Safe Community Sande Name of the Community: Sande i Vestfold Country: Norway Number of inhabitants in the community: 8,700 citizens Safe Community Programme started year: 2008 International Safe Communities Network Membership: Designation year: 2013 Name of the Certifying Centre: European Certifying Centre Application: http://www.ki.se/csp/pdf/application_a/sande_2013.pdf

For further information contact: Name: Anne Sofie Lauritsen Institution: Sande kommune Address: Postboks 300 Zip code: 3070 Municipality/ City: Sande Country: Norway Phone: +47 33787000 E-mail: postmottak@sande-ve.kommune.no www.sande-ve.kommune.no The programme covers the following safety promotion activities: For the age group 0-14 years Home

x Safety at homes with infants (Home visits program) x “Good rising of children” –regional project, collaboration home-kindergarten- school

Kindergarten x Sea safety, King crabs

x Photo: NJB kindergarten. Sea safety project for the «King crabs»

School

x Anti Bulling program MOT and Zippys friends and “This is my choice” x Sea safety day x Mini Anne First aid training for children x Fire safety program in collaboration with the fire brigade

Children 0-14 years:

Photo Sande News Paper Jorunn Stokke. Pictures above from the Sea safety day 2012

Leisure x Safe playgrounds/community greens

Traffic

x Cycle skills day

x Traffic: Bicycle helmets. “Cycle skills day “ at Haga primary school.

Photo Svein Ivar Pedersen, Sande News Paper.

x Secure stopping points for busses at the schools Example Selvik School:

x Tarkus safe traffic training program for children x Focus on traffic safety for different age groups as a part of the teaching program. x The national “Cats eye” day. Focus on the use of reflectors to improve visibility in dark for pedestrians. x School- patrol ensuring safe road crossing for the young students x Swimming training program

Evidence-based strategies: The work in the community is in line with the national strategy for the prevention of accidents and injuries 2009-2014.Work has been initiated on the basis of national statistics and research reports and supplemented by local records when possible. (http://www.who.int/mediacentre/factsheets/fs349/en/index.html)

Youth 15-24 years: Traffic:

x Speak out – traffic safety campaign for high school students. The program focus on Visibility, Alcohol non use,

Speed limit, Seat belts

School: x MOT –program for enforcing the students’ self-esteem and prevent bullying. x UNIQUE –Youth competence building for students in need of a practical educational opportunity. x The program “Good childhood” Training program for staff and professionals who meet children and adolescents.

The aim is to be able to intervene as early as possible if needed, to secure the health and wellbeing for a child or adolescent.

x SLT, violence and substance abuse prevention program. x Ung data –A survey conducted I junior and senior high for all the municipals in the region. The aim is to map the

conditions for childhood and adolescences, like belief in the future, use of substances etc. x “young girls” Conversation groups for young girls in secondary school. The aim is coping with life and own

limits. x The world mental health day” a program in junior and senior high.

Leisure: x “The yellow house” different activities after school.

Evidence-based strategies: http://www.who.int/substance_abuse/publications/global_alcohol_report/msbgsreur.pdf. . (http://www.proba.no/files/2013/04/Rapport-2011-05-Evaluering-av-MOT-i-ungdomsskolen-Sluttrapport.pdf) Adults 25-64 years: Traffic:

x Focus on road safety especial for pedestrians and cyclists by building of cycling and pedestrian paths. x Report service at the municipals homepage about faults and dangers in roads and public places. http://www.sande-

ve.kommune.no/no/Meld-fra/Meldfra/

Occupational:

x Road safety course for employees using vehicles in municipal work. x Regular first aid course for all staff in schools and kindergarten and other municipal employees. x Occupational health service available for all employees in municipal administration. x Program for safety promotion and preventing accidents related to the agriculture sector.

Other:

x Municipal volunteer bureau, collaboration with NGO`s, municipal administration and volunteers in conducting health promoting activities.

x Courses in “Psychological first aide” – a preparation in how to meet people in crisis. x “World mental health day” for all citizens. x “The meeting place” various activities connected to the “Yellow house” for people in a difficult situation in life.

Evidence-based strategies: The work in the community is in line with the national strategy for the prevention of accidents and injuries 2009-2014.Work has been initiated on the basis of national statistics and research reports and supplemented by local records when possible. http://www.arbeidstilsynet.no/artikkel.html?tid=227601 Elderly 65+ years:

x Fall Prevention for people over 65 years living at home. x Sand bucket project, delivering sand buckets to use on slippery courtyards for elderly people living at home. x Preventive home visits for people more than 75 years old. x Balance training group. x “Drop in” training facilities 2 times a week for seniors to maintain and increase level of function. x Sandetun activity centre for elderly people, providing seminars (fire an accident preventing) ,social meetings,

different activities, tours and so forth. x “Good life” groups for senior people to promote them to take care of own health and quality of life by influencing

habits and patterns of everyday life and to prevent loneliness. x Senior dance is a group with 55 members more than 55 years old (mostly more than 65) meting once a week with

the purpose to keep physically fit and socialize with others.

Evidence-based strategies: The work in the community is in line with the national strategy for the prevention of accidents and injuries 2009-2014.Work has been initiated on the basis of national statistics and research reports and supplemented by local records when possible. (http://www.acc.co.nz/PRD_EXT_CSMP/groups/external_providers/documents/publications_promotion/prd_ctrb118334.pdf)The Ortago program

Various Environments

Traffic – Prevention of injuries in traffic The Norwegian road authority (Statens vegvesen) keep a very god record an very accurate statistics of road accidents wich is available for the municipal and they make annual reports. They also conduct researches considering different matters due to traffic and preventive work. (http://www.vegvesen.no/Fag/Fokusomrader/Forskning+og+utvikling)

The left column represent accidents and the right represent number of persons killed. The red column is after the new Highway and the blue before. The reduction in killed and seriously injured in traffic for the new E 18 is 86%. Norwegian Public Roads Administration prepares reports with statistics and maps where injuries and accidents occurred. The latest report concerning injuries in the community represent the years 2008 to 20011. The statistics show a positive trend. The material used by municipal technical agency is based on the traffic safety plan and rotation of the road safety plan. Despite the decline of serious injuries and accidents prevention continue.

Si-fra (Speak out) This program is aimed to prevent hazardous driving amongst adolescents and is used at Sande highschool. It has been evaluated by SINTEF . The main result shows that pupils who have attended to the meetings at the school more often share their opinions and attitude towards hazardous driving and drug abuse while driving and the statistics shows positive results. The severe accidents among adolescents have decreased. http://www.sintef.no/upload/Teknologi_og_samfunn/Veg%20og%20samferdsel/Rapporter/A3827_Evaluering%20av%20kampanjen%20Sei%20ifra%20i%20Vestfold%20og%20Aust-%20og%20Vest%20Agder.pdf Traffic safety in schools Target group: Students 6-14 years, teachers and parents at primary schools Goal: Secure stopping points for bus Bus stops are upgraded and placed on the same side of the road as the school, regardless of direction like in Selvik. Haga and Bjerkøy schools. Haga school have made improvements that have increased the general safety of pedestrians.

Accidents and persons killed on the E 18 8 years before and 8 years after the new Highway

1) 2) 3) The sketches show Selvik primary school as an example of the development to improve the traffic safety. 1)The sketch at the left shows the situation before 2001. There were a bus stop at each side of the road and the children had to cross this heavily trafficked road.2) The sketch in the middle show the situation of today. The busses deliver the children so they do not have to cross the road, but there are some parking spaces there and some traffic during opening and closing time of the school. The sketch 3) on the right shows the situation to be in 2014/2015 when the rehabilitation of the school is finished. Then there will be no mingle with other traffic and cars cannot stop when they deliver children. Even further in the future it will be considered to set up the delivery point further away from the school premises.

Picture of the situation today at Selvik primary school. Voluntary bureau and collaboration with NGO In the municipal and public health plan it is described that voluntary center which was founded in 2008, is a coordinator between the NGOs and the local authority for communications in connection with projects that are

either initiated by the municipality or by the organizations. The municipality has about 100 NGOs. Female farmers (Bondekvinnelaget), Sande Health Association, and LHL (Association for Heart and Lung) is particularly active in preventive work in the community. Associations collaborating on some events like the commemoration of World Mental Health Day. The associations often take initiatives towards the volunteer bureau and the public health coordinator. The municipality will assist in convening meetings, participate and coordinate meetings and activities when necessary and assist with meeting facilities. Some of the projects the volunteer bureau have been involved in is:

x Sand Bucket Project: Voluntary pensioners use their private cars to take students from Small job central (UNIQUE students who attend alternative education) to supply sand buckets to people 70 years ore more. Sande voluntarily central supply address lists and contacts volunteer drivers. The municipality is responsible for the sand. The operation is advertised in the newspaper so that people not in the target group who want to get sand can contact the center.

x Småjobb sentralen (Odd jobbs) Youth from the Unique program conducts odd jobs like painting, gardening, shoveling snow for elderly people. The Bureau is the contact between the Youths and the eldery and organize the work.

x Health promoting activities for refugees. x Sea safety

The volunteer bureau help out to conduct the sea safety day together with the police, the firebrigade and Red Cross is represented, as well as

Fall Prevention for people over 65 years living at home. We have reliable national statistics on the matter of hip fractures among elderly people at the NPR register (Norwegian national register and injuries) and there are good evidence based research which support the significant of working with preventive programs for elderly people at risk. These data are used in our work to reduce accidents (http://www.acc.co.nz/PRD_EXT_CSMP/groups/external_providers/documents/publications_promotion/prd_ctrb118334.pdf) Some facts: x Every 3. home resident elderly over age 65 and 40-50% of those over 75 years fall at least once annually

(Skelton D, Todd c. Interventions to prevent accidential falls among older people. 1-28.2004. School of Nursing, Midwifery and Health Visiting, University of Manchester, Prevention of Falls Network Europe, HEN/WHO Document. http://www.euro.who.int/__data/assets/pdf_file/0018/74700/E82552.pdf)

x 10-20% of the falls require treatment in hospital (Pettersen R,: Fall tendency in the elderly. http://tidsskriftet.no/article/504076/

x Half of those admitted to hospital after the fall, dying during the first year (Rubenstein l. Falls in older people: Epidemiology, risk factors and strategies for prevention. Age and Ageing 2006 http://www.ncbi.nlm.nih.gov/pubmed/16926202)

There are 9000 hip fractures every year I Norway. The vast majority are due to falls inside the house. Hip fractures alone was estimated to cost Norway 1.5 billion per year. (Action programme for the prevention and treatment of osteoporosis and

osteoporotiske violations, health and Social Affairs http://helsedirektoratet.no/publikasjoner/nasjonal-faglige-retningslinje-for-forebygging-og-behandling-av-osteoporose-og-osteoporotiske-brudd/Publikasjoner/nasjonal-faglige-retningslinje-for-forebygging-og-behandling-av-osteoporose-og-osteoporotiske-brudd.pdf)

In NPR (National injury register) it is registered a total of 25 hip fractures in Sande in 2011 and in 2010. Of these 24 people are over 65 years old. Only one person is registered living at the nursing home. For 2012 the number of incidents was approximately the same, but there were more incidents at the nursing home.

The Sande municipality has an incidence which is roughly equal to the national average. At the national level most injuries happen at home and not outside during the winter. NPR- 2011 (Norsk Pasientskaderegister).

Based on these collected evidences we conduct different measures for elderly people. The “drop-in” program is voluntary training in the training room at the nursing home. It is an important low threshold -offer available for everyone. Sand buckets for people living at home are also available for everyone. We have now stated a “balance group”, in which the participants will be carefully selected. A screening using a simple test will be used on the participant to evaluate if he or she should participate in the program, supplemented with some criteria: x It must be documented a need for balance requisition training from a doctor. x The elderly person is living at home x The person had a fall during the past year and/or increased fall risk on the basis of failure related to motor

function balances (balance/strength/reduced time function). x The person must be able to take advantage of the verbal and visual instruction x The person must be motivated for training that could improve balance and function in everyday life, and

cooperate with the administrator of the balance group. Prevention of injuries in agriculture aimed at farmers.

(mostly adult people between 20 and 67 years) The work is based on national statistics and research report Injury-free farmer. And data from the Agricultural HSE (health and safety) see also the discussion in the boxes D.5 and E 3.2.

Agriculture is an industry where accidents often occur. The Labour authority's statistics tell that about a quarter of the fatal accidents in land-based industry occur within agriculture, this despite the fact that it is less than 3% of those employed working within this industry. The registrations of other work-related injuries in the agriculture business are inadequate.

Figure 1. Hip fracture in women in different countries, the number per 10 000 observation years (Lofthus 2001)

Figure 1 The risk of hip fracture increases with age in both sexes. In particular, increases the risk sharply after 70 years of age. Figur: Omsland, Folkehelseinstituttet).

(Ref www.fhi.no)

In 2008, there were 12 registered work injury deaths in agriculture In 2011 it was 4. The 2008 numbers is equivalent to 21.4 per 100 000 persons employed. In comparison, there were 3.5 deaths per 100 000 in manufacturing and 3.3 in the construction industry. That same year, it reported a total of 337 other work injuries in the fields of agriculture, forestry and aquaculture, this equates to 5 injuries per 1,000 persons employed. Corresponding figures in industry was 17 and in construction 14 work injuries per 1,000 persons employed. This disparity between the number of injuries and deaths gives us grounds to assume that there is a significant under-reporting of work-related injuries within agriculture. http://www.arbeidstilsynet.no/artikkel.html?tid=227601 It has been done very little research in this area. In 2011 The Norwegian institute of work-medicine at the ST. Olav Hospital in Trondheim conducted a survey in Nord- Trøndelag County. These data’s have been used in Sande and we were able to use the same Questionnaire to confirm the situation in our municipal. http://www.arbeidstilsynet.no/artikkel.html?tid=227601 A similar accident profile is confirmed in Sande. A further program of prevention efforts have not yet been rolled out. It will be developed in cooperation with the municipality, farmers' association, Country women’s association and agriculture HMS will continue to prior safety among farmers and agricultural workers. Sources for Statistics and surveillance used in the program: 1. National and regional statistics 2. Local surveys (survey among farmers and Quest Back in secondary school) 3. Registration, mapping of areas at risk for avalanches 4. Perceived risk manifested through thematic meetings and seminars The Safe Community organisation

Members of the steering group:

The steering committee Coordinating group Working groups

• Mayor (Chair) • Conciliar • Local authority health and welfare • Local authority for Childhood and Culture • Inter-municipal environmental health • Local authority for technical • Manager of volunteer bureau • Manager of Uniq • Leader for Sande farmers ass • Coordinator of SLT, MOT and emergency (staff advisor) • Public Health Coordinator

Participants have been project managers and volunteer- center, as well as coordinator for TL-work

• Maritime Safety • MOT • Injuries in Agriculture • Preventive home visits to elderly • Prevention outdoor / sand bins • Preventive work for refugees Police/SLT

Staff: Picture; The Councillor Olav Grande and the Major Karl Einar Haslestad which is the leader of the steering group.

International commitment Sande has attended to the Second European Regional Safe Community Conference Incorporating the 7th conference for Safe Communities, Reykjavik, Iceland, May 19-20, 2010 (three participants). The municipal attend to the national and regional network of Safe communities in Norway and have attended to all the national conferences.