Accident prevention in a large urban community.

Abstract

OUR PHILOSOPHY of accident prevention in Philadelphia involves the control of many specific types of accidental injuries rather than the discovery of an all-encompassing formula for prevention. In order to place ourselves in a position to conduct specific control measures, we have embarked on an orderly but limited series of studies. These studies have been designed to lead us from an overview of the general problem to a rather intimate knowledge of the circumstances of occurrence and methods of prevention of very specific injuries. The first of these studies was a sample survey of all types of accidental injuries. Our interest is not limited to injuries which occur in the home. This survey was designed to provide rates of various types of injuries in each of two health districts with sharply contrasting socioeconomic and educational levels in the population. In addition, it included detailed reports of injuries which occurred in the home. We have almost completed the field work of this survey and are now planning to move on to our next fact-finding step by seeking the cooperation of several large hospitals in reporting all accidental injuries seen by their staffs. Analysis of these reports should permit us to select various types and locations of injury-producing accidents for epidemiological follow-up. With the data obtained, we expect to be able to pinpoint the causes or circumstances of the accident with sufficient accuracy to permit the application of meaningful control measures. The recording and analysis of these reports is to be carried out in cooperation with the State Health Department which will be cooperating similarly with other communities. We expect to exchange experiences with these communities as our respective studies progress. Some preventive work has also been started, primarily in our poison control program which is an integral part of our total accident prevention program. A feature of this program is a service which provides 24-hour emergency information. This service, which is rendered through our medical examiner's office, seeks to minimize the consequences of an accident which has already occurred. Perhaps this effort to minimize the harmful results of an accident could be expanded in principle to other types of accidents by the wider teaching of first aid. We have done nothing in this regard but I think that such efforts are a legitimate part of an accident prevention program. Other aspects of the poison control program include voluntary reporting and provision of clinical data by hospitals and physicians,. epidemiological follow-up of all reported cases by public health nurses, and public and professional education. The data received from epidemiological follow-up are currently being analyzed to provide guidance in the development of specific preventive efforts.