Childhood injury prevention
CMAJ 1997;156(4):480
See response from: L.H. Francescutti
Re: Childhood injury prevention: time for tougher measures, by I.
Barry Pless, CMAJ 1996;155:1429-31 [full text / résumé]
Any of us who work in trauma treatment inevitably react emotionally to the issue of prevention of needless injuries. As Dr. Pless so clearly states in his editorial, a central structure is required if effective measures are to be taken in a way that affects all types of injuries.
Injury prevention provides an interesting paradox, because it is an area in which grassroots support is necessary. For example, the use of seatbelts and child seats in cars would have gone nowhere without social awareness, education in schools and the central prescription of standards requiring the use of seatbelts. The legislative change has been made on a province-by-province basis because motor-vehicle legislation is a provincial area. None the less, standards for seatbelts are mandated federally. Finally, the circle is closed by a high rate of compliance with legislation, which has been encouraged by the grassroots approach.
The BC Injury Prevention Centre was started in 1987 as the Spinal Cord Injury Prevention Program because of our concern about the avoidable spinal-cord injuries we treated. The centre's strategies for prevention include research, education, legislation and enforcement. Legislation needs to be at the federal and provincial level. However, the field of injury prevention has been burgeoning in popularity and needs a measure of coalition and confederation. The multiplicity of injury-prevention bodies reflects an interest at the grassroots level that may not result in enhanced effectiveness.
We therefore suggest that a federal agency be responsible for ensuring standards, as Pless outlines in his editorial. National organizations such as the Smart Risk Foundation (formerly the Canadian Injury Prevention Foundation) may be best employed in providing common curricula and materials that can be used in all of the provinces. Provincial government agencies such as the BC Committee for Injury Prevention may be best suited to linking the legislation and enforcement at a provincial level with the implementation groups. Groups such as ours are best able to support local bodies such as schools or organizers of events that need presentation materials and supportive speakers. We can also monitor injury trends because we work within a major trauma centre, and we may therefore be the best group to prepare public service announcements to enhance social awareness of the need for injury prevention.
Peter C. Wing, MB, MSc
Medical Director
BC Injury Prevention Centre
Director, Spine Program
Vancouver Hospital and Health Sciences Centre
Mary Ellen Lower
Director of Programs and Development
BC Injury Prevention Centre
Vancouver, BC
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