CHP 200: Community Health Program-l Mohamed M. B. Alnoor

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

2. Characterize injury as a public health problem • Detail the impact of injury • Identify control strategies • Highlight the key elements of effective programs • Address obstacles and catalogue resources • Identify provider’s role in prevention Purpose

3. Injury: Physical damage due to transfer of energy kinetic thermal chemical electrical radiant • Over a period of time, “exposure” that is either acute or chronic Definition:

4. KSA Traffic accidents • > 275,000 persons (men, women and children) • 6,000 deaths ( 16 per day ) - 60% : reckless driving - 34 % : speeding • 1/3 of all hospital beds • SR26 billion The toll:

5. 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

6. Disability far exceeds death rate • First, age 1- 44 • “Years of life lost” (YLL) concept: - Life expectancy for young shortened by death from injury - Comparable with heart disease and cancer - Young and productive members of society! Disability, Outcomes

7. Accident: An unexpected occurrence, happening by chance • Injury: A definable, correctable event, with specific risks for occurrence • A result of risk poorly managed • “Disease of injury” concept • Injury can be prevented! Injury, Not Accident!

8. Epidemiologic Triangle AGENT A causal relationship! Environment Host “Prevention is the vaccine for the disease of injury.”

9. The 4 E’s: • Education • Enactment/Enforcement • Engineering • Economic incentives/ penalties General Principles

10. Factors influencing Road Injuries, The Haddon Matrix

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

12. Categories of injury prevention: • Primary prevention: • Secondary prevention: • Tertiary prevention: Eliminate the event Diminish effect Improve outcomes

13. Strategies of injury prevention: Examples of effective injury prevention: National highway speed limits “Cycle” helmet laws Child passenger restraint laws Apartment window guards Smoke detectors

14. 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

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

16. Accidents are caused by: • Unsafe conditions • Unsafe acts Causes of Accident

17. 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 Causes of Accident

18. Unsafe Acts • Most difficult to address • Changing behavior isn’t easy • Best prevented by developing a “safety culture” Causes of Accident

19. Establish accountability for safety • Define safety responsibilities Safety Cultures

20. Establish accountability for safety Employees should be evaluated on their safety performance Doing a job correctly includes doing it safely Safety Cultures

21. Define safety responsibilities Employee responsibilities include Safety Cultures • Maintaining good housekeeping • Recognizing and reporting safety hazards • Using personal protective equipment (PPE)

22. Define safety responsibilities Employer responsibilities include Safety Cultures • Providing access to information • Providing personal protective equipment • Providing training

23. Equipment / Field Changes • Rule Changes / Coaching • Individual Preparation Preventing Sports Injuries

24. Preventing Sports Injuries Field/Equipment Changes Equipment Changes to prevent injuries Add equipment : • Helmets • Chin protectors

25. Preventing Sports Injuries Field/Equipment Changes Field modifications to prevent injuries • Avoid : • Potholes • grates • Anchoring soccer goals

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

27. 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? • Purchase the recommended equipment • Pre-participation physical exam • Preseason conditioning Preventing Sports Injuries Individual Preparation Prior to Participation

28. Practice within your limits • Stay well-hydrated • Know and follow the rules of the game Preventing Sports Injuries Individual Preparation At Participation

29. If injured • Seek medical attention prior to returning to play • Adequate rehabilitation is essential Preventing Sports Injuries Individual Preparation At Participation

30. Factors influencing Road Injuries, The Haddon Matrix