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Pless argues that the positions we put forward in our 2011 Commentary are ‘entirely wrong’ and challenges us to respond.1 ,2 We believe Pless has misunderstood parts of our Commentary and is wrong in respect to other parts, and so we have addressed the areas of disagreement that he raises. We have responded in detail as we believe the issues involved are fundamental to making significant progress in injury prevention. First though, we give a re-statement of the position taken by Molcho, Pickett, Rivara, Langley and Cryer in their respective Commentaries.1 ,3 ,4
We advocate acceptance of minor injury
The proposed position that minor injury (ie, injury that has no serious or long-term consequences) should be regarded as more acceptable than serious injury has been stated in the previous commentaries. For example, Molcho and Pickett3 wrote,
Identification of some types of childhood injury as more acceptable than others has implications for prevention efforts. First, professionals in the fields of health promotion and injury prevention should obviously continue to aim to provide safe contextual environments for sports and recreational activities in order to minimise harms, while bearing in mind that some injuries are still likely to occur. Second, some injuries will be accepted and tolerated as part of the healthy development of child populations. (p. 148)
Also, Rivara4 wrote,
I have long ignored injuries that do not make it to medical attention. Injuries requiring a band-aid and a mother's kiss are a part of growing up. (p. 149)
Our stated position was that1
the focus of injury prevention should be on important injury … defined as those injuries … which represent a high threat to life, high threat of disability, or high cost. (p. 73)
Intervene where the likelihood or frequency of serious injury is most significant
Pless summarises his first point made against our article, thus,
My point is that …
Contributors Both authors contributed to all aspects of the preparation of this commentary.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
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