Doctors demand centres for injury prevention

BMJ 1998; 317 doi: (Published 21 November 1998) Cite this as: BMJ 1998;317:1410
  1. Annabel Ferriman
  1. BMJ

    Injury is the leading cause of death and acquired disability among youngchildren and teenagers, yet far less money is spent on preventing injuries than on disorders that are less destructive, a new report says.

    Specialists in child health have produced a strategy document, Action onInjury, which calls for the establishment of four dedicated national agencies–in England, Wales, Scotland, and Northern Ireland–to implement programmes of injury prevention and control, to coordinate the national surveillance of injuries, and to initiate research into the problem.

    The document, introduced at a conference in London on Thursday, says that major steps need to be taken to reduce the annual toll of mortality and morbidity. In England and Wales injuries account for about 600 deaths and 130000 hospital episodes involving children under 16.

    “This is a field in which so much is known and so little implemented,” said Professor Barry Pless, editor of the journalInjury Preventionand editor of the strategy document.

    Stephen Jarvis, chairman of the Action on Injury steering group, which prepared the document and organised the conference, and professor of community child health at the University of Newcastle upon Tyne, pointed to several measures which experts knew to be effective but which had not been widelyadopted. These include the installation of smoke alarms in all households, traffic calming measures, modifications to car designs, and the separation of pedestrians from traffic.

    “There is good evidence that smoke alarms save lives. We know that fire and flames are one of the commonest causes of death among the under 5s. Butthe lesson from many studies is that you need legislation rather than persuasion to get them used in all households. We should legislate to have them fitted in new houses and put into all public housing and private rented accommodation,” he said.

    Professor Jarvis also called for more help from health visitors for first time mothers, for bull bars to be banned from cars (they are common on four wheel drive vehicles), and for more cities to emulate York's example by becoming more accessible to cyclists.

    “York railway station resembles a Dutch railway station because there are hundreds of bicycles parked there,” he said. If cities provided more cycle paths the proportion of children who cycle to school each day might rise from 3% to be closer to the Dutch total of 50%.

    Subscribers to Injury Prevention will receive a copy of Action on Injury with the December issue. Individual copies are available from Subscriptions Department, BMJ Publishing Group, BMA House, Tavistock Square, London WC1H 9JR. Members of the Royal College of Paediatrics and Child Health, the Royal College of General Practitioners, and the Faculty of Public Health Medicine may obtain a copy at a reduced price.

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    Children are warned of beach dangers at a new injury prevention project in Dorset

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