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The US Institute of Medicine of the National Academies has named seven behavioral scientists and health professionals as Robert Wood Johnson Health Policy Fellows for 2003–04 including Injury Prevention Associate Editor Susan Gallagher. Susan is Senior Scientist and Associate Director, Center for Injury and Violence Prevention, Education Development Center, Inc, Health and Human Development Programs, Newton, Massachusetts. The fellows—outstanding, mid-career scientists and health professionals working in academic and community based settings—were chosen on a competitive basis from nominations by academic institutions, as well as by organized health care delivery systems and other community based providers. The fellows will complete a wide range of activities designed to enrich their knowledge of the public policy process and foster a better understanding of how government health and biomedical research activities relate to the mission of their home institutions and local communities. After a period of orientation, each fellow will work in legislative or executive branch offices with key responsibilities for health legislation and programs.


The Department of Trade and Industry is, according to its press release, “refocusing its strategic priorities in relation to the provision of statistics”. In other words, the UK’s long established home and leisure injury surveillance systems, HASS and LASS, are being closed down. Data for 2000, 2001, and 2002 from the 18 sentinel hospitals will be added to the database during 2003, computing problems having dogged the system for three years. The inquiry service will be phased out in the autumn of 2003. Consumer Affairs Minster Melanie Johnson said that her department remained committed to ensuring that products in the UK are safe and would continue to have a key role in setting the regulatory framework around product safety. The closure is reportedly because of financial pressures and the work by the Department of Health to improve the local surveillance of accidental injury. It is not clear what work in the Health Department she was referring to as there are no signs of a replacement system on the horizon. National Health Service hospitals currently record details of patients who are admitted to hospital after an injury but not in the same detail as the HASS statistics.

The move has been condemned by safety organisations and the British Standards Institution, which depend heavily on the home and leisure accident surveillance systems for prioritising injury issues, identifying and monitoring interventions, and evaluating programmes.


The papers from a National Safety Council symposium on graduated driver licensing have been published in Journal of Safety Research. The collection of scientific research document both the higher risk and collision rates for teenage drivers and the benefits that have been realized from graduated driver licensing provisions. The papers are available in PDF format from


A report from the UK Department for Transport presents estimates of the risk of driver injury in popular models of car, if they are involved in a two car injury accident. It does not address issues of primary safety and gives no information on whether or not specific makes of car have different risks of being involved in an accident. The statistics are based on personal injury road accident data reported to the department by police forces in Great Britain. The report entitled Cars: Make and Model: The Risk of Driver Injury in Great Britain: 1996–2000 is available online at


Statistisches Bundesamt, Germany’s Federal Statistical Office, reported in June that there have been 692 000 fatalities on the country’s roads since 1953 when the collection of official road accident statistics was re-established. This number is larger than the current population of the city of Frankfurt/Main. The worst year was 1970 with over 21 000 fatalities. Since this peak, there has been a downward trend, except for a slight increase after the reunification of Germany. The year with the lowest total was 2002 with 6842 people killed. Over the same 50 years, 24.9 million road users have been injured.

The number of vehicles has risen from 4.76 million in 1953 (including 1.26 million cars) to almost 55 million, with 44.38 million cars, in 2002. The fatality rate has changed from 265 per 100 000 vehicles in 1953 to only 12 in 2002. This improvement has resulted from a several measures, including improvements in passive vehicle safety, vehicle technology, road construction, traffic regulation, and rescue services, as well as changes in the mix of traffic and the almost complete separation of pedestrians, bicyclists, and vehicles. Further information (in German):


US non-profit organisation Kids in Danger (KID) released a new report in February detailing the danger to children from recalled juvenile products. A Minefield of Danger: Children’s Product Recalls in 2002 reviews all children’s products recalled by the US Consumer Product Safety Commission in 2002. The report and a related fact sheet are available via It notes that of 210 products recalled, 90 were items intended for use by or care of children. Nancy Cowles, KID Executive Director, announced KID’s work on Test It Now!, a grassroots awareness campaign for children’s product safety that is working to move manufacturers and the government closer to mandatory standards and safety testing for durable children’s products.

KID has a workshop package to educate individuals about the dangers of unsafe children’s products. Don’t Learn About Recalls From Your Child is a 1–2 hour workshop presentation that educates participants about dangerous children’s products; informs participants about actions they can take to protect the children in their care from injury and death in juvenile products; and provides participants with tools and support to create a secure environment for children. Evaluation of the pilot program indicates that Don’t Learn About Recalls From Your Child lead to most parents and caregivers taking direct action to create a safer environment for children.


The European Child Safety Alliance, an initiative of the European Consumer Safety Association, has published a detailed overview of regulations and standards in Europe. The report describes the regulatory process, presents a list of the relevant standards and regulations and outlines recommendations for improving child safety. It can be downloaded via the new ECSA website,

The alliance is focusing its campaign efforts on water safety and drowning prevention, under the title Be water wise. The campaign has the participation of 16 European countries, aiming to communicate a clear and consistent message to reduce drownings. The website carries campaign materials in English and links to national child safety organisations that have national water safety materials they are able to share. The ECSA resources include a short list of key drowning prevention factors, a series of water safety ads, water safety and drowning prevention checklist, facts on childhood drowning, being water wise on holiday, a poster listing the key campaign messages and a short TV spot highlighting the importance of drowning prevention.


In cooperation with the US Consumer Product Safety Commission, toy maker Hasbro is voluntarily recalling about 300 000 Playskool Magic Start Crawl ‘n Stand toys. The toy, sold through Wal-Mart, was designed to encourage crawling babies to pull themselves up and stand. It can tip over during use and strike falling babies in the head, face or neck, resulting in injuries. Playskool has received 44 reports of the toys tipping over during use. There have been 26 reports of babies suffering injuries, including one minor concussion, and various bumps, bruises, black eyes, and cut lips.


In May, the Canadian government issued a warning that a toy commonly known as a yo-yo ball, yo-ball, or water yo-yo may pose a strangulation hazard to children. This follows bans on their sale in France, Switzerland, and the UK. This is the first toy to be banned in the UK for more than a decade. The yo-ball toy is made of a soft, extremely pliable plastic and consists of a liquid filled ball attached to a stretchy plastic cord that has a finger loop on one end. It presents a strangulation hazard due to the highly stretchable plastic cord which, when swung overhead, stretches to a great length because of the weight of the ball at its end. When the ball is swung overhead, as children like to do, the stretched cord can become wrapped around a child’s neck, and, as the cord recoils, it tightens. The resulting tight wrap and the sticky quality of the plastic cord make it very difficult to remove. This may lead to injury or strangulation of the child. There has been one near-miss reported in an Ontario paper—a father saved his daughter’s life by unwrapping the string of a yo-ball from around her neck. She was turning purple and could not remove it herself.

There are reports from Spain, where children have burst the ball, that the fluid in the ball may be toxic or contaminated, revealing a gap in the European toys standard that only requires accessible fluids to meet safety requirements.


All US states should prohibit inexperienced drivers from using cell phones behind the wheel, the US National Transportation Safety Board (NTSB) said in June. The NTSB said it wants other states to follow the example of Maine and New Jersey by adopting similar laws, although it can’t mandate the change. A 2002 study from the Harvard Center for Risk Analysis suggested that drivers talking on their phones were responsible for about 6% of US auto accidents each year, killing an estimated 2600 people and injuring 330 000 others.


A report, Unintentional fall-related injuries and deaths among seniors in British Columbia: Trends, patterns, and future projections, 1987-2012, is available on the British Columbia Injury Research and Prevention Unit’s website, It is an epidemiology report on falls and seniors living in British Columbia using current data from 1987 to 1998 and projections to year 2012.


The March 2003 edition of Injury Bulletin from the Queensland Injury Surveillance Unit (QISU) examined the circumstances of low speed (non-traffic) pedestrian injury deaths and emergency department presentations of children younger than 5 years to the 14 participating hospitals. The main findings were that 28 children younger than 5 years died as a result of a low speed, non-traffic pedestrian impact in Queensland in the seven year period, 1994–2000. This type of event is the third most frequent cause of injury death for toddlers (1–4 years) in Queensland. The authors, Richard Hockey, Elizabeth Miles and Ruth Barker, note that 60% of the vehicles involved in the deaths were reversing at the time and over 40% of the vehicles were four wheel drives. Two thirds of the deaths occurred at the victim’s home and the driver was most frequently a relative or family friend. In the four years to 2001, QISU recorded 68 emergency department presentations by children younger than five years for low speed runovers. Eighty percent of the injury presentations to emergency departments occurred at home and 60% required hospital admission. Injury Bulletin can be found at


The theme of Safe Kids Week 2003 in Canada was product safety, with a focus on baby walkers. The national safety organisation called for the federal Health Minister to ban walkers, under the Hazardous Products Act, a national law which has been in place since 1985. This law gives the government the right to prohibit or regulate particular products or product hazards, but so far baby walkers with wheels have not been included. They were subject a voluntary manufacturing ban adopted in 1989, but since then the industry association which agreed to and self policed this code has disbanded. That leaves baby walkers in a regulatory vacuum, and Safe Kids Canada is seeing an increase in sales through sidewalk vendors, some baby specialty shops, and through the internet.

A survey unveiled in June to mark the launch of Safe Kids Week showed that nearly one third of parents use or have recently used baby walkers with wheels (the type that a baby sits in) for their young children. Approximately 1000 babies are injured every year in Canada while using a walker. Safe Kids is alarmed that so many parents are still using them because they cause more serious injuries than any other children’s product. More than half of these are head injuries. Safe Kids Canada also urged all Canadian parents to stop using their baby walkers and to destroy them so other families cannot reuse them.

More than 5000 Canadian children each year end up in emergency rooms due to injuries from common children’s products, including walkers, playpens, and more. Yet the Safe Kids Canada/Johnson & Johnson survey revealed that the vast majority of parents (87%) assumed that the products they buy or receive as gifts for their child are safe.


All-terrain vehicle (ATV) safety was the focus of a US Consumer Product Safety Commission (CPSC) public hearing in West Virginia in June. ATV related injuries in the US have doubled in a recent five year period and deaths also continue to climb. ATV injuries requiring an emergency room visit increased by 104% from an estimated 54 700 in 1997 to more than 111 000 in 2001. In 2001, about a third of these victims were under 16 years old. In this same period the estimated number of ATV drivers increased 36%, driving hours grew by 50% and the number of ATVs increased by 40%, according to a recent CPSC analysis. For 1999, the last year for which death records are substantially complete, CPSC has reports of 357 people who died as a result of ATV use, up from 251 in 1998 and 241 in 1997.


The May issue of the ANEC newsletter reported that the European Standards Bodies, CEN, CENELEC and ETSI, have released their report on the identification of those product standards that are in need of early review under Mandate M283 (safety and usability of products by people with special needs). Mandate M283 was introduced under the European General Product Safety Directive. The tools needed by standards makers are relevant empirical ergonomic data. To be suitable for standards developers, data need to cover the range of human faculties—physical, sensory, and mental—at all ages. The report also sets out a number of recommendations and warnings, including the need for statistical evidence on home and leisure accidents. It suggests using data from the UK accident surveillance system (HASS). The disappearance of this UK home and leisure accident statistics collection, reported above, will make it more difficult to gather such vital data. The report highlights the concept of “usability”, which seems to be inconsistent with the scope of the General Product Safety Directive. The European Commission and the European Standards Bodies, says the report, should clarify those aspects of “usability” that may not be critical to the safe use of a particular product or service, possibly requiring the development of a hierarchical method of assessment.


US employers are spending an average of $280 per employee helping to pay for injuries that employees and their dependents suffer at home. These “off-the-clock” injuries result in a $38 billion a year financial burden to US employers according to a new study released in June by the Home Safety Council. The cost is almost double what employers endure for “off-the-clock” highway crashes ($19.5 billion). The economic cost study which looked at costs of unintentional home injuries from July 2000 to June 2001 was conducted by the Pacific Institute for Research and Evaluation on behalf of the Home Safety Council. The economic cost study included health insurance, sick leave, disability insurance, and life insurance payments, as well as the cost for recruiting and training replacements for employees who were killed and/or disabled by injuries in their home and the costs of workplace disruptions when employees were absent for shorter periods of time. The study can be downloaded from As part of Home Safety Month in June 2003, the Home Safety Council offered the public free advice and resources to help reduce unintentional injuries in the home, particularly the three leading causes of home injuries in the US: slips/falls, fires/burns, and poisonings.


A study released by the US Department of Transportation’s National Highway Traffic Safety Administration (NHTSA) in April showed the effectiveness of safety belt pretensioning devices, which pull safety belts snug as a crash begins, and load limiters, which allow belts to yield slightly during a crash to reduce the force on the wearer’s chest. The agency evaluated New Car Assessment Program frontal crash test data for model years 1998–2001. In these tests, vehicles are crashed into an unyielding barrier at 35 mph while instruments measure forces on the head, chest, and legs of test dummies. The combination of pretensioners and load limiters was shown, on average, to reduce the likelihood of chest and head injury. In addition, all vehicles that added either pretensioners or load limiters alone showed a reduction in head and chest injury. The full NHTSA Technical Report (DOT HS 809 562) and a shorter Evaluation Note (DOT HS 809 562), NCAP Test Improvements with Pretensioners and Load Limiters can be viewed online at


The Injury Control and Emergency Health Services Section (ICEHS) of the American Public Health Association has published commentaries since September 2002 in the section newsletters, focusing on the leadership history of the injury control movement in the USA. The series topics, prepared by Les Fisher, include: a descriptive time line of many key events in injury control in America, an analysis of the rivers and streams of historical paradigms, a eulogy for Daniel Patrick Moynihan’s work in injury control and many others. The ICEHS website is


CDC’s National Center for Injury Prevention and Control and the Harvard University Center for Population and Development Studies collaborated to produce a special issue of Injury Control and Safety Promotion (Vol 10, No 1–2, March to June, 2003) on The Global Challenge of Road Traffic Injuries. Edited by Vinand M Nantulya of Harvard and David Sleet of CDC, the issue contains 13 original papers, two short reports, a call-to-action on road traffic safety and health equity, and various commentaries. The papers emanate from an international conference in Cambridge, Massachusetts in April 2002 on the impact of road traffic injuries in low and middle income countries and possibilities for prevention.


The Victorian Government crackdown on excess speed has resulted in a significant boost to state revenue. The general increase in the number of fines was 53% but some areas increased by 249% and revenue rose from Aus $20.1 million to $33.5 million. There is some discussion over whether the overall increase is related to revenue raising. The Transport Minister argued that the jump in speed camera fines was a result of increased police activity, that the number of people speeding was not at an all-time high, but that the numbers being caught were, and that the numbers may well rise as speed cameras increase. The Minister argued that the overall speed of Victorian motorists had dropped and that a falling road toll was evidence the road safety strategies are working.


The safety roadshow, Heroes, developed in Canada, is now running in the UK. Smartrisk UK has been established as a non-profit organisation and a UK version of the Canadian show has been produced. The premier took place in Leeds in June. Contact Kevin Moore at kmoore{at}

Contributors to these news and notes include Joe Colella, Anna Cronin de Chavez, Anara Guard, Morag Mackay, Ted Miller, Barry Pless, Lucien Schlosser, Ian Scott, David Sleet, and Amy Zierler. Michael Hayes has edited the contributions. Items for the March 2004 issue, including calendar entries, should be sent to Michael Hayes at the Child Accident Prevention Trust, 18–20 Farringdon Lane, London EC1R 3HA, UK (fax +44 (0)20 7608 3674, email mh{at} by 1 December 2003.

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