Richard J. Waxweiler

Cost effectiveness analysis of a smoke alarm giveaway program in Oklahoma City, Oklahoma

Objective—To estimate the cost effectiveness of the Lifesavers Residential Fire and Injury Prevention Program (LRFIPP), a smoke alarm giveaway program. Setting—In 1990, the LRFIPP distributed over 10 000 smoke alarms in an area of Oklahoma City at high risk for residential fire injuries. The program also included fire prevention education and battery replacement components. Methods—A cost effectiveness analysis was conducted from the societal and health care systems perspectives. The study compared program costs with the total costs of medical treatment and productivity losses averted over a five year period. Fatal and non-fatal residential fire related injuries prevented were estimated from surveillance data. Medical costs were obtained from chart reviews of patients with fire related injuries that occurred during the pre-intervention period. Results—During the five years post-intervention, it is estimated that the LRFIPP prevented 20 fatal and 24 non-fatal injuries. From the societal perspective, the total discounted cost of the program was

Magnitude and Patterns of Family and Intimate Assault in Atlanta, Georgia, 1984

531 000. Total discounted net savings exceeded

Injuries to rescue workers following the Oklahoma City bombing

15 million. From the health care system perspective, the total discounted net savings were almost

Injury surveillance at the 1985 National Boy Scout Jamboree

1 million and would have a net saving even if program effectiveness was reduced by 64%. Conclusions—The program was effective in reducing fatal and non-fatal residential fire related injuries and was cost saving. Similar programs in other high risk areas would be good investments even if program effectiveness was lower than that achieved by the LRFIPP.

Developing a national policy for injury and violence prevention

A sample of police incident reports was used to examine the magnitude and patterns of family and intimate assault involving weapon use or threat, bodily force, or verbal threat of assault in a defined urban population during 1984. More than half of the incidents involved partners (spousal and nonspousal), about a fourth involved prior or estranged partners, and the remainder involved family members and relatives. The 1984 rate of nonfatal family and intimate assault was estimated at 837 per 100,000 population—the fatal rate was 7 per 100,000 population. Fatal and nonfatal victimization rates for blacks and other races were three times the rates for whites. Fatal incidents predominantly involved handguns, and nonfatal incidents most often involved bodily force. Most nonfatal victims (66%) and some perpetrators (13%) suffered physical injuries. Data on prior police contacts suggest that family and intimate assaults occur within a context of repeated violence. Information about prior incidents might contribute to preventive efforts by identifying people at high risk of being victims or perpetrators.

Incidence Rates of Firearm Injuries in Galveston, Texas, 1979–1981

The objective of this study was to identify and describe physical injuries to rescue workers in the aftermath of the Oklahoma City bombing. Data were obtained from medical records from 16 hospital emergency departments and specialty clinics in the Oklahoma City area, and reported visits to medical providers at the bombing site. Participants were rescue personnel from the Oklahoma City Fire Department, the mutual aid fire stations in the Oklahoma City area, the Federal Emergency Management Agencys Urban Search and Rescue teams, and military personnel stationed near Oklahoma City. All participants were involved in the rescue and recovery operation. The two main outcome measures were (1) the number, types, and rates of injuries; and (2) comparisons of case-finding methods, including medical chart review and telephone interview. The most common injuries were strains and sprains (21.4%), foreign bodies in eyes (14.5%), and laceration/crush/puncture wounds (18.4%). Of the four case-finding mechanisms, telephone interviews following the event identified the largest number of cases (84.5%). Most injuries were minor; some injuries such as chemical burns were preventable. The potential utility of other data collection mechanisms is considered.

Measuring adolescent behaviors related to intentional injuries

Few studies have examined the rate of injuries for those attending summer camps and other recreational facili ties. We developed a surveillance system for the 1985 National Boy Scout Jamboree to determine the inci dence, nature, and cause of injuries among participants. To characterize the more severe injuries among scouts, we monitored referral visits to an onsite Army hospital. During the 9 day event there was a total of 179 injuries requiring referral visits among the 24,885 scouts, for an overall incidence of 8.5 injuries per 10,000 person- days. Twenty-eight injuries (16%) involved fractures. Ten injuries required hospitalization, for an overall rate of 0.5 per 10,000 person-days. Thirty-six (20%) of the injuries occurred during six organized athletic activities. Of these six, two new Jamboree activities, the bucking bronco and bicycle motocross racing, had the highest event-specific rates, 14.4 and 11.4 injuries per 10,000 participants, respectively. These two events also ac counted for one-third of all fractures. In contrast, there were no firearm-related injuries among the 32,616 par ticipants in riflery events. This simple and inexpensive surveillance system provided a mechanism for monitor ing activity modifications, as well as useful information for the selection and planning of organized activities at future Jamborees and similar recreational events.

A retrospective cohort mortality study of males mining and milling attapulgite clay

As injuries can happen in any setting, to anyone and at any time, the preventive responses required need to be comprehensive. Accordingly, this requires the involvement of many stakeholders from different sectors and disciplines (Krug, Dahlberg, Mercy, Zwi & Lozano, 2002; Peden et al., 2004). The development and implementation of national policies are rational ways of obtaining commitment and coordinating the efforts, roles, responsibilities and resources of the many actors involved (Schopper, Lormand & Waxweiler, 2006). The lack of such coordination may lead to an incomplete or fragmented response and to duplication or divergence of efforts. A policy has essential elements that include a vision, with targets, actions, resources and actors required to successfully implement it over a defined time scale in a coordinated way. In addition to providing evidence on the burden and on what works for prevention, WHO’s world reports on violence and health and road traffic injury prevention promote the development of national prevention policies (Krug et al., 2002; Peden et al., 2004). This paper draws upon WHO’s Developing policies to prevent injuries and violence: guidelines for policy-makers and planners (Schopper et al., 2006).