A comparison of unintentional injury patterns occurring in two Swedish communities in 1978 and in 2008.

Surveillance and analyses of unintentional injuries can be used to help prioritise community prevention efforts. This study describes changes in local patterns for unintentional injuries resulting in deaths, hospitalisations, and outpatient visits to health care clinics and emergency rooms, comparing information from two different study periods, 1978 and 2008, in the Swedish communities of Falköping and Lidköping. Injury cases were analysed, and confidence intervals were derived. The study results show that while most injuries decreased comparing the first study period to the second, these changes were only significant in terms of decreases in outpatient care. This study points to the importance of more systematic collection data of injury events treated at the outpatient level, particularly for communities where there are relatively low numbers of injury-related deaths and hospitalisations.

The rise and fall of a National Safety Promotion Programme:the case of Sweden.

In 1982, when Sweden got a new Health Service Act, the health sector was given a new role - to collect, analyse and actively disseminate the knowledge it gained. A National Safety Promotion Programme was build up by the National Board for Health and Welfare, and a National Inter-sector Cooperation Group and medical advisory board were established. In 1992, the programme was transferred to the National Institute of Public Health. Later the Institute was given a new role and therefore the programme was relocated to the Swedish Rescue Service Agency. In some aspects we can see a parallel with the paradigm that was behind the Civil Protection Act 2003 and the Health Service Act 1982. It was a logic consequence to move the national programme to the rescue service sector. Within the National Rescue Service Agency the programme ended up in the line organisation, which lacked a cross-sector work orientation. The programme was closed down. In the article the reason for the decisions is described and also the background and the possibilities for the programme to act in different national boards as well as the preconditions for an inter-sector group.

Is Sweden still a role model for safety? An overview of unintentional injury data over the past two decades.

This study investigates injury-related mortality and hospitalisations, during 1987-2007 in Sweden. Injuries were classified according to International Classification of Diseases (ICD)--8 for pre-1987 injuries, ICD-9 for 1987-1996 injuries and ICD-10 for injuries occurring in 1997 and later. Data on mortality from injuries during 1987-2007 were collected from Sweden's national Cause-of-Death Register, while data concerning injury diagnoses leading to hospitalisation stays of at least 24 h, occurring during 1987-2007, were obtained from the national Patient Register. Crude rates were derived for injury-related deaths and injury-related hospitalisations for age-gender groups, using population data from Statistics Sweden. Our results showed a mixed picture of injury-related hospitalisations and deaths over the study period. Absolute numbers of injury-related deaths and injury-related hospitalisations decreased over time for the population as a whole and for many, but not all, age-gender groups. When assessing crude injury-related death rates and crude injury-related hospitalisation rates over time, as categorised by gender and age groupings, we also found unchanging or increased risks for injury-related deaths and/or hospitalisations for several age-gender groups. While Sweden has made remarkable progress in reducing injury-related deaths and hospitalisations, there are clear differences in risk that remain.

Differences in child injury hospitalizations in Sweden: the use of time-trend analysis to compare various community injury-prevention approaches.

AIM: Sweden's child injury fatality rates are among the lowest in the world. The country has engaged in a number of community injury-prevention programmes. The purpose of this study was to compare child injury hospitalization rates from the Skaraborg District with the rest of Sweden. Our study hypothesis was that municipalities that offered comprehensive child injury-prevention programmes would see significant decreases in their child injury hospitalization rates, compared with other areas. METHODS: The study areas comprised three groups, consisting of municipalities in Skaraborg that had adapted the Safe Communities approach to injury prevention programmes, other municipalities in the District, and the rest of Sweden. The aim of the analysis was twofold: (1) to fit time trends for children's injuries in various areas in an integrated manner; and (2) to compare time trends across locations between community safety-promotion programmes as well as with the control areas. Panel data models and parametric splines were used. RESULTS: There were differences between incidence rates in the study areas and with regard to gender. There was a steep decrease in injury rates in one of the Safe Communities study areas for both genders. CONCLUSIONS: The methods applied in this analysis reveal more detailed and sophisticated time trends than the usual simple linear regression approach. The model provided a clearer view of the interactions of gender, area, and time as they impacted on children's injuries, and allowed for better insight into the impact of safety programmes.

The Risk Line: a special telephone line to provide means of reporting potential dangers and to increase public participation.

Injuries constitute a significant public health problem. There is a risk of injury in any environment in which persons are present. The purpose of this paper is to describe the development and experiences from the Risk Line. The Risk Line is a special telephone number to provide means of reporting potential risks for injuries and dangerous products and to increase public participation in injury reporting. Various strategies have been used to make the Risk Line well known in the population. Weekly reports on the risk of playground, traffic, recreational, and residential injuries and dangerous products have been distributed to those who are responsible for eliminating these hazards. The major risk environments reported were traffic, recreational, residential environments, and playgrounds. Seventy-seven percent of the reported hazards had been eliminated. A majority of the public (72%) who had phoned the Risk Line stated that they had become more observant and aware of risks for injuries. In conjunction with injury statistics and safety inspections, information from the Risk Line can contribute to give an improved overall picture of where priorities are needed in safety promotion and injury prevention work.

Development of a Swedish bicycle helmet promotion programme--one decade of experiences.

OBJECTIVE: to describe 10 years of experiences of the Swedish National Bicycle Safety Programme which started during 1990 as part of an initiative taken by the World Health Organization (WHO). In relation to WHO's efforts with regard to accident and injury prevention, a global programme to increase helmet-wearing by two-wheel riders was launched. The idea was to introduce a simple 'vaccine' for everyone that was achievable at a low cost. The Swedish initiative was taken up by the Karolinska Institute and the National Institute of Public Health. METHOD: at an operational level, all available methods and data sources were utilized in the programme: surveillance of injuries, provision of information and advice, training and supervision, environment and product improvements, and legislation. RESULTS: considerable progress has been made in reducing bicycle-related injuries in Sweden over the last two decades. Cycling injuries among the elderly must be a matter of particular concern. CONCLUSIONS: our 10 years of experiences from a bicycle helmet promotion programme lead to the conclusion that there is a case for mandatory helmet wearing, as one of the most important strategies on the national level. But regional and community-based efforts will still need to be more comprehensive. Besides this, efforts must be made to intensify the activities of parties already involved in prevention programmes. New target groups must be approached, such as immigrants, vulnerable social groups, and teenagers. Sustainability of the Swedish Bicycle Helmet Initiative Group, including continued participation of group members and organizations, is the key--in the long term--to protecting Swedish bicyclists against head injuries.

Evaluation of an inter-organizational program for prevention of work-related injuries in a WHO Safe Community.

OBJECTIVE: To evaluate the effect of a community-based injury prevention program on work-related injuries. STUDY DESIGN: A population-based quasi-experimental design was used with pre- and post-implementation measurements in an intervention and a control area. The program was based on cross-sectoral participation in detecting and taking action against work-related injuries. Change in the relative risk of injury was estimated by the odds ratio. RESULTS: The relative risk of work-related injury decreased following program exposure, whereas a tendence toward increase was observed in the control area. Middle-aged men accounted for the largest decrease in injury risk. Among the women, a decrease was observed only in the upper middle-aged group. No female-dominated occupational area showed a decrease in injury risk following exposure to the program. CONCLUSION: The study showed that the community-based approach had a general effect on the incidence of work-related injuries.

Injuries to Swedish school pupils: Distribution and patterns by type of school and type of municipality.

The study examines the distribution of injuries and their patterns among Swedish school pupils. Data were gathered from an injury register created during the school year 1996/97, with the help of 79 schools and using a standardized registration form. Injury ratios (IRs) by gender, type of municipality, and type of school were measured all injuries aggregated and for five injury patterns. IRs did not vary much by gender, but showed considerable variation by type of school and type of municipality. A strong association was found between injury pattern and gender. Taken as a whole, the findings shed light on the circumstances under which school injuries are incurred. They suggest that targets for prevention may vary by gender, school level and, to some extent, by type of municipality. The extent to which the findings are generalizable is uncertain.