Hazard (Edition No. 25) V.I.S.S. December 1995 Victorian Injury Surveillance System Monash University Accident Research Centre Translating injury surveillance to prevention: an update As VISS is moving to a new system of data collection in 1996 it is timely to review our achievements over the past eight years. This edition of Hazard highlights some VISS success stories and outlines some of the challenges that face us in 1996 and beyond. Erin Cassell or more significant injury issues and progress has been made by VISS and Virginia Routley Joan Ozanne-Smith a discussion of actions that need to be other bodies but where there is good taken to reduce or eliminate the potential for further gains. In these Summary potential for injury. areas a modest increase in human and financial resources applied to the The first edition of Hazard was As background to this (the 25th) problem could be repaid by significant published in July 1988, the year in edition of Hazard, progress on all the reductions in the number and/or the which the Victorian Injury recommendations to reduce injuries severity of injuries. Surveillance System was established. made in Hazard was reviewed. The The quarterly publication of Hazard review not only covered follow-up Enclosed in this edition is a client is one of the major methods VISS action undertaken by VISS alone or in survey. In 1995 VISS received a uses to disseminate information. The collaboration with other Monash small grant from the Victorian selection of topics forHazard is based University Accident Research Centre Health Promotion Foundation to on the relative severity, frequency (MUARC) projects but also included support the implementation of and the potential preventability of significant action on VISS findings from VISS data analyses injury problems that emerge from recommendations taken by other and research. This grant included analyses of VISS hospital emergency bodies. VISS intends to continuously funds for a survey of VISS clients department presentations data and update this review as an ongoing and potential clients on their data reference to other relevant data Working Report. and other needs for progressing the sources. This edition of Hazard highlights recommendations for action Each Hazard edition includes the some VISS success stories. It also published in Hazard. findings from the data analysis on one focuses on injury issues where some VICTORIAN INJURY SURVEILLANCE SYSTEM HAZARD 25 page 1 Introduction Media coverage of injury issues in Hazard - 1995 Table 1 The Victorian Injury Surveillance System (VISS) was established in No. of 1988 to collect and analyse injury Injury Issue media Media coverage in 1995 data from hospital emergency requests departments and to disseminate Domestic 22 Print: AAP, Canberra Times, Herald Sun, information for the purposes of injury violence IPA Review, Shepparton News, Sunday prevention. VISS is currently funded Herald Sun, Sydney Morning Herald, The Age, The Australian, The Independent by the Victorian Health Promotion Monthly, Warrnambool Standard, Waverley Foundation. Gazette, Women's Day. The size and nature of the data Radio: ABC Sydney, SBS, Triple M collection has changed over the Television: A Current Affair (Channel 9), lifetime of VISS. It was initially a GP (ABC TV) collection of child injuries reported Dog 12 Print: Fairfax Suburban Newspapers, through the emergency department of bites/attacks Herald Sun, National Dog Magazine, the Royal Children’s Hospital under Sunday Age, Sunday Herald Sun, Sterling Media the directorship of Associate Professor Television: A Current Affair (Channel 9), Terry Nolan. MUARC took over Burke's Backyard (Channel 9) VISS management in 1990 and Horse related 8 Print: Herald Sun, Warrnambool Standard, developed the all age injury collection. injuries Weekly Times By 1992 VISS had expanded to five Radio: Country Hour (ABC Radio) hospitals on seven campuses. Television: Midday Show (Channel 9), Channel 9 VISS is currently in transition from Sports injuries 8 Print: Australian Golf Digest, Fairfax the manual collection of injury data in Newspaper Group, Herald Sun, Sunday selected emergency departments to a Age, Sydney Morning Herald statewide routine electronic collection Radio: 3BA using the National Minimum Dataset Television: Today Tonight (Channel 7) (Injury Surveillance). Smoking 5 Print: AAP, Herald Sun, The Age related injuries Radio: 3MP, 5DN VISS has also expanded to access In-line skating 3 Print: Shepparton News data and information from a wider injuries Television: The Today Show (Channel 9), range of sources so that a more News Channel Pay TV complete picture of injury issues is Escalator- 3 Print: Australian Doctor, Parents obtained. The other sources frequently related injuries (Australian Parenting Magazine), Herald accessed are the Australian Bureau of Sun Statistics (ABS), the Coroner’s Home injuries 3 Print: The Age Facilitation System (mortality) and Television: Better Homes (Channel 7), the Victorian Inpatient Minimum Channel 7 Dataset. Tractor-related 2 Print: Herald Sun, Weekly Times injuries Radio: The Country Hour (ABC radio), There are currently 166,137 cases of Country Roundup (Ace Network) injury on the VISS hospital emergency Shopping 2 Print: Herald Sun department database. VISS data are trolley injuries used to identify injury problems, Snake bites 2 Print: Sunday Herald Sun support research and, most import- Television: Burke's Backyard antly, to underpin the development of Farm injuries 2 Print: Warrnambool Standard, Weekly injury prevention strategies and Times Chainsaw- 1 support their implementation and Print: Gippsland Farmer evaluation. related injuries VICTORIAN INJURY SURVEILLANCE SYSTEM HAZARD 25 page 2 The latter is achieved by bringing hazards and potential solutions to the Progress on selected issues attention of the public and those who share the responsibility for Prevention of suicide - reducing car exhaust gas poisoning safeguarding Victorians - government [reported in Hazard 11, June 92; Hazard 20, Sept 94] departments and statutory authorities, manufacturers, retailers, insurers, Recommendations consumer and injury prevention groups, educators, researchers and • reduce access to the means of suicide, especially firearms and carbon specialist medical practitioners. monoxide gas [Hazard 11, June 92] • design modifications to motor vehicles to impede common methods of The media play an important and carbon monoxide poisoning, eg. modify/re-design car exhaust systems to responsible role in reporting VISS reduce or eliminate carbon monoxide emission, and mandate these design data and often follow up the injury changes by incorporating them into the Australian Design Rules (ADRs) issues highlighted in Hazard. Table 1 [Hazard 20, Sept 94] shows the media attention given to injury issues in 1995 that are directly • mandate, through changing ADRs, the incorporation of a sensing device attributable to the publication of in motor vehicles which monitors carbon monoxide levels and shuts down Hazard. The issue that excited the the motor when levels become life threatening [Hazard 20, Sept 94] most media attention was domestic • improve motor engine designs and catalytic conversion techniques to violence. complete the combustion process and thereby virtually eliminate carbon Over time, increasing emphasis has monoxide emissions [Hazard 20, Sept 94] been given by VISS to the vigorous • improve the identification and treatment of those who are most at risk of pursuit of the implementation of suicide [Hazard 11, June 92] recommendations based on VISS data and available research. Hazard 20 highlighted that carbon Cars built after 1986 have catalytic monoxide poisoning from car exhausts converters fitted which convert VISS is a major program of Monash was a major means of suicide in harmful carbon monoxide gas University Accident Research Centre Victoria, ranking second to hanging/ emissions to carbon dioxide gas. (MUARC) and Dr Joan Ozanne- strangulation. In 1994 carbon However, ongoing surveillance of the Smith, a Senior Research Fellow with monoxide gas was used by 98 trend in suicides in Victoria and MUARC, is the Director of VISS. Victorians and 447 Australians Australia by VISS shows no clear (source-ABS microfiche data) to evidence of a decline in the proportion commit suicide. of suicides from carbon monoxide poisoning in recent times. In fact, There is some research evidence which Victorian Inpatient Morbidity data suggests that restricting access to the indicate that hospital admissions for means of suicide can contribute to a carbon monoxide suicide attempts fall in overall suicide rates. For have steadily increased from 15 in example, a fall in suicides among 1989-90 to 56 in 1993-94. women in Australia occurred when access to barbiturates was tightened Information from the Victorian in the late 1960’s and in the U.K. Institute of Forensic Medicine also when natural gas replaced coal gas. confirms that gassings are still There is preliminary evidence that occurring in post-1986 vehicles, tighter firearm legislation in Victoria probably because catalytic converters may be having a similar beneficial do not work efficiently at a cold start. effect. VISS therefore recommended the consideration of other design VICTORIAN INJURY SURVEILLANCE SYSTEM HAZARD 25 page 3 modifications to cars to make carbon Youth Suicide, comprising the (Harrison & Cripps 1994; Harrison & monoxide emissions a less accessible Commonwealth Department of Dolinis 1995). During 1996 VISS means of