PREVENTION OF INJURIES AND VIOLENCE IN CHILDREN AND

ADOLESCENTSTereza Koprivova Herotova, Ph.D.

Eva Vaníčková, M.D., Ph.D.

Department of Child and Youth Health

CLASSIFICATION OF INJURIES

• BY INTENTION - intentional and unintentional• BY MECHANISM – traffic accidents, falls,

gunshot, drowning, thermic accidents• BY TYPE OF INJURY• BY SEVERITY OF INJURY• BY THE PLACE WHERE THE INJURY

OCCURED• BY CAUSES – e.g. alcohol, drugs• BY ACTIVITY – e.g. sport, entertainment, job• BY AGE

PREVALENCE OF INJURIES(Czech Republic)

• HOSPITALIZATION OF CHILDREN CAUSED BY INJURIES CCA 40 000 CASES PER YEAR

• 25 000 CHILDREN OF AGE BELOW 14 YEARS

• MOST SEVERE ARE TRAFFIC ACCIDENTS; THE NUMBER OF DEATHS CONTINUES TO DECLINE

• DROWNING CURRENTLY INCREASED IN TODDLERS AND ADOLESCENTS

MORTALITY

External causes of death in children, year 2005

Traffic accidents43%

Other external causes32%

Electricity, fire4%

Intentional self-harm6%

Attack1%

Drowning10%

Falls4%

TRAFFIC ACCIDENTS IN CHILDREN2009 & 2011

TOTAL NUMBER OF PARTICIPANTS IN ACCIDENTS BELOW 15 YEARS WAS:

830 PEDESTRIANS - 5 – 3 KILLED 104 – 118 SERIOUSLY INJURED 687 – 667 LIGHTLY INJURED3078 PASSENGERS – 8 – 1 KILLED 60 – 19 SERIOUSLY INJURED 921 – 448 LIGHTLY INJURED 327 CYCLISTS – 1- 3 KILLED 20 – 32 SERIOUSLY INJURED 254 – 265 LIGHTLY INJURED

Since 2000 there has been a 70% reduction in child deaths - passengers in a car; 67% reduction in children - pedestrians.

CONSEQUENCES OF TRAFFIC ACCIDENTS IN CHILDREN

TRAFFIC INJURY PREVENTION

• INDIVIDUAL

KNOWLEDGE OF TRAFFIC RULES, VISIBLE COLOURS, REFLECTIVE ELEMENTS, HELMETS

• VEHICLE

CONTRUCTION OF A VEHICLE, CHILD SEAT AND BUILT-IN SAFETY ELEMENTS

• ENVIRONMENT

SPEED- RETARDERS, TRAFFIC ROUNDABOUTS, TRAFFIC RULES, PROHIBITION OF ALCOHOL AND DRUGS, ROAD CONDITION

MOST FREQUENT INJURIES IN CHILDREN

• INFANTS – FALLS ON A HEAD

• PRESCHOOL AGE– FRACTURES, BURNS, POISONING, DROWNING

• SCHOOL AGE– FRACTURES AND CONTUSIONS OF SOFT PARTS

GIRLS: 11 YEARS BOYS: 13 YEARS MOST SERIOUS INJURIES: 15 – 19 YEARS DOMESTIC INJURIES: 0 – 5 YEARS TRAFFIC ACCIDENTS: 10 – 14 YEARS

SCHOOL INJURIES: 6 – 14 YEARS

POISONING IN CHILDREN

CAUSES: MEDICAMENTS 38 %

PLANTS 18 %

CHEMICAL PRODUCTS 11 %

CLEANING DETERGENTS 5 %

PREVENTION OF INJURIES IN CHILDREN

• PERMANENT SUPERVISION OF A CHILD• AWARENESS OF A CHILD• SAFETY AND SECURITY ELEMENTS, DESIGN

AND LAYOUT OF INTERIOR AND EXTERIOR ENVIRONMENT

• PREVENT ACCESS TO ALCOHOL, DRUGS, DETERGENTS, WEAPONS, ETC.

• SAFE COMMUNITY, SCHOOL PROJECTS AND CHILDREN FRIENDLY SCHOOL

• MEDIA CAMPAIGNS

PREVENTION LEGAL MEASURES

• USE OF CHILD DETAINEE SYSTEM LOCATED REARWARD FACING (current practice in Sweden and zero mortality of children)

• Mandatory USAGE OF CYCLING HELMETS• Mandatory PRIVATE POOL FENCING• Mandatory USAGE OF CHILD RESISTANT

PACKAGING OF MEDICAMENTS• CONSTRUCTION LAW treated to prevent

children dropping out of the windows in upper floors

TYPES OF VIOLENCE ACCORDING TO WHO (World Health Organization)

• Interpersonal violence is a part of social communication in each environment (family, school, job, community, society).

• Self - directed violence refers to violence in which the perpetrator and the victim are the same individual and leads to a self-harm.

• Collective violence is an activity developed by organized and prepared activity against certain group of people.

INTERPERSONAL VIOLENCE IN CHILDREN

• DOMESTIC VIOLENCE 1. syndrome of a child abuse and neglect 2. child as a witness of domestic violence 3. aggressive behavior of a child against adult

members of the household• BULLYING AND CYBERBULLYING 1. school 2. hobby group 3. sport clubs 4. camps

• PHYSICAL AND HUMILIATING PUNISHMENT1. school

2. hobby group 3. sport clubs 4. camps• MORAL AND SEXUAL HARASSMENT 1. family 2. school, hobby group, sport clubs, camps 3. virtual communication 4. community

• MENTAL AND EMOTIONAL DEPRIVATION

1. longterm stays in an institutional care• COMMERTIAL SEXUAL EXPLOITATION

1. child prostitution

2. child pornography

3. trafficking • RISKY VIRTUAL COMMUNICATION

1. cyber grooming

2. happy slapping

3. sexting

4. flaming

SELF - DIRECTED VIOLENCE

• SUICIDAL BEHAVIOR 1. Suicidal ideas 2. Suicidal thoughts 3. Suicidal tendencies 4. Suicide in communication 5. Suicidial attempt 6. Consumated suicide• INTENTIONAL SELF- HARM

ORGANIZED VIOLENCE

• CIVIL WAR, FAMINE• TRAFFICKING IN CHILDREN 1. sexual exploitation 2. child labour 3. abuse of children as slaves in the household 4. child marriages 5. military conscription of children 6. illegal adoption 7. in sports 8. acquisition and sale of organs for transplantation 9. forcing to beg

HEALTH, ECONOMIC AND SOCIAL CONSEQUENCES OF VIOLENCE

• PHYSICAL DAMAGE• STRESS AND IT’S BEHAVIORAL SYMPTOMS• POST-TRAUMATIC STRESS FAILURE• HIGHER MORBIDITY, LOWER PERFORMANCE,

COST OF INVESTIGATION AND THE LAW PROCESSES ETC.

• LOSS OF SOCIAL CAPITAL IN FAMILY AND OTHER RELATIONSHIP, TRANSMISSION OF VIOLENCE, FAMILY BREAKDOWN, LACK OF CREATION OF COMMUNITY COHESION

• NEGATIVE OPINIONS AND ATTITUDES IN SOCIETY

ENVIRONMENTAL MODEL OF VIOLENCE AS A BACKGROUND FOR

PREVENTION

Individual personality

Community Social environment

Society

Krug E. a kol. 2002

VIOLENCE PREVENTION

• IN SOCIETY

• IN COMMUNITY

• IN SCHOOL

• IN FAMILY

• PERSONAL SAFETY PLAN OF A

CHILD

References

• http://www.who.int/violence_injury_prevention/child/injury/world_report/en/index.html

• http://www.who.int/violence_injury_prevention/publications/child_injuries/en/index.html