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The National Health and Medical Research Council has released a major study Unintentional Injury in Young Males, 15 to 29 Years.1 The terms of reference of the working group were to undertake a review of available data and contributory factors and to identify, review, and assess means of prevention. The report sets out the size and nature of the injury problem; the influences on injury, such as sociocultural factors, alcohol, risk behaviour; countermeasures; policies for youth and injury; and recommendations.
Young men have four times the rate of injury death and three times the rate of hospitalisation as young women the same age;
Injury is responsible for 1600 deaths and 60 000 hospitalisations among these young men each years; death rates for all injuries are 77.8 per 100 000 and unintentional injury death 47.7 per 100 000;
Transportation is the leading cause of death (34.5 per 100 000), pharmaceuticals poisoning is next (3.2 per 100 000, one tenth the rate), with drowning close behind (3 per 100 000);
Hospitalisations are caused by transport injury (rate of 684.5 per 100 000), falls (144.8), sport and pharmaceutical poisoning (140.7);
The leading causes of presentation to emergency department for injury are occupational injury and sports related injury;
Those with higher injury risk rates are those in rural and remote areas, Aborigines, and Torres Strait Islanders, and those in certain occupations such as farm workers, factory hands, plant operators, etc;
Young indigenous males are more than twice as likely to die from injury as their non-indigenous counterparts.
Influences on injury risk
The report notes that raised injury patterns are seen across a wide spectrum of causes and that the dominant cause of unintentional injury death, motor vehicle crashes, have been the subject of extensive intervention, but that other causes are not documented well and associated with limited injury prevention activity.
The link between injury and lifestyle/behaviour and exposure to hazardous environments is reflected in the literature. A complex interaction of precursors such as thrill seeking, poor risk perception, risky cultural norms, inexperience, stress, and alcohol consumption is known about but untangling how they operate together has not yet been done. Similarly it is known that there is an association between injury and socioeconomic and education disadvantage, but the details of how and why are unclear.
The report analyses a range of interventions at the broad and the particular level that have been used to address injury.
There is strong supportive evidence for the effectiveness of certain personal protective equipment in reducing injuries including seatbelts, motorcycle helmets, bicycle helmets, and eye protectors in squash. There are many strategies found to offer promise but for which current evidence is inadequate.
The report identifies a range of interventions that can be put in place, research and evaluation that needs to be undertaken, key policy and structural issues requiring attention, and the need for further development of prevention oriented surveillance of injury.
It is noted that important questions of how to address the issue of injury among young males remain to be answered and the need to work systematically to deal with research, implementation, and decision making infrastructure is stressed.
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