| Saving Lives: Our Healthier Nation | ||||
|
7 Saving lives: accidents Target: to reduce the death rates from accidents by at least one fifth and to reduce the rate of serious injury from accidents by at least one tenth by 2010 - saving up to 12,000 lives in total 7.1 Accidents are responsible for 10,000 deaths a year across England. Accidental injury heads the league tables of causes of death among children and young people in England, Europe and America. It puts more children in hospital than any other cause. Accidental injury has in the past been one of the most neglected areas for preventive action, the commissioning of research and the education and training of health professionals. 'Accidental injury
puts more children in hospital than any How do we compare? 7.2 We have lower death rates from road accidents in this country than in most other European countries. We have seen substantial falls in the rate of children killed in accidents over the last 25 years. In our drive for a healthier nation, these and similar figures are encouraging. Fig 7.1 Death from motor vehicle traffic accidents:England performs comparatively well Fig 7.2 Death rates from all accidents in children 7.3 But in other areas the record is less good. Rates of death in childhood from pedestrian accidents in this country are amongst the highest in Europe. And, as children grow up, deaths from accidental injury account for a greater proportion of all childhood deaths. Among older people the rate of deaths from falls is not coming down. There are also substantial differences in deaths from accidents across the United Kingdom. For example, road accidents and serious injuries are more severe on our rural roads than in other areas. Fig 7.3 Child pedestrian deaths: England one of the worst records in Europe Fig 7.4 Accidents kill proportionately more children as they grow up Fig 7.5 Deaths from accidental falls in older people are not reducing 'road accidents and
serious injuries are more severe Causes 7.4 Road traffic accidents are a principal cause of accidental death and injury. Across the whole population in 1997, 3,559 people were killed, 42,967 were seriously injured and 280,978 were slightly injured in road traffic accidents. Every year 1,500 car drivers and adult passengers die in road accidents and one hundred times that number are injured. And every year 1,000 or so adult pedestrians and cyclists are killed and 40,000 are injured. Motorcyclists are at the highest risk of all. In 1997 for every 100 million kilometres travelled, 150 motorcyclists were killed or seriously injured compared with 89 cyclists and 4 car drivers. 7.5 Families can be destroyed by the loss of parents and breadwinners. But children's deaths are the most tragic waste of life. Despite the improvements, road traffic accidents remain the biggest single cause of accidental death amongst children and young people. Each year in England nearly 180 children die and almost 4,800 are injured as pedestrians or cyclists. Many are killed when playing or walking close to their own homes. Added to this are the 215 deaths and 2,690 or more serious injuries to children riding as car passengers. Fig 7.6 Childhood accident deaths involving head injury occur close to home 7.6 Older people are at particular risk of death and disability from falls. Osteoporosis (brittle bones) affects more people, especially women, as they grow older and can be a cause of accidents and contribute to the severity of those accidents. Broken wrists and hips become more likely and can mean lengthy hospital stays, creating long term health and social care needs for the individual. 'The younger the
child, the greater the risk''give greater 7.7 One third of all accidents to adults occur in the home. Many are linked with people falling or stumbling in the home. Over 3,000 people aged over 65 years are killed annually in falls. The home is also the setting for many serious accidents to children from a variety of causes: fires, burns, drowning, choking, poisoning and cuts from sharp objects. The younger the child, the greater the risk. About half of all deaths among children under 5 happen in the home. 7.8 Some occupations expose employees to greater potential risks than others. Those risks may take different forms. Some may be linked to the work environment, such as mining or quarrying, or with work processes such as those involving poisonous substances. Others are associated with a failure to manage risk, such as falls from a height or from moving vehicles, in the construction industry, for example. Controls for risks are covered in legislation and enforced by the Health and Safety Executive and local authorities. Over decades the number of accidents in these areas has fallen markedly. But there were still nearly 140 fatal accidents in the construction industry and agriculture combined in 1997-8. The Self-Reported Work-Related Illness Survey for1995 concluded that about 2 million people suffered from ill-health either caused or made worse by their work. 7.9 People use their leisure time in a whole variety of ways. Many choose to be physically active, which helps them to reduce the risk of coronary heart disease. Yet these activities also bring some risk of accidental injury. Every year about 800,000 people are injured while playing sport, 215,000 of them children. Action: reducing risk and staying healthy 7.10 We can all do a great deal to contain these risks of accidental injury. Sometimes it is a matter of taking simple precautions, such as remembering to wear a seatbelt. Sometimes it is a question of a better product design or the development of better controls. 7.11 We will reduce accidents by making the environment safer. We will reduce road traffic accidents through more careful planning of traffic flows; through traffic calming measures; by an effective speed management policy; and through encouraging the design of vehicles in ways which offer better protection not just to the occupants but also to others involved in collisions. We will do more to improve conditions and give greater priority to pedestrians and cyclists, including by designing safer routes to school through school travel plans. We will make sure our traffic management policies are best suited to their locations, whether urban or rural. The forthcoming Road Safety Strategy will set out in detail how we will make our roads safer. Fig 7.7 Traffic calming can cut pedestrian raod accidents 7.12 Careful design is important to minimise the risk of accidents in the home. For new homes, Building Regulations set standards for the design of the main features associated with accidents. These include stairs, balconies and the use of safety glass in doors and low-level windows. 7.13 In the playground accidents could be reduced through more careful equipment design, the use of soft materials as flooring, and more supervision.
7.15 We can also reduce accidents through safer behaviour. Road safety training has long been a feature of childhood, and there is evidence that training parents and children together is particularly effective. We have introduced a practical training manual for children called Kerbcraft, based on a successful road safety education scheme run originally in Drumchapel in Glasgow. 7.16 All of us can play a role in improving safety for other road users by driving safely, following the Highway Code. Cyclists can reduce risks to themselves by using safe cycle routes where they exist, and by taking part in cycling skills training courses. 7.17 Many parents discourage their children from walking and cycling precisely because they are worried about the dangers from traffic. But in using private cars more we are restricting not only children's physical well-being but also their social development. Unless they have the chance to learn early on how to make decisions for themselves, children may eventually be at more risk on the roads and in other public places. Our Safer Travel to School initiative will encourage more children to walk or cycle to school. 7.18 Many accidents in the home can be prevented
by taking simple precautions. The Department of Trade and Industry is
conducting a three-year campaign targeted at older people, their families
and carers setting out a few simple and practical steps which will help
to prevent falls in the home - the biggest cause of accidental deaths
in the home, and one which affects millions of people. The Department
of Trade and Industry is also actively promoting safety advice on a
range of other home safety topics, including gardening, carbon monoxide
poisoning and burns 7.19 We can encourage people to adopt safer behaviour which makes injury less likely by increasing awareness of the causes of accidents in the home, in leisure, and in the workplace; and what can be done to make them safer. For example, when the Department of Trade and Industry ran its campaign on firework safety in 1998, focusing on sparkler safety, injuries from sparklers dropped by 36 per cent. 7.20 Safety protection is another effective way of preventing accidental injury. Seat belts and child restraints have been shown to be effective in reducing deaths and the severity of injuries to occupants of road vehicles. Cycle helmets have been shown to reduce the risk of head injuries among cyclists by as much as 85 per cent. Smoke alarms have been shown to reduce the number of deaths and injuries from fires significantly. One recent study estimated that an 80 per cent reduction was achieved in the incidence of injuries from residential fires. People can make their enjoyment of sport freer of injuries by taking simple precautions suitable to the sport. Action: more effective treatment 7.21 To improve treatment for those who suffer accidental injury there must be fast, effective action at all levels from the time the injury occurs to the initial diagnosis and treatment and to the after-care. The physical and psychological injuries caused by accidents will be considered within the National Service Framework for Older People. 7.22 We have seen in the past the ways in which the sequence of events in response to accidental injury has been broken. Examples of ambulances failing to arrive in the critical time after a serious accident. Examples of children with serious injury lying too long in a local hospital whilst a bed is found in a specialist centre. Examples of failures to draw up good care plans leading to people with head injury not reaching their full recovery potential. These are the exceptions. But they must not be allowed to happen. 'frontline ambulances now have a fully qualified paramedic' 7.23 Frontline ambulances responding to 999 calls now have a fully qualified paramedic as well as a trained technician. Their training includes basic and advanced life support as well as a range of interventions which may be needed by people injured in accidents. Recent work indicates that patients cared for by paramedics recover better than patients who are not. 7.24 Following the 1997 Report Paediatric Intensive Care: A Framework for the Future, the Government has invested an additional £20 million in children's intensive care to ensure that critically ill children - for example, those suffering from head injury, burns or poisoning - can be swiftly transferred to a specialised centre accompanied by specially trained doctors and nurses. This aims to avoid past tragedies where staff and facilities were not available for such emergencies. 7.25 We are developing policies designed to ensure prompt and effective rehabilitation, treatment and care, to maximise people's recovery from accidental injury. Integrated action 7.26 In our fight against accidental injury we can be successful only if everyone recognises that:
7.27 Besides this, our Healthy Citizens programme will help to minimise the effects of accidents through our Health Skills programme for 14 _16 year-olds and for adults. 7.28 We will set up a high-level Task Force, accountable to the Chief Medical Officer, to oversee the first year of implementation of the contract to ensure that the essential groundwork is undertaken to set us on course for achieving the target. We will identify a person of national prominence to act as its champion, whose function will be to build and maintain momentum for action, to communicate the purpose of the contract and to engage people in it. 7.29 We will use the Public Health Development Fund to support the achievement of our target for accidental injury. Fig 7.8 Ways of beating accidental injury: examples of how everyone can play their part
| ||||
7.14 Drownings
in canals, rivers, ponds and swimming pools could be reduced through
the use of barriers which restrict access, through more teaching of
swimming and through more adult supervision.
