Injuries and their consequences produce a heavy burden on society in terms of short and long term disability, mortality, economic loss and health care costs. Whilst injuries account for only about three per cent of total deaths in Wales, the distribution of the age of death in those dying is very different from most other causes of death with a high proportion of deaths occurring in the young. After the age of one, injury is the first or second leading cause of death in most European countries, including Wales.
There is increasing concern being expressed to address the prevention of death and disability in Wales, for example the Chief Medical Officer, Dr Tony Jewell, is supporting the concept of ‘preventing the preventable’. Injuries are caused by predicable interactions between individuals and the environment in which they live and work. The term ‘accident’ is no longer used as it tends to suggest that injuries are random events and not amenable to prevention, when in reality they usually follow a predictable pattern of exposure and are largely preventable. Increasingly references are made to unintentional injuries or events, such as crashes or collisions, rather than terms such as ‘accidental injury’.
SafeHome is a web-based home safety and hazard assessment tool designed to reduce injuries in the home, particularly amongst children and older people. SafeHome has been developed by injury prevention researchers at Swansea and Cardiff Universities with input from a number of charities and organisations. Available on www.Safehome.org.uk, SafeHome enables the individual to complete a short online questionnaire. There are two forms available because some things are dangerous for young children that are not dangerous for adults and older children. A personal report is then generated which identifies hazards and safety features in their home and gives guidance on how to make their home safer. It will also compare hazards in your home with other houses.
SafeHome can be used by anyone, of any age, who has access to a personal computer. Alternatively, it can be accessed through the internet provision available at local public libraries. It is web-based and very simple to use. SafeHome can also be used by teachers in the classroom as part of Personal and Social Education sessions related to health and safety or as part of Information Technology lessons.
Working with the Centre for Health Information, Research and Evaluation (CHIRAL) at the School of Medicine, Swansea University, the Conwy and Denbighshire Local Public Health Team of the NPHS helped to pilot this tool across both counties in 2008. They were supported by Conwy and Denbighshire Local Authorities and Local Health Boards( now Betsi Cadwaladr University Local Health Board) As part of this trial, the type of hazards in the home were analysed.
A total of 53 households in Conwy and Denbighshire completed the tool. Particular hazards recorded (which are present in more than 50% of households in both counties) included:
Carbon monoxide monitors not fitted
No fire escape plans
Visitors not knowing about fire escape plans
Window locks not fitted on every upstairs window
Window locks within reach of children
Candles used in the home
Multiple appliances connected to sockets
No fire blankets or extinguishers available
Chemicals and hazardous substances not stored safely
Use of front rings of a cooker in houses with young children
Stairs with one or no handrails
No handrails fitted in baths
No non-slip surfaces or mats in baths
No anti-scald thermostatic mixing valve fitted to baths
No handrails fitted in showers
No handrails are fitted in reach of the toilet
Injuries, particularly injuries in the home, are an important public health issue. SafeHome is a web-based home safety and hazard assessment tool designed to reduce injuries in the home, particularly amongst children and older people. As a result of the pilot described, the tool is being simplified and further improved in collaboration with the charity Children in Wales. Use of the tool has highlighted particular home hazards in the counties of Conwy and Denbighshire, which could be used by partner organisations such as local authorities to plan risk-based provision of services and equipment. The hazards identified are likely to be applicable to other local authority areas across the UK.
By:
Dr Rob Atenstaedt, Consultant in Public Health Medicine and Local Public Health Director for Conwy & Denbighshire, National Public Health Service for Wales (NPHS)
Professor Ronan Lyons, Professor of Public Health and Co-Director of UKCRC DECIPHer (Development and Evaluation of Complex Interventions for Public Health Improvement) Centre
Samantha Turner Research Assistant, Centre for Health Information, Research and Evaluation (CHIRAL), Swansea University
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