Child and youth injury prevention: a public health approach

Question 1

What is the definition of injury?

Answer 1

“the physical damage that results when a human body is subjected to energy that exceeds the threshold of physiological tolerance or results in lack of one or more vital elements, such as oxygen”

Question 2

What is an example of a country with strong injury prevention policies and infrastructure?

Answer 2

Sweden

Question 3

What is the global burden of injury?

Answer 3

~950 000 children less than 17yo were killed by injury in 2004
87% unintentional

Question 4

What is the burden of injury in Canada?

Answer 4

Leading cause of death
Between 1994-2003 390 children <14yo died of unintentional injuries and 25 500 were hospitalized.
$16 billion cost due to injuries in 2994

Question 5

What are the leading cause of unintentional injury deaths in children?

Answer 5

1. MVC 17%
2. Drowning 15%
3. Threats to breathing 11%

Question 6

What is the leading cause of unintentional injury hospitalizations in children?

Answer 6

Falls (37%)

Question 7

What are the top three causes of unintentional injury deaths in under 1y?

Answer 7

1. Threat to breathing 54%
2. MVC 18%
3. Drowning 15%

Question 8

What are the top three causes of unintentional injury deaths in 1-4yo?

Answer 8

1. MVC 22%
2. Drowning 21%
3. Threat to breathing 19%

Question 9

What are the top three causes of unintentional injury deaths in 5-9yo?

Answer 9

1. MVC 58%
2. Drowning, Fall, Fire/Flame (6% each)
3. Threat to breathing (5%)

Question 10

What are the top three causes of unintentional injury deaths in 10-14yo?

Answer 10

1. MVC 55%
2. Drowning 13%
3. Fall 7%

Question 11

What are the top three causes of unintentional injury deaths in 15-19yo?

Answer 11

1. MVC 71%
2. Poisoning 7%
3. Drowning 6%

Question 12

What are the top three causes of unintentional injury hospitalizations in <1yo?

Answer 12

1. Fall 46%
2. Threat to breathing, Fire/Hot Object/Subsance (6% each)
3. Poisoning 5%

Question 13

What are the top three causes of unintentional injury hospitalizations in 1-4yo?

Answer 13

1. Fall 39%
2. Poisoning 15%
3. Fire/Hot object/substance 7%

Question 14

What are the top three causes of unintentional injury hospitalizations in 5-9yo?

Answer 14

1. Fall 56%
2. Struck by/against an obstacle, Pedal cyclist non-traffic (7% each)
3. MVC 7%

Question 15

What are the top three causes of unintentional injury hospitalizations in 10-14yo?

Answer 15

1. Fall 39%
2. Struck by/against an obstacle 15%
3. MVC, pedal cyclist non-traffic (8% each)

Question 16

What are the top three causes of unintentional injury hospitalizations in 15-19yo?

Answer 16

1. Fall 24%
2. MVC 21%
3. Struck by/against an obstacle 14%

Question 17

What is the injury pyramid?

Answer 17

For every death there are many more hospitalization and for every hospitalization there are many more who visit the ED

Question 18

What is the Haddon matrix?

Answer 18

Phase-Factor matrix of nine-cells looking at host, agent, and environment factors that can prevent or control injuries pre-event, during event, and post-event

Question 19

What are the leading causal factors for serious and fatal MVC?

Answer 19

1. Driving speed
2. Impaired driving
3. Lack of occupant restraint

Question 20

What is the reduction in risk of death and hospitalization with car seats?

Answer 20

1. Death: 71% infants 54% 1-4yo

2. Hospitalization: <4yo 67%

Question 21

What is the improvement of protection for young children with booster seats over seat belts?

Answer 21

59%

Question 22

What percentage of Canadian children are not using or incorrectly using care and booster seats?

Answer 22

44-81% car seats are used incorrectly
1/3 of 4-9yo do not use a booster seat
92% infants, 74% toddlers, and 96% school aged children sustaining severe MVC injuries were not restrained appropriately at the time of the crash

Question 23

What is the decrease in risk of traumatic brain injury when wearing a helmet while biking?

Answer 23

88%

Question 24

How much lower are head injury rates among child and youth cyclists in jurisdictions with helmet legislation?

Answer 24

25% lower

Question 25

What percentage of children 11-14% wore bike helmets?

Answer 25

45%

Question 26

What are risk factors for unintentional injury?

Answer 26

1. Male gender 2. Aboriginal 3. Rural setting 4. Lower SES

Question 27

Why are males at increased risk of injury?

Answer 27

1. Higher impulsivity 2. Higher activity levels 3. Socialization to encourage risks 4. Boys are more likely to attribute injuries to bad luck then their own choices

Question 28

Why are Aboriginal children at increased risk of injury?

Answer 28

1. Living in remote areas 2. Distance from medical treatment 3. Housing characteristics 4. Alcohol and substance abuse 5. Poverty

Question 29

Why are rural children at increased risk of injury?

Answer 29

1. Younger children are supervised on work settings 2. Older children are engaged in farm work 3. Higher rates of ATV use 4. Use of farm equipment

Question 30

What are the E's of injury prevention?

Answer 30

1. Education 2. Enforcement/legislation 3. Engineering (designing safer products and environments)

Question 31

What is an active measure?

Answer 31

Requires conscious action by individuals to prevent or minimize the risk of injury e.g. safety belt or booster seat

Question 32

What is a passive measure?

Answer 32

Do not require an individual to act to prevent injury and are often more effective in situations where active measures are less reliable and inconsistently applied. e.g. airbags, smoke alarms

Question 33

What are some recommendations to reduce the burden of child and youth injury in Canada?

Answer 33

1. Investing in a pan-Canadian injury prevention strategy 2. Support the development of a national IP body 3. Educate the public 4. Influence and implement best practice, evidence informed legislation and policies harmonized across all jurisdictions that support IP 5. Enforce existing IP legislation and regulations 6. Creating safer, supervised environments for children and youth 7. Sustain and advance the following injury surveillance: outpatient injuries, hospitalized trauma patients, trauma deaths 8. Sustain and advance current and new IP research programs