Injury Prevention: An International Perspective Epidemiology, Surveillance, and Policy

by Barss, Peter; Smith, Gordon S.; Baker, Susan P.; Mohan, Dinesh

• ISBN13: 9780195119824
• ISBN10: 0195119827
• Format: Hardcover
• Copyright: 1998-05-28
• Publisher: Oxford University Press

Summary

Throughout the world, injuries are the leading cause of death for young adults, adolescents, and children. Injury death and hospitalization are also high among the elderly. With the improved prevention and treatment of infectious and degenerative diseases, the importance of injuries as adebilitating factor has rapidly increased around the world. Better living conditions have decreased the number of some types of injuries--such as drownings and burns--but the proliferation of new, high-energy vehicles, machinery, and weapons has offset this trend by significantly increasing thenumber of other types of injuries. This book documents the nature and magnitude of the problem and provides basic approaches to injury prevention. Injury statistics are supplied for many developing countries and indigenous populations as well as for industrialized nations. Important differences among countries and cultures affectingthe types and circumstances of injury are illustrated in tables and figures that present extensive data and greatly enhance the book's usefulness. The many types of injuries covered in detail include those related to traffic, falls, burns, drowning, poisoning, animal and insect bites, envenomations,occupation, disasters, suicide, and homicide. The authors take a methodologic approach to the analysis of the health impact, circumstances, and costs of injuries. They detail the costs and health impact of injuries, as well as the role of health services in injury prevention. They describe surveillance methods and effective preventive measuresthat can be implemented relatively easily even in countries with limited resources. Reflecting the authors extensive experience in injury prevention in a variety of countries, this book will help readers understand this major health problem, the changes that could reduce it, and the means ofinfluencing crucial public policies. Succinct and practical, Injury Prevention is intended for public health practitioners who develop and evaluate injury surveillance programs, epidemiologists and other researchers who wish to understand the patterns of injury occurrence, and government officialsand policy makers concerned with public safety and injury prevention.

Author Biography

Peter Barss, M.D., Sc.D., M.P.H., is Head of Health Intelligence and Territorial Epidemiologist for the Canadian Arctic and Adjunct Professor of Epidemiology at McGill University, Montreal, Canada.
Gordon Smith, M.B., M.P.H., is Associate Professor of Public Health at Johns Hopkins University, Baltimore.
Susan Baker, M.P.H., is Professor of Public Health at Johns Hopkins University.
Dinesh Mohan, Ph.D., is State Bank of India Professor at the Indian Institute of Technology, New Delhi.

Table of Contents

1 Introduction: The Importance of Injuries	1	(11)
Developing Countries, Developing Areas, and Remote and Indigenous Communities	2	(1)
Injury Classification	3	(1)
Changing Patterns of Mortality	4	(3)
Importance of Adult Injuries	7	(1)
Importance of Childhood Injuries	8	(1)
Predictability and Preventability of Injuries	9	(1)
Accident Prevention vs. Injury Prevention and Injury Control	10	(1)
Passive vs. Active Protection	11	(1)
2 The Epidemiologic Basis for Prevention	12	(14)
Etiology and Nature of Injuries	12	(2)
Conceptual Models	14	(3)
Role of Epidemiology	17	(2)
Problems of Measurement	19	(3)
Information Needs	22	(1)
Information Needs at Different Levels	23	(2)
Conclusion	25	(1)
3 Assessing the Health Impact of Injuries: Mortality	26	(24)
Process of Mortality Reporting	26	(2)
Availability of Official Injury Mortality Data	28	(1)
Impact of Injuries as Assessed by Mortality Rates	29	(4)
Impact of Injuries as Assessed by Age-Specific and Age-Adjusted Death Rates	33	(4)
Impact of Injuries as Assessed by Premature Mortality	37	(2)
Reliability and Validity of Reports on Cause of Death from Injuries	39	(4)
Methods for Obtaining Supplemental Information on Causes and Circumstances of Injury Deaths: Community Mortality Studies	43	(5)
Injury Mortality Data Sources in Other Sectors	48	(2)
4 Assessing the Health Impact of Injuries: Morbidity	50	(18)
Process of Reporting Morbidity	51	(2)
Process of Reporting Injury Morbidity Data from Health Facilities	53	(1)
Availability of Population-Based Injury Morbidity Data from Health Facilities	54	(1)
Impact of Injury Morbidity as Assessed by Specific Injuries and by Age and Sex	54	(1)
Reliability and Validity of Injury Morbidity Data from Health Facilities	55	(2)
Injury Morbidity Data from Community Surveys	57	(1)
Impact of Injury Morbidity on Impairment, Disability and Handicap	58	(5)
Injury Morbidity Data in Other Sectors	63	(1)
Case Studies Using Simple Epidemiologic Data for Planning Injury Prevention in Papua New Guinea	63	(5)
5 Assessing the Community Impact of Injuries: Costs	68	(7)
Link Between Epidemiologic Surveillance of Injuries and Cost Estimates	69	(1)
Direct and Indirect Costs of Injury	69	(1)
Methods for Estimating Indirect Economic Costs of Injuries	70	(1)
Validity of Cost Estimates	71	(1)
Costs of Injury as a Proportion of GNP	71	(1)
Costs of Specific Injuries: Traffic Injuries and Per-Capita GNP	72	(1)
Costs of Disabilities	72	(1)
Injuries and Elasticity of Demand with Price	73	(1)
Opportunity Cost and Injury Interventions	74	(1)
Cost Estimates as a Justification for Injury Surveillance and Research	74	(1)
6 Determinants of Injuries	75	(28)
Identification of Risk Factors and Injury Determinants	75	(2)
Hazardous Exposures	77	(2)
Personal Risk Factors	79	(2)
Sex	81	(15)
Equipment Factors	96	(1)
Environmental Factors	97	(4)
Interaction of Multiple Determinants	101	(2)
7 Traffic Injuries: Introduction	103	(27)
Importance of Traffic Injuries	104	(1)
Special Features of Traffic Injuries in Developing Countries and Indigenous Communities	105	(3)
Multidisciplinary Nature of Traffic Injury Control	108	(2)
Risk of Injury by Type of Transport	110	(1)
Data Sources and Data Quality for Traffic Injuries	111	(1)
Indicators of Exposure and Severity	112	(7)
Crash Reports	119	(1)
Blackspot Analysis	119	(1)
Health Sector and Coroner Data	120	(1)
Special Research Studies	121	(1)
Examples of Overall Mortality from Motor Vehicles	122	(3)
Examples of Morbidity from Motor Vehicle Injuries	125	(1)
Regulatory Approaches for Prevention of Traffic Injuries	126	(2)
Organizational Aspects of Traffic Injury Prevention	128	(1)
Literature on Traffic Injuries	129	(1)
8 Traffic Injuries: Determinants by Road User Type	130	(21)
Injuries of Pedestrians	130	(6)
Injuries of Bicyclists and Motorcyclists	136	(6)
Open-Backed Vehicles and Public Transport	142	(1)
Off-Road Vehicles	143	(1)
Determinants of Motor Vehicle Crashes	144	(7)
9 Unintentional Injuries: Drownings, Falls, and Burns	151	(37)
Drowning and Other Water-Related Injuries	151	(14)
Falls	165	(9)
Burns and Smoke Inhalation	174	(14)
10 Unintentional Injuries: Poisonings, Bites, and Other Injuries	188	(31)
Poisoning	188	(10)
Bites, Wounds, and Envenomations from Land and Marine Animals and Insects	198	(10)
Skin Wounds, Penetrating Wounds, and Injuries from Cutting Tools	208	(4)
Eye Injuries	212	(3)
Other Injuries	215	(4)
11 Occupational Injuries	219	(14)
Special Circumstances in Developing Countries and Indigenous Communities	219	(1)
Reporting of Occupational Injuries	220	(2)
Types of Occupational Injuries	222	(2)
Injuries by Type of Occupation	224	(5)
Implications for Prevention	229	(4)
12 Injuries from Disasters	233	(12)
Definitions and Types of Disasters	233	(1)
Classification and Reporting of Injuries from Disasters	234	(2)
Injury Pattern by Type of Disaster	236	(1)
Examples of Mortality and Morbidity	237	(4)
Organizational Aspects of Disaster Prevention	241	(4)
13 Intentional Injuries: Homicide, Suicide, and Other Violence	245	(32)
Intentional Injuries	245	(2)
Homicide and Assault	247	(17)
Suicide	264	(13)
14 Choice and Development of Injury Prevention Programs	277	(30)
Developing an Injury Control Program	278	(4)
Integrating Research into Injury Control Programs	282	(5)
Social and Political Considerations	287	(3)
Intervention Strategies for Injury Control	290	(3)
Case Study: Cost Effectiveness and Cost Savings from Prevention of Traffic Injuries in the United States	293	(7)
Injury Prevention at the International, National, Regional, and Local Level	300	(7)
15 Injury Treatment and Rehabilitation: The Role of Health Services and Other Sectors	307	(16)
Treatment Systems for Injury	308	(1)
Hierarchical Levels of Injury Care	309	(4)
The Role of Health and Other Sectors: Policy and Research	313	(9)
Conclusion	322	(1)
16 Conclusion	323	(6)
References	329	(38)
Acknowledgments	367	(2)
Index	369	(8)
About the Authors	377