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Surveillance is often held to be a key element in the development of effective injury prevention programs. When based in emergency rooms, it provides better estimates of the magnitude of the injury problem than mortality data alone. Ideally, surveillance also provides early warnings of new hazards and may be used for program evaluation.
Before 1990, in Canada only statistics on mortality, hospitalizations, and from some surveys of specific injuries, were available. There was little information on the occurrence of injuries severe enough to require medical care but not necessitating a hospital admission. Without such data injuries arising from new causes could not be identified quickly and it was difficult to evaluate intervention programs using injuries as the outcome.
The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is an emergency room based injury surveillance system that operates in 10 pediatric and six general hospitals. Technical and financial support are provided by the Child Injury Division (CID) of the Laboratory Centre for Disease Control (LCDC), a Directorate of Health Canada (Canada's federal Department of Health). The main office of the program is in Ottawa; participating hospitals are located in seven provinces and one territory.
This paper provides an account of the development and operation of CHIRPP which was created in response to Canada's need for better data. This detailed description is intended to help colleagues in other countries who have similar concerns. Many papers have used data from this program,1–24 but no comprehensive description of it has been published previously.
Origins of the program
Following a visit to Australia in 1988, one of us (IBP) initiated efforts to create a system similar to its National Injury Surveillance and Prevention Program (NISPP) in Canada. The first step was to convince hospital administrators that such a system was important and feasible. Accordingly, directors of all …