Public Health Unintentional Injury Prevention
by
David A. Sleet
  • LAST REVIEWED: 15 June 2015
  • LAST MODIFIED: 29 November 2011
  • DOI: 10.1093/obo/9780199756797-0020

Introduction

Unintentional injuries, such as falls, motor vehicle crashes, and poisoning, are a large, predictable, and preventable national and international public health problem affecting individuals, families, and communities. Unintentional injuries are the fifth leading cause of death for people of all ages in the United States and the eighth leading cause internationally. Unintentional injuries are the biggest source of years of life lost prematurely in the United States. The consequences of injuries are extensive and wide-ranging, including physical, emotional, and financial burdens; in the case of disabling injuries, the consequences can last a lifetime. Every year, approximately 120,000 people in the United States and 3.9 million worldwide die from an unintentional injury. About 1 in 10 (or approximately 27 million Americans) had an injury serious enough to require treatment in an emergency department of a hospital. Globally, 138 million disability-adjusted life-years are lost annually, with over 90 percent of those occurring in low- and middle-income countries. Recent data from the Centers for Disease Control and Prevention (CDC) indicate that 68 percent of all fatal injuries and 93 percent of all emergency-room injury visits are due to unintentional injuries from falls, fires and burns, poisoning, drowning, choking, and transportation-related injuries (that includes drivers and passengers, pedestrians, and cyclists). Approximately 50 million injuries per year lead to estimated lifetime costs of $406 billion in medical expenses and lost productivity in the United States. The World Health Organization estimates that by 2020, traffic-related injuries alone will be the third leading contributor to the global burden of disease and injury, up from the eighth leading cause in 2011. Controlling unintentional injuries has been an intractable problem for nearly a century. Modern preventive medicine and public health, however, have embraced it in a systematic, coordinated way only since the early 1940s. Injury prevention first focused on changing individual behavior, then on environmental control, and then, more recently, on applying an ecological framework with growing attention to the human–environment interface. This unintentional injury overview is intended to be a resource for general inquiries into unintentional injury prevention, including childhood injuries, falls among older adults, motor vehicle safety, pedestrian safety, poisoning, fire-related injuries, and sports injuries. We identify resources that pertain to the definition, history, development, and application of principles of injury control for use in preventing unintentional injuries.

Introductory Works

Even though the problem of unintentional injuries (formerly called “accidents”) were described in journals as early as 1922, introductory works that addressed the entire field lagged behind by another thirty-five to forty years. Thygerson 1986 and Miller 1995 provide the widest array of introductory material on safety for the undergraduate student, while at the graduate level, Injury Prevention: Meeting the Challenge (National Committee for Injury Prevention and Control 1989) provides the foundation for study of the field. Evans 2004 presents a nice introduction and overview of most, if not all, of the scientific and policy issues around improving traffic safety. Thygerson, et al. 2008 offers a set of competencies to guide the field in preparing future leaders in injury prevention.

  • Evans, Leonard. 2004. Traffic safety. Bloomfield Hills, MI: Science Serving Society.

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    This book applies the methods of science to better understand this “epidemic on wheels.” Traffic safety is treated in detail with unconstrained analyses of the inadequacies of government in one of its chief responsibilities—to protect life. Explanations are offered for the ongoing US failure to keep up with safety progress found in other developed nations.

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    • Miller, Dean F. 1995. Safety: Principles and issues. Dubuque, IA: William C. Brown.

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      This undergraduate book focuses on how injuries and safety impact people’s lives. Many chapters discuss the home environment and its potential for reducing injuries, including general safety concepts related to fire, falls, and recreational pursuits.

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      • National Committee for Injury Prevention and Control. 1989. Injury prevention: Meeting the challenge. American Journal of Preventive Medicine Supplement 5.3. New York: Oxford Univ. Press.

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        This landmark book, once considered the “bible” for injury prevention, describes the burden of injuries and how to get started with data, program design/evaluation, and program implementation. There are individual chapters on traffic injuries, residential injuries, recreational injuries, occupational injuries, and all forms of violence. Preface by C. Everett Koop, former US Surgeon General.

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        • Thygerson, Alton L. 1986. Safety. 2d ed. Englewood Cliffs, NJ: Prentice-Hall.

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          This book introduces the field of safety and is an account of the foundations of safety, including efforts to reduce incidents that lead to injury and ways to control their impact. An undergraduate text that focuses on skills and knowledge needed to fulfill the safety education requirements of many colleges and universities. Originally published in 1977 as Accidents and Disasters.

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          • Thygerson, Alton L., Steven M. Thygerson, and Justin S. Thygerson. 2008. Injury prevention: Competencies for unintentional injury prevention professionals. 3d ed. Sudbury, MA: Jones and Bartlett.

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            The National Training Initiative on Injury and Violence Prevention’s core competencies and objectives, specifically those on unintentional injuries, form the chapters in this book. Presents the essential skills and knowledge generally regarded as necessary to work in the injury-prevention field. Although the core competencies focus on both violence and unintentional injuries, this book concentrates only on unintentional injuries, including motor vehicles, poisoning, falls, drowning, residential fires, and unintentional firearm-related injuries.

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            Textbooks

            Many of the textbooks on injury and trauma appear in the medical literature. Examples of popular textbooks are those related to the treatment and progression of traumatic brain injury, injuries of the musculoskeletal system, traumatic injuries to the teeth, emergency medicine, and sports medicine. Far fewer texts are devoted to injury prevention and control. The idea of a textbook on injury prevention might have started when epidemiologists were introduced to injuries, giving an impetus to create data systems, more fully describe injuries causally, and document trends. The classic work Baker, et al. 1992 illustrated that this was possible and necessary for the growth of the field. It was followed quickly by several other epidemiology-focused textbooks, including Robertson 2007. Only later, with Christoffel and Gallagher 2006, which addressed program delivery issues; Doll, et al. 2007, which addressed evidence-based practices; and McClure, et al. 2004, which addressed scientific foundations in the field, did a full complement of needed textbooks for graduate education in injury prevention emerge. Barss, et al. 1998 focuses on the global problem of injuries, suitable for courses in international health.

            • Baker, Sue, Brian O’Neill, Marvin J. Ginsburg, and Guohua Li. 1992. The injury fact book. 2d ed. Oxford Univ. Press.

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              Provides an unrivalled source of information for identifying groups of people whose activities, age, income, location, and education render them especially susceptible to serious injury. Used for many years as a standard textbook in graduate education, it comprehensively documents the magnitude of the injury problem. More than sixty causes of injury are explored, with six chapters on traffic injuries, which constitute almost one-third of all injury deaths. Originally published in 1984.

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              • Barss, Peter, Gordon Smith, Susan Baker, and Dinesh Mohan. 1998. Injury prevention: An international perspective. New York: Oxford Univ. Press.

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                Around the world, injuries are one of the leading causes of death for young adults, adolescents, and children. Eighty to 90 percent of injury deaths occur in low- and middle-income countries. This book documents the magnitude of the problem worldwide and provides basic approaches to global injury prevention.

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                • Christoffel, Tom, and Susan Scavo Gallagher. 2006. Injury prevention and public health: Practical knowledge, skills, and strategies. 2d ed. Sudbury, MA: Jones and Bartlett.

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                  This book is a guide to understanding and preventing unintentional and violence-related injury from a public health perspective. It provides a synthesis of three major elements: the nature and magnitude of injury; the basic concepts of injury prevention; and practical strategies and resources for planning, implementing, and evaluating prevention programs. Originally published in 1999.

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                  • Doll, Lynda, Sandy Bonzo, James A. Mercy, and David A. Sleet, eds. 2007. Handbook of injury and violence prevention. New York: Springer.

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                    The first book to identify and review evidence-based interventions in-depth so professionals can identify successful, promising, and ineffective strategies. Chapters cover specific injuries and violence, and program considerations such as implementation. This dual focus on intervention and application makes the handbook a bedrock text for professionals involved in delivering or managing prevention programs.

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                    • McClure, Roderick, Mark Stevenson, and Suzanne McEvoy, eds. 2004. The scientific basis of injury prevention and control. Melbourne, Australia: IP Communications.

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                      This book nicely describes the science used to conceptualize injury problems and design solutions. Twenty-four chapters are authored by thirty-eight international experts. Sections on historical perspectives; models for injury causation; and perspectives on epidemiology, biomechanics, engineering, and behavioral science are described in detail. This was the first comprehensive textbook produced in Australia, with an emphasis on Australasian examples, settings, and research findings.

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                      • Robertson, Leon S. 2007. Injury epidemiology. 3d ed. New York: Oxford Univ. Press.

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                        This book describes the Haddon model of understanding the phases and components of injury events and offers options for intervention. It includes a description of standard epidemiologic research methods and a review of data systems for categorizing injury severity. Originally published in 1992.

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                        Anthologies

                        Anthologies and edited books that include multiple contributors and address a specialized field include Graham 1988 on traffic safety, Liller 2006 on child and adolescent injury, and Gielen, et al. 2006 on behavioral approaches to injury. In each case, the editors have pulled together the senior authors in the field and provided commentary on the issues addressed.

                        • Gielen, Andrea Carlson, David A. Sleet, and Ralph DiClemente, eds. 2006. Injury and violence prevention: Behavioral science theories, methods and applications. San Francisco: Jossey-Bass.

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                          This volume, edited by three behavioral scientists with experience in public health and injury prevention, provides the first analysis of the application of behavioral science theories and methods to injury prevention. Whereas many works on injury dismiss or discount the role of behavioral science, this book demonstrates that behavioral science is not only relevant but central to reducing injury-related harm.

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                          • Graham, John D., ed. 1988. Preventing automobile injury: New findings from evaluation research. Dover, MA: Auburn House.

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                            An early effort to assess and document the merits of policies designed to prevent motor vehicle–related injuries, this book considers both behavioral and technological innovations and their successes. It evaluates injury-control policies related to drunk driving, lack of seat belts and child restraints, and highway speeding. The author is a former professor of policy and decision science at Harvard University and later served at the White House Office of Management and Budget from 2001 to 2006.

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                            • Liller, Karen DeSafey, ed. 2006. Injury prevention for children and adolescents: Research, practice, and advocacy. Washington, DC: American Public Health Association.

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                              This volume presents the most up-to-date research, practice, and advocacy efforts on the major killer of children and adolescents: injuries. Chapters emphasize the need for researchers and practitioners to work together in comprehensive efforts that include education, engineering, and legislative and enforcement strategies. Thirty-seven authors contribute their expertise and cover every facet of unintentional injuries and violence to children and adolescents. Second edition forthcoming as of 2011.

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                              Reference Works

                              The United States was prominent in identifying injury as a priority public health problem with the publication of Injury in America (Committee on Trauma Research, et al. 1985), which identified injury as the leading cause of death and disability among children and young adults and indeed the principal public health problem facing America. A subsequent series of reviews of the progress in developing an infrastructure to address injury at the national level followed, including Injury Control (Rivara, et al., 2001, cited under Research Methods, Theories, and Applications), Disability in America (Institute of Medicine 1991), and Reducing the Burden of Injury (Institute of Medicine 1999). Other important reference contributions have been Hemenway 2009, a review of the successes in the field, and Finkelstein, et al. 2006, a book on the costs of injury.

                              • Committee on Trauma Research, National Research Council, and Institute of Medicine. 1985. Injury in America: A continuing public health problem. Washington, DC: National Academy Press.

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                                By congressional request, the Institute of Medicine convened a committee to determine what is known about trauma (injury), what type of research is necessary, and how federal efforts could be better coordinated to reduce injuries. This report, published in 1985, was the culmination of those deliberations and set the path for the establishment of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention.

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                                • Finkelstein, Eric A., Phaedra S. Corso, and Ted R. Miller. 2006. The incidence and economic burden of injuries in the United States. New York: Oxford Univ. Press.

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                                  This congressionally mandated report estimates the impact of injuries in economic terms. The book discusses how, in 2000 alone, the 50 million injuries that required medical treatment will ultimately cost $406 billion. The authors examine medical expenses and productivity losses by gender, age, mechanism of injury, body region/body part injured, and severity, and also discuss recent trends.

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                                  • Hemenway, David. 2009. While we were sleeping: Success stories in injury and violence. Berkeley: Univ. of California Press.

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                                    This little book powerfully illuminates how public health works, with more than sixty success stories drawn from the area of injury and violence prevention. It also profiles individuals who have made important contributions to safety and highlights examples of prevention success from the United States and abroad.

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                                    • Institute of Medicine. 1991. Disability in America: Toward a national agenda for prevention. Edited by Andrew MacPherson Pope and Alvin Tarlov. Washington, DC: National Academy Press.

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                                      This reference work discusses not only disability caused by injury but also developmental disability, chronic disease, aging, and secondary conditions arising from primary disabling conditions. The emphasis in this report is on developing interventions that can prevent disabling conditions, reduce impairment, and improve functional independence.

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                                      • Institute of Medicine. 1999. Reducing the burden of injury: Advancing prevention and treatment. Edited by Richard J. Bonnie, Carolyn Fulco, and Catharyn T. Liverman. Washington, DC: National Academy Press.

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                                        Continues on from Injury in America, highlighting progress in the field since 1985. Identifies opportunities to leverage the resources and expertise of the numerous federal agencies and organizations involved and looks critically at the current response by the public and private sectors. Recommendations are presented related to data and surveillance, research priorities, trauma care systems, training, and coordination among federal agencies.

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                                        History

                                        Although treatments of cases of head and foot injuries are evidenced on papyrus dating back to 1600 BCE, and Hippocrates studied wounds and fractures as early as 500 BCE, relative to most branches of medical science, coordinated epidemiology and research characterizing modern injury prevention are relatively new. Consequently, there are few books that deal solely with the history of injuries in general or with injury prevention in particular. One exception is Cooter and Luckin 1997, which looks at injury prevention from a social history and anthropological perspective. Several good accounts of the historical path of injury prevention and control can be found in journal articles (Waller 1994, Fisher and Brown 2004, and Pless 2006), which provide many illustrations of the battle to engage public health in injury prevention. While much of the early work is rooted in state and local public health demonstration programs funded by the Kellogg Foundation, it provided, nevertheless, a foundation for expanding the field through science, professional discipline, partnerships, and public health training. One look back, in Widome 1991, traces the work of George Wheatley, the first chairman of the American Academy of Pediatrics Accident Prevention Committee, who, in 1954, popularized the “three Es” in injury control: education, endorsement, and engineering.

                                        • Cooter, Roger, and Bill Luckin, eds. 1997. Accidents in history: Injuries, fatalities and social relations. Clio Medica/The Wellcome Series in the History of Medicine 41. Amsterdam: Rodopi.

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                                          The authors point out that in the early 19th century, citizens recognized the need for the prevention of, systematic study of, and medical intervention for injury. There are chapters on the philosophy and sociology of accidents, as well as the surge of interest in accidents in the late 19th century. The thesis is that, throughout history, accidents are not arbitrary but rather have enduring social, economic, cultural, or political meaning.

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                                          • Fisher, Leslie, and Theodore Brown. 2004. Donald Budd Armstrong and W. Graham Cole: Early injury control advocates. American Journal of Public Health 94.6: 940–942.

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                                            This short article traces the careers of Donald Budd Armstrong and W. Graham Cole and their early contributions to the growth of the injury field from the 1940s to the 1960s. Building on earlier efforts, Armstrong and Cole galvanized the field and developed strong alliances with the National Safety Council, the American Public Health Association, and Metropolitan Life Insurance Company.

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                                            • Pless, I. B. 2006. A brief history of injury and accident prevention publications. Injury Prevention 12.2: 65–66.

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                                              Pless provides a nice account of the most cited and popular of the peer-reviewed articles from 1940 on that resulted from his “Web of Science” search using injury prevention or accident prevention as search terms. The tremendous growth in the field can be measured by a number of journal publications by decade from 1940 to 1949 (25), to more than 750 during the first half of 2000 to 2005. Pless also names the most cited authors and journals as well as the most published authors. Available online for purchase or by subscription.

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                                              • Waller, Julian A. 1994. Reflections on a half century of injury control. American Journal of Public Health 84.4: 664–670.

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                                                Using historical analysis and personal reflections, this article describes the development of injury control activities since 1940, focusing attention on the rise and fall of the US Department of Health, Education and Welfare’s Public Health Service Division of Accident Prevention. Modest injury control efforts were inaugurated in the 1940s and 1950s, but it was not until the 1960s that concerted efforts were made to formulate policies and practices to reduce injuries. These efforts soon dissipated, but a resurgence occurred in 1985 with the development of a new cadre of injury control professionals.

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                                                • Widome, Mark D. 1991. Remembering as we look ahead: The three Es and firearm injuries. Pediatrics 88:379–383.

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                                                  Widome, a pediatrician, described the history of developmentally based approaches to the prevention of childhood injury. In it, he discusses the work of George Wheatley, who was concerned about the nonbiologic vectors in a child’s environment that threaten life and limb, such as firearms and automobiles.

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                                                  Research Methods, Theories, and Applications

                                                  Given the interdisciplinary nature of injury prevention, it is not surprising that the field draws on theories and research methods from the disciplines of engineering, environmental health, behavioral science, education, and enforcement, among others. Settings have included the home, the community, worksites, and schools, each with their own set of challenges for research. Haddon, et al. 1964 was one of the first attempts at describing these various challenges and beginning to apply a common set of scientific methods to their exploration. Rivara, et al. 2001, on research and program evaluation, was a bold step in the current era as it attempted to apply modern-day solutions to a range of sophisticated and innovative research methods in injury prevention.

                                                  • Haddon, William, Edward A. Suchman, and David Klein. 1964. Accident research: Methods and approaches. New York: Harper & Row.

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                                                    This text represents the first comprehensive treatment of injury, assembled as a collection of articles on the most significant contributions to the field up to 1964. What’s unique about this book is its focus on embedding these studies (including some from the 1940s and 1950s) into examples of the growth in the use of scientific methodologies, theories, and applications to solve injury problems. Articles are accompanied by reflections and comments from the authors.

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                                                    • Rivara, Frederick, Peter Cummings, Thomas Koepsell, David Grossman, and Ronald Maier, eds. 2001. Injury control: A guide to research and program evaluation. New York: Cambridge Univ. Press.

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                                                      This book addresses the growing need for a comprehensive source of knowledge on all research designs available for injury-control research and evaluation. It includes choices in study design, details about study execution, and discussion of specific tools such as use of the injury severity scales, program evaluations, and systematic review methodology.

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                                                      Bibliographies

                                                      Because of the wide variety of disciplines that publish in injury prevention, there is no single source that can amass all the studies relevant to a particular injury topic or approach, and cross-disciplinary resources are not easily found through a database literature review. However, Sleet and Hopkins 2004 is the most comprehensive bibliography on the subject to date. It covers a wide variety of nontraditional fields (e.g., anthropology and communications) in which injury prevention articles are hard to find, but nevertheless present.

                                                      • Sleet, David A., and Krista Hopkins, eds. 2004. Bibliography of behavioral science research in unintentional injury prevention. Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.

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                                                        Includes more than 900 citations of journal articles, book chapters, government reports, and other publications. This bibliography—designed as a tool for researchers, practitioners, and students—documents the contributions of behavioral and social sciences to unintentional injury prevention and control from 1980 to 2003. Only unintentional injury topics are included (e.g., bicycle injuries, motor vehicle crashes, product safety, drowning, falls, fire and burns, etc.).

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                                                        Definitions

                                                        Unintentional injuries, such as those caused by motor vehicle crashes, drowning, falls, and fires, are defined by the CDC (see Centers for Disease Control and Prevention 2011) as “unintentional damage to the body resulting from acute exposure to thermal, mechanical, electrical or chemical energy, or from the absence of such essentials as heat or oxygen.” The terms injury and trauma are often interchangeable. Davis and Pless 2001 describes how the term injury is preferable to accident, as accident implies a random event or act of fate that is neither predictable nor preventable. Unintentional injury implies physiological damage to the body or the medical consequences of an incident involving the transfer of energy in amounts that exceed the body’s tolerance. Injuries are considered preventable through changes in aspects of the environment, individual behavior, products, social norms, legislation, and governmental and institutional policies to reduce or eliminate risks and consequences. The Centers for Disease Control and Prevention’s WISQARS interactive data-reporting system (see Centers for Disease Control and Prevention 2011) allows researchers and others to aggregate statistics on injury using standard definitions and data elements.

                                                        • Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. 2011. Injury Prevention & Control: Data & Statistics: WISQARS.

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                                                          The CDC uses standardized definitions for fatal and nonfatal injuries for purposes of queing their online WISQARS data system. It enables the public to aggregate and calculate rates and numbers of various types of injuries online using death data from the National Center for Health Statistics and emergency department data from the National Electronic Injury Surveillance System’s All Injury Program. Access to WISQARS is free, and in addition to running statistics on the type and frequency of injuries, by year, age, sex, and geography, it also calculates cost related to the injuries state by state.

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                                                          • Davis, Ronald M., and Barry Pless. 2001. BMJ bans “accidents”: Accidents are not predictable. British Medical Journal 322:1320–1321.

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                                                            This editorial explains why motor vehicle crash is an appropriate expression but motor vehicle accident is not. The authors argue that accident should be banned because its use in medical settings leaves the impression that injury events are acts of fate, or acts of God, instead of predictable and preventable occurrences.

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                                                            Journals

                                                            Most articles on unintentional injuries can be found in medical journals and journals focusing on epidemiology, preventive and emergency medicine, and critical care, with a few scattered throughout health behavior and health education, biomechanics, and environmental health. Since 1990, however, a growing number of journals have been exclusively dedicated to injury research, injury prevention, and safety promotion. Some of these include the American Journal of Public Health, Accident Analysis & Prevention (one of the longest-running journals in the field), and Safety Science (focusing primarily on occupational safety). Others are the Journal of Safety Research (published by the National Safety Council), Injury (the official journal of the British Trauma Society), the African Safety Promotion journal (focusing on African-relevant research and programs), Injury Prevention (a British Medical Journal publication), the International Journal of Injury Control and Safety Promotion (published in Europe), Journal of Injury and Violence Research, and Traffic Injury Prevention.

                                                            • Accident Analysis & Prevention. 1969–.

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                                                              Affiliated with the Association for the Advancement of Automotive Medicine, the journal covers accidental injury and damage, including the pre-injury and immediate post-injury phases. Articles deal with medical, legal, and economic issues; the biomechanics of impact and human tolerance limits to injury; modeling and statistical analysis of accident data; and policy, planning, and decision-making in safety.

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                                                              • African Safety Promotion: A Journal of Injury and Violence Prevention. 2002–.

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                                                                A forum for discussion and constructive debate among academics, policy makers, and practitioners active in the field of injury prevention and safety promotion. The journal is an accredited South African post-secondary education journal, and is peer-reviewed and published biannually. It features original full-length articles, theoretical papers, and reviews.

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                                                                • American Journal of Public Health. 1911–.

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                                                                  AJPH is the official journal of the American Public Health Association. Occasional articles on injury appear in this staple US journal in public health—far more than are published in public health journals in most other countries, such as Australia, the United Kingdom, and parts of Europe.

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                                                                  • Injury. 1969–.

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                                                                    An international journal dealing with all aspects of trauma care and accident surgery. The primary aim is to facilitate the exchange of ideas, techniques, and information among all members of the trauma community. Topics covered include: trauma systems and management; surgical procedures; epidemiological studies; surgery (of all tissues); resuscitation; biomechanics; rehabilitation; anaesthesia; radiology; basic science of local and systemic response to trauma and tissue healing.

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                                                                    • Injury Prevention. 1995–.

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                                                                      Official journal of the Society for Child and Adolescent Injury Prevention and the Society for the Advancement of Violence and Injury Research. Published by the British Medical Journal (BMJ) publishing group. The journal covers all phases of injury and all causes, ages, and mechanisms. Basic and foundational research, epidemiology, prevention research, and tertiary prevention are covered topics. It also provides international coverage and is highly interdisciplinary.

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                                                                      • International Journal of Injury Control and Safety Promotion. 1994–.

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                                                                        Associated with the European Association for Injury Prevention and Safety Promotion, this journal focuses on injury from a global perspective and publishes on topics related to international data, comparative studies, safety promotion programs, and program evaluation. Formerly known as Injury Control and Safety Promotion (2000–2004) and International Journal for Consumer and Product Safety (1994–1999).

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                                                                        • Journal of Injury and Violence Research. 2009–.

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                                                                          A peer-reviewed, open-access medical journal covering all aspects of traumatology, this journal includes quantitative and qualitative studies in the field of clinical and basic sciences about trauma, burns, drowning and falls, occupational safety, road safety, sport and leisure–related injury, youth violence, child and elder abuse, child and elder injuries, intimate partner abuse and sexual violence, self-harm and suicide, patient safety, safe communities, consumer safety, disaster management and terrorism, surveillance/burden of injury, and all other intentional and unintentional injuries.

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                                                                          • Journal of Safety Research. 1970–.

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                                                                            This is an interdisciplinary publication covering all areas of safety, including traffic, industry, farm, home, school, and the community. Articles are mostly empirical and include those related to human factors, accident investigation and analysis, countermeasure development and evaluation, and environmental factors and hazards. It is published and managed by the National Safety Council in Itasca, Illinois.

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                                                                            • Safety Science. 1978–.

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                                                                              Safety Science serves an international and multidisciplinary audience. It extends from safety of people at work to other spheres, such as transport, leisure and home, and every other field of hazardous activity. The journal covers the physics and engineering of safety; its social, policy, and organizational aspects; and the management of risks.

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                                                                              • Traffic Injury Prevention. 1999–.

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                                                                                The official journal of the Association for the Advancement of Automotive Medicine; The International Council of Alcohol, Drugs & Traffic Safety; the International Research Council on the Biomechanics of Injury; and the International Traffic Medicine Association. An archival and indexed journal addressing traffic safety, crash prevention, and injury control. Among the subjects covered are research on alcohol and drug impairment, behavior of traffic participants, injury mechanisms, impact biomechanics, injury prevention, and epidemiology. Published articles examine all phases of experimental, computational, statistical, emergency, clinical, and epidemiological research.

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                                                                                Disparities

                                                                                The poor and underserved are at the greatest risk of injuries and often lack the resources to access and purchase safety equipment. Borse, et al. 2008 describes the magnitude of these disparities in the United States, whereas Branche, et al. 2004 addresses the possible reasons for disparity, and solutions. Berger and Wallace 2007 attempts to describe the social conditions that might lead to disparities in the specific mechanism of injuries from a cultural and ecological framework.

                                                                                • Berger, L. R., and David Wallace. 2007. Reduce injuries: Eliminate disparities in child mortality rates among American Indian and Alaska Native children and youth. IHS Primary Care Provider 32.7: 203–208.

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                                                                                  Few health disparities have such potential for elimination as the discrepancy in child mortality rates among American Indian and Alaska Native children. This article emphasizes the gravity of these disparities and suggests interventions that might prevent all forms of injuries among native populations. Many injury-prevention strategies are effective, but too few are fully implemented in these communities where the need is the greatest.

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                                                                                  • Borse, Nagesh N., Julie Gilchrist, Ann M. Dellinger, Rose A. Rudd, Michael F. Ballesteros, and David A. Sleet. 2008. The CDC childhood injury report: Patterns of unintentional injuries among 0–19 year olds in the United States, 2000–2006. Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.

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                                                                                    The first report of its kind on the patterns of childhood injuries by age, sex, geographic region, and causal mechanism in the United States. It uses CDC data to provide an overview of unintentional injuries related to drowning, falls, fires or burns, poisoning, suffocation, and transportation-related injuries from 2000 to 2006. Graphics, maps, tables, and charts are included to illustrate disparities in childhood injuries.

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                                                                                    • Branche, Christine M., Ann M. Dellinger, David A. Sleet, Julie Gilchrist, and Sarah J. Olson. 2004. Unintentional injuries: The burden, risks, and preventive strategies to address diversity. In Praeger handbook of black American health: Policies and issues behind disparities in health. 2d ed. Vol. 1. Edited by Ivor Lensworth Livingston, 317–327. Westport, CT: Praeger.

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                                                                                      This book chapter describes the many factors that influence risks for injuries to black Americans related to general health and wellness, lifestyle, living environment, risk-taking behaviors, use of personal protective equipment, mood, and attitudes. Risk and prevention strategies are presented for motor vehicle injuries, residential fires, drowning, and falls among older adults. The role cultural differences play in blacks’ etiology is also discussed.

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                                                                                      Evidence-Based Guidelines and Manuals

                                                                                      It is important that injury-prevention strategies and interventions be based on evidence. What follows are credible, practical, and essential resources that help injury-prevention practitioners and researchers select effective interventions for their communities and serve to expand the science base underlying public health practice in injury prevention. The Centers for Disease Control and Prevention, Cochrane Collaboration, and the World Health Organization have led many of the successful efforts to identify what works in injury prevention. These include guidelines on school health (Centers for Disease Control and Prevention 2001) and bicycle helmet use (Centers for Disease Control and Prevention 1995). Zaza, et al. 2005 and Task Force on Community Preventive Services 2005 on motor vehicle injuries; Peden, et al. 2004 on road traffic injury prevention; and Cochrane Database of Systematic Reviews and Peden, et al. 2008 on child injury prevention are seen as landmarks to promote knowledge to action in injury prevention. Elvik, et al. 2009, a 1,078-page tome, deserves special mention because of its meticulous preparation in addressing one of the major causes of injury death in the world: road traffic injury.

                                                                                      • Centers for Disease Control and Prevention. 1995. Injury-control recommendations: Bicycle helmets. Morbidity and Mortality Weekly Report: Recommendations and Reports 44.RR-01: 1–17.

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                                                                                        These recommendations on the use of bicycle helmets are designed for state and local health departments or other organizations to help prevent head injuries among bicyclists. The guidelines contain information on the magnitude and extent of the problem of bicycle-related head injuries and the potential impact of increased helmet use, as well as barriers that impede increased helmet use.

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                                                                                        • Centers for Disease Control and Prevention. 2001. School health guidelines to prevent unintentional injuries and violence. Morbidity and Mortality Weekly Report: Recommendations and Reports 50.RR-22: 1–73.

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                                                                                          This report summarizes school health recommendations for preventing unintentional injury and violence among young people. The guidelines were developed by the CDC in collaboration with specialists from universities and from national, federal, state, local, and voluntary agencies and organizations. They are based on an in-depth review of research, theory, and current practice in unintentional injury and violence; health education; and public health.

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                                                                                          • Cochrane Database of Systematic Reviews.

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                                                                                            The Cochrane database includes many systematic reviews related to injury prevention. Past reviews have focused on low back pain (2002), bike helmet effectiveness (2005), the safe communities movement (2009), older adult falls (2005), alcohol servers (2008), and exercise and balance to prevent falls (2007).

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                                                                                            • Elvik, Rune, Alena Hoye, Truls Vaa, and Michael Sorensen. 2009. The handbook of road safety measures. Bingley, UK: Emerald Group.

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                                                                                              Translated from Norwegian, this second edition (previously published in 2004) gives state-of-the-art summaries of current knowledge regarding the effects of 128 road safety measures. It covers all areas of road safety, including traffic control, vehicle inspection, driver training, publicity campaigns, police enforcement, and general policy instruments. With many original chapters revised and several new ones added, extra topics covered in this edition include: post-accident care, DUI legislation and enforcement, environmental zones, and speed cameras.

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                                                                                              • Peden, Margie, Kayode Oyegbite, Joan Ozanne-Smith, et al., eds. 2008. World report on child injury prevention. Geneva, Switzerland: World Health Organization/UNICEF.

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                                                                                                This joint WHO/UNICEF report presents the current knowledge about the five most important causes of unintentional injury (road traffic injuries, drowning, burns, falls, and poisoning), and makes seven recommendations for action. The aims of the report are to raise awareness about the magnitude, risk factors, and impacts of child injuries globally.

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                                                                                                • Peden, Margie, Richard Scurfield, David A. Sleet, et al., eds. 2004. World report on road traffic injury prevention. Geneva, Switzerland: World Health Organization.

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                                                                                                  This report, co-sponsored by the WHO and the World Bank, coincided with the 2004 World Health Day dedicated to road safety. It was the first comprehensive guide to the epidemiology and prevention of traffic injuries. More than forty countries participated in this report, which claims that the road traffic injury toll can be reduced globally if the set of recommendations found in the last chapter can be implemented.

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                                                                                                  • Task Force on Community Preventive Services. 2005. Motor vehicle occupant injury. In The guide to community preventive services: What works to promote health? Edited by Stephanie Zaza, Peter A. Briss, and Kate Harris, 329–384. New York: Oxford Univ. Press.

                                                                                                    DOI: 10.1093/acprof:oso/9780195151091.003.0008Save Citation »Export Citation »E-mail Citation »

                                                                                                    This book chapter summarizes Task Force recommendations on interventions to reduce injuries to motor vehicle occupants, such as child safety seat laws, distribution and education programs, incentive and education programs, and communitywide information and enhanced enforcement campaigns. To increase safety belt use, recommendations include safety belt laws, upgrading secondary to primary enforcement laws, and implementing enhanced enforcement efforts. To reduce alcohol-impaired driving, the Task Force recommends 0.08% blood alcohol concentration (BAC) laws, minimum legal drinking age laws (maintaining 21 years as the legal age), sobriety checkpoints, lower BAC for young or inexperienced drivers, intervention training programs for servers of alcoholic beverages under certain conditions, and mass media campaigns under certain conditions.

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                                                                                                    • Zaza, Stephanie, Peter A. Briss, and Kate Harris, eds. 2005. The guide to community preventive services: What works to promote health? New York: Oxford Univ. Press.

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                                                                                                      This evidence-based material provides a transparent record of the results of systematic reviews in a variety of public health areas, including motor vehicle injury prevention, one of ten areas the CDC recognized as outstanding public health achievements of the 20th century. The motor vehicle systematic reviews cover effective strategies to increase seatbelt use and child restraint use and reduce drinking and driving. Data are also available online.

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