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CDC supports research on home and recreation injury prevention conducted by staff scientists and partners, such as injury control research centers and state health departments. Priorities include residential fires, older adult falls, and drowning and water safety. Highlights of CDC-supported research in this area during 2000–2001 include:
“Because of major strides in medicine and public health, we Americans are continuing to live longer—and healthier lives. As a result, injuries among older Americans now ranks with heart disease and stroke as a major contributor to death and disability among this
population.”
Statement by David W. Fleming, MD, Acting Director, Centers for Disease Control and Prevention, U.S.
Department of Health and Human Services on Falls Among Older Americans: CDC Prevention Efforts before the Senate Sub-committee on Aging Committee on Health, Education, Labor and Pensions June 11, 2002,
http://www.hhs.gov/asl/testify/t020611.html |
Fire-Related Injuries
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CDC is working with the U.S. Consumer Product Safety Commission, National Institute of Standards and Technology, National Fire Protection Association (NFPA), Underwriters’ Laboratories, U.S. Fire Administration, Department of Housing and Urban Development, and other partners to fund evaluation of how current and prototypic smoke alarm technologies perform in real fires. Researchers are testing the responses of various types of alarms to serious residential fires. In addition, researchers are evaluating how well the different types of alarms resist sounding when a fire is not present (i.e. “nuisance alarms”).
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To develop recommendations for the installation of home smoke alarms, CDC is funding a randomized trial of two types of smoke alarms installed in standardized positions on the main living floor in 784 owner-occupied dwellings in King County, Washington. Researchers will determine the proportion of functional alarms for each type at 9- and 18-month intervals. They will also identify reasons for nonfunctioning alarms,
determine the incidence of nuisance alarms, and examine correlations between functioning smoke detectors and sociodemographic features of the population.
Fall-Related Injuries Among Older Adults
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 CDC scientists determined that from 1989 to 1998, the rate of deaths resulting from fall- induced traumatic brain injury (TBI) among older adults increased 60%, from 19.3 per 100,000 population to 30.8. The proportions of TBI deaths from falls increased 58% among males (from 12% to 18%) and 42% among females (from 18% to 25%). Potential reasons for these increases include more sophisticated methods of diagnosing TBI, changes in reporting fall-related events on death certificates, and changes in demographic characteristics and health behaviors.
Further research is needed in this area to determine factors that contribute to fall risk.
Stevens JA, Adekoya N. Brain injury resulting from falls among elderly persons [letter to the Editor].
JAMA 2001;286(21):2665–6.
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Vanderbilt University is conducting a CDC-funded randomized controlled trial in 112 nursing homes. This research project will evaluate whether the Tennessee Fall Prevention Program (TFPP), a statewide program to train nursing home staff in safety practices, reduces serious injuries from falls among nursing home residents. Results from a pilot study showed that residents’ recurrent falls were reduced 19%. If effective, the TFPP will provide a model for feasible, cost-effective injury prevention programs in long-term care settings.
Water Safety
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 CDC researchers analyzed data collected during the first Injury Control and Risk Survey to assess how well American adults thought they could swim. They found that more than one third of the adult population reported that they were unable to swim at least one pool length or 24 yards. Younger respondents reported greater swimming ability than did older respondents, and self-reported ability increased with level of education. African Americans reported the most limited swimming ability, and more women than men reported limited ability, despite much lower drowning rates among women. These data will help public health practitioners identify groups at greater risk for drowning and better target water safety messages and swimming education efforts.
Gilchrist J, Sacks JJ, Branche CM. Self-reported swimming ability in U.S. adults, 1994.
Public Health Reports 2000;115(2–3):110–1.
Sports and Recreation Injuries
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CDC researchers used data from civilian and military studies to conduct a review of exercise-related injuries among women. The review provided basic recommendations for injury prevention. Women who are starting exercise programs should be realistic about their goals and should progress slowly from levels of frequency, duration, and intensity that are commensurate with their current physical fitness condition.
Gilchrist J, Jones BH, Sleet DA, Kimsey CD. Exercise-related injuries among women: Strategies for prevention from military and civilian studies.
MMWR 2000;49(RR-2):13–33.
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CDC researchers conducted a systematic review of interventions to prevent sports-related shin splints, common overuse injuries for which many prevention and treatment measures have been promoted. Few controlled studies regarding prevention have been completed. Shock absorbing insoles are the only intervention for which data suggest a benefit.
Thacker SB, Gilchrist J, Stroup DF, Kimsey CD. The prevention of shin splits in sports: A systematic review of literature.
Medicine & Science in Sports & Exercise 2002;34(1):32–40.
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CDC is collaborating with the American Academy of Orthopaedic Surgeons, the National Collegiate Athletic Association, the International Federation of Football Associations, and the Santa Monica Orthopedic and Sports Medicine Research Foundation to evaluate an intervention to prevent knee injuries (including anterior cruciate ligament, or ACL, injuries) among female soccer players. During the fall 2001 soccer season, nine NCAA Division I women’s soccer teams piloted the intervention and study mechanisms
to assess the feasibility of conducting a large, randomized controlled trial of the intervention. Both the program and the reporting mechanisms were well received. Recruitment for the randomized controlled trial is underway for the fall 2002 soccer season.
Playground Injuries
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Shredded rubber performed best in a CDC-funded test of loose-fill playground surfacing materials, according to a study conducted by CDC scientists and the National Program for Playground Safety (NPPS), a non-profit organization based at the University of Northern Iowa. The researchers used a standard testing procedure to evaluate various playground surfaces. Following shredded rubber, result showed sand, wood fibers, and wood chips also performed adequately, with little difference among the three. Pea gravel provided the least resilience, making it a poor choice for playground surfacing.
Mack MG, Sacks JJ, Thompson D. Testing the impact attenuation of loose-fill playground surfaces.
Injury Prevention 2000;6(2):141–4.
Injuries from Dog Bites
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CDC researchers examined data about fatal dog attacks that occurred during 1979–1998. They found that at least 25 breeds of dogs had been involved in the fatal attacks. Of the 227 fatal attacks for which data were available, more than two-thirds involved a single dog, and more than half involved dogs that were unrestrained on their owner’s property. The findings of this study provide insight into the circumstances surrounding deadly dog attacks and will help shape prevention efforts.
Sacks JJ, Sinclair L, Gilchrist J, Golab GC, Lockwood R. Breeds of dogs involved in fatal human attacks in the United States 1979–1988.
Journal of the American Veterinary Medical Association 2000;217:836–40.
School Health
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CDC researchers in unintentional injury, violence, and adolescent and school health worked with their partners to produce School Health Guidelines to Prevent Unintentional Injuries and Violence. This document, part of a series of CDC school health guidelines, addresses strategies schools can implement to reduce unintentional injuries and violence within a framework of comprehensive school health.
CDC. School health guidelines to prevent unintentional injuries and violence. MMWR 2001;50(RR-22):1–46.
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