Because resources for accident prevention are very limited, they must be channelled to where the loss of health and wellbeing is the greatest.

There are good sets of basic data available in Finland to study, with a high degree of reliability, fatal accidents and accidents requiring hospitalisation. The incidence of accidents requiring hospitalisation is certainly a good indicator of the incidence of serious accidents in general. However, hospitalisation is not a sufficient criterion for determining what is a serious accident. The number of accidents says nothing about their long-term consequences.

We need new indicators to be able to evaluate the social costs of various kinds of accident, i.e. long-term reduction in functional capacity or exclusion from work and social life. Information on the causes of accidents is also needed for accident prevention development, not just information on their consequences.

Effective targeting of prevention

Accident prevention should focus primarily on those accident categories with the most severe public health impacts. Accidents are the leading cause of death for young people and people of working age, up to the age of 45. It has been estimated worldwide that traffic accidents are one of the most common causes of death for children. Falling down is the most common cause of fatal accidents for people over the age of 65.

Research findings concerning the factors underlying accidents are slowly displacing the persistent notion that an accident is, as the concept suggests, a completely unpredictable event. Accident prevention is based on the assumption that the risk factors for accidents and injuries can be identified. It is equally important to learn what would help citizens make safety-positive choices and what would motivate managers of schools, old people’s homes or factories to develop safety management in their respective organisations.

Backgrounds to accidents are rarely investigated

The World Health Organisation and the World Bank have noted that accidents are the least studied epidemic in the world.

Finland has statutory systems in place for investigating accidents in the workplace and in traffic and for finding out their causes. These systems have supported efforts to prevent traffic accidents and occupational accidents for several decades now.

However, over 80% of fatal accidents occur not on the road or in the workplace but in situations not covered by statutory investigations. The current system thus takes no account of children, of the elderly or of those not in working life. The systems should be developed so that an increasing number of serious accidents would be thoroughly investigated.

Indicators for calculating the cost of long-term impacts

The THL accident group has launched a study to investigate the costs and long-term impacts of health impairments caused by fires. The study is intended to produce a computational model with which existing archive data can be mined to estimate the long-term impacts of other types of accident too, more reliably and accurately than before.

Aiming to combine research, action and funding

Accident prevention and prevention research is at present being conducted in various different sectors and bodies. The system should be consolidated. Boundaries should be lowered, and the overall system should be developed transparently and without prejudice.

Administrative structures and funding systems form obstacles to the transfer of know-how. There is plenty of safety management competence in enterprises and workplaces, and this competence and its methodical approaches are now needed in organisations that offer services to the elderly or sports services, for instance.

The new approach should also show in the selection of topics in accident research. Epidemiological research provides the groundwork for accident prevention, but system-level research and high-level research on preventive working methods to study their effectiveness are also needed. These would help make accident prevention more efficient and more equitable.

Anne Lounamaa Senior Research Officer
Injury Prevention Unit
National Institute for Health and Welfare (THL)

The Injury Prevention Unit develops, studies, monitors and disseminates information on injury prevention.

Injury prevention is divided into sub-fields that each has its own action plan and person in charge. The work focuses on the prevention of accidental falls of older people, prevention of accidents of children and young people, communications on injury-related issues, as well as development of a monitoring system for injuries.

Injury Prevention Unit