World Health Organization (WHO) on Road Traffic Injury Prevention.

Burden of Disease: Road traffic injuries are the leading cause of death by injury and the 9th leading cause of all deaths worldwide. Road traffic injuries are projected to become the third leading cause of disability-adjusted life years (DALYs*) lost worldwide by 2020, surpassed only by heart disease and major depression. Road Traffic Injuries (links to WHO information)

"World Health Day is an annual advocacy event hosted by WHO to mark the date of the Organization’s establishment.  Traditionally held on April 7, World Health Day is one of WHO’s key advocacy tools for reaching out and engaging the general public in discussion and debate on important health issues.

"For the first time in the history of WHO, in 2004, the Director-General devoted a World Health Day specifically to Road Safety.  Although road traffic collisions kill nearly 1.2 million people around the world every year, they are largely neglected as a health issue, perhaps because they are still viewed by many as events which are beyond our control.

Yet the risks are known.  They include speeding; driving under the influence of alcohol; non-use of helmets, seat belts and other restraints; poor road design; poor enforcement of road safety regulations; unsafe vehicle design, and poor emergency health services."

The above is from WHO's Toolkit for Organizers

In WHO's work on the Global Burden of Disease, they note an alarming change in the rank order of DALY* between 1990 and the projections for 2020. Road traffic injuries are projected to move from position number 9 to third place, outranked only by Ischemic Heart Disease and Unipolar Major Depression.

* Disability-Adjusted Life Year ( DALY) measures overall burden of a disease by combining the years of potential life lost due to premature death and the years of productive life lost due to the disability. One DALY is one lost year of healthy life.

Think globally, Act locally!

What can you do to help in your community?

Suggestions are welcome and may be published here.

Traumatic Brain Injury - a largely preventable major epidemic.

Leadership from physicians, lawyers, and rehabilitation specialists (and others experienced in the assessment and treatment of survivors of brain injury) is one of the best ways to influence public policy.

We all can promote better and more consistently used injury prevention strategies.

Where to start? If you're a grandparent or parent, don't trivialize the importance of safety restraints for children in cars or protective head gear for cycling and other sports. Be a role model! Research and clinical experience demonstrates that early trauma to the brain can leave an indelible imprint on the future personality and development of the child.

This section of drivesafe.com will be regularly updated to include a listing of useful resources about brain injury prevention and rehabilitation. Your suggestions for health promotion activities are very welcome and will be conveyed to the Council on Health Promotion of the BC Medical Association.

April 1 - 2, 2005 - Trial Lawyers Association of BC Conference "Medical & Legal Issues in Brain Injury"

A repeat of a popular educational event with internationally-renowned speakers. Several lawyers commented on the relative lack of interest or knowledge about traumatic brain injury issues among the physicians they deal with when acting for brain injured clients. Physician presenters acknowledged that this was a complex area, with many recent advances, and little attention paid to it historically in medical school curricula.

One of the audience made a reasonable request for wider distribution of the CDC's reference material intended for the use of physicians and patients:

"Dear Colleague:

The Centers for Disease Control and Prevention (CDC) is pleased to offer Heads Up: Brain Injury in Your Practice as part of a national initiative to prevent mild traumatic brain injury MTBI) and improve clinical management for patients with MTBI. This tool kit is part of CDC's response to the Congressional TBI Act Amendments of 2000, which mandate attention to this public health concern. Physicians play a key role in this national initiative by helping their patients prevent MTBIs and improving patient outcomes when MTBIs occur."

To order the free tool kit from CDC, click on the link above and look for the "Publications Order Form" link in paragraph three.

Some other highlights from the conference were:

· Standardized Assessment of Concussion (SAC), developed by McCrea et al.

· If this were used routinely in Emergency Departments, it would help greatly in identifying the 15 - 20 % of individuals with "Mild Traumatic Brain Injury" who will have serious and persistent symptoms so that they could have early intervention to assess for the appropriate level of rehabilitation treatment. Those that don't have abnormalities on screening could be safely reassured that the likelihood of residual symptoms is very small. The experience in military medicine and the football field can teach us improved strategies for routine assessment in the ER. The CDC also has National Center for Injury Prevention and Control with a clinical studies summary of Immediate Neurocognitive Effects of Consussion

The Standardized Assessment of Concussion pocket assessment card is available from:

Michael McCrea, PhD

Program Director, Neuroscience Center

Waukesha Memorial Hospital

721 American Ave., Suite 501

Waukesha, WI 53188