women's and children's hospital grand round
TRANSCRIPT
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CHILD INJURY PREVENTION IN SA – COMMUNITY CONSULTATION TO UNDERPIN THE WAY FORWARD FOR KIDSAFE SA.
Associate Professor Anne Johnson
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INTRODUCTION
22,865 children 0-4 years of age were admitted to hospital for injury (including accidental poisoning) across Australia (AIHW 2008).
This was second only to admissions to hospital for respiratory conditions.
Unintentional injuries are a major cause of disability, which can have a long-lasting impact on all facets of a child’s life; relationships, learning and play (WHO & UNICEF 2008).
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Click icon to add picture Preventable injuries
are higher amongst children compared with
other
age groups (ABS 2007).
Photo by Anne Johnson 2008
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More children die from injury in Australia (36%) than cancer (19%), and diseases of the nervous system (11%) combined.(ABS 2006).
Photo by Anne Johnson 2008
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Click icon to add picture Child
death rates from
injuries
have declined
by over
60%
since
1983 (AIHW 2005)
Photo by Anne Johnson 2008
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REDUCTION OF CHILD DEATH RATES
This reduction in child deaths provides evidence that dramatic success in reducing child injuries and deaths is possible through using multiple strategies such as: legislative changes environmental changes community action information education and training.
It is imperative to continue this downward trend of child deaths from injuries, and to reduce preventable and unintentional child injuries.
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CHILD DEATHS
Child deaths impact not only on the family, but also the community.
“Every day around the world the lives of …families are torn apart by the loss of a child to unintentional injury or so-called ‘accidents’ that could have been prevented. The grief that these families suffer – mothers, fathers, siblings, grandparents and friends – is immeasurable and often impacts on entire communities. Such tragedy can change lives irrevocably” (WHO & UNICEF 2008 p vii).
The pain is even greater if simple measures could have prevented the incident.
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CHARACTERISTICS OF CHILD INJURIES
There is a strong association between the type of injury a child sustains and the: age of a child developmental stage how the child interacts with their environments the type of activities the child undertakes socio-economic status, and gender.(WHO & UNICEF 2008)
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Click icon to add pictureChildren
0-4 years
of age are particularly vulnerable
to injuries
as they begin to explore
their environment.
Highest injury rates 1-2 year olds.
Photo by Anne Johnson 2008
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THE CHILD-INJURY PYRAMID
1 death
45 hospitalisations
1,300 treated and discharged from ED
Unknown number require first aid at home, early childhood
setting, GP, Pharmacist, Phone advice, etc.
(Gallagher 1984).
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CHILD INJURY PYRAMID
Difficult to get a true picture of child injuries. There are many injuries that are unaccounted for in the
child injury data. Some insights gained in the area of poisoning. For example:
SA data from the Department of Health indicated that in 2006-2007 there were 549 children 0-4 years of age hospitalised for poisonings.
Data from the Poison’s Information Centre in WA indicated that in 2008 there were 5,119 telephone calls to the Centre from SA for children 0-4 years of age.
(NB. unable to get 2008 data from the SA Dept of Health to compare admissions to hospital from poisoning for that year with Poison Information Centre data)
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MAIN INJURIES FOR CHILDREN 0-4 YEARS OF AGE ADMITTED TO SOUTH AUSTRALIAN HOSPITALS 2006-2007 (COMBINED METROPOLITAN AND COUNTRY; EXCLUDING DEATHS):
Falls 1090 Burns and scalds 589 Poisonings 549 Vehicle Accidents (car occupant) 79 Drowning 39 Cyclist 34 Pedestrian 26
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MAIN INJURIES BY AGE FOR CHILDREN 0-4 YEARS OF AGE ADMITTED TO SOUTH AUSTRALIAN HOSPITALS 2006-2007 (COMBINED METROPOLITAN AND COUNTRY; EXCLUDING DEATHS):
Reason 0-11mths 1 year 2 year 3 year 4 yearFalls 190 234 256 215 195
Burns & scalds 82 315 97 47 48
Poisonings 68 167 189 83 42
VA 12 16 16 15 20
Drownings 8 16 9 5 1
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IN THE STATE OF SOUTH AUSTRALIA IN 2006 10 CHILDREN DIED IN THE 0-4 YEAR AGE GROUP:
Three children died from transport related injuries
Three from drowning Four from accidental asphyxia.(Government of South Australia 2007)
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10 DEATHS IN 2007 IN THE 0-4 YEAR AGE GROUP WERE CAUSED BY:
Three children died from transport related injuries
Five children died from accidents. Four of these children died from either accidental hanging or asphyxia. The fifth child died from head injuries sustained when an object fell on the child.
Two children drowned.(Government of South Australia 2008)
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14 DEATHS IN 2008 IN THE 0-4 YEAR AGE GROUP WERE CAUSED BY:
Two children died from transport related injuries. Two from drowning. Two children died from ‘accidents’. One child
suffocated from entrapment in a filing cabinet and one child was strangled by a window blind cord.
Eight children died from associated unsafe sleeping situations.
(Government of South Australia 2009)
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Nearly 60% of
injuries in children 0-4 years happen
in the home and
backyard
Photos by Anne Johnson 2007
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Falls are
1.5 times
greater in country
areas
than metropolitan areas (AIHW 2008)
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Photo by Anne Johnson 2008
Photo by Anne Johnson 2008
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Poisonings
are
1.9 times greater
in country areas
than metropolitan areas (AIHW 2008)
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Photo Anne Johnson 2008
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Conducted a statewide consultation for KidSafe SA: 17 focus groups Several interviews Several telephone
discussions with families living on remote outback stations
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MET SOME AMAZINGLY TALENTED AND COMMITTED PEOPLE
Photos by Anne Johnson 2008
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SAFETY HAZARDS FOR YOUNG CHILDREN IN COUNTRY SA –
PERSPECTIVES OF FAMILIES OF CHILDREN 0-4 YEARS OF AGE
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PLAYGROUNDS
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Lack of footpaths
Photo by Anne Johnson 2008
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CHILDREN IN CARS
Keys left in the ignition Children left in cars when parents shopping
or using ATM Children not being restrained in cars or farm
vehicles People using inappropriate types of child
restraints
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ROADS AND ROAD SAFETY
Traffic Speeding on unfamiliar back roads (city
people/tourists/contract workers) Increasing heavy vehicles through towns ‘local drivers pretty bad’ Speeding on country roads, especially past
farm entrances Seasonal – harvest time; silo run through town;
tourist season Older drivers continuing to drive due to lack of
local public transport or limited community buses
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ROADS AND ROAD SAFETY
Pedestrian crossing issues Road safety
Teaching children road safety Children not wearing bike helmets Poor condition of roads Kangaroos and emus
Lack of child friendly environments Dangers in the community Entertainment venues Shops and supermarkets
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FARM ISSUES Dangers in the environment
Not having secure fences and gates to isolate farmhouse and children from working areas of farm
Heavy farm machinery Big sheds/workshops and equipment Chemicals Hay bales Silos for grain storage
Different practices More outdoor activities – greater risks More open spaces – wander off and get lost Commonplace to start riding horses and motor bikes at a
younger age Economic issues
Not able to afford to update infrastructure e.g. build chemical shed or purchase extra child restraint for farm vehicle
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SNAKES AND ANIMALS
Always have to be vigilant during snake season for snakes
Children interact with a wide range of animals from a young age
Wandering dogs Tying dogs up in the front of shops and
leaving them there Lack of access to dog education
programs
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OTHERS Motor bikes - begin riding between 2-4
years Open access to wide range of water
areas Too trusting Service model of Kmart and Target Council issues Parks/public spaces Hot environment Rental properties Unfamiliar environment - visiting
children from city; and country children visiting city
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KNOWLEDGE
What were three of the most frequently occurring types of unintentional injury for children 0-4 years of age that required hospitalisation in SA over the past two years?
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WHAT INFLUENCED THE PARTICIPANTS MOST IN THEIR APPROACH TO CHILD SAFETY?
Friends Family Groups Children Experiences Local stories
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WHERE DID PARTICIPANTS SOURCE INFORMATION ABOUT CHILD SAFETY?
Written information sources Books Magazines Pamphlets
Media Internet
Commercial sites Safety-oriented sites Health-oriented sites
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WHERE DID PARTICIPANTS SOURCE INFORMATION ABOUT CHILD SAFETY?
Education/training Safety-oriented organisations Health professionals and health services Child care, kindergarten and school Speciality stores Community events
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You can find the link to it on:
www.kidsafesa.com.au
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THE KIDSAFE SA STRATEGY
14 recommendations Raising awareness (3) Workforce development (1) Advocacy (3) Supporting legislation (1) Strategic partnerships (7)
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Any questions?
Photo from Kidsafe Vic