An Ounce of Prevention ... Pediatricians Can Influence Patients’ Safety Behaviors
In 2005, motor vehicle collisions were responsible for 1451 deaths and approximately 203,000 injuries in US children aged 14 years or younger.1 Each year, there are more than 200,000 emergency department visits among children in this age group who sustained playground injuries.2 On average, someone in the United States dies about every 2 hours as a result of a fire: most of these deaths occur in the home.3
These are somber statistics, but a newly published study suggests that the numbers of injuries and deaths can be reduced. Chen and colleagues4 of the CDC have just published the results of the second Injury Control and Risk Survey. This was a follow-up survey to one done in 1994. The investigators used a computer-assisted telephone interviewing system to obtain data from 9684 persons across the country. Respondents whose child had at least 1 medical visit in the past year were asked whether they or their child had ever received verbal or written information about injury prevention—including smoke detectors, the poison control number, and car seats for younger children. In addition to smoke detectors and seat belts, firearm storage and bicycle helmet use were covered for older children.
Of the 2541 respondents who had at least 1 child younger than 14 years and who had seen a health care provider in the past year, 42.4% had been counseled on at least 1 of the injury prevention topics. The rate was inversely related to the child’s age. For the most part, counseling was not dependent on demographic characteristics.
Overall, the percentage of respondents who had received counseling was not significantly higher than reported in the 1994 survey (39.3%). In 1994, fewer than 20% of those counseled were given information on more than 1 injury prevention topic. In the current study, more than 33% received information on multiple topics. Therefore, while a similar proportion of respondents had received some counseling, there was significant improvement in some of the specific injury prevention topics discussed—such as the use of bike helmets.
As in the 1994 study, the authors found a relationship between reported counseling on injury-specific topics and reported behaviors related to those topics. This reinforces the concept that—with proper counseling—we can influence the safety behaviors of our patients and their families.
This study is limited in that data were collected from patients rather than from documentation of counseling and observation of behaviors. However, the results make it clear that we still have a long way to go as far as counseling parents and children about injury prevention. We need to reach each and every family and remind them that simple steps (such as wearing seat belts and installing smoke detectors) can save lives. As pediatricians, we are in a position of influence: let’s use that power to reduce the incidence of preventable injuries and death among children.