2P-S1-2文本框: CHILDHOOD INJURIES: EPIDEMIOLOGICAL AND BEHAVIORAL DETERMINANTS IN PREVENTIVE STRATEGIES
Thomaidis T.
Dept. Mother and Child Health. National School of Public Health, Athens – Greece

Injuries are presently a leading cause of death or disability as well as a costly health care in the ages between 1 and 19 years, in most wealthy communities. In 1996 more than 13.000 children and adolescents in the U.S.A. died of unintentional (accidental) injuries, predominantly from traffic, drowning, hot object scalding, falls, suffocation, poisoning, etc. In Feb. 2001 UNICEF has reported from the Innocenti Research Center data, that 40% of all deaths in childhood and adolescence were due to injuries in 26 industrialized countries. Furthermore attention was drawn, that 12.000 death per year could be prevented, if the Swedish strategies were implemented, where death rate from unintentional injuries is as low as 5.2 per 100.000 children. Corresponding figures in other countries are: USA: 14.1; U.K.: 6.1; The Netherlands: 6.1, Greece: 7.6. In recent years “injury” has replaced the term “accident”, denoting that it is not a random (chance-related) situation but an environmental hazard, that can be eliminated and that any causative behavioral attitudes are subject to change by appropriate strategies or by various intervention models. Three key approaches to prevention should be elaborated: (a) education, (b) environment and product changes and (c) legislation. On the other hand, health care providers have numerous opportunities to intervene with parents, children and adolescents, promoting child safety practices outdoors and at home in a variety of settings, such as: physician’s offices, clinics, emergency departments and hospitals. Nevertheless, it is not possible to control all risk factors, providing absolute safety. There is still a need for collective multi-center epidemiological studies of all possible situations favoring unintentional injuries, coupled with correlative studies on parental psychology, level of child development, building construction errors, legislative gaps, effective health education, public compliance and finally political will and commitment.