Injury in America A Continuing Public Health Problem (1985) / Chapter Skim
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2 Epidemiology of Injuries: The Need for More Adequate Data
2 Epidemiology of Injuries: The Need for More Adequate Data
Pages 25-36
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From page 25... ...
A prerequisite for the scientific study of injury is the acquisition of data on which to base priorities and research. Despite the obvious importance of injury as a public health problem, information to permit the study of the epidemiology of most injuries is not available.209 Although there are basic data on time, place, and person for some injur ies and deaths , even basic information is often lacking as to the numbers and characteristics of people injured and the factors that influence injury causation, especially in nonfatal events.
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From page 26... ...
The acquisition of knowledge about motor-vehicle injuries is a direct result of the funding of research on injury epidemiology from two sources whose primary mandate is the study of automobile injuries -- the National Highway Traffic Safety Administration and the Insurance Institute for Highway Safety. Little funding has been available for research into the epidemiology of other in jur ies; consequently, our knowledge of these other in jur ies is slight .
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From page 27... ...
Almost half of fatally injured drivers and substantial proportions of adult passengers and pedestr fans k illed in motor-vehicle crashes -- as well as in falls, drownings, fires, assaults , and suicides -- have blood alcohol concentrations of 0.10 percent or higher . 2 0 6 In a study of emergency-room patients, alcohol was detected in 30 percent of the patients injured on the road, 22 percent in jured at home, 16 percent in jured on the job, and 56 percent injured in fights or assaults.~97 Contrary to popular perception, alcohol can reduce the human tolerance to impact and increase the risk of permanent paralysis and other serious injuries.
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From page 28... ...
For example, Utah uses a dense material to build itch roads, with resulting low coefficients of friction, and has more wet-weather crashes in which poor road friction is often a factor-than do surrounding states, which use a less dense material. Specific design features have been associated with high error rates not seen with other designs.
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From page 29... ...
The knowledge gained has led to important interventions, such as improved door locks and windshield glass, energyabsorbing steer ing columns, removal of roadside obstacles, and development of breakaway signs and lam hosts 3 9 S ~ ~ 2 2 ~ 6 6 ~ 7 ~ But important as - cts repin largely unknown, and we still need information about product features that contribute to injury and death in fires, falls, and recreational and other injuries. EATS OF ~ INJURY S==IL~CE SYSTEM Injuries have definable and correctable causes.
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From page 30... ...
) , nonmedical emergency activities Medical care Resuscitation, EMS, ER, hospitaliza tion, rehabilitation, long-term care Health outcome Death, amputation, permanent disability, disability days, costs, causes of morbidity and mortality EXISTING INJURY SURVEILLANCE SYSTEMS AND THEIR LIMITATIONS Information on injuries and injury-related events must be obtained from various sources and through different means.
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From page 31... ...
is a computeriied data base that describes fatal crashes since 1975 on the basis of information collected by agencies in each state government under contract to NETSA.~27 The sources include police accident reports, state vehicle registration files, state driver licensing files, state highway department files, vital statistics, death certificates, and coroner or medical examiner reports. The FARS information, which contains 90 data elements for each fatal crash, has proved invaluable to researchers
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From page 32... ...
As part of the National Health Interview Survey, NCHS collects information on ire juries, but the samples are small, details are few, and the data have only slight utility for epidemiologic research. The Consumer Product Safety Commission (CPSC)
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From page 33... ...
If a system for identifying the immediate cause of death from injury had been available, it would hare been apparent much sooner after World War I] that the immediate cause of death shifted from abock that resulted from blood loss to kidney failure, then to respiratory failure, and then to delayed infection caused by usually harmless organisms that overwhelm immune mechanisms and cause multiple organ failure.
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From page 34... ...
The long-term consequences of what may appear to be minor injury are essentially unknown. For example, the long-term effects of brain injuries that initially are considered minor are unknown, although data from recent studies of boxers suggest that even apparently minor head injury can have serious long-term seque}ae.~ ask Many types of injuries produce a wide range of chronic disabilities, but the long-term impact of injuries in the United States is unknown.
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From page 35... ...
More than 10 years later, research showed that dr iver-education programs actually increased injuries by encouraging teenagers to drive earlier and that such education did not reduce the crash involvement of those trained. 6 3 Valuable resources were wasted, because the interventions chosen were not based on adequate data or sound epidemiology.
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From page 36... ...
RECOMMENDATIONS 1. The United States requires effective injury surveillance systems for gather ing and integrating information from a variety of sources on which to base the planning and evaluation of control efforts.
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