Last partial update: July 2016 - Please read disclaimer before proceeding
Adult accidents and injuries in Australia
Disability and death through preventable accidents are a major problem in our society. Falls, road accidents, poisoning, drowning and workplace injuries are almost all preventable and account for over five per cent of the total burden of disease in Australia. They are even more important in children and injury in children is dealt with in the section on childhood and adolescent health.
It is also worthwhile noting that injury is the major single cause of death while traveling, accounting for about 25 per cent of deaths overall and 70 per cent of deaths in young people. Road accidents are the main cause, especially in developing countries and in association with motorbike / moped use. Drowning is also an important cause.
Road Traffic accidents
Road traffic accidents cause 2.2 per cent of disease burden in Australia and no discussion on accident avoidance would be complete without mentioning road safety. Campaigns to reduce road trauma are continually being run by governments, with the following issues being of paramount importance.
Drugs and driving
Alcohol use continues to be a major cause of motor vehicle accidents and to ensure their safety in a car, people must ensure the person driving has not consumed excess alcohol. This may be difficult if the person is a family member or friend. However, if parents (and society in general) expect their children to demonstrate this type of responsible behaviour, they should certainly do no less themselves. Remember, it only takes one accident. Excess alcohol should not be consumed the night before a long day of driving and it is also unwise to travel in a car where several passengers are intoxicated as they are very likely to disrupt the driver’s concentration.
As with alcohol, people should avoid illegal drugs when driving. Cannabis use is common in young people and its use is also a major cause of motor vehicle accidents.
When purchasing any medication, be sure to ask whether it will have an effect (especially sedation) on driving capability.
Driver fatigue
Accidents associated with driver fatigue are common. They are more likely to occur in the males under 30 years of age and sole drivers. People with short or long term sleep disturbances / deprivation are obviously also at increased risk, especially the following.
- People with a history of a recent fall-asleep accident
- Repeated near-miss fall-asleep episodes while driving
- Repeatedly falling asleep during other activities
- A high Epworth sleepiness score (See table below.)
These high risk people should preferably stop driving until they see their doctor as they are at real risk of having a fall-asleep motor vehicle accident and injuring themselves and their loved-ones / others. They need to be investigated to see if there is a cause for their sleepiness, such as sleep apnoea, and need their sleep problem treated. Those at lesser risk should avoid driving at night or in the country and should not drink ANY alcohol before driving.
Epworth sleepiness score |
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Directions How likely are you to doze off or fall asleep in the following situations? (In your usual way of life in recent times.) Even if you have not done some of these things recently try to work out how they would have affected you. Use a scale of 0 to 3 0 = no chance of dozing; 1 = slight chance of dozing; 2 = moderate chance of dozing; 3 = high chance of dozing. Then add up your responses to give a total score. (The range of scores is from 0 to 24) |
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Situation |
Chance of ‘doziness’ (Score 0 to 3) |
1. Sitting & reading |
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2. Watching TV |
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3. Sitting inactive in a public place |
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4. As a passenger in a car for an hour without a break |
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5. Lying down in the afternoon when circumstances permit |
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6. Sitting and talking to someone |
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7. Sitting quietly after a lunch without alcohol |
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8. In a car, while stopped for a few minutes in traffic |
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Total score (out of 24) |
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Grading of scores:
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Strategies that are helpful in avoiding driver fatigue include resting at least every two hours and avoiding driving long distances after a long day at work or at night, especially in the early hours of the morning. Power napping can help prevent driver fatigue as can sharing the driving load. People should be wary about driving when unwell.
Drivers who are responsible for accidents after they have gone 24 hours without sleep can be found guilty of negligence and have been successfully prosecuted.
Special care needs to be taken when driving in the country as deaths from motor vehicle accidents are three times more common in country areas. Contributing factors in addition to driver fatigue include poorer roads, speeding, and greater distances travelled by road by country people. Make sure that, when undertaking long trips, the motor vehicle is fully roadworthy; as it should always be.
Young driver safety / education
Driving when young can be a dangerous activity. Deaths (and hospitalizations) from motor vehicle accidents in the 15- to 24-year age group account for 27 per cent of all road deaths and occur at a rate three times that of the general population, with males predominating. Of concern is the fact that while fatalities in general have been steadily decreasing, this trend has not been apparent in young people in recent years (since 1998).
Newly licensed or novice drivers are especially at increased risk of crashing, with the first few months being a particularly dangerous period. About 14 per cent of drivers crash within the first 12 months of commencing driving, with inexperience, night-time driving, carrying similar-aged passengers and risky driving practices being contributing factors.
There is good evidence that restricting exposure to the above risk factors reduces the incidence of death and serious injury. Such a system is in place in New Zealand and has resulted in a reduction in serious injuries of almost 23 per cent. (Restrictions on driving late at night have provided the greatest benefit.)
Thankfully obtaining a driver’s license in Australia is much more difficult than it used to be with learners having to accumulate a considerable amount of on-road experience before being allowed to sit for their license. Parents can greatly assist in this process by sharing their knowledge while helping them gain this experience. It is a great opportunity to spend time with adolescents and is something adolescents appreciate and remember. (When else will an adolescent volunteer to sit for 50 hours plus with their parents!!)
Source – Adapted from Australian Institiute of Health and Welfare: Mathers 1999. |
Most Australian states have now opted to place restrictions on the novice drivers with respect to the number of passengers carried and times they are allowed to drive, although these restrictions do vary. Thus, parents, as the likely owner of the car the young person is driving, should consider applying restrictions to newly licensed adolescents until they have had at least six months additional driving experience. Some suggested restrictions include not driving with more than one other young person in the car and not driving late at night. Similarly, consideration should be given to not allowing teenagers to be driven by very experienced drivers at night or when several others are in the car.
The issue of alcohol and teenage driving is of obvious importance. See Alcohol use section for information regarding the issue of alcohol and driving. Also, see the section on getting home safely. See childhooh and adolescent health section for information regarding getting adolescents home safely
Youthsafe is a program dedicated to the prevention of injuries in young people aged 15-25 years, which is coordinated by Spinesafe, a not-for-profit organisation. www.youthsafe.org
Driving and the aged
Elderly people approaching the end of their ‘driving life’ should do so gracefully and stop before they are made to. They need to be aware of their limitations and take heed of any concerns expressed by family members, friends or their doctor. Injury to one’s loved ones or others in the community is very hard to live with, especially when already aware of the problem that caused it. Likewise, if there is an older family member that should not be driving, don’t be afraid to express concerns to them.
Workplace Injuries
Workplace injuries are far too common in Australia. Most jobs are associated with some kind of risk, whether it be from working with machinery, working at heights, exposure to dangerous substances, excessive tiredness from long hours etc. It is not always possible to reduce this risk level to zero. However, the risk should always be minimised. This is the responsibility of all employees from top management down. Everyone is important and no accident is acceptable.
The causes of workplace injury are numerous. They include unsafe attitudes, ignoring proper procedures, lack of knowledge regarding safe work practices, unsafe working equipment, a substandard working environment due to factors such as poor lighting, excess noise and moist floors, and distorted thinking due to fatigue, drug use, personal problems etc.
The following information provided in this section regarding reducing workplace injury is by necessity a very general outline of the issues involved in workplace safety.
Ways of reducing workplace risk
- Establishing a workplace Occupational Health and Safety Committee at the workplace. These committees are of great benefit in reducing injury and are compulsory in businesses employing more than 20 people where the majority of employees request that such a committee be formed. Workcover can advise on how to form such a committee.
- Determining what can be done to reduce risk. There are numerous people and organisations that can help provide this information including an occupational health representative at the work place, union representatives, employers, employer associations, Workcover in NSW www.workcover.nsw.gov.au , Safe Work Australia http://www.ascc.gov.au/ or private occupational health & safety consultants. (A directory is published by Workcover.) It is important that those directly responsible for worker safety and workers themselves be kept informed with up to date information about worker safety. This means continuing education. There should also be written safety instructions for each job, if necessary in several languages, which are updated as needed
- Provision of safety equipment. The employer needs to provide and keep up to date all equipment needed for providing a safe work place and ensure that it is maintained in good condition.
- Adequate supervision by management to ensure worker compliance with safety procedures.
- Effective systems to report hazards noticed by workers.
- Effective ways of dealing with safety hazards.
- Effective systems for checking the workplace for hazards.
- Regular (at least annually) review of the health and safety program.
- An effective accident reporting system
- A drug free working environment, especially with regard to alcohol.
Hearing loss and the work place
While adult-onset hearing loss is not a major cause of mortality, it is a major cause of disability in Australia. It is significantly more common in males and is a major workplace injury that receives insufficient attention, mainly because it usually develops slowly over a long period. Be aware of this fact and make sure that proper hearing protection is provided and used in the workplace (and at home).
Adult drowning
In all, about 350 people die from drowning in Australia each year. While the highest rates occur in the 0 to 4 year age group, most drowning deaths still occur in adults. Interestingly, the rates are fairly constant from age 15 to 80, but men outnumber women by a huge amount; about four to one.
A large contributing factor to the high male incidence is alcohol use. Alcohol is involved in about 40 per cent of adult drowning and people should not consume alcohol or other intoxicating drugs before or while swimming, especially in the surf.
Adults who have a medical problem that compromises their swimming ability should either not swim at all or do so with others very close at hand; if this is a safe option.
Education regarding safe swimming in the surf is important for both children and adults. It is always best to swim on a beach where there are lifeguards present. If lifesavers are not present, make sure there are at least a few friendly looking surfers around.
Between 1992 and 1998 about 40 drowning deaths occurred in people trying to rescue others in difficulty in the water, so it is important be sensible when attempting a water rescue. Thinking quickly first about how a rescue attempt is most likely to succeed is the best way to ensure the safety of all concerned. Don’t just panic and rush into the water. Factors to consider before attempting a rescue include looking for additional help (e.g. a friendly surfer), assessing the conditions, notifying others of the rescue attempt, and ensuring a floatation device is available (e.g. a boogie board). (It is always good to take a boogie board or other floatation device to the beach.) Finally, at least 20 per cent of adult drowning deaths are associated with watercraft accidents, so be careful in boats and again watch the alcohol!!
Managing a drowning victim
Cardiopulmonary resuscitation (CRP)
CPR can help save lives in many situations, including drowning, and all Australians should have a good working knowledge of how to do CPR. Courses are available from:
- St John’s Ambulance http://stjohn.org.au
- The Royal Life Saving Society of Australia http://www.royallifesaving.com.au
- The Red Cross of Australia www.redcross.org.au
Recently the basic principles of CRP have changed and people who have not studied CPR since mid 2006 should consider updating their knowledge.
When resuscitating a drowning victim, it is important to continue CPR for at least 30 minutes. Often drowning victims suffer from hypothermia (low body temperature) and this can help protect their brains from damage due to lack of oxygen. This means that CPR will be more likely to give a favourable outcome without significant brain damage, especially in children.
Aspiration of water and the use of oxygen
Many drowning survivors aspirate water into their lungs, adversely affecting their ability to provide oxygen to the blood. For this reason, all drowning victims should be treated with oxygen initially if available and assessed by a medically qualified person regarding the likelihood of aspiration. This usually means that an ambulance needs to be rung quickly. If there is evidence of aspiration, the person needs to be transferred to hospital by ambulance with oxygen.