Accident; analysis and prevention
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The first year of the mandatory bicycle helmet laws in Australia saw increased helmet wearing from 31% to 75% of cyclists in Victoria and from 31% of children and 26% of adults in New South Wales (NSW) to 76% and 85%. However, the two major surveys using matched before and after samples in Melbourne (Finch et al. 1993; Report No. 45, Monash Univ. Accident Research Centre) and throughout NSW (Smith and Milthorpe 1993; Roads and Traffic Authority) observed reductions in numbers of child cyclists 15 and 2.2 times greater than the increase in numbers of children wearing helmets. ⋯ Consequently, a helmet law, whose most notable effect was to reduce cycling, may have generated a net loss of health benefits to the nation. Despite the risk of dying from head injury per hour being similar for unhelmeted cyclists and motor vehicle occupants, cyclists alone have been required to wear head protection. Helmets for motor vehicle occupants are now being marketed and a mandatory helmet law for these road users has the potential to save 17 times as many people from death by head injury as a helmet law for cyclists without the adverse effects of discouraging a healthy and pollution free mode of transport.
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The mortality and hospital morbidity data usually used to quantify the burden of injury are generally considered to represent only the tip of the iceberg. This article documents the population-based morbidity arising from non-hospitalised injuries and demonstrates the public health importance of this group of injuries. A prospective cohort study was conducted in an Australian population using a sample of injured adults to identify the health outcomes arising from the range of injuries. ⋯ Sprains contributed as much to the total morbidity as all other injuries types combined and limb injuries contributed more to the total morbidity than injuries to the more central structures. The results of this study provide a strong argument for the recognition of the public health importance of minor injury. Strategies for the prevention and management of minor injury must be included in national programmes for injury control.