In reports of this kind, choices of terminology often signify positions on disputed issues of perspective or policy. Although the vocabulary of the injury field is less contentious than in many fields, a few terms are laden with policy significance and require clarification.

Injury and Accident

Architects of the injury field in the United States have made a concerted effort to displace the term "accident," which implies random events and bad luck, with the term "injury," implying predictability in the epidemiological sense and therefore amenability to prevention. Injury, moreover, refers to the health outcome being addressed. By focusing the attention on result or outcome, the term "injury'' is neutral with respect to causation, intentionality, and fault. The terminology has thereby facilitated scientific communication and helped disentangle issues of description from assumptions about etiology and fault.

Erasing the term "accident" from the vocabulary of the field has not erased it from everyday speech, however, and the general public and policy makers seem to understand the phrase "accident prevention" much better than they understand "injury prevention." Moreover, as noted by Bijur (1995), abandoning the term accident has left the field without a generic term for the events that may or may not result in bodily injury. Instead, many such terms are used to describe specific events (e.g., crash, collision, fire, poisoning, fall, shooting, fight). Interestingly, the phrase "accident prevention" continues to be used in the United Kingdom without the implications of fatalism feared by the field in this country, and Avery (1995) has proposed that this term be revived throughout the field to refer to interventions aiming to reduce events that present a significant risk of injury. However, the committee agrees with Bijur (1995) that this approach is inadvisable, not only because of its inescapable etiological connotations but also because it leaves no room for injury events that are intentionally caused (and are in no sense accidents).


Although the injury field focuses on preventing and treating a condition (the "injury") and ameliorating its consequences, intentionality (e.g., the actor's purpose and awareness of the risk of injury) is an important variable in studying the causes and prevention of injuries. According to the standard practice, injuries are divided into two categories: The term "unintentional" is used to refer to injuries that were unplanned ("accidents" in the earlier terminology), whereas the term "intentional" is used to refer to injuries resulting from purposeful human action (whether directed at oneself or others). This nomenclature is embodied in the

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