Intended for healthcare professionals


Injury Prevention: An International Perspective

BMJ 1998; 317 doi: (Published 12 December 1998) Cite this as: BMJ 1998;317:1665
  1. Barry Pless, editor of “Injury Prevention
  1. Montreal Children's Hospital, Canada

    Peter Barss, Gordon Smith, Susan Baker, Dinesh Mohan

    Oxford University Press, £42.50, pp 384

    ISBN 0195119827

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    Several years ago I reviewed this book in draft form at the request of the publisher. I was torn: it was a labour of love and a potentially important book, but it had numerous shortcomings. I conveyed my concerns but stressed that everything possible should be done to bring it to press. Thankfully, publisher and authors agreed. What we now have is a landmark addition to a remarkably small shelf of texts about this subject.

    Originally, the book was possibly too ambitious and too thorough and might have benefited only those already persuaded of the topic's importance. I feared that only they would scratch out the gems buried in it. It is now coherent, well organised, and well written. Although there are now no excuses for not using it, the question remains whether it will be used, and how.

    It seems reasonable to ask if books such as this are intended to inform or to foster action. Undoubtedly, it is both in the sense that better information helps equip established or aspiring agents of change. With this in mind, I judge the book a great success because it is difficult to imagine readers, even among the cognoscenti, who are not better informed after a careful read.

    This book provides, above all, a truly international perspective, using comparisons as the basis for highlighting problems in prevention in the developing world. These parallel, but differ from in essential ways, those in wealthier countries.

    The organisation is exemplary. Six initial chapters lay the foundation by emphasising the importance of injuries worldwide, defining the epidemiological basis for prevention, assessing the health impact in terms of mortality and morbidity and the effect on communities, and thoroughly examining determinants. The next seven chapters are organised around conventional lines by type of injury, with traffic accidents, quite appropriately, receiving the greatest emphasis. One unexpected but laudable chapter is devoted to disasters. The conclusion deals with the choice and development of programmes for prevention and treatment and rehabilitation.

    Injury prevention is now well beyond infancy as a specialty and should be of grave concern to policy makers everywhere. I don't expect health officials to read this book from cover to cover, but browse it they must when facts are needed to support policy initiatives. There is no better compendium and no more thoughtful presentation of this modern epidemic. But, as Foege concludes: “When Thucidides was asked when justice would come to Athens, [he] replied, ‘Justice will come to Athens when those who are not injured are as indignant as those who are injured.’ This book is a roadmap to indignation. It will take action by all of us if the potential power of this book is to be reflected in lives saved and suffering prevented.”

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