women's and children's hospital grand round

CHILD INJURY PREVENTION IN SA – COMMUNITY CONSULTATION TO UNDERPIN THE WAY FORWARD FOR KIDSAFE SA.

Associate Professor Anne Johnson

INTRODUCTION

22,865 children 0-4 years of age were admitted to hospital for injury (including accidental poisoning) across Australia (AIHW 2008).

This was second only to admissions to hospital for respiratory conditions.

Unintentional injuries are a major cause of disability, which can have a long-lasting impact on all facets of a child’s life; relationships, learning and play (WHO & UNICEF 2008).

Click icon to add picture Preventable injuries

are higher amongst children compared with

other

age groups (ABS 2007).

Photo by Anne Johnson 2008

More children die from injury in Australia (36%) than cancer (19%), and diseases of the nervous system (11%) combined.(ABS 2006).

Photo by Anne Johnson 2008

Click icon to add picture Child

death rates from

injuries

have declined

by over

60%

since

1983 (AIHW 2005)

Photo by Anne Johnson 2008

REDUCTION OF CHILD DEATH RATES

This reduction in child deaths provides evidence that dramatic success in reducing child injuries and deaths is possible through using multiple strategies such as: legislative changes environmental changes community action information education and training.

It is imperative to continue this downward trend of child deaths from injuries, and to reduce preventable and unintentional child injuries.

CHILD DEATHS

Child deaths impact not only on the family, but also the community.

“Every day around the world the lives of …families are torn apart by the loss of a child to unintentional injury or so-called ‘accidents’ that could have been prevented. The grief that these families suffer – mothers, fathers, siblings, grandparents and friends – is immeasurable and often impacts on entire communities. Such tragedy can change lives irrevocably” (WHO & UNICEF 2008 p vii).

The pain is even greater if simple measures could have prevented the incident.

CHARACTERISTICS OF CHILD INJURIES

There is a strong association between the type of injury a child sustains and the: age of a child developmental stage how the child interacts with their environments the type of activities the child undertakes socio-economic status, and gender.(WHO & UNICEF 2008)

Click icon to add pictureChildren

0-4 years

of age are particularly vulnerable

to injuries

as they begin to explore

their environment.

Highest injury rates 1-2 year olds.

Photo by Anne Johnson 2008

THE CHILD-INJURY PYRAMID

1 death

45 hospitalisations

1,300 treated and discharged from ED

Unknown number require first aid at home, early childhood

setting, GP, Pharmacist, Phone advice, etc.

(Gallagher 1984).

CHILD INJURY PYRAMID

Difficult to get a true picture of child injuries. There are many injuries that are unaccounted for in the

child injury data. Some insights gained in the area of poisoning. For example:

SA data from the Department of Health indicated that in 2006-2007 there were 549 children 0-4 years of age hospitalised for poisonings.

Data from the Poison’s Information Centre in WA indicated that in 2008 there were 5,119 telephone calls to the Centre from SA for children 0-4 years of age.

(NB. unable to get 2008 data from the SA Dept of Health to compare admissions to hospital from poisoning for that year with Poison Information Centre data)

MAIN INJURIES FOR CHILDREN 0-4 YEARS OF AGE ADMITTED TO SOUTH AUSTRALIAN HOSPITALS 2006-2007 (COMBINED METROPOLITAN AND COUNTRY; EXCLUDING DEATHS):

Falls 1090 Burns and scalds 589 Poisonings 549 Vehicle Accidents (car occupant) 79 Drowning 39 Cyclist 34 Pedestrian 26

MAIN INJURIES BY AGE FOR CHILDREN 0-4 YEARS OF AGE ADMITTED TO SOUTH AUSTRALIAN HOSPITALS 2006-2007 (COMBINED METROPOLITAN AND COUNTRY; EXCLUDING DEATHS):

Reason 0-11mths 1 year 2 year 3 year 4 yearFalls 190 234 256 215 195

Burns & scalds 82 315 97 47 48

Poisonings 68 167 189 83 42

VA 12 16 16 15 20

Drownings 8 16 9 5 1

IN THE STATE OF SOUTH AUSTRALIA IN 2006 10 CHILDREN DIED IN THE 0-4 YEAR AGE GROUP:

Three children died from transport related injuries

Three from drowning Four from accidental asphyxia.(Government of South Australia 2007)

10 DEATHS IN 2007 IN THE 0-4 YEAR AGE GROUP WERE CAUSED BY:

Three children died from transport related injuries

Five children died from accidents. Four of these children died from either accidental hanging or asphyxia. The fifth child died from head injuries sustained when an object fell on the child.

Two children drowned.(Government of South Australia 2008)

14 DEATHS IN 2008 IN THE 0-4 YEAR AGE GROUP WERE CAUSED BY:

Two children died from transport related injuries. Two from drowning. Two children died from ‘accidents’. One child

suffocated from entrapment in a filing cabinet and one child was strangled by a window blind cord.

Eight children died from associated unsafe sleeping situations.

(Government of South Australia 2009)

Nearly 60% of

injuries in children 0-4 years happen

in the home and

backyard

Photos by Anne Johnson 2007

Falls are

1.5 times

greater in country

areas

than metropolitan areas (AIHW 2008)

http://www.amcgltd.com/archives/brokenarm.jpg

http://www.worldofstock.com/slides/PCH5614.jpg

http://www.sportmanawatu.org.nz/images/custom/Active%20movement/climbing%20tree.JPG

Photo by Anne Johnson 2008

Photo by Anne Johnson 2008

Poisonings

are

1.9 times greater

in country areas

than metropolitan areas (AIHW 2008)

http://blog.luckyvitamin.com/wp-content/uploads/2009/05/lots-of-tablets2.jpg

http://www.wisebread.com/files/fruganomics/imagecache/blog_image_full/files/fruganomics/blog-images/cleaning-bottles.jpg

http://healthfoodheroes.files.wordpress.com/2009/06/alcohol-bottles-drinking-colorful.jpg

Photo Anne Johnson 2008

Conducted a statewide consultation for KidSafe SA: 17 focus groups Several interviews Several telephone

discussions with families living on remote outback stations

*

***

*

* **

** *

*

**

MET SOME AMAZINGLY TALENTED AND COMMITTED PEOPLE

Photos by Anne Johnson 2008

SAFETY HAZARDS FOR YOUNG CHILDREN IN COUNTRY SA –

PERSPECTIVES OF FAMILIES OF CHILDREN 0-4 YEARS OF AGE

PLAYGROUNDS

Click icon to add picture

Lack of footpaths

Photo by Anne Johnson 2008

CHILDREN IN CARS

Keys left in the ignition Children left in cars when parents shopping

or using ATM Children not being restrained in cars or farm

vehicles People using inappropriate types of child

restraints

ROADS AND ROAD SAFETY

Traffic Speeding on unfamiliar back roads (city

people/tourists/contract workers) Increasing heavy vehicles through towns ‘local drivers pretty bad’ Speeding on country roads, especially past

farm entrances Seasonal – harvest time; silo run through town;

tourist season Older drivers continuing to drive due to lack of

local public transport or limited community buses

ROADS AND ROAD SAFETY

Pedestrian crossing issues Road safety

Teaching children road safety Children not wearing bike helmets Poor condition of roads Kangaroos and emus

Lack of child friendly environments Dangers in the community Entertainment venues Shops and supermarkets

FARM ISSUES Dangers in the environment

Not having secure fences and gates to isolate farmhouse and children from working areas of farm

Heavy farm machinery Big sheds/workshops and equipment Chemicals Hay bales Silos for grain storage

Different practices More outdoor activities – greater risks More open spaces – wander off and get lost Commonplace to start riding horses and motor bikes at a

younger age Economic issues

Not able to afford to update infrastructure e.g. build chemical shed or purchase extra child restraint for farm vehicle

SNAKES AND ANIMALS

Always have to be vigilant during snake season for snakes

Children interact with a wide range of animals from a young age

Wandering dogs Tying dogs up in the front of shops and

leaving them there Lack of access to dog education

programs

OTHERS Motor bikes - begin riding between 2-4

years Open access to wide range of water

areas Too trusting Service model of Kmart and Target Council issues Parks/public spaces Hot environment Rental properties Unfamiliar environment - visiting

children from city; and country children visiting city

KNOWLEDGE

What were three of the most frequently occurring types of unintentional injury for children 0-4 years of age that required hospitalisation in SA over the past two years?

WHAT INFLUENCED THE PARTICIPANTS MOST IN THEIR APPROACH TO CHILD SAFETY?

Friends Family Groups Children Experiences Local stories

WHERE DID PARTICIPANTS SOURCE INFORMATION ABOUT CHILD SAFETY?

Written information sources Books Magazines Pamphlets

Media Internet

Commercial sites Safety-oriented sites Health-oriented sites

WHERE DID PARTICIPANTS SOURCE INFORMATION ABOUT CHILD SAFETY?

Education/training Safety-oriented organisations Health professionals and health services Child care, kindergarten and school Speciality stores Community events

You can find the link to it on:

www.kidsafesa.com.au

THE KIDSAFE SA STRATEGY

14 recommendations Raising awareness (3) Workforce development (1) Advocacy (3) Supporting legislation (1) Strategic partnerships (7)

Any questions?

Photo from Kidsafe Vic