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Index A Abdominal in jur ies b iomechan ical r esearch on, 59 "Table), 63 known and needed information on, 77 (Table) organ loss in, 72 Acceleration in juries, biomechanics of, 49, 50 Acute care of inDur ies, see Treatment of in jur ies Administration of injury research, 15-17, 109-118, 148 criteria in organization of, 110-111 possible locations of, 112-115 proposed function of, 111-112 recommendations on, 115-118 Age, and injuries, 26 of children, see Childhood . . ~ Incur zes of elderly, 19, 26 fatal 18-19 Aircraft, light, injuries associated with, 2, 42 Alcohol use, injuries related to, 27-28 biomechanical research on, 57 in motor vehicles, 22-24, 27 prevention of, 8, 38, 45 Amputation, traumatic, and replantation, 79 "Table), 86 155 Animal research on biomechanics of in juries, 55 Asphyxiation, death rate from, 22, 23 (Table) Assaultive in jur yes, 21 prevention of, 44, 143 Assessment of injuries, prior to hospi tal ization, 66-67 Athletics, in jur ies associated with, see Sports injuries Automatic protection strategies, in prevention of injuries, 7, 37, 40-41 Automobile injuries, see Mbtor-vehicle injuries B Behavioral factors in epidemiology of injuries, 26-28, 101 in prevention of injuries, 7-8, 37, 38-39, 103 (Table) Bioelectric prostheses, 95 (Table) Bio~echanical research, 8-10, 48-64 on alcohol-related injuries, 57 animal experiments in, 55 anthropomorphic dummies in, 10, 55, 56, 61, 64 in assessment of safety technology, 56

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156 on brain in juries, 9, 52, 61, 62 cadaver experiments in, 54, 61 federal funding of, 102-104 mathematical models in, 55, 56, 64 on mechanisms of injury, 49-53, 54 multidisciplinary approach to, 62 prevention strategies based on, 50-51 recommendations on, 9-10, 24, 53-57, 62-64, 144-14S response measurements in, 54-55 on tolerance to impact, 9, 50, 55-56, 61, 63, 144-145 Bleeding in jur ies, shock in, 67-68 Blindness , rehabilitation in, 95 (Table ) Blood vessel injuries biomechanics of, 52, 53 bleeding and shock in, 67-68 physical alterations and major problems in, 70-71 treatment of, 78 (Table) Bone injuries, see Fractures; Skeletal injuries Boxing, brain injuries associated with, 34, 43 Brain injuries, 1, 2 biomechanical research on, 9, 52, 61, 62 in boxers, 34, 43 cellular changes in, 70 lonq-term effects of, 20, 34 physical alterations and major problems in, 71 rehabilitation in, 12, 82 service delivery system in, 97 (Table) treatment of, 10, 11, 70, 11, 75-76 (Table) Burns, 86-88 collection of data on, 34 and knob arrangements on stoves, 28 pain after, 88 prevention of, 44 psyabosocial aspects of, 88 rehabilitation in, 11, 12, 81, 83, 87-88 research needed on, 87, 146 treatment of, 79 (Table), 146 yearly number of, 86-87 C Cellular changes from in juries, 70 Center for Injury Control, 3, 15-17, 116-118, 148 Or iter ia for organization of, 110-111 functions of, IS, is, 111-112, 116, 148 funding of, 16-17, 116-117 organizational structure of, 15-17, 117-118, 148 possible alternative locations for, 112-115 Centers for Disease Control, 15-17, 115, 116-117, 148 Cervical spine injury, biomechanical research on, 54 Chent injuries lung damage in, 72, 77 (Table) treatment of, 77 (Table) Childhood injuries in falls from tall buildings, 35, 102 fatal, 4, 18 influence of television on, 38 prevention of, 8, 38-39, 41 Committee members, biographies of, 149-153 Compressive strain, 51, 52 Consumer Product Safety Commission, 32, 33 Consumer products, see Product-related factor s Contracture of tissue after in jur ies, prevention of, 88, 94-95 (Table) Contusion injury, 52, 53 Costs of injuries, funding of researab on, 101 (Table)

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157 of injury research, funding of, see Funding of in jury r esearch of rehabilitation services, 83, 98 (Table) Crushing in jur ins, hiomechanic~ of, 49, 50, S1 D Data collection on injuries, surveillance systems for; see Surveillance systems Deafness, rehabilitation in, 95 (Table) Death f ram in jur ies, see Fatal injuries Deceleration injuries, 9 Department of Defense, 114 Department of Transportation, 114 . Disabilities after injuries long-term, 19-20 prevention of, 12, 91, 94 (Table) rehabilitation in, 80-98; see also Rehabilitation reporting of, 13 short-term, 19-20 Drowning death rate from, 18, 19 epidemiologic cats needed on, 35-36 prevention of, 35, 43 Drug use , and risk for injuries, 27-28 Dummies, anthropomorphic, in biomechanical research, 10, 55, 56, 61, 64 E Education and training of injury control researchers, 147-148 in prevention of injuries, 8, 35, 37, 38-39, 46, 89 Elderly persons, injuries of, 26 fatal, 19 prevention of, 8, 38 Emergency care of injuries in hospital emergency room, 67 prior to hospitalization, 65-67 research needed on, 145-146 second injury of spinal cord in, 88-89 Endocrine responses to injury management of, 68-69, 74 (Table) research needed on, 145 Energy exposure, injuries from, 21-22, 49, 50, 55 Environmental factors affecting mobility of handicapped, 96 (Table), 147 in epidemiology of injuries, 28-29, 101 (Table) in prevention of injuries, 40-41, 103 (Table) Epidemiology of in jur ies, 25-36 behavioral factors in, 26-28, 101 (Table) definition of, 25 environmental factors in, 28-29, 101 (Table) federal funding of research on, 100-102 in motor-vehicle accident., 6, 26, 31-32, 33, 34-, 140-141 recommendations for research on, 6-7, 25-36, 140-141 surveillance systems for monitoring, 29-33 uses of cats on, 33-36 Evaluation of injuries, prior to hospitalization, 66-67 Expenditures for injury research, 99-108; see also Funding of injury relearn F Facial in jur ies, biomechanical research cm, 58 (Table), 62

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158 Falls, injuries from, 2, 21 biomechanical research on, 50, 56 of children, 35, 102 fatal , 22, 23 (Table), 43 prevention of, 35, 43-44 Farm Mach inery, in j ur in associated with, 2 Fatal Accident Reporting System, 31, 100 Fatal injuries annual number of, 1, 4, 18 of children, 4, 18 co, lection of ~ tatis tics on, 31 compared with other causes of death, 4, 18, 19 (Figure) in drowning, 18, 19 in falls, 22, 23 (Table), 43 major categories of, 22, 23 (Table) in motor-veh~cle accidents, 18, 19, 21, 22, 23 (Table), 31-32 potential years of life lost to, 5 (Figure), 14 (Figure), 20 (Figure), 108 (Figure) regional variations in, 26 Federal government administration of injury research in, 109-118; see also Administration of injury research expenditures for injury research of, 99-108; see also Funding of injury research Femur, biomechanical research on injuries on, 52, 53, 60 "Table). 61 Fetal injury mechanisms, biomechanical research on, 60 (Table) Financial support of injury research, see Funding of injury research Firearms, injuries associated with fatal, 19, 23 (Table) prevention of, 44 Fire-related injuries, 18 burns, see Burns fatal, 22, 23 (Table) in inhalation of smoke, 87, 146 prevention of, 7, 37, 44 Football, brain injuries in, 43 Fractures biomechanical research on, 52, S3-54, 58 (Table), 59 (Table), 60 (Table), 61 healing of, 79 (Table), 85-86 nonunion of, 85-86 physical alterations and major problems in, 70-71 rehabilitation in,'85-86 treatment of, 70-71, 79 (Table) Funding of injury research, 1, 2, 3, 5 on biomechanics, 102-104 compared with other health- related expenditures, 13-1S, 106-107 cost-benefit analysis of, 106-107 current federal expenditures in, 13-1S, 9 9-108 on epidemiology, 100-102 on prevention, 102, 103 (Table ) private sources of, 99 of proposed Center for In jury Control, 16-17 116-117 on rehabilitation, 105, 106 (Table) on treatment, 104-105 G Genitourinary system injuries blomechanical research on, 60 (Table) treatment of, 72, 78 (Table) Geographical variations in injury rates, 26 in prehospital care of injured, 66

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159 Government, federal administration of injury research in, 109-118; see also Administration of injury research expenditures for injury research of, 99-108; see also Funding of injury research Gunshot wounds fatal, 19, 23 (Table ) prevention of, 44 H Handicapping conditions after injuries, see Disabilities after . . Incur zes Head in jur ies biomechanical research on, 9, 58 (Table), 61, 62, 63 brain in jur ies in, see _ .. . . . Grain Uncurled cellular changes in, 70 rehabilitation in, 82 Healing of fractures, 79 (Table), 85-86 of open wounds, 75 (Table) Hearing loss noise-induced, 60 (Table) rehabilitation in, 95 (Table ) Heart injuries, biomechanical research on, 51-52, S3, 59 (Table), 61 Helicopter services, for transportation of injured, 65-66 Helmet-use laws, for motorcyclists, 39, 40 High-risk groups for injuries, 26-27 Rome environment, prevention of injur ies in , 8 , 3 8 Hospital care of injuries, 1, 5, 10, 67-69 and prehospital care, 65-67 Human factors, see Behavioral factors I Immobility after injuries complications of, 90-91, 94 (Table) and mobility systems in rehabilitation, 96 (Table) Impact injuries, biomechanical research on, 8-10, 49, 50 and tolerance to impact, 9, 50, 55-56, 61, 63, 144-145 Independent-living centers and services, 98 (Table) Infections, postinjury research needed on, 14S treatment of, 69, 74 (Table ) Inhalation injuries, fire-related, 87, 146 Insurance Institute for Highway Safety, 6, 26 Interdisciplinary approach to injury research, 62, 109 International Classification of Diseased codes, related to injuries, 31 J Jaywalking by elderly pedestrians, 8, 38 X Kidney injuries, treatment of, 72, 78 (Table) Laws And regulations, in prevention of injuries, 7, 8, 37, 38, 39-40, 46-47 Lung injuries from smoke inhalation, 87, 146 treatment of, 72, 77 (Table) M Mathematica1 models in biomechanical research, 55, 56, 64

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160 Mechanisms of injury, 49-S3 research needed on, 53-54, 144 Metabolic responses in injury, 68-69, 74 (Table) research needed on, 145 Microsurgical techniques, in rehabilitation of injured, 79 "Table)' 86 Motorcycle injuries fatal, 41 and helmet-u';e laws, 39, 40 Motor-vehicle injuries annual cost of, 20-21 associated with alcohol use, 22-24, 27 biomechanical research on, 9, 56 environmental factors in, 28, 29 epidemiology of, 6, 26, 31-32, 33, 34, 140-141 fatal, 18, 19, 21, 22, 23 (Table), 31-32 f unding of research on , 9 9, 100, 102 and h igh-school dr iver education, 35, 38 prevention of, 7, 8, 37, 38, 41-42, 102, 142 and second injury of spinal cord, 89 yearly number of, 21 Multidisciplinary approach to injury research, 62, 109 Muscle injuries biomechanical research on, 60 (Table), 63 rehabilitation in, 11, 12, 84-85 National Accident Soling System, 32, 100 National Bureau of Standards;, 114 National Center for Health Statistics, 31 National Electronic In jury Surveillance System, 32, 33, 100 National Highway Traf f in Safety Administration, 6, 26, 31-32, 100 National Institutes of Health, 5, 13, 113-114 National Transportation Safety Board, investiga- tions funded by, 105 Neck injuries, biomechanical research on, 54, 58-59 (Table), 62, 63 Nervous system injuries biomechanical research on, 9 of brain, see Brain in jur ies nerve regeneration in, 90 physical alterations and major problems in, 70-71 preservation of residual function in, 9D, 95 {Table) rehabilitation in, 11, 12, 80, 81, 82, 83 of spinal cord, see Spinal cord injuries . treatment of, 70-71, 75-76 (Table) Neuroendocrine response to injury management of, 68-69, 74 {Table) research needed on, 145 o Occupational injuries, see Work-related injuries Occupational Safety and Health Administration, 32 Organ loss in injur ies , 72 Organizational structure of proposed Center for Injury Control, 117-118, 148 p Pain after burns, 88 Paralysis after injuries, 12, 20, 27 Paramedics, in prehospital care of injured, 66 Pedestrian injuries of children, 39

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161 fatal, 18 prevention of, 8, 38 Penetrating injuries, biomechanics of, 48 Perception of hazards, individual variations in, 142-143 Personality traits, and risk for injury, 28 Persuasive strategies in prevention of in jur ies, 7, 37, 38-39 Physical alterations from injuries, treatment of, 70-71 Physical barriers affecting mobility of handicapped, reduction of, 96 (Table), 147 Poisoning of children, prevention of. 41 death rate from, 22, 23 (Table) Prehospital care of injuries, 65-67 recommendations of, 67 second injury of spinal cord in, 88-89 Preretirement years of life lost annually, 14 (Figure), 108 (Figure) Pressure sores after spinal cord injuries, 12, 90-91 control and prevention of, 96 (Table), 147 Prevention of injuries, 2, 7-8, 37-47 in alcohol use, 8, 38, 45 in assaults and homicides, 44, 143 automatic protection mechanisms in, 7, 37, 40-41 behavioral factors in, 7-8, 37, 38-39, 103 (Table) biom~chanical approach to, 50-~l Center for Injury Control in, 3, 15-~7, 116-118, 148 in childhood, 8, 38-39, 41 in drowning, 35, 43 education and training in, 8, 35, 37, 38-39, 46, 89 effectiveness of strategies in, 143 environmental factors in, 40-41, 103 (Table) epidemiologic data in, 35 in falls, 35, 43-44 federal funding of research on, 102, 103 (Table) in fires, 7, 37, 44 general approaches to, 7-8, 37-41 laws and regulations in, 7, 8, 37, 38, 39-40, 46-47 in motor-vehicle accidents, 7, 8, 38, 41-42, 102, 142 phase approach to, 24 product design in, 40-41, 47, 103 (Table), 143-144 recommendations for research on, 8, 45-47, 142-144 in recreation, 43 in Elf-inflicted injuries. 44-45 in transportation, 41-42 in the workplace, 42-43 Product-related factors in epidemiology of injuries, 32-33, 100, 101 (Table), 141 funding of research on, 101 (Table), 103 (Table) in prevention of in jut ies , 40-41, 47, 103 (Table), 143-144 Prosthetic devices bioelectric, 95 (Table) research :~sues concerning, 86, 147 Psychological consequences of injuries in burns, 88 funding of research on, 101 (Table) recommendations for research on, 141 Recreation injuries musculoakeletal, 85

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162 prevention of, 43 in sports, see Sports injuries Rehabilitation, 11-13, 80-98 in brain injuries, 12, 82 in burns, 11, 12, 81, 83, 87-88 control of complications in, 91, 94 (Table) cost-effectiveness of, 83, 98 (Table) def inition of, 11, 80 federal funding of research on, 105, 106 {Table) financing of services in, 98 (Table) number of persons requiring, 82 recommendations on, 12-13, 92-93 in regional specialized centers, 81, 82, 97 (Table) research issues concerning, 12-13, 81-82, 84098, 146-147 in skeletal injuries, 11, 12, 84-85, 86 in spinal cord injuries, 12, 81, 82, 83, 85, 88-89 Replantation, after traumatic 39, 40 amputation, 79 (Table), 86 Reproductive system injuries biomechanical research on, 60 (Table) treatment of, 72, 78 (Table) Research, injury-related administration of, 15-17, 109-118, 148 on biomechanics, 48-64; see also Biomechanical research current status of, 2-3 on epidemiology, 6-7, 25-36, 140-141 funding of, 99-108; see also Funding of injury research multidisciplinary approach to, 62, 109 on prevention, 8, 45-47, 142-144 recommendations for, 139-148 on rehabilitation, 12-13, 81-82, 84-98, 146-147 training of personnel for, 147-148 on treatment, 10-11, 73, 145-146 Risks for injuries behavioral factors in, 7-8, 26-28, 37-39, 40, 101 (Table), 103 (Table) environmental factors in, 28-29, 40-41, 101 (Table), 103 (Table) product-related factors in, 32-33, 40-41, 47, 100, 101 (Table) 103 (Table), 141, 143-144 Rural areas injury rates in, 26 prehospital care of injured in, 66 S Safety technology biomechanical research on, 56 in prevention of injuries, 40-41 Seatbelt-use laws, 7, 37, 38, Self-care after injuries, 96 (Table) Self-inflicted injuries, see also Suicide prevention of, 44-45 . . . Sensory organ injuries biomechanical research on, 60 (Table) rehabilitation in, 95 (Table) Service delivery systems in rehabilitation, 97 (Table) Shear strain, 51, 52 Shock, management of, 67-68, 74 (Table) research needed on, 145 Skateboard injuries, 33 Skeletal injuries fractures in, see Fractures physical alterations and major problems in, 71

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163 rehabilitation in, 11, 12, 84-85, 86 S k in in jur ies biomechanical research on, 60 (Table) burns, 86-88; see also Burns Smoke detectors, 7, 37, 44 Smoke inhalation, lung injury from, 87, 146 Social attitudes toward handicapped, 97 (Table), 147 Socioeconomic factors, and risk for injuries, 26-27 Speed limits, and motor- vehicle in jur ies , 4 2 Spinal cord in jur ies, 1, 2 associated with trampolines, 43 biomechanical research on, 9, 61 physical alterations and major problems in, 71 preservation of residual function in, 90, 9S (Table) pressure sores as complication of, 12, 90-91 rehabilitation in, 12, 81, 82, 83, 85, 88-89 second, at time of emergency care, 88-89, 146 service delivery system in, 97 (Table) treatment of, 10, 11, 71, 76 (Table) Spine injuries, biomechanica1 research on, 54, 59 (Table ) Sports injuries in boxing, 34, 43 of brain, 34, 43 in football, 43 musculoakeletal, 85 prevention of, 85 Statistics on injuries, surveillance systems for collection of, 29-33; see also Surveillance systems Strain mechanisms in injuries, 51-52 Suicide, 21 collection of data on, 34 death rate from, 23 (Table) prevention of, 44-45 Surveillance systems, 6-7, 29-33, 100-102 data needs for, 29, 30 (Table) limitations of existing programs in, 30-33 on long-term effects of minor injuries, 34 on motor-vehicle accidents, 31-32, 33, 34 National Electronic Injury Surveillance System in, 32, 33, 100 recommendations on, 36, 140-141 uses of, 33~36 T Television influence on childhood injuries, 38 Tensile strain, 51, 52 Thermal injuries, see Burns Thoracic injuries, biomechanical research on, 59 {Table), 61, 63 Thoracolumbar spine injuries, biomechanical research on, 59 (Table) Tissue injury mechanisms of, 49-53, 85, 144 research needed on, 78 (Table), 144 treatment of, 70, 78 (Table) Tolerance to impact, biomechanical research on, 9, 50, 55-56, 61, 63, 144-145 Traffic accidents, injuries in see Motor-vehicle Incur yes Training and education of injury control researchers, 147-148 in prevention of injuries, 8, 35, 37, 38-39, 46, 89 Tr ampolines, 43 Transpor tation access of handicapped to, 96 (Table )

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164 of injured, 65-66. injuries related to, 41-42; see also Motor-vehicle injuries second injury of spinal cord in, 88-89, 146 Trauma centers, 10, 66, 67, 72, 75 (Table) Treatment of injuries, 10-11, 65-79 of brain, 10, 11, 70, 71, 75-76 (Table) in burns, 79 (Table), 146 with cellular changes that alter function, 70 characteristics of injuries requiring, 69-72 federal funding for research on, 104-105 historical, 24 hospital care in, 1, 5, 10, 67-69 infections complicating, 69, 74 (Table-) and loss of organ, 72 and neuroendocrine responses, 68-69, 74 (Table) of physical alterations, 70-71 prehospital care in, 65-67 prevention of complications in, 12 recommendations on, 10-11, 72-73, 145-146 and shock, 67-68, 74 (Table) of spinal cord, 10, 11, 71, 76 (Table) summary of known and needed information on, 74-79 (Table) yearly number of physician contacts for, 19 U Urban areas, prehospital care of injured in, 66 V Vascular injuries, see Blood vessel in juries Vertebral injuries, biomechanical research on , 54 , 59 (Table) W War injuries, rehabilitation in, 81 Wheelchairs, new designs of, -96 (Table) Work-related injuries collection of data on, 32-33 prevention of, 42-43 rehabilitation in, 84 Wounds, open, healing and treatment of, 75 tTable)