Health Matters

Health Matters

By Virginia Lester,
RN, MSN, ARNP

Injuries have been the leading case of death for infants, children and young adults since the mid 1940s. This article will be confined to ages of up to 24 years old.

Unintentional injuries are the leading cause of death and disability for this age group. More than 20,800 deaths were attributed to unintentional injuries in the year 2004. These injuries appear to peak during the toddler years (ages one to four) and again during the ages of 15 to 24. The primary mechanisms or causes of injury are dependent on the chronological age and developmental age of the child.

Each year more than 14 million children in this country sustain serious enough injury to require medical attention. Unintentional falls are the leading nonfatal cause of injury for children who are treated in emergency rooms throughout the country. The second most frequent cause of emergency room visits is being struck by or against an object. 

All of these numbers obviously translate into a burden to society beyond the heartbreak, emotional trauma and pain inflicted on the patients and families. Researchers at CDC have estimated the lifetime cost of unintentional injury for children age 12 and younger to be nearly $50 billion. This figure is broken down even more to estimate the direct medical costs to be more than $11.9 billion and future earnings to be more than $38.7 billion dollars. 
Historically, the trends directed toward controlling injury in this same age group (12 and younger) have accounted for a decline of 45 percent from 1987 to 2002 in the U. S. This reduction in mortality can be attributed to the increased use of seat belts and child safety seats, the reduction in drunken driving accidents, the increased use of child-resistant packaging, better safety awareness and improved medical care. 

The age of the child appears to be the best predictor of the risk for injury and the type of injury that may occur. Infants are more likely to have a fatal injury caused by suffocation (66 percent of deaths) followed by falls, motor vehicle crashes and burns.   Infants should be placed on their back for sleep, a firm bed and mattress should be safe and not allow the head to be wedged which can cause respiratory obstruction, avoid improper sleeping attire which may cause strangulation.

Falls from second story windows and down stairs can be prevented by guards. Toddlers and preschool children are more likely to be seriously injured or die because of motor vehicle collisions (both as an occupant and as a pedestrian), drowning, fires and burns, suffocation, falls and poisonings. Children in this age group have not developed the motor skills to maneuver or the mental maturity to recognize common safety hazards. Therefore extra attention must be devoted to child monitoring and education for safety and prevention.

School-aged children are more likely to engage in risk-taking behaviors that can lead to pedestrian injuries, bicycle injuries, drowning and unintentional firearm injuries, however motor vehicle occupant injury continues to be the most significant injury for this age group. Adolescents are most prone to motor vehicle injuries but are also at risk for poisonings, drowning, firearm injuries, falls, burns and intentional injury. 

In 1986, the U.S. Congress passed the Injury Prevention Act and in l992 funded the National Center for Injury Prevention and Control (NCIPC). This agency works with other federal agencies and funds research for injury prevention.

This legislation spawned the development of a new field of research for injury prevention.  Concepts for preventive measures developed by research provided the realization that 90 percent of injuries can be predicted and prevented. Some of these concepts included recommendations for:

• Temperature reduction of hot water heaters
• Trigger locks to prevent accidental discharge of firearms
• Reduction of the slope of ski trails
• Construction of bike paths and pedestrian sidewalks
• Helmets and safety glasses for protection during sports and related dangerous activities
• Creation of softer playground surfaces
• Installation and maintenance of smoke detectors in homes
State and federal legislatures both have found that injury prevention brought about by legislation is more effective than education alone. Planning, careful observation, vigilant adult supervision and thoughtful evaluation of our surroundings and hazards may be the strongest preventive tool of all. 
I am sure that all of these statistics and safety suggestions are not new to any of us.  Reminders and further study can only help to make this a safer place for our youth to live so they may have the opportunity to realize their dreams. 
The following web sites may be helpful for more specific, age related information:
• National Center for Injury Prevention
and Control – www.cdc.gov/ncipc
• U.S. Consumer product Safety Commis sion –www.cpsc.gov
• National Safety Council –www.nsc.org