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Injury prevention in practice
  1. Frederick P Rivara, Chair, ISCAIP
  1. Harborview Injury Prevention and Research Center, Box 359960, 325 Ninth Ave, Seattle WA 98104, USA (Phone: +1 206 521-1530, fax: +1 206 521 1562, e-mail: fpr{at}u.washington.edu)

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As many read this, they will be preparing to travel to Amsterdam in May for the 4th World Conference on Injury Prevention and Control. This will be a time to probe new and different approaches to current injury problems, to learn what works in one part of the world, and think how it might be adapted to your own corner of the earth. I always come away from these meetings with new ideas and renewed energy to carry them out.

The International Society for Child and Adolescent Injury Prevention (ISCAIP) will once again host a separate meeting on 21 May 1998, following the main conference, to explore particular challenges to the prevention of injuries to children and adolescents. Those of us planning this conference (our third) wanted to maximize participation and input by the members of ISCAIP and the audience. To do so, we are soliciting short (one page) comments by all members of ISCAIP on each of the four main conference topics. These will be summarized by a discussant following the main speaker, and will provide, we believe, a wonderful snapshot of the diverse approaches to injury control available around the world. Comments should be sent to ISCAIP c/o CAPT, 18–20 Farringdon Lane, London EC1R 3AU, UK to arrive by 20 April 1998.

Injury control activities in Europe

One of the most valuable features at our prior sessions was sharing of information about the current state of injury control activities in different parts of the world. We and the conference have grown too much, however, to do this successfully for all the countries and continents in which ISCAIP members are active. The focus this time will be on activities in Europe, since this is the site of the 4th World Conference. What are the programs in Europe which have been successful in reducing child and adolescent injuries? What have been some of the instructive failures? How much of what has been learned in Europe can be transferred to communities in other countries? Is what works in Stockholm relevant in Kuala Lumpur? In Melbourne?

Current issues in motor vehicle occupant safety for children

In most parts of the world, motor vehicle injuries are the leading cause of death and disability from trauma among children and adolescents. Great strides have been made in improving occupant protection, but many issues remain. What does the current crisis over the risks of airbag injuries to children in North America mean for the rest of the world? Will our global economy result in these same risks (that is same airbag design) to children riding in cars in Cape Town, Paris, and Delhi? Most infants travel in special child restraint devices, but many are inadequately restrained at age 3, 4, and 5. What changes are needed in product design (both vehicle and restraint devices), legislation and regulation, and education to insure that all children are adequately restrained?

Making regulations work

Abe Bergman, one of the grandfathers of injury control and a practitioner of what he calls “political medicine” for the last three decades, often remarks that getting a law passed or a regulation changed is relatively easy. The difficulty lies in getting it implemented in a way that achieves the desired outcome. Regulation and legislation have become part of the holy trinity of injury control, along with education and product/environmental modification. Why are some regulations effective in accomplishing the goal of reduced morbidity and mortality from injury, while others are ineffective, or even worse, harmful? What are the barriers to implementing injury control regulations? What are some of the successful regulations which have made a difference, and how has this been accomplished? What can we learn which will allow us to apply those same lessons in other communities and to different injury problems?

Intentional injuries: what should be the role of ISCAIP

Our journal, Injury Prevention, and the Society have focused primarily on unintentional injuries to children and adolescents. Nevertheless, intentional injuries are a major cause of death in many countries, in the form of child abuse of infants and young children, suicides of adolescents, and interpersonal violence among youth. Should the journal and ISCAIP expand to include these mechanisms of injury? Are the methods we use to study and prevent unintentional injury readily transferable to adolescent suicide and homicide? Can the journal, given its size, accommodate a whole new set of submissions? Will ISCAIP lose some of its identity by expanding its mission? These and other issues will be discussed in a lively debate between discussants taking the pro position and those arguing the con.

Our hope is that each of us attending the conference will come away with an intriguing idea and the energy to apply it back home. So send us your comments. See you in Amsterdam!

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