CHP 200: Community Health Program-lMohamed 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

chemicalelectrical

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 causalrelationship!

Definition: INJURY

“Disease of injury” concept

Causes of AccidentAccidents 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

ENVIRONMENT VEHICLE HUMAN

VISIBILITYPAVEMENTSIGNALSCONSTRUCTION

DEFECTSBREAKSTIRESAVOIDANCE SYSTEMS

AGEEXPERIENCEALCOHOL DRUGSSPEED

PRE EVENT

GUARD RAILSMEDIANSBREAKAWAY POSTS

AIR BAGSAUTOMATIC BELTSCRASHWORTHINESS

BELT USE HELMET USETOLERANCE

EVENT

EMS SYSTEMFIRST RESPONDERBYSTANDER CARE

POST-CRASHFUEL 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 1- 44 “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 ApproachFive steps:

What is the problem?SurveillanceWhat is the cause?Risk

identification What works?InterventionHow do you do it?Implementati

on Did it work? Outcome measurement

INJURY Injury Prevention

Examples of effective injury prevention:

Highway speed limits

Apartment window guardsSmoke detectorsChild 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 ChangesRule Changes / CoachingIndividual 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 InjuriesField/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 InjuriesRule

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 InjuriesIndividual Preparation

Purchase the recommended equipmentPre-participation physical examPreseason conditioning

Prior to Participation

INJURY Injury Prevention

Preventing Sports InjuriesIndividual Preparation

Practice within your limitsStay well-hydratedKnow and follow the rules of the

game

At Participation

INJURY Injury Prevention

Preventing Sports InjuriesIndividual Preparation

If injured Seek medical attention prior to

returning to play Adequate rehabilitation is essential

At Participation

INJURY Injury Prevention

Preventing Sports InjuriesIndividual Preparation