NEEDS AND OBJECTIVES FOR A NATIONAL PROGRAM ON CHILD SAFETY

(1)

studies may allow a clearer designation of

tile frequencies of the various antecedent

events. Through such analysis appropriate

pre’enti’e measures can be more rationally

chosen and better direction given to

fol-low-up research. The prevention of falls in

infants, our most precious and important

national resource, merits greater attention

and effort by the medical profession and by

all organizations interested in the welfare

of infants.

Acknowledgment

This investigation was supported by the Na-tional Safety Council, Exploratory Research Grant

70502-03. We wish to acknowledge the help of

John Cvwinski, M.D., Adolph A. Sattler, M.D.,

Raymond Lesser, M.D., Bernard Sered, M.D., Judy

Mitchell, RN., Sharon Wordell, IN., Diana Kova-cic, IN., and Mrs. Darla Strouse.

REFERENCES

1. Ingraham, F. C., and Matson, D. D.: Subdural

hematonia in infancy. J. Pediat., 24:1, 1944.

2. Lowrev, C. H.: The problem of hospital

acci-dents in children. PEDIATRICS 32:1064, 1963.

3. llarwood-Nash, D.C., Henrich, E. B., and Hus-son, A. R.: Statistical Analysis of 4,463 Cases

of Head Trauma Seen at the Hospital for

Sick Children. Presented before the Canadian

Association of Radiologists, Toronto, June,

1967.

4. Bender, L., and Schilder, P.: Psychopathology of Children with Organic Brain Disorders. Springfield: Charles C Thomas, p. 85, 1956. 5. Hurlock, E.: Developmental Psychology. New

York: McGraw-Hill, p. 36, 1953.

6. Feinberg, S.: An infant scale guard. J. Pediat.

70:441, 1967.

7. Recht, J.: Systems Safety Analysis: A Modern

Approach to Safety Problems. Chicago: Na-tional Safety Council, 1967.

NEEDS

AND

OBJECTIVES

FOR

A

NATIONAL

PROGRAM

ON

CHILD

SAFETY

Prepared by Home Department, National Safety Council, Chicago, Illinois

M

ANY organizations and agencies on the

national, state, and local level have

long been actively concerned and involved

in child-accident prevention programs.

However, no definitive statement of the

overall needs and objectives of such efforts

has ever been developed. Lacking such a

‘l)lueprint, many activities have suffered

from lack of direction and failure to

com-prehend tile total piettire.

In an attempt to correct this situation,

this statement has been prepared by the

National Safety Council’s Home

Depart-ment. As will be noted, we are not

en-deavoring to suggest how some of these

objectives will be achieved, nor who should

assume the responsibility for their

accom-plishment. Such problems will, of necessity,

be solved only through careful and

consid-ered deliberation by all parties concerned.

This statement is intended to serve as a

guide for all organizations concerned with

the needless toll of lives and injuries caused

by accidents to the children of our nation.

No single organization can hope to

under-take-much less solve-all the needs which

have been delineated herein. Responsibility

for the various objectives must be assumed

by those organizations which are most

logi-cally in a position to undertake appropriate

action. In many cases it will require the

combined facilities and talents of many

groups.

THE CHALLENGE

For children aged 1 to 14 years,

acci-dents claim more lives than the six leading

diseases combined. In 1966 it was reported

that 16,500 children ages 0 to 14 years, lost their lives through accidents. Seven

thou-sand one hundred of these accidents

oc-curred in the home and 6,100 were caused

through motor vehicle accidents. The

(2)

SUPPLEMENT

places, with the majority of these being

drownings. No nation can stand idly by and

permit its future strength to be dissipated

in this manner.

THE JOB TO BE DONE

It is unanimously agreed that the

reduc-tion of child accidents and deaths requires

a colossal effort. It cannot be done unless it

has the organized support of informed

citi-zens. Unfortunately, over the years, too

much of this support has been nominal. A

coordinated effort is needed to assure that

all forces work toward the same ends with

a minimum of friction and duplication of

effort. It will niake possible an achievement

far greater that the sum of the individual

efforts.

Research

Valid and practical child safety research

is fundamental to the prevention of

acci-dental injuries and reduction of the severity

of these accidents. Research can point out

critical accident situations requiring

atten-tion and develop new techniques for

lower-ing accidental potential. It can evaluate the

results of programs. It can demonstrate

which of several alternative methods is

most effective or economical.

To date too few research projects have

focused on accidents to children; and still

fewer of these studies have achieved their

goals. Continued progress in child-accident

reduction, therefore, calls for increased and

improved research.

OBJECTIVES-To encourage increased and

improved research it is recommended that:

1. Research activities on child-accident

prevention be coordinated on a national

basis.

2. Colleges and universities be

encour-aged to utilize their research facilities

to-ward solving the child-accident problem.

3. Programs be established for the

train-ing of researchers to specialize in

child-ac-cident control.

4. Appropriate research be undertaken

by all levels of major departments of

gov-ernment having responsibilities relating to

child-accident prevention.

5. Appropriate research be undertaken

by industry, professional groups and

volun-tary agencies having interests in or related

to child accident prevention.

6. Current child safety research

periodi-cally be evaluated and the findings compiled

and disseminated. Guides be developed

which contain suggestions for the

applica-tion of this knowledge.

7. Public and private grants and

con-tracts for basic and operational research be

increased.

8. Research results be publicized in

order to develop public appreciation and

support of further research.

Child Accident Data

Reliable child accident statistics and

ef-fective accident prevention programs are

inseparable. Without statistical records,

safety efforts are likely to be based largely

on opinion and guesswork.

A basic need exists for valid, reliable,

comprehensive, and continual

accidental-in-jury information. Scientific administration

requires such data for surveillance, research

and program evaluation. At present,

child-accident statistics are incomplete and

diffi-cult to utilize. Child-accident death reports

forwarded from state offices of vital

statis-tics are accumulated and tabulated by the

National Center for Health Statistics,

United States Public Health Service.

How-ever, these reports are not uniform and the

information is frequently unreliable for

pro-gram planning purposes. Further, a severe

time lag exists from the raw data phase to

the finished product.

Nonfatal statistics of poisoning incidence

are compiled on a sampling basis by the

National Clearinghouse for Poison Control

Centers, United States Public Health

Ser-vice; and nonfatal-accident statistics are

compiled from special studies of the

Na-tional Health Survey, conducted at periodic

intervals by the National Center for Health

Statistics, United States Public Health

Ser-vice. These sources cannot gather complete

(3)

they do provide guidance for solving some aspects of tile child-accident problem.

OBJ ECTIVES-TO encourage improved ac-cident statistics it is recommended that:

1. The “standard certificate of death” be

adopted by reference in all states. The

stan-dard certificate should be coded for

elec-tronic data processing

(

EDP

)

to reduce the

time lag now required to process all state

certificates at the National Center for

Health Statistics.

2. NIore detailed information be

col-lected consistently on nonfatal child

acci-dents by appropriate groups such as the

National Center for Health Statistics, the

National Clearinghouse for Poison Control

Centers, and the United States Public

Health Service regional medical centers.

3. Hospitals and the medical profession

i)e encouraged to provide basic statistical

data on nonfatal child accident cases.

4. The methodology of all child accident

data collection be scientifically designed to

assure the validity and reliability of the

findings.

Public Information

Basic to the success of child-accident

prevention programs is public awareness of

the problem. Therein lies the target of

pul)lic information programs. Public

infor-mation must be an integral part of any child safety program. It is not, however, the

entire program and cannot be substituted

for other essential accident-prevention

mea-sures. Public information specialists can

de-velop the understanding and support of

civic leaders for the many elements of a

balanced child safety program.

In order for child safety information to

be meaningful, it must deal with local

ac-tivities and appeal to local interests. Local

questions which need to be answered are:

How serious is tile problem? \Vho is

af-fected? \\7hat is the cost to the taxpayers

and individual families in terms of

prop-erty, social problems, suffering and death?

OBJECTIVES-TO improve public

informa-tion it is recommended that:

1. Public inforniation programs be

di-rected toward-

(

a

)

informing the public

about child accidents; their number, where

and how they occur, and why,

(

b

)

contin-ually emphasizing the need for individual

responsibility, and

(

c) defining and

ex-plaining local measures taken to control

child accidents and encouraging support of

these efforts.

2. Public information programs

(

a

)

be

keyed to the specific child safety needs and

coordinated with the local child safety

pro-gram,

(

b

)

be continuous,

(

c

)

utilize the

techniques of tinieliness, newsworthiness,

human appeal, and reader interest

(

and

other nierchandismg techniques

)

which

have been so successfully developed by the

mass niedia, and

(

d

)

utilize special

empha-sis programs such as Poison Prevention

Week and Fire Prevention Week.

3. Official agencies with child safety

re-sponsibilities, such as health, welfare, fire

and police departments, make pertinent

facts about child safety available to the

public, in cooperation with the mass media

and interested supporting organizations.

4. The public information profession in

active cooperation with each other, as vell

as with public officials and interested

orga-nizations, join in organized efforts to

dis-seminate information in support of

child-ac-cident prevention.

5. All agencies and organizations employ or utilize competent personnel to promote

child safety through all public information

channels.

Educational Programs

It should be obvious that if we are to

achieve a reduction in the number and

se-verity of child accidents, our educational

efforts must ultimately reach into every community. Unfortunately, there are many

obstacles to achieving this goal. Among of-ficial agencies at the state and local levels,

child-safety activities are often fragmented

by departmental responsibilities of the fire,

health, welfare, and police departments.

Because of this division of responsibility

and activity, these programs frequently

(4)

Likewise, relatively few public and

non-public school districts employ full-time

safety education supervisors or provide

their staffs vith adequate safety curriculuni

guides. Even where such guidance is

avail-able, school officials often admit that little

is known of the quantity or quality of the

instruction. Likewise, comparatively few

school systems maintain adequate

student-accident statistics to measure the progress

-or lack of progress-which the educational

programs are making.

Only in recent years have business and

industry realized that it is economically

ad-vantageous to conduct off-the-job stafety

ac-tivities for employees and their families.

However, the number of employees reached

by such programs still represents only a small

percentage of this nation’s employed

popu-lation and the number of such programs

concerned with any aspects of child safety

in minuscule.

Finally, many national, state, and local

organizations concerned with safety have

programmed child safety on a continuing

basis. However, where such activities are

undertaken, duplication of effort frequently

occurs on the community level because of a lack of coordination.

OBJECTIVES-TO improve citizen

educa-tion it is recommended that:

1. Child safety programming efforts on

all levels (a) be proportionate to the total

accident problem, (b) involve all

appropri-ate organizations and agencies, and (c) be

coordinated so that needless gaps or

dupli-cations are eliminated and the maximum

ef-fectiveness achieved.

2. Organizations and agencies operating

at the national level (civic, business, and

government) develop child safety programs on a continuing basis to stimulate their

state and local counterparts.

3. State and local organizations develop their programs of child safety to stimulate the public to action.

4. Funds be sought at all levels (national, state, and local) to carry out child safety educational programs.

5. Evaluation and reevaluation he

con-ducted periodically at all levels to determine

if programming efforts are proportionate to

the need and whether effective results are

being achieved.

6. School districts

(

a

)

seek to employ

full-time safety education supervisors

(

b)

1)rovide emphasis on child safety in all

ap-propriate courses of study, and

(

c

)

adopt a

24 hour-a-day student accident reporting

system and regularly analyze such reports

as the basis for their safety education

em-phasis.

7. Business and industry increase the

cx-tent to which off-the-job safety programs

include child safety and are effectively

car-ned out.

Environment

A child’s environment encompasses a

multi-tude of areas-clothing, toys, drugs, food,

furnishings, and a host of other consumer

products. The safety of a number of these

products is partially controlled by federal,

state, and local laws, such as those that

per-tam to foods, drugs, cosmetics and, to some

extent, clothing. The pressure to provide

more safety in equipment and products not

currently covered by voluntary product safety standards or laws is evident.

The environment of the child is also

af-fected by voluntary standards and, to some

degree, by those who manufacture these

products.

In addition, the family exercises a degree

of safety control in its selection of the

home, equipment and products it

pur-chases, the proper maintenance it provides,

and tile degree of discipline it achieves in

its family life.

OBJECTIVES-TO achieve a safer

environ-ment for the child it is recommended that:

1. Adequate guides be provided for fani-ilies to assist them in the purchase of safe

and hazard free products and equipment.

Special attention should be given to the

manufacturers recommendations and the

significance of recognized labels, such as

those of Underwriters’ Laboratories and the

American Gas Association.

(5)

re-HOW

SAFE

IS PUPIL

TRANSPORTATION?

Seymour Charles, M.D., and Annemarie Shelness

Abstract of a study of school bus laws, regulations and practices in the United States, conducted by

sponsibility and moral obligation for the

welfare of children by being encouraged

to :

(

a

)

comply vith existing voluntary

safety standards,

(

b

)

assume a stature of

responsibility for producing safe consumer

products,

(

c

)

where no standard exists,

take the initiative in voluntarily developing

safety standards for their products, based

on research and statistical data,

(

d

)

take

the initiative in forniulating labeling

com-pacts and sponsoring consumer education

progranis for products requiring special at-tention for safe use and storage.

3. \\There industry fails to provide

rca-sonable safety for the consumer, the need

for legislation should he considered.

SUMMARY

This statement is presented as a

nation-wide systems approach for controlling

acci-dental injuries and deaths to children. Basic

to the program outlined herein is the need

for more knowledge concerning the causes

the Physicians for Automotive Safet

W

HILE the American school bus is

claimed to be the safest form of

pas-senger transportation, a recent survey of

ac-cident rates and hazards revealed by the

Physicians for Automotive Safety (PAS)

in-dicated substantial deficiencies in school-bus safety. Individual states reported a con-fusing disparity in safety regulations; no

state possessed an optimal situation. No

uniform national standards for the medical

qualification, selection, training, and

super-vision of bus drivers exist. Existing

scien-tific knowledge concerning safety, like that

reported i)\’ the University of California at

Los Angeles Institute of Traffic and

Trans-portation’s study on school bus collisions,

1) have not been widely applied for pupil

and effects of these accidents. Facts are a

prime requisite to all other proposed mea-sures. Valid research and statistics will

throw light on what is now only educated

guesswork.

Increased and accurate data on all

as-pects of the child-accident probleni vill

en-able comprehensive public information and

education programs to determine priorities

and achieve their goals.

A safer environment for the child can be

achieved more rapidly, and with greater

ef-fectiveness, by pinpointing the problems

and eliminating the hazards. Likewise,

haz-ards can be controlled by consumer

prod-net-safety programs, and good maintenance

and discipline within the family.

The program proposed in this paper can

be a vital, strong, and worthwhile systeni if

it receives coordinated, sustained and

will-ing support-or, it can be just another good

plan, the victim of token support and

frac-tional effort. The choice is ours to make.

and driver protection. The collision

experi-ments with anthropometric dummies as

“passengers” were set up to establish the

feasibility of using seat belts or other

re-straining devices for youngsters in school

buses. The findings cover these and many

other aspects of vehicle design. Some of the

recommendations are: seat backs should be raised to a height of 28 inches; seat backs must have effective padding on the

rear panels and strong, well-padded arm

rests; seat belts should be provided for all

passengers but only in combination with the safety seats described above; drivers of school buses should wear seat belts; seats

must be anchored securely to the floor to

(6)

1969;44;876

Pediatrics