Academic journal article Bulletin of the World Health Organization

Legislation Coverage for Child Injury Prevention in China/Couverture Legislative En Matiere De Prevention Des Traumatismes Chez L'enfant En Chine/La Cobertura De la Legislacion En Materia De Prevencion De Lesiones Infantiles De China

Academic journal article Bulletin of the World Health Organization

Legislation Coverage for Child Injury Prevention in China/Couverture Legislative En Matiere De Prevention Des Traumatismes Chez L'enfant En Chine/La Cobertura De la Legislacion En Materia De Prevencion De Lesiones Infantiles De China

Article excerpt

Introduction

Child injuries are a public health problem in China. In 2010 --according to Global Burden of Disease estimates--approximately 86000 individuals aged 0-19 years suffered fatal injuries in China. (1) In 2008, the World report on child injury prevention listed several interventions that had been found effective against unintentional child injuries--e.g. child restraints in vehicles, cycling helmets, pool fencing and flotation devices--and encouraged low- and middle-income countries to adopt such interventions. (2) However, many of these interventions have yet to be widely implemented in China (3,4)--mainly because they are not mandated in national laws or regulations or because responsibility for their implementation has not been clearly assigned to one or more specific governmental departments.

Legal requirements and prohibitions can drive behavioural and environmental changes that can reduce the risk of injury. (5) There is substantial evidence--albeit mainly from high-income countries--to prove that legislative strategies can be effective in reducing child injuries caused by road traffic, drowning, burns, falls, poisoning or suffocation. (2,6) Between 1994 and 2003, for example, the rate of head injuries among people younger than 18 years decreased by 54% in those Canadian provinces that had legislation mandating helmet use for young cyclists but only by 33% in other Canadian provinces. (7) In New York City, United States of America (USA), legislation requiring landlords to install window guards in all rented properties led to a 96% decrease in the number of children who were seen at hospitals following unintentional falls from windows. (8)

Surprisingly, many interventions known to reduce child injury have not been widely covered by legislation. When investigating legislation covering 10 interventions against child injury in 29 member countries of the Organisation for Economic Co-operation and Development, it was found that none of the 29 countries had legislation covering all 10 interventions. Only seven of the countries--Australia, Canada, Iceland, New Zealand, Norway, Sweden and the USA--had legislation covering at least seven of the interventions. (9) The World Health Organization (WHO) recently reported that only 28 countries have adequate laws to reduce road traffic injuries by reducing traffic speeds and drink-driving and increasing the use of helmets, seat-belts and child restraints. (10)

The main aims of the present study were to determine which of a set of interventions to prevent child injury were covered by the laws and regulations of China and whether the implementation of such interventions had been assigned to specific governmental departments.

Methods

Selected injury-related causes

We focused on the most common causes of fatal unintentional child injuries in China. In 2010, according to Global Burden of Disease estimates, (1) drowning, road traffic injury, falls, poisoning and burns together accounted for about 73% of all injury-induced deaths among Chinese individuals aged 0-19 years. We therefore investigated these five causes and suffocation. Suffocation was included because, in China in 2010, it was associated with 32% of injury-induced deaths in urban areas and 52% of injury-induced deaths in rural areas of children younger than 1 year. (11)

Interventions

We investigated the 24 interventions that, according to the World report on child injury prevention, (2) were effective against the five causes that we chose from the Global Burden of Disease. These interventions had all been investigated in robust studies and found to be effective in other countries. (2) However, as suffocation was not considered, we also investigated three interventions that are known to be effective against child suffocation and are recommended by the European Child Safety Alliance (Table l). (6)

Data sources

In China, a law is defined as a legislative document issued by the Standing Committee of the National People's Congress. …

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