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  1. Anara Guard
  1., Waltham, Massachusetts, USA

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    Injury control research has repeatedly demonstrated the effectiveness of motorcycle helmets. In 1997, Taiwan passed a nationwide motorcycle helmet use law. A recent study compared head injuries in the two years immediately before and after passage of the law. Motorcycle related head injuries declined by 33% in the year after the law, even though there was an increase overall in the number of motorcycles in use. Altogether 63% of the injuries were caused by crashes with cars, and 16% by crashes with other motorcycles. We note that the authors refer to a national Transportation Department report that states helmet usage was only 21% before the law. According to the report, three months after passage 95.9% of motorcyclists wore helmets! (


    Another recent article examines motor vehicle crash injuries in Colombia, where the risk of traffic related death is 18 times that of the US and five times that of Europe. A newly standardized road injury reporting system allowed analysis of data for the nation and for the two largest cities. More than half of the traffic deaths were to pedestrians, and more than 95% of these occurred in the cities. The authors suggest a number of familiar countermeasures, including traffic calming, reduced speeds, increased lighting, alcohol breath tests, and education of policy makers and the public on the importance of injury prevention (


    Pedestrian injuries were also addressed by practitioners in Australia, who reported on the outcomes of a three year educational intervention with young children. Students, parents, teachers, and the local community were involved in the program, which also initiated some road environment changes. Many educational programs have relied on self reported behavior; this study validated these reports by unobtrusively observing the children as they crossed the street on the way to school. A key measure was whether these children, who were all under age 10, were accompanied by an adult to assist them with crossing safely. Children in the high and moderate intervention groups were significantly more likely to have such accompaniment and to play away from the road than their peers in the comparison group (

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    Australian researchers have also published results of a randomized trial to prevent falls and near falls among the elderly. A two year trial offered education and awareness, exercise sessions, home safety advice, and medical assessment in various combinations. Participants, who were healthy and aged 50 and over, recorded slips, trips and falls in daily calendars. The program not only was well received by participants, based upon their eagerness to continue to monitor falls, but it was low cost and delivered at the local level by a community based organization. Participants reported increased awareness of fall risk factors and prevention measures, and increased confidence in their abilities to prevent falls (


    Child resistant packaging has helped reduce the rates of unintentional poisonings, but iron continues to poison children in the United States. A review article describes the nature, trend, and hazard patterns of pediatric iron related poisonings from 1980 to 1996. Most involved children under the age of 5; many of the children were able to open the containers, or the containers had not been properly closed by adults. There were 69 deaths during this time period. Iron is readily available in pediatric and adult multivitamins, as well as in dietary supplements and prenatal vitamins. Recent changes in regulations to require unit dose packaging for the most potent supplements are expected to help reduce the frequency of iron related poisonings (


    Advocacy is an essential activity for injury prevention practitioners. One author has described a conceptual framework for public health advocacy that uses the model of an assembly line. Advocates assemble components in a process that results in the product of effective advocacy. The assembly line process has three distinct and sequential stages: information, strategy, and action. As in any assembly line, a team of workers is needed to build a strong and complete product, and each individual contributes to the entire process.

    Assembly lines were introduced into factories in order to maximize efficiency; are we indeed efficient at advocacy? (

    Have you read—or published—an interesting article recently? Please send the citation, and copy if possible, to the editor of Splinters & Fragments: Anara Guard, 44 King Street, Auburndale MA 02466, USA (fax: 1 781 478 2525; email: guardwilliams{at}