Newspaper article St Louis Post-Dispatch (MO)

Children, Elderly at Highest Risk for Injury

Newspaper article St Louis Post-Dispatch (MO)

Children, Elderly at Highest Risk for Injury

Article excerpt

CHILDREN and the elderly are especially at risk for injury - children because of their high activity levels and dependence on supervision and the elderly because the aging process exacerbates the severity of injuries.

Unintentional injuries kill 7,200 U.S. children ages 14 and younger each year, more than claimed by all common childhood diseases combined, according to the National Public Services Research Institute, a health economics research organization in Landover, Md. An additional 50,000 children each year are permanently disabled.

Traffic injuries involving children as vehicle passengers, pedestrians or bicyclists claim 3,000 lives, followed by drownings (1,150), fires and burns (1,100), suffocation (440), poisoning and choking (410), unintentional shootings (23) and falls (180). In comparison, intentional injuries kill about 1,600 children each year; 1,330 are murdered and 260 commit suicide.

Because children are at such high risk for injuries and because the relative risks for particular injuries are clearly age-specific, pediatricians have been leaders in developing intervention strategies.

One of the oldest and most sophisticated interventions is The Injury Prevention Program (TIPP) developed in 1983 by the American Academy of Pediatrics (AAP) to help its members become more effective and efficient in injury-prevention counseling.

Funded by Sandoz Pharmaceuticals, TIPP provides a counseling schedule that tells physicians when to discuss particular risks with parents as their children progress through early and middle childhood.

Thus, counseling during prenatal and newborn stages begins by stressing the importance of infant car seats, home smoke detectors and crib safety. By age 2 months, the discussion includes the risk of hot liquid burns; by 4 months, choking and suffocation risks. Bicycle and swimming pool safety talks begin at age 5, firearms hazards by age 10, and so forth.

TIPP also includes a safety survey for parents to complete. The survey is constructed to alert the physician to injury risks specific to each family, to allow for targeted counseling.

"It's been very well accepted by parents and pediatricians," said Joel L. Bass, M.D., who is chairman of the AAP section on injury and poison prevention. He added that the academy has distributed more than 16 million TIPP kits, and that the program has been revised and updated three times to reflect advances in injury-prevention research. He said that when TIPP is incorporated into a practice, effective counseling requires only about three minutes of physician time per visit.

"This is not intended to be a substitute for public policy, such as laws mandating the use of passive restraints in cars," Bass said. "But there will always be a need for one-to-one education. You can have a car-seat law, but some parents must still be instructed how to use them, and pediatricians have been shown to be very effective in that role."

The TIPP program also is cost-effective, saving $80 per visit in future costs related to medical care, lost earnings and pain and suffering for children younger than 4, according to Ted R. Miller, Ph.D., director of children's safety economics at the National Public Service Research Institute. …

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