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UNDER 1 YEAR
DROWHING AND WATER TRANSPORT
65 AND OVER
INHALATION AND INJESTI ON
144 FIRE ARMS
Mr. ROBERTS. Thank you.
Mr. COHEN. This focus of Service interest and program activity lies in the importance of scientific research as the basis for planning and developing effective accident prevention measures—and particularly research relating to the human factors in accidents and in accident prevention.
I do not mean to imply that accident-prevention research is an entirely new or recent concept. Much valuable work has been done in some fields for many years.
For the most part, however, this research has concentrated on making things relatively safe for humans to use. This includes research into the design of equipment and materials to reduce their inherent hazards for humans.
Of course, as I implied, a lot more needs to be done in that area. However, regretfully, not as much attention has been given to human behavior that causes or invites accidents. Yet, those who have studied accident prevention believe that the principal cause of accidents is human behavior.
Until recently the importance of human factors has been reflected primarily in campaigns designed to make people "safety minded” through training and education. Many of these campaigns have had beneficial results.
Unfortunately, the scientific data on which effective campaigns or other preventive measures can be based is limited at present. We need a great deal more research into the physiological, psychological, and environmental factors that make people act as they do.
What is particularly needed is an interdisciplinary research effort that will combine and coordinate the skills of research specialists in the various health sciences.
Among these sciences are pediatrics, geriatrics, preventive medicine, physical medicine, biomathematics (including computer programing), physiology (particularly stress physiology), and behavioral sciences.
Some facts we need are already being uncovered by basic and applied research into the sciences related to health. But, these findings must be analyzed and related to the requirements of accident prevention. In addition, we have recently begun to see the rich potential available in health and related research institutions for studies directed specifically toward major causes or forms of accidental death and injury.
In some instances, effective research will require special equipment or facilities. This is particularly true where the researcher needs to observe human behavior in very dangerous situations.
By stimulating the actual performance situations, we can make these tests without danger to the participants. An example, which has previously been discussed with your committee, is the need for a high fidelity driving simulator in research directed toward the causes of traffic accidents.
Such a simulator would allow us to put many drivers through identical tasks and individual drivers through a variety of tasks. The hazards to the test drivers and others, which would be unavoidable if this were attempted in actual traffic situations, could be eliminated.
Such a device would help us analyze the effects of driving under varying conditions, such as the influence of drugs, alcohol, fatigue, and other physiological factors. Thus, we could:
Substitute scientific facts for the subjective opinions which must govern our attitudes toward these factors today;
Discover whatever actual limitations on driving ability might be imposed by various chronic or acute diseases or other physical disabilities; and
Test the effects of such physiological and psychological factors as attitudes, emotions, and other motivational factors; and, study intensively the interactions that take place between the driver, the vehicle, the roadway, and other aspects of the environment.
In addition to automotive safety, which has deservedly received a major share of public concern, there are many other fields of accident prevention which deserve increased attention and in which sound research could lend, in our opinion, to the saving of many lives and the prevention of many crippling injuries.
Accidents in the home constitute another problem area in which research should yield beneficial results. These include such common mishaps as falls, electrical shock, burns, and wounds inflicted by knives, firearms, and utensils.
Here too, a variety of physiological, psychological, and environmental factors appears to be involved which we have lacked the research capability to explore adequately.
We also need to investigate such lifesaving techniques as resuscitation, proper storage of household medicines and other substances, and safer occupancy of the various kinds of human habitation.
With the increasing amount of leisure time available to the average American, we have witnessed an increasing number of deaths and injuries among those who engage in skiing, skin and scuba diving, hunting and camping, swimming and boating, amateur and professional sports like baseball and football, and boxing, I will add, and even gymnastics.
Public knowledge and use of the technique known as "drownproofing" could probably save many lives, among both swimmers and nonswimmers.
These are only a few illustratons of areas in which scientific research can open the way to progress in accident prevention. I hardly need add that such research-like research in other fields-must later be translated into programs of action before its full value can be realized.
This will require such intervening mechanisms and procedures as to the publication and dissemination of research findings, the conduct of experimental and demonstration programs, and the training of personnel in new accident-prevention concepts and techniques.
This brief projection of the needs and opportunities for research in accident prevention indicates the primary focus of accident-prevention interest and planning within the Public Health Service.
Before we continue, let me say that the Public Health Service itself cannot and should not conduct all needed research, nor is this a field in which miraculous results can be quickly achieved.
On the contrary, this is an area where the talents, resources, and interests of many agencies—both governmental and voluntary--can contribute to a common goal, and many years will pass before some of our most difficult accident-prevention problems can be solved.
The interest and purpose of the Public Health Service are to make certain that its own intramural research potential-and the potential of its programs for the stimulation and support of research by nonFederal agencies and organizations—will be fully utilized in a broad attack on accidental deaths and injuries.
I would like to ask your permission, Mr. Chairman, to insert something in the record here. We have compiled some new statistical evidence with regard to the accident probÏem which I think your committee might find of value.
Mr. ROBERTS. Without objection that will be included in the record. (The material referred to follows:)
THE ACCIDENT PROBLEM IN BRIEF
93, 806 Persons injured annually -
45, 000, 000 Persons bed disabled by injury
10, 227,000 Persons receiving medical care for injuries.
37, 671, 000 Persons hospitalized by injuries
1, 979, 000 Days of restricted activity
459, 963, 000 Days of bed disability-
113, 539, 000 Days of work loss.
83, 773, 000 Days of school loss..
11, 894, 000 Number of emergency room visits
10, 000, 000 Number of hospital bed days.-
20, 000, 000 Hospital beds required for treatment..
50, 000 Hospital personnel required for treatment
68,000 Annual cost of accidents.
$14, 500, 000, 000
EXTENT OF THE PROBLEM
Today accidents are the leading cause of death between ages 1 and 35. In this age span, far more people die from accidents each year than from any of the other leading causes, such as heart disease, cancer, or influenza and pneumonia.
There are about 90,000 accidental deaths each year. Almost 75 percent of these deaths are from one of the four leading types of accidents: Motor vehicle accidents cause about 40 percent; falls cause about 20 percent; fire and explosion cause about 7 percent; drowning causes about 5 percent.
Approximately 3 million man-years of life are lost each year because of accidental deaths. Nonfatal injuries
About 45 million persons (more than 1 person in 4) are injured annually according to the U.S. National Health Survey.
Of those injured each year about 19 million are injured in and about the home. Motor vehicles injure 4 million, and 8 million are injured while at work.
Of those who are injured, about 37 million receive medical care and 10 million are bed disabled. Disability
Annual losses resulting from injury include about 400 million days of restricted activity and about 100 million days of bed disability. Costs
The National Safety Council estimates that accidents cost $13.6 billion in 1960. Of_this total, $8.1 billion was attributable to injuries resulting from accidents.
Persons injured by accidents impose a heavy burden on our hospital facilities. The number of emergency room visits is estimated at 10 million and about 1.7 million persons are hospitalized for treatment of injury each year. Each year accidents result in about 16.5 million hospital bed-days and require the equivalent of about 50,000 hospital beds and 68,000 full-time personnel.