action plan to strengthen prevention of · intentional injuries as injuries that are purposely...

Action Plan toStrengthen Prevention of Unintentional Injuries in Hong Kong

Hong Kong Special Administrative Region of China

Action Plan to Strengthen Prevention of U

nintentional Injuries in Hong Kong

Nov 2014Printed by the Government Logistics Department Hong Kong Special Administrative Region of China

i

Action Plan to Strengthen Prevention

of Unintentional Injuries in Hong Kong

ii

ContentsPage

Abbreviations iii

Preface by Mr Patrick MA Ching-hang, Chairman of the Working Group on Injuries iv

1. Introduction 1

• Developingalocalstrategytostrengthenthepreventionofunintentionalinjuries 2

• Definitionandclassificationofinjuries 4

• Globaldiseaseburdenfrominjuries 5

• Globalactions 9

2. Injury prevention: Hong Kong situation 11

• Epidemiologyofinjuriesanddiseaseburden 12

• Injurysurveillanceeffortandinformationgap 16

• Interventionstopromotepreventionofunintentionalinjuries 17

• Fourpriorityareasidentified 22

• Elaborationofpriorityareas 23

3. Actions to strengthen prevention of unintentional injuries 33

• Goals 34

• Specificactions 35

• Leadactionparties,targetsandtimeframe 45

4. Making it happen 49

Annexes 51

1. Membership of Working Group on Injuries 52

2. Terms of reference of Working Group on Injuries 54

3. DiscussiontopicsinmeetingsoftheWorkingGrouponInjuries 55

iii

Abbreviations

Abbreviation Full name ACLS AdvancedCardiacLifeSupportA&E AccidentandEmergencyAED AccidentandEmergencyDepartmentAMS AuxiliaryMedicalServiceAMSA AsianMedicalStudents’AssociationBLS BasicLifeSupportBRFS BehaviouralRiskFactorSurveyC&ED CustomsandExciseDepartmentCHEP CentreforHealthEducationandHealthPromotionCHEU CentralHealthEducationUnitCHS ChildHealthSurveyCIPRA ChildhoodInjuryPreventionandResearchAssociationCISS CommunityInjurySurveillanceSystemDALYs Disability-AdjustedLifeYearsDH DepartmentofHealthEDB EducationBureauEHCs ElderlyHealthCentresEHS ElderlyHealthServiceFHB FoodandHealthBureauFHS FamilyHealthServiceHA HospitalAuthorityHCPF HealthCareandPromotionFundHHSRF HealthandHealthServicesResearchFundHKMA HongKongMedicalAssociationHKPF HongKongPoliceForceHMRF HealthandMedicalResearchFundICECI InternationalClassificationofExternalCausesofInjuryICHDP IntegratedChildHealthandDevelopmentProgrammeLCSD LeisureandCulturalServicesDepartmentLD LabourDepartmentMCHCs MaternalandChildHealthCentresNCD Non-communicableDiseasesNGOs Non-governmentalOrganisationsOSHC OccupationalSafetyandHealthCouncilPCO Primary Care OfficePHS PopulationHealthSurveyPMH PrincessMargaretHospitalPYLL PotentialYearsofLifeLostRCHEs ResidentialCareHomesfortheElderlySC SteeringCommitteeonPreventionandControlofNon-communicableDiseasesSFH SecretaryforFoodandHealthSHS StudentHealthServiceSHSCs StudentHealthServiceCentresUS UnitedStatesWGAH WorkingGrouponAlcoholandHealthWGDPA WorkingGrouponDietandPhysicalActivityWGI Working Group on InjuriesWHO WorldHealthOrganization

iv

PrefaceInjuriesareaglobalpublichealthproblem. According to theWorldHealth

Organization(WHO),about5.8millionpeopledieeachyearasaresultofinjuries,and

manynon-fatal injuriesresult in life-longdisabilitiesandsuffering. Assuch, injury

preventionisaccordedhighprioritybyWHOandmanycountries.

InHongKong,injurieshaveremainedoneoftheleadingcausesofdeathsincethe

1960s.In2013,injuriesrankedfifthamongtheleadingcausesofdeathandaccounted

for1860deaths. Injuriescouldleadtoprematuredeathanddisability. Theimpactof

injuriesonindividuals,familiesandsocietyshouldnotbeunderestimated.

Traditionally,unintentional injurieshavebeenregardedasrandom,unavoidable

“accidents”.Duringthelastfewdecades,however,abetterunderstandingofthenature

ofinjurieschangedtheseoldbeliefs.Today,unintentionalinjuriesareviewedaslargely

preventableeventsthroughbetterunderstandingoftheirriskfactorsandreductionof

theirlikelihoodandseverity.

InlinewithGovernment’sstrategicframeworkdocument“Promoting Health in Hong

Kong: A Strategy Framework for Prevention and Control of Non-communicable Diseases”

publishedin2008,theWorkingGrouponInjuries(WGI)wassetupin2012toadviseon

priorityactionsforhealthimprovementintheareaofinjuryprevention,andtomake

recommendationsonthedevelopment, implementationandevaluationofanaction

planforthepreventionofinjuries.

v

Fourmeetingsof theWGIwereheldtoexamine,amongotherthings,overseas

evidenceandlocalsituation,beforedrawingupthisActionPlantooutlinethedirection

andstepstotakeintheyearsaheadforeffectivepreventionofinjuriesinHongKong.

AsChairmanoftheWGI,Iwouldliketothankallmembersoftheworkinggroupand

otherswhohavecontributedtodevelopmentofthisActionPlan.

Everyindividualandorganisationhasaroletoplayinthepreventionofinjuries. I

takethisopportunitytoappealforconcertedeffortsfromstakeholdersacrosssectorsin

thisimportantendeavour.Iamconfidentthatinpartnership,wecanbuildahealthier

andsaferplacetolive.

PatrickMAChing-hang,BBS,JP

Chairman

Working Group on Injuries

1

1 Introduction

2

Introduction 1

1. Introduction

Developing a local strategy to strengthen the prevention of unintentional injuries

1.1 Thenumberofpeoplesufferingfromnon-communicablediseases(NCD) is increasing,both

worldwideandinHongKong. TocombatNCD,theDepartmentofHealth(DH)publisheda

strategicframeworkdocumententitled“Promoting Health in Hong Kong: A Strategic Framework

for Prevention and Control of Non-communicable Diseases” inOctober2008,whichprovidedan

armouryofoverarchingprinciplesforthepreventionandcontrolofNCD.

1.2 Tooverseetheimplementationofthestrategicframework,ahigh-levelSteeringCommittee

onPreventionandControlofNCD(SC)wasestablishedinlate2008. TheSCischairedbythe

Secretary forFoodandHealth (SFH),withmembers fromGovernment,publicandprivate

sectors,academiaandprofessionalbodies,industryandotherkeypartners.TheSCendorsedthe

settingupofworkinggroupstoassessandaddressbehaviouralNCDriskfactorsofpublichealth

significance.

1.3 TheWorkingGrouponDietandPhysicalActivity(WGDPA)wasestablishedon16December

2008totackleimminentproblemscausedbyunhealthydietaryhabits,physical inactivityand

obesity. The “Action Plan to Promote Healthy Diet and Physical Activity Participation in Hong Kong”

waslaunchedin2010.

1.4 TheWorkingGrouponAlcoholandHealth(WGAH)was

establishedon23June2009tolookintoproblemsrelated

toalcoholmisuse. The“Action Plan to Reduce Alcohol-

related Harm in Hong Kong”waslaunchedin2011.

3

Introduction1

1.5 As injurypreventionmerits special attention, theWorkingGroupon Injuries (WGI)was

establishedon6February2012toadviseonthepriorityareasforactionandtodrawuptargets

andactionplansrelatedto injuryprevention. TheWGI ischairedbyMrPatrickMAChing-

hangandcomprisesstakeholdersfromthepublicandprivatesectors,representativesfromthe

academia,DistrictCouncils,educationsector,healthcareprofessionals,socialservicessectorand

relevantgovernmentdepartments.ThemembershipandthetermsofreferenceoftheWGIare

listedinAnnexes1and2respectively.

1.6 SinceitsestablishmentinFebruary2012,WGIhasmetfourtimestodiscuss:

i. Globaldevelopmentofinjurypreventionandlocalsituationofinjuries;

ii. PriorityareastostrengtheninjurypreventioninHongKong;

iii. Recommendationstostrengtheninjuryprevention;and

iv. ActionPlantostrengtheninjuryprevention.

ThetopicsdiscussedinthemeetingsarelistedinAnnex3.

1.7 Aftercarefulconsiderationoftheavailableevidenceandthelocalsituation,theWGIproduced

an “Action Plan to Strengthen Prevention of Unintentional Injuries in Hong Kong”,highlighting

fivestrategicdirectionsandninerecommendationstostrengtheninjurypreventioninHong

Kong. TheActionPlanwasendorsedbytheSCinSeptember2014. To implementthenine

recommendationstherein,theWGIproposed16specificactionswhicharesetoutindetail in

Chapter3ofthisdocument.

4

Introduction 1

Definition and classification of injuries

1.8 TheWorldHealthOrganization(WHO)defines injuriesasthephysicaldamagethatresults

whenahumanbodyissuddenlyorbrieflysubjectedtointolerablelevelsofenergy.Itcanbea

bodilylesionresultingfromacuteexposuretoenergyinamountsthatexceedthethresholdof

physiologicaltolerance,oritcanbeanimpairmentoffunctionresultingfromalackofoneor

morevitalelements(i.e.air,water,warmth),asindrowning,strangulation,orfreezing1,2.

1.9 Injuriescanbedividedintointentional injuriesandunintentional injuries. TheWHOdefines

intentionalinjuriesasinjuriesthatarepurposelyinflicted,eitherbythevictimsthemselves(i.e.

suicideandsuicideattempts)orbyotherpersons(i.e.homicide,assault,rape,childabuse,elderly

abuse,andfamilyviolence),andunintentional injuriesas injuriesthatarenot intentionally

inflicted(i.e.roadtrafficinjuries,fallinjuries,sportinjuries,occupationalinjuries,childpoisoning,

burnsanddrowning).2

1.10 Toavoidoverlappingof important injury topicsalreadyreceivingattention fromrelevant

authorities,theWorkingGroup,afterdeliberation,hasdecidedthatthescopeofthis“Action

Plan to Strengthen Prevention of Unintentional Injuries in Hong Kong” shouldbeconfinedto

unintentionalinjuries.

1 Injuries and Violence: The Facts. WHO. 20102 WorldHealthOrganization(2010).TEACH-VIP E-Learning – Foundations and methods.Availableat:http://teach-vip.edc.org/documents/IpGp/InjuryPreve

ntionGeneralPrinciples.pdf,accessed23April2014

5

Introduction1

Global disease burden from injuries

1.11 Injuriesandviolenceareamongthemostprominentpublichealthproblems intheworld.

Everyyear, intentionalandunintentionalinjuriescauseasignificantnumberofdeaths,human

sufferingsanddisabilities,bothgloballyandlocally. Worldwide,injuriesaccountfor5.8million

deathseachyear,comprising10%ofalldeaths.1Thisequatestoalmost15000injurydeathsper

day. Thetopleadingcauseofdeathgloballyfrominjuriesisroadtrafficaccident. Roadtraffic

injuriesalonearepredictedtoincreasein importanceandbecomethefifthleadingcauseof

deathin2030(Figure1andTable1).1

Figure 1: Causes of injury deaths worldwide in 2004

Roadtraffic

23%

Suicide

15%

Homicide

11%

Falls

8%

Drowning

7%

Fires

6%

Poisoning

6%War

3%

Other*

21%

* ”Other”includessmothering,asphyxiation,choking,animalandvenomousbites,hypothermiaand hyperthermia,aswellasnaturaldisasters.

Source:Global burden of disease.WorldHealthOrganization.2004

6

Introduction 1

Total 2004

1. Ischemicheartdisease

2. Cerebrovasculardisease

3. Lowerrespiratoryinfections

4. Chronicobstructivepulmonarydisease

5. Diarrhoealdiseases

6. HIV/AIDS

7. Tuberculosis

8. Trachea,bronchus,lungcancers

9. Roadtrafficcrashes

10. Prematurityandlowbirthweight

11. Neonatalinfectionsandother

12. Diabetesmellitus

13. Malaria

14. Hypertensiveheartdisease

15. Birthasphyxiaandbirthtrauma

16. Suicide

17. Stomachcancer

18. Cirrhosisoftheliver

19. Nephritisandnephrosis

20. Colonandrectumcancers

Total 2030

1. Ischemicheartdisease

2. Cerebrovasculardisease

3. Chronicobstructivepulmonarydisease

4. Lowerrespiratoryinfections

5. Roadtrafficcrashes

6. Trachea,bronchus,lungcancers

7. Diabetesmellitus

8. Hypertensiveheartdisease

9. Stomachcancer

10. HIV/AIDS

11. Nephritisandnephrosis

12. Suicide

13. Livercancer

14. Colonandrectumcancers

15. Oesophagealcancer

16. Homicide

17. Alzheimerandotherdementias

18. Cirrhosisoftheliver

19. Breast cancer

20. Tuberculosis

Table 1: Leading causes of deaths in 2004 and 2030 (predicted) worldwide

Source:World health statistics 2008(www.who.int/whosis/whostat/2008/en/index.html)

1.12 Injuriesandviolencearesignificantcausesofdeathandillhealthinallcountries,buttheyarenot

evenlydistributedaroundtheworldorwithincountries,andsomepeoplearemorevulnerable

than others.1

1.13 Morethan90%ofdeathsthatresultfrominjuriesoccurinlow-andmiddle-incomecountries.

Injurydeathratesare2.5timeshigherinpoorerEuropeancountriesthaninwealthierones.1

1.14 Injuriesarealeadingcauseofdeathamongyoungpeople. Amongpeoplebetweentheages

of5and44years,injuriesareoneofthetopthreecausesofdeath.1Roadtrafficinjuriesarethe

leadingcauseofdeathamongthoseagedbetween15and29years,withhomicideandsuicide

thefourthandfifthleadingcausesofdeathrespectivelyamongthisgroup.1Amongtheelderly,

fallsarethemostcommoncauseofinjurydeath.1

7

Introduction1

1.15 Twiceasmanymenaswomendieeachyearasaresultofinjuries.Thethreeleadingcausesof

deathfrominjuriesformenareroadtrafficinjuries,suicideandhomicide,whileleadingcauses

forwomenareroadtrafficinjuries,suicide,andfire-relatedburns(Figure2).1

Figure 2: Death rates per 100 000 population, by different causes of injury and sex, World, 2004

30

25

20

15

10

5

0Suicide Drowning FallsFires Poisoning RoadtrafficinjuryHomicide

Deathra

tesper100

000

pop

ulation

Men Women

Source:Global burden of disease.WorldHealthOrganization.2004

1.16 Foreverydeathfrominjurytherearemanymoreinjuriesthatresultinhospitalisation,treatment

inemergencydepartments,ortreatmentbypractitionersoutsidetheformalhealthsector.

AccordingtoastudypublishedbyWHO, intheworld’shigh-incomecountriessuchasthe

Netherlands,SwedenandtheUnitedStates(US),foreverypersonkilledbyinjury,approximately

30timesasmanypeoplearehospitalisedandroughly300timesasmanyaretreatedinhospital

emergencyroomsandthenreleased.3Intermsofthenumberofpeoplebeingaffected,deaths

constituteonlyasmallpartofthetotalinjurytoll.Infact,foreveryvictimkilledbyinjury,many

moreareseriouslyandpermanentlydisabledandmanymoreagainsufferminor,short-term

disabilities.4 Themortalityandmorbidityofinjuryeventscanbestberepresentedbyaninjury

pyramid.Fatalinjuriesusuallyrepresentthetipofthepyramid,whichmeanstheyarerelatively

rare. Midwaydownthepyramidareinjuriesresultinginhospitalisations,medicalattentionat

emergencycareunitsoroutpatientclinics,andfurtherdownareinjurieswhichdonotresultin

medicaltreatmentbutmayneverthelesscauseleaveabsencesandproductivityloss.

3 CDC(2005).CDC Injury Surveillance Training Manual Participant Guide 2005.Availableat:http://stacks.cdc.gov/view/cdc/11390,accessed23April20144 HolderY,PedenM,KrugEetal(Eds).Injury surveillance guidelines.Geneva,WHO.2001

8

Introduction 1

Figure 3: Graphic representation of the demand on the health sector caused by injuries

Source:Injuries and Violence: The Facts.WorldHealthOrganization.2010.

Injury pyramidGraphicrepresentationofthedemandonthehealthsectorcausedbyinjuries

Fatal injuries

Injuries resulting in

hospitalizations

Injuries resulting in visits to emergency departments

Injuries resulting in visits to primary care facilities

Injuries treated outside the health system, not treated, or not reported

1.17 Manyoftheinjuredwillbeleftwithdisablingconsequences,andinsomecases,permanent

ones.5 Whendisabilityresultedfrominjuriesisalsotakenintoconsideration,injuriesrepresent

anevenmoresignificantpublichealthproblem,especiallyinlightofthefactthatinjuriesaffect

mainlyyoungpeople,thatistosay,theeconomicallymostproductivesectorofthepopulation.

Injuriescanhaveanimpactatpersonalaswellashouseholdlevels,particularlywhentheinjured

personisthebreadwinner.

1.18 Globally, injuriesaccount for10.4%6ofalldisability-adjusted lifeyears (DALYs),andthis is

expectedtoincreaseto20.1%7by2020. Besideshugephysicalandmentalharmthatinjuries

andviolenceproduceonthoseaffected,considerableeconomiclossesarecausedtovictims,

theirfamilies,andtonationsasawhole,includingproductivitylossesduetoinjurydeathand

disability,combinedwiththecostsoftreatmentandrehabilitationoftheinjured.Theeconomic

costofroadtrafficcrashesgloballyhasbeenestimatedatUS$518billionandcostmostcountries

between1-2%oftheirgrossnationalproduct.1

5 FazlurRahmanAKM.A model for injury surveillance at the local level in Bangladesh: implications for low-income countries.Stockholm,KarolinskaInstitute, 2000.

6 WorldHealthOrganization.2011.Health statistics and health information systems.http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html,accessed30December2011.

7 MurrayCJL,LopezAD.Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study.Lancet,1997,349:1498–1504.

9

Introduction1

1.19 Injuriesandviolencehavenotmadetheirwayintotheglobalhealthagendafora longtime

despitetheirbeingpredictableandlargelypreventable. It isnowbelievedthatmanyinjuries

andmuchviolencecanbeprevented. There isabroadrangeofstrategiesbasedonsound

scientificevidenceshowntobeeffectiveinreducinginjuriesandviolence,andthesestrategies

needtobemorewidelyadopted.Declineininjurieshasbeenobservedmainlyinhigh-income

countriesdue largelytoapplicationof theseeffectivepreventionandtreatmentstrategies

throughconcertedeffortsthatinvolve,butarenotlimitedto,thehealthsector.Theinternational

communityneedstoworkwithgovernmentsandnon-governmentalorganisations(NGOs)

aroundtheworldtoimplementtheseprovenmeasuresandreducetheunnecessarylossoflife

thatoccurseachdayasaresultofinjuriesandviolence.Actionmustbetakennowtodecrease

theadverseimpactcausedbyinjuriesinourcommunity.1

Global actions

1.20 In1996, theForty-ninthWorldHealthAssemblyadoptedResolution49.25. TheResolution

declaredviolencea leadingglobalpublichealthproblem. InresponsetotheOrganization’s

increasingcommitmenttoaddress injuriesandviolence,theWHO’sDepartmentofViolence

andInjuryPreventionandDisability(VIP)wasestablishedinMarch2000.Itactsasafacilitating

authorityfor internationalscience-basedeffortstopromotesafetyandpreventviolenceand

unintentional injuries,tomitigatetheirconsequences,andtoenhancethequalityof lifefor

personswithdisabilitiesirrespectiveofthecauses.8,9

1.21 The World report on violence and healthwasreleasedinOctober2002.Itwasthefirstmostvisible

productofVIP.AsaresultoftheResolutionWHA56.24onImplementingtheRecommendations

of the World Report on Violence and Health(2003),manyMemberStateshavestartedtodevelop

nationalreports,plansofaction,networksandotheractivitiesstemmingfromtheReportand

designedtopreventviolence.TwoguidingdocumentsDeveloping policies to prevent injuries and

violence: guidelines for policy-makers and planners and Preventing injuries and violence: a guide for

ministries of healthwerereleasedin2006and2007respectivelytodescribethenecessarysteps

forcreatinganinjuryandviolencepreventionpolicy. TheWHOWesternPacificRegionalso

releasedaguidingdocumentRegional Framework for Action on Injury and Violence Prevention

2008-2013 Strengthening Injury and Violence Prevention in the Western Pacific Region to assist

countriesindefiningandpreventingavoidabledeathsanddisabilityfromthesecauses.

8 WorldHealthOrganization.2011.Violence and Injury Prevention and Disability (VIP).Availableat:http://www.who.int/violence_injury_prevention/about/en/index.html,accessed24April2014

9 WorldHealthOrganization.2002.Department of Injuries and Violence Prevention Annual Report 2002

10

Introduction 1

1.22 Inrecentyears,WHOhassignificantlysteppedupitsactivitiesintheareaofinjuryandviolence

prevention.TheOrganization’sWorld report on child injury prevention, World report on road traffic

injury preventionandWorld report on violence and healthandtheresolutionsrelatedtothese

reportspassedbytheWorldHealthAssemblyandtheWHORegionalCommitteesspecificallycall

upongovernmentstoidentifyfocalpointsforinjuryandviolencepreventionwithinMinistriesof

Healthtocoordinateandfacilitatenationalefforts.

1.23 In2010,GeneralAssemblyoftheUnitedNationsproclaimed2011–2020theDecadeofActionfor

roadsafety,withaglobalgoalofstabilisingandthenreducingtheforecastedlevelofglobalroad

fatalitiesbyincreasingactivitiesconductedatnational,regionalandgloballevels. TheUnited

NationsRoadSafetyCollaborationhasdevelopedtheGlobal Plan for the Decade of Action for

Road Safety 2011-2020 10asaguidingdocumenttosupporttheimplementationofitsobjectives.

1.24 Manygovernmentsaroundtheworldhavedevelopednational injurypreventionpolicies,

strategiesand/orplansofaction. Althoughtheseinstrumentsvaryinnatureandscope,they

servetoguideanation’seffortstopreventinjury-relateddeathanddisability.Ofthesenational

injurypreventionpolicies,strategiesand/orplans,somearecomprehensivepertainingtoall

injury-relatedmortalityandmorbidity,whileothersfocusonaparticulartypeofinjuriessuch

asroadtrafficinjuriesorviolence-relatedinjuriesoraparticulargroupofintendedbeneficiaries

suchaschildren,youthorwomen.Muchdependsontheburdenposedbythesepublichealth

concernsandthegovernment’spreparednessandabilitytorecognisetheseas issuestobe

addressed.

1.25 Increasingawarenessinthelastfewdecadesthatinjuriesandviolencearepreventablepublic

healthproblemshasledtothedevelopmentofpreventivestrategies.Therewerealreadymany

scientifically-provenmeasurestoreducekeycausesof injury-relateddeaths. Inthe lightof

accumulatingevidence,evidence-basedandeffectiveinterventionsforinjurypreventionmaybe

consideredforadoptionlocally.

1.26 Theultimategoalistopreventinjuriesandviolencefromhappeninginthefirstplace. Atthe

sametime,muchcanbedonetominimisedisabilityandill-healtharisingfrominjuryevents

thatdooccur. Providingqualitysupportandcareservicestovictimsofviolenceandinjuries

canpreventfatalities,reducetheamountofshort-termandlong-termdisabilities,andhelp

thoseaffectedtocopewiththeimpactoftheviolenceorinjuriesontheirlives.Improvingthe

organisation,planningandaccesstotraumacaresystems,includingpre-hospitalandhospital-

basedcare,canhelpreducetheeffectsofinjuries.

10 UnitedNationRoadSafetyCollaboration.2011.Global Plan for the Decade of Action for Road Safety 2011-2020.Availableat:http://www.who.int/roadsafety/decade_of_action/plan/en/#,accessed25June2014

11

Injury prevention: Hong Kong situation2

2 Injury prevention: Hong Kong situation

12

Injury prevention: Hong Kong situation 2

2. Injury prevention: Hong Kong situation

Epidemiology of injuries and disease burden

2.1 Duringtheyears1983-2013,thenumberofregistereddeaths inHongKongdueto injuries

rangedfrom1551to2243peryear(Figure4). In2013,1860registereddeathswerecaused

byinjuries,accountingfor4.3%oftotaldeaths. Injurieswerethefifthleadingcauseofdeath.

Thedeathratesduetoinjuriesformaleandfemalewere36.1and17.1per100000population,

respectively. Intheagegroup1-14years, injurieswerethesecondleadingcauseofdeathin

2013. Itremainedinthesecondplaceconsistently inthepasttenyears,withexceptions in

2009and2010. Inthesetwoyears, injuriesweretheleadingcauseofdeathinthisagegroup

(1-14years).

Figure 4: Number of registered deaths in Hong Kong due to injuries, 1983-2013

5 00

1 000

1 500

2 000

2 500

Year

Num

berofreg

isteredde

aths

1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 201319830

Source:DepartmentofHealth

12

13


2.2 Amongthe1860registereddeathsrelatedtoinjuries in2013(Figure5),thecausesofdeath

indescendingorderwereintentionalself-harm(999or53.7%),falls(232or12.5%),transport

accidents(140or7.5%),accidentalpoisoningbyandexposuretonoxioussubstances(137or

7.4%),accidentaldrowningandsubmersion(30or1.6%),assault(27or1.5%),exposuretosmoke,

fireandflames(18or1.0%)andotherexternalcauses(277or14.9%).

Figure 5: Injury mortality by causes of death, 2013 (N=1 860)


Otherexternalcauses

14.9%

Exposuretosmoke,fireandflames

1.0%

Assault

1.5%

Accidentaldrowningandsubmersion

1.6%

Accidentalpoisoningbyandexposure to noxious substances

7.4%

Transportaccidents

7.5%

Falls

12.5%

Intentionalself-harm

53.7%

2.3 Despitethefactthat injuriesrankedonlythefifthamongleadingcausesofdeath in2013,

potentialyearsoflifelost(PYLL)attributabletoinjuries,thatis,externalcausesofmorbidityand

mortality,rankedsecondamongallcausesofdeath(Figure6). This istosay, injuriesimpose

aheavyburdenonprematuremortality. ThePYLLatage75causedbyinjuriesaccountedfor

15.7%ofthetotalin2013.Itrankedsecondaftertheleadingcausecancer(43.4%ofthetotal)

andwasfollowedbyheartdiseases(10.0%),cerebrovasculardiseases(5.0%).

14


120 000

100 000

80000

60 000

40 000

20 000

0

Malign

antne

oplasm

s

Diseas

esofhe

art

Cerebr

ovascu

lardise

ases

Pneumonia

Nephrit

is,neph

roticsy

ndrom

e

andnep

hrosis

Septica

emia

Chroni

clower

respirat

orydis

eases

Diabet

esmellit

us

Dement

ia

Alloth

ercaus

es

Externa

lcause

sofmo

rbidity

andmo

rtality

Potentialyearsoflife

lostata

ge75

107 006 (43.4%)

38788(15.7%) 24 564

(10.0%) 12281(5.0%)

11389(4.6%) 4 241

(1.7%)3478(1.4%)

3 443(1.4%)

1 717(0.7%)

188(0.1%)

39 346(16.0%)

Figure 6: Potential years of life lost at age 75 by ten leading causes of death in Hong Kong, 2013

CausesofDeathSource:DepartmentofHealth

2.4 Regardingmorbidity,amongallin-patientdischargesanddeathsinallhospitalsin2013,97837

episodeswereduetoinjuries. Injuriesaccountedfor5.1%oftotal in-patientdischargesand

deathsinthatyear. Amongthese97837episodesofinjury-relatedin-patientdischargesand

deaths,fallsaccountedforthelargestshare(39450episodesor40.3%),followedbyaccidental

exposuretootherandunspecifiedfactors(25643episodesor26.2%)andexposuretoinanimate

mechanicalforces(7627episodesor7.8%).

2.5 Amongalldeathsduetoinjuries,theproportionofdeathscausedbyintentional injuries(i.e.

injuriesthatarepurposely inflictedeitherbyvictimsthemselvesorotherpersons)remained

relativelystableduringthepastdecade(Figure7).In2013,55.2%ofthetotalnumberofdeaths

causedbyinjurieswereintentionalinnature.11

11PublicHealthInformationSystem,SurveillanceandEpidemiologyBranch,CentreforHealthProtection,DepartmentofHealth,GovernmentofHongKongSAR.

15


Year

Intentional Unintentional2 500

2 000

1 500

1 000

500

02004 20092006 20112005 20102007 20122008 2013

Num

berofreg

isteredde

aths

41.1% 44.9%45.1% 49.0% 49.0% 45.1% 43.9%

46.1% 49.2%44.8%

58.9% 55.1% 54.9% 51.0% 51.0% 54.9% 56.1% 53.9% 50.8% 55.2%


Figure 7: Number of intentional and unintentional injury deaths, 2004 - 2013

2.6 Apartfromcollectingmortalityandhospitalisationstatistics,DHhadalsoconductedaterritory-

widehouseholdsurvey, the InjurySurvey, in2008tocollectpertinent informationonthe

characteristicsandburdenofunintentional injuries inHongKong. 6.2%oftheHongKong

populationreportedtohavesustainedatleastoneunintentionalinjurythatlimitedtheirnormal

activitiesinthe12monthsbeforeenumeration.Theratewassimilarinbothgendergroupsand

wasfoundtobehighestforelderlypeopleaged75andabove(8.9%).12

2.7 Accordingtothe Injury Survey 2008,thethreecommonestcausesofinjuryepisodeswerefalls

(32.2%),sprain(25.8%)andsports(14.1%).Fallswerefoundtohaveoccurredmorecommonlyin

femalesandattheextremesofage(aged0-14and55andabove).Over80%ofinjuryepisodes

affectedtheextremities.12

2.8 ThePopulationHealthSurvey(PHS),anotherterritory-widehouseholdsurveyconductedin

2003-2004,showedthat14.3%ofpeopleaged15andabovereportedthattheyhadsustained

aninjurythatwasseriousenoughtolimittheirnormalactivities inthe12monthspreceding

thesurvey.13 Asignificantlygreaterproportionofmales(17.4%)thanfemales(11.7%)reported

so.13ThedifferencebetweenthisSurveyandInjury Survey 2008isexplainedbythedifferentcase

definitioninthesetwosurveys.InthePHS (2003/2004),allinjuriesthatwereseriousenoughto

limitone’snormalactivitieswereincluded,regardlessofbeingintentionalorunintentional. In

Injury Survey 2008,onlyunintentional injuriesthatwereseriousenoughtolimitone’snormal

activitieswereincluded.

12DepartmentofHealth(2010).Injury Survey 200813 DepartmentofHealth(2005).Population Health Survey 2003/2004

16


2.9 Accordingtothe Injury Survey 2008, theaveragecostofthetotalmedicalexpenses incurred

ineachinjuryepisodewasHK$1929.0(medianHK$300). Thetotalcostincurredasaresultof

injurieswasestimatedatHK$838.6million(95%CIHK$473.9milliontoHK$1203.4million)in

2008. Thecostincreasedwithageandwasthehighestinpersonsaged65andabove. More

thanhalfofthe injuryepisodes(51.3%)sustainedbyemployedpersonscausedthemtobe

absentfromworktemporarily foranaverageof19.8days(median7.0days). Themeanand

mediannumbersofpaidsickleavestakenwere13.5and5.0days,respectively. Themeanand

mediannumbersofunpaidsickleavestakenwere29.6and7.0days,respectively.36.2%ofthe

injuryepisodescausedthevictimstochangetheirnormaldailyactivitiesand1.4%causedthem

todevelopresidualdisabilitiesfor6monthsorlonger.17.1%oftheinjuryepisodessustainedby

studentscausedthevictimstotakedaysofffromschooltemporarilyforanaverageof11.5days

(median3.0days).12

Injury surveillance effort and information gap

2.10 Aneffectivesurveillancesystemforinjuriescanhelpprovideuseful informationtoassessthe

healthneedsofthepopulationandmonitorpotential impactsofpublichealthinterventions.

Formortalitydata,adeathregistrationsystemmanagedbyImmigrationDepartmentisinplace

toregisterandcollectinformationrelatedtodeaths. Thissystemgathersdeathsreportableto

theCoronerandthosethatarenon-reportable.TheCoronersOrdinancesetsout20categories

ofdeathwhichshouldbereportedtotheCoroner. Deathcausedbyanaccidentor injuryis

oneofthese20categories.Asformorbiditydata,theGovernmentcollectsin-patientdischarge

statisticsfromallpublic,privateandcorrectionalinstitutionhospitals.

2.11 Tofill informationgapscurrentlynotcoveredbymortalityandmorbiditydata,community

surveyscanserveaspopular tools. TheDHhasconductedseveralcommunitysurveys to

collectlocalinformationoninjuryfordifferentagegroups.ThePHS (2003/2004)andtheregular

BehaviouralRiskFactorSurvey(BRFS)obtainedsomeepidemiological informationoninjuries

forsubjectsaged15andoverandadultsaged18-64,respectively. The Injury Survey 2008was

conductedbasedontheWHOInjurySurveillanceGuidelinestocollectpertinent information

aboutthelocalcharacteristicsandburdenofunintentionalinjuriesofallages.TheChildHealth

Survey(CHS)conductedin2005alsocollecteddataoncommontypesofinjuriesinchildren,as

wellasinjurypreventionbehaviours. Inaddition,someNGOsandacademia*alsoconducteda

numberofrelevantcommunitysurveys.

* ExamplesincludetheHongKongChildhoodInjuryPreventionandResearchAssociation(CIPRA)andTheHongKongPolytechnicUniversity

17


2.12 In2003,anInjurySurveillanceSystemwassetupintheAccidentandEmergencyDepartment

(AED)ofPrincessMargaretHospital. TheprogramwasfundedbytheOccupationalSafetyand

HealthCouncil(OSHC)andcollaboratedwithTheHongKongPolytechnicUniversity.Underthis

surveillancesystem,detailsofallinjury-relatedcaseswererecorded.Sincethen,thesurveillance

systemhasbeenextendedtotwomorehospitals(CaritasMedicalCentreandTseungKwanO

Hospital).ThisInjurySurveillanceSystemenabledresearcherstoidentifyinjuryblack-spotsand

designpreventivemeasurestoreduceinjuryoccurrenceincommunitysettings.

2.13 Fromavailabledata,wehaveagoodunderstandingonthepatternandburdenofthemajor

typesofinjuries. However,systematiccollationandanalysisofdataisstill lackinginanumber

ofareassuchastheprevalenceofsportsinjuries, injuryepisodesthatrequiremedicalcarein

theAEDandinjuryepisodesthatarenotsevereenoughtorequirehospitalisation.Besides,only

limitedinformationisavailableonattitudeandbarriersofthepopulationtowardsadopting

particularinjurypreventionmeasures.

Interventions to promote prevention of unintentional injuries

Raising public awareness to injury prevention

2.14 Injuriescausesignificantmorbidityandmortalitythatwarrantsourattention.InHongKong,the

Governmentanddifferenthealthadvocateshavetakentheinitiativetoimplementavarietyof

interventionsstrivingtoprovideasafeenvironmentforthegeneralpublictolive,study,work

andplay.Educationisofparamountimportancetoincreasepublicliteracyandinfluencetheir

attitudes,beliefsandbehaviourstowardsinjuryprevention.

2.15 VariouspublicitycampaignshavebeenconductedwithsupportfromtheInformationServices

Departmentbydifferentpolicybureauxanddepartments toarousepublicawarenessof

safetyandinjuryprevention. Examplesofthesecampaignsincludepromotionofroadsafety,

occupationalsafety,againstchildneglectandabuse,etc.Mostofthesecampaignsaresustained

throughouttheyearandsomeofthemare longstandingpromotion,andemployavariety

ofpublicityandadvertisingmeans including information leaflets,media interviews,media

campaigns,publicworkshops,exhibitions,communityinvolvementactivitiesandcounseling.

Someexamplesofmediacampaigns include“Ifyoudrink,don’tdrive!”and“Let’senhance

householdfiresafety”.

18


Encouraging research on injury prevention

2.16 TheGovernmentestablishedseveralhealth-relatedfundstoencouragehealthpromotiongood

practicesandlocalresearchtoinformhealthpolicyformulation.TheHealthCareandPromotion

Fund (HCPF)wasestablished in1995with theaimof improvingeffectivenessofhealth

promotionanddiseasepreventionactions.Anumberofinjury-relatedinterventionshavebeen

subsidisedbythefund.Ontheotherhand,theHealthandHealthServicesResearchFund(HHSRF)

wasestablishedin2002tofacilitatethegenerationofnewknowledgeinareasofhumanhealth

andhealthservicesto improvehealthofthelocalcommunity. Thefundwasmanagedbya

ResearchCouncilchairedbySFH,whichdeterminedtheresearchagendaandfundingcontrol

mechanism. Researchoninjuriesandpoisoningwasmadeasoneofthethematicpriorities.

Asannouncedinthe2011-2012BudgetSpeech,theHHSRF(togetherwithitsfundingambit)

subsumedunderthenew”HealthandMedicalResearchFund(HMRF)”whichcontinuesto

provideaclear,focusedresearchagendaforpublichealthtopicsincludinginjuryprevention.

Interventions to promote injury prevention by the Department of Health

2.17 TheDHhascommittedtosafeguardingthehealthof thecommunity throughpromotive,

preventive,curativeandrehabilitativeservices. Injurypreventionhasbeenpromotedbythe

DHtothegeneralpublicthroughvariouschannels.Thefollowingparagraphssummarisethese

activities.

2.18 TheNon-CommunicableDiseaseDivisionoftheSurveillanceandEpidemiologyBranchofCentre

forHealthProtectionisresponsibleforsurveillanceandcontrolofNCDofpublicimportanceto

HongKongandformulationofstrategiesinrelationtoNCDprevention. Throughconducting

healthsurveys,forexampleInjurySurvey,PHSandBRFS,theDivisionregularlycollects,collates,

analysesanddisseminatessurveillancedataon injuries. The informationcollected isuseful

for formulatinginjurypreventionstrategies;planning, implementingandevaluatinghealth

promotionprogrammes;organisinginjurypreventionandcontrolactions;andconductingrisk

communicationactivitiesthroughtheelectronicpublication“NCD Watch”andthe“ChangeFor

Health”website.

19


2.19 Throughanetworkof31MaternalandChildHealthCentres(MCHCs),theFamilyHealthService

(FHS)providesacomprehensiverangeofhealthpromotionanddiseasepreventionservices

forchildrenfrombirthto5yearsofagethroughtheIntegratedChildHealthandDevelopment

Programme(ICHDP). ICHDPaimstoprovideparents-to-beandparentswithanticipatory

guidanceonchildcare,childdevelopmentandparentingissuesthroughinformationleaflets,

audiovisualresources,workshopsandindividualcounselling. Informationrelatedtovarious

aspectsofchildinjuryprevention, includinghomesafety,preventionofdrugpoisoning,risks

of leavingchildunattendedandintroductionofchildcarefacilities,etc.areprovidedtoalert

parentstopossibleinjurytrapsandrisks,andeducatethemonpreventivemeasuresspecificto

children’sdevelopmentalstage.Besides,theFHShastakenastepfurtherbyproactivelyreaching

outtoparents/childcareworkersthroughothere-channels. Videosonhomesafetymeasures

aremadeavailableinthe“FamilyHealthServiceYouTubeChannel”. Throughthe“Parent-Child

e-Link”onlinemembershipprogrammes,e-newslettersonvariousaspectsofparentingandchild

care,includingalertsonhomesafetymeasures,aresenttoparentsaccordingtotheageoftheir

growingchildren.E-newslettersonspecifictopicsarealsosenttoprofessionalusers.Anonline

self-learningparentingprogramme,“ParentingMadeEasy”waslaunchedtofacilitatecarers/

professionalstoaccessevidence-basedandpracticalparenting informationoftheirchoice

throughanimations,videos,interactivegamesandhyperlinks.Importanttopicsonchildinjury

preventionatspecificagesarecovered intheParentingMadeEasywebsite. TheFHSalso

deliverstalksoninjurypreventiontochildcareworkersandconductsmediainterviewtoraise

publicawarenessontheimportanceofchildinjuryprevention.

2.20 TheStudentHealthService(SHS)aimstosafeguardboththephysicalandpsychologicalhealth

ofschoolchildrenthroughcomprehensive,promotiveandpreventivehealthprogrammesto

enablethemtogainthemaximumbenefit fromtheeducationsystemanddeveloptheirfull

potential.TheSHSoperates12StudentHealthServiceCentres(SHSCs),whichprovidesservices

suchashealthassessment,healtheducationandindividualhealthcounsellingforallprimaryand

secondaryschoolstudents.TheSHSprovidesregularhealthtalksoninjurypreventionincluding

sportsafety,homeaccidentpreventionandoutdoorsafetytoprimaryandsecondaryschool

studentsattendingtheirannualhealthcheckattheSHSCs.Healtheducationmaterialsincluding

pamphletsonsportsafety&injurypreventionareavailableandpostedontheSHSwebsite.

20


2.21 TheElderlyHealthService(EHS)providesprimaryhealthcaretotheelderlysoastoimprovetheir

self-careability,encouragehealthylivingandstrengthenfamilysupport inordertominimise

illnessanddisability.VisitingHealthTeamsofEHSconductintegratedassessmentforResidential

CareHomesfortheElderly(RCHEs)throughouttheterritoryeveryyear.Dataonnumberoffalls

ateachRCHEiscollectedtohelpintheplanningoffallpreventionprogrammes. Besides,the

EHSconductshealthtalkssurroundingthesubjectofinjurypreventionatElderlyHealthCentres

(EHCs),socialcentresandRCHEs.Thesetopicsinclude“FallPrevention”,“Homesafety”,“Roadand

Trafficsafety”,“Burn&Scald”and“Choking(Swallowing)”.Theseprogrammesaredevelopedbya

multi-disciplinaryhealthcareteamincludingdoctors,nurses,physiotherapistsandoccupational

therapists,andtailor-madeforcommunitydwellingeldersandthoselivingintheRCHEsaswell

astheircarers(train-the-trainer). Asamodelcentreoffamilymedicinepracticeintheprimary

caresetting,EHCperformsregularholistichealthassessmentforenrolledmemberscoveringfall

riskassessment.Clientsidentifiedwiththeriskoffallareofferedmultidisciplinaryinterventions.

For instance, thesemay involvemedicationmodificationbydoctors,specialeducationand

training,prescriptionofaids(e.g.bedsidecommode)andhomeassessmentandmodification

(e.g. recommendationof installingbedsiderail)etc.andperiodicalreviewsbyalliedhealth

professionalssuchasoccupationaltherapistsandphysiotherapists. TheEHShascollaborated

withprofessionalandcommunityorganisationssuchasNGOs,HongKongMedicalAssociation

(HKMA),andAsianMedicalStudents’Association (AMSA) inorganising large-scalehealth

seminars,trainingworkshopsandexerciseclassesonfallprevention. In2013,atotalof40fall

preventionambassadorsweretrainedincollaborationwithasocialcentrefortheelderlywho

wouldfurtherdisseminatefallpreventionmessagesinthecommunity.

2.22 ThePrimaryCareOffice(PCO)haspublishedtheReferenceFrameworksforcareofdifferent

populationgroups,namelychildrenandolderadults,inprimarycaresettings.TheseReference

Frameworksprovidecommonreference tohealthcareprofessionals for theprovisionof

continuing,comprehensiveandevidence-basedcare inthecommunity,empowerpatients

andtheircarers,andraisepublicawarenessoftheimportanceoftheproperpreventionand

managementofchronicdiseases,aswellashealthpromotionanddiseasepreventionfor

differentpopulationgroups.Adoptionofsafeandhealthybehaviours,includinginjuryandfall

prevention,areamongthehealthissuesbeingpromotedthroughthesereferenceframeworks.

2.23 Selectedhealtheducationalmaterialsonsportsinjurypreventionareavailablefromthewebsite

andpre-recordedtelephoneinformationsystemoftheCentralHealthEducationUnit(CHEU).

21


Interventions to promote injury prevention by other government departments and local

organisations

2.24 Foractionstobeeffective,thereisaneedforconcertedeffortsacrossabroadpublichealthfront,

requiringintra-sectoralandinter-sectoralcollaborations. ManyNGOsandcommunitygroups

havebeenimplementinghealthpromotionprogrammestargetingatriskpopulationsubgroups

andindividualstopromotesafetyawarenessandinjuryprevention.

2.25 Tofosterthedevelopmentofasafecommunity,resourcescanbemobilisedacrosssectorsto

implementeffective injurypreventionprogrammesat localcommunity levels. TheAlliance

forHealthyandSafeCitiesplaysanactiveroleinthisarea.DistrictsinthisAllianceorganiseda

varietyoflargescaleactivities, includingrovingexhibitions,publicityprogrammesandHome

SafetyAngeltraining,etc.,topromotesafetywithinthecommunity.

Capacity building for injury prevention

2.26 Capacitybuildingstrengthensthecommunity’sabilitytopreventandtacklehealthproblemsby

increasingpeople’sknowledgeandskills. Increasedsafetyliteracycanhelpextendandsustain

theeffectofinjuryprevention.

2.27 Someorganisationshaveprovidedtrainingonspecificknowledgeandskillsinrescueandinjury

prevention.Forexample,theHongKongLifeSavingSocietyorganisesdifferenttypesandlevels

oftrainingcoursesincludingpoolrescue,openwaterrescue,aswellasaquaticfirstaids,etc.

CoursesforemergencymedicaltrainingsuchasAdvancedCardiacLifeSupport(ACLS)Provider

CourseandBasicLifeSupport (BLS)ProviderCourseareorganisedregularly inHongKong

toprovidetrainingformedicalprofessionals,paramedicsandanyinterestedcitizens. Some

organisationshaveadoptedthetrain-the-trainerapproachtosustaintheeffectofthepromotion

programmes.Forexample,theOSHC,theCentreforHealthEducationandHealthPromotionof

theChineseUniversityofHongKong(CHEP)andtheHongKongChildhoodInjuryPrevention

andResearchAssociation (CIPRA) formanalliance topromotesafeandhealthyschools.

Guidanceisprovidedfortheschoolstodevelopsafetyandhealthypolicyandmanagement

systemstobuildasafeenvironmentforallstudentsandstaff.

22


Four priority areas identified

2.28 Thescopeofinjuriesisverybroad. It isnotpossibletocoveralltypesofinjuries,settingsand

populationgroups.Hencepriorityareasandagenericframeworkoninjurypreventionshould

beconsideredtoguideactions.AccordingtoWHO,insettingprioritiesforinjuryprevention,we

havetoconsideravailableresources,attitudeofthepublic,whethertheinjuryproblemhasbeen

adequatelydefinedandmeasured(i.e.,whoisinjured,how,why,andatwhatrate)andwhether

aneffectivemeasure isavailable.14 Afterdeliberation,WGImembers reachedaconsensus

thattheactionplanshouldfocusoninjurieswithgreatestpublichealthimpact,payparticular

attentiontolarge-scaledsettingsandapproachessuchassportsandhousehold;aswellasdirect

effortstoco-operatewithrelevantstakeholdersinrespectivefields,inordernottoduplicatethe

workalreadycarriedoutbyothergovernmentdepartmentsorparties.

2.29 Basedontheseprinciplesandfollowingseveralroundsofdiscussion,consensuswasreached

inWGItofocusonfourpriorityareas(sportsinjuries,falls,domesticinjuriesotherthanfallsand

drowning).Thesefourareasofunintentionalinjurytypeswillbeelaboratedfurtherinthenext

section.

2.30 WGImembersalsodeliberatedontopicsthatmightnotbesuitabletobecoveredaspriority

areas.Currently,mortalitydataontrafficincidentswerealreadykeptbyDHanddataontraffic

incidentswerekeptbytheHongKongPoliceForce (HKPF). RoadSafetywasanareawell

addressedintheCommissioner’sOperationalPrioritiesofHKPFinrecentyears. HKPFwould

continuetoallocatemanpowerandresourcetopromoteroadsafety. Moreover,thenumber

ofviolentcrimereportedwasnotedtobedecreasinginrecentyears. Asforthenumberof

occupationalinjurycases, ithasbeendecliningoverthepasttenyearsthroughpromotionof

occupationalsafetybytheOSHCandlawenforcementactionsbytheLabourDepartment(LD).

SinceHKPFandLDhavelongbeentacklingtheseinjurymatterssystematically,WGImembers

consideredapttosetthefocusonotherpriorityareas.

14 WorldHealthOrganization(2010).TEACH-VIP E-Learning – Foundations and methods.Availableat:http://teach-vip.edc.org/documents/IpGp/InjuryPreventionGeneralPrinciples.pdf.,accessed23April2014

23


Elaboration of priority areas

Sports injuries

2.31 According to the InternationalClassificationofExternalCausesof Injury (ICECI)ofWHO,

sports injury isan injuryepisode inwhichtheperson is injuredwhenhe/she isengagedin

sports-relatedactivity(e.g.competition,recreationalparticipationandwarm-up).

2.32 Asshowninthe Injury Survey 2008,amongthe460000 injuryepisodessustained inthe12

monthsbeforeenumeration,20.8%(or95500) tookplacewhenthe injuredpersonswere

engagedinsports-relatedactivities. Stronggenderdifferencewasdemonstrated insports

injuries,inwhichmalecomprised69.4%ofallepisodesofsportsinjuries. Ahigherproportion

ofsportsinjuriesoccurredamongindividualsaged15to24(accountedfor27.1%)and35to44

(accountedfor19.8%), indicativeofhigherparticipationinsportsactivitybytheseagegroups

(Figure8).

Figure 8: Sports injuries in Hong Kong by age group, 2008

30%

25%

20%

15%

10%

5%

0%

Source:DepartmentofHealth(2010).Injury Survey 2008

15-24 25-34 45-5435-44

Age groups

55-64 65-74 75andabove

5-14

Prop

ortio

nofpop

ulation

sustaining

sportsin

jurie

s(%

)

10.1%

27.1%

12.5%

19.8%16.9%

6.2%2.6%

4.8%

24


2.33 Analysedbythetypeofsportsactivitytheseinjuriesinvolved(Figure9),soccerandbasketball

toppedthelist. Nearlyhalf (49.1%)ofthe95500episodesofsports injurieswererelatedto

soccer(26.8%)andbasketball(22.3%).

Figure 9: Sports injuries in Hong Kong by sports activity, 2008


Sportsactivity

30%

25%

20%

15%

10%

5%

0%

Soccer

Basket

ball

Tennis

Badmin

tonHiking

Cycling

Hand

ball

Tracka

ndfiel

d

Volley

ball

Swimm

ing

RunningJog

ging

Yoga

Others

Prop

ortio

nofsportsin

jurie

s(%

) 26.8%

22.3%

6.9% 5.6% 5.1% 4.6% 3.7% 3.2% 2.6% 2.4% 2.3% 1.7% 0.7%

12.2%

2.34 InHongKong,sportsparticipation isactivelypromoted for itshealthbenefit. Morbidity

couldhavebeenunder-estimatedasmostpeoplesufferingfromsports injurieswouldnot

requirehospitalisationormedicalattention. Moreover,statisticsonworkloadofalliedhealth

professionals relatedtosports injurieswerenot routinelycapturedandhencenot readily

available. WGIconsidereditappropriatetofocusonsports injuriessincesports isapopular

undertakingformanypeople.

2.35 Measuresproventobeeffectivetopreventsports injuriesvary innature,andmay include

protectiveequipment,environmentalmodificationandsafetytraining. Theuseofprotective

sportsequipmentcanprotectagainst injuriesforcertainsports(e.g.helmetsforcyclingand

cricket). Theuseofhelmetswhencyclingcanreducetheriskofheadandbrain injuriesby

between63%and88%.15

15 TownerE,DowswellT,MackerethC,JarvisS(2001).What works in preventing unintentional injuries in children and young adolescents? An updated systematic review.PreparedfortheHealthDevelopmentAgency(HAD),London.DepartmentofChildHealth,UniversityofNewcastleuponTyne.

25


2.36 Capacitybuildingandskillsdevelopmentare importantpartsofsafesportspromotion. Forinstance,amongpeopleparticipating insports, trainingprogrammeshavebeenused toimproveco-ordination,strengthandtechnique,aswellasincreaseawarenessofinjuryrisksandpreventionstrategies.

2.37 Environmentalmodificationalsoplaysanimportantroleinreducingsportsinjuries. Loweringtheheightofplaygroundequipment,increasingthedepthofimpact-absorbingsurfacesaroundequipmentandmodifyingplayingsurfacesinsportssuchasgymnasium,trackandfield,weredemonstratedtoreducetheseverityoftheimpactfromsportsorleisureinjuries.

Falls

2.38 Falls topthe tollofunintentional injury-relateddeathsandhospitalisations. Agenerallyincreasingtrendisobservedinrecentyears.In2013,fallscaused232deaths(12.5%ofallinjury-relateddeaths),havingincreasedfrom118deaths(5.3%ofall injury-relateddeaths) in2004.Therewere39450fall-relatedhospitalisations(40.3%ofall injury-relatedhospitalisations) in2013,representingan increasefrom30576fall-relatedhospitalisations(41.6%ofall injury-relatedhospitalisations)in2004.

2.39 Fallsdemonstratestrongagerelevance,astheyaremoreprevalentattheextremesoflife(Figure10). Amonginjuriessustainedduetoallcauses,fallsaccountedfor73.0%inindividualsaged65yearsandabove. Itaccountedfor63.9%ofallcausesofinjuriesinindividualsaged0to4.Moreover,fallsdemonstrateanobviousgenderdifference. Intheyoungerextremeofage,i.e.personsaged14andbelow,57.4%offallsoccurredamongmalechildren(versus42.6%infemalechildren). Inpersonsaged65orabove,thepatternisreversed-72.3%occurredinfemaleand27.7%inmale.

Figure 10: Proportion of falls among all causes of injuries by age group and gender, 2008

100%

75%

50%

25%

0%

Age groups

0-4 45-5415-24 65-745-14 55-6425-34 75andabove

35-44 AllAges

Prop

ortio

nsustaining

injurie

s(%

)

Other causes Fall(Male) Fall(Female)


26


2.40 Highprevalenceofunintentionalresidentialfallinjurywasobservedamongchildrenandelderly.Themajordiseaseburdenrelatedtofallsalsooccurredamongthesepopulationsubgroups.Forexample,accordingtodatacollected inacollaborativestudybetweenKwaiTsingSafeCommunityandHealthyCityAssociationandPrincessMargaretHospital(PMH),elderlyfallswasidentifiedasoneofthemajorinjurycausesinthatdistrict,andfallsinelderlycarecentreswerenot uncommon.16Accordingtoanotherlocalstudy17,highpopulationdensityisoneoftheriskfactorsforthissituation.Crowdedlivingenvironmentplayedanimportantrolebycontributingtoahighprevalenceoffalls,especiallyinthedomesticsetting.

2.41 Manystudiesshowedthathomemodificationinterventionalonehadnosignificanteffectonelderlyfallsoutcome.Multi-factorialinterventionsincludingexercisetobuildmusclestrength,visioncorrection,homehazardmanagementshowedmorepromisingeffects.18

Domestic injuries (other than falls)

2.42 Homeistheplacewherepeoplespendmostoftheirtime. Domestic injuriesrecordedthehighest injuryrateamongallenvironmentalsettings,accordingtothe InjurySurvey2008.Domesticinjuriesincludeavarietyofinjuriessustainedthroughdifferentmechanisms.Domesticinjurieshavethusbecomeafocusofattentionamongpublichealthprofessionals.

2.43 Aboutone-fifth(20.4%)oftheinjuryepisodestookplaceathome,followedbytransportarea:publichighway,streetorroad(17.8%)andsportsorathleticsarea(13.5%). Itwasestimatedthat94000episodesofdomestic injuriesoccurredin2008. Domestic injuriesaccountedforthelargestshareamongalltypesofinjuriesinelderlyandfemale. Inelderly,domesticinjuriesaccountedfor43.1%amongallinjurytypes.Amongallagegroups,personsaged0-4,65-74and75andabovehadhigherrateofsustainingdomesticinjuriescomparedwithotheragegroups(Figure11).

16 KwaiTsingSafeCommunityandHealthyCityAssociation.Injury Surveillance Report. 2010.17 ChowCB,LuisBP,etal(2003).Unintentional residential child injury surveillance in Hong Kong. J Paediatr Child Health.2003Aug;39(6):420-6.18Modification of the home environment for the reduction of injuries (Review) (2009). Cochrane Collaboration. 2009, Issue 1.

27


2.44 Stronggenderdifferencewasdemonstratedindomestic injuries, inwhichfemalecomprised

78%ofallepisodesofdomestic injuries. In female, injuriesoccurringathomeaccounted

for29.8%whichformedthelargestshareamongallsettings,followedbythoseoccurringin

transportareasincludingpublichighways,streetsorroads(19.4%);recreationalareas,cultural

areas,orpublicbuildings(12.1%);andschoolsandeducationalareas(10.7%).

Figure 11: Domestic injuries in Hong Kong by gender and age, 2008

100%

80%

60%

40%

20%

0%

Age groups

0-4 45-5415-24 65-745-14 55-6425-34 75andabove

35-44 AllAges

Prop

ortio

nsustaining

injurie

s(%

)

Other causes DomesticInjuries(Male) DomesticInjuries(Female)


2.45 AccordingtotheInjurySurvey2008,domesticinjurieswereduetoseveralmajorcauses,namely

falls,sprain,cutting/piercing,hit/struck,burn,animalbiteandcrush. Causesotherthanfalls

accountedfor60.8%ofalldomesticinjuries(Figure12).

Figure 12: Domestic injuries by causes, 2008

50%

40%

30%

20%

10%

0%Prop

ortio

nofdom

estic

injurie

s(%

)

Falls Animalbite

Cutting/piercing

SportsInjury

OthersSprain CrushHit/struck

Burn

∑ = 60.8%


39.1%

25.1%

13.8%9.4%

4.3% 3.1% 2.4% 2.3%0.4%

28


2.46 Measuresproventobeeffectivetoimprovehomesafetyvarywidelyinnature. Thereisgood

evidencefortheeffectivenessofsafetyeducationprogrammesinincreasingsafetybehaviours

andtheuseofsafetydevices.19 Theutilisationofhomesafetyequipmentsuchascupboard

catches,stairgates,windowlocks, fireguards,electricsocketcovers, thermometerstotest

watertemperatures,anti-scalddevicesinhotwatertapsandsmokealarmscanofferprotection

against injuriesoccurring inthehome. Studiesshowedthatwindowsafetymechanismsto

preventchildrenfromopeningwindows,suchasbarsandpositionlockingdevices,areeffective

measurestopreventfalls. Windowbarshavebeenshowntoreducedeathsfromwindowfalls

by35%.20 Securestorageforpoisonsremovesalargerportionofpoisoningriskthanparental

supervisionandmaybeaneffectiveinterventionofpreventingpoisoninginjury.21,22

2.47 On theotherhand,product safety is important to safeguard consumerhealth. With

advancementintechnologyandproductengineering,saferproductsaredesignedtoprevent

injuryoccurrence.Comparativetestscanalertthemtoproducthazards,helpconsumersmake

rationalchoices,andinduceimprovementsinproductqualityandsafety.

2.48 Toachieveahighadoptionofprovensafety interventions, thetwobasicapproachesareto

raiseawarenessandincreaseaccessibilitytothesemeasures.Forsafetyinterventionsinvolving

behaviouralchange,effortshouldbemadetoeducatemembersofthepublictheexistenceof

hazardandeffectivenessofcertainmeasures.

2.49 Althoughmanysectorsarealreadyworkingonthisarea,westillobserveaconsiderablenumber

ofdomesticinjurieseveryyear.Thereisapossibilitythatthosewhoneedtoknowmayfailtoget

themessage.Thisrightlyillustratestheimportanceoftargetedriskcommunication.

19 HarborviewInjuryPreventionandResearchCenter(2001).Best Practices.Seattle,UniversityofWashington.20 SpiefelCN,LindamanFC(1995).Children can’t fly: a programme to prevent childhood mortality from window falls.InjPrev1995:1(3):194-8.21 KrugA,EllisJ,HayI,MokgabudiN,RobertsonJ(1994).The impact of child-resistant containers on the incidence of paraffin (kerosene)ingestion in children. S

AfrMedJ1994;84(11):730-734.22 WoolfAD,SapersteinA,ForjuohS(1992).Poisoning prevention knowledge and practices of parents after a childhood poisoning incident. Pediatrics1992;

90(6):867-870.

29


Drowning/near-drowning

2.50 Thenumberofaccidentaldrowningandsubmersiondeathsfluctuatedoverthepasttenyears

(Figure13). Therewere21to56deathsannually. Therewasnoclearincreasingordecreasing

trend.In2013,therewere30deathcasesresultingfromaccidentaldrowningandsubmersion.

Drowning,fromtimetotime,causedsubstantialmortalityinHongKong.

Figure 13: Number of registered death due to accidental drowning and submersion (W65-W74) by

gender in Hong Kong, 2004-2013

60

50

40

30

20

10

0

Year

2004 20092006 20112005 20102007 20122008 2013

Num

berofreg

isteredde

ath

Men WomenSource:DepartmentofHealth

4540

56

3035

3943

29

21

30

80.0%62.9%

76.8%65.1%

81.0%

75.0% 66.7%56.7%

69.0% 83.3%

20.0% 37.1% 23.2% 34.9%19.0%

25.0% 33.3% 43.3% 31.0% 16.7%

30


5-14

1.8

1.6

1.4

1.2

1

0.8

0.6

0.4

0.2

0

Year

2004 20092006 20112005 20102007 20122008 2013

Age

-specificde

athrate(p

er100

000

pop

ulation)

Source:CensusandStatisticsDepartment,DepartmentofHealth

Figure 14: Age-specific death rate due to accidental drowning and submersion (W65 - W74) in

Hong Kong, 2004-2013

Age group 65+45-6415-441-4

2.51 Stronggenderdifferenceisdemonstratedindrowning-relatedmortalitystatistics,inwhichmale

comprisesaround60%to80%ofdeathcasesannually.Besides,obviousagedifferenceisnoted

indrowning-relatedmortalitystatistics.Age-specificdeathrateduetoaccidentaldrowningand

submersionincreaseswithage. Age-specificdeathratewasthehighestfortheagegroup65

andaboveinthepastdecade(Figure14).

31


2.52 Amongall501registereddeathsduetodrowninginthepastdecade,133(26.5%)werewater-

transportrelatedand368(73.5%)werenot(Figure15). Amongthese368nonwater-transport

relateddrowningcases,mosthappenedinnaturalwater(e.g.sea,riverandstream)followedby

swimmingpoolandbath-tub.

Figure 15: Number of registered death caused by drowning in Hong Kong, 2004-2013

250

200

150

100

50

0Sea,river,

stream (whilein)

Sea,river,stream (fallinto)

Swimmingpool

Bath-tub Others

206

75

279

51

Numberofregistereddeathcausedbynonwater-transportincidentinHongKong,2004-2013(N=368)

Water-transport

133

Non Water-transport

368

NumberofregistereddeathcausedbydrowninginHongKong,2004-2013(N=501)


32


2.53 Althoughthenumberofdeathsduetodrowningissmallcomparedwithothermajortypesof

injuries,fatalityrateisexceptionallyhighamongdrowningcases(Figure16).Inthepastdecade,

foreverytenpersonsadmittedtothehospitalduetowater-transportaccident(V90-V94),nine

endedupindeath.Figureswereevenmorealarmingforaccidentaldrowningandsubmersion

(W65-W74). Foreverytenpersonsadmittedtothehospital,seventeenendedupdying. This

wasbecausecasualtieswereusuallysentdirectlytothepublicmortuarywithouttheneed

forhospitaladmission. Thisphenomenonisuniquefordrowning,amongalltypesofinjuries

(V01-Y98)observedinHongKong. Inotherwords,drowning/near-drowningismore lethal

comparedwithothercausesof injuries. Asshown incorrespondingfigures fromthepast

decade,drowninghasoneofthehighestfatalityrateamongallinjuries. Thesignificantpublic

healthimpactshouldnotbeunderestimated.

Figure 16: Causes of injuries by ten leading case fatality rate in Hong Kong, 2012

250%

200%

150%

100%

50%

0%

Casefatalityrate*(%

)

Accidentaldrowningand

submersion

Water transport accidents

Intentionalself-harm

Medicaldevices

associatedwithadverseincidentsin

diagnosticandtherapeutic

use

Pedestrianinjuredintransport accident

Exposureto forces of

nature

Bus occupant injuredintransport accident

Occupant of pick-up truckorvaninjuredintransport accident

Other accidentalthreats to breathing

Accidentalpoisoning by andexposure

to noxious substances


* Casefatalityratereferredtotheproportionofregistereddeathsinthenumberofin-patientdischargesanddeaths.** Casefatalityrateexceeded100%becausesomecausaltiesweresentdirectlytomortuarywithoutadmittingtohospital.Thesecases

thusdidnotappearinhospitalrecord,i.e.in-patientdischargesanddeaths.

Causes of injuries

193.3%**(W65-W74Accidentaldrowningandsubmersion,involvingbath-tub,swimmingpool,naturalwater)

57.9%(V90-V94Watertransportaccident,involvingwatercraftlikepassengership,fishingboat,yacht,water-skis,canoe)

2.54 Utilisationof lifeguardserviceandswimmingonly inguardedbeachesorpoolsprevent

drowning,withstrongevidence.Theseareareaswhereefforthasbeenmadetocontaintherisk

ofdrowning.Thereareotherareaswhereactionscanbeintroduced.Examplesofneglectedor

hiddenhazardsincludeoutdoorwaterbodies(e.g.streamsandrivers)andindoorwaterbodies

(e.g.washingmachinesfilledwithwaterandnotinoperation).

33

Actions to strengthen prevention of unintentional injuries3

3 Actions to strengthen prevention of unintentional injuries

3434

Actions to strengthen prevention of unintentional injuries 3

3. Actions to strengthen prevention of unintentional injuries

3.1 In2008,DHpublishedastrategicframeworkdocumenttitled“Promoting Health in Hong Kong:

A Strategic Framework for Prevention and Control of Non-communicable Diseases”withtheoverall

goaltoincreasepositivehealthandqualityoflifeofthepeopleofHongKong.

3.2 Toachievetheabovegoal,differentpriorityareaswereidentifiedandthreeworkinggroups

includingthecurrentWGIwereestablished.TheWGIrecognisestheimportanceofconcerted

effortsof theGovernmentanddifferentsectors inthecommunitytocreateasustainable

environmenttostrengtheninjuryprevention. It isofequal importancethat individualstake

responsibilityforhisorherownhealth,aswellasthehealthoftheirfamiliesandcommunities,

bymakinginformedandhealthierchoiceswithregardtoinjuryprevention.

Goals

3.3 Followingcareful reviewofoverseasevidence,examinationof the

local situationandconsultationwithstakeholders, theWGI,after

deliberations, identified fourareasofconcern,namely falls, sports

injuries,domestic injuries (other than falls), anddrowning/near-

drowning.Recommendationsareformulatedwiththefollowinggoals:

1 Tostrengtheninjurysurveillancebybuildingasustainableinjury

surveillancesystem;

2 Toraisepublicawarenessofinjurypreventionbystrengthening

riskcommunication;

3 Toempower thepublic tomake informedchoiceson injury

prevention;and

4 ToreducetheburdenofinjuriesinHongKong.

35


Specific actions

3.4 Toachievethestatedgoals,a totalof16specificactionsareproposed insupportof the9

recommendationsunderpinning5strategicdirections. Table2providesasummaryofthese

actions.

Strategic direction 1: Support new and strengthen existing health promotion activities on injury

prevention

(Recommendation 1A)Developandimplementahealthcommunicationstrategyandadvocacyin

supportofinjuryprevention

3.5 Manyinjuriesandsufferingcanbeavoidedifpreventivemeasuresareproperlytaken.Hence,it

isofutmostimportancethatthepublicisinformedandempoweredwithrespecttopreventive

measures. Effectiveriskcommunicationisafundamentaltooltoassistthepublictorecognise

risksandmake informedchoicesabouttheirhealthand lives. Differentorganisationsare

currentlypromotinginjurypreventionbuttheireffortsarescatteredandnotsystematic.Ifthere

isbettercollaborationandcooperationbetweendifferentparties,synergisticeffectscanbe

generated,thuspropagatinghealthmessagestothepublicmoreeffectively.

Action 1: Devise a health communication strategy to articulate messages positively as safety

promotion and performance enhancement in addition to the traditional ways as injury prevention

and damage minimisation

3.6 Oneimportantaspectofinjurypreventionistodisseminatekeymessagestothepublictoraise

theirawarenessoninjuryprevention. However,thepublic isnotahomogenousgroupand

thereforethemessagesmustbetailor-madetodifferentaudiences. Toachievethis, theDH

shouldtaketheleadtodeviseahealthcommunicationstrategycustomisedtovariousaudiences

onrelevant injurypreventionsubjectsusingappropriatemeans. Throughorganisedand

systematicefforts, injurypreventionmessagescanbeeffectivelycommunicatedwithspecific

targetgroups.Keythemesandideascanbesystematicallystructuredwithinthecommunication

strategy.

(Recommendation 1B)Strengthenexistinghealthpromotionactivitiesoninjurypreventionand

maximisetheutilisationofreadilyavailableresourcesforinjuryprevention

36


3.7 Small-scaleandshort-termhealthpromotionactivitiesmaygeneratepopulationhealth

impactswhicharebriefandlimitedinscale. Bypoolingresources,thereisahigherchanceto

maximisehealthimprovementeffects. Withclosercollaborationandorganisedeffortsamong

stakeholders,existinghealthpromotionactivitiesoninjurypreventioncanbestrengthenedand

resourcesbetterdeployedforthegoodofsocietyasawhole.

Action 2: Make use of existing and newly obtained mortality and/or morbidity data, credible sources of information and evidence-based practices to develop injury prevention messages in such forms that appeal to varying audiences and to support health promotion activities

3.8 Currently,therearestakeholderspromotinginjurypreventionsuchastheHongKongJockey

ClubSportsMedicineandHealthSciencesCentrewhichfocusesonsportsinjuryprevention.It

isalsonotedthatrecommendationsoninjurypreventionweremadeintheCoroners’ Report

(publishedannuallybytheCoroner’sCourt)andtheReports of the Child Fatality Review Panel

(publishedby theChildFatalityReviewPanelwhich isan independentmulti-disciplinary

non-statutorybodywithmembersappointedby theDirectorofSocialWelfare). These

recommendationsofferedinsightintopopulationgroupsatriskofsustainingfatalinjuries.These

reportsprovideinsightsintopromotionalgapstobeaddressedatpubliceducationlevel. The

DHwillconductregularreviews,forinstance,onanannualbasis, intothesereportstoextract

usefulmessagestocommunicatewiththewiderpublic.

Strategic direction 2: Generate a comprehensive and effective information system to understand the epidemiology of injuries and to provide advice and support on prevention of injuries

(Recommendation 2A)Widenthescopeofinjurysurveillance

3.9 TheWHOdefinedsurveillanceas“systematicongoingcollection,collationandanalysisofdata

andthetimelydisseminationof informationtothosewhoneedtoknowsothatactioncan

betaken”.23 Injurysurveillanceisessential. Withouteffectivesurveillance,itwouldbehardto

identifythetrendsandat-riskgroups,letaloneformulatingspecificpreventivemeasures. The

sustainabilityofaninjurysurveillancesystemisalsocrucialassurveillanceneedstobeongoing

toreflecttimetrends.Moreover,aninjurysurveillancesystemwillneedtorecordtheinjurytype

aswellasthedetailsofeachincident.Asastart,theexistingadministrativestatisticsofrelevant

stakeholdersisagoodsourceofdatatobeusedforsurveillancepurpose.

23 WorldHealthOrganization(2013)Surveillance.Availableat:http://www.who.int/tobacco/surveillance/about_surveillance/en/,accessed11October2013

37


Action 3: Explore the use and systematic analysis of selected data collected in Hospital Authority (HA) hospitals to strengthen knowledge on epidemiology of injury cases requiring Accident and Emergency (A&E) attendance and hospitalisation

3.10 ThisproposedactionfocusesonanalysingthetypesofinjuriesthatrequireA&Eattendanceor

hospitalisation. Areviewofexistingsourcesoflocalsurveillancedataoninjuriesshowedthat

monitoringofmostpartsoftheinjurypyramidisalreadyinplace.Injuriesrangingfromfatalto

untreatedonesarecapturedbytheDeathRegistry,coronerrecords,in-patientdischargerecords

ofHAhospitalsandthevarioussurveys.InjuriesresultinginadmissionstoA&Earecapturedby

thedomesticinjuryinformationsystemsinseveralHAhospitals,asaproxyofthistypeofinjuries.

However,analysisoninjury-relateddatacapturedinA&Eisminimalandthereisnosystematic

disseminationofsuchinformationtothosewhoneedtoknow.WithsurveillanceofA&Edata,

amorecompletepictureoftheburdencausedbyinjuriescanbeobtainedandindicatorsfor

assessingtheburdenofinjuriescanbecalculated.

Action 4: Carry out a review of drowning cases kept by the Coroner’s Court, with a view to

understanding the demographic details, contributory factors of fatal incidents for the development

of injury prevention messages

3.11 Themortality statisticscurrentlymaintainedbyDH isagoodsourceof information for

studyingtheoverallpatternoffataldrowningcases. However, itoffersminimal information

onthedemographiccharacteristicsandmechanismsofthefatalities. Withmorethorough

understandingofthesefactors,appropriatemeasurestopreventfataldrowningcanbepossible.

3.12 Thisproposedactionsuggeststhatareviewshouldbeconductedondrowningcaseskeptbythe

Coroner’sCourt.Astherewerearound30-60casesofdrowningeachyearinthepastdecade,

reviewingfataldrowningaccidentsinthepast5-10yearswouldbeafeasibleandmanageable

exercise.Ifthemomentumofthisexerciseismaintained,thecontentofthereviewwillforma

goodbasisforroutinedrowningsurveillance.

38


Action 5: Explore a pilot programme to assist schools to implement an injury surveillance

system to identify contributing and precipitating factors for injuries within the school and pinpoint

areas for improvement actions

3.13 Thisproposedactionfocusesonfalls,sportsandotherinjuriesoccurringatschool. According

to the Injury Survey 2008,35.6%ofinjuriessustainedbychildrenaged14andbelowoccurred

inschoolsoreducationalareas.11Thoroughunderstandingoftheepidemiologyofinjuriesisa

prerequisiteforeffectiveinjuryprevention;hencesurveillanceofinjuriesoccurringinschools

isessential.Currentlythereisnostandardisedanduniversallyadoptedinjuryreportingsystem

concerningfalls,sportsinjuriesandotherinjuriesoccurringatschoolsandeachschoolhasits

owninternalproceduresinhandlingsuchincidents.Moreover,itisnotedthatevenifthepractice

ofrecordinginjuriesisinplace,thepurposeismoreonrecordingadministrativemanagementof

incidentsratherthanidentificationofcausationandpreventionofinjuryrecurrence.Thelackof

gooddocumentationofinjuriesandpreventiveactionsalsoputsschoolsinalessadvantageous

positionwhenfacedwithcomplaintsandpossible litigation. Withcollaborationbetween

stakeholdersincludingtheDH,theOSHC,theEducationBureau(EDB),SchoolCouncilsandsome

pilotschools,itishopedthatexistinggoodpracticescanbeharnessedtoformapracticalsystem

torecordandbetterunderstandthenatureofinjuriesoccurringinschools.

Action 6: Explore the possibility of accessing new sources of injury data to enrich the existing

injury surveillance system to alert the public where injuries are more to occur

3.14 TheDHcurrentlymaintainsmortalitydata,whereasmorbiditydatacanbeaccessedfromHA.

Otherformsofmorbiditydatacanbeobtainedfromsourcessuchastheadministrativestatistics

oftheAuxiliaryMedicalService(AMS)regardinginjuriesthatoccuroncyclingtracksetc. This

informationwouldbeusefulforstudyingthecharacteristicsofinjuriesrelatingtocycling,which

isbecomingincreasinglypopular. Withroutinecollection,collationandanalysisofthesedata,

thepubliccanbealertedtothe“blackspots”and“riskbehaviours”whichcommonlyresult in

injuries. Inrespectofthemeansof informationdissemination,bothtraditionalmeanse.g.

settingupwarningsignsatblackspotsandelectronicmeanse.g.websitesormobileapplications

canbeconsidered.

(Recommendation 2B)Strengthentheexisting injurysurveillancesystemtomake itusefuland

sustainable

39


3.15 TheDHhasconductedanumberofsurveyswiththecomponentofinjuriesinthepast.In2003-

2004,theDHconductedthefirstPHStostudythepatternsofhealthstatusandhealth-related

issuesofthegeneralpopulationinHongKongforpersonsaged15yearsandabove.Thesecond

roundofPHS isnowundercommissioning. In2005-2006, theCHSwasconductedamong

childrenaged14andbelowinHongKongtoprovidesupplementaryinformationtothePHSby

includingbaselinedataonthehealthandwell-beingofchildreninHongKong.SinceOctober

2004,theBRFSoftheDHhascontinuouslymonitoredthetrendofhealth-relatedbehaviours

foradultsaged18-64throughaseriesof telephonesurveysconductedsystematicallyand

periodically.In2008,theDHconductedtheInjurySurveytocollectpertinentinformationonthe

characteristicsandtheburdenofunintentionalinjuriesinHongKongpopulation.

Action 7: By conducting in-depth analysis on existing and updated data collected from surveys,

strengthen understanding of the pattern and trend of injuries

3.16 DatafromsurveysconductedbytheNon-CommunicableDiseaseDivisionoftheSurveillance

andEpidemiologyBranchofCentreforHealthProtectionhavebeenusedtopublisharticles

writtenbytheDH,otherorganisationsandresearchers.Tobetterutilisethesesurveydata,more

in-depthanalysismaybeconductedandarticlespublishedandwidelydisseminatedinvarious

mediatoreachdifferentaudiences.

(Recommendation 2C) Promote researchof feasibility, efficiencyandcost-effectivenessof

interventionstopreventinjuries

3.17 Asubstantialamountofstudiesontheeffectivenessandcost-effectivenessofinterventionsto

preventinjurieshavebeenconductedoverseas.Ontheotherhand,localstudiesarelimitedand

itisimportanttoinvestigatethepossibleeffectandfeasibilityofnewandexistingmeasuresto

preventinjuries.Inthisregard,academicinstitutionsandotherNGOsshouldbeencouragedto

submitapplicationsforfundstoconductresearchstudiesrelatingtoinjuryprevention.

Action 8: Encourage more research on the four major types of injuries identified (i.e. sports

injuries, falls, domestic injuries other than falls and drowning)

3.18 TheResearchOfficeof theFoodandHealthBureau (FHB)organisesa forumeveryyear to

encouragerelevantparties,includingacademiaandNGOs,toapplyfortheHCPFandHMRF.In

ordertoencouragepotentialapplicantstoconductresearchoninjuryprevention,theDHcould

highlightthethematicprioritiesoninjurypreventionduringtheforumsorganisedbyFHB.

40


Strategic direction 3: Strengthen partnership and foster engagement of all relevant stakeholders

(Recommendation 3A) Toworkwithgovernmentbureaux/departments,otherhealthpromotion

partners,NGOs,schools,employeesandemployersofdifferentindustriestodevelopandimplement

measuresthataresensitivetotheneedsofthepublicinachievingpreventionofinjuries

3.19 Healthpromotionanddiseasepreventionrequiretheinvolvementofnotonlythehealthsector

butthewholecommunity.Workinginpartnershipwithallrelevantstakeholdersatcommunity

level iscrucial for thesuccessof injuryprevention. Giventhecomplexityandchallenges

in relation to injuryprevention,healthauthorities,healthcareprofessionals,government

departments,theeducationsector,thehousingsector,thesportssectorandotherNGOshaveto

worktogethertodevelopandimplementmeasuresthataresensitivetotheneedsofthepublic

inachievinginjuryprevention. TheDHwillplayabridgingroleintheseprocesses,bringing

togetherstakeholdersandpromotingthesharingofexperienceandgoodpractices,toenablea

largerpartofthepopulationtobenefit.

Action 9: Support schools to strengthen injury prevention through voluntary participation in

health and safety programmes covering school policy, injury surveillance, first aid training, staff

development, student education, warm-up exercise before sports and parental engagement, with a

long term goal to facilitate the implementation of EDB’s Healthy School Policy.

3.20 Thecomponentof injurysurveillancewillbeimplementedasafirststep. Othercomponents

willbeimplementedconsequentially. Guidelinesforschoolsonsettingupasystemtorecord

injuriesareusefulforprotectingtheschoolsthemselvesanddevelopingstrategiestoprevent

furtherinjuriesamongstaffandthestudentpopulation.SchoolswillbesupportedbyEDBand

DHinstrengtheninginjurypreventionstrategiesandmeasures inschools, includingrecord

keepingoncasesofinjuries.Itmustbeemphasisedthattheaimofkeepinganinjuryrecordisto

helptheschooldesignandimplementpreventivemeasuresratherthanfindingfault.

3.21 Withsurveillancesystemsinplace,patternsof injurieswithrespecttotime,placeandperson

couldbereadilyidentified,studiedandcomparedbeforeandafterinterventions.Interventions

suchasacomprehensiveschoolpolicy,firstaidtraining,staffdevelopment,studenteducation,

warm-upexercisebeforesportsandparentalengagementcouldbecustomisedandpromoted

tomeettheneedsofschoolpopulation.Existingsafeschoolprogrammesandinitiativescould

alsobepromotedforadoptionbyagreaternumberofschools.

41


Action 10: Collaborate with the Leisure and Cultural Services Department (LCSD) to strengthen

sports injury awareness, surveillance and prevention

3.22 It isnotedthatalargenumberofpeopleusethefacilitiesoforparticipateinsportsactivities

organisedbytheLCSD. In2012-13,theLCSDorganisedabout37800recreationalandsports

activities formorethan2136600participantsofallagesandabilities.24 TheLCSDplaysa

significantroleinpreventingsportsinjuries.TheDHwillcollaboratewiththeLCSDtoenhance

effortsonsportsinjuryawareness,surveillanceandprevention.

3.23 Injury-relatedadministrativestatisticsofLCSD'ssportsamenities(e.g.sportscentre,beachand

swimmingpool)mightbeacquiredasaproxyofconductingsurveillanceonsportsinjuries.This

injurysurveillanceinitiativewillbeacontinuousone,andthefrequencyofobtainingdatafrom

LCSDistargetedtobeonceayear. Aggregatedstatisticaltabulationanddescriptionofthese

tableswillbepublishedinareport/articleinprintedorelectronicformforwiderdissemination.

Action 11: Engage stakeholder groups (ranging from service providers to users) and raise their

awareness on injury prevention and safety promotion through briefing(s), sharing session(s) or

seminar(s)

3.24 Seminarswouldbeheldwhentheactionplanoninjurypreventionislaunched,sothatmessages

on injurypreventioncouldbedisseminatedto relevantstakeholders. Dependingonthe

audiencetargeted,thecontentofthesegatheringsshouldbecustomisedtoachievethegreatest

buy-inandimpact.

Strategic direction 4: Build capacity and capability to prevent injuries

(Recommendation 4A)Developpersonal skills toadopt injurypreventivemeasures through

communicationofevidence-basedadvice

3.25 Effectiveriskcommunicationisafundamentaltooltoassistthepublictomakeinformedchoices

abouthealthand living. Many injurieshappenbecausethepublic lacktheknowledgeor

understandingoftheriskofinjuriesandinjurypreventionskills.Withknowledgeandawareness,

safetyliteracyisincreasedandthepublicaremorelikelytotakeactionstopreventinjuries.Thus,

theWGIrecommendsdevelopingevidence-basedadvicetoempowerandenablethegeneral

publictomakeinformedchoicesaboutinjuryprevention.

24 LeisureandCulturalServicesDepartment(2013)Annual Report 2012-2013.Availableat:http://www.lcsd.gov.hk/dept/annualrpt/2012-13/en/leisure/leisure03.html,accessed25October2014

42


Action 12: Raise awareness and safety literacy of cyclists for them to adopt safe practices and

protective gear while cycling

3.26 CyclingisatypeofphysicalactivitiesthathasgainedpopularityinrecentyearsinHongKong.

However,alargenumberoffatalandseverelyinjuredcasesofcycling-relatedinjurieshavealso

beenrecorded.

3.27 IntheroutinecyclingsafetyworkshopsorganisedbyRoadSafetyCouncil forprimaryand

secondaryschoolstudents,elementsofinjurypreventionandperformanceenhancementwill

berecommendedtothecoachoftheseworkshops. Theseelementsinclude(1)warm-upand

cool-downexercises;(2)updatedlocalsituationofcyclinginjury(e.g.surveillanceresultsfrom

AMSdata);(3)propercyclinggear;and(4)safecyclingskillsandroadmanner.Evaluationofsuch

educationalactivitiesisalsorecommended.

Action 13: Institute community-wide education on interventions proven to be effective in injury

prevention in high risk situations.

3.28 Thisproposedactionfocusesondomesticinjuriesandfalls.TheConsumerCouncilandtheHong

KongCustomsandExciseDepartment(C&ED)havepublicationsonproductsafety,especially

oninstallationsandproductsthatareusedinthedomesticsetting. Suchinformationwillbe

reviewedandleveragedoninrelevantriskcommunicationactivities.

Action 14: Promote knowledge-based interventions to PE teachers and coaches as a means to

raise sports performance and prevent sports injuries using a train-the-trainer approach

3.29 Developingskillsforsportscoachesonsports injurypreventioncouldbemoreefficientthan

teachingindividualplayersasthetrainers,afterbeingequippedwiththeknowledgeandskills

onsportsinjuryprevention,caninturnteachindividualsportsplayersonknowledgeandskills

whileservingasrolemodelsthemselves.TrainingsessionstoPEteachersandcoachesmaybe

organisedwiththehelpoftheEDBandLCSDtocoverconcepts,principlesandpracticesofinjury

preventioninspecificsettingsaswellasexercisesdesignedandtestedtopreventsportsinjuries

andenhancesportsperformance. Expertiseonsports injurypreventionmaybesoughtfrom

relevantsportsexperts.

(Recommendation 4B)Strengthencommunityawarenessandactionstopreventinjuries

43


3.30 TheWGIconsiders it importanttoempowerthegeneralpublicwithskillsandknowledgeof

injuryprevention.Byusingthetrain-the-trainerapproach,messagesofinjurypreventioncanbe

morequicklyandeffectivelydisseminatedtoindividuals.Hence,capacitybuildingprogrammes

targetingteachers,sportscoachesandpeerleadersshouldbeorganisedtogenerateacascading

effectwithinthecommunity.

Action 15: Produce teaching aids to strengthen safety awareness and promote injury prevention

actions by staff and students. Content to be introduced should be tailored to students’ academic

needs

3.31 Schoolsareagoodstartingpoint for theeducationof injurypreventionaschildrencan

benefitdirectlyandalsopropagatethemessagesto their families. TheDHwill studythe

currentcurriculumandteachingresources,andwhereappropriate,makerecommendationsof

age-appropriateinformationandmaterialsoninjurypreventiontobeintroduced.Teachingaids

forprimaryschoolstudentsoninjuryprevention,calledthe“InjuryPreventionProgrammein

PrimarySchools”,werepreparedbytheCIPRA.Inordernottoreinventthewheel,theseteaching

aidswillbereviewedbyteachersbeforeconsideringrevisionandpromotionofuse. After

collectionoftheircomments,changescouldbemadetotheteachingaidsasappropriatebefore

promotionforusebyteachersasteachingaids.

Strategic direction 5: Ensure a health sector that is responsive to the NCD challenges and to improve

the healthcare system

(Recommendation 5A) Engagehealthcareprofessionalsinpromotingmessagesandpracticesthat

preventinjuriesandidentifyingandmanagingat-riskgroups

3.32 Primarycaresettingisanimportantplacetopromotehealthtothepublicincludingthoseat-risk

ofinjuries,asfamilydoctorsandotherprimarycareprovidersareoftenthefirstcontactpointfor

membersofthecommunity.Contactduringconsultationallowsprimarycareproviderstooffer

adviceoninjurypreventionsuchasprovidingsafetytips/self-helpmaterials,briefintervention/

counsellingandreferraltospecificservicesasappropriate. TheWGIrecommendsengaging

healthprofessionalsinreducinginjuries.

44


Action 16: Engage primary care providers in dissemination of injury prevention information to

increase the accessibility of at-risk groups to community support

3.33 Peoplewith functionaldisabilities,degenerativeconditions,problemofpoly-pharmacyor

childcareproblemsareathigherriskoffallsandothertypesofdomestic injuries. Asprimary

carepractitionersareoftenthefirstpointofcontactfortheseclientgroups,byraisinginjury

awareness, theystandabetterchanceof identifyingandmanagingat-riskgroups. The

Hong Kong Reference Framework for Preventive Care for Children in Primary Care Settingsand

Hong Kong Reference Framework for Preventive Care for Older Adults in Primary Care Settings

provideappropriateguidanceandremindersfordoctorstoinstillconceptsandskillsinat-risk

populationsandtheircarersforpromotinghomesafetyandinjuryprevention.

3.34 SomeNGOsareprovidingcommunitysupporttoelderlyatriskoffalls. Theseconsistofhome

assessmentandmodification,adviceonuseofwalkingframesandassistivedevices,training

ofcarers,etc. Suchservicenetworksshouldbepromotedandextendedtocoverprimarycare

providerssothatpersonsatriskoffallmaybereferredtoaccessalreadyexistingcommunity

supportservices.

45


Table 2: Lead action parties, targets and timeframe

Targets and timeframeStrategic directions Recommendations Actions Lead action parties

(1) Supportnewandstrengthen existing healthpromotionactivitiesoninjuryprevention

(2) Generateacomprehensiveandeffectiveinformationsystemtounderstandtheepidemiologyofinjuriesandtoprovideadviceandsupportonpreventionofinjuries

Startingfrom2015,ahealthcommunication strategy fordifferenttargetgroupswillbedevelopedandimplemented.

From2015,evidence,facts,statisticsandrelevantinformationwillbecollatedandupdatedregularlytosupporthealthpromotionactivities.

By 2015-16, a mechanism willbedevisedtoobtaininjury-relateddatafromHAforanalysis.

In2016,thereviewondrowningcaseskeptbyCoroner’sCourtwillbecompleted.

Startingfrom2015,DHwillengageanumberofprimaryandsecondaryschoolsinapilotprojecttolearnabouttheinjuryreportsoftwareCommunityInjurySurveillanceSystem(CISS)developedbyOSHCandexplorepossibilityofadoptiontoenhanceinjurysurveillanceinschools.

• (1A)Developandimplementahealthcommunication strategyandadvocacyin support of injury prevention

• (1B)Strengthenexistinghealthpromotionactivitiesoninjurypreventionandmaximisetheutilisationofreadilyavailableresourcesforinjuryprevention

• (2A) Widenthescopeofinjurysurveillance

[Action 1]Deviseahealthcommunication strategy to articulatemessagespositivelyassafetypromotionandperformance enhancement inadditiontothetraditionalwaysasinjurypreventionanddamageminimisation

[Action 2] Make use of existingandnewlyobtainedmortalityand/ormorbiditydata,crediblesourcesofinformationandevidence-basedpracticestodevelopinjurypreventionmessagesinsuchformsthatappealtovaryingaudiencesandtosupporthealthpromotionactivities

[Action 3]ExploretheuseandsystematicanalysisofselecteddatacollectedinHospitalAuthority(HA)hospitalstostrengthenknowledgeonepidemiologyofinjurycasesrequiringAccidentandEmergency(A&E)attendanceandhospitalisation

[Action 4] CarryoutareviewofdrowningcaseskeptbytheCoroner’sCourt,withaviewtounderstandingthedemographicdetails,contributoryfactorsoffatalincidentsforthedevelopmentofinjurypreventionmessages

[Action 5]Exploreapilotprogrammetoassistschoolstoimplementaninjurysurveillancesystemtoidentifycontributingandprecipitatingfactorsforinjurieswithintheschoolandpinpointareasforimprovementactions

• DH

• DH• OtherrelevantGovernmentdepartments

• DH• HA


• DH• EDB• Academia• OSHC

46



(3) Strengthenpartnershipandfosterengagementofallrelevantstakeholders

Witheffectfrom2015,DHwillenhancetheinjurysurveillancesystembyacquiringadministrativestatisticsfromdepartmentsandagenciessuchasAMS,whichhavearoleininjurypreventionandmanagement.

Startingfrom2015,in-depthanalysisandinterpretationofinjurydatawillbeconducted,andby2016,articleswillbepublishedtoreachdifferenttargetaudiences.

Thetargetistodesignatethefour major types of injuries in 2015 as thematic priorities for fundingsourcesandpromoteinterest in such research topicsthroughforum/workshop.

The component of injury surveillance(Action5)willbeintroducedinpilotschoolsin2015followedbytargetedactions in response to injury patterns specific to each school.ContinuedsupportfromEDBwillbeenlistedtorolloutarangeofinjurypreventionactionsinschoolsinthe2016/17yearandbeyond.

From2015onwards,DHwillworkwithLCSDtoexploretappingintoinjury-relatedadministrativestatisticsofgovernmentsportsamenities(e.g.sportscentre,beachandswimmingpool)foruseasaproxyforconductingsurveillanceofsportsinjury.InputwillalsobeprovidedtoLCSDforconductingcommunitybasedsurveystorevealtheprevalenceofsportsinjurytoinformpoliciesandactions that promote safe sport.

• (2B)Strengthenthe existing injury surveillancesystemtomakeitusefulandsustainable

• (2C) Promote research offeasibility,efficiencyandcost-effectivenessofinterventionstopreventinjuries

• (3A)Toworkwithgovernmentbureaux/departments,otherhealthpromotionpartners, NGOs, schools,employeesandemployersofdifferentindustriestodevelopandimplementmeasuresthataresensitivetotheneedsofthepublicinachievingpreventionofinjuries

[Action 6] Explorethepossibilityofaccessingnewsourcesofinjurydatatoenrich the existing injury surveillancesystemtoalertthepublicwhereinjuriesaremore to occur

[Action 7]Byconducting in-depthanalysisonexistingandupdateddatacollectedfromsurveys,strengthenunderstandingofthepatternandtrendofinjuries

[Action 8]Encouragemoreresearch on the four major typesofinjuriesidentified (i.e.sportsinjuries,falls,domesticinjuriesotherthanfallsanddrowning)

[Action 9] Supportschoolsto strengthen injury preventionthroughvoluntaryparticipationinhealthandsafetyprogrammescoveringschoolpolicy,injurysurveillance,firstaidtraining,staffdevelopment,studenteducation,warm-upexercisebeforesportsandparentalengagement,withalongtermgoaltofacilitatetheimplementationofEDB’sHealthySchoolPolicy

[Action 10]CollaboratewithLeisureandCulturalServicesDepartment(LCSD)to strengthen sports injury awareness,surveillanceandprevention


• DH

• DH• OtherrelevantGovernmentdepartments/bureau

• EDB• DH

• LCSD• DH

47



(4) Buildcapacityandcapabilitytopreventinjuries

(5) EnsureahealthsectorthatisresponsivetotheNCDchallengesandtoimprovethehealthcaresystem

Seminarsforhealthpromotionpartnersandrelevanttargetgroupswillbeorganisedonaregularbasis.Thefirstseminarwillbeconductedforthelaunchingoftheplanin2015.

In anticipation of more injury reportsarisingfromcyclingasanincreasinglypopularactivity,workshopsorganisedbytheRoadSafetyCouncilforprimaryandsecondaryschoolswillbeenrichedwithelementsoninjurypreventionandperformanceenhancement in 2015.

Startingfrom2015,DHwillreviewrecommendationsonproductsafetyissuedbyvariousgovernmentdepartmentsandstatutorybodies,andorganisethemformoretargetedpromotionunderthe4priorityareas.

In2015,DHwillworkwithEDBandLCSDtoenrichtrainingcontentforPEteachersandcoacheswiththefocusonsportsinjuryprevention.The target is to incorporate relevanttrainingcontentfrom2016/17onwards.

Teachingmaterialswillbereviewedtotargetprimarystudents’learningneedsanddisseminatedforteachers’usefrom2016/17onwards.

Startingfrom2015,DHwillliaisewithprimarycareprovidersandNGOstoenhanceaccessofthepublicto community support servicesthataimtopreventandreduceelderlyfall.

• (4A)Developpersonalskillstoadoptinjurypreventivemeasures through communication of evidence-basedadvice

• (4B)Strengthencommunityawarenessandactionstopreventinjuries

• (5A)Engagehealthcareprofessionalsinpromoting messages andpracticesthatpreventinjuriesandidentifyingandmanaging at-risk groups

[Action 11] Engagestakeholdergroups(rangingfromserviceproviderstousers)andraisetheirawarenessoninjurypreventionandsafetypromotionthroughbriefing(s),sharingsession(s)orseminar(s)

[Action 12]Raiseawarenessandsafetyliteracyofcyclistsforthemtoadoptsafepracticesandprotectivegearwhilecycling

[Action 13] Institute community-wideeducationoninterventionsproventobeeffectiveininjurypreventioninhigh risk situations

[Action 14] Promote knowledge-basedinterventionstoPEteachersandcoachesasameanstoraisesportsperformanceandpreventsportsinjuriesusingatrain-the-trainer approach

[Action 15]Produceteachingaidstostrengthensafetyawarenessandpromoteinjurypreventionactionsbystaffandstudents.Contenttobeintroducedshouldbetailoredtostudents’academicneeds

[Action 16]Engageprimarycareprovidersindisseminationofinjurypreventioninformation to increase the accessibilityofat-riskgroupstocommunity support

• DH• NGOs

• RoadSafetyCouncil

• DH• Academia• OtherrelevantGovernmentdepartments

• DH• ConsumerCouncil

• C&ED• NGOs

• EDB• LCSD• DH• Academia

• EDB• DH• OtherrelevantGovernmentdepartments

• DH• Professionalbodies

• NGOs

48


49

Making it happen4

4 Making it happen

5050

Making it happen 4

4. Making it happen

4.1 TotakeforwardthisActionPlan,DHneedstoactivelyengageindialogueandcollaborative

partnershipswithNGOsandcommunitystakeholders. DHalsoneedstocommunicatethe

purpose,content,progressandachievementsof theActionPlanasaneffectivemeansof

mobilisinginter-sectoralandcross-disciplinarysupport. Adoptingthehealthleadershiprole,

theGovernmentstandsreadytoprovidepeoplewithinformationoninjurypreventionandwork

closelywithallsectorstocreatesupportiveenvironmentsforpeopletomakehealthychoicesfor

themselvesandtheirfamilies.

4.2 TheNCDchallengeahead isgreater thanever. TheWGIdoesnotunderestimatepotential

barriers,difficulties andchallenges. Notwithstanding theabove,we recogniseactive

participationbyeveryoneinthecommunityisamajorkeytosuccess.Byworkingtogether,each

ofuscanmakeHongKongasaferandhealthierplacetolive.

51

Annexes

Annexes

52

Annexes

Annex 1

Membership of Working Group on Injuries

Chairman

MrPatrickMAChing-hang,BBS,JP

Vice Chairman

DrLAMPing-yan,JP

DepartmentofHealth(February2012toJune2012)

DrConstanceCHANHon-yee,JP

DepartmentofHealth(sinceJune2012)

Members

DrCharlesCHANChing-hai

DrPeterCHANHung-chiu

DrCHOWChun-bong,BBS,JP

ProfSianGRIFFITHS,OBE,JP

MsAngieLAIFung-yee,MH

MrLIUAh-chuen,MH

MrNGSze-fuk,GBS,SBS,JP

DrKathleenSOPik-han,BBS,JP

DrPatrickYUNGShu-hang

53

Annexes

Ex-officio Members

DrThomasTSANGHo-fai,JP DepartmentofHealth(February2012toDecember2012)

DrLEUNGTing-hung,JP DepartmentofHealth(sinceDecember2012)

MrVictorHOChun-ip EducationBureau(sinceNovember2013)

MrKONGMan-keung HongKongPoliceForce(February2012toApril2013)

MrDickyLAUCheng-fung HongKongPoliceForce(sinceNovember2013)

MrTSOSing-hin,JP LabourDepartment(February2012toSeptember2012)

MrLIChi-leung LabourDepartment(sinceNovember2012)

MissOliviaCHANYeuk-oi,JP LeisureandCulturalServicesDepartment

(November2013toNovember2014)

MrRichardWONGTat-ming LeisureandCulturalServicesDepartment(sinceNovember2014)

MsCaranWONGKa-wing SocialWelfareDepartment(February2012toAugust2012)

MrFUNGMan-chung SocialWelfareDepartment(sinceNovember2012)

Secretary

DrLEUNGTing-hung,JP

DepartmentofHealth

(February2012toDecember2012)

DrReginaCHINGCheuk-tuen,JP

DepartmentofHealth

(sinceDecember2012)

54

Annexes

Annex 2

Terms of reference of Working Group on Injuries

(a) Toassesstheepidemiology,riskfactorsandsocioeconomicdeterminantsofinjuriesamongthe

localpopulation;

(b) Tomakerecommendationsonthehealthimprovementneedsofthelocalpopulationinrelation

tothepreventionofinjuries;

(c) Toreviewlocalandinternationalgoodpracticesandinterventionstrategiestopreventinjuries;

and

(d) Tomakerecommendationsonthedevelopment, implementationandevaluationofaplanof

actionforthepreventionofinjuriesinHongKong.

55

Annexes

Annex 3

Discussion topics in meetings of the Working Group on Injuries

Date Topics

Firstmeeting

Secondmeeting

Thirdmeeting

Fourthmeeting

6February2012

7January2013

29November2013

24June2014

Global Development of Injury Prevention

(WGIPaperNo.01/2012)

• DefinitionandClassificationofInjuries

• GlobalDiseaseBurdenofInjuries

• WorldHealthOrganization’sCommitmentonInjuries

• Overseasexperienceandscientifically-provenmeasures for injury

prevention

Local Situation of Injuries


• EpidemiologyandDiseaseburden

• Datacollectionandinjurysurveillance

• Localsituationofhealthpromotionformajortypesofinjuries

Strengthening Injury Prevention in Hong Kong


• PrinciplestoguidetheworkofWGI

• Identificationofpriorityareas

• TwoPillarsininjuryprevention

Recommendations to Strengthen Injury Prevention in Hong Kong


Action Plan to Strengthen Injury Prevention in Hong Kong


Action Plan toStrengthen Prevention of Unintentional Injuries in Hong Kong

Hong Kong Special Administrative Region of China

Action Plan to Strengthen Prevention of U

nintentional Injuries in Hong Kong

Nov 2014Printed by the Government Logistics Department Hong Kong Special Administrative Region of China

action plan to strengthen prevention of · intentional injuries as injuries that are purposely...

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