Vol. 1, issue 3, September 2005
Newsletter of the Working Party on Accidents and Injuries (supported by the EC Public Health Programme)
Editorial
The basic principles of the European Union are the freedom of movement of people, goods, services and capital. In the growing single market, millions of people and products are being transported in greater quantity and speed. Yet, with this increase in mobility, factors such as congestion, pollution and road accidents are also on the rise. Transportation is a vital part of our every day lives and we use roads for business and personal purposes. Nevertheless, nearly 50,000 people die a year due to road accidents. Actions are being carried out in efforts to reduce road traffic accidents. This issue focuses on road traffic accidents, the FOCUS article is attributed to vulnerable road users and on page 3 you will find an interview with the President of FEVR. We are delighted to inform you that the Pre-event will be taking place this month and invite you to visit our site to register on-line if you have not done so already http://195.134.113.92/keppasite/pre_event/ There will be two sessions dedicated to new member states and accession countries. During these sessions, experts will present an overview of the injury burden in their new MS, the surveillance systems, interventions, policies and future challenges. In addition, we are honoured to have Mr. Trakatellis, EuroParliament, as a key speaker during the closing ceremony. He will talk about the challenges and perspectives of the Public Health in the EU. Finally, http://www.actiononinjuries.org, the website of the WP-AI is under construction and will be launched in October 2005. The site will serve to promote the prevention of accidents and injuries by disseminating results derived from projects and research, information and good practices. In regard to the coming launch of the website we are pleased to introduce a slightly different design of the Newsletter. Your comments are, always, very welcome. Eleni Petridou WP-AI Secretariat as
FOCUS on Vulnerable Road Users
By Frazer Goodwin, Policy Officer, European Transport Safety Council (ETSC) Venturing onto the road continues to be one of the most risky activities we all engage in during our daily lives. In the EU 25, nearly 50,000 lives are lost annually due to road accidents, while approximately 2.5 million injuries occur. To put this into another context, it is the same number of lives lost in just over a year as the USA lost during the entire Vietnam War. According to the WHO (World Health Organisation), road accidents and injuries are the ninth highest global cause of DALYs (disability adjusted life years) and are set to be the third highest by 2020 - above HIV/AIDS, tuberculosis, diarrhoeal diseases and war1.
“In the EU 25, nearly 50,000 lives are lost annually due to road accidents while, approximately 2.5 million injuries occur.”
Photos: Justin Cooper
Moreover, it does not matter which type of road transport you use, car, bus, bicycle or walking, all are risky as the appropriate evidence based measures to reduce traffic injuries have not been fully implemented. However, the most vulnerable on the road are those unprotected by an outside shield, namely pedestrians and two-wheelers2. Vulnerable road users have a fatal accident risk 7 to 9 times higher than those travelling by car over the same distance3. This situation has been compounded by the fact that the greatest efforts in improving road safety have focused on car occupants. Continuing and strengthening these efforts remains important, but it is also vital that transport safety begins to give much more attention to protecting the most vulnerable of our road users. Furthermore, the situation across Europe for vulnerable road users is as mixed as the general road safety picture. Unsurprisingly, Member States that have a poor record overall on road safety also have a poor record for vulnerable road users. In Poland for example, 45.8% of road deaths are pedestrians or cyclists, whereas the EU average is 24%4 and this is in a member state where the factors that make roads dangerous such as older vehicles, poor road conditions and low levels of traffic law enforcement all mean that car occupants themselves already have a high risk. The relative risks for vulnerable road users are therefore extremely high. What is more surprising, however, is that some Member States that have a comparatively good road safety record overall still have high levels of risk for
Table of Contents
FOCUS on vulnerable road users European & national news Interview with the President of FEVR New member state in the spotlight WHO Europe on road traffic injury Project updates Events 1-2 3-4 3-5 5 5-7 6 8
Action on Accidents and Injuries, Volume 1: Issue 3: September 2005
Visit our new website at http://www.actiononinjuries.org
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EUROPEAN NEWS New EU health data published
The first set of EU-wide health data from the European Community Health Indicators (ECHI) project has been published on the Commission's Public Health website. The aim of ECHI is to produce better and more comparable data that will enable policy makers to track developments in the health status of EU populations. The ECHI indicators aim to cover the 25 MS, the EU Candidate Countries (Romania, Bulgaria, Turkey), the West Balkan Countries, the USA, Canada and Japan and the data they contain is available in English, French, German and Spanish. The ECHI pages on the Public Health website will be developed over the coming months and updated on a regular basis . More information:http://europa.eu.int/ comm/health/ph_information/ dissemination/echi/echi_en.htm
vulnerable road users. The UK is an example of such a member state, where despite having the best overall EU road safety record, pedestrian safety is only at the EU average, and accident rates for child pedestrians are higher than in most other EU Member States5. There are many measures known to have worked in helping to protect vulnerable road users, which target all aspects of reducing road risk from improving roads and vehicle design to changing the behaviour of road users. However, according to ETSC, the most important measure that policy makers need to take to protect vulnerable road users is limiting traffic speeds. Traditionally, this has been done with a combination of consensual speed limits and traffic calming measures like road humps and bends. Yet there continues to be strong resistance from motoring organisations against efforts to control speeds. Unfortunately, what is frequently lacking is either the political will necessary to implement the measures, or the conviction that protecting the most vulnerable should be the cornerstone of road transport policy6. Technology now offers the potential for vehicle speeds to be regulated by technology inside the car. This technology – intelligent speed adaptation (ISA) ranges from informative systems advising the driver to active intervention preventing speeds in excess of the legal limit. Whilst this technology would be an additional cost to motorists, the costs to society of ignoring speed continue to be far higher. Numerous field trials of ISA have been carried out and the cost to benefit ratios – just for reduced accidents, are between 1:5 and 1:127. Yet cost is still used as one of the reasons not to require ISA technology in new cars. This year a new VOICE has been heard urging our leaders to begin to accept their responsibilities and demonstrate the political leadership necessary to protect vulnerable road users. Vulnerable road users Organisations In Cooperation across Europe (VOICE) brings together different European organisation that campaign for vulnerable road users from different perspectives as well as organisations of vulnerable road users8. VOICE will campaign at a European level to ensure that the measures needed to protect vulnerable road users – lower speed, less aggressive car fronts, promotion of better infrastructure for cyclists and pedestrians – are taken. Additionally, fact sheets will be prepared addressing the needs of vulnerable road users in 12 Member States9. Allied to the production of these fact sheets will be an indepth study in each of these Member States into a specific location that is problematic to vulnerable road users. VOICE thereby forms alliances across the various policy communities active in protecting vulnerable road users and will highlight the need to change policies from local to the European level. One of the most important conclusions of the 2004 WHO European report, ‘Preventing Road Traffic injury: a public health perspective for Europe’ was the need for the health community to become the champion for road safety. The message to policy makers should be that protecting society’s most vulnerable should extend to society’s greatest risk - road transport. For more information: policy@etsc.be
References
Europe: it’s all downhill from now (published in the Guardian, 6 July 2005)
The ski slopes of France, Austria, Germany, Italy and Spain may be a new battleground in the debate on the future of Europe. Just as relations between its political leaders slide downhill faster than a Winter Olympic champion, the European Union is taking the first steps towards harmonising rules on preventing accidents among an estimated 25m skiers and snowboarders. Who pays for the rescue and treatment of tourists who come a cropper is proving an increasingly serious issue, according to researchers. It has been suggested there may have been 250,000 skiing accidents a year in the old 15-member EU, 90,000 in Austria alone. A two-year project aimed at cutting the number of skiing injuries and deaths starts in September. The European Commission, which is providing 60% of the funds for the research led by Italian public health experts, hopes it will help bring in new EU-wide rules. Claudio Detogni, project leader for Beprasa (Best Practices in Prevention of Skiing Accidents in Europe), said: "One of the problems is it involves tourists. Tourists are from different countries. Other countries do not have mountains but have a lot of citizens who are moving to the mountains." British insurers recently warned that taking a completed E111 form to
1. 2. 3. 4. 4.
WHO World report on road traffic Injury Prevention – WHO 2004 As defined by the Scientific Expert Group on the Safety of Vulnerable Road Users (RS7-98). Safety of Vulnerable Road Users, OECD, 1998. ETSC Transport safety performance in the EU - a statistical overview 2003. Figures taken from European Commission CARE database for 2003. From UK Department of transport road safety web site Think! “Britain's child pedestrian death rate has improved over the last few years but is still worse than that of several other European countries. The rate per 100,000 children (aged up to 14) was 0.9 in 2001, compared with 0.4 in the Netherlands, 0.5 in France and 0.6 in Germany”. See the bottom of page at: http:// www.thinkroadsafety.gov.uk/overview.htm The member state that has attempted to change to this priority for transport policy is Sweden with it’s policy of “Vision Zero”. See O. Carstens et al 2000, a joint publication by the University of Leads and the UK Motor Industry Research Association. For more details on VOICE and a list of all the participating organisations see the VOICE web site on www.etsc.be/voice.php
The 12 Member States being covered are: Austria, Belgium, Czech Republic, Greece, Hungary, Ireland, Italy, Lithuania, Poland, Portugal, Spain, UK.
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European slopes might not cover all the bills. It also reported an increase in "slope rage", with punch-ups on the piste a common cause of injuries.
INTERVIEW
with Brigitte Chaudhry, President of FEVR
The European market still without child resistant lighters
This summer, Member States have once again failed to come to a decision on enforcing child resistant lighters in the European market. Since the adoption of the standard EN 13869 ‘Lighters - Child resistance for lighters - Safety requirements and test methods’ in 2002, ANEC has repeatedly urged the European Commission to publish the references of this standard in the Official Journal. However, Member States have not been able to agree on the approach to be adopted to establish and enforce a child resistant requirement for disposable lighters, and so the references of the standard are unfortunately still not published. There is considerable opposition from Chinese lighter manufacturers, citing discriminatory practices and barriers to trade. In the case that Member States cannot agree on the approach for dealing with a certain risk, the Commission can adopt a decision requiring the Member States to take temporary measures to ensure that only those disposable lighters that are child resistant are placed on the market and supplied to consumers. Such a temporary decision is intended to prevent further casualties, pending a permanent solution addressing child safety issues for all types of lighters. (Source: http://www.anec.org)
In this interview with Brigitte Chaudhry, President of FEVR, the Fédération Européenne des Victimes de la Route or European Federation of Road Traffic Victims, the cold reality of being a road traffic victim is brought to light. 1. Could you briefly explain what the Federation's key objectives are? FEVR is formed by national European associations of victims and families of killed or disabled road traffic victims and has the status of a Non Governmental Organisation recognised (roster) by the Economic and Social Council of the United Nations. FEVR’s main aims are to:
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offer support and help to road crash victims by providing free emotional, practical and legal assistance; to contribute to road safety by highlighting road danger and the causes of crashes in order to influence institutions and authorities to enforce road safety measures more effectively.
FEVR, the only known federal organisation to do so, champions the rights of road crash victims and represents their interests at international level, just as its member and associated organisations do at national levels. 2. Based on your experience at FEVR could you please explain the often forgotten psychological and social effects of being a road traffic victim? Moira Winslow, Chairman of Drive Alive, South Africa, stated what all our organisations experience daily in our contact with affected families: "The human suffering for victims and their families of road traffic-related injuries is incalculable". FEVR conducted a study into the impact suffered by road crash victims, and the findings in relation to the bereaved, as well as the injured and their families, were shocking: 26-37% were suicidal, 62-72% lost interest in everyday activities, 30-60% suffered anxiety attacks, sleeping disorders, nightmares and general health problems, 64% suffered from depression, and almost 100% declared they could not enjoy life as before. Some 80% of those questioned had feelings of anger and resentment at the way their tragedy was treated- almost 100% said that there had been no justice in their case. As a result, many families experienced isolation and financial hardship, since many could no longer carry out their occupations for psychological or physical reasons. 3. In addition to the huge burden of the cost of injuries related to road accidents (i.e. medical costs) could you explain other aspects of the economic impact of road accidents with which road traffic victims are confronted? In addition to the complete loss or decrease of earnings, the bereaved have to find immediately large sums for the funeral, for travelling in connection with the death, for legal advice, etc., and they also often suffer the loss of support from the person who was killed. Regarding the injured and their families - the health problems and financial losses suffered by them are enormous and frequently long lasting or permanent, made all the worse by the reluctance of insurance companies to pay the full damages entitlements. Research needs to be conducted in Europe into the relationship between bereavement and injury through a road crash and poverty – such research in Bangladesh showed a very close link.
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NATIONAL NEWS Adoption of a 5 year Strategic Plan for the Prevention of Unintentional Childhood Injuries in Cyprus
The Ministry of Health of Cyprus is currently submitting a proposal to the Ministerial Council for the adoption of a 5 year strategic plan, for the prevention of unintentional childhood injuries in the country. The Advisory Committee for the Prevention of Childhood Injuries and Poisonings, of the Ministry of Health of Cyprus, developed the Plan following a two day workshop in Nicosia in November 2004. The workshop was coordinated by:
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Prof. Eleni Petridou, Athens University, Medical School, Secretariat WP Accidents and Injuries
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Dr. Dinesh Sethi, WHO European Centre for Environment and Health Dr. Rosa Gofin, Senior Lecturer, Hadassah and Hebrew University Israel
Of course, it needs to be remembered that the financial impact is suffered by the whole society. Road crashes are the leading cause of premature death and acquired disability of young people, in particular young men under 40 – the people we have raised and educated, and then allowed to be wiped out, maimed or brain injured, instead of having them contribute to the economy and well being of our countries and families. 4. From the perspective of FEVR, what are the most important measures that need to be taken to increase the safety of vulnerable road users? Vulnerable road users are first of all our children, the elderly and disabled – people whose right to protection ought to be ensured, then all other pedestrians and cyclists, and also motorcyclists. A civilised society should protect its vulnerable. Many factors contribute to the continuing danger to vulnerable road users, but underlying all is the general acceptance of numerous injuries and deaths in traffic – the term “accident” implying that they just happen and little can be done about it. This means that there is a lack of priority by the police and legal authorities to investigate and deal seriously with the causes.
(The Coordinators of the workshop with members of the Advisory Committee)
and a big number of local stakeholders participated actively in the workshop. The goal is to decrease mortality from injuries in children by 30% by the year 2015. The Strategic Plan describes activities for the injury priority areas of three age groups (0-4 years, 5-14 years and 15-18 years), assigns responsibilities to various stakeholders in the field and sets a timeframe for the implementation. It also describes monitoring and introduces indicators to evaluate the progress attained. Based on this Strategic Plan, the Ministry of Health of Cyprus is submitting the proposal for approval by the Ministerial Council and is for the adoption of the Strategic Plan by all Ministries involved. Ministries are going to develop their own Plan of Action, based on the 5 year Strategic Plan, with a clear timeframe and will cover all the expenses derived, from their own yearly Budget. In addition they will submit a yearly report about the progress in implementing the Plan of Action. The service of the Advisory Committee for the Prevention of Childhood Injuries and Poisonings is renewed and will cover the follow up and if indicated, the coordination of the implementation process. The proposal is expected to be approved by the Ministerial Council by the end of August 2005. For any further information please contact the Advisory Committee for the Prevention of Childhood Injuries and Poisonings, Medical and Public Health Services Ministry of Health, Cyprus (cycomnet@cytanet.com.cy).
The danger at source must be addressed: it is not constructive or responsible to promote only the wearing of cycle helmets and reflective or bright clothing, or focus on training children, while not restricting the power of cars produced for public highways, nor the promotion of speed capacity as the most attractive feature of vehicles, and while not enforcing a duty of care on motorists towards the vulnerable. Legal actions for product liability are difficult to bring by victims, but we know of attempts, and there are regular complaints to broadcasting authorities about speed promotion. A 30km/h well enforced speed limit in urban areas would do more to protect pedestrians and cyclists than any other measure. Regardless of fault, vulnerable road users would stand a chance of ending up in a plaster cast, instead of a coffin, if impact speeds were reduced to ‘survivable speeds.’ 5. What is your opinion concerning the EC efforts and their involvement in road traffic injury prevention? Is this goal a substantial priority and are these actions sufficient? In 2001, the EC announced its ambitious ' White Paper on European transport policy' with a clear goal of halving the number of road accident victims by 2010. Following, in 2003 the Commission published its European Road Safety Action Programme. We of course welcome all efforts aimed at reducing the huge scale, but would like to remind that such a target means, especially from the perspective of victims, that we are actually planning to accept tens of thousands of people being killed, and millions injured. This seems morally wrong and would not be acceptable in any other sphere. We would like the vision adopted and pursued that road use should not represent greater risks than any other everyday activity. Enforcement and its deterrent effect, both pre- and post-crash, should also be seen as an important road safety measure, but this is not the case at present. Neither are rehabilitation and care of road crash victims appreciated as being essential in alleviating the seriousness of the consequences of crashes. 6. In the WHO World Report on Road Traffic Injury Prevention it is concluded that road safety has received insufficient attention at both the international and national levels. What reasons for not receiving sufficient attention may exist? How is FEVR involved in promoting awareness of road traffic safety? It is a fact that the true global scale of road death and injury is not fully appreciated. Furthermore, the official figures in each country are a huge under-estimate of the real situation. We believe there are two main reasons for that – firstly, there is no systematic recording by hospitals of road injuries, even though they represent a major public health problem; instead we rely on largely non-mandatory recording of these health data by the police; secondly, road death and injury are not treated by the media as national disasters, but as individual tragedies. We need courageous and independent journalists to make in depth documentaries on this subject, so that the bigger picture will emerge for all to see. How is FEVR involved in promoting road safety? Well, road victims are the unfortunate by-product of the transport system. We are in a unique position to draw attention to its failings and are trying to do just that. We think that
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NEW MS IN THE SPOTLIGHT Road Safety in the Czech Republic
In 2004, a five year project supported by the Ministry of Transport, and steered by the Centre for Traffic Research, was launched to address the high number of road accidents and traffic injuries in the Czech Republic. The project, consisting of an educational intervention programme combined with an environmental study, is aimed at the following population groups: pregnant women, parents of children aged 0-3 years, preschool and school children up to 18 years old. The project will be implemented as a pilot study in the region of South Moravia, which has a population of 1.2 million and is home to the second biggest city in the Republic. Upon completion the project will be evaluated and then offered as a national educational programme. The first year of the project was dedicated to an extensive research of modern forms of traffic safety education, as the present forms used in Czech schools had become obsolete and were largely ineffective. A team of specialists will follow up with the design of an integral educational curriculum based on best practices and offered to all who can influence the traffic safety of children. Teachers, caregivers, police, paediatricians, maternity centre staff, parents and pregnant women will be approached in the pilot study region. Combined efforts of education and health professionals supported by local police and traffic specialists should strengthen the awareness of injury prevention possibilities and competences. The Centre of Injury Prevention at the Charles University in Prague is one of the main partners of the project and provides the contact with health professionals and prepares the educational materials for pregnant women and parents of children aged 0-3, who will be reached through the paediatricians’ consultation rooms. Pregnant women visit the obstetrician at regular intervals and this provides a unique opportunity to instruct them on safe driving, the proper use of safety belts in cars and the safe transport of their newborn babies. In addition, a sticker with instructive drawings is stuck on to their maternity card – a document every pregnant woman carries in the Czech Republic for emergency and benefit reasons. But what is most valuable from an injury prevention point of view is the possibility to introduce epidemiological methods and developmental aspects
we should be listened to. 7. In your opinion, what role can the public health sector play in assisting victims of road traffic? Could you maybe elaborate on the special needs of road traffic victims suffering from post-traumatic stress disorder? The health sector has been amazingly silent vis-à-vis this major health catastrophe. The World Health Assembly discussed this topic - in May 2004 – for the first time after thirty years! The resources for research and development are smaller than for almost any other cause of premature deaths and acquired disabilities. Many bereaved relatives and many injured suffer PTSD, yet their needs are almost totally disregarded until now. Our study showed the profound impact on them - we would like a large Europe-wide study into the impact of violent bereavement and injury on family members of all ages, which should also investigate the impact of injustice. 8. Is FEVR involved with, or connected to, any injury prevention efforts in the field of road traffic safety? FEVR is a member of the Road Safety Collaboration, recently set up by the World Health Organisation as Coordinator on road safety issues, following their election by the UN General Assembly last April. We are always willing to forge collaborations with European counterparts, especially on research projects involving road victims. We are looking forward to new initiatives and hope that resources will be made available for such research. We believe that our unique experience of the post crash stage would make our contribution to any working party aimed at road injury prevention of crucial importance, since an appropriate response to the consequences of crashes and prevention are interdependent.
Key messages from PREVENTING ROAD TRAFFIC INJURY: a health perspective for Europe
By Francesa Racioppi, World Health Organization, European Centre for Environment and Health The decision to make “road safety” the theme of World Health Day 2004 has been of strategic importance in placing the intolerable toll caused by road traffic crashes under the attention of the media, policy makers and civil society world-wide (Box 1). It contributed to raise awareness about the magnitude of this tragedy, highlight the opportunities for prevention and prompted a reflection on the role that different actors, including the health sector, can play in addressing this tragedy. This was substantiated by the World Report on Road Traffic Injury Prevention and the report Preventing road traffic injury: a public health perspective for Europe, which the World Health Organization (WHO) launched on World Health Day1.
Box 1: Overview of road traffic injuries in the European Region Every year about 127,000 people are killed and 2.4 million injured in road crashes in the European Region of WHO. Low- and middle-income countries in the eastern and southern part of the Region are most severely affected. About one third of road crash victims are aged 15–29 years. In the European Union, road crashes comprise 97% of all transport crash deaths and more than 93% of all transport crash costs and are the leading cause of death and hospital admission for people younger than 50 years. The risk of death among motorcyclists in the European Union is 20 times higher than for car users per kilometer traveled. The fatality risk for cyclists and pedestrians is 7– 9 times higher than that for car users. The socioeconomic cost – much of which is borne by the health sector – is estimated to be about 2% of a country’s gross domestic product In addition to other adverse transport-related health effects such as air pollution, global warming, noise and increasingly sedentary lifestyles, an unacceptably high price is currently being paid for motorized mobility in human and economic terms. Source: A call to action: Key messages from the WHO report "Preventing road traffic injury: a public health perspective for Europe WHO Regional Office for Europe, 2004
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into the educational programme, to be followed by effectiveness control mechanisms. For more information please contact: Veronika Benesova, Centre for Injury Prevention, Charles University in Prague, 2nd Faculty of Medicine: veronika.benesova@lfmotol.cuni.cz
In Europe, the achievements of countries such as Sweden, the Netherlands and the United Kingdom, which report the lowest mortality due to road traffic injuries in the European Region2, stimulated an analysis of the key factors that can lead to success. This was done also with views of drawing from these experiences to support action across the broad range of social, economic, political and cultural conditions that characterise the European Region, and that in part are reflected in the vastly different levels of road safety reported across the Region (Figure1). Together with a reflection on the more pro-active role that the health sector can play in addition to maintaining its leadership in injury surveillance and in the post-crash phase of road crashes, this has led to the identification of some pillars which set the foundations of a new thinking about road safety in Europe:
Figure 1: Standardised mortality rates from road traffic injuries per 100 000 population in the WHO European Region, last available year (source: Mortality indicators by cause of death, age and sex (off line version). Supplement to the WHO European health for all database. Copenhagen, WHO Regional Office for Europe, 2005
PROJECT UPDATES Child Safety Action Plan (CSAP)
CSAP is a large-scale European project whose purpose is to use standardised tools and processes to develop national action plans to enhance child safety in 18 countries in the European Union. The project is led by the European Child Safety Alliance, a professional network that focuses on strategies aimed at bringing about reductions in injury-related deaths and disability amongst children 0 to 18 years of age in the European Union. The project is being completed in partnership with ECOSA/EuroSafe, WHO, UNICEF, EPHA, the European Commission and Alliance partners in each of the 18 participating countries. The project is evolving extremely well with progress continuing on three fronts. Firstly a set of indicators has been pulled together based on existing international data sets and primary data collection by country partners. A team of partner researchers at the University of Udine is gathering and analysing some of the data from existing international data sets and the CSAP Secretariat are working on others. In addition a data collection tool for the primary data collection is being piloted in Austria, Hungary, Greece, the Netherlands, Norway and Portugal and will be revised and distributed for completion by the remaining country partners following the CSAP partner workshop to be held in Brussels, Belgium in November 2005. Secondly, work continues on the development of a Good Practice Guide. The guide, whose purpose is to serve as a resource to support countries in selecting and implementing evidence-based actions as part of their action plans, will include the following: an overview of current best-evidence in table or matrix format to facilitate summary of the identified best-evidence strategies; and at least 13 case study examples of good practice based on the bestevidence strategies from Europe. It is anticipated that this resource will be completed by the end of 2005. Finally country partners have begun the assessment phase of the planning
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1. Building safety into the transport system A major turn-around point for road safety has been the understanding that preventive strategies focusing mainly on improving the behaviour of road users were unable to bring about significant effects. This led several countries to adopt effective strategies in the 1970s and 1980s addressing infrastructure, vehicles and users throughout the system and targeting preventing crashes, reducing injury severity in crashes and ensuring post-crash care. In the 1990s, this systems approach was refined further into one that also placed human limitation – both behavioural and physical – and speed control as central design parameters of the road transport system. Since people make intentional or unintentional errors in traffic, crashes cannot be totally avoided. Controlling speed, however, leads to fewer deaths and serious injuries in the event of a crash. Speed at the time of collision is the key determinant of the kinetic energy the human body sustains in a crash. Building in system safety is common in other modes of transport, such as railways and aviation, and in most sectors of the economy, in which mechanisms are introduced to prevent possible operator or user failure from occurring or from causing unacceptable harm. Bringing this concept into the domain of road safety has represented a major shift from abrogating the responsibility for safety mostly on individuals to making it a shared societal responsibility. Importantly, this also requires that the societal values underlying road safety policies are made explicit, including whether human life can be considered as a “tradable variable” when making decisions about the attributes of transport systems. One of the best examples of these founding statements is offered by the “Vision Zero” policy adopted by Sweden and other European countries.
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process by completing an assessment of current leadership, infrastructure and capacity to support child safety in each of their countries. In addition each partner has been working to engage government and national stakeholders to participate in the development of an action plan. National level action planning will begin in 2006. Regular updates on the project are also available in the CSAP Communiqué, a quarterly newsletter that is available on the Alliance website at http://www.childsafetyeurope.org For more information on the project please contact the Project Secretariat at secretariat@childsafetyeurope.org
2. Integrating road safety within sustainable transport and public health policies When road safety becomes an integral aspect of sustainable transport, the potential additional contribution of such measures as reducing emissions of noise and air pollutants and providing conditions that can promote walking and cycling that were originally designed to achieve other health or environmental protection goals becomes apparent. In addition, the range of strategies available to improve road safety becomes broader and more costeffective, as investments deliver multiple health benefits compared with piecemeal approaches. For example, maintaining speeds below levels that may cause death or serious injury not only saves the costs of avoided injuries but also saves costs resulting from air pollution, noise and the barrier effect created by the fear of vulnerable road users to engage in walking and cycling and the resulting health risks related to sedentary lifestyle. 3. Strengthening the role of the health sector The health sector should consider developing stronger leadership in road safety to be an essential part of its core business and a way of fulfilling its mission of protecting the human right to health. In particular, the health sector should:
European Network for Safety Among Elderly (EUNESE)
This past July the European Network for Safety among Elderly concluded its first year. The aims of EUNESE are not only to act as a platform for the exchange of information and expertise between health practitioners, but also to take a proactive approach in order to reach both the public and policymakers and ensure that the health of elderly citizens is placed at the centre of Europe’s political agenda. So far 54 organisations (mostly universities and health care organisations) from 16 European countries have joined the network. Existing members are expected to act as a catalyst for the further recruitment of possible associates and the expansion and strengthening of the network. Sustainability of the network is going to be evaluated during the following years of the project’s term. The website of EUNESE, which is currently under development, is expected to be introduced this coming October at the next project meeting. Both intentional and unintentional causes of death due to injuries among the elderly population (65+), were extracted from WHO’s mortality data and used for the calculation of the age-adjusted mortality rates for both intentional and unintentional injuries among senior citizens. Based on the analysis of the data, a document entitled “Patterns and suggested explanations for the differential injury mortality among elderly in the EU-25” was circulated among the EUNESE Partners for comments. The document contained a comprehensive and descriptive outline of the main findings of WHO’s mortality data analysis. It also provided valuable information regarding the main causes of death among the elderly due to injuries, by
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become the leading advocate for road safety; provide evidence-based information; become active in promoting the demand for greater safety; lead research and innovation, and mainstream road safety into the policies of other sectors and into the public health agenda.
More information from WHO Europe: http://www.euro.who.int/violenceinjury Contact: violenceinjury@ecr.euro.who.int
References 1. The World Report on Road Traffic Injury Prevention can be downloaded from http:// www.who.int/world-health-day/2004/infomaterials/world_report/en/; the report Preventing road traffic injury: a public health perspective for Europe can be downloaded from http:// www.euro.who.int/violenceinjury/injuries/20040326_2 2. The WHO European Region includes 52 Member States
IDB RE-LAUNCHED (Project update)
The IDB Re-launch and Seminar on the 28th and 29th of June 2005 in Luxembourg not only marked the mid-term of the Injury Database Project of the Public Health Programme 2003. It also marked the beginning of a new chapter in the short but nevertheless turbulent history of DG SANCO’s central Injury Database: Going public. The IDB as an internet database was set up under the Injury Prevention Programme in 1999 in order to provide central access to the data collected in the Member States under the EHLASS Programme since 1993. The IDB – then under the name Injury Surveillance System – was rolled out in the participating Member States in 2000 and 2001. However, mainly because of organisational shortcomings, indicated also by the frequent changes of name, this database has led quite a secluded existence. Preparing for going public and a substantial gain in visibility hence is the main objective for second half of the IDB project. The main prerequisites for the IDB re-launch were presented and discussed at the Luxembourg IDB seminar. These were: draft of the IDB homepage, new IDB query tool, IDB public access dataset and IDB terms of use and data delivery. Besides an update on IDB product development, under the chair of Horst Kloppenburg, the seminar also featured various presentations on virtually all aspects of national and EU-level use and usefulness of the IDB – given by Birthe Frimodth-Moller, Saakje Mulder, Lucia Masiero, Rupert Kisser, Renzo Pace Asciak and Marc Nectoux to name just a few. This IDB seminar focussed on the achievements of the “old” IDB network, the EU-15 network on Home and Leisure Accidents. The next seminars will certainly focus on an exciting new IDB development – the All Injury data collection in the new Member States. Contact: robert.bauer@sicherleben.at
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Action on Accidents and Injuries, Volume 1: Issue 3: September 2005
comparing the corresponding mortality rates among the EU25 countries. In addition, a first draft has been developed which includes retrieved resources such as:
EVENTS
WP-AI Meeting
To be confirmed
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Articles, publications, research papers pertaining to injury prevention and safety promotion among seniors. Related websites & organisations Information regarding implementation and effectiveness of elderly injury prevention policies, practices and activities. Demographic data regarding the increase of elderly population (65+) in Europe. Morbidity data, mainly on falls and road traffic accidents, among seniors from five European countries.
2005
Website: www.aipcr2006.it 1 April, Durban, South Africa 6th International Conference on Measuring the Burden of Injury More information: Stephen Luchter E-mail: sluchter@earthlink.net
2-5 April , Durban, South Africa 8th World Conference on Injury Prevention and Safety Promotion Web: safety2006.info
14-16 September The 1st Safe Community Conference on Injury Surveillance E-mail: jon-andreas.jenssen @trondheim.kommune.no Web: http://www.trondheim.com/ safecity
29 September– 1 October, Eretria, Greece Pre-Event to the First European Conference on Injury Prevention and Safety Promotion Towards a Safer Europe: time for action E-mail: sanast@med.uoa.gr. Web: http://195.134.113.92/ keppasite/pre_event/
These initial lists of resources will be further supplemented and updated throughout the project. Four operational pilot projects from four Member States have been implemented. These aim to translate policy priorities into specific operational projects, pilot studies and potential guidelines that would create measurable injury prevention efforts geared towards the various sub-segments of the elderly population. These are elderly who are self sufficient (whether living alone or with a partner) and those who live in supportive communities. The emphasis is on evidence-based priority topics (such as injuries among senior residents living in nursing homes and rehabilitation centres, pedestrian injuries, etc.). A best practices policy manual on sustainable injury control and safety promotion in an aging European society, both for seniors living independently as well as for seniors residing in nursing homes, is being developed. The manual will detail cost-effectiveness and evidence-based best practices for prevention of injuries in the elderly population. A draft manual will be presented at the EUNESE meeting in October. The second project meeting is on 1-2 October, 2005 in Eretria, Greece. This meeting aims to evaluate the progress of the project so far, enhance the active involvement of all the partners, and to systematise and schedule the future activities of the project. Contact: sdikal@med.uoa.gr
April 6-7, Cape Town, South Africa 2nd International Seminar on Injury Research Methods Organised by ECOSA-Eurosafe & the Medical Research Council, Cape Town More information: Saakje Mulder E-mail: s.mulder@consafe.nl W e b : h ttp : // w w w . m r c . a c .z a / conference/ecosa/index.htm
4-7 October, Madrid, Spain Trafic E-mail: trafic@ifema.es Tel: +34 9172 25790 November 6-8, Halifax, Canada Canadian Injury Prevention and Safety Promotion Conference Evidence to Action: Injury, Violence and Suicide Prevention Tel.: +1 613 798 8029 E-mail: purpledog@sympatico.ca Web: http:// www.injurypreventionconference.ca November 9-11, Karlstad, Sweden 6th Nordic Safe Communities Conference Conf. Secretariat: Janet Edwards E-mail: janet.edwards@srv.se Web: http:// www.raddningsverket.se/nscc November 14-15, Solihull, England Reducing risks and injuries at home: National home safety congress 2005 Tel.: +44 870 777 2120 E-mail:events@rospa.com Web: http://www.rospa.com
If you would like your event to be listed in the Agenda please contact j.cooper@consafe.nl
Working Party on Accidents and Injuries The WP-AI was established in 2003 under the guidelines laid out by the Council and the European Parliament and replaces the former Injury Prevention Programme (IPP). The aim of the WP-AI is to support public health activities that seek to reduce all accidents and injuries. Co-ordinating Secretariat 2004 to March 2006) (April
Eleni Petridou, Project Leader and Stephanie Anast, Collaborator, Center for Research and Prevention of Injuries Medical School, University of Athens. For enquiries please contact Stephanie at sanast@med.uoa.gr. Newsletter Editorial Board E. Petridou, Medical School, University of Athens, Greece E. Negri, Istituto di Ricerche Farmacologiche "Mario Negri", O. Kalakouta, Cyprus, Ministry of Health,
B. Thelot, Institut de Veille Sanitaire Y. Rahim, Norwegian Safety Promotion Centre Editor & Design Justin Cooper: For editorial matters please contact Justin at: j.cooper@consafe.nl.
2006
27-30 March, Torino, Italy XII International Winter Road Congress, PIARC E-mail:piarc2006@congressiefiere.com
For WP-AI members, the Newsletters are also available on the WP-AI Web-Board under the forum Function II: Dissemination
Action on Accidents and Injuries, Volume 1: Issue 3: September 2005
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