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Anyone who has played in the sea will know there are waves that are great for surfing but there are others that will dump you, and there is also the occasional rip which can carry you out to sea. To complicate surfing further there is the weather to contend with, other users of the sea, rocks, and the odd shark. Roberts suggests that capitalising on increasing concerns about air pollution, noise, and congestion may be easier, in some instances, than focusing on injury reduction in seeking to make transportation safer.1 I am inclined to think he may be right, the trouble is that there is the odd shark lurking around. For example, while I have no doubt that many parents transport their children to school by car because they have concerns about the risks of cycling or walking they also may be concerned about the risk of sexual assault to their children. Thus, in some cases at least, seeking to encourage cycling by making walking and cycling “safe” from a transportation perspective may be insufficient to bring about changes in transportation behaviour.
It is also important to note that policies that may be good for the environment can have negative consequences for injury. This is well illustrated by the following recent note in The Times in London: “An increase in motorcycle deaths, caused partly by a surge in the number of older “born-again” bikers, has forced ministers to rethink plans to encourage motorcycling (Arthur Leathley writes). Registrations in 1997 rose by 36 per cent on the total for 1996. Ministers had promoted motorcycling as a way of solving pollution and congestion problems but a 16 per cent rise in deaths last year means there will be little reference made to motorcycling when a white paper on alternatives to the car is unveiled next month”.2 In this instance it appears that concerns about injury mortality will have more sway than those about congestion, pollution, and energy consumption.
The conservation lobby can also have a potentially negative effect on injury. For example, several years ago a proposal for a new ski field in New Zealand was vigorously opposed by conservationists. While they were unsuccessful in stopping the development they were successful in having stringent conditions placed on the company on the degree to which the natural landscape could be changed. As a consequence the ski field has several large boulders on or near ski runs that present a hazard to the all too common out of control skier. Presumably similar arguments apply to trees on many North American ski fields.
While Robert's paper was concerned with safer transportation, his suggested strategies are, in theory, applicable to other areas. For example, in seeking to bring about a reduction in domestic hot water temperatures consideration should be given to promoting the benefits in terms of reduced energy bills. In New Zealand most homes use electricity as their primary source of energy for heating, lighting, cooking, etc. It has been estimated that an electric hot water storage cylinder accounts for approximately 40% of electricity costs in the average New Zealand home.3 Given the rarity of scalds due to excessive tap water temperatures, promoting the personal savings of reducing of hot water cylinder temperatures has more appeal as a method of reducing injury risk since there is an immediate return to everyone. In pursuing this strategy we would have allies among the energy conservationist and those who are opposed to damming more rivers for hydropower generation because it reduces recreational opportunities such as kayaking, rafting, and fishing. We could also no doubt enlist the support of those who are opposed to the development of nuclear power stations. A strategy which, it has been suggested, would meet our growing energy needs and at the same time save our rivers from being dammed.
Unfortunately our health colleagues can knock us off our surfboards. For example, there is negligible risk of contracting legionella from domestic hot water systems. Nevertheless health authorities in New Zealand have opposed reducing domestic hot tap water temperatures to 50°C.4 The fear of the unknown and unseen disease appears to be greater than the known and seen mortality and morbidity of scalds.
What Robert's article illustrates is that we need to think laterally in trying to achieve our objective of reducing injury and, in doing so, we should note that like water the environmental wave can be our best friend and our worst enemy.
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