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Paediatr Child Health. 1998 Nov-Dec; 3(6): 389–390.
PMCID: PMC2851300

Preventing injury among Canadian children

Richard S Stanwick, MD MSc FRCPC FAAP, Chair

For over 30 years, the Canadian Paediatric Society (CPS) has actively promoted the health and safety of Canadian children through its Injury Prevention Committee. Compiling evidence of the committee’s accomplishments has at times resembled an archeological dig. But once assembled, the collective contributions of the committee to child injury prevention in Canada and around the world are remarkable.

As with most historical reviews, some important subjects and individuals will inadvertently be omitted. For this, I apologize in advance and welcome any additions to the CPS archives about the committee’s work.

The committee was born in 1967 as the Safety Promotion Committee. It was renamed the Accident Prevention Committee before finally becoming the Injury Prevention Committee in 1988. This latest change reflects the membership’s recognition that the term ‘accident’ as something due to chance, fate or act of God is an inaccurate depiction of the possible prevention of most childhood mishaps. Over the years, the chairpersons of the committee have included Vera Gellman, Luc Chicoine, John Doyle, André L’Archevêque, Milton Tenenbein and Richard Stanwick.

Many of the committee’s achievements have become accepted safety practices across Canada. There has been significant progress in reducing morbidity and mortality from childhood injuries in Canada – a change revealed by statistical trends. The successes of the committee underscore the importance of persistence, patience and perseverance in injury control. Some of the injury prevention initiatives in which the committee has been involved are highlighted below.

In 1967, the committee expressed grave concerns about crib safety, particularly inappropriately spaced railings and decorative finials on the corner posts of cribs. The federal government reacted in 1974 by setting new safety standards for cribs. Subsequent efforts focused on redesigning mattress frame supports and standardizing mattress sizes.

Also in 1967, the committee supported an Essex County, Ontario experiment with child resistant closures (CRC) and promoted the wide adoption of the ‘Palm-NTurn’ safety cap on all medication bottles. By 1973, CRCs were mandatory on all medications sold in Ontario.

Working with the federal government, the committee helped develop a safety standard for infant and child car seats in 1973. Members, under the leadership of chair André L’Archevêque, also called for nationwide legislation to make the devices mandatory for children under five years of age. It was an extremely successful effort. By 1985, Yukon and the Northwest Territories were the only North American jurisdictions without legislation regarding infant and child car seat restraints.

In 1979, the committee realized that ignitions of children’s sleepwear were causing serious burns. Its efforts were instrumental in formulating federal sleepwear standards.

The committee’s discussions and subsequent appearance on CBC-TV’s Marketplace led to the federal government’s ban on lawn darts in 1987.

Under the leadership of chair John Doyle, The committee articulated concerns about the lack of standards for pacifiers. Subsequent regulation addressed the size of pacifiers and their shields as well as the chemical composition of the pacifiers (no nitrosamines).

From early on, the committee suggested that paediatric hospitals form safety committees to ensure that children are not injured in hospitals. This idea came to fruition with the formulation of such bodies in Canadian paediatric centres.

The committee’s concerns about the lack of good epidemiological data on childhood injuries led to an advisory role in the launch of the Canadian Accident and Injury Reporting and Evaluation system, and its successor, the Canadian Hospital Injury Reporting and Prevention Program. This network provides a national overview as well as collecting quality local data at centres where the program operates.

The committee embarked in a partnership with Consumer and Corporate Affairs Canada to create safety posters for paediatricians’ offices. For a number of years, the boards holding the posters were regularly updated with product warnings and seasonal safety advisories.

The committee called for playground equipment standards and, by 1990, assisted in formulating playground standards for the Canadian Standards Association (CSA). The standards focused on building safety features for the equipment and the surface under the equipment.

Under Board of Directors representative John Stoffman, the committee identified walkers as a significant and unnecessary risk to the health of young children. The changes required in the design of walkers were such that manufacturers found it no longer feasible to make this product.

The committee addressed the subject of sudden infant death syndrome in 1985, with a careful epidemiological review of the evidence. The same rigour was necessary to study the issue of sleeping position, and, along with its partners, the CPS promoted a change in infants’ sleeping position from stomach to back in 1993. This important change has resulted in a substantial drop in the number of sudden infant death syndrome cases in Canada.

Bicycle helments became a subject of deliberation in 1993. In cooperation with the American Academy of Pediatrics (AAP), the Injury Prevention Committee enlisted the support of Sandoz, a major pharmaceutical company, to provide funding for quality bicycle helmets. The campaign culminated in a partnership with the Canadian Medical Association to make inexpensive CSA-approved bicycle helmets available to thousands of patients and their families in Canada.

In 1987, then-chair Milton Tenenbein was commissioned to provide a report on the need for child-resistant starting mechanisms for disposable cigarette lighters. The findings resulted in the introduction of this safety mechanism.

Other significant works written in partnership include the Poisons – Emergency Treatment, Keep Your Child Safe (1), and the safety and injury prevention chapters in Well Beings (2) and Little Well Beings (3). The committee assisted the AAP’s committee in its statement writing and the French translation of The Injury Prevention Program (TIPP).

The committee is currently attempting to establish closer ties with Health Canada, the department now responsible for the Hazardous Products Branch, the Children’s Bureau and Safe and Supportive Environments. Fortunately, many other organizations dedicated to child safety have formed. The CPS Injury Prevention committee’s future is likely to serve as a source of authoritative information on key injury prevention issues. This role can be fufilled via guidelines as well as timely contributions on important injury prevention subjects in publications such as Paediatrics & Child Health. It is anticipated that the rich legacy of the past committee members will spur future members to help reduce morbidity and mortality associated with the number one threat to the health of Canadian children – unintentional injury.

REFERENCES

1. Keep Your Child Safe. Ottawa: Canadian Paediatric Society; 1995.
2. Well Beings. Ottawa: Canadian Paediatric Society; 1996.
3. Little Well Beings. Ottawa: Canadian Paediatric Society; 1994.

Articles from Paediatrics & Child Health are provided here courtesy of Pulsus Group