance with planning injury prevention (94%) would be helpful to their centres. Children's centres need further support if they are to effectively tackle this important public health area.     

近海石油生产工人职业压力与职业性意外伤害关系的探讨

目的　探讨近海石油生产中职业压力等社会心理因素与职业性意外伤害的关系。方法采用横断面设计 ,自填问卷方式 ,对 5 6 1名海上平台作业人员进行调查。内容包括 :一般情况、职业压力、A型性格、社会支持和应对措施等社会心理因素 ,以及过去 1年工作过程中发生意外伤害情况。结果　 76人 (13.5 % )报告过去 1年发生过 1次或 1次以上职业性意外伤害 ,共计 14 1人次 ,其中 18人次严重伤、2 6人次中度伤、97人次轻微伤。控制年龄、文化程度、婚姻状况、海上工作年限和工种等潜在混杂因素后的多因素logistic回归分析表明 ,感受“工作中的管理问题及与同事间的关系”压力越大 ,发生职业性意外伤害的危险性越高 (OR =1.33,95 %CI :1.0 5～ 1.6 8,P <0 .0 5 )。缺乏朋友情感支持者较少报告意外伤害 (OR =0 .37,95 %CI:0 .2 2～ 0 .6 3,P <0 .0 0 1)。结论　提示加强对工人的培训和工作指导 ,提倡同事间的相互合作和支持 ,对降低工作中职业性意外伤害的发生有着重要意义。     

Injury mortality in the European Union 1984-1993: An overview

Background: Approximately 190,000 European Union (EU) citizensdie annually as a result of an injury. In response, the EuropeanCommission identified accidents and injuries as a priority areafor action in the field of public health in 1993. In 1984, theWorld Health Organization (WHO) Health for All targets wereset in Europe to reduce unintentional injuries by 25% and reversethe rising trends in suicide by the year 2000. The aim of thisstudy was to examine the trends in mortality due to externallycaused physical injuries between 1984 and 1993 in the 15 countrieswhich are currently members of the EU. Methods: Injury mortalitydata for all countries were obtained from the WHO and nationalgovernment agencies. Age-standardized mortality rates were calculatedfor both unintentional and intentional injuries and examinedover time. Results: Downward trends in age-standardized injurymortality due to unintentional injuries were identified in mostcountries. Marked variations were observed between countries,with low rates in the UK, The Netherlands and Sweden and highrates in Finland, Portugal and France. Age-standardized suiciderates decreased In most countries over the study period, withmarked variations between countries. In general, countries innorthern Europe experienced higher suicide rates than countriesin southern Europe. Mortality rates due to homicide and otherviolent causes were low and relatively stable over the studyperiod. Conclusions: Most countries appear to be on track tomeet the WHO targets for unintentional injury mortality andsuicide mortality. However, disparities between countries remain,for reasons that are unclear. While mortality data were valuablein describing the epidemiology of fatal injury in Europe, agreementon standardized practices of data collection, coding and analysiswould improve the comparability of data between countries.     

Global Childhood Unintentional Injury Study: Multisite Surveillance Data

Objectives. We aimed to analyze the epidemiology of childhood unintentional injuries presenting to hospitals in 5 select sites in low- and middle-income countries (LMICs) (Bangladesh, Colombia, Egypt, Malaysia, and Pakistan).Methods. We collected standardized data from children ages 0 to 12 years at participating emergency departments (EDs) in 2007. Statistical analyses were conducted to compare the characteristics of these injuries and to explore the determinants of injury outcomes.Results. Among 2686 injured children, falls (50.4%) and road traffic injuries (16.4%) were the most common, affecting boys more often (64.7%). Home injuries were more common among younger children (average 5.41 vs 7.06 years) and girls (38.2% vs 31.7%). Following an ED visit, 24% of injured children were admitted to the hospital, and 6 died. Injury outcomes were associated with risk factors, such as age and sex, to varying extents.Conclusions. Standardized ED surveillance revealed unintentional injuries are a threat to child health. The majority of events took place inside the home, challenging traditional concepts of children’s safety and underscoring the need for intensified context-appropriate injury prevention.Injuries cause upwards of 5 million deaths each year, of which unintentional injuries account for approximately 80% (3.9 million).1 Unintentional injuries kill approximately 830 000 children every year, and more than 95% of child injury deaths (both intentional and unintentional) occur in low- and middle-income countries (LMICs).2 The 5 most common unintentional injuries reported by the World Health Organization (WHO) are road traffic injuries (RTIs), falls, burns, drowning, and poisoning.2 Global aggregate data reveal that the burden of childhood unintentional injuries is highest in South-East Asia and Africa, with a cause-specific mortality of 64 and 55 children per 100 000 population, respectively.1,2 The disproportionate share of the burden of unintentional childhood injury in LMICs results from a number of factors. First, children are more susceptible to injuries because of their curious nature, which, combined with their low capacity to assess and comprehend risks, and a general lack of safe play spaces in many LMICs, puts them at high risk.3 Second, global economic trends have uprooted communities and traditional forms of subsistence, necessitating persons from rural areas moving to urban slums and at times forcing children into labor, some in hazardous conditions, to contribute to a household’s income. For instance, it has become increasingly dangerous for children to share the road with the ever-growing number of motor vehicles.2,3 In this light, unintentional injuries not only affect children themselves, leaving them temporarily hospitalized or with short- or long-term disabilities, but also adversely affect their families and society as a whole.2,4–6The WHO has called for better data collection on child injury and its determinants for the purposes of national research and investment priority settings, as well as the targeting of high-risk groups.2 Reductions in child injury mortality have been observed in several high-income countries (HICs) as a result of the implementation of evidence-based programs.2,7,8 Likewise, a number of studies have provided reliable information to characterize the pattern of injuries in HICs.9,10 Despite the high burden of unintentional injuries in LMICs, there are few studies that provide standardized data from multiple sites. In the absence of reliable national population data, hospital-based data are an important source of injury information, particularly for children.11,12 In response, the Global Childhood Unintentional Injury Surveillance (GCUIS) study was initiated to collect standardized child injury data from emergency departments (EDs) at 5 sites: Bangladesh, Colombia, Egypt, Malaysia, and Pakistan.4,13 The objectives of the GCUIS study were (1) to determine the epidemiology of 5 major childhood unintentional injuries in 5 EDs in urban LMIC sites; (2) to explore potential risk factors and determinants of injury severity and outcomes, based on the injury records in the GCUIS study; and (3) to briefly summarize the characteristics of injuries sustained in homes, based on GCUIS data.6 In 2009, partial data from GCUIS were analyzed to report the initial pattern of injuries in 4 sites.13 This article adds data from an additional site and further analyses; therefore, it provides more insights into key unintentional injuries.     

2007-2008年北京市0~6岁儿童伤害社区监测结果分析

【目的】 通过社区监测了解儿童伤害特点,制定有针对性的干预措施。 【方法】 采用分层整群抽样方法抽取北京市城市2个街道和农村3个乡镇,通过社区卫生服务中心和幼儿园监测0~6岁儿童伤害发生情况。 【结果】 2007-2008年平均每年监测0~6岁儿童8 085人,2年中,0~6岁儿童伤害发生率从2.09%下降至1.75%。儿童主要伤害原因为跌伤(49.51%)、钝器伤(12.30%)、动物伤害(10.36%)、烧烫伤(10.03%)和道路交通伤害(8.09%);城市儿童以跌伤、钝器伤为主,农村儿童以跌伤、动物伤害和道路交通伤害为主。儿童伤害主要发生地点为家中(32.04%)、幼儿园(22.98%)、院子/楼梯/楼道(14.24%)、道路(13.59%)和休闲活动场所(11.33%);主要伤害部位为头部(50.81%)、上肢(28.80%)和下肢(14.24%);以无意伤害、轻度伤害为主。 【结论】 社区伤害监测为儿童伤害预防提供了一个切实可行的数据收集途径。跌伤、钝器伤是城市儿童防范的重点,犬咬伤和自行车辐条伤是农村儿童防范重点。     

Unintentional injury mortality in India, 2005: Nationally representative mortality survey of 1.1 million homes

ABSTRACT: BACKGROUND: Unintentional injuries are an important cause of death in India. However, no reliable nationally representative estimates of unintentional injury deaths are available. Thus, we examined unintentional injury deaths in a nationally representative mortality survey. METHODS: Trained field staff interviewed a living relative of those who had died during 2001-03. The verbal autopsy reports were sent to two of the130 trained physicians, who independently assigned an ICD-10 code to each death. Discrepancies were resolved through reconciliation and adjudication. Proportionate cause specific mortality was used to produce national unintentional injury mortality estimates based on United Nations population and death estimates. RESULTS: In 2005, unintentional injury caused 648 000 deaths (7% of all deaths; 58/100 000 population). Unintentional injury mortality rates were higher among males than females, and in rural versus urban areas. Road traffic injuries (185 000 deaths; 29% of all unintentional injury deaths), falls (160 000 deaths, 25%) and drowning (73 000 deaths, 11%) were the three leading causes of unintentional injury mortality, with fire-related injury causing 5% of these deaths. The highest unintentional mortality rates were in those aged 70 years or older (410/100 000). CONCLUSIONS: These direct estimates of unintentional injury deaths in India (0.6 million) are lower than WHO indirect estimates (0.8 million), but double the estimates which rely on police reports (0.3 million). Importantly, they revise upward the mortality due to falls, particularly in the elderly, and revise downward mortality due to fires. Ongoing monitoring of injury mortality will enable development of evidence based injury prevention programs.     

Local injury information,community participation and injury reduction

Abstract: Better injury prevention is now a national health priority in Australia. Applying the health promotion strategies of the Ottawa Charter to injury prevention forms the basis of the World Health Organization's worldwide Safe Communities program. Taking such a community-focused approach has led to quantifiable reductions in injuries in several overseas countries, particularly in Scandinavia where falls of up to 30 per cent in particular injuries have been reported over a three-year period. In the Illawarra area of New South Wales, data from local hospital emergency departments have been used as the basis for a ‘community information’ strategy, in an attempt to replicate this overseas experience in an Australian setting. Reductions of 17 per cent in attendances by children for injuries (P < 0.001) and a 14 per cent fall in accident-related hospital admissions of children (not statistically significant) have been observed over the course of the four-year intervention. Problems of community definition and external confounding influences outside the control of the project make it difficult to confirm a causal relationship. However, community information forms one important component in a comprehensive local injury-reduction strategy.     

2006－2013年全国伤害监测系统中儿童道路交通伤害病例变化趋势及现况特征分析

目的 了解中国儿童道路交通伤害门/急诊病例变化趋势及现况特征,为制定相关干预措施和政策提供依据.方法 利用2006-2013年全国伤害监测系统(NISS)数据,分析儿童道路交通伤害病例变化趋势及人口学、伤害事件和临床等现况特征.结果 2006-2013年NISS儿童道路交通伤害病例数量呈上升趋势,一直居儿童非故意伤害发生原因的第二位,但占儿童非故意伤害病例总数的比例呈下降趋势.2013年儿童道路交通伤害男女性别比值为1.82,17岁年龄段占10.86％;机动车车祸病例占66.44％,7、8月、周末和17:00-18:00时为高发期,65.42％的伤害是发生在驾乘交通工具时;伤害性质73.53％为挫伤/朦伤,伤害部位33.81％为头部,轻病例占76.42％,伤者74.86％的就医结局为治疗后回家.结论 儿童道路交通伤害问题不容忽视,中学高年级男生和学龄前男童是儿童道路交通伤害干预的重点人群,应针对不同年龄和性别儿童开展道路交通安全教育.     

中国部分地区2012-2014年中学生意外伤害流行现状

分析中国4个地区2012-2014年中学生意外伤害流行病学状况及变化趋势,为中学生意外伤害防控提供依据.方法 汇总新乡、阳江、重庆和沈阳4个地区2012-2014年在校中学生意外伤害的调查数据,比较不同人口统计学特征间意外伤害检出率的差异及不同年份间检出率的变化趋势.结果 2012-2014年,中学生意外伤害检出率分别为39.1%,39.2%和34.2%,最常见的意外伤害类型是跌落伤(18.4%)、切割伤(14.7%)、烧烫伤和腐蚀伤(9.4%)、动物咬伤(7.6%)和道路交通伤(6.3%).男生2012-2014年意外伤害的检出率分别为40.7%,40.1%和37.0%,女生依次为37.6%,37.2%和31.6%,男生意外伤害检出率均高于女生(P值均<0.01);初中生意外伤害的检出率分别为40.5%,41.9%和36.0%,高中生依次为37.7%,36.5%和32.5%,初中生意外伤害检出率高于高中生(P值均<0.01);意外伤害的检出率在地区之间差异也均具有统计学意义(P值均<0.01),其中新乡和阳江地区检出率呈下降趋势,而重庆和沈阳地区则表现出先升后降的变化趋势.结论 四地区意外伤害检出率虽有下降趋势,但仍有近1/3的中学生受到意外伤害的危害.预防中学生意外伤害是应对公共卫生领域变化的重要举措.     

学龄前儿童意外伤害流行病学调查

目的了解幼儿园儿童意外伤害发生状况。方法回顾性调查武汉市某幼儿园463名3~6岁学龄前儿童1年间意外伤害的发生情况。结果幼儿园儿童意外伤害发生率为11.45%;家中和幼儿园是易发生伤害的场所;意外跌落为最常见的伤害;伤害部位以头部为主;发生季节以夏、冬季较多;伤害程度以轻度居多;伤害的人均治疗费用453.43元,以自费为主。结论幼儿园儿童意外伤害发生率较高,应加强安全管理和教育,预防儿童意外伤害。     

Injury and Illness Costs in the Certified Safe Farm Study

CONTEXT: The Certified Safe Farm (CSF) intervention program aims to reduce occupational injuries and illnesses, and promote wellness to reduce health care and related costs to farmers, insurers, and other stakeholders. PURPOSE: To evaluate the cost effectiveness of CSF. METHODS: Farms (316) located in a 9-county area of northwestern Iowa were recruited and randomized into intervention and control cohorts. Intervention farms received occupational health screenings, health and wellness screening, education, on-farm safety reviews, and performance incentives. For both cohorts, quarterly calls over 3 years were used to collect self-reported occupational injury and illness information, including costs to the farmers and their insurers. FINDINGS: Annual occupational injury and illness costs per farmer paid by insurers were 45% lower in the intervention cohort ($183) than in the control cohort ($332). Although out-of-pocket expenses were similar for both cohorts, combined costs of insurance and out-of-pocket expenses were 27% lower in the intervention cohort ($374/year per farmer) compared to the control cohort ($512/year per farmer). Within the cohort of intervention farmers, annual occupational injury and illness cost savings were directly associated with on-farm safety review scores. Reported health care costs were $237 per farmer in the safest farms (those farms scoring in the highest tertile) versus $485 per farmer in the least safe farms (lowest tertile). CONCLUSIONS: Results suggest that farmers receiving the intervention had lower health care costs for occupational injuries and illnesses than control farmers. These cost savings more than cover the cost of providing CSF services (about $100 per farm per year).     

Safe Communities in China as a Strategy for Injury Prevention and Safety Promotion Programmes in the Era of Rapid Economic Growth

Due to its rapid economic development, China is facing a huge health, social, and economic burden resulting from injuries. The study’s objective was to examine Safe Communities in China as a strategy for injury prevention and safety promotion programmes in the era of rapid economic growth. Literature searches in English and Chinese, which included grey literature, were performed on the Chinese Journal Full-text Search System and Medline, using the words “Safe Community”, “injury”, “economics”, and “prevention”. The results showed that the existing 35 recognized members of the International Safe Community Network have not placed due emphasis on suicide prevention, which is one of the leading problems in both rural and urban China. A few groups, such as children, the elderly, cyclists, and pedestrians, have received due emphasis, while other vulnerable groups, such as migrant workers, motorcyclists, students, players, and farmers have not received the necessary attention from the Safe Community perspective. As the evidence describes, Safe Communities in China can be a very effective strategy for injury prevention, but four aspects need to be strengthened in the future: (1) establish and strengthen the policy and regulations in terms of injury prevention at the national level; (2) create a system to involve professional organizations and personnel in projects; (3) consider the economic development status of different parts of China; and (4) intentional injury prevention should receive greater attention.     

A prospective population based study of childhood injuries: the Velestino town study

BACKGROUND: Unintentional injuries in childhood constitute a significant public health problem. Our purpose is to estimate the incidence of identifiable unintentional childhood injuries of any type and severity, and to document risk factors of non-transient nature. METHODS: We have undertaken a prospective population-based investigation in a Greek town with a population of 748 children (0-14 years old). All identifiable injuries have been monitored during a twelve-month period through information provided by the health care outlets or educational institutions as well as the police station and the regional hospital. RESULTS: The overall incidence was 28.2 per 100 person-years (95% confidence interval from 24.4 to 32.0), whereas the incidence of injuries with Hopkins Injury Severity Score equal to or higher than four was 6.3 with 95% confidence interval 4.5 to 8.1. The incidence of total injuries was higher among boys than among girls (p<0.01) and the gender difference was particularly evident among older children. Almost half of the injuries were due to falls and more than 20% were due to cutting. Children of younger and less educated parents have higher risk for injury and children from families with more injuries were more likely to be injured themselves. There was no evidence that somatometric characteristics were associated with injury risk. CONCLUSION: The incidence of unintentional childhood injuries is high and represents a considerable health burden. Family related variables are important risk factors for childhood injuries, whereas somatometric characteristics play a minimal role. Key points: Incidence and risk factors of all injuries in a population-based study among children. About 28 per 100 children got injured over a period of one year. There is evidence that younger paternal age and lower education may be associated with increased injury risk. Family related variables seem to be important risk factors for childhood injuries, whereas somatometric characteristics play minimal role.