CHP 200: Community Health Program-l Mohamed M. B. Alnoor SAFETY and INJURY PREVENTION

 Definition of injury  Epidemiologic Triangle  Causes of Accident  Impact of injury and accidents  Prevention of Injury CONTENT

 Injury: Physical damage due to transfer of energy Definition: kinetic thermal chemical electrical radiant Over a period of time: “exposure” either acute or chronic INJURY

 Accident: An unexpected occurrence, happening by chance  Injury: a definable, understandable, predictable, preventable, correctable event, with specific risks for occurrence. Injury, Not Accident! Definition: INJURY  A result of poorly managed risk

Epidemiologic Triangle “Prevention is the vaccine for the disease of injury.” Environment Host AGENT A causal relationship! Definition: INJURY  “Disease of injury” concept

Causes of Accident Accidents are caused by: – Unsafe acts – Unsafe conditions Most difficult to address Changing behavior isn’t easy Best prevented by developing a “safety culture” INJURY

Unsafe Conditions  Easiest to correct (and very cost effective)  Easiest to prevent Safety audits Safety inspections Maintenance schedules for equipment Encouraging employee reporting Good housekeeping INJURY Causes of Accident

ENVIRONMENTVEHICLEHUMAN VISIBILITY PAVEMENT SIGNALS CONSTRUCTION DEFECTS BREAKS TIRES AVOIDANCE SYSTEMS AGE EXPERIENCE ALCOHOL DRUGS SPEED PRE EVENT GUARD RAILS MEDIANS BREAKAWAY POSTS AIR BAGS AUTOMATIC BELTS CRASHWORTHINESS BELT USE HELMET USE TOLERANCE EVENT EMS SYSTEM FIRST RESPONDER BYSTANDER CARE POST-CRASH FUEL LEAKS FIRE AGE PHYSICAL CONDITION POST EVENT Factors influencing Road Injuries, The Haddon Matrix INJURY Causes of Accident

 > 275,000 persons (men, women and children)  6,000 deaths ( 16 per day ) - 60% : reckless driving - 34 % : speeding  1/3 of all hospital beds  SR 26 billion The toll: INJURY KSA Traffic accidents

In USA  80% blunt, 20% penetrating  Motor vehicle, gunshot, falls etc..  Drowning, poisonings  5th leading cause of death (1996)  First, age 1 through 44 (1996) Mechanism, Outcomes INJURY

 Disability far exceeds death rate  First, age  “Years of life lost” (YLL) concept: Disability, Outcomes INJURY - Life expectancy for young shortened by death from injury - Comparable with heart disease and cancer - Young and productive members of society!

 Direct Costs Medical Costs (including worker’s comp) Indemnity Payments  Indirect Costs Time Lost (by worker and supervisor) Schedule delays Training new employees Cleanup time / equipment repairs Legal fees Cost of Accidents INJURY

The Iceberg Effect Cost of Accidents On average, the indirect costs of accidents exceed the direct costs by a 4:1 ratio INJURY

Categories of injury prevention:  Primary prevention:  Secondary prevention:  Tertiary prevention: Eliminate the event Diminish effect Improve outcomes INJURY Injury Prevention

The 4 E’s:  Education  Enactment/Enforcement  Engineering  Economic incentives/ penalties General Principles INJURY Injury Prevention

Public Health Approach Five steps: What is the problem? Surveillance What is the cause? Risk identification What works? Intervention How do you do it? Implementation Did it work? Outcome measurement INJURY Injury Prevention

Examples of effective injury prevention: Highway speed limits Apartment window guards Smoke detectors Child passenger restraint laws “Cycle” helmet laws Strategies of injury prevention: INJURY Injury Prevention

 Establish accountability for safety  Define safety responsibilities Safety Cultures INJURY Injury Prevention

 Establish accountability for safety Safety Cultures INJURY Injury Prevention Employees should be evaluated on their safety Performance: Doing a job correctly includes doing it safely

 Define safety responsibilities Employee responsibilities include  Maintaining good housekeeping  Recognizing and reporting safety hazards  Using personal protective equipment (PPE) Safety Cultures INJURY Injury Prevention

 Providing access to information  Providing personal protective equipment  Providing training Safety Cultures INJURY Injury Prevention  Define safety responsibilities Employer responsibilities include

 Equipment / Field Changes  Rule Changes / Coaching  Individual Preparation INJURY Injury Prevention Preventing Sports Injuries

Equipment Changes to prevent injuries Add equipment :  Chin protectors Field/Equipment Changes  Helmets INJURY Injury Prevention Preventing Sports Injuries

 Avoid :  Potholes  grates  Anchoring soccer goals INJURY Injury Prevention Preventing Sports Injuries Field/Equipment Changes Field modifications to prevent injuries

 Rule changes to adjust for injury patterns Example = “spearing” in football  Officials Must enforce the established rules  Coaches Teach the appropriate techniques INJURY Injury Prevention Preventing Sports Injuries Rule Changes/Coaching

 Learn about the game prior to signing up  Is this sport appropriate for your child?  Does your child wish to participate?  Who will be supervising practices/games? Prior to Participation INJURY Injury Prevention Preventing Sports Injuries Individual Preparation

 Purchase the recommended equipment  Pre-participation physical exam  Preseason conditioning Prior to Participation INJURY Injury Prevention Preventing Sports Injuries Individual Preparation

 Practice within your limits  Stay well-hydrated  Know and follow the rules of the game At Participation INJURY Injury Prevention Preventing Sports Injuries Individual Preparation

 If injured  Seek medical attention prior to returning to play  Adequate rehabilitation is essential At Participation INJURY Injury Prevention Preventing Sports Injuries Individual Preparation