PEOPLE IN THE NEWS

John Howard, Chief Executive of the UK safety organisation, Royal Society for the Prevention of Accidents (RoSPA), died suddenly on 16 July. John joined RoSPA 20 years ago from industry as Director of Home and Leisure Safety. He later became responsible for road safety as well, and then in 1992 for all areas of RoSPA’s campaigning, including safety at work. He was responsible for promoting change in a wide cross section of fields, from the need for fire safe furniture and factory fitted plugs on electrical goods to the latest law banning the use of hand held mobile phones while driving. He helped to establish RoSPA as one of the world’s leading safety organisations. John was more than just an administrator; he was deeply committed to reducing death and injury. He will be greatly missed throughout the safety community in the UK and beyond.

Dr Jeffrey Runge has resigned as Administrator of the US National Highway Traffic Safety Administration (NHTSA) to become Chief Medical Officer at the Department of Homeland Security. He stepped down as the US top traffic safety official in late August. Dr Runge, a former emergency room physician from Charlotte, North Carolina, has led NHTSA since 2001. As Chief Medical Officer, he will oversee bioterrorism policy and coordinate responses to any biological attacks under reforms at the 2 year old agency.

In July Dr Ileana Arias was named as the Director of the Centers for Disease Control and Prevention’s (CDC) National Center for Injury Prevention and Control. Dr Arias has been acting Director since June 2004. Before that, she was the Chief of the etiology and surveillance branch in the Division of Violence Prevention in CDC’s Injury Center. Prior to joining CDC in 2000, Dr Arias was the Director of Clinical Training and Professor of Clinical Psychology at the University of Georgia in Athens. Dr Arias is clinical psychologist with research expertise in intimate partner and family violence.

EUROPE STILL WITHOUT CHILD RESISTANT LIGHTERS

EU Member States have again failed to come to a decision on enforcing child resistant lighters in the European market. Extraordinarily, the primary argument given is that of “insufficient evidence of serious risks”. In the July/August edition of its newsletter, consumer European safety organization ANEC, believes that any scarcity of evidence is due more to the absence of a comprehensive European accident data collection system. Since the adoption of the standard EN 13869 Lighters - child resistance for lighters - safety requirements and test methods in 2002, ANEC has repeatedly urged the European Commission to publish the references of this standard in the official journal. However, Member States have not been able to agree on the approach to be adopted to establish and enforce a child resistant requirement for disposable lighters, and so the references of the standard are unfortunately still not published. There is considerable opposition from Chinese lighter manufacturers, citing discriminatory practices and barriers to trade. ANEC believes though that commercial interests should never be allowed to prevail over consumer safety, particularly vulnerable consumers such as children. Accident statistics from the US show a considerable drop in casualties since the regulation on child resistant lighters was introduced, and there is no reason why this should not be the case in Europe too.

DEATHS UP SINCE FLORIDA HELMET LAW REPEAL

The CDC Public Health Law News (August 10, 2005) reported that two studies released in August say that US states that repeal mandatory motorcycle helmet laws run the risk of increased deaths and healthcare costs for injured bikers. A National Highway Traffic Safety Administration (NHTSA) study found an 81% increase in the number of motorcyclists killed in Florida in the 3 years following the repeal of the state’s helmet law in 2000. The cost of hospital care for injured bikers rose from $21 million to $44 million in the 30 months after the helmet law was repealed. A study by the Insurance Institute for Highway Safety found that the rate of motorcycle fatalities increased 25% from 2001 to 2002, compared with the 2 years prior to the repeal of the helmet law. Nationally, motorcycle fatalities have increased 7 years in a row, up nearly 8% last year to 4008. Only 20 states and the District of Columbia currently require all motorcycle riders to wear helmets, down from 47 states in 1975.

ALCOHOL ADVERTISING AND THE NEW ZEALAND BILL OF RIGHTS

Does the Sale of Liquor (Youth Alcohol Harm Reduction) Bill’s proposal to raise the purchase age and restrict alcohol advertising breach the Bill of Rights? This was the quandary facing New Zealand’s Ministry of Justice. The Ministry’s opinion: sort of—but any inconsistency with the Bill of Rights was justified. The Sale of Liquor Bill, being introduced in the New Zealand parliament, proposes a raising of the drinking age to 20 years of age, and seeks to restrict broadcasting of liquor advertising programmes to after 10.00pm on any day. The Ministry of Justice examined the member’s bill against the New Zealand Bill of Rights Act, and concluded that the proposal to restrict the hours in which broadcasting liquor advertising programmes may occur is a justifiable restriction. The proposed increase in the legal drinking age from 18 to 20 years gives rise to a prima facie issue of discrimination on the ground of age. However, the opinion was that although the Bill contains discriminatory aspects, it does not introduce discrimination that is so unreasonable as to be considered “unjustified”.

NO MORE PHTHALATES IN TOYS

The European Parliament has decided to ban permanently the use of phthalates in children’s toys. It has been decided that three phthalates will be banned in all toys and childcare articles and three others in all toys and childcare articles that are likely to be placed in the mouth of children. Scientific studies have identified phthalates as endocrine (hormone) disrupters and linked the use of phthalates to allergies and asthma.

US HIGHWAY CRASHES—A “NATIONAL EPIDEMIC” …

Deaths on US highways are a "national epidemic", according to the US Transportation Secretary Norman Mineta, who urged Americans to consider seat belt use as preventive medicine. According to statistics released in late April, 42 800 people died on US highways in 2004, up from 42 643 the year before. The NHTSA report predicts the seventh straight yearly increase in motorcycle deaths, with almost 4000 fatalities in 2004, up 7.3% from 2003. According to the national transportation report, 56% of occupants killed in passenger vehicles were not wearing safety belts. Passenger car occupant fatalities dropped by 2.4% and pick-up truck deaths fell 2%, while sport utility vehicle deaths rose almost 5%. Pedestrian deaths declined by about 3% from 4749 to 4598. The report also estimated the number of registered vehicles increased from 230.8 million in 2003 to 235.4 million in 2004. The number of fatal crashes involving young drivers ages 16–20 increased slightly from 7353 in 2003 to 7405 last year.

…WHILE BRITAIN’S 2004 TOLL LOWEST SINCE 1926

The number of people killed on Britain’s roads in 2004 was the lowest figure since records began in 1926, figures published by the Department for Transport in June show. In 2004, 3221 people died in road accidents, down 287 or 8% on the figures from 2003 when 3508 people were killed. This is despite an estimated increase in road traffic of 2% in 2004. Against the government’s targets for reducing casualties by 2010, the figures for casualties in 2004 indicate that the number of people killed or seriously injured was 28% below the baseline, the number of children killed or seriously injured was 43% below the baseline, and the provisional estimate of the rate of slight casualties per 100 million vehicle kilometres was 20% below the 1994–98 average. Visit http://tinyurl.com/c3joo for more information.

CDC ECONOMIC ANALYSIS OF FALL-RELATED INJURIES AMONG OLDER ADULTS

A recent analysis by the CDC determined that, in 2000, fatal and non-fatal fall-related injuries among adults aged 65 and older in the US resulted in $19.5 billion in direct medical care costs. Using national surveillance data to estimate incidence and Medicare data to estimate costs, researchers determined that there were 10 300 fatal and 2.6 million non-fatal fall injuries among older adults. Medical costs for fatal falls totalled $179 million. Costs for non-fatal injuries totalled $19.3 billion, of which 63% was for injuries that required hospitalization, 21% was for injuries treated in emergency departments, and 16% was for injuries treated in outpatient settings. Total medical costs for fall injuries among women ($14.3 billion) were nearly three times those for men ($5.2 billion), and this difference was consistent regardless of where medical treatment was delivered. The disparity in costs is likely explained by the larger proportion of women in the older population (18.9 million v 13.9 million) as well as by women’s higher non-fatal fall injury rate (94.8 per 1000 population v 57.7 per 1000 population). Although these cost estimates do not include the costs associated with reduced quality of life, the magnitude of the economic burden for fall-related injuries underscores the need for implementing effective intervention strategies. Recent systematic reviews note that the most effective interventions are exercises such as Tai Chi, balance and gait training, and strength building. Also effective is reducing the number and types of medications used, particularly psychoactive medications. Improving home safety by reducing environmental hazards can reduce falls when used in combination with other intervention strategies. Among people at high risk (eg those who have fallen at least once before), clinical assessment when combined with individualized fall risk reduction and patient follow up is an effective intervention strategy. Implementing these interventions can decrease the incidence of fall-related injuries, reduce the associated medical costs, and improve quality of life for older adults.

UAE SEAT BELT CAMPAIGN

Two students at Zayed University in the United Arab Emirates have designed a project aimed at spreading safety awareness while travelling, which will be displayed at all petrol stations of sponsoring company ADNOC. The UAE has a law requiring the driver and front seat passenger to use seat belts. However, there is no law requiring children to get securely buckled up.

HIGHWAY BILL IMPOSES STRICT CAR SAFETY RULES

Sweeping auto safety initiatives make a transportation bill passed by the US Congress in July the most comprehensive legislation of its kind in years. As part of the bill, Congress is ordering the NHTSA to impose a number of more stringent safety measures, including the first performance standards aimed at decreasing the likelihood of a rollover, a particularly deadly kind of accident that claims more than 10 000 American lives annually. Passenger vans capable of carrying 15 passengers, which have been the subject of scrutiny because of their rollover risk, will be subject to government crash tests for the first time, including frontal and side impact testing and rollover testing. The vans, along with the largest sport utility vehicles and pickup trucks, will also be subject to some regulations from which they are currently exempt. The legislation bars schools from buying or leasing 15 passenger vans unless automakers redesign them to meet the same special safety requirements of school buses. Additionally, states will again receive federal money if they pass laws that allow police officers to pull over drivers just because they are not wearing a seatbelt, or if their state has a higher than average seatbelt use rate.

NSW CHANGES SMOKE ALARM LAW AFTER DEATHS

The Australian state of New South Wales (NSW) has introduced mandatory smoke alarm legislation following a spate of deaths. NSW residents who fail to install smoke alarms in their homes could face fines of up to $550 under laws introduced into state parliament in June. The laws will require smoke alarms to be fitted in all homes and buildings where people sleep by May 1 next year. People selling homes will need to certify that smoke alarms have been installed. The laws, which are supported by the state opposition, were announced in response to the deaths of 13 people in house fires in just 2 weeks.

SAFE KIDS WORLDWIDE

The US child safety organisation, National Safe Kids, will now operate under the banner of Safe Kids Worldwide. This evolution reflects the union of the nearly 20 year old Safe Kids grassroots network in the US with the burgeoning international Safe Kids movement, each with the mission of preventing accidental injuries to children ages 14 and under. Currently, there are 16 member countries and more than 450 local coalitions.

MAJOR US RECALLS

In July, the US Consumer Product Safety Commission (CPSC) announced a voluntary recall of two models of strollers sold between 1994 and 2002. Consumers were advised to stop using recalled products immediately until a repair kit has been obtained. Over 1.14 million strollers from Graco Children’s products Inc are involved. The strollers can fail to latch properly and unexpectedly collapse while in use. This can result in broken bones, cuts, bumps, bruises, and other injuries to young children riding in the stroller and consumers pushing the stroller. For one brand, Graco has received reports of 306 collapses causing 230 reported injuries, including a broken arm and a cut to a child requiring 46 stitches; while for the other model the manufacturer has received reports of 223 stroller collapses causing 34 reported injuries including 18 bumps and bruises to the head or body.

CPSC has also announced the recall of about 2.6 million slow cookers from Massachusetts company The Holmes Group. The handles on the base of the slow cookers can break, posing a risk of burns from hot contents spilling onto consumers. These products were previously recalled for the same hazard. CPSC has received a total of 126 reports of handles breaking, including 33 reports of consumers who reported burn injuries from the hot contents of these slow cookers.

EASE OF USE RATINGS FOR CHILD SAFETY SEATS FOR 2005

Child safety seats are easier to use according to an annual US NHTSA survey released in June. NHTSA rated 92 child safety seats from 14 different manufacturers for 2005. Clearer labels and instructions accounted for most of the improvements. Improved ratings were also scored for ease of installation and whether the seats had to be assembled after purchase or came pre-assembled and ready for use. A copy of the 2005 "ease-of-use" ratings can be found at http://tinyurl.com/3nmy4.

UPDATE ON TEACH-VIP

In direct response to the historical neglect of the injury area and the need to strengthen capacities to prevent injury, WHO has developed a modular injury prevention and control curriculum known as TEACH-VIP. This unique curriculum has taken several years and the efforts of a global network of injury experts to develop. Pilot testing of the curriculum has taken place between September 2004 and June 2005. Twenty three settings around the world have pilot tested the material, with local translations of selected parts of the content into seven different languages. The curriculum contains a series of questionnaires to elicit feedback from trainers and trainees. The evaluation to date has been strongly positive, with the vast majority of respondents (which have included public health government agency staff, public health students, medical and nursing undergraduate and postgraduate students, and members of NGOs) ranking the course materials very highly. Well over 80% of respondents indicated they felt the materials met an important unmet need in their setting and a similar proportion indicated they would use the material in their work setting. WHO is very pleased by this response and wishes to make as many collaborators as possible aware that TEACH-VIP became freely available for general circulation in September 2005. Suitable venues that should be made aware of these training materials include public health schools, medical and nursing training institutions, government counterparts in health ministries, and other ministries relevant to injury prevention (eg transport, education, justice and so on), and non-governmental organizations or entities involved in injury prevention. Visit http://tinyurl.com/97abd for further information and to register to receive the material when it becomes available. Although only in English at present, WHO is working on financing translation into several other languages and making locally translated versions exchangeable across settings.