translating injury surveillance to prevention: an update

VICTORIAN INJURY SURVEILLANCE SYSTEM HAZARD 25 page 1

Hazard(Edition No. 25)December 1995

Victorian InjurySurveillance SystemMonash UniversityAccident Research Centre

Translating injury surveillanceto prevention: an updateAs VISS is moving to a new system of data collection in 1996 it is timely to review our achievements over the past eightyears. This edition of Hazard highlights some VISS success stories and outlines some of the challenges that face us in1996 and beyond.

Erin CassellVirginia RoutleyJoan Ozanne-Smith

SummaryThe first edition of Hazard waspublished in July 1988, the year inwhich the Victorian InjurySurveillance System was established.The quarterly publication of Hazardis one of the major methods VISSuses to disseminate information. Theselection of topics for Hazard is basedon the relative severity, frequencyand the potential preventability ofinjury problems that emerge fromanalyses of VISS hospital emergencydepartment presentations data andreference to other relevant datasources.

Each Hazard edition includes thefindings from the data analysis on one

or more significant injury issues anda discussion of actions that need to betaken to reduce or eliminate thepotential for injury.

As background to this (the 25th)edition of Hazard, progress on all therecommendations to reduce injuriesmade in Hazard was reviewed. Thereview not only covered follow-upaction undertaken by VISS alone or incollaboration with other MonashUniversity Accident Research Centre(MUARC) projects but also includedsignificant action on VISSrecommendations taken by otherbodies. VISS intends to continuouslyupdate this review as an ongoingWorking Report.

This edition of Hazard highlightssome VISS success stories. It alsofocuses on injury issues where some

progress has been made by VISS andother bodies but where there is goodpotential for further gains. In theseareas a modest increase in human andfinancial resources applied to theproblem could be repaid by significantreductions in the number and/or theseverity of injuries.

Enclosed in this edition is a clientsurvey. In 1995 VISS received asmall grant from the VictorianHealth Promotion Foundation tosupport the implementation offindings from VISS data analysesand research. This grant includedfunds for a survey of VISS clientsand potential clients on their dataand other needs for progressing therecommendations for actionpublished in Hazard.

V.I.S.S.


IntroductionThe Victorian Injury SurveillanceSystem (VISS) was established in1988 to collect and analyse injurydata from hospital emergencydepartments and to disseminateinformation for the purposes of injuryprevention. VISS is currently fundedby the Victorian Health PromotionFoundation.

The size and nature of the datacollection has changed over thelifetime of VISS. It was initially acollection of child injuries reportedthrough the emergency department ofthe Royal Children’s Hospital underthe directorship of Associate ProfessorTerry Nolan. MUARC took overVISS management in 1990 anddeveloped the all age injury collection.By 1992 VISS had expanded to fivehospitals on seven campuses.

VISS is currently in transition fromthe manual collection of injury data inselected emergency departments to astatewide routine electronic collectionusing the National Minimum Dataset(Injury Surveillance).

VISS has also expanded to accessdata and information from a widerrange of sources so that a morecomplete picture of injury issues isobtained. The other sources frequentlyaccessed are the Australian Bureau ofStatistics (ABS), the Coroner’sFacilitation System (mortality) andthe Victorian Inpatient MinimumDataset.

There are currently 166,137 cases ofinjury on the VISS hospital emergencydepartment database. VISS data areused to identify injury problems,support research and, most import-antly, to underpin the development ofinjury prevention strategies andsupport their implementation andevaluation.

Media coverage of injury issues in Hazard - 1995 Table 1

Injury IssueNo. of media

requestsMedia coverage in 1995

Domestic violence

22 Print: AAP, Canberra Times, Herald Sun, IPA Review, Shepparton News, Sunday Herald Sun, Sydney Morning Herald, The Age, The Australian, The Independent Monthly, Warrnambool Standard, Waverley Gazette, Women's Day.Radio: ABC Sydney, SBS, Triple MTelevision: A Current Affair (Channel 9), GP (ABC TV)

Dog bites/attacks

12 Print: Fairfax Suburban Newspapers, Herald Sun, National Dog Magazine, Sunday Age, Sunday Herald Sun, Sterling MediaTelevision: A Current Affair (Channel 9), Burke's Backyard (Channel 9)

Horse related injuries

8 Print : Herald Sun, Warrnambool Standard, Weekly TimesRadio: Country Hour (ABC Radio)Television: Midday Show (Channel 9), Channel 9

Sports injuries 8 Print: Australian Golf Digest, Fairfax Newspaper Group, Herald Sun, Sunday Age, Sydney Morning HeraldRadio: 3BATelevision: Today Tonight (Channel 7)

Smoking related injuries

5 Print: AAP, Herald Sun, The AgeRadio: 3MP, 5DN

In-line skating injuries

3 Print: Shepparton NewsTelevision: The Today Show (Channel 9), News Channel Pay TV

Escalator-related injuries

3 Print: Australian Doctor, Parents (Australian Parenting Magazine), Herald Sun

Home injuries 3 Print: The AgeTelevision: Better Homes (Channel 7), Channel 7

Tractor-related injuries

2 Print: Herald Sun, Weekly TimesRadio: The Country Hour (ABC radio), Country Roundup (Ace Network)

Shopping trolley injuries

2Print: Herald Sun

Snake bites 2 Print: Sunday Herald SunTelevision: Burke's Backyard

Farm injuries 2 Print: Warrnambool Standard, Weekly Times

Chainsaw-related injuries

1Print: Gippsland Farmer


The latter is achieved by bringinghazards and potential solutions to theattention of the public and those whoshare the responsibility forsafeguarding Victorians - governmentdepartments and statutory authorities,manufacturers, retailers, insurers,consumer and injury preventiongroups, educators, researchers andspecialist medical practitioners.

The media play an important andresponsible role in reporting VISSdata and often follow up the injuryissues highlighted in Hazard. Table 1shows the media attention given toinjury issues in 1995 that are directlyattributable to the publication ofHazard. The issue that excited themost media attention was domesticviolence.

Over time, increasing emphasis hasbeen given by VISS to the vigorouspursuit of the implementation ofrecommendations based on VISS dataand available research.

VISS is a major program of MonashUniversity Accident Research Centre(MUARC) and Dr Joan Ozanne-Smith, a Senior Research Fellow withMUARC, is the Director of VISS.

Hazard 20 highlighted that carbonmonoxide poisoning from car exhaustswas a major means of suicide inVictoria, ranking second to hanging/strangulation. In 1994 carbonmonoxide gas was used by 98Victorians and 447 Australians(source-ABS microfiche data) tocommit suicide.

There is some research evidence whichsuggests that restricting access to themeans of suicide can contribute to afall in overall suicide rates. Forexample, a fall in suicides amongwomen in Australia occurred whenaccess to barbiturates was tightenedin the late 1960’s and in the U.K.when natural gas replaced coal gas.There is preliminary evidence thattighter firearm legislation in Victoriamay be having a similar beneficialeffect.

Cars built after 1986 have catalyticconverters fitted which convertharmful carbon monoxide gasemissions to carbon dioxide gas.However, ongoing surveillance of thetrend in suicides in Victoria andAustralia by VISS shows no clearevidence of a decline in the proportionof suicides from carbon monoxidepoisoning in recent times. In fact,Victorian Inpatient Morbidity dataindicate that hospital admissions forcarbon monoxide suicide attemptshave steadily increased from 15 in1989-90 to 56 in 1993-94.

Information from the VictorianInstitute of Forensic Medicine alsoconfirms that gassings are stilloccurring in post-1986 vehicles,probably because catalytic convertersdo not work efficiently at a cold start.

VISS therefore recommended theconsideration of other design

Progress on selected issuesPrevention of suicide - reducing car exhaust gas poisoning[reported in Hazard 11, June 92; Hazard 20, Sept 94]

Recommendations

• reduce access to the means of suicide, especially firearms and carbonmonoxide gas [Hazard 11, June 92]

• design modifications to motor vehicles to impede common methods ofcarbon monoxide poisoning, eg. modify/re-design car exhaust systems toreduce or eliminate carbon monoxide emission, and mandate these designchanges by incorporating them into the Australian Design Rules (ADRs)[Hazard 20, Sept 94]

• mandate, through changing ADRs, the incorporation of a sensing devicein motor vehicles which monitors carbon monoxide levels and shuts downthe motor when levels become life threatening [Hazard 20, Sept 94]

• improve motor engine designs and catalytic conversion techniques tocomplete the combustion process and thereby virtually eliminate carbonmonoxide emissions [Hazard 20, Sept 94]

• improve the identification and treatment of those who are most at risk ofsuicide [Hazard 11, June 92]


modifications to cars to make carbonmonoxide emissions a less accessiblemeans of suicide. One intervention, acarbon monoxide sensing devicewhich turns off the engine when thecarbon monoxide reaches a dangerouslevel, has been assessed as costeffective in terms of lives saved. VISSalso made suggestions for engineereddesign changes to car exhaust systemsand these have been sent to experts inthe field for comment.

VISS circulated copies of Hazard 20,which highlights the problem andpossible solutions, to senior staff incar manufacturing companies,automotive bodies, governmentdepartments of transport, engineeringacademics and members of the varioussuicide prevention working partiesthat have been set up by governmentand other bodies. In December 1995updated and comprehensiveinformation was sent to these andother interested organisations seekingtheir co-operation and advice on howto progress action on the issue.

The national arm of the AustralianMedical Association (AMA) has alsopublicly stated its interest in pursuingthis suicide prevention initiative. In1995 the AMA wrote to Members ofParliament and automotive manu-facturers urging action and the AMA’sEthics, Science and Social IssuesCommittee and policy officer intendto pursue this matter in early 1996.

VISS has provided information on itsactivities to the AMA and offered tosupport the AMA’s efforts to restrictaccess to the means of suicide. In1996 VISS will continue to com-municate and co-operate with theAMA on this issue.

In late 1995 VISS established contactwith the Commonwealth Inter-departmental Working Group on

Youth Suicide, comprising theCommonwealth Department ofHuman Services and Health, theAttorney General’s Department andthe Commonwealth Department ofTransport, and the Youth SuicidePrevention Advisory Group, whichhas also been set up by theCommonwealth Department ofHuman Services and Health.

The latter has been established toprovide the Commonwealth withexpert and consumer advice on youthsuicide prevention activity. MUARC(through action by VISS) has beeninvited to be represented on a workinggroup of this committee which willexplore issues around access to themeans of suicide and possible optionsfor a national project or legislativeactivities.

Awareness raising among health andinjury professionals has also been partof the VISS implementation agenda.Information on the use of carbonmonoxide poisoning as a commonmeans of suicide was a majorcomponent of a paper presented at the1994 Public Health Association(PHA) Conference - ‘Non-trafficmotor vehicle injury’ (Routley V.).Posters on the topic have been acceptedfor the Third International Conferenceon Injury Prevention and Control tobe held in Melbourne in February1996 and the associated FourthInternational Conference on ProductSafety Research.

The challengeThe prevention of suicides is acomplex task and restriction of accessto the means of suicide is oneintervention where there appears tobe good potential to save lives. Since1991 suicides have surpassed motorvehicle traffic accidents as the majorcause of injury deaths in Australia

(Harrison & Cripps 1994; Harrison &Dolinis 1995). During 1996 VISSwill step up its efforts to bring togethera coalition of interested parties topush for action on the problem of carexhaust gassings and pursue theopportunities afforded to progress thisissue through its representative on theworking group of the CommonwealthYouth Suicide Prevention AdvisoryGroup.

Scalds prevention - hot drinks[reported in Hazard 3, June 1989;Hazard 11, June 92, Hazard 12September 1992]

Recommendations-hotdrinks

• develop new designs for cups,mugs, some electric kettles andcoffee makers which incor-porate the use of heavier materialand a lower centre of gravity toprevent tipping over [Hazard 3,June 1989]

• introduce a spill-resistant mugonto the Australian market[Hazard 12, Sept 92]

• educate carers to keep hot drinksout of reach of children and to useplacemats instead of tablecloths[Hazard 12, Sept 92]

• design kitchens to eliminatedangerous pathways between keywork areas, and kitchen bencheswith a rounded lip to catch spills[Hazard 12, Sept 92]

Follow-up action

• media: Herald Sun 1992,Montage April 1994, BaysideTimes April 1995, Colac HeraldJune 1995

• information requests: 18 generalscalds requests, including tworegarding spill-resistant mugs


Preventing hot drink scalds- spill resistant mugsIn 1992 VISS identified that the majorcause of scald injuries to children washot drinks being pulled or knockedonto young children. An updatedanalysis of all cases of child scalds onthe VISS database to June 1995 (Table2) reveals that this is still the case,39% of scald injuries to children agedunder 15 years are tea and coffeescalds.

For this reason VISS has concentratedmuch of its efforts on getting anattractive and well designed spillresistant tea/coffee mug onto theAustralian market. The availabilityof a safe, attractive spill-resistant mugwould facilitate the promotion of thiscountermeasure to child scalds toparents and carers of young children.It is especially important to safeguardone to two year olds as they are thehighest risk group for hot drink scalds.

The spill resistant mug was firstidentified as a promising counter-measure to child scalds in Hazard 12(Sept 1992). As shown in theaccompanying sketch, VISS considers

All of the products that were assessedhad some of the design characteristicsrequired but none appeared ideal, forexample, they had a wide base but nolid or had the safety features but weretoo large, too ugly or too expensive.

VISS subsequently approached anumber of Australian design and mugmanufacturing companies who wereall very helpful but their ultimateresponse was not encouraging. Thecost of developing prototypes andtooling up for production appearsprohibitive because of the smallvolume domestic market. NSWHealth experienced a similar reactionfrom the cup and mug manufacturersthey approached.

VISS also followed up a mug designthat was recently patented in the USA.An interesting design feature is thatthe mug can only be used if the lid isin place. The US health productcompany that sought the patent iscurrently at the stage of seekingfinance for tooling for production.VISS has supplied contacts for themanufacturer to follow up and willmeet the designer for discussions inFebruary 1996.

Scald injuries to children aged <15 years Table 2

Mechanism factor N %hot drinks - tea, coffee 672 39hot water - cooking 372 21

hot water - bath, tap, shower 241 14

hot water - other 104 6

cooking oil, fat 89 5

hot water - n/s 88 5

soup, gravy 81 4other 103 6

Total 1750 100%VISS data: RCH, WH, PANCH 1989-93,

LRH 4 years July 1991 to June 1995. Update of table in Hazard 12 September 1992.

Spill-resistant mug Figure 1

the essential features of a safe spillresistant mug to be a narrow mouth, awide, high friction base for maximumstability and a sip-through lid whichstays on (with minimum spillage)when the mug is in use or tipped over.

As a first step, VISS collected samplesof spill resistant mugs from companiesin Australia and the USA where theuse of this mug is promoted to coffeedrinking commuters (not a practicewe want to encourage amongAustralian drivers!).


Another avenue of investigation thatwas implemented concurrently was afield assessment of consumer attitudeto a spill-resistant mug. In 1995 the7 Eleven spill-resistant mug wasmarket tested for VISS in a researchproject conducted by Carmelo Caputo,Peter Liodakis, Vicki Psihogios andLivia Rivera, students of MonashUniversity Medical School. Thisproject examined the effectivenessand acceptability of the spill resistantmug (donated by 7 Eleven) among agroup of 50 family day care workersemployed by the City of DandenongCouncil.

The researchers reported that thecaregivers responded positively. Theproduct was found to be acceptableand convenient to use but theresearchers recommended thatawareness raising education on scaldsprevention should accompany itsintroduction. The caregiverssuggested a number of changes interms of size, shape and material toimprove the mug’s consumer appealand safety.

These research findings were used torefine VISS design specifications fora spill resistant mug. VISS recentlyinterested a South Australian mugand lid manufacturing company inthe design and, possibly, themanufacture of the product. Thecompany is currently engaged inexploring the best design, in terms ofeffectiveness and aesthetics. Theirfirst concept sketches will besubmitted to VISS in January 1996.

The issue was raised nationally in apaper presented to the First NationalConference on Injury Prevention andControl held in Sydney in 1995(Commonwealth Department ofHuman services and Health 1995)and a paper on the researchunderpinning these developments has

been accepted for presentation to theFourth International Conference onProduct Safety Research to be held inCanberra in February 1996.

A VISS staff member is also co-ordinating the Spill-Resistant MugWorking Party of the VictorianPrevention of Child Injury Committee(established by the Department ofHealth and Community Services).

The challengeThe recent progress on thedevelopment of the design andprototype of a spill-resistant mug willinfluence the steps that will be takenin 1996. VISS intends to approachpotential sponsors if the prototypedesign satisfies VISS specifications.Kidsafe has indicated a strong interestin assisting in marketing the productwhen it becomes available.

More than three years have elapsedsince VISS identified scalds from cupsof tea and coffee as the major risk forthermal injury among young childrenand recommended the developmentof an acceptable spill resistant mug.In this period three hundred moreVictorian children have presented withscalds from hot cups of tea and coffeeto the four hospital emergencydepartments covered by VISS.

The time and persistent effort thatwere required to progress this Hazardrecommendation exemplifies the needfor more infrastructure and projectspecific funding to increase thecapacity of VISS to pursue interven-tions that arise from its researchfindings.

Burns prevention -cigarettes/lighters/matches[reported in Hazard 11, June 92;Hazard 12, Sept 92; Hazard 21,Dec 94]

Recommendations

• consider installing sprinklers ininstitutions housing elderlysmokers [Hazard 11, June 92]

• consider the introduction oflegislation for the mandatorymanufacture of low fire risk (selfextinguishing) cigarettes[Hazard 12, Sept 92; Hazard21, Dec 94 ]

• develop a low cost child-resistant cap for cigarettelighters and a child-resistantmatchbox (or import from USA.and U.K. respectively) andmandate their use in Australia[Hazard 12, Sept 92; Hazard21, Dec 94 ]

• support initiatives to reducesmoking [Hazard 21, Dec 94]

As reported in Hazard 12 and 21 burninjuries to children resulting fromplaying with cigarette lighters,although uncommon, are severe.Cigarette lighters were the cause of16% of the 31 smoking related deathsrecorded on the Victorian Coroner’sFacilitation System database duringthe period 1989/90 to 1991/92.Almost all of the cigarette lightercases involved a child under 5 yearsold playing with the lighter.

VISS Hospital EmergencyDepartment database shows that overhalf the children under five years whosuffer burns from cigarette lightersrequire admission to hospital.

Hazard 21 called for governments toregulate that all cigarette lighters on


sale in Australia should have child-resistant catches. To date there hasbeen no positive response from theCommonwealth or any Stategovernment, despite the introductionof this safer product onto theAustralian market.

Cricket, and to a lesser extent Bic,child resistant cigarette lighters arenow sold in major supermarket chains.Cricket lighters are currently promotedby Bryant and May through mediaadvertising and a lighter swap scheme.

At the suggestion of VISS, Kidsafehas arranged for a display pack of 25cigarette lighters to be donated byBryant and May to every Maternaland Child Health Centre in Victoria.These centres will promote a lighterswap scheme to parents of youngchildren as a means of raisingawareness of the availability of thisproduct among one of the highest riskgroups This promotion will exposesome 25,000 parents across Victoriato this safer product.

Similar exchange schemes operate atthe Child Safety Centre at the RoyalChildren’s Hospital (RCH),Melbourne and, for families whosechildren are fire lighters, through thePsychiatry Department of the RCH.

Despite the initiatives to educate theconsumer taken by Bryant and Mayand child injury prevention bodies,child resistant lighters currently makeup only four percent of the Australiancigarette lighter market share. Thispoor uptake by consumers indicatesthat more stringent measures arerequired.

The Cricket child resistant disposablelighter retails at more than double theprice of regular disposable lighters($1.95 v. 89-95 cents). Whileincreased production would reducethe cost of the child resistant lighter,

its higher price acts as a disincentivefor the wider implementation of thissafety measure.

Another burn prevention recommen-dation in Hazard 21 was the intro-duction of a child resistant matchboxsuch as Matchguard, which ismanufactured in the U.K.

Efforts by VISS to interest localmanufacturers in the production of asimilar product (designed to hold thestandard size Australian smallcardboard match box) have not beensuccessful. The high cost of toolingand low volume local market are againgiven by manufacturers as reasons fortheir lack of interest in manufacturingthis safety product.

The challengeMore active intervention by therelevant government authorities isrequired to decrease these burninjuries. Child resistant cigarettelighters are mandatory in the USAand Canada so there is a persuasiveprecedent for similar regulatory actionin Australia. The MelbourneMetropolitan Fire Brigade and otherfire prevention bodies are majorprotagonists for regulations in thisarea. VISS will continue its efforts tostimulate government regulatoryaction in 1996.

Child resistant Figure 2cigarette lighter

Child falls prevention -babywalkers[reported in Hazard 14, Mar 93 (homeinjuries); Hazard 16, Sept 93 (thesafety of babywalkers); Hazard 20,Sept 94 (an update)]

Recommendations

• impose an Australian productban on babywalkers or, lesspreferably, change the design toincorporate a broad base that iswider than household doorways[Hazard 14, Mar 93]

• raise public awareness of therisks associated with baby-walkers and the necessity ofstair guards and supervision[Hazard 16, Sept 93]

• encourage retailers to refuse tosell babywalkers [Hazard 16,Sept 93]

Follow-up action• media: The Sunday Age,

Townsville Bulletin, Herald-Sun, Sunday Herald Sun,Waverley Gazette, Channel 7,ABC Regional TV.

• information requests: nine,including invited submissionfrom the Federal Minister forConsumer Affairs.

• research study, based on VISSdata, on facial injuries sustainedby small children in babywalkers or prams.

• exposure data provided throughthe Australian Bureau ofStatistics (ABS) “Safety in theHome” survey conducted inMelbourne in November 1992enabled VISS to calculaterelative risk compared to othernursery items [Hazard 20, Sept94] which further supported theneed for a product ban orchanged design.


Babywalkers are an injury hazard. InVictoria each year there is a risk that1 in every 192 babywalkers will causea significant injury resulting in ahospital emergency departmentpresentation to a child less than oneyear of age. Babywalkers have beenshown to be of no benefit to the baby,in fact there is evidence that their usemay hinder child development.

VISS and other Australian andoverseas data have consistently shownthat babywalker use is associated withserious injury, for example, stairwayfalls and burns. In the US in 1993babywalkers were associated with25,000 hospital emergency depart-ment presentations among childrenaged 5-15 months and the deaths of11 children in the period from 1989through 1993 (Murray 1995).

VISS has maintained continuouspressure on Commonwealth and StateConsumer Affairs bodies to havebabywalkers banned, or, lesspreferably, the Australian standardrevised (as was done in Canada) todemand a broader and more stablebase. This latter approach to theproblem would limit the mobility ofbabies using babywalkers, preventingthem getting through doorways. TheFederal Bureau of Consumer Affairs(FBCA) has declined to place aproduct ban on babywalkers citinglegal impediments as it is the use,rather than the product itself, that isunsafe.

However, in 1995 the Federal Ministerfor Consumer Affairs, The Hon.Jeannette McHugh wrote to 350retailers of babywalkers asking themto voluntarily withdraw this product.This action was influenced by thedecision of the Myer group ofdepartment stores to withdrawbabywalkers from sale following

earlier adverse media reportsgenerated by VISS.

The Minister’s action through theFederal Bureau of Consumer Affairsand the media attention given to theissue as a result of reports in threeissues of Hazard appear to have had abeneficial effect in Victoria.

A VISS survey of 13 major retailoutlets in a cross section of Melbournesuburbs in November 1995 found thatother major general retail chains(Target, K-Mart and Toys R Us) hadwithdrawn babywalkers from sale“because they were unsafe ordangerous”, as had some specialistnursery furniture retailers.

Two of the five specialist nurseryfurniture retailers that still soldbabywalkers reported that they onlystocked models which they perceivedto have special safety features (forexample, models with eight wheels

and a high padded back or wheels thatcan be locked). The retailers regardedthese models as comparatively safe,indicating that they also had someawareness of the injury issue.

The issue has been raised by VISS inconference papers given at the SecondWorld Conference on Injury Control,Atlanta USA, 1993; the Public HealthAssociation Seminar ‘The Health ofMothers and Children’, Melbourne1993; the Children’s NurseryFurniture Seminar, Royal Children’sHospital, Melbourne, 1994; and theHealth and Community ServicesConference, ‘Healthy Families,Healthy Children’, Melbourne, 1994.

The challengeIn 1996 VISS will continue to workwith other child injury preventionagencies to pressure the FederalBureau of Consumer Affairs to reviewits position and place a product ban onbabywalkers.

Shopping trolley fitted with child seat Figure 3


Child falls prevention -falls from shopping trolleysOn a recent trip to the U.K. a VISSstaff member photographed ashopping trolley fitted with a childseat and harness in a Safewaysupermarket (Figure 3).

The danger posed to children byshopping trolleys, mostly fall-relatedinjuries, was highlighted in Hazard22. VISS hospital emergencydepartment data shows that in theperiod 1989-1993 shopping trolleyswere responsible for 268 injuries,predominantly to children under fiveyears of age.

Baby capsules are fitted to someshopping trolleys in Coles New WorldSupermarkets in Australia. However,as shown in Hazard 22, shoppingtrolley injuries peak among 1-3 yearolds and major causes are youngchildren standing in, climbing in orout of, or reaching too far out ofshopping trolleys.

In 1996 VISS will again approachAustralian supermarkets chains toconvince them of the advantages oftaking a responsibe attitude to theprevention of these unnecessaryinjuries to young children by providingchild restraints in shopping trolleys.

commonly associated with finger jaminjuries to older children.

Consequently, VISS assisted thedevelopment of a ‘finger-safe guard’which shielded the hinge side of thedoor.

Research into injuries in the homeand child care settings for Hazardsissues 14 and 16 found finger jaminjuries to be frequent and severeinjuries in both these locations.

Since 1993 VISS has concentrated onpromoting the finger-safe guard,raising community and governmentawareness of the problem, andimplementing preventive measures inchild care settings.

In late 1993 and early 1994 VISSraised with relevant governmentdepartments, Ministers andcommittees the need to includecountermeasures to finger jam injuriesin either the Quality Improvementand Accreditation System or in theNational Standards for Centre BasedLong Day Care. These approacheswere unsuccessful.

In May 1995 VISS again raised thedoor finger jam issue in a submissionin response to the ‘Future Legislativeand Regulatory Framework forChildren’s Services Discussion Paper,April 1995’. The draft frameworkwill be released for comment in 1996.

As an interim measure VISS wrote anarticle on finger jam protection forInformation Update 1/95 (recentlyre-named ‘Extra’), the newsletter ofthe Preschool and Childcare Branchof the Primary Care Division of theDepartment of Health & CommunityServices, Victoria.

This newsletter was circulated to3,500 registered or governmentfunded children’s services including

Finger jam injuriesfrom doors[Reported in Hazard 10, Mar 92(schools); Hazard 14, Mar 93 (home);Hazard 16, Sept 93 (childcaresettings)]

Recommendations

• install the safest type of door forlocation, door closures, wedgesand finger safe guards in homes,schools and child care settings[Hazard 10, Mar 92; Hazard14, Mar 93; Hazard 16, Sept93]

• include measures to preventfinger jam injuries in child caresettings in the Children’sServices Centres Regulations1988 [Hazard 16, Sept 93]

Follow-up action

• media: Herald-Sun (VicHealthregular Monday column), ABCradio

• information requests: 12including Kidsafe, Civic MutualPlus, Shire of Yarra Ranges,Department of Health andCommunity Services

In 1989 VISS identified finger jaminjuries as common in children under5 years. Within the previous year(1988-89) 143 injuries occurred as aresult of a child jamming his/her fingerin a door. Finger jams often result incrushes, fractures and evenamputations.

A follow-up study conducted byMUARC on a sample of these childfinger jam cases (Ozanne-Smith et al1992, unpublished) found that themost severe finger jam injuries tochildren, especially to one and twoyear olds, involved the hinge side ofthe door. The opening side was more


childcare, preschool and occasionalcare centres, school-age services, peakbodies and interested associations.

Civic Mutual Plus, the insurer of 98%of Victorian Local Government Areas(LGAs) included finger jam protectionin their March 1995 Risk ManagementManual update. Their attention wasdrawn to the issue by media reports ofVISS findings published in Hazardand the information used in thismanual update was largely from VISS.

In terms of implementation, in 1995the Shire of Yarra Ranges was awardeda grant of $10 000 by the VictorianDepartment of Health and CommunityServices to reduce finger jam injuriesamong children in their own homesand child care settings.

The Shire incorporated informationfrom VISS on the prevention of fingerjam injuries, including the use of doorguards, in their training program fornew child care workers and raisedawareness of the issue among thegeneral public during Children’s Week1995. The Shire will produce aneducational video on the topic in 1996.

Kidsafe has included VISSinformation on finger jam injuries inits leaflet on outdoor safety in pre-school centres to be distributed in1996.

Sales of this door hinge finger jamprotective device have increased at anaccelerated rate during 1995. Salesalmost doubled from 338 in the secondquarter of the year to 640 in the thirdquarter.

This jump in sales can be attributed toa number of factors: the RiskManagement Manual update; asuccessful litigation case which drewattention to the issue; greaterawareness through VISS input into

the media and a Department of Health& Community Services publication;and the promotion work undertakenby the Child Safety Centre at theRoyal Children’s Hospital amongchild care bodies seeking governmentaccreditation.

During 1995 VISS encouraged aneducational toy shop Hop, Step andJump to stock finger safe guards asthe number of sale outlets for theproduct was very limited.

A recent development is theestablishment by the VictorianPrevention of Child Injury Committeeof the Finger Jam Prevention WorkingParty. Its brief is to examine theissues surrounding finger jam injuries,develop prevention strategies andmake recommendations on theirimplementation. VISS is representedon this working party.

The challengeIn 1996 VISS will continue its effortsto increase community awareness ofthis issue and push for the use ofproducts which prevent door fingerjams in homes, child care settings,kindergartens and schools through itswork for the Victorian Prevention ofInjury Committee and other avenues.

Community awareness (and sales) ofthe finger-safe guard will need toincrease dramatically for this measureto have any significant impact on thefinger jam injury problem.

Prevention of needlestickinjuries[reported in Hazard 17, Sept 93(workplace)]

Recommendations

• use disposable syringes [Hazard17, Sept 93]

• develop and promote the use ofsafer products eg. pliable andpuncture resistant gloves, lowcost retractable needles andother devices such as rubbersheath removers that minimisecontact with a sharp [Hazard17, Sept 93]

• educate health care staff aboutcurrent recommendations oninfection control practices andways to reduce exposure[Hazard 17, Sept 93]

• immunise hospital staff againstHepatitis B [Hazard 17, Sept93]

Accidental needlestick injuries are aserious concern because of the risk ofblood-borne transmission of HepatitisB and C and HIV. There were 225needlestick injuries reported on theVISS hospital emergency presenta-tions database in the period 1991-1992. Injured workers were pre-dominantly registered nurses, medicalpractitioners, State enrolled nursesand cleaners.

Hazard 17 recommended an holisticapproach to this problem whichincludes education of healthcareworkers and the development andpromotion of safer products.

A company that has taken thisapproach and invested heavily inresearch and development of safety-engineered products and educationprograms to minimise the risk from


hypodermic products is BectonDickinson, the world’s largestmanufacturer of needles and syringes.

As shown in the Figure 4, theB-DSafety Lok Syringe is fittedwith a sliding shield that locks overthe needle and an indicator whichturns red to green to confirm that theshield is in place and safe for disposal.This syringe is suitable for widespreadgeneral use in place of standarddisposable syringes. However, thehigher cost-per-item (currently morethan double the cost of a standarddisposable syringe) is a barrier to use,although the cost differential isshrinking as the volume of productionincreases.

Another of the company’s productsthat has the potential to significantly

reduce needlestick injuries in hospitalsettings is the Interlink IV AccessSystem (co-promoted with BaxterHealthcare). This intravenous therapysystem introduces an advanced designinjection site and safe blunt cannulato replace conventional needles. Iteliminates up to 80% of the sharpsteel needles formerly used forintravenous administration.

While many hospitals have intro-duced needleless systems for theadministration of anaesthetics,Victoria appear to be lagging behindother States in adopting hospital-wideneedleless systems. From theinformation supplied to VISS in late1995, sixteen NSW hospitals haveintroduced a hospital-wide system,while the Maroondah Hospital is theonly Victorian hospital to do so.

The B-DSafety Lok Syringe Figure 4

ReferencesChalmers D. “Prevention of armfractures in playground falls. Do wehave the answers?” in Proceedingsfrom The First National Conferenceon Injury Prevention and Control heldon 27-28 February 1995, Sydney,NSW. Commonwealth Departmentof Human Services and Health .AGPS, 1995.

Harrison JE, Cripps RA (editors).Injury in Australia: an epidemiologicalreview. Canberra, AGPS, 1994(Chapter 10).

Harrison JE, Dolinis J. InjuryMortality Australia 1993. AustralianInjury Prevention Bulletin 10, August1995.

Murray T. “US pediatricians urgerecall, ban on baby walkers”. InjuryPrevention 1995;1: 149-151.

Ozanne-Smith J et al. “Finger jaminjuries to children in doors” in Childaccident and injury preventionresearch in other than road accidents(unpublished). Monash UniversityAccident Research Centre. 1992.

Victorian Injury Surveillance SystemHazard Volume 1, Editions 1 to 10,Injury data and prevention. MonashUniversity Accident Research Centre.March 1993.

Victorian Injury Surveillance SystemHazard Volume 2, Editions 11 to 20,Injury data and prevention. MonashUniversity Accident Research Centre.February 1995.

Victorian Injury Surveillance System“Smoking-related injuries” in HazardEdition 21, Domestic Violence.Monash University AccidentResearch Centre. December 1994.

Victorian Injury Surveillance SystemHazard Edition 22, Product relatedinjury - a selection (domesticarchitectural glass and shopping trolleysinjuries). Monash University AccidentResearch Centre. March 1995.

B-D is a registered trademark of Becton Dickinson & CompanyInterLink is a registered trademark of Baxter Healthcare


Issu

es in

Brie

f

Issu

eP

reve

ntio

n of

dom

estic

arc

hite

ctu

ral

gla

ss in

jurie

sIn

jurie

s as

soci

ated

with

rol

lerb

lad

ing

Dur

ing

the

per

iod

1989

to

1993

the

re w

ere

862

arc

hite

ctu

ral g

lass

inju

ries

re

cord

ed o

n th

e V

ISS

hos

pita

l em

erge

ncy

dep

artm

ent

data

base

. M

ost o

f th

em o

ccur

red

in t

he h

om

e an

d in

volv

ed g

lass

doo

rs a

nd

win

dow

s.

Rol

lerb

ladi

ng in

juri

es h

ave

ris

en

fro

m n

o re

cord

ed c

ases

in V

ISS

pa

rtic

ipa

ting

hos

pita

ls in

198

9 to

113

cas

es in

19

92 a

nd 1

47

case

s in

199

3.

Nea

rly h

alf o

f rol

lerb

ladi

ng in

juri

es r

ecor

ded

in 1

993

we

re w

rist i

njur

ies,

80

%

The

inju

red

wer

e p

redo

min

ant

ly m

ale

and

in th

e yo

ung

er a

ge g

roup

s (u

nder

5

year

old

s fo

r ch

ildre

n a

nd 2

0-24

yea

r ol

ds fo

r ad

ults

age

d >

15 y

ears

).

frac

ture

s.

Ele

ven

per

cent

wer

e he

ad in

jurie

s.

Th

e 10

-14

yea

r ol

d ag

e gr

oup

is m

ost a

t ris

k an

d in

juri

es o

ccur

mos

t of

ten

on

foo

tpat

hs a

nd p

ublic

T

he v

ast

maj

ority

of

the

inju

ries

we

re la

cera

tions

to t

he u

ppe

r lim

bs a

nd

face

.ro

ads.

A

sm

all f

ollo

w-u

p st

udy

in 1

992

sho

we

d th

at r

olle

rbla

ding

inju

ries

occu

rred

whe

n u

sers

wer

e le

arni

ng o

r w

hen

expe

rien

ced

rolle

rbla

ders

we

re

tryi

ng n

ew

stu

nts

(m

ost o

f the

inju

red

wer

e no

t we

arin

g w

rist g

uard

s).

Haz

ard

cov

erag

eE

diti

ons:

7,

June

19

90;

14,

Mar

93;

16

, S

ept 9

3; 2

2,

Mar

95

Ed

ition

: 15

, Ju

l 93

Key

re

com

men

datio

ns*

incl

ude

the

198

9 r

evis

ion

of t

he A

ustr

alia

n S

tand

ard

(A

S 1

288)

on

"Gla

ss

in B

uild

ings

- S

ele

ctio

n a

nd I

nsta

llatio

n"

in V

icto

ria's

bu

ildin

g c

ode

whi

ch

requ

ires

safe

ty g

lazi

ng m

ater

ials

in s

ome

resi

dent

ial s

itua

tions

* c

reat

e ar

eas

for

rolle

rbla

ding

sep

arat

ed f

rom

tra

ffic

and

ped

est

rians

and

en

cou

rage

initi

al t

rain

ing

in a

pro

tect

ed e

nvir

onm

ent

[Haz

ard

15]

* c

hild

ren

und

er 5

yea

rs o

ld s

hou

ld n

ot u

se r

olle

rbla

des

[Haz

ard

15]

whe

re a

nnea

led

gla

ss w

as

prev

ious

ly a

ccep

tabl

e [H

azar

d 7]

* r

epla

ce a

nne

ale

d gl

ass

with

saf

ety

gla

ss w

hene

ver

glas

s is

re

plac

ed

in

* p

rom

ote

the

use

of s

afet

y e

quip

me

nt (

hel

met

s, w

rist

pro

tect

ors,

kn

ee a

nd

elbo

w g

uard

s) [H

azar

d 15

]ex

istin

g ho

mes

[H

azar

d 22

]*

red

uce

the

pric

e le

vel d

iffer

entia

l bet

we

en s

afet

y a

nd a

nnea

led

glas

s [ H

azar

d 22

] *

pro

mot

e th

e a

pplic

atio

n o

f spe

cial

pla

stic

film

, ba

rs, r

ails

or

war

ning

st

icke

rs o

n ex

istin

g ha

zard

ous

glas

s [H

azar

d 7

& 2

2]

* r

olle

rbla

de h

ire

outle

ts s

houl

d al

so h

ire o

ut p

rote

ctiv

e e

quip

men

t; h

irers

an

d se

llers

sho

uld

giv

e ad

vice

on

fittin

g o

f rol

lerb

lade

s, o

ffer

initi

al t

uitio

n an

d re

com

men

d t

he u

se o

f sa

fety

eq

uipm

ent

[Haz

ard

15]

Med

ia fo

llow

-up

* G

lass

Aus

tral

ia (

trad

e jo

urna

l)*

She

ppar

ton

New

s; T

he A

ge; T

he T

oday

Sho

w (

Cha

nne

l 9);

Aus

tral

ian

Jour

nal o

f Pae

diat

rics

and

Chi

ld H

ealth

; Kid

safe

Mag

azin

e.

Info

rmat

ion

requ

ests

* e

igh

t inc

ludi

ng O

'Brie

n's

Gla

ss*

fou

r in

clu

ding

Dep

artm

ent

of O

rtho

pae

dics

(R

oyal

Chi

ldre

n's

Hos

pita

l)

Fur

ther

act

ion

* r

esea

rch

stu

dy

by D

rs N

olan

and

Co

urt (

Roy

al C

hild

ren

Hos

pita

l) on

a

sam

ple

of c

hild

ren

inju

red

by d

omes

tic g

lass

[Haz

ard

7]*

CS

IRO

co

ndu

cted

a s

tud

y to

de

term

ine

the

na

ture

of

the

dom

estic

gla

ss

invo

lved

in in

jurie

s [H

azar

d 7]

* r

esea

rch

use

d as

Cas

e S

tudy

in R

epo

rt t

o th

e A

ustr

alia

n C

ons

um

er's

C

ounc

il (1

993

) (S

afe

ty in

the

Mak

ing

Pro

duc

t S

afe

ty f

or t

he Y

ear

200

0 -

Mol

ler,

J.

199

4)

Impl

emen

tatio

n*

Vic

toria

ado

pte

d th

e 19

89 r

evis

ion

to t

he "

Gla

ss in

Bui

ldin

gs"

Sta

nda

rd

into

its

build

ing

code

, ope

ratio

nal f

rom

Ap

ril 1

991

for

new

hou

ses

and

ho

use

s un

derg

oin

g re

nova

tion

[Haz

ard

7]

* M

UA

RC

ha

s pr

epar

ed

a re

sear

ch p

ropo

sal t

o ex

amin

e th

e e

ffect

ive

ness

of

wris

t gu

ard

s an

d in

vest

igat

e th

eir

wea

ring

rat

e b

y ro

llerb

lad

ers.

Fut

ure

chal

leng

es*

mo

nito

r th

e e

ffec

tive

ness

of t

he r

evi

sed

Aus

tra

lian

Sta

nda

rd a

nd B

uild

ing

code

req

uire

men

t as

an

inju

ry p

reve

ntio

n m

easu

re

* p

rom

ote

the

use

of s

afet

y g

lass

whe

n d

ome

stic

gla

ss is

be

ing

repl

ace

d

* r

esea

rch

the

use

and

effe

ctiv

ene

ss o

f pro

tect

ive

equ

ipm

ent

esp

ecia

lly

wris

t gu

ard

s*

sur

vey

hire

out

lets

to

det

erm

ine

curr

ent p

ract

ice

reg

ardi

ng s

afet

y to

ho

use

hold

ers

, gla

zier

s a

nd in

sura

nce

com

pan

ies,

with

att

entio

n to

re

duci

ng t

he p

rice

diffe

rent

ial

* a

s an

inte

rim

mea

sure

pro

mot

e th

e a

pplic

atio

n o

f spe

cial

pla

stic

film

, ba

rs, r

ails

an

d/or

war

ning

stic

kers

on

exis

ting

haza

rdo

us g

lass

educ

atio

n an

d m

easu

res

* in

vest

iga

te w

heth

er

safe

ty s

trat

egie

s ar

e pr

omot

ed/

impl

emen

ted

by t

he

rolle

rbla

der

s' a

ssoc

iatio

n


Issu

eP

lay

equi

pmen

t-re

late

d in

jury

D

og b

ites

The

re w

ere

4,23

7 ca

ses

of p

lay

equi

pmen

t-re

late

d in

jury

to

child

ren

unde

r 15

yea

rs o

f age

rep

orte

d by

VIS

S p

artic

ipat

ing

hosp

itals

in th

e pe

riod

1989

-93

. T

he 5

-9 y

ear

age

grou

p w

as m

ost a

t ris

k of

thes

e in

jurie

s. I

njur

ies

In t

he f

ive

year

per

iod

1989

to 1

993,

109

3 ch

ildre

n pr

esen

ted

to V

ISS

pa

rtic

ipat

ing

hosp

itals

with

dog

bite

s, 2

6% o

f th

ese

case

s w

ere

adm

itted

to

hosp

ital.

Chi

ldre

n un

der

5 ye

ars,

par

ticul

arly

todd

lers

, wer

e m

ost a

t ris

k .

mos

tly o

ccur

red

in s

choo

l pla

ygro

unds

and

oth

er c

hild

care

set

tings

(47

%),

fo

llow

ed b

y pr

ivat

e ho

mes

(18

%)

and

publ

ic a

nd p

rivat

e or

com

mer

cial

pl

aygr

ound

s an

d am

usem

ent

area

s (1

7%).

O

ver

80%

of

inju

ries

resu

lted

Out

door

s at

hom

e w

as th

e m

ost

freq

uent

loca

tion

for

child

dog

bite

inju

ries

(54%

of c

ases

). I

n th

e th

ree

year

per

iod

1991

-94,

ther

e w

ere

516

adul

t ca

ses

of d

og b

ite in

jury

rep

orte

d in

the

VIS

S d

atab

ase.

from

falls

. M

onke

y ba

rs, s

lides

or

slid

ing

boar

ds,

swin

gs a

nd s

win

g se

ts

wer

e th

e pi

eces

of

play

equ

ipm

ent

mos

t fre

quen

tly in

volv

ed in

inju

ries

to

Haz

ard

cov

erag

eE

ditio

ns: 2

, Dec

88

(joy

whe

els)

; 3, J

uly

1989

; 4, N

ov 1

989;

10

, Mar

92

(sch

ools

);14

, Mar

93

(hom

e in

jurie

s);

16, S

ept 9

3 (c

hild

car

e se

tting

s)E

ditio

ns: 3

, Jul

y 19

89; 4

, Nov

89;

12

, Sep

t 92;

18

, Mar

ch 9

4 (w

ork-

rela

ted)

Key

re

com

men

datio

ns*

add

ress

des

ign

fact

ors

that

are

ass

ocia

ted

with

pla

y eq

uipm

ent i

njur

ies

incl

udin

g he

ight

of e

quip

men

t, sa

fety

rai

ls, s

ize

and

dist

ance

bet

wee

n ba

rs,

stab

ility

and

layo

ut o

f equ

ipm

ent a

nd r

evis

e A

ustr

alia

n S

tand

ards

* p

rom

ote

the

deve

lopm

ent o

f a

radi

ator

cap

tha

t has

a s

afet

y va

lve

and

devi

ces

such

as

mag

netic

def

lect

ors

whi

ch d

efle

ct th

e bo

iling

rad

iato

r w

ater

/ste

am d

ownw

ards

to p

rote

ct t

he m

otor

ist o

r m

echa

nic

[ Haz

ard

20]

[Haz

ard

3, 1

4, 1

6]*

inst

all a

nd m

aint

ain

effe

ctiv

e im

pact

abs

orbi

ng u

nder

surf

acin

g to

the

reco

mm

ende

d de

pth

of 2

00m

m (

com

mun

ity p

layg

roun

ds 2

50m

m)

* d

evel

op a

rad

iato

r ca

p w

hich

can

not b

e re

mov

ed if

the

wat

er te

mpe

ratu

re

is a

bove

a d

esig

nate

d te

mpe

ratu

re o

r pr

essu

re [ H

azar

d 1

2 &

20]

* pr

omot

e th

ese

safe

ty r

ules

to m

otor

ists

: wai

t for

the

vehi

cle

radi

ator

cap

[Haz

ard

3, 1

4, 1

6]*

atte

nd to

the

desi

gn, m

aint

enan

ce a

nd c

onfo

rman

ce to

the

new

Aus

tral

ian

Sta

ndar

d (A

S 2

155)

, whe

n av

aila

ble,

for

play

equ

ipm

ent a

nd u

nder

surf

acin

g in

all

prim

ary

scho

ols,

chi

ld c

are

sett

ings

(in

clud

e

to c

ool d

own

befo

re to

uchi

ng; r

elea

se to

the

first

clic

k an

d re

mov

e ca

p if

th

ere

is n

o pr

essu

re [ H

azar

d 2

0]

conf

orm

ance

in C

hild

ren'

s S

ervi

ces

Cen

tres

Reg

ulat

ion

Med

iafo

llow

-up

Her

ald-

Sun

, Ade

laid

e A

dver

tiser

, A

BC

rad

io, H

eral

d-S

un, T

he S

unda

y A

ge,

60 M

inut

esIn

form

atio

n re

ques

tsP

layg

roun

ds -

fiv

e in

clud

ing

The

Pla

ygro

unds

and

Rec

reat

ion

Ass

ocia

tion

of

Vic

toria

, S

hire

of B

ulla

Saf

e Li

ving

Pro

gram

, in

divi

dual

loca

l gov

ernm

ent

coun

cils

Sch

ool p

lay

area

s -

23 in

clud

ing

Out

door

Edu

catio

n D

epar

tmen

t, S

hire

of

Bul

la S

afe

Livi

ng P

rogr

am, L

atro

be V

alle

y B

ette

r H

ealth

Pro

gram

, Q

ueen

slan

d C

ounc

il of

Par

ents

and

Citi

zens

; pro

pose

d S

choo

lsaf

e p

rogr

amF

urth

er a

ctio

n*

Pla

ygro

und

and

Rec

reat

ion

Ass

ocia

tion

of V

icto

ria fo

llow

-up

stud

y of

pl

aygr

ound

inju

ries

iden

tifie

d by

VIS

S, i

nclu

ding

site

inve

stig

atio

ns a

nd

inte

rvie

ws

with

vic

tims/

care

rs p

ublis

hed

with

rec

omm

enda

tions

[ Haz

ard

10

* V

ISS

atte

mpt

s to

con

tact

the

man

ufac

ture

r of

mag

netic

def

lect

ors

wer

e un

succ

essf

ul -

the

pro

duct

is n

o lo

nger

on

the

mar

ket

Mar

92]

Impl

emen

tatio

n*

nin

e jo

y w

heel

s re

mov

ed fr

om p

layg

roun

ds b

y S

t Kild

a C

ounc

il ov

er a

th

ree

mon

th p

erio

d fo

llow

ing

VIS

S r

epor

t[Haz

ard

2, D

ec 8

8]*

the

1982

Aus

tral

ian

Sta

ndar

d ha

s be

en u

nder

rev

iew

by

a S

tand

ards

Aus

tral

ia C

omm

ittee

sin

ce 1

986

but

no a

gree

men

t on

revi

sion

s ha

s be

en

reac

hed

to d

ate

* S

tand

ards

Aus

tralia

is c

urre

ntly

con

side

ring

the

adop

tion

of th

e N

SW

K

idsa

fe G

uide

lines

on

Saf

e P

layg

roun

dsF

utur

e C

halle

nges

* fu

rthe

r re

sear

ch to

con

firm

and

ref

ine

findi

ngs

repo

rted

at

the

Firs

t N

atio

nal C

onfe

renc

e on

Inju

ry P

reve

ntio

n an

d C

ontr

ol 1

995

by D

r D

avid

C

halm

ers

(Inj

ury

Pre

vent

ion

Res

earc

h U

nit,

NZ

) re

gard

ing

fall

heig

hts

and

* id

entif

y th

e re

spon

sibl

e au

thor

ity w

ho s

houl

d ta

ke u

p th

e is

sue

of n

on-

traf

fic m

otor

veh

icle

rel

ated

inju

ries

incl

udin

g ca

r ra

diat

or s

cald

s

play

grou

nd e

quip

men

t inj

ury

(i.e.

that

falls

from

hei

ghts

in e

xces

s of

1.5

m

etre

s w

ere

over

four

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- INDEX -Subject Edition PagesBabywalkers, update .................................................................................................................. 16,20........................... 1-4,12-13Bunkbeds ......................................................................................................................................... 11 ....................................... 12Bicycles

- Bicyle related injuries ......................................................................................................... 6 ...................................... 1-8- Cyclist head injury study ................................................................................................... 2, ......................................... 2- Cyclist head injury study updates ............................................................................... 7,8,10 ................................. 8,13,9

Burns- Scalds ................................................................................................................................... 3 ...................................... 1-4- Burns prevention ............................................................................................................... 12 .................................... 1-11

Chainsaw injuries ............................................................................................................................ 22 .................................. 13-17Child care settings ........................................................................................................................... 16 .................................... 5-11Data base use, interpretation & example of form ............................................................................ 2 ...................................... 2-5Deaths from injury (Victoria) ......................................................................................................... 11 .................................... 1-11Dishwasher machine detergents - Update ...................................................................................... 18 ....................................... 11Dogs

- Dog related injuries ............................................................................................................. 3 ...................................... 5-6- Dog bite injuries ................................................................................................................ 12 ....................................... 12

Domestic architectural glass ........................................................................................................7,22............................. 9-10,2-5Domestic Violence .......................................................................................................................... 21 ...................................... 1-9Drownings/near drownings

- Immersions .......................................................................................................................... 2 ......................................... 3- Pool fencing leglislation, update ..................................................................................... 2,7 ...................................... 3,7- Drownings & near-drownings at home ............................................................................... 5 ...................................... 1-4

Escalator and elevator injuries ....................................................................................................... 24 .................................... 9-13Exercise bicycles, update ............................................................................................................... 5,9 ...............................6,13-14Home injuries .................................................................................................................................. 14 .................................... 1-16Horse related injuries ...................................................................................................................7,23............................. 1-6,1-13Infants - injuries in the first year of life ........................................................................................... 8 .................................... 7-12Intentional injuries .......................................................................................................................... 13 .................................... 6-11Latrobe Valley

- The first three months ......................................................................................................... 9 .................................... 9-13- Latrobe Valley injuries .................................................................................. * March 1992 ...................................... 1-8- Injury surveillance & prevention in the L. V. ..................................................... *Feb 1994 .................................... 1-14

Lawn mower injuries ...................................................................................................................... 22 ...................................... 5-9Martial arts ...................................................................................................................................... 11 ....................................... 12Motor vehicle related injuries, non-traffic ..................................................................................... 20 ...................................... 1-9Needlestick injuries......................................................................................................................... 11 ....................................... 12Older people, injuries among.......................................................................................................... 19 .................................... 1-13Off-street parking areas .................................................................................................................. 20 .................................. 10-11Playground equipment ...................................................................................................................... 3 ...................................... 7-9Poisons

- Child resistant closures ....................................................................................................... 2 ......................................... 3- Drug safety and poisons control ......................................................................................... 4 ...................................... 1-9- Dishwasher detergent, update ........................................................................................10,6................................. 9-10,9

Roller Blades ................................................................................................................................... 15 .................................. 11-13School injuries................................................................................................................................. 10 ...................................... 1-8Shopping trolley injuries................................................................................................................. 22 .................................. 10-12Skateboard injuries............................................................................................................................ 2 ...................................... 1-2Smoking Related injuries ................................................................................................................ 21 .................................. 10-12Sports

- Sports related injuries.......................................................................................................... 8 ...................................... 1-6- The 5 most common sports ................................................................................................. 9 ...................................... 1-8- Adult sports injury............................................................................................................. 15 .................................... 1-10

Tractor injuries ................................................................................................................................ 24 ...................................... 1-8Trampolines..................................................................................................................................... 13 ...................................... 1-5VISS: early overview ........................................................................................................................ 1 ...................................... 1-5VISS: how it works ........................................................................................................................... 1 ...................................... 6-8Work Related Injuries ................................................................................................................ 17,18........................... 1-13,1-10

* Special edition


Editorial BoardProfessor Peter Vulcan, Monash University Accident Research Centre

Dr Joan Ozanne-Smith, Monash University Accident Research Centre

Assoc. Professor Terry Nolan, Department of Paediatrics, Melbourne University

Mr. Jerry Moller , National Injury Surveillance Unit

VISS StaffDirector: Dr Joan Ozanne-Smith

Co-ordinators: Virginia RoutleyGraeme Watt

Research Assistant: Karen Ashby

Administrative Assistant: Christine Chesterman

Data Processor: Julia Palmer Latrobe Regional Hospital

Associate Director: Dr Terry Nolan(Child Injuries)

GeneralAcknowledgementsParticipating HospitalsLatrobe Regional Hospital (Traralgon and Moe)

The contributions to the collection of VISS data by the director and staff of theEmergency Departments of these hospitals, other particpating clinicians, MedicalRecords Departments, and ward staff are all gratefully acknowledged. Thesurveillance system could not exist without their help and co-operation.

Coronial ServicesAccess to coronial data and links with the development of the Coronial Service’sstatistical database are valued by VISS.

National Injury Surveillance UnitThe advice and technical back-up provided by NISU is of fundamental importanceto VISS.

How toAccess VISSData:VISS collects and tabulates informa-tion on injury problems in order tolead to the development of preventionstrategies and their implementation.VISS analyses are publicly availablefor teaching, research and preventionpurposes. Requests for informationshould be directed to the VISS Co-ordinators or the Director bycontacting them at the VISS office.

VISS is located at:Building 70Accident Research CentreMonash UniversityWellington RoadClayton, Victoria, 3168

Postal address:

As above

Phone:

Reception (03) 9905 1808

Co-ordinators (03) 9905 1805(03) 9905 1815

Director (03) 9905 1810

Fax (03) 9905 1809


VISS is a project of the Monash University Accident Research Centre.

Hazard was produced by the Victorian Injury Surveillance Systemwith the layout assistance of Glenda Cairns, Monash University Accident Research Centre.Illustrations by Jocelyn Bell, Education Resource Centre, Royal Children’s Hospital and

Ann James, Books Illustrated.

ISSN-1320-0593

Printed by Sands and McDougall Printing Pty. Ltd., North Melbourne

Project Funded byVictorian Health Promotion Foundation

translating injury surveillance to prevention: an update

Documents