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Abstract
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BACKGROUND: In Israel, as in other developed
countries, injuries are a leading cause of death and disabilities among children
and youth between 1-19 years of age and the leading cause for Potential Years of
Life Lost up to 65 years of age. In 1997, 225 children died as a result of
accidental injuries, compared to 151 cases of death due to other internal
causes. The most prevalent cause of death being motor vehicle accidents, rating
3:100,000: drowning--1:100,000 and falls, burns, suffocation and
poisonings--less than 1:100,000 each. Mortality rates are just the tip of the
iceberg, the most extreme outcome of an injury. Hospitalization rates and
emergency room visits are higher. Injury was the cause for one out of 3 children
to visit the emergency department. Hence, in 2001, there were 187,531 visits due
to trauma, an annual rate of 712:10,000. The hospitalization rate due to
injuries was 67:10,000 and the mortality rate was 8:100,000. Injuries in the
community: Data concerning injuries in the community are relatively rare since
no surveillance system exist. In their article "Childhood injuries in
northern Israel--prevalence and risk factors", Miron at al. describe the
prevalence, demographic variables and risk factors of injuries in the community
of northern Israel. The article contributes to our knowledge of accidental
injuries at the level of the primary care physician in the community. The
findings indicate that falls and blows are the most common causes for mild
injuries that usually occur in the home and backyard, and Arab children are at
special risk for injuries, in general, and falls, in particular. These findings
are consistent with existing data. Prevention is the way: 71-95% of all injuries
can be prevented by simple means. This has been proven in many countries that
managed to reduce mortality from accidental injuries by 10-20%. In the U.S.A.,
for example, the percentage was reduced to about 35% in a decade. In Sweden, 3
decades of constant preventive efforts combined with close monitoring of the
data have proven effective in reducing rate of mortality due to accidental
injuries in children by 80%. The strategies which have proven to be effective
are education and publicity, safer products and surroundings, promoting public
policy, enforcement, data collection, research and evaluation and empowerment. A
combination of strategies is most effective. National Vision: Despite the dismal
picture, accidental injuries in children can be prevented and are not
inevitable. It is wise to look at injuries as a heterogeneous group of
illnesses, with different etiology, risk groups, and 'preventive
treatments'--a group of diseases which are all preventable. It is very
important that a national strategy for child safety be established accompanied
by an adequate budget. Above all, it requires a lot of faith and commitment for
the only vision: making the world a safer place for children. |