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The
Sig
nific
ance
of A
ccid
ents
•M
ore
than
400
Am
eric
ans
die
each
day
du
e to
inju
ries
from
acc
iden
ts•
Mos
t peo
ple
expe
rienc
e a
sign
ifica
nt in
jury
at
leas
t onc
e in
thei
r lif
etim
e•
Man
y ar
e di
sabl
ed o
r in
cur
larg
e m
edic
al
cost
s
His
tory
of I
njur
y P
reve
ntio
n
•Jo
hann
Pet
er F
rank
sug
gest
ed th
at a
ccid
ent
prev
entio
n ac
tiviti
es s
houl
d be
par
t of a
co
mpr
ehen
sive
hea
lth p
rogr
am in
178
8–
The
goa
l was
to te
ach
or m
otiv
ate
citiz
ens
to
act s
afet
y–
The
cou
ntry
was
prim
arily
rur
al–
Uni
nten
tiona
l inj
urie
s w
ere
attr
ibut
ed to
hu
man
err
or–
An
emph
asis
on
indi
vidu
al r
espo
nsib
ility
mad
e se
nse
His
tory
of I
njur
y P
reve
ntio
n (c
ontin
ued)
•In
the
early
190
0s a
utom
obile
mak
ers
and
insu
ranc
e co
mpa
nies
beg
an r
esea
rch
on
acci
dent
s–
The
focu
s w
as o
n hi
gh-r
isk
indi
vidu
als
and
high
-ris
k be
havi
ors
–P
reve
ntio
n st
rate
gies
focu
sed
on th
e in
divi
dual
•P
sych
olog
ists
em
phas
ized
the
impo
rtan
ce o
f em
otio
nal a
ntec
eden
ts to
life
eve
nts
from
191
5 to
19
40–
It w
as a
ccep
ted
that
som
e in
divi
dual
s w
ere
“acc
iden
t pro
ne”
Acc
iden
t Pro
ne In
divi
dual
s?
•A
lthou
gh r
esea
rch
pers
iste
d on
the
acci
dent
pr
one
pers
onal
ity fo
r 50
yea
rs, n
o on
e ty
pe o
f pe
rson
was
mor
e “p
rone
” th
an o
ther
s •
Psy
chol
ogic
al in
terv
entio
ns d
id n
ot a
ppea
r to
w
ork
for
thos
e w
ho e
xper
ienc
ed m
ore
acci
dent
s•
It w
as d
eter
min
ed a
ccid
ents
wer
e ca
used
by
hum
an e
rror
, pro
duct
des
ign,
men
tal o
r ph
ysic
al
impa
irmen
t, en
viro
nmen
tal c
ondi
tions
, and
oth
er
fact
ors
J. J
. Gib
son
(190
4–19
79)
•A
psy
chol
ogis
t ins
trum
enta
l in
chan
ging
pe
rcep
tions
abo
ut a
ccid
ent c
ause
s•
Bef
ore
his
wor
k ac
cide
nts
wer
e co
nsid
ered
ran
dom
eve
nts
for
whi
ch n
o on
e bu
t the
vic
tim w
as r
espo
nsib
le•
He
defin
ed a
n ac
cide
nt a
s an
“u
ncon
trol
led,
unp
lann
ed r
elea
se o
f en
ergy
tran
sfer
”
J. J
. Gib
son
(190
4–19
79)
(con
tinue
d)
•J.
J. G
ibso
n id
entif
ied
five
agen
ts c
ausi
ng
inju
ries:
–K
inet
ic o
r m
echa
nica
l ene
rgy
–C
hem
ical
ene
rgy
–T
herm
al e
nerg
y–
Ele
ctric
al e
nerg
y–
Rad
ioac
tive
ener
gy
Hug
h D
eHav
en (
1895
–198
0)
•A
pilo
t in
WW
I w
ho w
as a
ble
to w
alk
away
fr
om a
ser
ious
cra
sh•
Beg
an c
rash
inve
stig
atio
n re
sear
ch a
nd
cras
h te
stin
g•
His
wor
k re
sulte
d in
bet
ter
auto
mob
ile
desi
gn, s
eat b
elts
, and
air
bags
to r
educ
e th
e se
verit
y of
acc
iden
tal i
njur
ies
Dr.
Joh
n S
tapp
(19
10–1
999)
•A
n A
ir F
orce
col
onel
inve
stig
atin
g sa
fety
ha
rnes
ses
for
pilo
ts•
Con
duct
ed e
xper
imen
ts o
n bi
omec
hani
cs
of a
ccel
erat
ion
and
dece
lera
tion
at h
igh
spee
ds•
He
was
kno
wn
to p
erso
nally
test
saf
ety
harn
esse
s su
bjec
ted
to e
xtre
me
ener
gy
tran
sfer
forc
es
Dr.
Joh
n E
. Gor
don
(189
0–19
83)
•A
col
onel
in th
e m
ilita
ry in
WW
II•
Stu
died
non
battl
e in
jurie
s ex
perie
nced
du
ring
war
, pra
ctic
es, a
nd o
n le
ave
•S
tudi
ed th
e di
strib
utio
n of
cau
ses
of in
jury
be
caus
e he
bel
ieve
d ep
idem
iolo
gy w
as
usef
ul fo
r st
udyi
ng a
ccid
ents
Ros
s M
cFar
land
(19
01–1
976)
•A
psy
chol
ogis
t and
trai
ner
of a
viat
ion
med
icin
e sp
ecia
lists
•D
ocum
ente
d th
at h
ighw
ay c
rash
es a
mon
g m
ilita
ry p
erso
nnel
wer
e m
ore
prev
alen
t th
an p
lane
cra
shes
•A
pplie
d er
gono
mic
s to
sho
w th
at g
ear
shift
de
sign
wou
ld r
educ
e th
e nu
mbe
r of
ac
cide
nts
Erg
onom
ics
•A
fter
WW
II th
e fie
ld o
f erg
onom
ics
was
bo
rn•
“The
bod
y of
kno
wle
dge
abou
t hum
an
abili
ties,
hum
an li
mita
tions
, and
oth
er
hum
an c
hara
cter
istic
s re
leva
nt to
des
ign”
•U
sed
to d
esig
n to
ols,
mac
hine
s, s
yste
ms,
ta
sks,
jobs
, and
env
ironm
ents
for
safe
hu
man
use
Dr.
Will
iam
Had
don
(192
6–19
85)
•A
n en
gine
er a
nd p
ublic
hea
lth p
hysi
cian
for
New
Y
ork,
“th
e fa
ther
of i
njur
y ep
idem
iolo
gy a
nd
inju
ry c
ontr
ol”
•B
elie
ved
the
way
to
redu
ce in
cide
nce
and
seve
rity
of a
ccid
ents
was
to s
tudy
the
kin
etic
en
erg
yin
volv
ed•
Look
ed a
t the
cra
sh s
eque
nce
for
his
rese
arch
•H
is w
ork
repr
esen
ted
the
first
epi
dem
iolo
gica
l st
udy
for
inju
ry r
esea
rch
that
incl
uded
rel
ativ
e ris
k an
d in
tera
ctio
n of
con
trib
utor
y fa
ctor
s
The
Had
don
Mat
rix
•T
hree
pha
ses
of a
n ac
cide
nt1.
Pre
-inju
ry p
hase
Whe
n co
ntro
l of e
nerg
y ex
pend
iture
is lo
st2.
Inju
ry p
hase
Less
than
one
sec
ond;
whe
n en
ergy
is
tr
ansf
erre
d to
peo
ple
and
caus
es d
amag
e3.
Pos
t-in
jury
pha
seW
hen
atte
mpt
s ar
e m
ade
to r
epai
r th
e da
mag
e an
d re
gain
phy
siol
ogic
al
hom
eost
asis
Ral
ph N
ader
(19
34–p
rese
nt)
•H
is 1
959
artic
le T
he S
afe
Car
You
Can
’t B
uyde
clar
ed th
at a
utom
obile
mak
ers
wer
e de
sign
ing
cars
for
styl
e, c
ost,
and
perf
orm
ance
whi
le ig
norin
g ac
cide
ntal
in
jurie
s, d
isab
ilitie
s, a
nd d
eath
s•
His
196
5 bo
ok U
nsaf
e at
Any
Spe
edfo
cuse
d on
env
ironm
enta
l asp
ects
of t
he
pre-
cras
h an
d cr
ash
phas
es o
f aut
o ac
cide
nts
Ral
ph N
ader
(19
34–p
rese
nt)
(con
tinue
d)
•H
e ta
rget
ed G
ener
al M
otor
s’ fa
ulty
rea
r su
spen
sion
sys
tem
on
the
Cor
vair
•H
e dr
ew a
ttent
ion
to th
e fa
ct th
at s
ome
auto
mob
ile m
anuf
actu
rers
wer
e hi
ding
in
form
atio
n ab
out p
rodu
ct s
afet
y•
He
foun
ded
the
NG
O P
ublic
Citi
zen,
cr
edite
d w
ith th
e pa
ssag
e of
sev
eral
law
s ap
prop
riate
to e
nviro
nmen
tal h
ealth
Pub
lic H
ealth
Initi
ativ
es
•T
he W
. K. K
ello
g F
ound
atio
n aw
arde
d gr
ants
for
publ
ic h
ealth
dem
onst
ratio
n pr
ojec
ts in
the
1950
s an
d 19
60s
•T
he D
ivis
ion
of S
peci
al H
ealth
Ser
vice
s fo
r th
e U
.S. P
ublic
Hea
lth S
ervi
ce in
itiat
ed in
jury
con
trol
pr
ogra
ms
for
–R
adio
logi
cal h
ealth
–T
uber
culo
sis
–A
ir po
llutio
n–
Chr
onic
dis
ease
s
U.S
. Gov
ernm
enta
l Age
ncie
s
•In
195
6 th
e D
ivis
ion
of A
ccid
ent
Pre
vent
ion
was
add
ed to
add
ress
hig
hway
an
d no
nhig
hway
saf
ety
conc
erns
•In
196
7 th
e N
atio
nal H
ighw
ay S
afet
y B
urea
u (N
HS
B)
was
form
ed w
ith D
r.
Had
don
as d
irect
or; i
t was
late
r re
nam
ed
the
Nat
iona
l Hig
hway
Tra
ffic
Saf
ety
Adm
inis
trat
ion
(NH
TS
A)
U. S
. Gov
ernm
enta
l Age
ncie
s (c
ontin
ued)
•In
the
1970
s, th
e C
onsu
mer
Pro
duct
S
afet
y C
omm
issi
on w
as c
reat
ed•
Em
erge
ncy
med
ical
ser
vice
s w
ere
also
ex
pand
ed in
the
1970
s to
red
uce
deat
hs
due
to a
ccid
ents
•In
the
1980
s, s
ubst
antia
l im
prov
emen
ts in
hi
ghw
ay s
afet
y ha
d be
en g
aine
d
U. S
. Gov
ernm
enta
l Age
ncie
s (c
ontin
ued)
•In
198
5 th
e C
omm
ittee
on
Tra
uma
Res
earc
h pu
blis
hed
Inju
ry in
Am
eric
are
port
ing
all i
njur
ies
•A
fter
that
, Con
gres
s–
Pro
vide
d fu
ndin
g fo
r in
jury
con
trol
res
earc
h to
th
e C
ente
rs fo
r D
isea
se C
ontr
ol–
Est
ablis
hed
the
Nat
iona
l Cen
ter
for
Inju
ry
Pre
vent
ion
and
Con
trol
•T
he A
mer
ican
Pub
lic H
ealth
Ass
ocia
tion
(AP
HA
) re
esta
blis
hed
its in
jury
con
trol
sec
tion
Inte
ntio
nal I
njur
ies
•T
hose
that
res
ult w
hen
one
pers
on in
tend
s to
har
m h
imse
lf/he
rsel
f or
anot
her
pers
on–
Hom
icid
e–
Sui
cide
–R
ape
–D
omes
tic v
iole
nce
•P
hysi
cal a
ssau
lt•
Oth
er a
busi
ve b
ehav
iors
Hom
icid
e
•N
early
hal
f of a
ll de
aths
from
fire
arm
in
jurie
s ar
e vi
ctim
s of
hom
icid
e•
The
mur
der
rate
has
falle
n to
its
low
est
leve
l in
thre
e de
cade
s (6
per
100
,000
po
pula
tion)
•It
is th
e th
ird le
adin
g ca
use
of d
eath
for
child
ren
ages
5 to
14
year
s of
age
•M
ore
than
80%
of i
nfan
t hom
icid
es a
re th
e re
sult
of c
hild
abu
se b
y pa
rent
s
Sui
cide
•U
sual
ly s
elf-
infli
cted
•D
iffic
ult t
o de
term
ine
as n
ot a
ll su
icid
al
deat
hs a
re id
entif
ied
•S
uici
de r
ates
are
ver
y hi
gh a
mon
g yo
ung
peop
le in
Jap
an, C
hina
, Eur
ope,
and
the
U.S
.
Dom
estic
Vio
lenc
e
•P
hysi
cal v
iole
nce
and
abus
ive
beha
vior
le
adin
g to
inte
ntio
nal i
njur
y•
Unf
ortu
nate
ly v
ery
com
mon
•A
ssau
ltis
a v
erba
l thr
eat
•B
atte
ryis
a p
hysi
cal t
hrea
t
Rap
e
•It
is in
tent
iona
l, no
t an
acci
dent
•It
is a
crim
e of
vio
lenc
e, n
ot p
assi
on•
For
ced
sexu
al in
terc
ours
e–
The
re is
phy
sica
l dam
age,
psy
chol
ogic
al
dam
age,
and
pos
t-tr
aum
atic
syn
drom
e
•S
tatu
tory
rap
e is
sex
with
a m
inor
und
er
age
21•
It ca
n le
ad to
arr
est a
nd p
rose
cutio
n
Uni
nten
tiona
l Inj
urie
s
•Im
plie
s ci
rcum
stan
ces
that
cou
ld n
ot b
e av
oide
d; e
rror
s in
judg
men
ts; p
oor
heal
th;
or la
ck o
f phy
sica
l abi
lity
to a
void
har
m•
Cou
ld b
e du
e to
hum
an e
rror
, fau
lty
prod
uct d
esig
n, im
pairm
ent,
envi
ronm
enta
l co
nditi
ons,
and
oth
er fa
ctor
s•
The
lead
ing
caus
e of
dea
th fo
r in
divi
dual
s un
der
age
45•
Fift
h le
adin
g ca
use
of d
eath
in th
e U
.S.
Uni
nten
tiona
l Inj
urie
s: M
VA
s
•M
otor
veh
icle
acc
iden
ts (
MV
As)
are
the
mos
t com
mon
cau
se o
f dea
th 1
5–25
yea
rs
of a
ge•
Tee
nage
rs h
ave
the
high
est r
ate
of M
VA
-re
late
d de
aths
•S
enio
rs o
ver
age
75 a
re th
e se
cond
hi
ghes
t•
MV
As
are
the
mos
t com
mon
cau
se o
f se
rious
inju
ry
DU
I/DW
I
•D
rivin
g U
nder
the
Influ
ence
(D
UI)
or
Driv
ing
Whi
le In
toxi
cate
d (D
WI)
acc
ount
s fo
r 45
% o
f MV
A fa
talit
ies
•T
he h
ighe
st in
toxi
catio
n ra
tes
in fa
tal
cras
hes
wer
e am
ong
21–2
4 ye
ar o
lds
•Y
oung
driv
ers
arre
sted
for
DU
I/DW
I are
fo
ur ti
mes
mor
e lik
ely
to d
ie in
a fu
ture
M
VA
Zer
o T
oler
ance
Law
s
•M
any
stat
es h
ave
this
law
•It
does
not
mat
ter
wha
t the
blo
od a
lcoh
ol le
vel
(BA
C)
is o
f a m
inor
•T
he u
se o
f pre
scrip
tion
pain
kille
rs a
nd o
ver-
the-
coun
ter
antih
ista
min
es a
re tr
eate
d th
e sa
me
if th
e pe
rson
is d
rivin
g•
If an
und
erag
e pe
rson
is c
augh
t driv
ing
unde
r th
e in
fluen
ce o
f dru
gs o
r al
coho
l (D
UI o
r D
UIA
) th
eir
licen
se c
an b
e re
voke
d, th
ey c
an s
pent
tim
e in
jail,
and
a fi
ne m
ust b
e pa
id
Oth
er C
ause
s of
MV
As
•H
eavy
traf
fic a
nd tr
affic
del
ays
•C
onst
ruct
ion
•D
istr
actio
ns (
infa
nts
and
child
ren,
cel
l ph
ones
, foo
d, m
aps)
•In
cons
ider
ate
or im
paire
d dr
iver
s•
Agg
ress
ive
driv
ing
beha
vior
s
Agg
ress
ive
Driv
ers
•E
xcee
d th
e sp
eed
limit
•T
ailg
ate
the
car
in fr
ont o
f the
m•
Cha
nge
lane
s fr
eque
ntly
•V
erba
lly a
buse
or
mak
e ru
de g
estu
res
to
anot
her
driv
er•
Dis
obey
traf
fic s
igns
Red
ucin
g R
isk
of M
VA
Inju
ries
•K
eep
your
veh
icle
in g
ood
cond
ition
•Le
t roa
d co
nditi
ons
and
traf
fic d
icta
te g
ood
driv
ing
beha
vior
•O
bser
ve th
e sp
eed
limit
exce
pt w
hen
ther
e is
fog,
rai
n, s
how
, or
ice
on th
e ro
ad•
Use
the
“tw
o se
cond
rul
e” r
athe
r th
an
tailg
ate
•W
ear
safe
ty r
estr
aint
s an
d se
at b
elts
Saf
ety
Res
trai
nts
for
Infa
nts
and
Chi
ldre
n
•S
eatb
elts
hol
d oc
cupa
nts
in p
lace
dur
ing
a co
llisi
on–
Pre
vent
s ej
ectio
n–
Pro
tect
s th
e pe
rson
from
obj
ects
in th
e ca
r•
Infa
nts
and
child
ren
shou
ld b
e in
the
back
sea
t•
Infa
nts
(less
than
1 y
ear)
sho
uld
face
the
rear
of
the
car
•C
hild
ren
(wei
ghin
g 40
lbs.
or
mor
e) c
an fa
ce
forw
ard
Hom
e S
afet
y
•In
jurie
s oc
cur
from
falls
, poi
soni
ngs,
gun
s,
fires
, and
pow
er e
quip
men
t•
You
ng c
hild
ren
have
the
high
est r
isk
•C
abin
ets
with
toxi
c m
ater
ials
, med
icin
es,
and
guns
sho
uld
be lo
cked
•M
atch
es a
nd li
ghte
rs s
houl
d be
kep
t in
a sa
fe p
lace
•P
ower
equ
ipm
ent s
houl
d ha
ve s
afet
y sh
ield
s
Gun
Con
trol
•T
he 1
968
Gun
Con
trol
Act
pro
hibi
ts th
e sa
le o
f rif
les
by m
ail a
nd th
e sa
le o
f gun
s to
min
ors,
fe
lons
, or
addi
cts
•T
he 1
993
Bra
dy H
andg
un C
ontr
ol A
ct p
rovi
des
for
a w
aitin
g pe
riod
befo
re s
omeo
ne c
an b
uy o
r tr
ansf
er a
han
dgun
to a
noth
er w
hile
a c
rimin
al
chec
k is
mad
e•
The
199
4 V
iole
nt C
rime
Con
trol
and
Law
E
nfor
cem
ent A
ct b
anne
d th
e m
anuf
actu
re, s
ale,
an
d po
sses
sion
of c
erta
in a
ssau
lt w
eapo
ns
Whi
ch A
re Y
ou?
•P
ropo
nent
s re
cogn
ize
the
high
inci
denc
e of
dea
ths,
dis
abili
ties,
and
inju
ries
due
to
guns
•O
ppon
ents
feel
it is
thei
r rig
ht to
car
ry a
gu
n fo
r pr
otec
tion
Pro
duct
Saf
ety
•T
he C
onsu
mer
Pro
duct
Saf
ety
Com
mis
sion
(C
PS
C)
was
cre
ated
in 1
972
beca
use
som
e pr
oduc
ts p
rese
nted
an
unre
ason
able
ris
k of
inju
ry•
The
CP
SC
req
uire
s sa
fety
labe
ls, r
ecal
ls
haza
rdou
s pr
oduc
ts, a
nd b
ans
them
Sch
ool S
afet
y
•C
ross
wal
k sa
fety
for
pede
stria
ns is
a
conc
ern
–M
any
scho
ols
have
vol
unta
ry c
ross
ing
guar
ds
•T
he s
ale
of d
rugs
on
scho
ol p
rope
rty
is a
fe
dera
l offe
nse
•B
ully
ing
is a
con
cern
•B
us s
afet
y is
a c
once
rn–
Sch
ool b
uses
are
not
req
uire
d to
hav
e se
at
belts
Pla
ygro
unds
•Ja
ne A
ddam
s pr
ovid
ed a
pla
ygro
und
at
Hul
l Hou
se in
Chi
cago
for
imm
igra
nt
child
ren
livin
g in
tene
men
ts•
Pla
ygro
und
equi
pmen
t is
lega
lly
cons
ider
ed “
an a
ttrac
tive
nuis
ance
”
Pla
ygro
und
Haz
ards
•W
ood
equi
pmen
t may
be
trea
ted
with
ar
seni
c–
Chi
ldre
n sh
ould
was
h th
eir
hand
s af
ter
play
ing
and
befo
re e
atin
g
•D
ange
rous
equ
ipm
ent i
nclu
des:
–M
erry
-go-
roun
ds, t
eete
r-to
tters
, sw
ings
, sl
ides
, clim
bers
(ju
ngle
gym
, mon
key
bars
)
Rec
reat
iona
l Nee
ds
•N
atio
nal p
arks
wer
e de
sign
ated
•T
he p
arks
and
rec
reat
ion
mov
emen
t ex
pand
ed a
fter
WW
II•
The
Pre
side
nt’s
Fitn
ess
Pro
gram
en
cour
aged
phy
sica
l act
ivity
for
good
he
alth
Saf
ety
Rul
es F
or…
•W
alki
ng, j
oggi
ng•
Bik
ing
•H
orse
back
rid
ing
•S
wim
min
g•
Boa
ting
•H
ikin
g an
d m
ount
ain
clim
bing
•A
ll-te
rrai
n ve
hicl
es a
nd s
now
mob
iles
•S
kiin
g an
d sn
owbo
ardi
ng•
Hun
ting
and
fishi
ng
Mec
hani
sms
of In
jury
•T
he c
ircum
stan
ces
foun
d af
ter
a cr
ash
or
acci
dent
that
det
erm
ines
how
inju
ries
wer
e re
ceiv
ed
Haz
ards
Mec
hani
cal
•O
ccur
whe
n th
e tr
ansf
er o
f mec
hani
cal
ener
gy r
esul
ts in
im
med
iate
or
grad
ually
acq
uire
d in
jury
Psy
chos
ocia
l•
Usu
ally
fact
or in
to
mec
hani
cal h
azar
ds•
Incl
udes
DU
I/DU
IA,
dist
ract
ions
, pre
senc
e in
cr
ime
area
s, n
ot u
sing
sa
fety
dev
ices
, not
he
edin
g sa
fety
adv
ice
•E
mot
ions
suc
h as
ang
er,
fear
, fee
ling
a la
ck o
f co
ntro
l or
viol
ence