Child injury prevention Aotearoa

	INCORRECT USE OF CHILD CAR SEATS IN THE SPOTLIGHT A recent pilot study by Otago University’s Injury Prevention Research Unit suggests around 75% of drivers are using child car seats incorrectly. Some 60% percent of drivers in the study made at least one error installing the child car seat in the vehicle, and 65% made at least one error installing the child in the child car seat. (continued below)
	John Wren ensuring Reilley Hanifan-Oaks is correctly secured in child car seat.

Incorrect use of child car seats in the spotlight

Home visiting for chld injury prevention

Kidsafe Week 2001

• Taranaki – getting the right fit
• Internet competition
• Farmers Trading Company - discount booster seats
• Child restraint seminars
• 2001 - Ambassadors take up their posts

Looking to our December issue

Advocacy Update

• Baby walker - Mandatory Standard
• Increasing the use of child resistant packaging
• Child Special Interest Group

Water Hazard Mapping Project

Info Centre Update

Staff Update

INCORRECT USE OF CHILD CAR SEATS
IN THE SPOTLIGHT
(continued)

A recent pilot study by Otago University’s Injury Prevention Research Unit suggests around 75% of drivers are using child car seats incorrectly. Some 60% percent of drivers in the study made at least one error installing the child car seat in the vehicle, and 65% made at least one error installing the child in the child car seat.

Such high levels of incorrect useage are obviously a real concern as correctly used, child safety seats can greatly reduce the risk of death and injury to our children in motor vehicles.

The Otago University research, funded by the Health Research Council, was co-ordinated by John Wren who has recently joined the staff here at Safe Kids. It involved 207 drivers of 306 child passengers in Dunedin last year and also gathering information from 45 drivers using focus groups.

Many of the errors made by drivers were "serious" errors, with about half of the drivers not using the top straps on child car seats and nearly half failing to secure harness strap ends. Depending on the type of error, age of the child and vehicle type, a single error can increase the probability of a serious head and/or chest injury by up to 25%. The focus group interviews were used to identify barriers to correct use of child car seats - the main ones being the design of the cars and car seats, the costs involved in using the seats, inadequate vehicle safety standards and a lack of authoritative information on when and how to use the different types of seats.

The study showed the design of child car seats is a key factor in their incorrect useage. Many people complained the seats were too big and bulky and that they were very awkward to carry. Participants reported that not only did this prevent the correct use of a child car seat, but also caused back injuries to the caregiver. One woman said she'd defy any man to carry 10 kgs around. She commented that 'obviously a man designed it'.

The size and shape of many vehicles create problems, too. For example, it can be difficult to fit two child car seats and an adult or teenage passenger in the back seat. Highly contoured car seats make the secure installation of child car seats difficult as well.

John Wren points out that while it is recommended that all child seats should be in the middle of the back seat, it is very difficult to lift a child restraint into this position or through a side door.

Socio-economic barriers to the use of child car seats were also identified by the research. One cost was changing a car to one more suited to children. Low-income couples may not be able to afford to change their vehicle.

The cost of child car seats is also considerable. They cost about $300 each to buy and to rent there's an average deposit of $30 up front, plus a weekly rental, which is a significant burden for low-income families.

A final issue appears to be the lack of an authoritative source of information on which type of car seat is best for a particular child and on consumer 'best safety practice’. Participants in the study said they were getting conflicting messages from the range of organisations involved.

Looking to the future, John suggests that the biggest single action to reduce barriers to the correct use of child car seats in New Zealand may well be to adopt the new vehicle safety standards introduced in the United States in September last year.

New Zealand's vehicle design standards for child car seats are up for review next year and adopting the American standard would immediately reduce all the reasons for errors by about 50%. All new American vehicles are required to have anchor points for tether straps fully installed and fixed bars in the back seat. The child car seat is simply plugged into specially-designed holes in the back seat. This does away with the need for using adult seat belts and locking clips. No belts would be needed except for the top tether strap.

The numbers of children killed in New Zealand in off road drive-overs is considerably higher than in many other industrialised countries. Drive-over injuries are usually severe and often fatal. Children hit by cars, even when driven at low speeds, typically experience massive injuries. Many of these children are killed instantly. Others experience severe head, abdominal and chest injuries which have devastating and long lasting effects.

While there have been a number of studies conducted, both within New Zealand and overseas, to determine the rate and circumstances of injury of children hit by vehicles in residential driveways, there is a need to update the information and this is what the project will initially focus on.

Recent Starship Hospital and coroners’ records of children injured in driveways will be reviewed to determine the rate, severity and circumstances of injury. The results of the study will be used to detect possible risk factors. This will assist us to identify injury prevention strategies that could be used in the attempt to prevent or reduce further driveway injuries and fatalities.

As many of you will be aware, late last year the Ministry for Consumer Affairs released a discussion paper on baby walker safety calling for comment on a range of possible options. We were delighted to note that the Ministry was putting forward as their preferred option the development of a mandatory standard. While this was not the product ban that so many of us had been calling for, it is certainly a great step forward.

Submissions on the discussion document closed on 16 February and many of you will have responded to the call. In our submission we summarised our position as follows:
“Safekids strongly support the adoption of a mandatory standard as a step towards reducing the incidence and severity of baby walker injuries. However, it is necessary to ensure that ongoing monitoring of the impact of the standard is carried out to ensure that the standard is effective in reducing baby walker injuries. Should the evidence show that the re-designed products do not substantially reduce the risk of injury, a product ban and recall should be undertaken.”

Injury prevention practitioners have over recent years been able to take real pleasure in observing a slight but steady reduction of injuries to school age children. Unfortunately there has been no such downward trend evident for the younger age group. Safekids has just completed a project for the Ministry of Health which it’s hoped, will contribute towards a change for the better. The project focused on home visiting as a strategy for delivering injury prevention messages to caregivers of the under 5s in the home.

The first step in the project was a comprehensive international literature review undertaken by a researcher from the Injury Prevention Research Centre. The review clearly established that home visiting programmes do have the potential to deliver injury prevention information and bring about positive health changes to families with preschoolers.

The next step was an intensive stock-take of current home visiting by health providers in two selected communities, the urban community of Ranui in West Auckland and the semi-rural community of Kawakawa/Moerewa in Northland. All service providers who made home visits to families with a preschooler were included. In all, some 15 providers were interviewed.

The stocktake showed that in the two communities the delivery of injury prevention messages was uneven and concentrated mainly on the child’s early months. Whilst in some instances information was provided systematically, other home visitors provided safety information more opportunistically, often only after they had finished dealing with other health and social support needs. Significant differences also emerged in the number of service providers operating in urban and rural areas. Positive parenting skills training relating to safer family practices was the most common type of injury prevention information provided. Information on potential home safety hazards and ways to modify the home were also common safety messages. Home-checklists were used by few home visitors, and no service providers actually demonstrated safety equipment. Several providers were, however, involved in low cost child car seat schemes.

Photographed left to right Helen McCracken and Carolyn Teehan looking over Home Visiting report

Included in the project was a review of the training and professional backgrounds of service providers. This found there was a general lack of systematic injury prevention training. Home visitors tended to draw on their professional training. Ad-hoc injury prevention training is available to some service providers.

Focus groups were also used to ask caregivers about the safety messages they received. The most frequent source of useful safety information for caregivers came from family and friends. They also find the ongoing relationship with the Plunket Nurse allowed developmentally appropriate information to be passed on effectively.

The project report drew up a series of recommendations aimed at four distinct groups of stakeholders, policy makers, funders, injury prevention organisations and home visiting service providers. Recommendations included the need for more and better funding of home visiting programmes and greater co-ordination of service delivery, culturally appropriate and effective services to meet diverse and differing cultural expectations and better training and resources.

	KIDSAFE WEEK 2001
	Taranaki - getting the right fit for Kidsafe Week

The Taranaki Kidsafe Week Coalition will be out in force over Kidsafe Week checking car restraints throughout the region. The two Taranaki coalitions have joined forces and between them will be running ten car restraint checking clinics from Patea through to Waitara. The regional coalition is made up of representatives from a number of organisations, including: ACC Health Promotion Unit, Taranaki Health Plunket, and Manaaki Oranga. Most of the clinics will be held at local Plunket rooms, where there will be entertainment for children and the chance for parents and caregivers to win one of several car seats being given away.

Taranaki coalition checking baby Samantha Greenhill’s child restraint.

Health Promoter and the North Taranaki Coalition Co-ordinator, Sarah Wilson, explained that the majority of parents in Taranaki are wanting to do the right thing and are buckling their kids up in car seats.

"What we’re not sure of is how many of them are doing it correctly," said Sarah Wilson.

Fiona Greenhill from the South Taranaki coalition said the clinics are an opportunity for parents and caregivers to get the right advice.

"That will ensure that their children are as safe as possible when travelling. At the same time we hope it will be really great fun for all concerned".

Kidsafe Week - Internet Competition Kidsafe Week is once again launching into cyber space to get the safety belt message across to children. This year’s Kidsafe Week web site features an interactive competition for primary and intermediate school children, aimed at increasing children’s knowledge related to safety belts. Children who correctly answer the 5 multi choice questions, enter a regional prize draw. Safekids will be promoting the competition to both teachers and children, and based on last years experience we’re sure it’ll be a popular site. If you want to check out the Kidsafe Week 2001 Internet Site and the safety belt competition the address is www.kidsafe.org.nz The Kidsafe Week Info-line is once again up and running and Simon Whitlock, the Safekids Information Manager, is ready to answer any queries you may have about Kidsafe Week. The Info-line number is 09 828 0503. We’d love to hear from you.

Farmers Trading Company discount booster seats for Kidsafe Week

Farmers have got behind the booster seat message and are providing a substantial discount on the Baby Love booster seat during Kidsafe Week.

Often when children start school at age 5 they and their parents believe that they have ‘out grown’ their booster seat. The Kidsafe Week message is that children are much safer in a booster seat until around 7, or until they have reached the maximum weight for their specific seat.

"Farmers are proud to be associated with this promotion," says Anne Ng-Casey, Farmers Advertising Manager " we believe every child should be protected from injury and therefore we’re delighted to be able to make the safe option, a cheaper option during Kidsafe Week".

The discounted booster seat will be available in Farmers stores from the 3^rd to the 18^th October. Coalitions will be receiving discount vouchers to distribute to parents and Farmers own catalogue will profile the special, along with a Kidsafe Week message.

Child Restraint Seminars During August over 500 Kidsafe Week coalition members, Plunket volunteers and members of the injury prevention workforce attended child restraint seminars. ACC provided funding for 16 seminars to be held throughout New Zealand in preparation for Kidsafe Week. Sue Campbell, Plunket’s National Child Safety Advisor ran each session, drawing on her considerable skill and expertise. Participants who attended gained valuable knowledge on how to correctly fit child restraints into vehicles and how to check for common mistakes. Feedback from those that attended has been extremely positive. Not only did participants increase their skill level, they also got an insight into how much more there is to know. Many of those who attended will be putting their newly acquired skills to work during Kidsafe Week. A number of coalitions are now gearing up to run child restraint checks with local families as part of their activities for Kidsafe Week 2001. Participants being put through their paces as part ofACC funded car restraint seminars 2001 AMBASSADORS TAKE UP THEIR POSTS Five famous Kiwis have signed on for the job of Kidsafe Week Ambassadors for 2001. Television personalities Suzy Cato and Neil Waka, entertainer Pio Terei, veteran broadcaster and train enthusiast Merv Smith and former Silver Fern Teresa Tairi, will help promote the two themes for Kidsafe Week 2001 - child car restraint use and poisons prevention. During the Week the five will attend a number of events in the North Island, beginning with the national launch in Wellington on October 12, this year hosted by LTSA. In addition, they’ll be involved in the national media campaign, promoting the aims of the Kidsafe Week key agencies. Pio, who joined Safekids and the other key agencies to raise awareness of the event last year, says he’s delighted to be asked back. “This is a great cause and I’m just so pleased to be helping out. After all, there’s nothing more important than whanau and keeping them safe is a top priority.” Sue Kendall says as the Week’s National Co-ordinator she’s thrilled the five agreed to take part - and believes their mana in the wider community will help boost awareness of the event and broader child safety issues. The five famous faces helping to keep our kids out of hospital – Kidsafe Week 2001 Ambassadors from left) Suzy Cato (holding 8 month old Eloise Woodley-Phillips), Teresa Tairi (with 3 month old Merlyn Gunn), Pio Terei, Merv Smith, and Neil Waka with Isaac Woodley-Phillips and Kahu Ropata (both 4) and Apiata Ropata (9). Looking to our December issue The next issue of Safe Kids News will feature an article that tells a very important story, Rupert’s story. In April 1997 Rupert Frost was drowned in a private swimming pool in Parnell, Auckland. Four years later, in April of this year, Rupert's family achieved some degree of closure when the Council made a commitment to enforcing their swimming pool fencing policy which had been legislated for since 1987. At this time a memorial plaque to Rupert was erected in Alberon Reserve, close to where Rupert lost his life. Rupert’s story is a tragedy that should never have happened. Like so many other so called "accidents" to children, Rupert’s death was caused by a particular set of circumstances, what happened could have been predicted and therefore prevented. Rupert’s parents were determined that their son’s death would not be seen as another tragic accident. They set out to make visible the circumstances leading to Rupert’s death and to advocate for changes to Council swimming pool fencing policies. Rupert’s story is not about allocating blame. Rather it shows how some good can come out of an experience as searing as the loss of a child. With next year’s Kidsafe Week again focusing on water safety we feel it is an article well worth featuring.

 

Child Injury Prevention Aotearoa

ADVOCACY UPDATE

This update covers 3 issues. The first, babywalkers is an old favourite. The second , increasing the use of child resistant packaging taps into our advocacy objective for this year’s Kidsafe week. The third is an introduction to advocacy on a different level, a special interest group within the Injury Prevention Network.

Baby walker Mandatory Standard

Baby walker features in the Ministry of Consumer Affairs "Spot the dangers" poster.

The Ministry of Consumer Affairs received a number of submissions in response to their December 2000 discussion paper on the need for a product safety standard for baby walkers. Readers would recall that their preferred option was a mandatory standard. The Minister has now agreed in principle to proceed with the proposal to regulate. He will carry out a final round of consultation with interested parties on technical details of the proposed standard before taking his decision to government. The proposed standard will be similar to the New South Wales standard, and based on parts of a voluntary American standard. It will set out safety requirements that would help prevent baby walkers from tipping and from toppling down stairs. Product information and safety warnings will also have to be sold with, and on, baby walkers. Of course second hand walkers pose the same hazard as the new product so it’s great to note that these are also covered in the proposed standard. This may mean that in the medium to short term sales of second hand baby walkers will cease. So by October 1 or soon after we should have in place a mandatory standard for all baby walkers imported into New Zealand, with a possible provision of a further 3 months for retailers to clear stocks. While we should all be feeling very pleased about the proposed standard I know we will also be keeping a careful eye on the outcome. If there is no downward trend over time as a result of this "safer" baby walker, then we will need to revisit our call for a baby walker ban and product recall.

Increasing the use of child resistant packaging

Poisoning is a significant injury issue for our young children. For the under 5s, it is the second leading cause of an injury admission to hospital. Common household drugs and medications are easily the leading cause of a poisoning.

The good news is that we know that dispensing these medicines in child resistant packaging (CRP) has the potential to reduce poisonings. The bad news is that New Zealand lags behind many other countries in child safety packaging protection for poisons. Both the United States and Britain have for example, adopted safety packaging for all prescribed medicines.

Child’s play – without CRP

Currently in New Zealand there are six classes of medicines that are required by regulation to be dispensed in strip or blister packaging. In addition Pharmac funds child resistant caps on a dozen oral liquid preparations, the so-called "dirty dozen". As part of Kidsafe Week 2001 we are encouraging our coalitions to become involved in advocating to MPs for the extension of child resistant packaging. To help with this, we have prepared a position paper on CRPs that backgrounds the issue. Included with the paper is some information on how to go about advocating to their MP.

The position paper sets a clear advocacy objective. We recommend (as a minimum) that child safety packaging should be mandatory for the medicines currently listed in the recently (2001) released Code of Ethics for Pharmacists. This would bring New Zealand in to line with the situation that exists in Australia. We are asking MPs for their support in principle, for any legislation or changes to regulations that increase the use of child resistant packaging.

This is an advocacy issue that we will be looking to progress after Kidsafe Week and one we would welcome wider involvement in. If you would like more information on CRPs, Simon on safekids@iconz.co.nz, phone 09 820 1193 can supply you with our Information Pack on Childhood Poisonings. We’d also welcome input from anyone who would like to strategise on this issue. Please contact Helen on hmccracken@adhb.govt.nz or phone 09 820 1198

 

Child Special Interest Group

The Injury Prevention Network of Aotearoa/ New Zealand sees one of its tasks as providing a forum for people with common interests to discuss, debate, and advocate for change. Rather than looking at specific issues, the IPN believes it can best contribute by concentrating its critical thinking at a policy level, looking at how injury and injury prevention fits into the big picture in New Zealand.

While individual agencies such as Safe Kids are already working effectively to address child injury, anyone who cares about child safety can have a role to play. To assist collaboration at a national level, the IPN is developing a Special Interest Group specifically for those interested in advocacy on child injury prevention issues. It’s hoped that the group will provide strategic advice to the IPN on key issues which will enable them to take effective action.

Special interest advocacy groups are a new venture for the IPN, so the way they work is not set in concrete. It’s likely the group will develop a network of interested parties within the membership, keeping in touch with topical issues, identifying issues of concern, and when necessary, developing plans to address specific issues. The first face to face meeting for the Child Special Interest Group will be held at the injury prevention conference "Weaving the Strands" to be held in Wellington 31 Oct - 2 Nov.

For further information email the network on network@ipn.org.nz or phone Val Norton the national co ordinator, on 04 472 2563

WATER HAZARD MAPPING PROJECT A water hazard mapping project jointly funded by the Ministry of Health and the Waitakere Licensing Trust was undertaken recently by WaterSafe Auckland in Waitakere City. Five early childhood centres were involved and care was taken to include representation from language nests, kohanga reos, commercial centres and early childhood associations. Teresa McKenzie who co-ordinated the project for WaterSafe Auckland believes the project has shown that water hazard mapping can be an effective strategy for increasing child safety around water. The benefits include empowering the particular communities and families involved to adopt water safe practices and raising awareness in the wider community about water safety issues. Water hazard mapping is essentially an awareness raising, come adult education, exercise. Each centre involved in the Waitakere project received a large display map along with other display and resource material. Each child also received an information flyer, a black and white map and stickers to identify the water hazards close to their home and early childhood centre to complete the activity at home with their parents/caregivers. The latest GIS (Geographical Information System) mapping system was used to transfer water hazards such as storm water drains, inlets and outlets, home swimming pools, streams and tidal waterways on to A1 colour, laminated maps. The location of these hazards was then disseminated to the public, predominantly through early childhood centres and playgroups. The initial evaluation of this water hazard mapping project highlighted community collaboration and the use of latest technology as effective strategies to enhance water safety culture and to provide opportunities to adopt safer behaviours for those taking part. The water hazard mapping is currently being completed in two of the wards of Manukau City, Mangere and rural Clevedon. The continuation of the project beyond this point will depend on the outcome of Water Safe Auckland’s applications for on going funding. For more information please contract Teresa McKenzie on (09) 306 0809, email watersafe.ak@xtra.co.nz

 

Info Centre Update

Call for New Information and Resources

If you have any information, publications, reports, resources or programmes, which have been developed in your area, around childhood unintentional injury prevention, please contact Simon, at the Safekids Information Centre and we’ll add them to the info centre collection. Often, good work is done at a local level but this work is not seen outside that region. Collaboration is the key, so…

Please send Simon a copy of those pamphlets, factsheets, videos, posters and other resources, which you have developed, as well as any evaluation reports etc. These will be catalogued and added to the Information Centre collection as a valuable resource for others working within the field of childhood unintentional injury prevention. We can also promote your resources in future copies of Safe Kids News.

The Information Centre is able to purchase resources and publications, so please bear us in mind. All senders of ‘new information’ will receive a personalised thank-you note from Simon as well as a chocolate fish!

A Reminder: KidsInfo Bulletin & Information packs

This computer-generated report detailing the last 100 items to be added to the info centre collection can be sent by email to anybody interested in receiving it. Email Simon at the Safekids Information Centre to be added to the list – safekids@iconz.co.nz (a number of people have already subscribed to this service and the feedback has been positive.) Five information packs are now available on request. General Baby walkers Drive overs Hot water scalds Poisonings

We are now in the process of developing information pack number 6, on motor vehicle passenger injuries. This should be available by the time the next issue of Safe Kids News goes to print.

New Resources Available from Safekids Junior KidSafe ‘Kia Tupato Tamariki’ Kit    cost=$67.00 This is a childhood unintentional injury prevention resource kit, which has been developed by Taranaki KidSafe, for use with pre-schoolers. It is a bilingual resource and appropriate for use in early childhood centres/kohanga reo etc. Each kit includes: 3 Safekids factsheets, a set of 9 discussion pictures, a set of 6 child safety picture books (3 Maori /3 English), and 2 videos "Keep Kids Safe" (1 Maori /1 English).

Capable Country Kids    cost=$9.00 This is a resource guide, developed by Taranaki KidSafe, for teaching about physical safety and risk management in rural settings. "This resource guide has been designed to encourage and support primary school based programmes that assist students to identify and manage the challenges and risks they may encounter in rural settings."

From the Horse’s Mouth    cost=$3.00 This is a fold-out poster which provides some safety advice for horse riders: (1) approved helmet, (2) safe footwear, (3) good position, and (4) correct boots. On the reverse are four different cartoon strips with a safety message for each of the four scenarios. These resources are available on request from the Safekids Information Centre. Items will be dispatched with an invoice.

Staff Update Safekids has recently welcomed a new staff member to our team. Dr. John Wren (photo alongside), previously with the Injury Prevention Research Unit at Otago University, has joined Safekids as our Senior Analyst. "John has a diverse background which gives him real strength to approach injury prevention through an environmental change and engineering focus", says Shelley Hanifan, Safekids Director. "This strength will be of great value to Safekids, as the best injury prevention involves this kind of change." Just two of the positions that John has held include Motor Mechanic and Factory Inspector. He also has extensive experience in injury prevention, in an occupational setting and in injury prevention research. As well as a strong technical background and an environmental change focus, John brings a great sense of humour! John has also recently become engaged to be married - so congratulations from all of us to John. Other changes at Safekids include the return of Shelley Hanifan from maternity leave to her position as Safekids Director. Helen McCracken, who was Acting Director during Shelley's leave, has agreed to stay on at Safekids doing national advocacy, training and project management. "I am really pleased that Helen is staying on. She did a fabulous job as Director during my leave, and always does. Helen is also great fun, and she adds as much value in fun as she does in skills and talents", says Shelley. Helen and Poni Dowding (Safekids Strategist) will both be away in Europe for holidays during the next few weeks.

We welcome your contribution to Safekids News. If there is an issue, information or programme which you’d like to tell other child injury prevention people about, just call Rhonda to discuss including it in Safekids News on (09) 820 1190 or Email: rhondaj@adhb.govt.nz