Injury prevention

In the previous Module, you have been introduced to the various frameworks and models that are commonly used to understand injuries and their risk factors. In this topic, we shall apply an appropriate one to look into risk factors, taking road traffic injuries as an example. Start exploring this topic by looking at the analysis of risk factors of road traffic injuries developed by the WHO. This is the key resource for this topic (and is downloaded from the WHO Road safety training manual website).

As you read, think of the extent to which each of the risk factors may apply to your local setting.

As you will note after going over this resource, there are so many factors that are characterized as ‘risk factors." The usual purpose of understanding any risk factor is to identify how to modify it with an intervention. This brings us to the concept of modifiability. As you go over those many risk factors, ask yourself whether it is a modifiable one and if it is not modifiable, why does it matter to know it anyway? The commentary by Cameron - Time for a Paradigm Shift in Conceptualizing Risk Factors in Sports Injury Research can help you understand these concepts and answer these questions. Although this paper discusses these concepts in the context of sports injuries, the ideas are transferable to the context of road traffic injuries.

In Unalterable host factors? A social epidemiologist's view of the Haddon matrix, Lu goes further into the concept of modifiability. Lu presents a challenging view of how we think about non-modifiable risk factors, arguing that modifiability depends on our point of view: “Many host factors that have been defined as 'unalterable' from the biological or clinical point of view might actually be 'alterable' from a sociological or cultural point of view”. While you read this paper, try to apply Lu’s view to the seemingly non-modifiable risk factors that you encounter in your reading on the risk factors of road traffic injuries; again, although Lu’s paper discusses pesticide poisoning in response to another paper on that type of injury, the ideas presented should be applicable to the risk factors of any other injury.

Falls and violence: Although our main focus in this topic is on the risk factors of road traffic injury, we encourage you to explore the literature on the risk factors of other causes of injury, e.g. falls and violence. The WHO had produced a multitude of ‘World Reports’ that also include summaries of the risk factors for various injuries - e.g. WHO Global Report on Falls Prevention in Older Age. If you go to the WHO Violence and Injury Prevention webpage, you can navigate through the various injury mechanisms on the left-hand panel and locate those world reports and other useful resources in the specific pages for those mechanisms.

Drowning: While thinking about other injuries, let's not forget drowning. Here are some headline facts from the World Health Organisation fact sheet on drowning:

• Drowning is the 3rd-leading cause of unintentional injury death worldwide, accounting for 7% of all injury-related deaths.
• There are an estimated 360 000 annual drowning deaths worldwide.
• Global estimates may significantly underestimate the actual public health problem related to drowning.
• Children, males and individuals with increased access to water are most at risk of drowning.

Further:

• Low- and middle-income countries account for over 90% of unintentional drowning deaths.
• Over half of the world's drowning occurs in the WHO Western Pacific Region and WHO South-East Asia Region
• Drowning death rates are highest in the WHO African Region, and are 15-20 times higher than those seen in Germany or the United Kingdom, respectively

This article will provide more information on the risk of injury due to substance use, with emphasis on the consumption of alcohol alone or in combination with other drugs. Read the content under the headings "Abstract," "Introduction," and "Discussion."