advances in the epidemiology

7/25/2019 Advances in the Epidemiology

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ADVANCES IN THE EPIDEMIOLOGY

OF INJURIES

AS A BASIS FOR PUBLIC POLICYBy Dr. William Haddon, Jr., MD, MPH

Public Health Reports, Vol. 95, eptember! "ctober #9$%, pp. #!&'#.

(his article )*d+ances in the epidemioloy o- inuries as a basis -or public policy/has been published in Journal 0andmar1s in *merican 2pidemioloy by Public HealthReports3hich is a o4cial ournal o- the .. Public health er+ice. (his paper hasbeen 3ritten by Dr. William Haddon Jr. 3ho 3as a leader in hih3ay accidentresearch since #969 o- the 7nsurance 7nstitute -or Hih3ay a-ety and 3as the 8rst-ederal Hih3ay a-ety hie-. Paper hihlihts the importance o- inury control asthat has been hampered by the -ailure due to proper reconition o- inuries aentsas +ehicle and +ectors.

(he paper has been 3ritten 1eepin in mind that the readers are pro-essionals and

policy ma1ers -rom di:erent 8elds and thus author completely describes the paper

in +ery ob+ious and simple manner based on his researches that inuries cannot

occur 3ithout the action o- a speci8c aent li1e those o- in-ectious diseases and he

denote the +ehicles as aents -or inury in a particular crash. He de8nes inury as a

disease that results -rom an acute e;posure o- the human body to trans-er o-

enery -rom the en+ironment around it in a +ery short time and speci8es the time

as &$ hours or less. He hihlihts the -act that se+eral measures has been ta1en by

societies to deal 3ith all types o- en+ironmental ha


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en+ironmental conditions pre+ailin at that time 3ithout sho3in any resistance to

the conditions.

7t is said that Pre+ention is better than cure. 7n transportation sa-ety, it has been

documented in paper that i- se+eral sa-ety measures has been ta1en in the desin

o- +ehicles many o- the -atalities could ha+e been reduced i- the +ehicle had been

desined to pro+ide proper crash pac1ain to the occupants o- the +ehicle ashumans ha+e certain amount o- ability to trans-orm the mechanical enery 3ithout

-atal inuries and can sustain aainst the impact o- a particular inury o- lo3er

impact on human body.

7nuries and diseases can be understood as same thin 3ith aents 3ith di:erence

that inuries are those 1ind o- damae to body 3hich are produced and re?ected

3ithin &$ hours o- contact o- an aent and trans-er o- enery or e+en a shorter

period 3hereas disease ta1e much more loner time o- e;posure o- an aent. 7t can

be understood by hih speed cameras 3hich captures in +ery hih rane li1e o-

about '%%%% -rames per second and 3hen seen in slo3 motion o- about '%!@%

-rames per sec, it is clearly seen and identi-y the aent o- particular inury and

that>s the 3ay adopted by 7nsurance institute o- Hih3ay a-ety to sho3 to people

-or a clear understandin amon people o- di:erent understandins.

*uthor has prepared a matri; named as Haddon matri; -or pre+ention o- crashes by

identi-yin role o- human, +ector and en+ironment. He has identi8ed the measures

to be ta1en under three heads i.e pre crash, crash and post!crash and listed certain

counter measures to be ta1en under each head -or the sa-ety o- indi+iduals to

lessen the conse=uences o- particular inuries but some o- them are such that they

can not be promoted in the public to adopt li1e 3earin o- helmet by pedestrians

may reduce about 5%A o- -atalities durin crash but cannot be 3idely accepted by

the public and policy ma1ers 3ill be denoted as -ools by the +ulnerable public and

3ill be demoti+ated by e+en the most educated persons.

*uthor has listed #% strateies to counter the occurrence o- inury by ta1in se+eral

e:ecti+e measures to reduce the occurrence. (hese can be adopted to sa-euard

aainst inuries. ome statistical numbers could be used to support the strateies as

the paper has been published 3ith the moti+e to promote the reduction o- inuries

and is intended to be read by the +arious pro-essionals and policy ma1ers 3hich can

help in implementin the strateies i- they are supported by the numbers o- inuries

reduced.

Motor +ehicle manu-acturer>s i+e emphasis on that it>s the responsibility o- an

indi+idual amon the public to be sa-e and ta1in steps to reduce inury but policy

ma1ers should ma1e la3s to -ocus on the responsibility o- the manu-acturer>s o-+ehicle to adopt the desin o- +ehicle in such a 3ay that occupant o- that +ehicle is

sa-e ta1in sa-ety as the 8rst concern. (here are certain thins that sho3s that

there is some ?a3 in a system li1e that i- roads are desined -or bein runnin

ma;imum at #%% 1ms per hour than 3hy the +ehicle manu-acturer>s pro+ide the

ma; speed o- e+en '%% 1ms per hour in +ehicles promotin the public to dri+e -ast

and ot inured and e+en leadin to -atalities most o- the time 3ith a probability o-

bein an -atality o- $%A i- not dri+in at the posted speed.


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(he la3s should be such that emphasis should be i+en on the inury control by

ma1in desins o- roads, +ehicles sa-er and not hopin that the public 3ill be

responsible -or its o3n sa-ety -or use o- +ehicle. 7t has been seen that education o-

usersdri+ers don>t 3or1 as i- the dri+ers are i+en an opportunity by +ehicle

manu-acturers to dri+e at '%% 1mhour, they 3ill certainly try to do that 3ithout

thin1in o- the conse=uences and thus measures should be ta1en as such that users

are less +ulnerable to inury caused by +ehicles.

With the e:ecti+e emphasision o- the author on the inored topic o- inury, it is

e;pected that certain stress is to be i+en on ta1in pre+enti+e measures o- inuries

also alon 3ith diseases and try to reduce the e:ect o- aent and promote sa-ety

amon the public by adoptin some methodoloies and issuin uidelines -or

enerali

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