CHAPTER THIRTEEN

UNINTENTIONAL INJURIES

DR. BUDHWANI
INTERESTING STUFF

Sam Moss
I lived in Korea

Sharon Osterbind
I'm on the Women's soccer team

Sidni Smith
I am exactly five feet and I enjoy fishing
SIERRA LEONE

Why should we celebrate?

https://www.facebook.com/SierraNetworkSalone/videos/932359
470174289
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TODAY IN UNDERGRADUATE EDUCATION

What do you think about your generation?

http://www.theatlantic.com/magazine/archive/2015/09/the-coddling-of
-the-american-mind/399356
/
During the 2014-15 school year, for instance, the deans and department
chairs at the 10 University of California system schools were presented by
administrators at faculty leader-training sessions with examples of
microaggressions. The list of offensive statements included: America is the
land of opportunity &I believe the most qualified person should get the job.
Theres a saying common in education circles: Dont teach students what to
think; teach them how to think. The idea goes back at least as far as Socrates.
Today, what we call the Socratic method is a way of teaching that fosters
critical thinking, in part by encouraging students to question their own
unexamined beliefs, as well as the received wisdom of those around them.
Such questioning sometimes leads to discomfort, and even to anger, on the
way to understanding.
But vindictive protectiveness teaches students to think in a very different way.
It prepares them poorly for professional life, which often demands intellectual
engagement with people and ideas one might find uncongenial or wrong.
 THE IMPORTANCE OF UNINTENTIONAL
INJURIES

Among the single leading causes of death and DALYs lost

worldwide
6% of deaths worldwide, 8% of DALYs lost
KEY DEFINITIONS

Injury - the result of an act that damages, harms, or hurts;

unintentional or intentional damage to the body resulting from
acute exposure to thermal, mechanical, electrical, or chemical
energy or from the absence of essentials as heat or oxygen

Unintentional injuries - that subset of injuries for which there is

no evidence of predetermined intent

Unintentional injury deaths result from a variety of causes such

as motor vehicle traffic crashes, falls, firearms, drownings,
suffocations, bites, stings, sports/recreational activities, natural
disasters, fires or burns, and poisonings.
THE BURDEN OF UNINTENTIONAL INJURIES

More than 90% of deaths from unintentional injuries in 2001

were in low- and middle-income countries
Percentage of deaths from unintentional injuries was twice as
high in low- and middle-income countries as in high-income
countries
Deaths only represent part of the burden
Significant differences between rates in males and females
Variation among different regions
TABLE 13.1: DEATHS FROM
UNINTENTIONAL INJURIES, 2001
TABLE 13.2: PERCENTAGE DISTRIBUTION OF
DEATHS AND DALYS FROM UNINTENTIONAL
INJURIES
 TABLE 13.3: DEATH RATES FROM
UNINTENTIONAL INJURIES
Source: Adapted with
permission from Norton R,
Hyder AA, Bishai
D, Peden M. Unintentional
injuries. In: Jamison DT,
Breman JG,
Measham AR, et al., eds.
Disease Control Priorities in
Developing
Countries. 2nd ed.
Washington, DC and New York:
The World Bank
and Oxford University Press;
2006:738.
 TABLE 13.5: PERCENTAGE OF TOTAL
DEATHS FROM UNINTENTIONAL INJURIES

Source: Adapted with

permission from Lopez AD,
Mathers CD,
Murray CJL. The burden of
disease and mortality by
condition: data,
methods, and results for
2001. In: Lopez AD,
Mathers CD, Ezzati
M, Jamison DT, Murray CJL,
eds. Global Burden of
Disease and Risk
Factors. Washington, DC
and New York: The World
Bank and Oxford
University Press; 2006:126-
127.
CHILDHOOD INJURY

98% of childhood injury deaths are in low- and middle-income

countries
Represent 2.7% of total deaths for children ages 0-4 and 3.5% of
total deaths for children ages 5-14 in low- and middle-income
countries
Children ages 0 -14 years comprise 30% of the population but
account for about 50% of total injury-related DALYs
RISK FACTORS FOR UNINTENTIONAL
INJURIES

Developmental immaturity relative to dangers present in

environment
Inability to provide adult supervision and child care
Exposure to unsafe workplaces
Poor motor safety practices
THE COSTS AND CONSEQUENCES OF
INJURIES

Direct costs including medical care, hospitalization, rehabilitation

and funeral services
Indirect costs including lost wages, sick leave, disability
payments, and insurance payouts
Rapidly increasing economic burden due to road traffic injuries in
some countries
Psychosocial consequences such as pain, fatigue, memory loss,
changes in work status, altered family dynamics
ADDRESSING KEY INJURY ISSUES

Formal surveillance systems to provide information on numbers

and patterns
Interventions designed for individual communities
Haddons Matrix to demonstrate interaction of environment,
vector, and host
Education, enforcement, and engineering efforts
HADDON MATRIX

Host, Vector, Environment

Pre-Event, Event, Post-Event

Motor Vehicle Injury

EMERGENCY MEDICAL SERVICES

Low-cost, but effective ways of improving EMS:

Special vehicles for low-income or rural communities
Advance arrangements with owners of available transport
Training truck drivers to provide first aid and transport
Training healthcare personnel who work in emergency situations
FUTURE CHALLENGES

Focusing additional attention on unintentional injuries in low-

and middle-income countries
Integrating lessons learned in high-income countries
Engineering safety into newer roads
Increasing knowledge of injury prevention