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ACCIDENT PREVENTION
The long-term solution to the injury problem is prevention. The
major responsibility for accident prevention rests not with the
medical profession, but with educators, industrialists, engineers,
public health officials, regulatory officials, and private citizens.
Although the physician is concerned primarily with increasing
survival and lessening disability of victims after accidents occur,
there are many ways in which the medical profession can help to
prevent accidents. These include the detection and reporting of
health hazards introduced into the environment; calling attention
to the relationship of design of vehicles, appliances, houses, and
public buildings to types of accidents; and identifying the roles of
human behavioral, physical, emotional, and mental defects, acute
and chronic illness, alcohol, and drugs in accident liability.
One of the outstanding pieces of evidence of the value of
accident prevention is in the improved safety record of employees
in private industry as a result of the improved design of power
machinery and the teaching of safety measures. Precise standards
are followed in the construction of most buildings, equipment
and appliances. Paradoxically, the hazards to the consumer in
using these products of industry may go undetected or uncorrected.
The introduction of a new drug receives close scrutiny and its
untoward or "accidental" effects are reported until its use and
limitations are well established, but there is little requirement that
hazards or limitations of a new machine or an appliance be
detected, reported, and corrected early in its use. There seems to
be no explanation for the lack of national standards or codes with
respect to motor vehicles or their equipment. Thirty states do not
even require periodic automobile inspection;5 they have become
dumping-grounds for vehicles that fail to pass inspection in states
that do require it. Federal imposition of proved safety standards
and of periodic inspection, if applied as vigorously to vehicles
engaged in interstate travel as are the regulations that preclude
interstate commerce of drugs unapproved by the Food and Drug
Administration, could greatly reduce the nation's annual traffic toll.
Prevention of accidents involves training in the home, in the
schools, and at work, augmented by frequent pleas for safety in
10
OCR for page 11
the news media; first aid courses and public meetings; and inspec-
tion and surveillance by regulatory agencies. Hazards involved in
fabrication and utilization of vehicles, highways, appliances, farm
implements, homes, and public buildings, or arising from partici-
pation in sports, or from fire, natural disaster, or national emer-
gencies concern practically every segment of modern society. Of the
nearly 52 million nonfatal accidental injuries in 1965, only 7 per-
cent were caused by motor vehicles. Accident prevention must be
directed to the 43 percent which occurred in the home; the 16 per-
cent in industry and the 34 percent in public places, recreation,
other forms of transportation, etc.6
There is need for an advisory agency in the form of a National
Council on Accident Prevention, with representation from appro-
priate government agencies, industry, engineering, architecture,
insurance, public health, education, the behavioral sciences, and
medicine. Its major mission would be to ascertain the causes of
accidental injury and to recommend or initiate measures necessary
for their control or elimination. It would coordinate the findings
and regulations now prescribed by industry and by the numerous
federal safety laws dealing with neatly industries and administered
by government departments whose primary missions are directly
or indirectly related to health. It would identify needs and enlist
federal and private support of research and of programs in federal
departments, states and communities, and specialized research
laboratories in the epidemiology and prevention of accidents.
Some of these needs and many of the problems and their solutions
have been identified by the Division of Accident Prevention of
the U. S. Public Health Service and by the National Safety Council.
The National Traffic Safety Advisory Committee, as provided for
in the EIighway Safety Act of 1966, affords for the first time a
means by which preventive measures and standards can be deline-
ated for all transport vehicles, including not only highway vehicles
but also railroad, aviation, and coast guard conveyances. More
than half of the accidental deaths, disabilities, and costs are
unrelated to transportation, and factors peculiar to highways,
vehicles and drivers constitute but a part of the total accident
prevention problem.
RECOMMENDATION
Formation of a National Council on Accident Prevention at the Executive
level for coordination of information and advice on implementation of
measures and regulations now vested in scattered private, industrial,
and federal agencies, and for research, public education, and develop-
ment of improved standards in accident prevention.
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Representative terms from entire chapter:
health hazards
