Injury prevention

Injury prevention is an effort to prevent or reduce the severity of bodily injuries caused by external mechanisms, such as accidents, before they occur. Injury prevention is a component of safety and public health, and its goal is to improve the health of the population by preventing injuries and hence improving quality of life. Among laypersons, the term "accidental injury" is often used. However, "accidental" implies the causes of injuries are random in nature.. Researchers use the term "unintentional injury" to refer to injuries that are nonvolitional but preventable. Within the field of public health, efforts are also made to prevent or reduce "intentional injury." Data from the U.S. Centers for Disease Control, for example, show unintentional injuries are the leading cause of death from early childhood until middle adulthood. During these years, unintentional injuries account for more deaths than the next nine leading causes of death combined.

Injury prevention strategies cover a variety of approaches, many of which are classified as falling under the “3 E’s” of injury prevention: education, engineering modifications, and enforcement/enactment. Some organizations, such as Safe Kids Worldwide, have expanded the list to six E’s adding: evaluation, economic incentives and empowerment.

Measuring effectiveness
Research in is challenging, because the usual outcome of interest is deaths or injuries prevented, and it is nearly impossible to measure how many people did not get hurt who otherwise would have. Education efforts can be measured by changes in knowledge, attitudes, beliefs and behaviors, before and after the intervention, however tying these changes back into reductions in morbidity and mortality is often problematic.

Examining trends in morbidity and mortality in the population is usually not difficult and may provide some indication of the effectiveness of injury prevention interventions. However, this approach suffers from the potential of ecological fallacy, where the data shows an association between an intervention and a change in the outcome, but there is actually no causal relationship.

Traffic and automobile safety
Traffic safety and automobile safety are a major component of injury prevention because it is the leading cause of death for children and young adults into their mid 30’s. Injury prevention efforts began in the early 1960s when activist Ralph Nader, exposed the automobiles as being more dangerous than necessary with his book Unsafe at Any Speed. This led to engineering changes in the way cars are designed to allow for more crush space between the vehicle and the occupant.

Engineering: vehicle crash worthiness, seat belts, airbags, locking seat belts for child seats.

Education: promote seat belt use, discourage impaired driving, promote child safety seats.

Enforcement and enactment: passage and enforcement of primary seat belt laws, speed limits, impaired driving enforcement.

Pedestrian safety
Pedestrian safety is the focus of both epidemiological and psychological injury prevention research. Epidemiological studies typically focus on causes external to the individual such as traffic density, access to safe walking areas, socioeconomic status, injury rates, legislation for safety (e.g., traffic fines), or even the shape of vehicles which affects the severity of injuries resulting from a collision. Epidemiological data show children aged 1–4 are at greatest risk for injury in driveway and sidewalks. Children aged 5–14 are at greatest risk while attempting to cross streets.

The body of psychological research on pedestrian safety is currently much smaller than that in the epidemiological field, but is rapidly growing. Psychological pedestrian safety studies extend as far back as the mid-1980s when researchers began examining behavioral variables in children. Behavioral variables of interest include selection of crossing gaps in traffic, attention to traffic, the number of near hits or actual hits, or the routes children chose when crossing multiple streets such as while walking to school. Behavioral studies often collect such variables which imply risk of injury; e.g., children engaging in risky behaviors may be assumed to be at greater risk if actually crossing a street alone. The most common technique used in behavioral pedestrian research is the pretend road, in which a child stands some distance from the curb and watches traffic on the real road. The child then walks to the edge of the street when a crossing opportunity is chosen. Research is gradually shifting to more ecologically valid virtual reality techniques. Leading scientists in psychological pedestrian safety research are Dr. Benjamin Barton, Dr. David Schwebel and Dr. James Thomson.

Other
The following is an abbreviated topic list of some common focus areas of injury prevention efforts:
 * Bicycle safety
 * Boat and water safety
 * Child passenger safety
 * Consumer product safety
 * Firearm safety
 * Fire and burn safety
 * Home safety
 * Impaired driving
 * Pedestrian safety
 * Poison control
 * Toy safety
 * Traffic safety
 * Sports injury safety
 * Occupational safety and health