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. 1995 Dec;1(4):249–255. doi: 10.1136/ip.1.4.249

Can we prevent accidental injury to adolescents? A systematic review of the evidence.

J Munro, P Coleman, J Nicholl, R Harper, G Kent, D Wild
PMCID: PMC1067615  PMID: 9346041

Abstract

OBJECTIVES: As part of the Department of Health strategy The Health of the Nation, a systematic review of published and unpublished literature relating to the effectiveness of interventions in reducing accidental injury in the population aged 15-24 years was carried out. METHODS: The literature was reviewed under the standard setting headings of road, work, home, and sports and leisure, and graded for quality of evidence and strength of recommendation using a scale published in the UK national epidemiologically based needs assessment programme. RESULTS: The most effective measures appear to be legislative and regulatory controls in road, sport, and workplace settings. Environmental engineering measures on the road and in sports have relatively low implementation costs and result in fewer injuries at all ages. There is little evidence that purely educational measures reduced injuries in the short term. Community based approaches may be effective in all age groups, and incentives to encourage safer behaviour hold promise but require further evaluation. The potential of multifactorial approaches seems greater than narrowly based linear approaches. CONCLUSIONS: Few interventions to reduce injury in adolescents have been rigorously evaluated using good quality randomised controlled trials, and where such evidence is available, fewer have been shown to be definitely worthwhile. Many studies relied on surrogate measures rather than actual injury rates, and substantial issues relating to the efficacy or implementation of preventive measures in adolescent and young adult populations remain unresolved.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albright J. P., Powell J. W., Smith W., Martindale A., Crowley E., Monroe J., Miller R., Connolly J., Hill B. A., Miller D. Medial collateral ligament knee sprains in college football. Effectiveness of preventive braces. Am J Sports Med. 1994 Jan-Feb;22(1):12–18. doi: 10.1177/036354659402200103. [DOI] [PubMed] [Google Scholar]
  2. Barone G. W., Rodgers B. M. Pediatric equestrian injuries: a 14-year review. J Trauma. 1989 Feb;29(2):245–247. [PubMed] [Google Scholar]
  3. Bjärås G., Danielsson K., Schelp L., Sjöberg D., Skjönberg G. Safety rounds in public environments: experience of a new tool for prevention of accidental injuries. Accid Anal Prev. 1990 Jun;22(3):223–228. doi: 10.1016/0001-4575(90)90014-c. [DOI] [PubMed] [Google Scholar]
  4. Blignaut J. B., Carstens I. L., Lombard C. J. Injuries sustained in rugby by wearers and non-wearers of mouthguards. Br J Sports Med. 1987 Jun;21(2):5–7. doi: 10.1136/bjsm.21.2.5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bourne N. D., Reilly T. Effect of a weightlifting belt on spinal shrinkage. Br J Sports Med. 1991 Dec;25(4):209–212. doi: 10.1136/bjsm.25.4.209. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Brown T. D., Van Hoeck J. E., Brand R. A. Laboratory evaluation of prophylactic knee brace performance under dynamic valgus loading using a surrogate leg model. Clin Sports Med. 1990 Oct;9(4):751–762. [PubMed] [Google Scholar]
  7. Burry H. C., Calcinai C. J. The need to make rugby safer. Br Med J (Clin Res Ed) 1988 Jan 16;296(6616):149–150. doi: 10.1136/bmj.296.6616.149. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Chenier T. C., Evans L. Motorcyclist fatalities and the repeal of mandatory helmet wearing laws. Accid Anal Prev. 1987 Apr;19(2):133–139. doi: 10.1016/0001-4575(87)90032-7. [DOI] [PubMed] [Google Scholar]
  9. Condie C., Rivara F. P., Bergman A. B. Strategies of a successful campaign to promote the use of equestrian helmets. Public Health Rep. 1993 Jan-Feb;108(1):121–126. [PMC free article] [PubMed] [Google Scholar]
  10. Coté T. R., Sacks J. J., Lambert-Huber D. A., Dannenberg A. L., Kresnow M. J., Lipsitz C. M., Schmidt E. R. Bicycle helmet use among Maryland children: effect of legislation and education. Pediatrics. 1992 Jun;89(6 Pt 2):1216–1220. [PubMed] [Google Scholar]
  11. Dannenberg A. L., Gielen A. C., Beilenson P. L., Wilson M. H., Joffe A. Bicycle helmet laws and educational campaigns: an evaluation of strategies to increase children's helmet use. Am J Public Health. 1993 May;83(5):667–674. doi: 10.2105/ajph.83.5.667. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. DeJoy D. M. An examination of gender differences in traffic accident risk perception. Accid Anal Prev. 1992 Jun;24(3):237–246. doi: 10.1016/0001-4575(92)90003-2. [DOI] [PubMed] [Google Scholar]
  13. Delhomme P. Comparing one's driving with others': assessment of abilities and frequency of offences. Evidence for a superior conformity of self-bias? Accid Anal Prev. 1991 Dec;23(6):493–508. doi: 10.1016/0001-4575(91)90015-w. [DOI] [PubMed] [Google Scholar]
  14. Dorsch M. M., Woodward A. J., Somers R. L. Do bicycle safety helmets reduce severity of head injury in real crashes? Accid Anal Prev. 1987 Jun;19(3):183–190. doi: 10.1016/0001-4575(87)90002-9. [DOI] [PubMed] [Google Scholar]
  15. Dunbar J. A., Penttila A., Pikkarainen J. Drinking and driving: success of random breath testing in Finland. Br Med J (Clin Res Ed) 1987 Jul 11;295(6590):101–103. doi: 10.1136/bmj.295.6590.101. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Evans L. Cycle helmets and the law. BMJ. 1994 Jun 11;308(6943):1521–1522. doi: 10.1136/bmj.308.6943.1521. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Farrow J. A. Young driver risk taking: a description of dangerous driving situations among 16- to 19-year-old drivers. Int J Addict. 1987 Dec;22(12):1255–1267. doi: 10.3109/10826088709027485. [DOI] [PubMed] [Google Scholar]
  18. Firer P. Effectiveness of taping for the prevention of ankle ligament sprains. Br J Sports Med. 1990 Mar;24(1):47–50. doi: 10.1136/bjsm.24.1.47. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Fosser S. An experimental evaluation of the effects of periodic motor vehicle inspection on accident rates. Accid Anal Prev. 1992 Dec;24(6):599–612. doi: 10.1016/0001-4575(92)90012-8. [DOI] [PubMed] [Google Scholar]
  20. Fyfe I. S., Guion A. J. Accident prevention in skateboarding. J Sports Med Phys Fitness. 1979 Sep;19(3):265–266. [PubMed] [Google Scholar]
  21. Garrick J. G., Requa R. K. Role of external support in the prevention of ankle sprains. Med Sci Sports. 1973 Fall;5(3):200–203. [PubMed] [Google Scholar]
  22. Gorman R. L., Charney E., Holtzman N. A., Roberts K. B. A successful city-wide smoke detector giveaway program. Pediatrics. 1985 Jan;75(1):14–18. [PubMed] [Google Scholar]
  23. Graitcer P. L., Kellermann A. L., Christoffel T. A review of educational and legislative strategies to promote bicycle helmets. Inj Prev. 1995 Jun;1(2):122–129. doi: 10.1136/ip.1.2.122. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Hammond J., Varas R. Coordinated strategies in burn prevention programs: a case study. J Burn Care Rehabil. 1990 Jul-Aug;11(4):376–378. doi: 10.1097/00004630-199007000-00021. [DOI] [PubMed] [Google Scholar]
  25. Hingson R., Merrigan D., Heeren T. Effects of Massachusetts raising its legal drinking age from 18 to 20 on deaths from teenage homicide, suicide, and nontraffic accidents. Pediatr Clin North Am. 1985 Feb;32(1):221–232. doi: 10.1016/s0031-3955(16)34769-1. [DOI] [PubMed] [Google Scholar]
  26. Ingemarson H., Grevsten S., Thorén L. Lethal horse-riding injuries. J Trauma. 1989 Jan;29(1):25–30. doi: 10.1097/00005373-198901000-00005. [DOI] [PubMed] [Google Scholar]
  27. Janda D. H., Wojtys E. M., Hankin F. M., Benedict M. E., Hensinger R. N. A three-phase analysis of the prevention of recreational softball injuries. Am J Sports Med. 1990 Nov-Dec;18(6):632–635. doi: 10.1177/036354659001800613. [DOI] [PubMed] [Google Scholar]
  28. Janda D. H., Wojtys E. M., Hankin F. M., Benedict M. E. Softball sliding injuries. A prospective study comparing standard and modified bases. JAMA. 1988 Mar 25;259(12):1848–1850. doi: 10.1001/jama.259.12.1848. [DOI] [PubMed] [Google Scholar]
  29. Jones N. E., Pieper C. F., Robertson L. S. The effect of legal drinking age on fatal injuries of adolescents and young adults. Am J Public Health. 1992 Jan;82(1):112–115. doi: 10.2105/ajph.82.1.112. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Jones N. P. One year of severe eye injuries in sport. Eye (Lond) 1988;2(Pt 5):484–487. doi: 10.1038/eye.1988.97. [DOI] [PubMed] [Google Scholar]
  31. Kelly S. P. Serious eye injury in badminton players. Br J Ophthalmol. 1987 Oct;71(10):746–747. doi: 10.1136/bjo.71.10.746. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Kennerley-Bankes J. L. Squash rackets: a survey of eye injuries in England. Br Med J (Clin Res Ed) 1985 Nov 30;291(6508):1539–1539. doi: 10.1136/bmj.291.6508.1539. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Laberge-Nadeau C., Maag U., Bourbeau R. The effects of age and experience on accidents with injuries: should the licensing age be raised? Accid Anal Prev. 1992 Apr;24(2):107–116. doi: 10.1016/0001-4575(92)90027-g. [DOI] [PubMed] [Google Scholar]
  34. Lane J. C., McDermott F. T. Effectiveness of cyclist helmets. Lancet. 1994 Oct 1;344(8927):965–965. [PubMed] [Google Scholar]
  35. Levy D. T. The effects of driving age, driver education, and curfew laws on traffic fatalities of 15-17 year olds. Risk Anal. 1988 Dec;8(4):569–574. doi: 10.1111/j.1539-6924.1988.tb01200.x. [DOI] [PubMed] [Google Scholar]
  36. Levy D. T. The effects of driving age, driver education, and curfew laws on traffic fatalities of 15-17 year olds. Risk Anal. 1988 Dec;8(4):569–574. doi: 10.1111/j.1539-6924.1988.tb01200.x. [DOI] [PubMed] [Google Scholar]
  37. Levy D. T. Youth and traffic safety: the effects of driving age, experience, and education. Accid Anal Prev. 1990 Aug;22(4):327–334. doi: 10.1016/0001-4575(90)90048-p. [DOI] [PubMed] [Google Scholar]
  38. Levy D. T. Youth and traffic safety: the effects of driving age, experience, and education. Accid Anal Prev. 1990 Aug;22(4):327–334. doi: 10.1016/0001-4575(90)90048-p. [DOI] [PubMed] [Google Scholar]
  39. Lund A. K., Williams A. F., Zador P. High school driver education: further evaluation of the DeKalb County study. Accid Anal Prev. 1986 Aug;18(4):349–357. doi: 10.1016/0001-4575(86)90048-5. [DOI] [PubMed] [Google Scholar]
  40. MacKinnon D. P., Woodward J. A. The impact of raising the minimum drinking age on driver fatalities. Int J Addict. 1986 Dec;21(12):1331–1338. doi: 10.3109/10826088609074858. [DOI] [PubMed] [Google Scholar]
  41. Maimaris C., Summers C. L., Browning C., Palmer C. R. Injury patterns in cyclists attending an accident and emergency department: a comparison of helmet wearers and non-wearers. BMJ. 1994 Jun 11;308(6943):1537–1540. doi: 10.1136/bmj.308.6943.1537. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Mann R. E., Vingilis E. R., Leigh G., Anglin L., Blefgen H. School-based programmes for the prevention of drinking and driving: issues and results. Accid Anal Prev. 1986 Aug;18(4):325–337. doi: 10.1016/0001-4575(86)90046-1. [DOI] [PubMed] [Google Scholar]
  43. Martens C. H., Ross L. E., Mundt J. C. Young drivers' evaluation of driving impairment due to alcohol. Accid Anal Prev. 1991 Feb;23(1):67–76. doi: 10.1016/0001-4575(91)90036-5. [DOI] [PubMed] [Google Scholar]
  44. McDermott F. T., Lane J. C., Brazenor G. A., Debney E. A. The effectiveness of bicyclist helmets: a study of 1710 casualties. J Trauma. 1993 Jun;34(6):834–845. doi: 10.1097/00005373-199306000-00015. [DOI] [PubMed] [Google Scholar]
  45. McDermott F., Lane J. Protection afforded by cycle helmets. BMJ. 1994 Oct 1;309(6958):877–877. doi: 10.1136/bmj.309.6958.877b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Mills N. J., Whitlock M. D. Performance of horse-riding helmets in frontal and side impacts. Injury. 1989 Jul;20(4):189–192. doi: 10.1016/0020-1383(89)90108-3. [DOI] [PubMed] [Google Scholar]
  47. Morton J. G., Burton J. F. An evaluation of the effectiveness of mouthguards in high-school rugby players. N Z Dent J. 1979 Jul;75(341):151–153. [PubMed] [Google Scholar]
  48. Muller A. An evaluation of the effectiveness of motor cycle daytime headlight laws. Am J Public Health. 1982 Oct;72(10):1136–1141. doi: 10.2105/ajph.72.10.1136. [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Muller A. Evaluation of the costs and benefits of motorcycle helmet laws. Am J Public Health. 1980 Jun;70(6):586–592. doi: 10.2105/ajph.70.6.586. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Nicholl J. P., Freeman M. R., Williams B. T. Effects of subsidising bus travel on the occurrence of road traffic casualties. J Epidemiol Community Health. 1987 Mar;41(1):50–54. doi: 10.1136/jech.41.1.50. [DOI] [PMC free article] [PubMed] [Google Scholar]
  51. Pentz M. A., Dwyer J. H., MacKinnon D. P., Flay B. R., Hansen W. B., Wang E. Y., Johnson C. A. A multicommunity trial for primary prevention of adolescent drug abuse. Effects on drug use prevalence. JAMA. 1989 Jun 9;261(22):3259–3266. [PubMed] [Google Scholar]
  52. Preusser D. F., Williams A. F., Lund A. K., Zador P. L. City curfew ordinances and teenage motor vehicle injury. Accid Anal Prev. 1990 Aug;22(4):391–397. doi: 10.1016/0001-4575(90)90054-o. [DOI] [PubMed] [Google Scholar]
  53. Redman S., Sanson-Fisher R., Cockburn J. Rehabilitation programs for drink drivers: a critical appraisal. Community Health Stud. 1988;12(4):418–427. doi: 10.1111/j.1753-6405.1988.tb00608.x. [DOI] [PubMed] [Google Scholar]
  54. Roberts M. C., Fanurik D. Rewarding elementary schoolchildren for their use of safety belts. Health Psychol. 1986;5(3):185–196. doi: 10.1037//0278-6133.5.3.185. [DOI] [PubMed] [Google Scholar]
  55. Roberts M. C., Fanurik D., Wilson D. R. A community program to reward children's use of seat belts. Am J Community Psychol. 1988 Jun;16(3):395–407. doi: 10.1007/BF00919378. [DOI] [PubMed] [Google Scholar]
  56. Robertson L. S. Blood alcohol in fatally injured drivers and the minimum legal drinking age. J Health Polit Policy Law. 1989 Winter;14(4):817–825. doi: 10.1215/03616878-14-4-817. [DOI] [PubMed] [Google Scholar]
  57. Robertson L. S. Crash involvement of teenaged drivers when driver education is eliminated from high school. Am J Public Health. 1980 Jun;70(6):599–603. doi: 10.2105/ajph.70.6.599. [DOI] [PMC free article] [PubMed] [Google Scholar]
  58. Robertson L. S., Kelley A. B., O'Neill B., Wixom C. W., Eiswirth R. S., Haddon W., Jr A controlled study of the effect of television messages on safety belt use. Am J Public Health. 1974 Nov;64(11):1071–1080. doi: 10.2105/ajph.64.11.1071. [DOI] [PMC free article] [PubMed] [Google Scholar]
  59. STENGER J. M., LAWSON E. A., WRIGHT J. M., RICKETTS J. MOUTHGUARDS: PROTECTION AGAINST SHOCK TO HEAD, NECK AND TEETH. J Am Dent Assoc. 1964 Sep;69:273–281. doi: 10.14219/jada.archive.1964.0290. [DOI] [PubMed] [Google Scholar]
  60. Schelp L. The role of organizations in community participation--prevention of accidental injuries in a rural Swedish municipality. Soc Sci Med. 1988;26(11):1087–1093. doi: 10.1016/0277-9536(88)90183-9. [DOI] [PubMed] [Google Scholar]
  61. Schwarz D. F., Grisso J. A., Miles C., Holmes J. H., Sutton R. L. An injury prevention program in an urban African-American community. Am J Public Health. 1993 May;83(5):675–680. doi: 10.2105/ajph.83.5.675. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Silver J. R. Injuries of the spine sustained during rugby. Br J Sports Med. 1992 Dec;26(4):253–258. doi: 10.1136/bjsm.26.4.253. [DOI] [PMC free article] [PubMed] [Google Scholar]
  63. Silver J. R., Stewart D. The prevention of spinal injuries in rugby football. Paraplegia. 1994 Jul;32(7):442–453. doi: 10.1038/sc.1994.71. [DOI] [PubMed] [Google Scholar]
  64. Simpson A. H., Unwin P. S., Nelson I. W. Head injuries, helmets, cycle lanes, and cyclists. Br Med J (Clin Res Ed) 1988 Apr 23;296(6630):1161–1162. doi: 10.1136/bmj.296.6630.1161-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  65. Sitler M., Ryan J., Hopkinson W., Wheeler J., Santomier J., Kolb R., Polley D. The efficacy of a prophylactic knee brace to reduce knee injuries in football. A prospective, randomized study at West Point. Am J Sports Med. 1990 May-Jun;18(3):310–315. doi: 10.1177/036354659001800315. [DOI] [PubMed] [Google Scholar]
  66. Somers R. L. On the cost of repealing motorcycle helmet laws. Am J Public Health. 1983 Oct;73(10):1216–1216. doi: 10.2105/ajph.73.10.1216-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  67. Spaite D. W., Murphy M., Criss E. A., Valenzuela T. D., Meislin H. W. A prospective analysis of injury severity among helmeted and nonhelmeted bicyclists involved in collisions with motor vehicles. J Trauma. 1991 Nov;31(11):1510–1516. doi: 10.1097/00005373-199111000-00008. [DOI] [PubMed] [Google Scholar]
  68. Struckman-Johnson D. L., Lund A. K., Williams A. F., Osborne D. W. Comparative effects of driver improvement programs on crashes and violations. Accid Anal Prev. 1989 Jun;21(3):203–215. doi: 10.1016/0001-4575(89)90011-0. [DOI] [PubMed] [Google Scholar]
  69. Thompson D. C., Thompson R. S., Rivara F. P., Wolf M. E. A case-control study of the effectiveness of bicycle safety helmets in preventing facial injury. Am J Public Health. 1990 Dec;80(12):1471–1474. doi: 10.2105/ajph.80.12.1471. [DOI] [PMC free article] [PubMed] [Google Scholar]
  70. Thompson R. S., Rivara F. P., Thompson D. C. A case-control study of the effectiveness of bicycle safety helmets. N Engl J Med. 1989 May 25;320(21):1361–1367. doi: 10.1056/NEJM198905253202101. [DOI] [PubMed] [Google Scholar]
  71. Thuen F., Maeland J. G. Accident prevention activities in the Norwegian municipalities: the local response to a nationwide campaign. Scand J Soc Med. 1993 Jun;21(2):129–134. doi: 10.1177/140349489302100213. [DOI] [PubMed] [Google Scholar]
  72. Torg J. S., Vegso J. J., Sennett B., Das M. The National Football Head and Neck Injury Registry. 14-year report on cervical quadriplegia, 1971 through 1984. JAMA. 1985 Dec 27;254(24):3439–3443. [PubMed] [Google Scholar]
  73. Turner C. H. Mouth protectors. Br Dent J. 1977 Aug 2;143(3):82–86. doi: 10.1038/sj.bdj.4803948. [DOI] [PubMed] [Google Scholar]
  74. Wasserman R. C., Buccini R. V. Helmet protection from head injuries among recreational bicyclists. Am J Sports Med. 1990 Jan-Feb;18(1):96–97. doi: 10.1177/036354659001800116. [DOI] [PubMed] [Google Scholar]
  75. Wasserman R. C., Waller J. A., Monty M. J., Emery A. B., Robinson D. R. Bicyclists, helmets and head injuries: a rider-based study of helmet use and effectiveness. Am J Public Health. 1988 Sep;78(9):1220–1221. doi: 10.2105/ajph.78.9.1220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  76. Waters E. A. Should pedal cyclists wear helmets? A comparison of head injuries sustained by pedal cyclists and motorcyclists in road traffic accidents. Injury. 1986 Nov;17(6):372–375. doi: 10.1016/0020-1383(86)90073-2. [DOI] [PubMed] [Google Scholar]
  77. Watson G. S., Zador P. L., Wilks A. Helmet use, helmet use laws, and motorcyclist fatalities. Am J Public Health. 1981 Mar;71(3):297–300. doi: 10.2105/ajph.71.3.297. [DOI] [PMC free article] [PubMed] [Google Scholar]
  78. Weisbuch J. B. The prevention of injury from motorcycle use: epidemiologic success, legislative failure. Accid Anal Prev. 1987 Feb;19(1):21–28. doi: 10.1016/0001-4575(87)90014-5. [DOI] [PubMed] [Google Scholar]
  79. Williams A. F., Karpf R. S., Zador P. L. Variations in minimum licensing age and fatal motor vehicle crashes. Am J Public Health. 1983 Dec;73(12):1401–1403. doi: 10.2105/ajph.73.12.1401. [DOI] [PMC free article] [PubMed] [Google Scholar]
  80. Yamamoto T., Kigawa A., Xu T. Effectiveness of functional ankle taping for judo athletes: a comparison between judo bandaging and taping. Br J Sports Med. 1993 Jun;27(2):110–112. doi: 10.1136/bjsm.27.2.110. [DOI] [PMC free article] [PubMed] [Google Scholar]
  81. de Wet F. A. The prevention of orofacial sports injuries in the adolescent. Int Dent J. 1981 Dec;31(4):313–319. [PubMed] [Google Scholar]
  82. van Mechelen W., Hlobil H., Kemper H. C., Voorn W. J., de Jongh H. R. Prevention of running injuries by warm-up, cool-down, and stretching exercises. Am J Sports Med. 1993 Sep-Oct;21(5):711–719. doi: 10.1177/036354659302100513. [DOI] [PubMed] [Google Scholar]

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