Can child injury prevention include healthy risk promotion?

To reflect on the role of risk-taking and risky play in child development and consider recommendations for the injury prevention field, a symposium was held prior to the November 2013 Canadian Injury Prevention and Safety Promotion Conference. Delegates heard from Canadian and international researchers, practitioners and play safety experts on child development, play space design and playground safety, provision of recreation, and legal and societal perceptions of risk and hazard. The presenters provided multidisciplinary evidence and perspectives indicating the potential negative effect on children's development of approaches to injury prevention that prioritise safety and limit children's opportunities for risky play. Delegates considered the state of the field of injury prevention and whether alternative approaches were warranted. Each presenter prepared a discussion paper to provide the opportunity for dialogue beyond attendees at the symposium. The resulting discussion papers provide a unique opportunity to consider and learn from multiple perspectives in order to develop a path forward.

Safety management and public spaces: restoring balance.

Since 2000, the reputation of health and safety in the United Kingdom has been tarnished, so much so that it has become the subject of both a media circus and a government inquiry. This not only threatens the worthy goals of health and safety, but also impacts upon the associated tool of risk assessment itself such that "risk assessment" is increasingly seen by the public at large as a term inviting ridicule, even abuse. The main thrust of the government's examination of health and safety has been its concern that safety requirements were placing a disproportionate burden on business. However, there is another source of discontent, which is public chagrin over the impact of injury control measures upon life beyond the conventional workplace, in particular upon the public spaces that people frequent in their leisure time and on the activities they engage in there. This article provides a perspective on this second dimension of the crisis in confidence. It describes how many U.K. agencies with responsibilities for a wide portfolio of public amenities ranging from the provision of play spaces for the young to the management of publicly accessible countryside, the maintenance of urban and rural trees, the stewardship of sites of cultural heritage, and the pursuit of outdoor educational activities have responded to some conflicts posed to their services by the new safety culture. It concludes with a discussion of implications for the management of public space and for risk assessment itself.

Further thoughts on the utility of risk matrices.

Risk matrices are commonly encountered devices for rating hazards in numerous areas of risk management. Part of their popularity is predicated on their apparent simplicity and transparency. Recent research, however, has identified serious mathematical defects and inconsistencies. This article further examines the reliability and utility of risk matrices for ranking hazards, specifically in the context of public leisure activities including travel. We find that (1) different risk assessors may assign vastly different ratings to the same hazard, (2) even following lengthy reflection and learning scatter remains high, and (3) the underlying drivers of disparate ratings relate to fundamentally different worldviews, beliefs, and a panoply of psychosocial factors that are seldom explicitly acknowledged. It appears that risk matrices when used in this context may be creating no more than an artificial and even untrustworthy picture of the relative importance of hazards, which may be of little or no benefit to those trying to manage risk effectively and rationally.

The rise and fall of a regulator: adventure sports in the United kingdom.

Following a tragic accident in 1993 involving the deaths of teenagers while kayaking a new regulatory regime was imposed upon some adventure sports providers in the United Kingdom. In particular, a new regulatory body, the Adventure Activities Licensing Authority (AALA), was established to oversee the sector. Yet in 2010, a government-sponsored review recommended that AALA be abolished and this recommendation has been quickly accepted by government. This article explores the background to these developments through documentation, interviews with those affected by the AALA regime, and court cases. Evidence reported here, perhaps surprising, is that AALA itself is seen in a very positive light by many, even those it regulates. What may have happened is that AALA became caught up in a wider debate about the place and management of risk in life beyond the workplace, which has been simmering in the United Kingdom for a decade or more, and of which it fell foul. It may also be that adventure sports, because they entail voluntary engagement with high consequence hazards, starkly expose serious questions about the application of conventional, factory-originated risk assessment approaches to life in general.

Virtual Risk Management-Exploring Effects of Childhood Risk Experiences through Innovative Methods (ViRMa) for Primary School Children in Norway: Study Protocol for the ViRMa Project.

BACKGROUND: Research indicates that risky play benefits children's risk assessment and risk management skills and offers several positive health effects such as resilience, social skills, physical activity, well-being, and involvement. There are also indications that the lack of risky play and autonomy increases the likelihood of anxiety. Despite its well-documented importance, and the willingness of children to engage in risky play, this type of play is increasingly restricted. Assessing long-term effects of risky play has been problematic because of ethical issues with conducting studies designed to allow or encourage children to take physical risks with the potential of injury. OBJECTIVE: The Virtual Risk Management project aims to examine children's development of risk management skills through risky play. To accomplish this, the project aims to use and validate newly developed and ethically appropriate data collection tools such as virtual reality, eye tracking, and motion capturing, and to provide insight into how children assess and handle risk situations and how children's past risky play experiences are associated with their risk management. METHODS: We will recruit 500 children aged 7-10 years and their parents from primary schools in Norway. Children's risk management will be measured through data concerning their risk assessment, risk willingness, and risk handling when completing a number of tasks in 3 categories of virtual reality scenarios: street crossing, river crossing, and playing on playground equipment. The children will move around physically in a large space while conducting the tasks and wear 17 motion-capturing sensors that will measure their movements to analyze motor skills. We will also collect data on children's perceived motor competence and their sensation-seeking personality. To obtain data on children's risk experiences, parents will complete questionnaires on their parental style and risk tolerance, as well as information about the child's practical risk experience. RESULTS: Four schools have been recruited to participate in data collection. The recruitment of children and parents for this study started in December 2022, and as of April 2023, a total of 433 parents have consented for their children to participate. CONCLUSIONS: The Virtual Risk Management project will increase our understanding of how children's characteristics, upbringing, and previous experiences influence their learning and ability to handle challenges. Through development and use of cutting-edge technology and previously developed measures to describe aspects of the children's past experiences, this project addresses crucial topics related to children's health and development. Such knowledge may guide pedagogical questions and the development of educational, injury prevention, and other health-related interventions, and reveal essential areas for focus in future studies. It may also impact how risk is addressed in crucial societal institutions such as the family, early childhood education, and schools. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/45857.

Factors influencing subjective ranking of driver distractions.

Driver distraction is recognised as a significant cause of road traffic incidents. However, the more objective measurement and ranking of the relative importance of individual distractions in contributing to incidents tend to differ from subjectively-held rankings. To investigate this, the present study examines qualitative characteristics of 14 driver distractions to determine if these characteristics might explain the discrepancy. The conclusion is that for laypersons, qualitative characteristics, such as equity and familiarity, do contribute to their ranking of driver distractions. This poses some interesting issues for risk managers. For example, should safety interventions aimed at driver distractions be based purely on factual data and life-saving potential, or should they accommodate qualitative factors of salience to the public?

Trends in fall injuries associated with children's outdoor climbing frames.

Falls from publicly owned climbing equipment are often cited as the major cause of injury on children's outdoor playgrounds and have been the focus of substantial interventions in the UK since the early 1980s. Analysis of national data on falls from climbing frames for 1988 to 2002 shows that the main discernible trend during this period is an increase in the occurrence of injuries to the lower arm. Whether this is attributable to a behavioural response to some of the interventions, or to some other factor, is unknown.

Societal concerns and risk decisions.

Societal concern is a relatively new term and refers to hazards with the capability to generate socio-political responses. Hazards invoking societal concerns pose a challenge to decision makers for they oftentimes have major policy implications yet frequently lack the analytic support affording them such elevated status. Regulators and corporate risk managers, therefore, have been confronted with the difficult question -how and to what extent should societal concerns be factored into risk management decisions? - a question which is compounded by the tendency of 'politicians' to want to accommodate these concerns. Here we first seek to explore the drivers of societal concerns prior to considering the implications for decision makers. We conclude that societal concerns stem from highly disparate causes, are not necessarily originated by the public as is often implied, and as such have markedly differing legitimacies. Furthermore, we note that attempts to incorporate societal concerns into risk decisions raise a host of methodological, political, and ethical issues which suggest, at the very least, that deep caution is required, especially where policy implications are high.

Foreign travel and the risk of harm.

Systematic data on the risk of fatal and non-fatal injury from external causes to those who travel abroad for purposes of business or pleasure are seldom recorded and are consequently hard to come by. In this paper, the risk of fatal injuries to foreign travellers using historical and newly acquired data from national databases is estimated. Overall, it appears from these data that the risk of fatal injury to foreign travellers lies in the range of 20 to 90 per 100 000 person-years of exposure for many destinations worldwide, although different rates may pertain in selected situations where special conditions apply, for example, where there is heavy participation in risky sports or increased driving. This level of fatal injury risk is not noticeably different from that of staying in one's home country if one lives in a Western-style industrial country, although the types of hazards responsible may vary in type and proportion. With increasing levels of travel, and the growing popularity of more adventurous pursuits, it is possible that risks could be increasing in this sector.

Environmental risk assessment and the intrusion of bias.

The concept of managing the environment and any associated human health impacts by means of such science-based tools as toxicological evaluation, risk assessment, and economic appraisal has become widely accepted in professional circles. These increasingly complex methodologies have not won universal support, however, even among the technically minded, and the wider public has in many cases remained sceptical. The public's seeming lack of enthusiasm has frequently been assigned to ignorance of science, irrationality even, and some attempts have been made to ameliorate the situation by means of education, though with little evidence of success. However, this review advances an alternative explanation, namely, that the disenchantment has more to do with procedural than technical matters. Many issues, although treated with technical risk assessment appear to have forced themselves onto the agenda because of factors only passingly connected with risk, and which are more related to the intrusion of disputed values and other sources of bias. This paper also notes that the intervention of bias in decision making is rife, and is found as much in professional as in public approaches. This need not itself be a problem, providing it is recognised and openly expressed. However, there remains a need for much greater circumspection and frankness by professions about the status of their art, and a determined effort if the full social benefits of environmental risk assessment (ERA) are to be realised.

Policy issues and risk-benefit trade-offs of 'safer surfacing' for children's playgrounds.

The case for the universal application of 'safer surfacing' in playgrounds is assessed in terms of absolute risk, cost-benefit, and qualitative factors, and found to be open to question on each front. In parallel, it is noted that members of the child welfare and play communities are increasingly of the view that playgrounds are losing their appeal for children, which in turn has its own health, safety and developmental consequences. In part, this loss of attractiveness may have linkages with the recent concern over play safety and the imposition of measures such as 'safer surfacing'. It is proposed that the drive for play safety, which has existed for some 20 years, should be succeeded by a more holistic approach which, rather than considering play safety in isolation, acknowledges the importance of all attributes of play including child safety both on and off playgrounds, potential beneficial aspects of childhood risk exposure, adventure, and play value.

The UK Committee on Radioactive Waste Management.

The UK Committee on Radioactive Waste Management is charged with recommending to Government, by July 2006, options for the long term management of the UK's radioactive waste legacy. These options should inspire public confidence. Now, more than halfway into the time allotted, we, as two former members of the Committee, express our concerns at the wayward approach that has been adopted. The Committee has placed emphasis on gaining public confidence but this has been done at the expense of recruiting the best scientific expertise in the management of radioactive waste, an act which we believe will actually undermine public confidence. Furthermore, given also the immense importance of this decision to public safety, national security and the national interest, we believe urgent steps should be taken to review the Committee's process, its management and its sponsorship.