ABSTRACT. An estimated 8500 individuals, approximately 45% of them children younger than 15 years, were treated in US hospital emergency departments during 1999 for fireworks-related injuries. The hands (40%), eyes (20%), and head and face (20%) are the body areas most often involved. Approximately one third of eye injuries from fireworks result in permanent blindness. During 1999, 16 people died as a result of injuries associated with fireworks. Every type of legally available consumer (socalled "safe and sane") firework has been associated with serious injury or death. In 1997, 20 100 fires were caused by fireworks, resulting in $22.7 million in direct property damage. Fireworks typically cause more fires in the United States on the Fourth of July than all other causes of fire combined on that day. Pediatricians should educate parents, children, community leaders, and others about the dangers of fireworks.
Objective: To develop an assessment and reporting tool for a trauma center's community partnership strategy to deliver injury prevention programs in a large metropolitan area.
Method:The tool was designed to track prevention activity and serve as a reporting format for the parent health system, county designating agency, and the American College of Surgeons' Trauma Center Verification Process. The tool collected data including trauma center paid and volunteer personnel time, equipment, resource, and financial costs, community group and public agency contributions, number of community members receiving prevention material or presentations, impact on public policy, and print and broadcast media coverage. These measurements were incorporated in a reporting grid format. Six youth injury prevention programs were evaluated over a recent 2-year interval to demonstrate the tool's usefulness.
Results: Of six programs, three focused on motor vehicle injuries, one on teen suicide, one on firearm injuries, and one on drug and alcohol abuse. Trauma Center personnel asset allocation included 3% full-time equivalent by the Trauma Medical Director, 30% by the Injury Prevention and Community Outreach Coordinator, and 473 person hours (both work and volunteer) by physicians, nurses, and other personnel. Trauma Center equipment and fixed asset expenses totaled $3,950 and monetary contribution totaled $4,430. Community groups and public agencies contributed 20,400 person hours with estimated in-kind costs exceeding $750,000. Five of the six programs continued during the 2-year period. A gun-lock giveaway program was suspended because of a product recall.A total of over 29,000 youth received prevention material and presentations. Four public policy initiatives and 18 Trauma Center media stories with over 50 mentions and 37 new community partnerships resulted. The reports generated were easily incorporated in the trauma center's reports to local and national organizations and agencies.
Teen-driver motor vehicle crashes (MVCs), MVC-related injuries, and MVC-related costs before (1993-1995) and after (1997-1999) the implementation of the teen driver licensing (TDL) program in Kentucky are evaluated. Data collected as part of the study are used to recommend actions to enhance the effectiveness of Kentucky’s TDL program. The study involved the analysis of teen crash data pre-TDL and post-TDL by using data from the Kentucky Accident Reporting System database and the Kentucky Transportation Cabinet driver license file. The study also involved analysis of crash data in relation to crash costs by using the CrashCost software program. Findings indicate that implementation of the TDL program in Kentucky resulted in a substantial (32 percent) reduction in MVC rates for 16-year-old drivers from before the TDL program and a similar reduction in crashes after midnight, fatal crashes, and injury crashes for the 16-year-old age group. Cost analysis indicates an estimated annual reduction of $34.2 million in 16-year-old teen-driver MVC-related expenses. However, after a dramatic reduction in the number of crashes for ages 16 to 16.5 (learner permit stage), the number of crashes rose sharply for ages 16.5 to 17, when drivers may have progressed to independent driving. There were no decreases in crash rates for 17- and 18-year-old drivers under the TDL program. Results from this study indicate a need for more effective measures to decrease MVCs for ages 16.5 to 18, such as upgrading to a full graduated driver licensing program.
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