Because ATV and bicycle crashes have been associated with serious injury in children, the authors compared the demographics, mechanism of injury, injury severity, and outcome of children with ATV- and bicycle-related injuries. Further, the authors sought to identify wheteher ATV-related injuries elicited changes in risk-taking behaviour. A retrospective, comparative analysis of children admitted for ATV-related injuries and children admitted for bicycle-related injuries to a pediatric trauma centre between Jnauary 1991 and June 2000 was performed. A phone survey was conducted to determine self-reported changes in safety behavours or use patterns after ATV injury. Results showed that the mean age was 11.1 years for ATV crahes versus 9.4 years for bicycle crashes. 93% of ATV crashes ocurred in children less than 16 years of age; 31% in children less than 11 years of age; and 7% in children less than 6 years of age. Male-to-female ratio was about 3:1 for both groups. White race accounted for 97% of ATV injuries compared with 79% of bicycle injuries. Falls from ATVs or bicycles were the most common mechanism of injury. Collisions with motor vehicles were more common for cyclists, whereas collisions with stationary objects were more common among ATV riders. 16% of ATV crashes were caused by a roll-over mechanism. Mean injury severity scores were significantly higher for victims of ATV crashes. ATV-related trauma was associated with multiple injuries, more operative interventions, and longer hopsital stays. Location and distribution of injuries were similar for both groups. Helmet use was low in both groups but higher for ATV riders. Mortality rate was similar for both groups. There was a 39% response rate for the phone survey post ATV injury. 53% of respondents owned the ATV, and 70% of these received safety information at the time of purchase. However, only 14% of the injured riders received any formal training before riding ATVs. Postinjury, 60% of children continued to ride, although 42% reported decreased riding time. 54% of children reportedly wore helmets preinjury, and there were no changes in helmet use postinjury. There were no differences in pre- and postinjury parental supervision. In conclusion, both ATV and bicycle-related injuries occurr predominantly in boys, but ATV victims are older and almost all are white. Almost all ATV injuries occurred in childen under the age of 16 years. Although, both ATV and bicycle crashes cause severe injuries in children, injury severity is higher for ATV carshes in terms of multiple injuries, need for operative intervention, and longer length of stay. Despite severe injuries, the majority of children injured by ATVs continue to ride, albeit fewer hours per day, and safety behaviours remain unaltered. These data reinforce the current American Academy Pediatrics stance that legislation prohibiting the use of ATVs in childen under the age of 16 years without a valid driver's license should be pursued and enforced aggressively.

The release of the Canadian Paediatric Society position statement on its recommendations for all-terrain vehicle (ATV) use in Canada (see rec # 8090) serves as a reminder of the concern the medical and injury prevention community have regarding the continual increase in the number of injuries associated with ATV use. Even over the past five years, a period when voluntary standards, education and some legislative efforts should have offered solutions to this problem, studies continue to show increasing risks of injury to children operating ATVs, both recreationally and on the farm. According to the American Consumer Product and Safety Commission (CPSC), not only are absolute numbers increasing among all ages, but the rates of injuries per driving hour and per driver have jumped significantly from 1997 to 2001. While 18-year-old to 25-year-old operators have the highest probability of sustaining an injury, the next highest is for those aged 12 to 16 years, whose risk almost doubled over this time period. Taking away the effect of alcohol, which plays a larger role in ATV-related injuries sustained by young adults, it is likely that the true risk may actually be highest for the younger age range. Expectedly, comparable escalations in injuries have occurred in Canada. A recent report from the Canadian Institute for Health Information revealed a 50% increase in ATV-related hospitalizations from 1996/1997 to 2000/2001, with 36% occurring in children and youth. This is clearly a red flag not to be ignored. The reality is that ATVs are getting bigger and faster, as are the industry and sales. Unfortunately, preventive policy development has not kept pace.

Although the sale of all-terrain vehicles (ATVs) to children under 16 years of age was prohibited in 1988, they continue to represent half of the ATV-associated injuries. The authors conducted a retrospective review of ATV injuries admiited to their institution from 1988 to 1998. 76 patients were identified over the 10 year period and children <16 years accounted for 50% of these. Only 8% of these children wore helmets. In conclusion, despite industry regulation, nearly half of ATV injuries continue to involve children < 16 years of age. The consent decree restricting access of children < 16 years of age to ATVs has been ineffective and expired in April 1998. Significant morbidity and mortality cotinues to occurr in children < 16 years of age who operate these vehicles. Reform is needed, such as legislation, that would mandate the sale of safety equipment on ATV purchase, as well as provide for ATV safety education.

A letter to the editor which discusses strategies for reducing ATV associated injuries, including changes in ATV design features.

All-Terrain Vehicles (ATVs) have become a major source of morbidity and mortality with more than 600 deaths nationwide. nearly half of those injured are children under 16 years. 23 ATV accidents were seen at the Guthrie Medical Center over a 30 month period ending in August 1986. 10 patients (43.5%) were under 16 years old. of those injured who were older, alcohol was involved in 70% of the accidents. Five accidents occurred on highways (21.7%), in spite of laws banning their use on public roads. Rollover type accidents and collisions were the most frequent mechanisms of injury (39% and 35%). Of 18 patients known not to have worn a helmet, 61% sustained a closed head injury. ATVs present a serious hazard to adult and children riders alike. Age limits, state licensing, safety programs, and protective equipment are all recommended as a means to reduce injury and death from recreational riding.

BACKGROUND: All-terrain vehicle (ATV)-related injuries remain a large public health problem in the United States and disproportionately affect American youth. Although children account for only 14-18% of ATV riders, they comprise 37-57% of those injured in ATV-related accidents. Since the U.S. Consumer Product Safety Commission began collecting data in 1982, 23% of ATV-related deaths have occurred in children. OBJECTIVE: With this review, we outline the major risk factors for injuries among young ATV riders in the United States and suggest research-based interventions to successfully modify such risk factors. DISCUSSION: We reviewed data from 16 published reviews regarding epidemiology and risk factors among ATV-related injuries in American children. All data pointed to young driver age and lack of appropriate safety equipment as major risk factors for such injuries. Although these risk factors are modifiable, legislation and programs designed to mitigate such risks have been unsuccessful. Among adults, the brief intervention model has become widely used among trauma patients exhibiting risky behaviors. Additionally, peer-to-peer interventions have demonstrated success with respect to drug and alcohol use in school-aged children. Both the brief and peer-to-peer interventions are promising avenues for decreasing risky ATV-related behavior in youths but have not been studied in this field. CONCLUSIONS: ATV-related injuries disproportionately affect American youths. Although risk factors for such injuries are modifiable, current methods for intervention (mainly legislation) have not been successfully implemented. The brief intervention and peer-to-peer interventions have shown promise in other fields and should be studied with respect to pediatric ATV use.

A variety of educational efforts, policies, and regulations have been adopted to reduce all-terrain vehicle (ATV) injury in children. Despite this, ATV use by children continues and serious injuries are common. The purpose of this study was to investigate the knowledge, practices, and beliefs of ATV users to help develop effective educational strategies to promote safer ATV use. Focus groups were conducted to characterize participant ATV use and safety awareness as well as to explore avenues for prevention. Feedback on draft ATV safety public service announcements was elicited. Themes of transcribed focus group data were summarized. The setting for this study was a rural state with high ATV use and injury rates. Subjects were adult and adolescent ATV users. The main outcome measures were summaries of focus group discussions. Results showed that ATV riders frankly discussed current use and safety behaviors and were aware of some ATV risks. Youths felt that age specific regulation was unlikely to be a helpful strategy. Participants endorsed messages demonstrating graphic consequences as likely to get the attention of young riders regarding risks. Educational settings were suggested, including hunter and driver safety classes. In conclusion, efforts to improve ATV safety awareness should clearly show pediatric ATV injury risk and safety practices. Campaigns must also show realistic understanding of current use practices to be credible for users. Messages emphasizing the consequences of ATV use were endorsed as most likely to have impact. Approaches based on age based restrictions were considered unrealistic and alternative strategies were suggested.

"Since 1987, the American Academy of Pediatrics (AAP) has had a policy about the use of motorized cycles and all-terrain vehicles (ATVs) by children. The purpose of this policy statement is to update and strengthen previous policy. This statement describes the various kinds of motorized cycles and ATVs and outlines the epidemiologic characteristics of deaths and injuries related to their use by children in light of the 1987 consent decrees entered into by the US Consumer Product Safety Commission and the manufacturers of ATVs. Recommendations are made for public, patient, and parent education by pediatricians; equipment modifications; the use of safety equipment; and the development and improvement of safer off-road trails and responsive emergency medical systems. In addition, the AAP strengthens its recommendation for passage of legislation in all states prohibiting the use of 2- and 4-wheeled off-road vehicles by children younger than 16 years, as well as a ban on the sale of new and used 3-wheeled ATVs, with a recall of all used 3-wheeled ATVs.

The U.S. Consumer Product Safety Commission initiated a formal regulatory proceeding in 1985 to evaluate the hazards associated with all-terrain vehicles (ATVs) and to consider a range of regulatory alternatives. In December 1987, the government and ATV industry filed preliminary consent decrees in U.S. District Court that contained provisions intended to satisfy the Commission's concerns about ATVs. Final consent decrees were approved by the Court in April 1998. This study examines he effectiveness of the consent decrees and concomitant publicity in reducing ATV-related injuries by evaluating changes in driver and market behaviour following the consent decrees. The results suggest that CPSC actions have had a positive impact in reducing ATV injuries.

All-terrain vehicles (ATVs) continue to be a source of morbidity and mortality in the pediatric population despite recommendations from the American Academy of Pediatrics that children <16 years old not ride in or drive ATVs. ATV injuries have increased significantly in both children and adults most years since 1997. The objective of this study was to assess the effectiveness of ATV regulations for children on serious injuries by comparing ATV-related admissions to level I and II trauma hospitals in a state with and a state without ATV regulations. This was an ecologic study with subjects being children <16 years old who died and/or were treated in the trauma system of Pennsylvania or North Carolina after ATV crashes. Injury types and cause of death were examined for all children. Comparisons were made by state (Pennsylvania [regulated] and North Carolina [unregulated]) for patterns of injury, place of injury, helmet use, and death. Results showed that there were 1080 children identified in the trauma registries between January 1997 and July 2000. Forty-four percent required intensive care. Head injuries were the primary cause of death (45.7%). Fewer North Carolina children than Pennsylvania children (16.7% vs 35.8%) wore helmets, and they were more likely to be <11 years old (35.1% vs 27.8%). Living in North Carolina was an independent predictor for not wearing a helmet. In conclusion, living in Pennsylvania was associated with decreased risk factors for ATV injury such as young age and riding unhelmeted. However, despite regulations, many children suffered serious morbidity and mortality. These data support the recommendation that children <16 years old should be prohibited from riding or driving ATVs.

All-Terrain Vehicles (ATVs) have resulted in over 1,400 deaths and 400,000 injuries in the USA since their introduction in the 1970s. Analysis of deaths due to ATVs have been limited to a few states. Death certificates for ATVs were abstracted for the years 1983-1989 in Wisconsin. 52 deaths were analysed; 44 (85%) were male, and 26 (50%) were under age 18. Head injuries accounted for 33 (63%) of the deaths. 31 (60%) of the deaths were "immediate". Following the model developed by Haddon, there are several promising injury control strategies: limiting the use of ATVs to those 16 or older, increasing visibility of vehicles through means such as flags, increasing helmet usage, and improving emergency medical system services. many of these strategies are best promoted through statewide legislative policy changes. This injury study model of ATV deaths suggests that a more balanced approach towards injury reduction should have an equal emphasis on improving injury prevention and acute care.

All-terrain vehicles (ATV) use by children leads to severe injury and death. Since the US Consumer Product Safety Commission consent decree expired in 1998, there has been little movement in regulating ATV use for children (<16 yr). The authors hypothesized that states with laws and regulations restricting pediatric ATV use may abrogate excess death compared with states without such restrictions. Pediatric mortality data reported to the consumer product safety commission from 1982 to 1998 were analyzed as well as state all-terrain vehicle requirements compiled by the Specialty Vehicle Institute of America in August 2001. The authors calculated ATV mortality rate by dividing ATV mortality frequency by 1980–2000 pediatric census results. They compared the top 26 states with the highest ATV mortality rates (TOP) with those of all other states (OTH) in terms of age, ATV type, ATV occupancy, and ATV laws. Chi-square analysis was performed. Results showed that there were 1,342 ATV pediatric deaths during the 16-year period. The TOP states averaged approximately a 2-fold increase in adjusted ATV mortality rate compared with the national ATV pediatric mortality rate. Ninety-two percent of TOP states have no licensing laws compared with 73% of the OTH states. There is no difference between groups with regard to minimum age requirements and safety certification. In conclusions, current legal and regulatory standards have low probability of decreasing ATV-related pediatric mortality. States should adopt laws that restrict the use of ATV’s for children less than 16 years of age and potentially prevent excess ATV-related pediatric mortality.

from 1985-1997, the U.S. Consumer Product Safety Commission (CPSC) identified 113 deaths associated with all-terrain vehicles (ATVs) in West Virginia. This report summarises data from the CPSC ATV-related death database and on-site and/or follow-up telephone investigations; findings indicate that approximately two thirds of deaths were caused by injury to the head or neck. Consistent use of helmets by riders can substantially reduce ATV-related deaths.

The objective of this study was to estimate the numbers and rates of ATV-related nonfatal injuries to riders aged >15 years who were treated in U.S. hospital emergency departments 2001-2003. It was concluded that existing legal regulatory standards are ineffective in reducing injuries among young ATV riders. Renewed efforts by health care providers to counsel parents and advocate for more stringent minimum age requirements are recommended.

The purpose of this article is to provide a brief history of ATV use and regulation, describe the injury burden on pediatric patients, and suggest preventive guidelines for pediatric medical providers.

A brief article which provides some ATV related child injury statistics from the USA, focusing on the state of Kentucky. Some safety advice from the US Consumer Product Safety Commission is also listed.

All terrain vehicles (ATVs) are designed for off-road use. They have three or more wheels, an engine capacity exceeding 50 ml and a gross weight of less than 1,000 kilograms. They're also known as farm bikes, three-wheelers or four-wheelers. There are around 70,000 ATVs in New Zealand, mostly used on farms. Apart from road crashes, ATVs are the single most common cause of work-related fatalities. This factsheet explains the registration and licensing requirements for ATVs, and provides some guidelines on using them safely, including a section on 'children and ATVs' and on carrying passengers. See also: http://www.transfund.govt.nz/factsheets/19.html

All terrain vehicles (ATVs) are designed for off-road use. They have three or more wheels, an engine capacity exceeding 50 ml and a gross weight of less than 1,000 kilograms. They're also known as farm bikes, three-wheelers or four-wheelers. There are around 70,000 ATVs in New Zealand, mostly used on farms. Apart from road crashes, ATVs are the single most common cause of work-related fatalities. This factsheet explains the registration and licensing requirements for ATVs, and provides some guidelines on using them safely.

All-terrain vehicles, including three- and four-wheeled recreation and utility off-road motorized devices, are a serious risk to the public especially to children younger than 16 years. Statistics show the injuries, which often are musculoskeletal in nature, and fatalities are increasing: in 2002, approximately 111,000 people sustained injuries related to all-terrain vehicles. Although agencies such as the Consumer Product Safety Commission initially recognized and restricted three-wheeler sales, they largely have failed to address the problem caused by other all-terrain vehicles during the past 10 years. To reduce the frequency and severity of injuries from all-terrain vehicles, numerous methods have been recognized and discussed. State and federal laws are needed to implement these methods to protect the public; these legislative solutions also are included in the discussion.

All-terrain vehicles (ATVs) are motorized vehicles with three or four wheels and large, low-pressure tires. They are designed to be used by a single operator in off-road areas, not on public roads. They can weigh up to 272 kg (600 lbs). ATVs are not safe for children and young teenagers, who don't have the strength or skill to handle them properly. Still, many kids do use them, especially in rural or remote areas. And each year, many children and youth are seriously injured or even killed while riding an ATV. This fact sheet is designed to help parents learn more about ATVs, so that they can keep their children and youth safe.

"Love your child, fasten their seatbelt while in the car". This is a pamphlet produced in Samoan which discusses child restraints and provides useful information with regards to their correct use.

This is a pamphlet, written in Samoan, which provides some information about cot death and its prevention.

A family learns how to ride in their car safely. Primary school level.

This poster features a photo of a girl who had been run over clutching her battered cycle helmet which has obvious tyre marks on it. The poster also has the text: "It was really scary when the tyres drove over my head" and it describes how her injuries were sustained and concludes that authorities: "... are sure that if Paula hadn't been wearing her helmet she would now be dead. Make sure you never hit the road without a helmet". See also record # 9671.

This A4 sized poster has the text: Always cycle with a helmet. Hit your head without a helmet and you risk skull fractures, brain damage and permanent injury.

This 'rubber' non-slip bath mat from Plunket and Water Safety New Zealand is part of a drowning prevention project. A well as the mat there is a poster and it is planned that there will also be stickers (to be given at the 9 month Well Child check). Plunket nurses will give families the bath/shower mat at the five month Well Child check for the baby while discussing water safety tips for toddlers with parents and caregivers. The blue mat features the safety messages in English and Maori and an image of a rubber duck printed in white.

A fold out poster with a water safety message about water safety for children, (especially preschoolers) and supervision.

This is a pamphlet which bears the following message in English and several Pacific Island languages (Samoan, Cook Island Maori, Tongan, Niuean): "Always wear your safety belt. Love yourself. Love your family. Wear your safety belt." On the reverse: -Wearing a safety belt can save your life or reduce serious injury. -The driver is responsible for making sure children under 15 are wearing a safety belt. -The fine for not wearing a safety belt is $150 for EACH PERSON. -A safety belt must be worn in the back seat.

Catalogue of Amar Marketing who provided material which supported the 'Safekids Campaign Leadership Conference 2008: Partnerships for prevention' held in Auckland on March 6-7 2008.

This CD-ROM of a powerpoint presentation/ celebration of the ten year history of Kidsafe Week and the Safekids Campaign 1996-2006. Presented at the Safekids Campaign Leadership Conference 2006 held in Auckland on March 9-10. Played at the Conference dinner when awards to Coalition members were also made. A similar presentation was also taken to Washington to the Safekids Worldwide Conference later in October 2006.

This printout of a webpage contains information about traditional necklaces of amber beads which have been gaining popularity as a necklace for teething babies. The amber supposedly relieves pain when against the skin. This webpage warns that the necklaces are not intended to be chewed on and that if they are and they break they could pose both a choking and a strangulation risk. Babies should not be left sleeping with these necklaces. They may also present a hanging hazard. See: http://www.consumeraffairs.govt.nz/productsafety/consumerinfo/amber_teething.html

This supplementary issue of the American Journal of Preventive Medicine, from November 2001, focuses on a review of evidence relevant to the reduction of injuries to motor vehicle passengers by increasing child restraint and seat belt use, and reducing alcohol-impaired driving. Articles of interest have also been catalogued independently.

Several studies have reviewed injury events in child-care centers and point to modifiable hazards that can be reduced or prevented. Although additional research about the epidemiology of such injuries is needed, a prevention strategy at the community level may be initiated. This would include the formulation of injury prevention standards, the adoption of these standards, and the monitoring and enforcement of these standards at both the center and community levels. This article provides a perspective from the US and European countries and includes a discussion of standards from the recent American Public Health Association/ American Academy of Pediatrics publication.

This brief annotation outlines some of the history of motor vehicle safety regulations in the USA

There are about 75,000 pedestrian crashes in the United States each year. Approximately 5000 of these crashes are fatal, accounting for 12% of all roadway deaths. On college campuses, pedestrian exposure and crash-risk can be quite high. Therefore, the authors analyzed pedestrian crashes on the campus of the University of North Carolina at Chapel Hill (UNC) as a test case for their spatially-oriented prototype tool that combines perceived-risk (survey) data with police-reported crash data to obtain a more complete picture of pedestrian crash-risk. The authors use spatial analysis techniques combined with regression models to understand factors associated with risk. The spatial analysis is based on comparing two distributions, i.e. the locations of perceived-risk with police-reported crash locations. The differences between the two distributions are statistically significant, implying that certain locations on campus are perceived as dangerous, though pedestrian crashes have not yet occurred there, and there are actual locations of police-reported crashes that are not perceived to be dangerous by pedestrians or drivers. Furthermore, the authors estimate negative binomial regression models to combine pedestrian and automobile exposure with roadway characteristics and spatial/land use information. The models show that high exposure, incomplete sidewalks and high crosswalk density are associated with greater observed and perceived pedestrian crash-risk. Additionally, the authors found that people perceive a lower risk near university libraries, stadiums, and academic buildings, despite the occurrence of crashes.

This report analyses data from 1 Septmember 1990 until 31st June 1993. The aims of the report were: to perform a descriptive analysis of the data collected on the Auckland Hospital database between those dates; to recommend if any changes could be made to improve the information collected and the way in which it is collected; to recommend if the collection of detailed data should continue.

This report analyses 22 months of data from 1st september 1990 until 31 june 1993 with the aim of performing a descriptive analysis of the data collected on the Auckland Hospital Database. To recommend if any changes could be made to improve the information collected and the way in which it is collected. To recommend if the collection of detailed data should continue.

London is a large capital city with a population of approximately seven million people. It shares many problems with other large cities around the world, including deaths due to re. Many of these re deaths can be linked to social problems such as poor housing, loneliness, illness, etc. Data from the London Fire Brigade Real Fire Library— a unique database of information collected from real re incidents by dedicated teams of re investigators operating in the Greater London Area has been used to obtain a range of statistics about fatal res and re death victims for the 5-year period from 1996 to 2000. Most deaths occurred in unintentional dwelling res. The statistical information has therefore been analysed to identify the main factors involved as to why people die in unintentional dwelling res and see what lessons can be learnt from these deaths. Common risk factors identi ed in the unintentional dwelling re deaths investigated include smoking, alcohol, old age, disability, illness, living alone, social deprivation and not having a working smoke alarm tted. Comparisons are also made with the results found from other studies and measures for preventing unintentional dwelling re deaths are examined.

Head injury is the leading cause of death and critical injury in skiing and snowboarding accidents. Data relating to head injuries occurring on the ski slopes were collected from the trauma registry of a Level I trauma center located near a number of ski resorts. Results showed that from 1982 to 1998, 350 skiers and snowboarders with head injuries were admitted to our Level I trauma center. Most of the injuries were mild, with Glasgow Coma Scale (GCS) scores of 13 to 15 in 81% and simple concussion in 69%. However, 14% of patients had severe brain injuries, with GCS scores of 3 to 8, and the overall mortality rate was 4%. Collision with a tree or other stationary object (skier-tree) was the mechanism of injury in 47% of patients; simple falls in 37%; collision with another skier (skier-skier) in 13%; and major falls in 3%. Skier-tree collision and major falls resulted in a higher percentage of severe injuries, with GCS scores of 3 to 8 in 24% and 20%, respectively, and mean Injury Severity Scores of 14 and 17, respectively. Mortality from skier-tree collision was 7.2%, compared with 1.6% in simple falls and no deaths from skier-skier collision or major falls. The risk of sustaining a head injury was 2.23 times greater for male subjects compared with female subjects, 2.81 times higher for skiers/boarders < 36 years of age compared with those > 35 years, and 3.04 times higher for snowboarders compared with skiers. In conclusion, skier-tree collision was the most common mechanism for head injuries in patients admitted to our Level I trauma center, and resulted in the most severe injuries and the highest mortality rate. Because most traumatic brain injuries treated at our facility resulted from a direct impact mechanism, we believe that the use of helmets can reduce the incidence and severity of head injuries occurring on the ski slopes.

Drowning has been identified as the leading cause of unintentional death of young children ages 0 - 4 years, worldwide. This Australian retrospective case series study examined the frequency and distribution of protective stratagems (legislative compliant safety barrier, adequate caregiver supervision, water familiarisation and early CPR) amongst drowning deaths of young children in Victoria. In 65% (52 out of 80) none of the four protective stratagems were in place, and in only one case were all 4 stratagems known to be present. These results suggest that if the presence of all four stratagems is increased, this may reduce the incidence of this type of drowning. The authors call for more research and also suggest that a consensus on the definition of adequate supervision is needed.

"This report prevents an overview of the causes of injury to children undr 15 years of age who attended the Emergency Department at Good Health Wanganui. It identifies the main types of injuries and where these injury events occurred. It provides us with data that is specific to the Wanganui Region. This will be used to assist in the planning and targeting of projects to reduce the incidence and severity of unintentional injury in children under 15 years."

Abstract The geographical distribution of child injury morbidity in Auckland between 1982 and 1987 was examined. Analysis of total injury, pedestrian injury and vehicle occupant injury, with the census area unit as the basic spatial entity revealed distinct variations in child injury morbidity by census area unit. Morbidity rates were above average in parts of the central urban area and South Auckland and below average on the North Shore. Total injury morbidity and pedestrian injury morbidity rates were strongly correlated with census area unit unemployment rates, which were used as a measure of socio-economic deprivation. Geographical areas with high rates of child injury morbidity, to which injury prevention resources can be directed, were identified. In particular, the results suggest that injury prevention programmes should be targeted at socio-economically disadvantaged communities.

The geographic distribution of child injury morbidity in Auckland between 1982 and 1987 is examined. The analysis is of total injury, pedestrian injury and vehicle occupant injury.

Contact sports have high rates of injury. Protective equipment regulations are widely used as an intervention to reduce injury risk. The purpose of this study was to investigate the injury prevention effect of regulations governing protective equipment in two full-body contact sports. Injury rates in US collegiate football were compared to New Zealand club rugby union. Both sports involve significant body contact and have a high incidence of injury. Extensive body padding and hard-shell helmets are mandated in collegiate football but prohibited in rugby union. Results showed that the injury rate in football was approximately one-third the rugby rate. The head was the body site with the greatest differential in injury incidence. Rugby players suffered numerous lacerations, abrasions, and contusions to the head region, but the incidence of these injuries in football was almost zero. Injury rates were more similar for the knee and ankle, two joints largely unprotected in both sports. In conclusion, the observed differences are consistent with the hypothesis that regulations mandating protective equipment reduce the incidence of injury, although important potential biases in exposure assessment cannot be excluded. Further research is needed into head protection for rugby players.

Belt-positioning booster seat use (BPB) is an effective technology to prevent severe child injury in cases of car crash. However, in many countries, age-appropriate car restraint use for children aged 4-7 years old remains the lowest among all age groups. The aim of this study was to identify the main determinants of BPB use through a comprehensive approach. An ecological model was used to analyze individual, parent-child relationships, and neighborhood characteristics. Parents of children enrolled in the first and second grades completed a self-reported questionnaire (n=745). The data were subjected to multilevel modeling. The first level examined individual and parent-child relationship variables; in addition the second level tested between neighborhood variance. According to parental self- reports, 56.6% of their children had used a BPB on each car trip during the previous month. The results indicated that the determinants positively related to BPB use were individual and parental; namely, the number of children in the family, the parents' car seat belt use, parental knowledge of children's car safety principles, and a highly authoritative parenting style. Children's temperaments and parental supervision were not associated with BPB use. At the neighborhood level, a small difference was found between neighborhoods for BPB users compared to non-users.

Unintentional injuries are a major cause of disability and death among children. Initial strategies to address child safety issues have primarily either focused on the environment, trying to identify "risk environments", or on the individual, trying to identify "at risk children". More recently, the interaction between child and environment is starting to be addressed in order to enhance the understanding of childhood injuries. The present review suggests a framing of these studies in ecological theory, which implies that children with certain characteristics perceive certain affordances in the environment. In this context, risk may be considered a relational concept. The literature on risk prevention is reviewed and the role of caregivers in managing affordances is emphasized.

Geographic studies of the incidence and prevalence of child pedestrian injury collisions in different community environments have been primarily descriptive and idiosyncratic, reflecting one or another likely determinant of the places where these injuries occur. The current study maintains that multiple determinants of child pedestrian injury collisions must be considered in evaluating the unique contributions of any one community feature to injury rates. These features include local characteristics of populations, such as rates of unemployment, and places, such as locations of schools. Schools are one stable geographic feature associated with regular, often concentrated periods of complex and congested traffic patterns. The objective of the present study was to examine annual rates of child pedestrian injury in four California communities with a focus on the unique contribution of schools to injury risk. The authors predicted that annual numbers of child pedestrian injury collisions (both in-school and summer combined) would be greater in communities with higher youth population densities, more unemployment, fewer high-income households, and higher traffic flow. It was hypothesized that youth population density and its interaction with the number of schools in a given area would be related to greater rates of child pedestrian collisions during in-school months. An ecological approach was taken that divided the four communities into 102 geographic units with an average of 6321 people residing in each unit. Archival data on traffic flow, number of child pedestrian injury collisions and locations of schools were obtained from state agencies. Individual-level data were obtained from a general population survey conducted in the communities. The results showed that annual numbers of injuries were greater in areas with higher youth population densities, more unemployment, fewer high-income households, and greater traffic flow. Annual numbers of injuries during in-school months were greater in areas containing middle schools and greater population densities of youth.

The purpose of this present study was to conduct an economic evaluation of the mandatory helmet wearing legislation in Western Australia. The study had two main objectives. First, the effectiveness of the helmet wearing law in reducing head injuries to cyclists in Western Australia was evaluated, taking into account trends in head injuries to pedestrians (who were used as a control group for bicyclists). Second, the cost-effectiveness of the bicycle helmet legislation was examined in terms of its costs and outcomes. The only outcome included in the cost-effectiveness analysis was the change in the number of head injuries to bicyclists. Other possible outcomes, such as the impact of the legislation on cycling activity and associated changes in physical fitness and related health conditions, were not included in the analysis.