Injury Causation

PhD course jan- febr 2008

Leif Svanström

Injury Causation

”A kind of”

summary of previous teaching in the Course

Research/Evaluation of

Safety promotion & Injury Prevention

Leif Svanström

Injury Causation

Which are the causes to intervene on?

Research/Evaluation of

Safety promotion & Injury Prevention

Leif Svanström

Relation between Homo sapiens, environmental and societal levels

Disease, injury, material or psychological damage in relation to Homo Sapiens/environmental/societal systems

Causes of Injuries – Factors related to injuries

from

A. Physical Environment

B. Social Environment

C. Habits of Life

D.”Individual” Risk Factors

A. Physical Environment (Areas)1. Transport 2. Housing

3. Production , Commercial , Service 4. Public (School, Public facilities, Institutions)

5. Sports 6. Entertainment , Culture and Park

7. Nature8. Sea, Lake & River

1.Transport Area

Rules of thumb:

10-15% of All Injuries

Children: 60% of deceased, 15-19 years of age: 80%

- High Energy Content Involved

O-VISION

on traffic

What did You learn?

Prevention Demands

Co-operation Between Societal Sectors – Intersectoral work

Contribution from Voluntary Organizations – peoples participation

- Decentralized Work (A Safe Community)

Three Main Areas of Prevention

Separate Un-protected Road Users

Alcohol: 0 – tolerance

Decrease Average Speed

2. Housing Area30-40% of all injuries

Home Accidents: Happens in all Types of Homes and Every Kind of Dwelling as

Apartment, Villa, Outhouse, Garden & Yard. incl. Accidents on Farms, but un-related to Farming or Lumbering.

Children % Elderly Dominate:- Children in Different Stages of Development

- Fall Injuries- 75% of Injuries in the Elderly in Homes

3.Production, Commercial, Service Areas

10-20 % of All Injuries

Mortal Injuries-Decrease of Mortal Injuries-Related to Transport Vehicles

-Falls-Falling Objects

-Machines

The Most Dangerous Branches:

- Foreign and Coastal Shipping- Slaughter- Iron and Steel- Stowing- Metal Recycling (Non-Iron) out of Scrap- Butchery- Ship-Yard- Concrete Industry

Farming & Lumbering, Construction Industry, Transport are Branches with High Mortality Risk.

Environmental Exposure and Injuries

- Organic Solvents- Noise- Lighting- Climate- Heavy Physical Load

Transport Injuries within the Work Sector must be Noticed!

4. Public Area (School, Public facilities, Institutions)

About 10% of All Injuries

- School is more Dangerous to Children than Work to Grown-ups

- 7-9 Years: 1/3 of All Injuries;10-15 Years: ½ of All Injuries (Grown-ups: 1/3 are Work-related)

- Physical Education is 3 Times More Risky than Other Lessons. Basketball, Handball and Gymnastics and In-Door Soccer are most Common.

5. Sports Area15-20% of All Injuries - increasing

- Relatively Few Mortal Injuries

In Sweden:

- Folksam Insurance Company: 4% Leads to Invalidity- Per 1,000 Insured:

- Ice-Hockey 40.4- Handball 18.8- Basketball 9.9

- Bandy 7.8

6.Entertainment, Culture and Park Areas

2-4% of All Injuries

The Area has been Investigated to a Very Limited Extent

7. Nature3-6% of All Injuries

Mountain Accidents are Registered.

Snow-Mobile Related Injuries has been Studied.

8. Sea, Lake & River1-3% of All Injuries

- Has decreased the last 100 Years- Mostly Due to less Exposure

- The Number of Accidents are Halved the Same Time as the Number of Boats has been Doubled

- 6 out of 10 Deceased were Under Influence of Alcohol- ½ were doing Sports-Fishing

- Bigger Boats show fewer Mortal Injuries

B. Social EnvironmentExamples:

- Different Schools- Pupils Mix- Ethnicity

- School Bussing- Long School Hours

- Alternative Pedagogic Programs

- Psycho-Social Load

- Urbanization- Unemployment

-Work Organization, Stress, Monotony, Stimulation,

Demand/ Control, Decision Making, Shift Work

C. Habits of Life1. Tobacco

2. Alcohol- All Injuries: 1/3 Males, 1/6 Females

- High: Single Accidents in Traffic, Drownings, Falls, Snow-Mobiles

- 1/5 of All Emergencies at Hospitals- More when Injury Diagnosis

3. Diet

4. Physical Activity- Regular Warming up

- Experience

D. "Individual"Risk Factors(1)1. Age and Gender

- Children, esp. Boys are Over-Represented- Older Women are Over-Represented

- Younger Men and Motor Vehicles- Women and Falls

- All Road Users Accidents are Dominated by Males, Motor Bike and Moped Related Accidents Strikes

Males to 90 %- Males over 40 Years of Age dominates Boat Accidents

D. "Individual"Risk Factors(2)

2. Genetics-Accident Proneness - Does it Exist?

3. Bodily Constitution

4. Previous Diseases or Injuries