Safeguarding youth from agricultural injury and illness: The Australian experience

[Extract] As of 31 March 2022, there were 25,890,773 estimated resident population in Australia across the eight states and territories (1). In the 2020–21 Financial year, there was 387 million hectares of agricultural land (50% of Australia's land mass), of which the majority (86%) was used for grazing (2). There were 228,372 people in the Australian agricultural workforce in 2016, 69% were males, the median age was 56 years, and a third (37%) were owner operators (3). In Australia, fatalities on Australian farms have remained steady over the last decade, with 1,584 between 2001–2020 (4). Children represent approximately 15% of these deaths (5, 6). Issues that have been found to be of importance to farmers about the safety of their children on farms in Australia include: general danger avoidance and safety, machinery, moving vehicles, bike safety, animal handling, personal protective equipment (PPE), supervision, speed, water safety and chemicals (5)

The role of technology in healthy living medicine

Health care consumers are taking control of their health information and desire a greater role in managing their health. Approximately 77% of Americans now own a smartphone and the use of health apps have doubled over the past two years. These effects are particularly notable in patients with chronic disease, now representing half the adult population and responsible for 86% of United States health care (HC) costs and 70% of deaths. New opportunities exist as a result of recent advances in home-based wireless devices, apps, wearables, and interactive systems enabling health delivery systems to monitor, advise and treat disease near real time and engage patients in healthy living medicine. These technologies will provide a new framework for patient engagement and care delivery that will enhance clinical outcomes and generate precision interventions that ultimately reduce HC costs

Exploring the Delivery of Swimming and Water Safety Teacher Training to Culturally and Linguistically Diverse Communities

The dearth of information on the delivery of specific culturally and linguistically diverse (CALD) programs presents a major limitation in the effort to prevent drowning, particularly when drowning rates of people from countries other than Australia are increasing. This study describes programs delivered by the aquatic industry for CALD communities in New South Wales (NSW), explores what CALD communities believe their water safety education needs are, and evaluates AUSTSWIM’s current training methods to ascertain which is most effective when training candidates from CALD communities. We found an absence of specialized aquatic programs being run at aquatic facilities for CALD communities. Barriers to participation included a lack of understanding of the cultural perceptions toward water safety and the different emphasis on the need for swimming skills and water safety education. The likelihood of AUSTSWIM Teacher of Swimming and Water Safety candidates’ having successful aquatic training outcomes increases with a combined learning approach that pairs meaningful practical applications with ongoing mentor support. Engagement of CALD communities’ using these kind of water safety programs will be essential if Australia wants to reduce the drowning burden

Exploring the impact of remoteness and socio-economic status on child and adolescent injury-related mortality in Australia

Injuries are a leading cause of harm for children. This study explores the impact of determinants of health on children (0–19 years) injury-related mortality (namely remoteness and socio-economic disadvantage, calculated using the index of relative socio-economic advantage and disadvantage (IRSAD)). Cause of death data from the Australian Bureau of Statistics were sourced for children in Australia between 1 July 2007 to 30 June 2017. Fifteen injury categories (ICD-10-AM external cause codes) were used. Burden and trends by injury mechanism were explored. A total of 5153 children died; with road traffic incidents (3.39 per 100,000 population), intentional self-harm (2.46) and drowning (0.72) being the leading mechanisms. Female fatality rates in very remote areas (8.73) were nine times higher than in major cities (Relative Risk [RR] = 8.73; 95% Confidence Interval [95% CI]: 4.23–18.00). Fatality rates increased with remoteness; very remote areas recording an injury-related fatality rated six times (RR = 5.84; 95 %CI: 3.76–9.12) that of major city residents. Accidental poisoning and intentional self-harm fatalities were more likely in high IRSAD areas, while road traffic fatalities were more likely in low and mid socio-economic areas (X2 = 69.1; p < 0.001). People residing in regional and remote areas and from low socio-economic backgrounds already face significant health and lifestyle challenges associated with disadvantage. It is time to invest in injury prevention interventions for these populations, as well as upstream policy strategies to minimize any further preventable loss of life

Child injury prevention: it is time to address the determinants of health

Injuries, although almost entirely preventable, accounted for more than 4.4 million deaths and resulted in over 520 million cases of nonfatal injury-related harm globally in 2017 [1]. Road traffic injuries, falls and drowning are leading injury mechanisms [2–4]. However, some population groups are more vulnerable to being injured than others. This Special Issue sought to unpack this concept by exploring the determinants of health and their impact on child injuries

Improving pool fencing legislation in Queensland, Australia: attitudes and impact on child drowning fatalities

Four-sided, non-climbable pool fencing is an effective strategy for preventing children from drowning in home swimming pools. In 2009, the Queensland Government introduced legislation to improve the effectiveness of pool fencing. This study explores community attitudes towards the effectiveness of these legislative changes and examines child (<5 years) drowning deaths in pools. Data from the 2011 Queensland Computer-Assisted Telephone Interviewing (CATI) Social Survey include results from questions related to pool ownership and pool fencing legislation. Fatal child drowning cases between 1 January 2005 and 31 December 2015 were sourced from coronial data. Of the 1263 respondents, 26/100 households had a pool. A total of 58% believed tightening legislation would be effective in reducing child drowning deaths. Pool owners were more likely to doubt the effectiveness of legislation (p < 0.001) when compared to non-pool owners. Perceptions of effectiveness did not differ by presence of children under the age of five. There were 46 children who drowned in Queensland home pools (7.8/100,000 pools with children residing in the residence/annum) between 2005 and 2015. While pool owners were less likely to think that tightening the legislation would be effective, the number of children drowning in home swimming pools declined over the study period. Drowning prevention agencies have more work to do to ensure that the most vulnerable (young children in houses with swimming pools) are protected

Traversing community attitudes and interaction experiences with large agricultural vehicles on rural roads

Agriculture is one of Australia's largest rural industries. Oversized and slow moving industry equipment and vehicles, hereafter referred to as large agricultural vehicles (LAVs), use public roads. Restrictions exist regarding their on-road operation, but whether this is a function of the risk that their on-road use represents is unknown. A convenience sample of community members was used to explore perspectives about LAVs' presence on roads. An online survey was used to explore LAV interaction experiences, risk perceptions, and how best to promote safe interactions. Ethics approval was obtained. The participants' (N = 239) exposure to LAVs on roads in the last 12 months was variable, but there were clear seasonal points when encounters could be expected. The participants indicated that LAVs have a right to drive on the road (94.8%), and most interactions were neutral, with four LAV crashes reported. Other vehicle types were perceived as representing a higher risk to rural road safety than LAVs. The use of the driver's license test to increase knowledge about LAVs' presence, how to respond, and the use of signs were suggested in order to improve safety. The participants commonly interacted with LAVs, and rarely experienced negative events such as crashes. Continued communication about LAV presence on rural roads is an important consideration in order to help ensure safe interactions

Perceptions about alcohol harm and alcohol-control strategies among people with high risk of alcohol consumption in Alberta, Canada and Queensland, Australia

Objectives: To explore alcohol perceptions and their association hazardous alcohol use in the populations of Alberta, Canada and Queensland, Australia. Methods: Data from 2500 participants of the 2013 Alberta Survey and the 2013 Queensland Social Survey was analyzed. Regression analyses were used to explore the association between alcohol perceptions and its association with hazardous alcohol use. Results: Greater hazardous alcohol use was found in Queenslanders than Albertans (p<0.001). Overall, people with hazardous alcohol were less likely to believe that alcohol use contributes to health problems (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.27 to 0.78; p<0.01) and to a higher risk of injuries (OR, 0.54; 95% CI, 0.33 to 0.90; p<0.05). Albertans with hazardous alcohol use were less likely to believe that alcohol contributes to health problems (OR, 0.48; 95% CI, 0.26 to 0.92; p<0.05) and were also less likely to choose a highly effective strategy as the best way for the government to reduce alcohol problems (OR, 0.63; 95% CI, 0.43 to 0.91; p=0.01). Queenslanders with hazardous alcohol use were less likely to believe that alcohol was a major contributor to injury (OR, 0.39; 95% CI, 0.20 to 0.77; p<0.01). Conclusions: Our results suggest that people with hazardous alcohol use tend to underestimate the negative effect of alcohol consumption on health and its contribution to injuries. In addition, Albertans with hazardous alcohol use were less in favor of strategies considered highly effective to reduce alcohol harm, probably because they perceive them as a potential threat to their own alcohol consumption. These findings represent valuable sources of information for local health authorities and policymakers when designing suitable strategies to target alcohol-related problems

Exploring the burden of fatal drowning and data characteristics in three high income countries: Australia, Canada and New Zealand

Background: Drowning is a leading and preventable cause of death that has suffered an attention deficit. Improving drowning data in countries would assist the understanding of the full extent and circumstances of drowning, to target interventions and evaluate their effectiveness. The World Health Organization identifies data collection as a key strategy underpinning effective interventions. This study compares unintentional fatal drowning data collection, management and comparison using the databases of Australia, Canada and New Zealand. Methods: Cases of fatal unintentional drowning between 1-January-2005 and 31-December-2014 were extracted. Cases were combined into a single dataset and univariate and chi square analysis (p < 0.01) were undertaken. Location and activity variables were mapped and combined. Variables consistently collected across the three countries were compared to the ILCOR Drowning Data Guideline. The authors also recommend variables for a minimum core dataset. Results: Of 55 total variables, 19 were consistent and 13 could be compared across the three databases. When mapped against the ILCOR Drowning Data Guideline, six variables were consistently collected by all countries, with five compared within this study. The authors recommend a minimum core dataset of 11 variables including age, sex, location, activity, date of incident, and alcohol and drug involvement). There were 8176 drowning deaths (Australia 34.1%, Canada 55.9%, New Zealand 9.9%). All countries achieved reductions in crude drowning rates (Australia - 10.2%, Canada - 20.4%, New Zealand - 24.7%). Location and activity prior to drowning differed significantly across the three countries. Beaches (X2 = 1151.0;p < 0.001) and ocean/harbour locations (X2 = 300.5;p < 0.001) were common in Australia and New Zealand, while lakes/ponds (X2 = 826.5;p < 0.001) and bathtubs (X2 = 27.7;p < 0.001) were common drowning locations in Canada. Boating prior to drowning was common in Canada (X2 = 66.3;p < 0.001). Conclusions: The comparison of data across the three countries was complex. Work was required to merge categories within the 20% of variables collected that were comparable, thus reducing the fidelity of data available. Data sources, collection and coding varied by country, with the widest diversity seen in location and activity variables. This study highlights the need for universally agreed and consistently applied categories and definitions to allow for global comparisons and proposes a core minimum dataset