Safety Facts:

Think First Safety Facts:

• Spinal Cord Injury
• Brain Injury
• Safety Belts
• Bike Safety
• Roller Sports Safety
• Water Safety
• Playground Safety
• Fire Arms Safety

Washington State Safety Laws:

• Washington State Seatbelt Law – Click-It or Ticket
• Teens Graduated Licensing Program in Washington State
• Washington State Booster Seat Law
• Seattle Bike Helmet Law

Spinal Cord Injury

General Information
A spinal cord injury (SCI) is damage to the spinal cord that results in a loss of function such as mobility or feeling. The spinal cord does not have to be severed in order for a loss of functioning to occur. In fact, in most people with SCI, the spinal cord is intact, but the damage to it results in loss of function.

Death and Injury Statistics
Approximately 7,800 new spinal cord injuries occur each year in the U.S. Researchers estimate that an additional 4,860 die before reaching the hospital. Current estimates include 250,000-400,000 individuals who are living with spinal cord injuries or spinal dysfunctions.

Causes of Spinal Cord Injuries include:
* Motor vehicle incidents (44%)
* Acts of violence (24%)
* Falls (22%)
* Sports (8%) (two-thirds of sports injuries are from diving.)
* Other (2%)

Falls overtake motor vehicles as the leading cause of injury after age 45. Acts of violence and sports cause fewer injuries as age increases. Acts of violence have overtaken falls as the second most common source of spinal cord injury in the last four years.¹

Who Most Likely Incurs This Type of Injury
Of the 250,000-400,000 individuals who are living with spinal cord injuries or spinal dysfunction:
* 82% male, 18% female.
* Highest per capita rate of injury occurs between ages 16-30.
* Average age at injury, 33.4.

Health Costs
Lifetime costs: Average yearly health care and living expenses (in 1992 dollars) that are directly attributable to SCI vary greatly according to the severity of the injury:

Estimated lifetime costs discounted at 4% depend on severity of injury and age at injury:

These figures do not include any indirect costs such as losses in wages, fringe benefits and productivity which could average almost $38,000, but vary substantially based on education, severity of injury and pre-injury employment history.²

Prevention Tips
* Always wear a safety belt when riding in an automobile.
* Remember to follow the rules of the road and especially speed limits.
* Always wear proper safety gear when engaging in any sport.
* Always check the depth of the water before diving in; remember, feet first, first time!
* Never dive into a pool unless it is 9 feet or higher; never dive into an above-ground pool.
* Explain to children that guns are dangerous and that children never should touch guns or remain in a friends' home where a gun is accessible.
* Talk with your teen about ways to solve arguments and fights without guns or violence.
* Always keep your gun unloaded and locked up. Lock and store bullets in a separate location.

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1. National Spinal Cord Injury Statistical Center at the University of Birmingham. NSCIA, 5/96.
2. National Spinal Cord Injury Statistical Center; 1717 6th Avenue South, Room 544, Birmingham, AL 35233; (205)934.3320.
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ThinkFirstSM is a service mark of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons.
©Copyright 1997-2003, ThinkFirst National Injury Prevention Foundation.

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Brain Injury

General Information
In general, injury is the leading cause of mortality among Americans under 45 years of age. Traumatic brain injury (TBI) is responsible for the majority of these deaths. ¹

Death and Injury
* It is estimated that TBI claims more than 56,000 American lives, annually.² Each year, approximately 373,000 Americans are hospitalized as a result of TBI. Of these, 99,000 individuals sustain moderate to severe brain injuries resulting in lifelong disabling conditions. ³
* Vehicle crashes are the leading cause of TBI, accounting for 50% of all injuries. Falls are the second leading cause, accounting for more than 20% of all TBI.
* More than 50% of persons with brain injury were intoxicated at the time of injury.^{4, 5}
* After one traumatic brain injury, the risk for a second injury is three times greater; after a second TBI, the risk for a third injury is eight times greater.⁶
* In the 15 seconds it takes to read these statistics, one person in the U.S. sustains a traumatic brain injury.⁷

Where and When these Injuries Most Likely Occur
* Most TBI's occur mid afternoon to early evening, on weekends and during summer months. ⁸
* Children especially are at risk in the afternoon hours after they are dismissed from school. In 1995, 42.6% of children's injuries occurred on roads, 34.3% at home and 6.6% in recreation areas. ⁹

Who Most Likely Incurs This Type of Injury
* Males 14-24 years old are the highest risk category, followed by infants and the elderly.
* Males are twice as likely as females to sustain TBI due to differences in risk exposure and lifestyles.
* According to the National Pediatric Trauma Registry, more than 30,000 children sustain permanent disabilities as a result of brain injury every year.¹⁰

Health Costs
* The cost of TBI in the United States is estimated to be $48.3 billion, annually.
* Hospitalization accounts for $31.7 billion of the total, annually, whereas fatal brain injuries cost the nation $16.6 billion.

Prevention Tips
* Always wear a SNELL-, ANSI- and/or ASTM-certified bicycle helmet and/or protective gear when riding a bicycle, skate board, or in-line skating.
* Always wear a motorcycle helmet when riding a motorcycle.
* Always wear a safety belt when driving or riding in a motor vehicle.
* Never drink and drive. Always have a designated driver.
* Always observe and obey speed limits, traffic signs and signals.
* Make sure when playing on a playground that the ground surface is soft and free of debris and rocks.

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1. Brain Injury Association
2. Kraus JF, McArthur, DL Epidemiology of Brain Injury. Los Angeles: University of California Los Angeles, Dept. Of Epidemiology, Southern California Injury Prevention Research Center, Feb. 1995. In press.
3. Kraus J, Sorenson S. Epidemiology. In Silver J, Yodofsky S. Hales R (eds), Neuropsychiatry of TBI. Washington, DC: American Psychiatric Press, Inc., 1994.
4. Ruff RM, Marshall LF, Klauber MR, Blunt BA, Grant 1, Foulkes MA, et al. Alcohol abuse and neurological outcome of the severely head injured. Journal of Head Trauma Rehabilitation. 1990; 5:21-31.
5. Kreutzer JS, Doherty R, Harris JA, Zasler ND. Alcohol abuse among persons with traumatic brain injury. Journal of Head Trauma Rehabilitation 1990; 5:9-20.
6. Annegers JF, Garbow JD, Kurland LT, et al. The incidence, causes and secular trends of head trauma in Olmstead County Minnesota, 19935-1974. Neurology 1980; 30:912-919.
7. FDA Consumer. Head Injuries. Health Response Ability Systems, 1993. (File downloaded from AOL).
8. Rimel RW. Jane JA. Characteristics of the head-injured patient. In Tosenthal M, Griffith ER, Bond MR, Miller JD (eds). Rehabilitation of the Head Injured Adult. Philadelphia: FA Davis 1983.
9. Research and Training Center in Rehabilitation and Childhood Trauma. National Pediatric Trauma Registry. Boston: Tufts University School of Medicine, New England Medical Center, April 1995.
10. Research and Training Center in Rehabilitation and Childhood Trauma. National Pediatric Trauma Registry. Boston: Tufts University School of Medicine, New England Medical Center, Spring 1993
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ThinkFirstSM is a service mark of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons.
©Copyright 1997-2002, ThinkFirst National Injury Prevention Foundation.

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Safety Belts

General Information
Motor vehicle crashes are the leading cause of death for persons from 5-27 and a major source of injury in all age groups. Studies have shown that safety belts are about 45% effective in preventing deaths and can reduce the risk of moderate to severe injury by 50%. In recent years, safety belt use has increased to a national rate of 68%, resulting in the prevention of many unintentional injuries. In fact, between the years of 1982 and 1995 safety belts saved an estimated 75,087 lives.

Death and Injury Statistics (1995)
* The average American is more likely to be involved in a traffic crash than be a victim of a crime.¹
* Motor vehicle crashes are the primary cause of on-the-job death and injury.
* 41,798 people were killed in traffic crashes.
* An average of 115 persons died each day -- one every 13 minutes -- from motor vehicle crashes.
* 84% of deaths were to occupants, 16% were to pedestrians, bicyclists and others.
* Approximately 2/3 of those killed were not wearing safety belts.
* Of those killed, occupants between ages 10-24 had the lowest safety belt usage rate.
* Drivers under 25 have the highest death rate.
* 67% of deaths occurred to males.
* 46% of males who died in crashes were unrestrained, 34% of females were unrestrained.
* 3,386,000 people were injured in traffic crashes.

When and Where Injuries and Deaths are Most Likely to Occur (1995)
* The highest number of fatal crashes occur between the hours of midnight and 3 a.m. on Saturdays.
* The highest number of crashes resulting in injury occurred Fridays between 3 p.m. and 6 p.m.
* Slightly more than one-half of fatal crashes occurred on roads with posted speed limits of 55 mph or more.

Who is Most Likely to Incur This Type of Injury (1995)
* When driver death rates are calculated on the basis of estimated annual travel, the highest rates are found in the youngest and oldest drivers. Compared with death rates for drivers 25-65, the rate for teenage drivers is four times as high and the rate for older drivers is 17 times as high.

Health Costs
* In 1995, the cost of motor vehicle crashes was $150.5 billion, annually.
* Employers pay more than $50 billion annually.
* Costs include medical care, legal fees, property damage and lost work time.
* Crashes drive up the cost of Worker's Compensation, Social Security and private health and disability insurance.

Prevention Tips
* Wear your safety belt for every ride.
* Learn the correct way to wear a safety belt, including:
-- lap belt -- should fit snugly and be worn low across the hips and pelvis.
-- shoulder belt -- should fit snugly and cross the chest and collarbone.
-- seat should be in an upright position.
* If you are the driver, make sure all passengers are properly buckled before you start to drive.
* Children under 14 should be buckled in the back seat.

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1. Traffic Safety Facts 1995, U.S. Department of Transportation, Crime in the United States, U.S. Department of Justice
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ThinkFirstSM is a service mark of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons.
©Copyright 1997-2002, ThinkFirst National Injury Prevention Foundation.

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Bike Safety

General Information
Each year in the United States, 20,000 cyclists are admitted to hospitals and 580,000 receive emergency room treatment. Seven hundred fifty-seven bicyclists were killed in crashes with motor vehicles in 1996, 8 percent fewer than in 1995 and down 25 percent since 1975.¹

Death and Injury Statistics
* Seven hundred fifty-seven bicyclists were killed in crashes with motor vehicles in 1996, 8 percent fewer than in 1995 and down 25 percent since 1975.²
* A non-helmet wearing bicyclist hospitalized with a head injury is 20 times as likely to die than those who did wear a helmet. ³

When and Where Injuries and Deaths are Most Likely to Occur
* Bicycle deaths are most likely to occur in summer from 6-9 p.m.¹
* Nationally, more bicyclists were killed in urban areas than in rural areas and 33% of bicycle deaths occurred at intersections in 1996.¹

Who Most Likely Incurs This Type of Injury
* Nearly one-fourth of all significant brain injuries in children 14 years or younger are bicycle-related, and most bicycle-related hospital admissions and deaths are due to injuries to the skull and brain. Having children wear bicycle safety helmets every time they ride can reduce the risk of head injury by 85%. ⁴

Health Costs
* For children ages 4 to 15, every bike helmet saves this country $30 in direct health care costs, $95 in other tangible costs and $270 in quality of life. If 85% of all child cyclists wore helmets in one year, the lifetime medical cost savings would total $109 million to $142 million. It is very expensive to treat a child with a bike-related head injury. These medical costs may sometimes last the child's lifetime. For example, in 1991, bicycle crashes involving children ages 4 to 15 caused 52,000 nonfatal head injuries and 93,000 nonfatal face and scalp injuries. Lifetime medical payments for these injuries will approach $200 million. Every bicycle helmet saves health insurers $29 and auto insurers $12.⁵

Prevention Tips
Before using your bicycle, make sure it is ready to ride. You always should inspect your bike to make sure all parts are secure and working properly.
Remember to:
* Always wear a bicycle helmet. The helmet should fit snugly and not move from side to side. The front of the helmet should be approximately one inch above the eyebrows and the chin strap should be buckled snugly.
* Always wear a helmet that has or exceeds the safety standards developed by the SNELL Memorial Foundation, ANSI and/or the American Society for Testing and Materials (ASTM) when riding a bicycle.
* Inflate tires properly and check brakes before riding.
* See and be seen. Always wear neon, fluorescent, or other bright colors when riding during the day.
* Carry books and other items in a bicycle carrier or backpack.
* Avoid riding at night; it is far more dangerous than riding during the day. If you have to ride at night, wear something that reflects light, make sure you have reflectors on the front and rear of your bike, and that your headlight is on.
Bicycles are considered to be vehicles and bicyclists must obey the same rules as motorists.

When riding, always:
* Ride single file in the same direction as other vehicles. Go with the flow of traffic--not against it!
* Obey the traffic signs, signals and lane markings.
* Signal your moves to others. Be courteous to pedestrians and other vehicle operators.
* Before you enter any street or intersection, check for traffic by looking left-right-left.
* Stay alert at all times. Watch out for potholes, cracks, wet leaves, storm grates, railroad tracks or anything that could make you lose control for your bike.
* When turning left-or right, always look behind you for a break in traffic, then signal before making the turn. Watch for left or right-turning traffic.
* Ride so other drivers can see you. Stay out of drivers' blind spots.
* Ride far enough from the curb to avoid the unexpected from parked cars, such as doors opening.

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1. U.S. Department of Transportation's Fatality Analysis Reporting System/Insurance Institute for Highway Safety, 1005 N. Glebe Rd., Arlington, VA 22201. August 1997.
2. U.S. Department of Transportation's Fatality Analysis Reporting System/Insurance Institute for Highway Safety, 1005 N. Glebe Rd., Arlington, VA 22201. August 1997.
3. Monograph by the John Hopkins Injury Prevention Center, sponsored by the Snell Memorial Foundation.
4. "Helping With Bike Safety" American Academy of Pediatrics, TIPP, the Injury Prevention Program.
5. Children's Safety Network Economics and Insurance Resource Center and National Public Services Research Institute 3/96
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ThinkFirstSM is a service mark of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons.
©Copyright 1997-2002, ThinkFirst National Injury Prevention Foundation.

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Roller Sports Safety

Death and Injury Statistics
1.1 skateboard injuries and 3.0 roller skating injuries are reported for every inline skating injury ³

Inline Skating:
* Head and face injuries account for 11,000 injuries each year ⁴
* Inline skating injuries can be prevented in 90% of circumstances6
* 2/3 of skaters do not wear any safety equipment ⁸

Skateboarding:
* In the year 2000, nearly 50,000 children were treated in hospital emergency rooms for skateboard-related injuries9
* 6 out of every 10 skateboard injuries are among children under 15 years of age ¹⁰

Scooters:
* In the year 2000, over 40,000 injuries required emergency room treatment ¹¹
* Head injury occurs in 27% of incidents involving scooters ¹²

Who is most likely to incur this type of injury?
* The greatest number of injuries occur within the 0-14 age group ¹⁹
* Children younger than 15 accounted for 85% of scooter injuries 21
* Because of their lack of ability, beginners are more likely to be injured from inline skating ²⁰

Prevention Tips
* Always wear protective gear; helmet, wrist, elbow, and kneepads
* Stay on a surface that is smooth and free of debris
* Obey traffic rules
* Don’t go out at night
* Only one person should be on a skateboard or scooter
* Be aware of those around you
* Select a skateboard suitable for your level
* Avoid poorly constructed scooters ²¹

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3. http://www.aggressive.com/health/stastics.cfm
4. http://www.nsc.org/library/facts/inline.htm
6. http://www.lifeessentialsbyzee.com/safety/zlife_saftey_sports_018.html
8. http://www.vahealth.org/civp/bike/index.html
9. http://www.safekids.org/tier3_cd.cfm?content_item_id=1211&folder_id=540
10., 12., 19. http://www.aaos.org/wordhtml/press/kidsroll.htm
11., 20., 21. http://orlando.nsc.org/articles/0901.htm

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Water Safety

Death and Injury Statistics
* 5,000 children age 14 and under are hospitalized each year as a result of near drowning. 20% will endure severe and permanent disabilities, ⁴ while 15% will die in the hospital.⁵
* Personal floatation devices would have prevented approximately 89% of boating-related drowning in the years 2001-2002 ⁶
* 70% of preschoolers that drown are in the care of one or both parents at the time of the incident ⁷
* Approximately 1,000 recreational diving injuries occur each year⁹, 90% of diving injuries result in quadriplegia. ¹⁰
* In the year 2001, alcohol was associated with 25-50% of adolescent and adult water recreation deaths ⁸

Who is most likely to incur this type of injury?
* Over 80% of drowning victims are male ¹⁴
* For children under age 14, drowning represents the second leading cause of injury-related death ¹⁴

Health Costs
* Each year, pool drowning and near drowning of children 14 and under cost the United States $6.2 billion ¹⁶

Prevention Tips
* Always swim with a buddy, and make sure children are always supervised by an adult ¹⁸
* Never drink alcohol when participating in the water activities
* Never dive in water less than 9 feet deep ¹⁹
* Always wear a U.S. Coast Guard approved life jacket when boating ²⁰
* Enter the water feet first the first time to test to see if an area is safe to dive ²¹
* Four-sided isolation fencing that is self-closing and self-latching, and gates that are at least five feet high should be installed around home swimming pools ²²
* Learn CPR
* Don’t dive in above ground pools ³⁰

How much water can you drown in?
* One inch of water can cause a child to drown. This means everything from the toilet or bathtub to a pond or pool can be a risk to a child ¹

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1., 2., 3. www.safekids.org/tier3_cd.cfm?folder_id=181&content_item_id=353
5., 11., 16. www.firehouse.com/safekids/factsheets/drown.html
6., 8., 14. CDC injury Fact Book 2001-2002
7. www.ocfa.org/resident/watch/drowning.htm
9., 10. www.thecitizennews.com/main/archive-020529/healthwise/hw-02.html
18., 19. www.cdc.gov/ncipc/factsheets/drown.htm
22. www.safekids.org/tier3_cd.cfm?folder_id=300&content_item_id=1651
21. www.safety.kirtland.af.mil/magazine/htdocs/sum97/pg8.htm
30. www.drpaul.com/factsheets/watersafe.html

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Playground Safety

Death and Statistics
* Over 200,000 children visit emergency rooms each year due to playground-related injuries.³
* 79% of ALL playground injuries involve falls. Falls also account for 90% of the most SEVERE playground injuries⁵

Who is most likely to incur this type of injury?
* Males account for 62% of all playground deaths¹¹
* 46% of school-related injuries are to those ages 10-14¹³
* 49% of injuries to the head and face are to children age four and under ¹⁴

Health Costs
* School-related medical costs for children age 14 and under account for more than $2 billion in medical spending each year¹⁵

Prevention Tips
* Playground equipment is designed for different age groups and should be used accordingly
* Never leave children unsupervised
* To better absorb shocks from falls, make sure 12 inches of loose fill such as wood chips, pea gravel, shredded tires, mulch, or sand completely covers the playground floor
* A bar should be present at the top of a slide so children will have to sit before going down
* Maintain playground equipment
* Make sure guardrails surround elevated platforms
* Hoods or drawstrings can get caught in equipment. Remove them before children are allowed to play.

What piece of playground equipment is so dangerous that experts recommend it be removed?
* Monkey bars, climbing equipments is responsible for 40% of playground injuries²

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2., 3., 4. www.nsc.org/library/facts/plgrdgen.htm
6., 7., 8., 11., 12., 13. www.safekids.org/tier3_cd.cfm?content_item_id=342&folder_id=177
15., 16. www.safekids.org/tier3_cd.cfm?content_item_id=342&folder_id=540

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Fire Arms Safety

General Information
There are 192 million privately-owned firearms in the U.S., many of which are handguns. From 1985 to 1994, violent crimes committed with firearms increased by a much wider margin than those committed with other weapons. During this 10-year time period, firearm-related offenses were chiefly responsible for the overall 42% increase in murders, robberies and aggravated assaults.

Death and Injury Statistics

In 1992, handguns were used to murder 13 people in Australia, 33 in great Britain, 36 in Sweden, 60 in Japan, 97 in Switzerland, 128 in Canada and 13,495 in the United States.

Who Most Likely Incurs This Type of Injury
* Guns kept in the home for self-protection are 43 times more likely to kill a family member or friend than to kill an intruder.
* Firearms are the number two killer of men and women 10-34 years of age, second only to motor vehicle crashes.
* Firearm homicide is the leading cause of death for black males ages 15-34.
* The risk of suicide is five times greater if there is a gun in the home.²
* The risk of domestic homicide is three times greater if there is a gun in the home.³

Health Cost
* In 1992, the cost of firearm injuries in pain, suffering and lost quality of life is estimated to be $75 billion dollars.
* It costs more than $14,000 to treat each child wounded by gunfire -- enough to pay for a full year at a private college.

Prevention Tips
Talking with Young Children...
* Explain to children that guns are dangerous and that children never should touch guns or remain in a friends' home where a gun is accessible.
* Tell children that gun violence in the media is not real -- in real life children are hurt and killed with guns.

Talking with Teens...
* Talk with your teenager about his/her thoughts and feelings --depressed teens commit suicide with guns more often than with any other method.
* Talk with your teen about ways to solve arguments and fights without guns or violence.

If you own a gun...
* Remember, young children are curious by nature and eagerly explore their environments.
* Even the best behaved teenagers don't always follow the rules. Pre-teens and teens often are attracted to guns and sometimes see them as symbols of power.

Police recommend the following safety steps if you have a gun:
* Always keep your gun unloaded and locked up. Lock and store bullets in a separate location.
* The best way to reduce gun risks is to remove the gun from your home.

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1. National Center for Health Statistics
2. American Academy of Pediatrics
3. National Center for Health Statistics, Monthly Vital Statistics Report, Vol. 45, #11 (S) 2. June 12, 1997.
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ThinkFirstSM is a service mark of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons.
©Copyright 1997-2002, ThinkFirst National Injury Prevention Foundation.

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Washington State Safety Laws:
Think First wants you to know some important Washington State Safety Laws

Washington State Seatbelt Law – Click-It or Ticket

In June 2002, Washington enacted a primary seatbelt law for everyone. Motorist can be pulled over and ticketed if the driver or passenger is not wearing a seatbelt, even if no other law is violated. The law is a primary offense and is subject to a traffic infraction penalty of an $86 ticket.

For information on new laws affecting Washington State Drivers and information about Click It or Ticket, please visit: http://www.dol.wa.gov/ds/newlaws.htm

Teens Graduated Licensing Program in Washington State

For information about Washington State Drivers Licenses Restrictions for Teens, please visit: http://www.dol.wa.gov/ds/teen.htm

Washington State Booster Seat Law

On July 1, 2002, Washington's new Child Restraint Law went into effect. This law, also known as the Anton Skeen Act, is one of the strongest child restraint laws in the nation. It requires the use of booster seats for older children. In 2000, Washington was the first state in the nation to pass this type of law.

As of July 27, 2003, tickets cost $101.00 for each improperly restrained child, including if the child safety seat harness is not buckled, or if the older child has put the shoulder belt behind his back.

For more information on key provisions of the booster seat law and how to correctly install them please visit: http://depts.washington.edu/booster/anton_skeen_bill.htm

For information on how to get Booster Seat Coupons for Target stores visit: http://depts.washington.edu/booster/coupons.htm

Seattle Bike Helmet Law

After August 17, 2003, bicyclists in Seattle found not wearing a bike helmet while riding a bike will be cited for violating the bike helmet regulation and will receive a $30 fine.

Several studies have shown that legislation in combination with education increases helmet usage and decreases head injuries, and bike helmets reduce head injuries by 65 - 85%.

Seattle is now joining the growing list of communities with bike helmet regulations. Many communities in Washington State have recognized the importance of bike helmet ordinances and regulations as part of a sound injury prevention strategy.

For more information about the Seattle Helmet Law, please visit: http://www.metrokc.gov/health/news/03071801.htm

For information on where you can find low cost of free bike helmets in Seattle and King County please visit: http://www.metrokc.gov/health/injury/helmets.htm

How to Correctly Fit a Bike Helmet Brochure- please feel free to print this out for yourself and others: How to Fit a Bike Helmet.pdf

* Check with your local community to see if there are bike helmet regulations and ordinances

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