Impact of product safety changes on accidental exposures to liquid laundry packets in children.

OBJECTIVES: To evaluate the impact of the ASTM International (formerly American Society of Testing Materials) safety standard and associated product safety changes on accidental exposures to liquid laundry packets (LLPs) in children. METHODS: The National Poison Data System was queried for reports of accidental exposures to LLPs in children <6 years old received from 01 July 2012 to 31 December 2018. In 2014, ASTM International began developing a standard specifying voluntary product changes to reduce the risk of LLP exposures in young children. Product changes were made between 2013 and 2016. Exposures were grouped into baseline, transition, and post periods based on the timing of the standard's implementation. Exposure counts and sales adjusted rates were compared between the baseline and post period for all exposures and exposures involving healthcare facility (HCF) evaluation, HCF admission, and major medical outcomes. RESULTS: A total of 73,942 accidental exposures in children <6 years old were reported (baseline: 10,229, 13.8%; transition: 43,507, 58.8%; post: 20,206, 27.3%). The percentage of exposures involving HCF evaluation (41.5% to 33.8%), HCF admission (4.5% to 1.9%), and major medical outcomes (0.6% to 0.1%) decreased from the baseline to post period. Sales adjusted rates of all exposures decreased 57.4% (4.920-2.094 exposures/1 million packets sold). Decreases also occurred in HCF evaluations (65.0% decrease; 2.026-0.708 exposures/1 million packets sold), HCF admissions (81.4% decrease; 0.218-0.041 exposures/1 million packets sold), and major medical outcomes (90.9% decrease; 0.030-0.003 exposures/1 million packets sold). CONCLUSIONS: The morbidity of accidental exposures to LLPs in children decreased substantially following implementation of the ASTM International safety standard. Ongoing monitoring should be performed to determine if additional safety measures are required.

Patinetes, no todo se evita con el casco / Scooters; not everything is prevented with the safety helmet

No disponible

Protecting the future: Fatal incidents on Australian farms involving children (2001-2019).

OBJECTIVES: To assess the demographic and causal factors, plus trends in rates of fatal farm incidents involving children (<15 years) in Australia over the 2001-2019 period. DESIGN: A descriptive retrospective epidemiological study of the National Coronial Information System. SETTING: Australia. PARTICIPANTS: Cases involving children (<15 years), where incidents have occurred on a farm (1 January 2001-31 December 2019). RESULTS: There has been essentially no change in the fatality rate for farm-related child injury deaths across Australia in the 2001-2019 period (-0.009/year). Men and children aged 0-4 years were significantly more likely to be involved in these incidents. Most cases were recreational in nature (81%), with seven agents (water bodies, quads [all-terrain vehicles], tractors, utes, cars, motorbikes and horses), accounting for 75% of cases. Water bodies were responsible for over 31% of deaths. CONCLUSION: The lack of progress addressing child farm injury mortality requires urgent attention. The overall rates and pattern of injury-related deaths have stagnated, necessitating new and innovative approaches to address the issue. The emerging National Injury Prevention Plan might provide scope to improve the focus on and implementation of evidence-based approaches.

Conceptualization of Major Stakeholders in Emergency Management of Childcare Facilities.

This study aims to conceptualize the key stakeholders in emergency management of childcare facilities for applicable nations by referring to the Korean case. Qualitative content analysis is the main methodology used. Unique features are gathered from the Korean literature on childcare facilities and then summarized; however, universal principles from the English language literature on international childcare facilities are emphasized. The analysis of five major stakeholders in Korean childcare facilities, namely, governments, community personnel, parents, childcare providers, and children, shows that their current efforts are directed only at general safety management. Multi-hazard management or an integrated approach in terms of social work is thus provided as an alternative for not only Korea but also other nations.

Injury Prevention: Freestylers' Awareness of FIS Code of Conduct for Snow Parks.

The objectives of the present study were to assess general perceptions of safety in snow parks (SPs), general knowledge of rules existence, and both active and passive awareness of the International Ski Federation (FIS) rules contained in its Code of Conduct for SPs in order to define target groups for injury prevention-specific education interventions. Data were drawn from 436 freestylers randomly interviewed. The study was conducted during the 2018-2019 winter season in the SP of a major winter resort located in the Spanish Pyrenees. A questionnaire assessing personal data (gender, age, gear used, self-reported skill, and frequency of use), general perceptions on safety, general request for rules, and awareness of existing rules in SPs was developed. Chi-square goodness-of-fit tests were used to compare characteristics between groups. It was revealed, for accident prevention purposes, a concerning general lack of knowledge of existing rules in SPs (63% of participants ignored them). Risk-inducing situations that could result in severe injuries, such as familiarity with the right progression in choosing features and/or stunts or with safety equipment, were largely assessed incorrectly (94% and 70% of participants, respectively). Appropriate intuitive behavior increases with experience: youths and beginners are less able to implement FIS rules than more experienced freestylers.

A six-year review of patients admitted to hospital with injuries related to quad bike use.

AIM: To describe quad bike injury-related hospitalisations in the Midland region over a six-year period. METHOD: A retrospective review of anonymised, prospectively-collected trauma registry data from 1 July 2012 to 30 June 2018 was undertaken. Cases include patients hospitalised with quad bike-related injuries. Non-major injuries are included to provide a clearer picture of the trauma burden. RESULTS: Three hundred and forty-six injuries resulted in hospitalisation with 70.2% of events occurring on a farm. Males outnumbered females 3.7:1. Forty-six children (<16 years) were hospitalised, of which 23 were injured on-farm and seven on a road. Over six years there was an annual average increase of 7.3% for all events occurring on a farm, 2.6% for injuries occurring during a farming activity and 4.7% for off-farm recreational injuries. CONCLUSION: Despite continued public debate and education on the safe use of quad bikes, injuries severe enough to require hospitalisation continue to occur. Children continue to be injured, both as riders and passengers. Ageing farmers are a developing area for concern. While workplace safety garners most of the safety attention, two other areas also deserve injury prevention consideration; injuries that occur on-farm but not during farming activities and those occurring off-farm to recreational riders.

The built environment and active transportation safety in children and youth: a study protocol.

BACKGROUND: Active transportation, such as walking and biking, is a healthy way for children to explore their environment and develop independence. However, children can be injured while walking and biking. Many cities make changes to the built environment (e.g., traffic calming features, separated bike lanes) to keep people safe. There is some research on how effective these changes are in preventing adult pedestrians and bicyclists from getting hurt, but very little research has been done to show how safe various environments are for children and youth. Our research program will study how features of the built environment affect whether children travel (e.g., to school) using active modes, and whether certain features increase or decrease their likelihood of injury. METHODS: First, we will use a cross-sectional study design to estimate associations between objectively measured built environment and objectively measured active transportation to school among child elementary students. We will examine the associations between objectively measured built environment and child and youth pedestrian-motor vehicle collisions (MVCs) and bicyclist-MVCs. We will also use these data to determine the space-time distribution of pedestrian-MVCs and bicyclist-MVCs. Second, we will use a case-crossover design to compare the built environment characteristics of the site where child and youth bicyclists sustain emergency department reported injuries and two randomly selected sites (control sites) along the bicyclist's route before the injury occurred. Third, to identify implementation strategies for built environment change at the municipal level to encourage active transportation we will conduct: 1) an environmental scan, 2) key informant interviews, 3) focus groups, and 4) a national survey to identify facilitators and barriers for implementing built environment change in municipalities. Finally, we will develop a built environment implementation toolkit to promote active transportation and prevent child pedestrian and bicyclist injuries. DISCUSSION: This program of research will identify the built environment associated with active transportation safety and form an evidence base from which municipalities can draw information to support change. Our team's national scope will be invaluable in providing information regarding the variability in built environment characteristics and is vital to producing evidence-based recommendations that will increase safe active transportation.

CONASS Debate: seminário internacional sobre Segurança no Trânsito (2º Dia)

O volume e a gravidade dos acidentes de trânsito afetam diretamente os sistemas de saúde e suas redes assistenciais, desde o atendimento pré-hospitalar até a reabilitação. Considerando a importância social e econômica desta temática, o Conass irá realizar nos dias 25 e 26 de abril de 2017 o Seminário Internacional sobre Segurança no Trânsito, com a participação de palestrantes do Brasil, Argentina, Canadá, Portugal, França e Espanha, que apresentarão estratégias e ações adotadas para a promoção da segurança no trânsito e redução da mortalidade e morbidade em seus países. No Brasil, as mortes no trânsito vem crescendo nos últimos anos, conforme revela o “Plano Nacional de Redução de Acidentes e Segurança Viária para a Década 2011-2020”, do Ministério das Cidades. Em 2012, segundo o “Retrato da segurança viária no Brasil 2014”, do Observatório Nacional de Segurança Viária, mais de 45 mil pessoas morriam no Brasil em consequência de acidentes (39% a mais do registrado dez anos antes e 5% a mais do que no ano de 2010). Isso significa 23,6 vítimas fatais a cada 100 mil habitantes, um óbito a cada 12 minutos. A quantidade de feridos em 2012 chegou a 177.487 pessoas. O evento reuniu representantes de organizações sociais que atuam na segurança no trânsito; do Samu (Serviço de Atendimento Móvel de Urgência); Detran (Departamentos de Trânsito); Corpo de Bombeiros e Polícias Militar e Rodoviária de todo o país, além de parlamentares, técnicos e dirigentes dos ministérios da Saúde, Transportes, Educação, Cidades, além de gestores da saúde e técnicos das secretarias de saúde de todo o país. Seminário Internacional sobre Segurança no Trânsito Data: 25 e 26 de abril de 2017 Horário: 25 de abril – das 14h às 18h / 26 de abril – das 9h às 13h Mais informações: http://www.conass.org.br/especialista...

CONASS Debate dia 26/04: Antônio Carlos F. Nardi

Palestrante: Antônio Carlos F. Nardi, secretário executivo do Ministério da Saúde do Brasil

CONASS Debate dia 25/04: Gregória Paixão von Amann

Palestrante: Gregória Paixão von Amann, coordenadora do Programa Nacional de Prevenção de Acidentes, Ministério da Saúde de Portugal

Public interest in gun control in the USA.

To characterise public interest in gun control in the USA using internet search queries, we undertook a cross-sectional study of the relative popularity Google Trends searchers for 'Gun Control', 'Second Amendment', 'National Rifle Association' and 'Mass Shooting' from May 2015 to December 2018. 740 weeks of data were queried. Graphed data revealed nine major inflection points. Seven of the nine (78%) major inflection points were associated with mass shootings, while two of the nine (22%) were related to political events by either the president of the USA or a presidential candidate. Our exploration of Google Trends shows the frequency of national searches related to gun control peaks with mass shootings over a 1-2-week period and then stabilises to nominal relative popularity thereafter suggesting a need to engage the public on gun control during 'trough' periods in order to sustain national interest and dialogue.

Unintentional injury deaths among American Indian residents of the Fort Apache Indian Reservation, 2006-2012.

This study aims to describe the epidemiology of unintentional injury deaths among American Indian residents of the Fort Apache Indian Reservation between 2006 and 2012. Unintentional injury death data were obtained from the Arizona Department of Health Services and death rates were calculated per 100 000 people per year and age adjusted using data obtained from Indian Health Service and the age distribution of the 2010 US Census. Rate ratios were calculated using the comparison data obtained through CDC's Web-based Injury Statistics Query and Reporting System. The overall unintentional injury mortality rate among American Indians residing on the Fort Apache Indian Reservation between 2006 and 2012 was 107.0 per 100 000. When stratified by age, White Mountain Apache Tribe (WMAT) mortality rates for all unintentional injuries exceed the US all races rate except for ages 10-14 for which there were no deaths due to unintentional injury during this period. The leading causes of unintentional injury deaths were MVCs and poisonings. Unintentional injuries are a significant public health problem in the American Indian and Alaska Native communities. Tribal-specific analyses are critical to inform targeted prevention and priority setting.

Net-societal and net-private benefits of some existing vehicle crash avoidance technologies.

Most light-duty vehicle crashes occur due to human error. Many of these crashes could be avoided or made less severe with the aid of crash avoidance technologies. These technologies can assist the driver in maintaining control of the vehicle when a possibly dangerous situation arises by issuing alerts to the driver and in a few cases, responding to the situation itself. This paper estimates the societal and private benefits and costs associated with three crash avoidance technologies, blind-spot monitoring, lane departure warning, and forward-collision warning, for all light duty passenger vehicles in the U.S. for the year 2015. The three technologies could collectively prevent up to 1.6 million crashes each year including 7200 fatal crashes. In this paper, the authors estimated the net-societal benefits to the overall society from avoiding the cost of the crashes while also estimating the private share of those benefits that are directly affecting the crash victims. For the first generation warning systems, net-societal benefits and net-private benefits are positive. Moreover, the newer generation of improved warning systems and active braking should make net benefits even more advantageous.

The prevalence of fire and CO safety amenities in Airbnb venues that permit smoking - Findings from 17 countries.

Airbnb hosts rent their homes to guests as an alternative to traditional hospitality settings. Airbnb venues are not uniformly regulated for allowing smoking or requiring fire-safety amenities. This study quantified the reported prevalence of fire-safety amenities in 413,339 Airbnb venues that allow smoking in 43 cities in 17 countries. Proportions of host-reported smoke detectors and carbon monoxide (CO) alarms, and those that allow smoking were calculated. Across the entire sample 9.3% (n = 38,525) allowed smoking. An overall evaluation of those venues shows that 46% (n = 17,569) had smoke detectors compared to 64% of the 374,814 venues that do not allow smoking, a statistically significant difference (X2 = 5277 p < 0.01). A similar difference is found between venues that allow smoking and had CO alarms (19%, n = 7176) and the 33% of venues that prohibit smoking (X2 = 3442, p < 0.01). Among this sample, most Airbnb venues that allow smoking are less likely to have safety amenities.

Pediatric dog bites: a population-based profile.

BACKGROUND: Previous studies have identified risk factors for dog bites in children, but use data from individual trauma centers, with limited generalizability. This study identifies a population risk profile for pediatric dog bites using the National Trauma Data Bank. We hypothesized that the population at risk was younger boys, that such bites occur at home, are moderately severe, and are on the face or neck. METHODS: For this retrospective cross-sectional study, a sample of 7912 children 17 years old and younger with International Classification of Diseases (ICD)-9 event code E906.0, for dog bites, were identified. Datasets from 2007 to 2014 were used. Data included patient's gender, age, ICD-9 primary and location E-codes, AIS body region and AIS severity. RESULTS: Most children were 6-12 years old and female, but a similar number fell into the narrower range of 0-2 years old. Injuries in the younger group frequently occurred at home, on the face and head, and with minor severity. Age of the child predicts the location of incident (P<0.001), the severity of injury (P<0.001) and the body region of the injury (P<0.001). Body region of the injury predicted its severity (P<0.001). DISCUSSION: Younger children are more likely to receive dog bites, and bites incurred are likely of greater severity. Children this young cannot yet be taught how to properly interact with a dog. CONCLUSIONS: Dog bites are a significant source of morbidity for children. Based on the population risk factors profile generated, this study recommends targeting live dog education towards the parents of young children.

A concept mapping approach to identifying the barriers to implementing an evidence-based sports injury prevention programme.

BACKGROUND AND AIM: Understanding the barriers to programme use is important to facilitate implementation of injury prevention programmes in real-word settings. This study investigated the barriers to coaches of adolescent female soccer teams, in Victoria, Australia, implementing the evidence-based FIFA 11+ injury prevention programme. METHODS: Concept mapping with data collected from 19 soccer coaches and administrators. RESULTS: Brainstorming generated 65 statements as barriers to 11+ implementation. After the statements were synthesised and edited, participants sorted 59 statements into groups (mean, 6.2 groups; range, 3-10 groups). Multidimensional scaling and hierarchical cluster analysis identified a six-cluster solution: Lack of 11+ knowledge among coaches (15 statements), Lack of player enjoyment and engagement (14), Lack of link to football-related goals (11), Lack of facilities and resources (8), Lack of leadership (6) and Lack of time at training (5). Statements in the 'Lack of 11+ knowledge among coaches' cluster received the highest mean importance (3.67 out of 5) and feasibility for the Football Federation to address (3.20) rating. Statements in the 'Lack of facilities and resources' cluster received the lowest mean importance rating (2.23), while statements in the 'Lack of time at training' cluster received the lowest mean feasibility rating (2.19). CONCLUSIONS: A multistrategy, ecological approach to implementing the 11+-with specific attention paid to improving coach knowledge about the 11+ and how to implement it, linking the 11+ to the primary goal of soccer training, and organisational leadership-is required to improve the uptake of the 11+ among the targeted coaches.

School-Based and Community-Based Gun Safety Educational Strategies for Injury Prevention.

BACKGROUND: Nearly 1,300 children in the United States die because of firearm-related injury each year and another 5,790 survive gunshot wounds, making the prevention of firearm-related unintentional injury to children of vital importance to families, health professionals, and policy makers. OBJECTIVE: To systematically review the evidence on school-based and community-based gun safety programs for children aged 3 to 18 years. STUDY DESIGN: Systematic review. METHOD: Twelve databases were searched from their earliest records to December 2016. Interventional and analytic studies were sought, including randomized controlled trials, quasi-experimental studies, as well as before-and-after studies or cohort studies with or without a control that involved an intervention. The low level of evidence, heterogeneity of studies, and lack of consistent outcome measures precluded a pooled estimate of results. A best evidence synthesis was performed. RESULTS: Results support the premise that programs using either knowledge-based or active learning strategies or a combination of these may be insufficient for teaching gun safety skills to children. CONCLUSIONS: Gun safety programs do not improve the likelihood that children will not handle firearms in an unsupervised situation. Stronger research designs with larger samples are needed to determine the most effective way to transfer the use of the gun safety skills outside the training session and enable stronger conclusions to be drawn.

Prevenção de acidentes domésticos no Distrito Federal / Prevention of domestic accidents in the Federal District

Os acidentes domésticos são importante causa de internação hospitalar e mortalidade entre crianças, adultos e pessoas idosas, mobilizando não só o setor saúde, mas também os profissionais de segurança pública, em especial os bombeiros, que são os primeiros respondentes a diversas dessas ocorrências. Considerando a demanda de ações intersetoriais que atentem para os diferentes tipos de acidentes domésticos, é necessário consolidar ações e campanhas e debater potencialidades e barreiras à implementação dessas atividades junto aos diferentes atores que atuam nessas ocorrências. Devido à magnitude do problema das quedas, em especial entre idosos, a maior parte da literatura científica sobre acidentes domésticos está focada em soluções de prevenção para esse público.