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The latest systematic reviews produced by reviewers working with the Cochrane Injuries Group (CIG), and published on the Cochrane Library, include one on an important prevention topic—the prevention of burns and scalds in children. Such injuries are of course a significant cause of morbidity and mortality.1 The review also addresses the need to determine whether injury countermeasures that are accepted as being effective can be successfully rolled out in the wider community.
The reviewers who took on this task are based at Injury Prevention and Control Australia and the School of Population Health, University of Queensland, Australia. After a comprehensive search, they only found three studies that met their criteria for inclusion. Only one of these showed a significant decrease in paediatric burn and scald injury in the intervention community compared with the control community. The reviewers have concluded: “There are a very limited number of research studies allowing conclusions to be drawn about the effectiveness of community-based injury prevention programmes to prevent burns and scalds in children … It is important that a framework for considering the problem of burns/scalds in children from a prevention perspective be articulated, and that an evidence-based suite of interventions be combined to create programme guidelines suitable for implementation in communities throughout the world”.
As is the case with most Cochrane reviews, the results highlight the need for further research and it is to be hoped that they will influence the direction that such research will take. It is also worth noting that the three included studies in the review were all conducted in developed countries (the USA or Norway). Most of the global fire related burn injury burden, nevertheless, falls on developing countries.2 Financial and other constraints may make it impossible to implement in these countries interventions that look promising in high income nations. It is essential to determine what interventions are effective in cutting injury rates in “the majority world”.
More CIG reviews are on the way—some on the treatment of injury and some on prevention. One of our latest review protocols is on a prevention topic—motorcycle helmet legislation.3 The authors are again based in Australia, a country where injury prevention research and Cochrane Collaboration activities are both at encouragingly high levels. The reviewers set out on their project at a time when many countries around the world still lack legislation requiring motorcyclists to wear helmets. Indeed, many states in the USA have repealed or weakened their helmet legislation. The review will examine the effect of motorcycle helmet legislation on death and injury rates in motorcyclists, and on helmet wearing rates.
Among recently registered CIG titles, for which protocols have yet to be published are: “Home safety education for injury prevention”, “Interventions for reducing the use of babywalkers”, “Community-based interventions for preventing alcohol-related injuries”, and “Interventions for drowning prevention”.
We invite you to comment on our systematic reviews and to suggest topics that we should address in the future. New reviewers are also welcome; you don’t have to be Australian!
Competing interests: Paul Chinnock is employed by the London School of Hygiene, on a grant from the UK NHS, to be the Managing Editor of the Cochrane Injuries Group.
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