Accident Compensation Research Articles

The burden of healthcare-associated infections in New Zealand public hospitals 2021.

There are no contemporary data on the burden of healthcare-associated infections (HAIs) in New Zealand. To estimate the economic burden of HAIs in adults in New Zealand public hospitals by number and monetary value of bed days lost; number of deaths, number of life years lost, and the monetary value (in NZ dollars); Accident Compensation Commission (ACC) HAI treatment injury payments; and disability-adjusted life years (DALYs). The annual incidence rate was calculated from the observed prevalence of HAIs in New Zealand, and length of patient stays. Total HAIs for 2021 were estimated by multiplying adult admissions by incidence rates. The excess length of stay and mortality risk attributed to those with HAI was calculated using a multistate model. Payments for treatment injuries were obtained from the ACC. DALYs for HAIs were estimated from the literature. The incidence rate of HAI was 4.74%, predicting 24,191 HAIs for 2021, resulting in 76,861 lost bed days, 699 deaths, with 9,371 years of life lost (YoLL). The annual economic burden was estimated to be $955m comprised of $121m for lost bed days, $792m for cost of YoLL, and $43m ACC claims. There were 24,165 DALY which is greater than many other measured injuries in New Zealand, eg motor vehicle traffic crashes with 20,328 DALY. HAIs are a significant burden for patients, their families, and the public health system. Preventive guidelines for many HAIs exist and a strategic plan is needed to reduce HAIs in New Zealand.

The Legality of the Minister of Finance Letter Regarding Work Accident Compensation for Ad Hoc Election Organizers of 2019

The Legality of the Minister of Finance Letter Regarding Work Accident Compensation for Ad Hoc Election Organizers of 2019

Is Farming a Risk Occupation for Cardio-cerebrovascular Diseases? A Scoping Review on Cardio-cerebrovascular Disease Risk in Farmers.

In the Republic of Korea, cardiocerebrovascular disease (CCVD) is recognized as an occupational disease when sufficient evidence of a work-related burden exists. In 2021, approximately 26.8% of the payments from occupational disease insurance under the Industrial Accident Compensation Insurance Act were allocated to CCVDs. However, due to the specific nature of insurance policies for farmers, CCVD is not acknowledged as an occupational disease in their case. We reviewed studies on the differences in the incidence, prevalence, and mortality rates of CCVDs between farmers and the general population or other occupations and described the exposure of farmers to risk factors for CCVDs. Several studies showed that farming is a high-risk occupation for CCVDs, with the following risk factors: long working hours, night work, lack of holidays, and strenuous physical labor; physical factors (noise, cold, heat, humidity, and vibration); exposure to hazardous gases (diesel exhaust, carbon monoxide, hydrogen sulfide, carbon disulfide, nitrogen oxides, and polycyclic aromatic hydrocarbons), pesticides, and dust (particulate matter, silica, and organic dust); exposure to a hypoxic environment; and job-related stress. Social isolation and lack of accessible medical facilities also function as additional risk factors by preventing farmers from receiving early interventions. Farmers are exposed to various risk factors for CCVDs and are an occupation at risk for CCVDs. More studies are needed in the future to elucidate this relationship. This study lays the groundwork for future research to develop guidelines for approving CCVDs as occupational diseases among farmers.

Effect of COVID-19 lockdowns on maxillofacial fractures in New Zealand: a retrospective study

Introduction: The New Zealand Accidents Compensation Corporation received 28,901 new claims for maxillofacial fractures between January 2018 and December 2021, at an annual cost of NZ$70–80 million. We have previously reported interpersonal violence as the most common cause of maxillofacial fractures disproportionately affecting young Māori males. This study provides an update on the incidence and cause of maxillofacial fractures with a specific review of the impact of COVID-19 lockdowns. Methods: Patients referred to the Wellington Regional Plastic, Maxillofacial and Burns Unit from 1 January 2018 to 31 December 2021 were identified from our maxillofacial fracture database. Age, ethnicity, gender, cause of injury, risk factors, and fracture pattern and management were analysed. Results: Out of 1281 patients identified, 75.2 per cent were male, most commonly (38.7%) aged 16–30 years. Interpersonal violence, falls and sports accounted for 37.6 per cent, 24.9 per cent, and 24.0 per cent of all maxillofacial fractures, respectively. Māori (22.0%) and New Zealand Europeans (55.7%) were the two largest groups, most commonly affected by interpersonal violence and falls, respectively. There was a relative increase in referral rates for females and for those older than 60 years (1.78 per 10 person-days versus 0.014 per 10 person-days and 4.2 per 10 person-days versus 1.8 per 10 person-days, respectively) and a decrease in the rates of interpersonal violence and sports related referrals (1.2 per 10 person-days versus 3.4 per 10 person-days and 0.41 per 10 person-days versus 2.19 per 10 person-days, respectively) during COVID-19 lockdowns, compared with outside lockdown. Conclusions: Interpersonal violence remains the main cause of maxillofacial fractures. There is a need for a national prevention strategy to reduce this. During COVID-19 lockdowns, there was a relative increase in the referral rates of females aged 60 years and over. Both sports and interpersonal violence showed significantly reduced referral rates during lockdowns, while falls, road traffic accidents and other were referred at a similar rate as out of lockdown.

Validating the capture rate of revisions by the New Zealand ACL Registry: An analysis of all-cause reoperation following primary ACL reconstruction.

To validate the New Zealand Anterior Cruciate Ligament(ACL) Registry's capture rate of revisions by cross-referencing Registry data with reoperations data recorded by the Accident Compensation Corporation (ACC) and identify risk factors for all-cause reoperation. Primary ACL reconstructions performed between April 2014 and September 2019 were individually matched on a record-by-record basis between the two databases. The ACC database was used to identify patients who underwent a reoperation with manual review of operation notes to identify whether a revision or other procedure was performed. This was combined with the number of revisions separately recorded in the New Zealand ACL Registry, which was used as the denominator value to calculate the Registry's capture rate of revisions. Patient and surgical data recorded in the Registry were analysed to identify independent predictors for all-cause reoperation. A total of 8046 primary ACL reconstructions were matched between the New Zealand ACL Registry and the ACC databases. The reoperation rate was 8.9% (n = 715) at a mean follow-up of 2.5 years. Meniscal-related procedures were the most common reoperation (n = 299, 3.7%), followed by revision ACL reconstruction (n = 219, 2.7%), arthrofibrosis (n = 185, 2.3%), cartilage (n = 56, 0.7%)and implants (n = 32, 0.4%). The New Zealand ACL Registry captured 96% of revisions. Younger age (hazard ratio [HR] > 1.4, p < 0.001), earlier surgery (HR > 1.3, p = 0.05), concurrent meniscal repair (medial meniscus HR = 1.9, p < 0.001 and lateral meniscus HR = 1.3, p = 0.022)and hamstring tendon autografts (HR = 1.4, p = 0.001) were associated with a higher risk of reoperation. The New Zealand ACL Registry captured 96% of revisions. Risk factors for all-cause reoperation included younger age, earlier surgery, meniscal repairand hamstring tendon autografts. Level III.

Satisfaction of households in surrounding communities of protected areas with economic compensation for wildlife accidents: a case study of Xishuangbanna National Nature Reserve in China

PurposeThis study aims to investigate the satisfaction of farmers with the compensation policy for wildlife-caused damages and its influencing factors, analyze the current situation of satisfaction with the compensation policy among farmers, identify factors significantly affecting satisfaction, and explore ways to optimize the compensation policy and improve the satisfaction of farmers based on the effects of various influencing factors.Design/methodology/approachThe Xishuangbanna National Nature Reserve in Yunnan Province, China, is selected as the research area for the study. Through field interviews, 370 valid questionnaires were collected to obtain relevant data on farmers' satisfaction with the compensation policy for wildlife-caused damages. The Oprobit model is utilized to explore the factors influencing farmer satisfaction and to analyze their underlying reasons.FindingsThe study reveals that farmers in the communities surrounding the Xishuangbanna National Nature Reserve generally experience low satisfaction with the compensation policy, particularly concerning satisfaction with compensation amounts, which tends to be dissatisfied on average. Satisfaction with the compensation policy is significantly influenced by individual characteristics and household labor structure, while the degree of human-wildlife conflict, wildlife conservation attitudes and household income structure have insignificant impact. Among individual characteristics, gender, education level, health status, and ethnicity are highly significant. In household labor structure, the number of agricultural laborers, non-agricultural laborers, and household agricultural labor time are highly significant.Originality/valueBuilding on the overall satisfaction of farmers with the compensation policy, this study further decomposes policy satisfaction into satisfaction with compensation amounts, coverage, and procedures. It provides more targeted recommendations for enhancing satisfaction with the compensation policy, which can help effectively mitigate human-wildlife conflicts and achieve harmonious coexistence between humans and nature.

Ethnic variation in access to publicly funded care for unintentional injuries in older adults in Aotearoa New Zealand: a retrospective study

BackgroundMāori (the Indigenous people of Aotearoa New Zealand (NZ)) are more likely to experience injury than non-Māori, but less likely to have effective access to publicly funded injury care services....

Gym and Fitness Injuries amongst those Aged 16–64 in New Zealand: Analysis of Ten Years of Accident Compensation Corporation Injury Claim Data

BackgroundTo provide epidemiological data for minor and moderate-to-serious injury claims for gym and fitness related injuries amongst those aged 16–64 in New Zealand, to inform the development of an injury prevention program.MethodsRetrospective analytical review of gym and fitness related injury entitlement minor and moderate- to-serious Accident Compensation Corporation (ACC) claims from 1 July 2011 to 30 June 2020. Data were analysed by cause of injury, geographical region, sex, age, body site and injury type. Qualitative analysis of free text describing the activity causing the injury was conducted.ResultsOver the ten-year period, 16–64 year olds made 345,254 injury claims, costing ACC NZ$241,298,275 in treatment charges. Soft tissue injuries were the most prevalent making up 96% (331,343) of all claims and 88% (NZ$213,049,197) of the total charges. Strenuous movement with lifting (n = 154,467, 47%), strenuous movement without lifting (n = 84,469, 25%), impact/contact with object (n = 39,610, 12%) and impact/contact with ground (n = 25,351, 8%) were the top four mechanisms resulting in injury, accounting for 92% of soft tissue injuries. Males and females aged 21 to 30 years old were most frequently injured. The four most injured body sites (lower back/spine, shoulder, knee, neck/back of head) accounted for 63% of injuries in females, and 65% in males.ConclusionsThe most common cause of injury from gym and fitness activity claims in 16–64 year olds in New Zealand was lifting/carrying/strain resulting in lower back/spine and shoulder (including clavicle/blade) soft tissue injuries. Soft tissue injuries accounted for 96% of the total claims. Males and females aged 21 to 30 years old were most frequently injured age group.

RISK FACTORS FOR MENISCAL REPAIR FAILURE FOLLOWING CONCURRENT PRIMARY ACL RECONSTRUCTION: RESULTS FROM THE NEW ZEALAND ACL REGISTRY

BackgroundAnterior cruciate ligament (ACL) reconstruction with concomitant meniscal injury occurs frequently. Meniscal repair is associated with improved long-term outcomes compared to resection but is also associated with a higher reoperation rate. Knowledge of the risk factors for repair failure may be important in optimizing patient outcomes.PurposeThis study aimed to identify the patient and surgical risk factors for meniscal repair failure, defined as a subsequent meniscectomy, following concurrent primary ACL reconstruction.MethodsData recorded by the New Zealand ACL Registry and the Accident Compensation Corporation, the New Zealand Government's sole funder of ACL reconstructions and any subsequent surgery, was reviewed. Meniscal repairs performed with concurrent primary ACL reconstruction was included. Root repairs were excluded. Univariate and multivariate survival analysis was performed to identify the patient and surgical risk factors for meniscal repair failure.ResultsBetween 2014 and 2020, a total of 3,024 meniscal repairs were performed during concurrent primary ACL reconstruction (medial repair = 1,814 and lateral repair = 1,210). The overall failure rate was 6.6% (n = 201) at a mean follow-up of 2.9 years, with a failure occurring in 7.8% of medial meniscal repairs (142 out of 1,814) and 4.9% of lateral meniscal repairs (59 out of 1,210). The risk of medial failure was higher in patients with a hamstring tendon autograft (adjusted HR = 2.20, p = 0.001), patients aged 21–30 years (adjusted HR = 1.60, p = 0.037) and in those with cartilage injury in the medial compartment (adjusted HR = 1.75, p = 0.002). The risk of lateral failure was higher in patients aged ≤ 20 years (adjusted HR = 2.79, p = 0.021) and when the procedure was performed by a surgeon with an annual ACL reconstruction case volume of less than 30 (adjusted HR = 1.84, p = 0.026).ConclusionWhen performing meniscal repair during a primary ACL reconstruction, the use of a hamstring tendon autograft, younger age and the presence of concomitant cartilage injury in the medial compartment increases the risk of medial meniscal repair failure, whereas younger age and low surgeon volume increases the risk of lateral meniscal repair failure.

Whakaari/White Island disaster. An analysis informed by sociological theories of risk

On December 9, 2019, the volcano on Whakaari/White Island, a popular New Zealand (NZ) tourist destination, erupted. Twenty-two people died. Drawing on sociological theories of risk, most particularly on systems-thinking, this qualitative analysis describes the origins of the disaster, formulates questions for the authorities and suggests actions to reduce the chances of a repeat. It is concluded that the safety culture of NZ’s adventure tourism (AT) industry requires attention. It is also concluded that bureaucratic devices such as the adventure tourism insurance cover provided by NZ’s Accident Compensation Corporation (ACC) may have encouraged, through a risk-compensation dynamic, greater risk-taking. It is suggested that improved oversight will deliver a safer adventure tourism industry. It is recommended that the authorities investigate to what extent insurance cover influences business practices.

The Causes of Rejection of Medical Care Benefits for Industrial Accident Compensation Insurance, A retrospective analysis

Objectives: The purpose of this study is to analyze the reasons of the claim rejections and denials compensated by dentalrelated the Industrial Accident Compensation Insurance (IACI) that is operated by the Korea Workers’ Compensation and Welfare Service (COMWEL).Methods: We collected 803 claims from one consultant who responded to dental-related medical inquiries commissioned by the Daegu and Gyeongbuk Workers’ COMWEL from January 2021 to May 2023. We analyzed the approval status and the reasons for non-approval, based on the reviewed response materials and dental online medical consultation data.Results: Among the initial and supplementary compensation applications, there were 79 cases with insufficient examina-tions, 72 cases with incomplete records, 19 cases with errors, 148 cases due to pre-existing conditions, and 6 cases where the applicant was ineligible for medical benefits. The reasons for re-evaluation after data supplementation included 122 cases of inadequate examinations, 76 cases of incomplete records, 24 cases with logical errors, 11 cases with insufficient photographs, and 57 cases for a combination of these reasons.Conclusions: In the context of industrial injury compensation claims, the denial of claims often arises from missing or incomplete dental records, diagnostic omissions, or logical inconsistencies between records, diagnoses, and treatment plans. Therefore, it is essential to ensure accurate medical records, appropriate examinations, and evidence-based diagnosis. Spe-cial attention should also be given to the collection of clinical data, including photographs.

A supported primary health pathway for mild traumatic brain injury quality improvement report.

Introduction Best-practice guidelines recommend that patients are followed-up to check if they have recovered following a mild traumatic brain injury (mTBI) and to refer to concussion services, if needed. However, in New Zealand, rates of follow-up are low and access to concussion services can be delayed. Aim We aimed to improve rates of follow-up and access to concussion services for mTBI patients aged ≥8 years by the implementation of a supported health pathway and test its success. Methods The pathway included a decision support tool, funded follow-up appointments, clinician training and a patient education resource. Sociodemographics, injury details and proportions of patients receiving a follow-up by type and time were extracted from the Accident Compensation Corporation (ACC) database between 18 May 22 and 30 June 23 and compared to national ACC data prior to implementation. Results Data were extracted for 220 patients, with a mean age of 31.5 years, 51.4% female and 21.4% Māori and Pacific. There was an increase in the proportion of patients receiving a follow-up from 36% pre-implementation to 56.8% post-implementation. Sixty-three patients (28.6%) accessed a concussion service post-implementation compared to 10% pre-implementation. Time to concussion service reduced from an average of 55 (s.d. = 65.4) to 37 days (29.5). Discussion Risk factor criteria within the decision support tool need to be weighted to improve specificity of referrals. Timing from injury to medical review in primary care needs to be considered. This quality improvement project provides preliminary evidence for implementation of a supported health care pathway for mTBI.

Risk factors for reoperation for arthrofibrosis following primary anterior cruciate ligament reconstruction.

The purpose of this study is to identify the rate and risk factors for a reoperation for arthrofibrosis following primary anterior cruciate ligament (ACL) reconstruction. Prospective data recorded in the New Zealand ACL Registry were cross-referenced with data from the Accident Compensation Corporation (ACC). Primary ACL reconstructions performed between April 2014 and May 2021 were analysed. The ACC database was used to identify patients who underwent a reoperation for a diagnosis of arthrofibrosis. Multivariable survival analysis was performed to compute adjusted hazard ratios (aHR) and 95% confidence intervals. A total of 12,296 primary ACL reconstructions were analysed, of which 230 underwent a reoperation for arthrofibrosis (1.9%) at a mean follow-up of 3.6 years. A higher risk of arthrofibrosis was observed in females (aHR = 1.76, p = 0.001), patients with a history of previous knee surgery (aHR = 1.82, p = 0.04) and when a transtibial drilling technique was used (aHR = 1.53, p = 0.03). ACL reconstruction >6 months after injury had the lowest rate of arthrofibrosis (1.3%, aHR = 0.45, p = 0.01). There was no difference in risk between early surgery within 6 weeks versus delayed surgery between 6 weeks and 6 months after injury (2.9% versus 2.1%, aHR = 0.78, not significant). Female sex, previous knee surgery and a transtibial drilling technique increased the risk of reoperation for arthrofibrosis. Early surgery within 6 weeks of injury was not associated with an increased risk when compared with surgery between 6 weeks and 6 months after injury. Level III.

ACC and treatment injuries: is it time to rethink injury causation?

In Aotearoa New Zealand, personal injuries resulting from medical treatment are covered under the Accident Compensation Act 2001. However, before victims of medical injury can receive cover and compensation, they must first satisfy several legal tests. Much criticism and legal action have surrounded the interpretation and application of these legal tests, primarily because of its focus lying on injury causation instead of supporting the incapacitated. This article examines the issues present within the current legislative framework for treatment injury coverage and proposes a potential solution to address the underlying problem.

Penyelesaian Ganti Rugi Atas Kecelakaan Kapal di Indonesia dalam Perspektif Tanggung Jawab Perdata

Two formulations of problems in this study, namely: (1) What are the results of civil liability analysis in settling compensation for ship accidents in Indonesia. (2) How does the judge's judgment through the District Court Decision compare with the Shipping Court Decision on the case. The type of research raised is Normative Juridical Research (literature law research). The source of data in this study is secondary data. Secondary data are data obtained from literature studies. Secondary data in the field of law viewed from the point of binding strength can be divided into 3 (three), namely primary legal material, secondary legal material, and tertiary legal material This research uses a case approach (case appoarch) and a legal approach (statua appoarch). The analysis method used is a qualitative normative method, namely research by describing conditions and facts about the object of research. The results of this study, namely, the Perspective of Civil Responsibility in the Settlement of Compensation for Ship Accidents in Indonesia (Case Study of District Court Decisions and Shipping Court Decisions) can be concluded that the Shipping Court Decision is only limited, that is, it does not mention the compensation of Shipping Companies to the owner of the goods, because the competence and jurisdiction possessed by the Shipping Court is very limited.

NetballSmart, Implementation of a National Injury Prevention Program

Reducing lower-limb injuries in netball, particularly anterior cruciate ligament injuries, is a priority. The Accident Compensation Corporation (a no-fault national insurance system) partnered with Netball New Zealand to create the “NetballSmart” injury prevention program. Targeted research informed the successful implementation, dissemination, and adoption of the injury prevention program. Research included a nationwide epidemiological study, video analysis investigating netball injury risk maneuvers, and intervention studies exploring the effectiveness of injury prevention program warm-up resources on physical capability in youth netball. An identified spike in ankle-knee injury incidence of school-age netball players at season start and prior to tournaments along with a high overall prevalence within these ages led to the creation of age-specific educational workshops and resources focused on effective preparation, skill transition, strengthening, and balance. Observational video analysis highlighted behaviors that potentially increased the risk of anterior cruciate ligament injury and a progressive landing skills program was developed. The NetballSmart Dynamic Warm-up and Power Warm-up significantly improved player physical capability. Consequently, time to perform the Power Warm-up before all games at a national intermediate school tournament was incorporated into competition-time, reducing workload by 25%. A targeted social media and ambassador endorsement plan increased performance of the NetballSmart Dynamic Warm-up/Power Warm-up by 14% prior to games and 15% before trainings nationally. Accident Compensation Corporation injury data between 2018 and 2022 showed a 6,050 (32%) reduction of all body site and a 2,968 (33%) decrease of combined ankle-knee injury claims. Similarly, by 2021 there was a 11% decrease in fractures/dislocations, a 13% decrease in soft tissue injuries, and a 9% decrease in anterior cruciate ligament surgical repairs. During this delivery period, Accident Compensation Corporation reported that the whole of life returns on investment was NZD$4.10, for every dollar funded to the NetballSmart Injury Prevention Programme.

자동차대여업자의 운행자성

The contents related to the operator's responsibility under the Automobile Accident Compensation Security Law are virtually the same from the time it was enacted as Law No. 1314 on April 4, 1963. Under these circumstances, the Supreme Court has no choice but to continue its attempts to embody abstract concepts as it extends the concept of existing operating profit and control to ideological concepts. Even if it is understood that it is in line with the legislative purpose of the Automobile Accident Compensation Security Law, it is questionable how long the Supreme Court's interpretation can keep pace with changes in society through technological development. In this judgment, it was questionable whether the vehicle rental company could recognize the driver's personality in the event of an accident due to the tenant's violation, even though the vehicle rental company had restrictions and exemption regulations on the operator of the vehicle as the content of the contract with the tenant. The Supreme Court judges the driver's management of car based on the concept of existing operating profit and operating control (two-way theory), but as the concept of existing operating profit and operating control is abstract, the conclusions of the lower court and the Supreme Court were different. In the end, if the abstract concept of existing operating profit and operation control leads to individual case judgments, there is a risk of reaching unreasonable conclusions in form, and there is a risk of differences in drawing conclusions according to the subjectivity of judges depending on individual cases. If so, it would be more purposeful to interpret the provisions of Article 3 of the Automobile Accident Compensation Security Law to judge the driver's personality based on the subjective sense of responsibility of the party based on an objectified third party.

Analysis of the Effectiveness of Motor Vehicle Insurance at PT. Jasa Raharja

This study aims to test the analysis of the effectiveness of motor vehicle insurance at PT. Jasa Raharja branch Medan. Insurance at PT. Jasa Raharja Motor are an effort to protect citizens, especially from the risk of road traffic accidents, to provide compensation to victims of traffic accidents or to their heirs. This research took 4 respondents, consisting of 1 employee PT. Jasa Raharja, and 3 people who were victims of traffic accidents, and received compensation funds. This method uses interview techniques. The interview technique was carried out in an unstructured manner using an interview guide. Research data analysis is descriptive. The results of this research indicate that PT. Jasa Raharja still seems to be good and consistent in carrying out its duties as a fund collector and distributor of traffic accident compensation funds. Traffic accident victims and recipients of compensation funds revealed that PT. Jasa Raharja is satisfied with the services provided. The benefits obtained at PT. Jasa Raharja are indeed effective and efficient because they have achieved the targets desired by PT. Jasa Raharja Branch Medan.

Evaluating Airline Liability and Compensation in Indonesian Aviation

This study investigates the regulatory framework and legal implications of airline liability in the context of air crash victims' rights in Indonesia, focusing on the enforceability of release and discharge agreements imposed by airlines. The research adopts a normative legal method, employing legislative and conceptual approaches to scrutinize primary and secondary legal materials related to aviation accident compensation. The primary sources include the Indonesian Aviation Act No. 1 of 2009, Article 141, and the Minister of Transportation Regulation PM 41 of 2011, alongside the Warsaw Convention of 1929. Secondary sources comprise academic literature, including books, journals, and research reports. The data were analyzed qualitatively, evaluating the extent to which the concepts of release and discharge align with the prevailing legal principles of transportation liability. The findings reveal that the Indonesian aviation regulations mandate airlines to compensate for deaths, permanent disabilities, or injuries resulting from air accidents, including to the heirs, with a cap set at Rp1.25 billion per passenger. However, the legal strength of release and discharge statements is considered weak, as they are not explicitly regulated, potentially disadvantageous to victims forced to sign as a precondition for compensation, and contrary to consumer protection laws prohibiting the shift of airline responsibilities to consumers. The study recommends a thorough government review of these release and discharge provisions to ensure alignment with national aviation laws, consumer protection statutes, and civil codes, emphasizing fairness and the protection of victims' and heirs' rights. This research contributes to the discourse on aviation liability in Indonesia, highlighting the need for legal reforms to uphold justice and certainty in airline compensation practices.Highlights:&#x0D; &#x0D; Weak Legal Foundation: Release and discharge agreements in Indonesia's aviation sector lack explicit legal backing, undermining their enforceability.&#x0D; Conflict with Consumer Laws: These agreements often contradict consumer protection laws by shifting airline responsibilities to consumers.&#x0D; Need for Legal Reform: There is a pressing need for regulatory review and reform to align compensation practices with fairness and legal standards.&#x0D; &#x0D; Keywords: Aviation Liability, Compensation, Release and Discharge, Consumer Protection, Legal Reform

The effect of the ‘Swim Reaper’ program on water safety awareness, drowning mortality and morbidity among males aged 15–34 years in Aotearoa, New Zealand

Background and Objective: To increase water safety awareness among young males New Zealand introduced the Swim Reaper program in 2016. The program ran annually over summer and in 2018/19 an evaluation was conducted. The objective of this study was to evaluate the impact of the 2018/19 Swim Reaper social media-based campaign on self-reported water safety awareness and identify changes in fatal and nonfatal drowning rates for New Zealand resident males aged 15–34 years before and after the 2016 Swim Reaper program. Methods: Online surveys pre (December-2018) and post (February-March-2019) Swim Reaper campaign were used to estimate water safety awareness post-campaign relative to pre-campaign using negative binomial regression adjusted for potential confounders. Interrupted time series (ITS) analysis, adjusted for seasonality, explored changes in drowning mortality, hospital admissions and Accident Compensation Corporation (ACC) claims pre and post program introduction (2016). Results: A total of 518 males responded (50.6% post-campaign). There were significant improvements (post vs. pre-campaign) in self-reported water safety awareness. ITS analysis showed a reduction in drowning related hospital admissions post relative to pre-program (RR = 0.47; [95%CI: 0.24–0.90]; p = 0.02). Discussion: Young males are an at-risk cohort for drowning and creating behavior change among this group can be challenging. Using a unique, humor-based approach the Swim Reaper program appears to be having some impact on self-reported water safety behaviors, as well as unintentional drowning-related hospitalization rates. Further evaluation, more clearly linked to campaign themes, is required to ascertain direct impact of the program. Conclusion: The novelty and reach of the campaign within the context of a prevailing downward trend in drownings may provide support for social media-based programs targeting this hard-to-reach demographic.