Injuries Are Not AccidentsYuan, Zhanpeng, Ph.D.
Tel.6875 9982; 139 8612 0848E-mail: email@example.com
To Get Aware of Accident in PHNew Course Contentat least to me
How to Deal with Accidents as a PH Practitioner?Objectives
The Types and Study of Injuries
Due to Accident?
What to do from a PH perspective?
Injuries Defined by WHOResulting from traffic collisions, drowning, poisoning, falls or burns - and violence - from assault , self-inflicted violence or acts of warkill more than five million people worldwide annually and cause harm to millions moreAccount for 9% of global mortality, and are a threat to health in every country of the world.
For every death, it is estimated that there are dozens of hospitalizations, hundreds of emergency department visits and thousands of doctors appointmentsA large proportion of people surviving their injuries incurs temporary or permanent disabilities.
Leading Injury Categories
Major Types of Injury in USAMotor Vehicle InjuriesOccupantsRoad SharersPedestrains, Motorcyclists, and Bicyclists
Firearms2nd leading cause in US
Other PlacesSource: http://chartsbin.com/view/0lz
Injury from A PH PerspectiveAn emerging topic in global health todayinjury epidemiologyInjuries represent a significant burden today in both developed and developing economies
Capture our interest very frequently through catastrophesan airplane crash or the car crash in which Princess Diana diedTo reduce their burden into the futureMany questions remain about the appropriate way to do this
A couple drowns after their boat capsizes with no life vests on board. These incidents are often dismissed as "accidents." Correcting these misperceptions is part of the mission of the Harborview Injury Prevention and Research Center (HIPRC).
In 1985, the National Academy of Sciences issued a report that described injuries as the "most important public health problem facing our nation today". That same year the HIPRC was formed as one of the first centers in the nation specifically devoted to research on and prevention of injuries.
To Study Injury
Injury EpidemiologyAn Introduction
From The Epidemiological PstvWhat are injuries?
Why should we have an interest in injuries and research into the epidemiology of injuries?
Causes of InjurySource: http://www.pitt.edu/~super1/lecture/lec0231/index.htm
All injuries can be characterized as suchInjuries arising from automobile crashes can be characterized as injuries which arise from the transfer of energy between the victim and a stationary object (the ground) or a moving object (another vehicle), which lead to trauma and possibly death. Abnormal Energy Transfer
Ways of Energy Transfer n InjuryPenetrating
Energy Transfer and InjuryPenetratinglocalized in one area
Non-Penetratingdispersed over a broad area
Burnthermal energy transfer
Major Mechanical InjuriesMotor vehicle accidents
OtherThey count for 74%
Facts about Injury in Ontario, CD
Where Does Epidemiology Tie in?Epidemiologists interested in injuries?Injuries, a leading cause of mortality and morbidity in both the developed and developing worldchallenge to both understand the basic underpinnings of their occurrence (the frequency risk factors) and to develop intervention programs to reduce their impactthe work of William HaddonElegantly outlined how epi applications have relevance to injuries (discussed further later)
Where Do Injuries Stand among"The Global Burden of Disease", Harvard University Press, 1996.
Injuries Standings in USA
YLL, or YPLL as in The Textbook
What factors may account for this observation?
What events could explain this observation? Several factorsThe item of comparison, injury mortality, is quite broad. Injuries encompass a wide variety of categories, from accidents to homicides to falls and poisonings.Injuries from one category, e.g. crashes or violence, may be more common in some areasPublic transport systems may be better developed in some areasEconomic development in its initial stages may lead to higher rates of occupational injuries. Can you think of other reasons?
What to Do about Injuries?Injury ControlIn its simplest form, injury prevention and control represents a reduction in the incidence and/or prevalence of an injury
John Last in the Dictionary of Epidemiology (Oxford University Press)Prevention of injuries is characterized by a reduction in the incidence of injury events.Injury control denotes the programs that seek to reduce the frequency and severity of injuries.
Without a doubt, the father of injury epidemiology and injury control is William Haddon. The former director of the National Highway Traffic Safety Administration and the Insurance Institute for Highway Safety played a leading role in bringing epidemiologic principles to injury research and intervention programs.
Source: Hargarten SW. International travel and motor vehicle crash deaths; the problem, risks and prevention. Travel Medicine International 106-109, 1991.
Recommended ReadingBaker SP, O'Neill B, Ginsburg MJ, Li G: The Injury Fact Book. New York: Oxford University Press, 2nd ed., 1992. Chang DC, Tencer AF, Triece B, et al: Geometric changes in the cervical canal during impact. Spine 1993; 19:1(55-172. Grossman DC, Milligan BC, Deyo RA: Risk factors for suicide attempts among Navajo adolescents. Am J Public Health 1991; 81:870-4. Jaffe KM, Fay GC, Polissar NL, et al: Severity of pediatric traumatic brain injury and neurobehavioral recovery at one year: A cohort study. Arch Phys Med Rehabil 1993; 74:587-595. Jurkovich GJ, Rivara FP, Gurney JG, et at: The effect of acute alcohol intoxication and chronic alcohol abuse on outcome from trauma. JAMA 1993; 270:51-56. Koepsell TD, Wolf ME, McCloskey L, et at: Medical conditions and motor vehicle collision injuries in older adults. J Am Geriatric Soc 1994; 42:695-700. National Academy of Sciences. Injury in America. Washington, DC: National Academy Press, 1985. Sloan JH, Kellermann AL, Reay DT, et at: Handgun regulations, crime, assaults and homicide: A tale of two cities. N Engl J Med 1988; 319:1256-1262. Thompson RS, Rivara FP, Thompson DC: A case control study of the effectiveness of bicycle safety helmets. N Engl J Med 1989; 320:1361-1367.