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National Accident Forum for Ireland
Following an initiative from the Office for Health Gain, a National Accident Forum has been established in Ireland, reports Dr Marie Laffoy, writing in the Journal of Health Gain. The forum, which focuses on deaths and injuries to all age groups, has a mission to facilitate a coordinated approach to accident prevention at national and regional level. The spur to its establishment was a report by the chief executive officers of the health boards, which drew attention to the fact that over 40% of childhood deaths result from accidents and that over half a million Irish people require treatment for accidents each year. Marie Laffoy, a public health specialist at the Eastern Health Board, highlights childhood poisoning as an easily preventable injury, noting that Ireland has no regulations for child resistant containers. The Journal of Health Gain is published by the Office of Health Gain, Phoenix Hall, St Mary's Hospital, Dublin 20, Ireland.
Draft national injury strategy for Australia
The National Injury Prevention Advisory Council released a draft national strategy for public comment in the last quarter of 1998. The council, working with very limited resources, had decided on a three part strategy. A “framework” document to put injury in context and to gather together material to make the best possible case for injury prevention; a series of “specific strategies” that will address particular priority issues and will be built up over time—the first strategy will relate to falls; and a “best buys” report that will attempt to bring together information on achievable, cost effective, proved interventions that are immediately available for use. The draft strategy is available from the Injury Prevention Unit of the Commonwealth Department of Health and Aged Care, www.health.gov.au/pubhlth/strateg/injury/index.htm.
Canadian national strategy on injury prevention
Injury prevention centres and scientists across Canada have begun work on a national strategy to build research capacity and collaborate on community programs. In a country as expansive as Canada, communication and coordination is a continuing challenge. The group that met last fall is advocating for a stronger leadership role from the national health ministry, particularly in funding both research and prevention programs. The Alberta Centre for Injury Prevention and Control, for example, published some compelling figures in a recent newsletter: while injury represented 11% of the total economic burden of illness in Canada in 1993 (or more than C$14 billion), only 1.2% of all illness related research dollars were devoted to injury.
Bunk beds ... again
There are certain subjects that come up in News and Notes almost every time—and bunk beds seem to be one of them. Injury Issue Monitor, the journal of the Research Centre for Injury Studies at Flinders University of South Australia, highlights a report by Peter Thompson of South Australia's Health Commission. The report calls for the Australian/New Zealand bunk beds standard being made mandatory, a recall of dangerous bunk beds as many have a long life span, and an on-going education programme for parents and carers. Contact Peter Thompson for more information or a copy of the detailed report via.
In November 1998, the US Consumer Product Safety Commission (CPSC) announced that more than 37 000 wooden bunk beds were being recalled because they had spaces on the top bunk that presented potential entrapment and strangulation hazards to young children. The spaces could be large enough for a child's body to pass through, but small enough to entrap a child's head. Since 1990, 39 children have died from becoming trapped in wooden or metal bunk beds with similar spaces. Almost all of the children were 3 years old or younger. Since 1994, more than half a million potentially hazardous bunk beds have been recalled in the US.
A healthy partnership
Safe Start in Vancouver report on the Healthy Home Centre, an innovative partnership between the Children's and Women's Health Centre of British Columbia and Canada's federal housing agency. In a room-by-room resource centre, the project combines public education on indoor air quality, adapting housing for disabilities, and home safety. Further details: Healthy Home Centre, 4500 Oak Street, Vancouver, BC, Canada V6H 3N1 (fax: +1 604 875 2440, or at two web sites: www.healthyhomecentre.com or www.healthierhomes.com).
Reports on Australia's health and cost of injury
The Australian Institute of Health and Welfare (AIHW) has released two reports Australia's Health in 1998 and Health System Costs of Diseases and Injury In Australia 1993–94. References to the reports can be found at the AIHW web site: www.aihw.w.gov.au.
New on the Research Centre for Injury Studies web site
Two new reports can be found on the web site of the Research Centre for Injury Studies at Flinders University of South Australia (www.nisu.flinders.edu.au): Study of Injury in Five Cape York Communities, and Australian Injury Prevention Bulletin 18: Spinal Cord Injury, Australia 1996/1997.
Strangulation hazard prompts huge recall
In November, the US CPSC announced the voluntary recall of more than 9.6 million play yards/playpens with protruding rivets because they pose a strangulation risk. Since 1983, the CPSC has received eight reports of toddlers who strangled in their playpens when pacifier strings or clothing they were wearing caught on the playpens' protruding rivets. The CPSC advised consumers to check the outside top rails of their playpens for protruding metal rivets. The rivets are similar to nut and bolt fasteners, but cannot be removed. The rivets protrude about one quarter to one half inch from the outside top rails of the playpens. The CPSC also reminded parents and caregivers that a pacifier should never be hung from a string around a child's neck.
International standard for child sized fingers published
The November 1998 edition of the European Association for the Coordination of Consumer Representation in Standardisation (ANEC) newsletter reported that the international standard for child sized test fingers was published as International Electrotechnical Commission (IEC) 1032 at the beginning of 1998. The standard includes a provision for the use of the same two child finger test probes as were included in the European standard EN 71 (Safety of Toys): probe A, designed to simulate the finger of children under 36 months of age, and probe B, representing children in the age range of 3 to 14 years. ANEC lobbied for the inclusion of these two probes in the standard. This is a significant improvement compared with the earlier version of IEC 1032, in which probe A was not included. Consumer groups had campaigned to have a greater consideration of child safety in household electrical appliances standards. The use of the child sized test finger must ensure that children cannot access live or otherwise dangerous parts of a product.
Recall of pool floats
Major US retailer, K-Mart Corporation, recalled 114 000 Splash Club Deluxe Baby Floats last year. The seat of the pool toy can tear at the seam causing children to unexpectedly fall into the water and possibly drown. K-Mart has received one report of the float's seat tearing and causing a child to fall into the water. No injuries have been reported.
Child resistant packaging (CRP) research
Since CRP was first introduced almost 30 years ago the only recognised way to test whether or not a particular pack was likely to resist children has been to test them with children. Similarly, the only way to really know if adults could open and safely reclose the packs was to test them with adults. This method has worked well and has resulted in the development of a range of packs that have protected numerous children from accidental poisoning. Now, the British Standards Institution has commissioned British research company, ICE Ergonomics, and the CE Packaging Partnership to examine existing mechanical test methods for reclosable CRP and report back on their suitability for inclusion in the standard. The work involves collating data on the strength and dexterity of the children who must be kept out of the packages and the adults who must get into them; looking at existing US mechanical tests to assess their suitability for inclusion in the standard; gathering data on UK and European CRPs and how they have performed in both panel and any mechanical tests; relating the available mechanical tests to the strength and dexterity of children; looking for gaps in the data and missing test methods. Further details: Mrs Jackie Cockburn, ICE Ergonomics (tel: +44 1509 283323, fax: +44 1509 283360, e-mail:).
Injuries from hypodermic syringes—needlestick injuries—were the theme of the August 1998 edition of Injury Bulletin from the Queensland Injury Surveillance Unit (QISU). They were by no means confined to hospitals; many occur in public outdoor areas such as parks, with children under 14 years making up over half of the victims. Injury Bulletin is available from QISU, Mater Hospitals, South Brisbane, Queensland 4101, Australia (fax: +61 7 3840 1684, e-mail: www.powerup.com.au/~qisu)., web site:
Canada warns against PVC infant toys
Soft vinyl teethers and rattles pose a potential health risk to very young children, Health Canada has warned. The government ministry now advises parents and caregivers to dispose of these products. Laboratory tests on animals have shown that prolonged exposure to the plasticizer DINP, used to keep the vinyl soft, can cause kidney and liver damage. The Health Canada advisory says that children weighing less than 8 kg would have to suck or chew on a toy with DINP for three or more hours daily in order to be at risk. While retailers were removing the toxic infant toys from store shelves, manufacturers were asked to find a safe substitute for DINP within six months, by May 1999. Although several European countries have taken similar steps, the US has not. Media commentators and some health organizations expressed frustration that Health Canada provided a public list of some teethers and rattlers which do not contain DINP, instead of also publishing the names of the products which are potentially hazardous. This advisory also underscored gaps in Canada's Hazardous Products Act, currently under review. Without specific mention of a product such as PVC additives, regulators can only negotiate with industry to comply with their requests. Details of the advisory are available at Health Canada's web site: www.hc-sc.gc.ca/advisory.
Fisher-Price recall Power Wheels ride-on battery powered vehicles
Toy giant Fisher-Price is conducting a voluntary recall involving up to 10 million battery powered Power Wheels ride-on cars and trucks. The vehicles' electrical components can overheat and cause fires. Children can suffer injuries from fires and house fires can occur. Additionally, wiring problems can prevent the vehicles from stopping. There have been approximately 700 reports of electrical components failing and overheating while the cars and trucks were being ridden, charged, parked, or stored. About 150 fires have been reported. Nine children suffered minor burns to the hands, legs, or feet; and up to $300 000 in property damage to 22 houses and garages have been reported. There have also been 71 reports of vehicles not stopping. Six children suffered bruises, scratches, or bumps when their vehicles hit a car, truck, pole, window, or fence. The recalled Power Wheels cars and trucks have been sold under nearly 100 model names.
Laser pointer regulations
The State of Victoria, Australia, has introduced new regulations under its Control of Weapons Act to reduce risks to public safety by the potential misuse of laser pointers. They were being used as toys by some children, unaware of the fact that they can cause serious eye injury and disorientation.
Helmet home page
The home page of the Malaysian Helmets Initiative is www.geocities.com/HotSprings/Resort/7200.
The Children's Safety Network is interested in information on the weight of children's backpacks. They have been receiving an increased number of inquiries, seeking guidance on the appropriate weight that children of various ages should be expected to carry. Changes in school policies, ranging from removal of school lockers to shortened time between classes, have led to students carrying many or all of their books for the greater portion of the school day. They would welcome information on studies, published reports or articles, anecdotal information, or examples of schools which have taken steps to remedy this situation. Please contact Anara Guard at the Children's Safety Network (tel: +1 617 969 7100 ext 2230, e-mail:).
Transport safety research digest
Britain's Department of the Environment, Transport and the Regions has published the September 1998 edition of its research digest Current Road and Vehicle Safety Research. Vol 1: Road Safety Research. It highlights the range of research sponsored by the department, including many projects on child behaviour, educational and training initiatives, the safety of young and inexperienced drivers, and traffic and highway engineering. The digest provides details of where completed research projects have been published, including many that only appear as project reports and therefore may not be accessible through database searches. The digest is available from Road Safety Division, DETR, 2/14 Great Minster House, 76 Marsham Street, London SW14DR, UK (fax: +44 171 676 2029, e-mail: ). A companion volume on research sponsored by the department's Vehicle Standards and Engineering Division is available from Maureen Sparks, Zone 2/06 at the same address (e-mail: ).
Change in “shock ads” for road safety?
The Victorian Transport Accident Commission (TAC), which has been a prime mover behind the graphic, shock tactic media campaigns that are credited with playing a significant part in changing behaviour and reducing the road toll, is likely to change its strategy for the latest series of campaigns. There has been regular controversy for some time in the press about the continuing effectiveness of these type of ads and much discussion over the desensitisation that is argued to accompany the campaigns. However, the prospect of significant changes in style has more to do with the effectiveness of the strategy in reaching the next major target of the campaign, drivers aged 16–20 years.
Information about the TAC and the campaigns can be found at www.tac.vic.gov.au. An evaluation of the Victorian mass media campaigns, “Mass media publicity supporting police enforcement and its economic value” by Cameron and Newstead can be found in the papers at the Monash University Accident Research Centre web site at www.general.monash.edu.au/muarc/.
Aggressive driving web site
The Center for Public Safety and Injury Prevention at the University of Albany's School of Public Health has updated its online resource directory Aggressive Driving: Research & Resources. Look at the web address: www.albany.edu/sph/injr_016.html. The directory is organised by topic (for example legislative approaches, research, enforcement, education, etc) and contains direct links to many current research reports, monographs, and datasets pertaining to this emerging public health and public safety concern.
Safe Communities report
The Centre for Peace Action at University of South Africa has published its report on the Sixth International Conference on Safe Communities which took place in 1997. Copies can be ordered from the Karolinska Institute (fax: +46 8 33 46 93, e-mail:).
US push in-car safety for older children
US federal officials have appointed an expert 21 member panel comprising car makers, child seat manufacturers, and medical specialists to focus attention on ways to decrease the number of deaths of child car occupants. “Children riding totally unrestrained is the biggest problem”, said Phil Haseltine of the American Coalition for Traffic Safety, who was asked to head the panel.
There has been plenty of government publicity about the need for parents to use child seats. In all 50 states, laws require children to be restrained in vehicles but usually target children only to ages 4 or 5. In contrast, although the government recommends that all children under age 13 ride in back seats, most states lack seat belt laws requiring older children to be restrained in the back. And the older children get, the less likely parents are to buckle them up, according to government data.
The percentage of children who were unrestrained when they died in car crashes increases with age, according to 1997 federal accident data analysed by the University of Pennsylvania. Of the 604 children up to age 4 who were killed in car crashes in 1997, 45% were not in child seats or seat belts. For fatally injured 5–9 and 10–15 year olds, 55% and 68% respectively were unrestrained.
Babywalker issues around the world
The Queensland Injury Surveillance Unit (QISU), Child Accident Prevention Foundation of Southern Africa (CAPFSA) and Europe's consumer group ANEC each drew attention to problems associated with babywalkers. QISU issued the following advice in August 1998: “Given the dangerous nature of babywalkers, and that they have been shown to be of no benefit to the baby and in fact may hinder child development, their sale and use should be actively discouraged”.
The July 1998 edition of CAPFSA Reporter reviewed the safety of babywalkers and listed seven tips for parents, including never leave a baby unsupervised in a walker. It has to be questioned whether such unrealistic advice is useful. Meanwhile, in Europe, the dilemma centres around whether members of CEN (European Committee for Standardization) should vote for or against a draft standard that does not address mobility, a key safety issue. By voting against, the argument is that all the positive features of the new standard would be lost; by voting in favour, it may be seen as endorsing an imperfect standard.
Using the punning slogan, “This is one baby-sitter you can't trust”, a coalition in British Columbia ran a province-wide babywalker disposal program in October 1998. Lidia Kemeny, director of the Safe Start program at BC's Children's Hospital in Vancouver, reports that more than 30 communities participated and received “tremendous” media coverage. At the time of writing, evaluations were still being compiled from around the province, but in Vancouver alone, the city's waste management department picked up more than 200 walkers in the week after the disposal day. Families were encouraged to drop off walkers at designated recycling stations or, if more convenient, to simply put walkers out with the weekly garbage, after removing the wheels.
Deaths in car trunks
There has been hubbub in the US about deaths of children in trunks of car—11 deaths during the summer of 1998. Advocates are trying to push vehicle manufacturers to install a switch which would allow a trapped person to escape.
Winter words of wisdom
Manitoba Child Injury Prevention News, published by IM-PACT, the Injury Prevention Centre of Winnipeg Children's Hospital, reminds us that winter in Manitoba means snow ... and plenty of it. For children, snow and ice equal lots of fun. The thrill of the hill, the sparkling sound of skateblades on ice, the crack of the hockey stick ... winter is a special time for Canadian kids. Any activity that involves speed, however, can lead to serious injury—and tobogganing is a good example. With awareness, the right equipment, and the right environment, injuries can be prevented. Here is some information from IM-PACT to keep kids playing safe all winter:
• Children can reach speeds of up to 50 kph on sledding hills, according to a study by Safe Kids in Edmonton in 1996. At such speeds, an unprotected fall or collision can cause serious injury, even death.
• Sledding or tobogganing injuries are not rare. The Emergency Department of Winnipeg Children's Hospital saw 59 cases of sledding related injuries in 1996. That's about 10 local children hurt while sledding, on average, during each of our six months of winter.
• Of these 59 children (ages 2–19), close to one quarter had injuries serious enough to be admitted to hospital. Fractured arms and legs brought 30 kids to emergency, and there were four cases of internal injury, two minor head injuries, and one concussion. Nearly all the children were between 5 and 14 years old and more than 75%o were boys.
• Half of these injuries occurred between 4 pm and midnight, when visibility is likely to be poor. Typically, kids were hurt when they lost control of the sled and crashed into an object or another tobogganer. A more detailed study in Ottawa found similar patterns of sledding injuries.
These numbers are just a snapshot of the sledding injuries in our area. The statistics come from CHIRPP the Canadian Hospitals Injury Reporting and Prevention Program, which collects information at 15 emergency departments across Canada. People who see doctors in other clinics are not represented in these numbers.
Editor's note: I have no qualms about publishing winter safety news just as half of us enter spring. Remember that (a) safety advice keeps—it will be winter again before you know it—and (b) half of us are going into autumn! This immensely informative and readable newsletter is published by IM-PACT, Children's Hospital CN104, 840 Sherbrook St, Winnipeg MB, Canada R3A 1S1 (fax: +1 204 787 2070, e-mail: www.im-pact.mb.ca). It ends with the footnote “Please post, publish, or photocopy. Preventing childhood injury is everybody's business”. How refreshing!, web site:
Youth suicide prevention communications project
The Australian Institute of Family Studies has been engaged to address the information and communication needs of those involved in youth suicide prevention. The institute will produce a bulletin; take stock of youth suicide prevention activities; establish an internet site containing information on state and federal strategies, statistics, bibliographies, contacts, a database of activities, etc; establish an e-mail discussion list; and provide a clearinghouse and information service. The institute can be contacted at 300 Queen St, Melbourne, Victoria 3000, Australia and on the web at www.aifs.org.au/external/ysp/.
The first issue of CVIC Responsibilities, the newsletter of the Center for Violence and Injury Control at Allegheny University of the Health Sciences, included articles on dog bite injuries and bicycle helmets. Contact CVIC, 320 East North Avenue, Pittsburgh, PA 15212-4772, USA.
“Hands on” child safety awards
The Child Accident Prevention Foundation of Southern Africa (CAPFSA) presents annual “Hands on” child safety awards to individuals and companies who have made an outstanding contribution to child safety. In 1998, the awards went to Gerber Purity and the Paraffin Association of Southern Africa, both long term sponsors of the Foundation, Rukea Abdroef, a nurse whose volunteer hours to the cause are an example to all, and Shaamela Cassiem (RAPCAN) for her input into CAPFSA training courses on child molestation.
Database on product safety expertise
A database of people and organisations at Australia's Monash University Accident Research Centre can provide access to expertise on a wide range of consumer product safety and safe product design. Further details: Shauna Sherker, Accident Research Centre, Monash University, Wellington Road, Clayton, VIC 3168, Australia (fax: +61 3 9905 1809, e-mail:). The research centre also holds Victorian data from coroners, hospital admissions, and emergency rooms on product related injuries.
Canadian coalition for child passenger safety
A draft “train the trainer” manual to improve the correct use of child restraints across Canada has been developed by experts from Canadian provinces Alberta, Manitoba, Ontario and Saskatchewan, thanks to a grant from Health Canada. The next step is to establish a national coalition to guide the development and implementation of this new program. Safe Kids Canada will be the interim secretariat. Further details: Kelly Grover, Safe Kids Canada (tel: +1 416 813 7287, e-mail:).
New faces at the Child Accident Prevention Trust (CAPT)
All change at the UK's CAPT: Lesley Corner, Child Safety Week manager for five years, has moved on and has been replaced by Pushpa Dougall. Funding from the Princess of Wales Memorial Fund has enabled CAPT to start community development work in Northern Ireland; Martin Ryan is working on this programme. A new information officer, Kate Pordage, joined CAPT in January from the Road Safety Department in Luton.
US toy manufacturers agree to rid products of lead
The Toy Manufacturers of America, whose members represent about 85% of US toy sales, has pledged that its members will help reduce children's exposure to hazardous lead levels. They will go beyond what the law requires by eliminating lead from their products. This follows a request by the US CPSC that asked all manufacturers to eliminate the use of lead in products used in or around households, schools, or in recreation. Lead poisoning in children is associated with behavioral problems, learning disabilities, hearing problems, and growth retardation. It is estimated that approximately 930 000 children between the ages of 1 and 5 have blood lead levels that are of concern.
Young children are most commonly exposed to lead in consumer products from direct mouthing of objects or handling the objects and then putting their hands in their mouths. “Because lead accumulates in the body, even exposures to small amounts of lead can present health risks. That's why we are encouraging companies to voluntarily eliminate lead in all consumer products to prevent any unnecessary exposure of children to lead”, said CPSC Chairman Ann Brown.
CPSC warns about flammable loose fitting garments used as children's sleepwear
In November, the US CPSC issued a warning advising people not to put children to sleep in loose fitting T shirts or other oversize clothes made from cotton or cotton blends. These garments catch fire easily and have been associated with 200–300 burn injuries to children requiring emergency room treatment annually. Loose fitting clothing stands away from the body, making contact with an ignition source more likely and if it is also non-flame resistant the clothing allows an air space next to the body that helps keep the fire burning. Most manufacturers use hang tags on their snug fitting sleepwear to tell consumers that the product meets federal safety standards. The hang tags remind consumers that a snug fit or flame resistance is necessary for safety.
UK Child Safety Week recognition
An opinion poll conducted after CAPT's Child Safety Week showed that almost 30% of parents and carers were aware of the week, almost double the 1997 figure. What's more, Child Safety Week was the best known “week” run at the end of June, with the second placed week lagging far behind. Brief details of the evaluation of Child Safety Week from Nusret Ali, CAPT, 18–20 Farringdon Lane, London EC1R 3HA, UK (fax: +44 171 608 3674, e-mail:).
Comprehensive Children's Safety Network Notes
The wealth of information found in Children's Safety Network Notes from the Massachusetts based Children's Safety Network makes it essential reading for everyone working in the field. The summer 1998 edition provided details of their work on violence prevention, evaluating community based interventions (see their web site www.edc.org/HHD/csn/esecbi/), and rural and agricultural safety, as well as providing extensive listings of new resources from many sources, government web sites for children, conference details and news. Children's Safety Network Notes can be obtained from Education Development Center Inc, 55 Chapel Street, Newton, MA 02458-1060, USA (fax: +1 617 244 3436, e-mail: , web site: www.edc.org/HHD/csn).
Farm safety guidelines
Parents, farmers, and employers struggle with basic questions surrounding children's safe involvement in agricultural tasks, notes an article in the newsletter of the National Children's Center for Rural and Agricultural Health and Safety. Staff members from the center with advisors from Canada, Mexico, and elsewhere in the US are developing North American guidelines for children's agricultural tasks. The guidelines will assist parents and employers in assigning age appropriate tasks to children aged 7–16 years. The guidelines will include parent checklists based on child development and the requirements of specific jobs. They are due for release in April 1999. Further details: Marshfield Clinic, National Farm Medical Center, 1000 North Oak Ave, Marshfield, WI 54449-5790, USA (fax: +1 715 389 4996, web site: www.marshmed.org/nfmc/children).
Contributors to these News and Notes include Anara Guard, Ian Scott, Jan Shield, Kathy Weber, and Amy Zierler. Contributions have been edited by Michael Hayes. Items for the September 1999 issue should be sent to Michael Hayes at the Child Accident Prevention Trust, 18-20 Farringdon Lane, London EC1R 3HA, UK (fax: +44 171 608 3674, e-mail:) by 1 June 1999.
In search of brevity... and clarity
In search of ways to minimize a growing backlog of papers eagerly awaiting publication, we intend to initiate a new policy—a 3000 word limit on original articles. As well as permitting us to publish more papers, more rapidly, I am convinced it will also improve their literary quality. An unnecessarily wordy paper is as unattractive as an overgrown garden. Writers should heed the surgeon's credo: “When in doubt, cut it out”. It is often humbling to discover how much a paper is improved when a tough editor says, “yes, we will accept it but only if you reduce it to 1000 words”. We don't intend to be that draconian but instead will push for our target with occasional, well merited exceptions. To assist in this task, I also ask future contributors to provide a word count and urge everyone to consider the brief report format. As an incentive, experience shows that shorter papers usually get higher ratings. At any rate, most editors prefer them, and that should be sufficient to prompt widespread compliance.