Unintentional Injury Prevention

by

David A. Sleet

• LAST REVIEWED: 15 December 2016
• 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.

  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.

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

  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.

• 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.

  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.

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

  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.

• 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.

  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.