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Injury Epidemiology

Injury Epidemiology. Ten Basic Principles. Thomas Songer, PhD University of Pittsburgh. Injuries occur as the result of. energy transfer that is delivered in excess of a threshold. Causes of Injuries. Energy Transfers that Exceed our Abilities for Compensation

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Injury Epidemiology

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  1. Injury Epidemiology Ten Basic Principles Thomas Songer, PhD University of Pittsburgh

  2. Injuries occur as the result of energy transfer that is delivered in excess of a threshold

  3. Causes of Injuries • Energy Transfers that Exceed our Abilities for Compensation • Types of energy that can cause injury • Mechanical - Thermal • Electric - Chemical • Radiation

  4. Energy Transfer and Injuries • Penetrating • Non-Penetrating • Compression • Burn

  5. Injuries are not Accidents

  6. Models are used by epidemiologists to provide a framework for understanding injuries; their occurrence and their prevention

  7. Public Health Model Define the problem Identify risk factors Intervene Evaluate social Identify genetic morbidity environmental mortality health care cost

  8. Social-Ecologic Model Individual Relationship Community Society

  9. Injury Surveillance Systems Form the Basis for Injury Control

  10. Injury Surveillance

  11. Sentinel Events • An event(s) that can be used to assess the stability or change in the health of a population. John Last Dictionary of Epidemiology

  12. Injury Research Requires a System for Classifying Injuries

  13. ICD Codes • Diagnosis Codes (N-Codes – ICD 9; S, T Codes – ICD 10) • Record the clinical nature of the injury and the area of the body injured • Cause of Injury Codes • E-Codes (ICD – 9) • Record the external cause of the injury • Often missing in the medical record • V, W, X, Y Codes (ICD – 10) • record external causes

  14. Most injuries are relatively minor, and do not require any medical attention.

  15. Degrees of Injury Severity Severe Impairment Hospitalization Emergency Dept. Physician Visit Households

  16. Injuries and the Factors Underlying Injuries can be Examined from an Epidemiologic Framework.

  17. Injuries and the Epidemiology Triad Human (Host) Environment Mechanical Energy (Agent)

  18. Risk factors for motor vehicle crashes Age Gender Experience Human Alcohol Fatigue Failure Design Speed Road Conditions Traffic Weather Vehicular Environmental

  19. Causal Factors for Injuries Are Not as Well Defined as You Might Think They Are

  20. Develop hypothesis Descriptive Studies Investigate it’s relationship to outcomes Case-control Studies Define it’s meaning with exposures Cohort Studies

  21. The Injury Field has been at the Forefront of Interventions

  22. Traditional Approach to Injury Control • Education • Enforcement • Engineering

  23. The Haddon Matrix

  24. The Haddon Matrix use for planning, resource allocation, strategy identification Human Vehicle Environment Pre-event Event Post-event

  25. The Haddon Matrix Human Vehicle Environment Pre-event alcohol night, rain no seat belt no air bag tree too close to road Event slow emergency response Post-event

  26. Ten Methods for Limiting Energy Transfer 1. Prevent the development of energy form 2. Reduce the amount of energy 3. Prevent the energy release 4. Alter the rate of energy release from it’s source or it’s spatial distribution 5. Separate structures from the energy release by space or time

  27. Methods to limit energy transfer... 6. Place a barrier between the released energy and susceptible structures 7. Modify surfaces that can be impacted 8.Strengthen structures susceptible to damage from energy transfer 9. Prevent the extension of existing damage 10. Carry out intermediate and long-term repair and rehabilitation

  28. Evaluation of Interventions Are Necessary, Yet They Are Often Not Done

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