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Reducing the Burden of Injury: Advancing Prevention and Treatment
The agent of injury is often a product obtained by a consumer in the marketplace (including motor vehicles, firearms, or other consumer products). Many of the great successes of injury prevention have involved research demonstrating that product alterations may reduce the risk of an injury-causing event or ameliorate its effects. Research on pre-event interventions resulted in the development of center high-mounted brake lights on automobiles that assist in preventing rear-end collisions by giving drivers that follow a quicker warning of deceleration (Rausch et al., 1982; Kahane, 1989; McKnight et al., 1989); childproof caps to keep medicine, that can cause poisonings from being opened (discussed earlier); and safety locks on firearms (see Chapter 5).
Prevention of fire-related injuries encompasses a wide range of opportunities for modifying the vector of thermal energy to reduce the risk that the energy will escape from control. For example, research has demonstrated the feasibility of safer designs for cigarettes (to make them self-extinguish more quickly) and lighters (to make them less likely to be ignited by a child). This research has led to product liability litigation against manufacturers of cigarettes and lighters, and has also provided the scientific basis for a 1994 Consumer Product Safety Commission regulation requiring cigarette lighters to be child-resistant. Research has also demonstrated the feasibility of making mattresses and upholstered furniture less flammable and, accordingly, less likely to be ignited by cigarettes, leading to the implementation of industry safety standards.
Research on the safety features of these products is conducted primarily by manufacturers, regulatory agencies, or watchdog consumer organizations. From the perspective of "intervention research," research questions concern the incentives for developing and implementing product safety designs that arise in the market (through which manufacturers respond to consumer preferences for safety); the efficacy of "interventions" designed to modify these incentives through direct regulation by authorized agencies (through standard setting or remedial action); or the indirect regulatory effects of bad publicity and tort liability. Surprisingly few researchers have explored empirically the operation of the market for safety, the effects of tort liability, and the effects of regulatory action. This area of research is in need of greater attention, particularly the safety effects of tort liability; here, public health proponents typically assume that expansive liability rules are safety enhancing, whereas skeptics believe that the existing liability scheme tends to reduce safety by retarding innovation or inducing override behavior (Sugarman, 1990; Rose-Ackerman, 1991; Viscusi, 1992; Viscusi and Magat, 1995; Dewees et al., 1996).