National Injury Prevention Day

Set to take place on July 5^th, 2022, National Injury Prevention Day aims to raise awareness on the impacts of unintentional injuries that are often preventable and predictable. The purpose of this day is to inform the public on how to avoid such injuries.

Consider that as of 2015, the greatest cause of death in Canadians aged 1 to 34 was unintentional injuries. Unintentional injuries include events such as falls, motor vehicle accidents, and poisonings which can occur at home, at work, or during sporting events. These injuries can occur due to environmental, physical, cognitive and sensory factors. It should be noted that poisonings do not include complications which can take place during surgery or medical care.

Unintentional injuries can lead to deaths which could have been prevented, serious injuries, and economic costs. The cost? As of 2018, the cost of unintentional injuries to the Canadian Health Care system was about $20.4 billion according to the Government of Canada (2022).

Injury prevention includes reducing one’s risk of severe injury caused by external factors. For example, injuries can occur due to car accidents and work-related accidents (external factors). Occupational therapists (OTs) are well-equipped to assist individuals in preventing unintentional injuries and experts for dealing with injury prevention in the home, community and during sporting events, if needed. Let’s consider some ways to prevent unintentional injuries below.

Falls are the leading cause of unintentional injuries within the home in people of all ages. As OTs, we perform home assessments which allow us to see individuals within their natural home environment. During home assessments, we analyze the person’s personal, occupational and environmental factors to detect where there may be a discrepancy in fit between the individual and their household. This thorough investigation provides us with an overview of what adaptations or modifications may be necessary to prevent a fall in the home, community or workplace. Falls prevention could involve all of the following:

• Adding modifications to the environment to suit the individual and to increase their safety, such as in the home. This could include removing rugs and slippery furniture, increasing lighting within the home or in-front of the home, decluttering the home environment and/or floors, putting in secure non-slip rugs, installing hand rails/ and grab bars where appropriate, installing bed assist rails, recommending bedside commodes to use at night, and more.
• Assessing the individual’s fear of falls and providing recommendations.
• Assessing the individual’s sensory status (assessing for their vision and visual impairments, hearing difficulties, lack of touch and sensation, etc).
• Assessing the individual’s cognitive status (assessing for memory, concentration, attention and more. All of which are imperative to navigate the home safely).
• Assessing the individual’s physical status to determine whether they can navigate within their home safely. OTs consider the following question: Is the individual at risk for falls due to a lowered activity tolerance or weakness?
• Recommending non-slip and appropriate footwear to prevent falls.
• Recommending an exercise program to complete at home to increase activity tolerance.
• Recommending a medical alert necklace for individuals to use if they do fall. This will assure that the individual can get immediate help, when needed.

Falls are important to prevent as they can lead to further difficulties and injuries which disable one’s ability to engage in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Tripping hazards are important to consider to prevent falls. Please see the following list to get an idea of common tripping hazards in the home or workplace:

• Cluttered environment/floors/desks/counters.
• Poor lighting.
• Floors that present with uneven surfaces or with carpets that are not slip-proof.
• Poor view of the clutter due to lack of sufficient eyewear.
• Lack of handrail use when mobilizing the stairs or no handrails within the home.
• Tools that are loose.
• Uneven steps.
• Loose rugs.
• Extension cords.
• Damaged flooring.
• Wet floors.
• Not using handrails when mobilizing the stairs.
• Not wearing appropriate footwear when mobilizing or ascending/descending the stairs.

(Leland et al., 2012; Tajudin, 2021’ Kilbourne, 2009; Ballinger & Brooks, 2013; Safety Company of Canada, 2020).

It’s important to recognize tripping hazards as they are often difficult to see or we may not pay attention to them. Tripping hazards are important to consider as they can lead to musculoskeletal injuries, fractures, sprain and strain injuries, bruising, trips, and falls. Being aware of them is the first step to injury prevention. Education can assist us to avoid trips, slips and/or falls.

The following are suggestions on how to avoid tripping hazards in the home and workplace:

• Good housekeeping, that is, declutter the environment regularly.
• Use containers such as garbage or recycling bins to organize unwanted items. Place a few throughout the home or workplace.
• Assure that your home or workplace is clean prior to and after finishing a task.
• Keep materials stacked in a manner that prevents slips, trips and/or falls (like extension cords and other tripping hazards).
• Organize hoses and electrical outlets.
• Increase lighting in the home or workplace.
• Place handrails where possible (along stairwells).
• Wear appropriate footwear.
• Clean the floors if there are spills or cluttering.
• Don’t place items on stairs.
• Report slipping hazards if you notice any in the workplace.
• Speak with your employer regarding tripping hazards in the workplace to remain aware and educated.
• Place tripping hazard signs such as the following in the workplace, if possible:

(Leland et al., 2012; Tajuddin, 2021; Ballinger & Brooks, 2013).

The workplace often has numerous hazards that can be prevented to avoid unintentional injuries. In 2013, it was found that every 15 seconds a work-related accident occurred (Abdalla et al., 2017). These can be avoided by remaining educated on what common workplace injuries occur and how to avoid them.

Common workplace injuries and how they occur can be seen in the chart below:

Common workplace injury	How does it occur	How to avoid this injury
Repetitive strain injury	Often occurs due to “repetitive use, vibrations, compression or long periods in a fixed position.” These injuries often occur due to repeated strain over prolonged periods of time, that is, without breaks. (Howell, 2020).	Take frequent breaks and stretch often. Use ergonomic equipment as much as possible. For example: wireless keyboards and mice, standing desks, etc. to create a safe workplace environment.
Loud noise exposure	Can lead to deafness or worsened hearing.	Avoid exposure to loud workplaces, and use safety equipment for ear protection.  Assure annual inspections occur at your company to assure you have the most up-to-date safety equipment.
Back injuries	Most frequent type of injury individuals can get while working. Could happen due to overexertion and poor posture.	Receive education on proper body mechanics, lifting techniques, lifting devices, proper posture, and how to organize your workplace. Consider stretching and taking frequent breaks as well as using the most appropriate work equipment for your workplace.
Car crashes	Could be due to looking the wrong way, another car may move into your lane; many possibilities of how it can occur.	Employees should be educated on all safety precautions to ensure they feel safe at work. For example, they should be educated on use of seat belts, traffic, avoiding drinking and driving, and more.

Further, always take action to protect your psychosocial health. Psychosocial health can be impacted by work-related stress or the environment. It can include the following:

• Increasing work demands
• Ongoing deadlines and increasing pressure from management
• Unclear designation of your work role
• Isolation at work
• Poor managerial support
• Job insecurity
• Burn-out

If you experience one or more of the above, consider speaking with your supervisor and expressing your concerns or seek to speak with a guidance counsellor who can provide further direction on how to address your concerns. Burn-out is very serious and should not be left unaddressed.

(Edet, 2021; Abdalla et al., 2017)

Back and workplace injuries are common. As of 2009, researchers have found that lower back pain has significantly increased over the last 14 years (Freburger et al., 2009). This is especially important as more and more people are beginning to work from home. Back injuries are possible when working from home on a desk monitor, when gardening, when working and lifting heavy boxes, when working around the home and more. Back injuries are often preventable when proper body mechanic principles are applied.

Proper body mechanics involve placing the body in a state of alignment wherein an individual achieves the most optimal state of balance and ability to perform movement. When the body is aligned and the proper body mechanics are applied, individuals can decrease their risk of sprain and strain, and back injuries.

As occupational therapists, we can provide education on body mechanics including the following:

• Move in the direction of the movement, avoid twisting motions at the level of the spine during movement.
• Try working at waist level and avoid bending at the waist.
• Bend at the hips and knees thereby allowing your legs to do more of the heavy lifting rather than your back.
• Push items rather than pulling them to avoid expending more energy and to prevent injury.
• Use assistive devices, whenever possible. Occupational therapists can recommend assistive devices for you, when appropriate.
• OTs can prescribe a body mechanics program to be implemented in the workplace.
• Keep objects close to your core to maintain your center of gravity. For example, if carrying heavy items, consider keeping the item as close to your core as possible as seen in the following diagram:

(Owens, 2000).

For those working at home, consider the following:

• Consider obtaining a wireless mouse and keyboard to assist with ergonomics and prevent repetitive strain injuries as well as to avoid leaning toward the screen while typing.
• Keep your feet flat on the ground or use a footrest.
• Support your mid to lower back either with an ergonomically friendly chair or lumbar support.
• Assure your forearms are supported while typing.
• Try keeping your elbows, hip and knees at 90 degrees each.
• Try keeping your monitor at eye level.
• Declutter your work desk, if possible.
• Try keeping your monitor at about arm’s length distance from you (~46-60 cm).
• Take frequent breaks and stretch often.
• Look away from the screen and try focusing your gaze on a far object.

Step 1: Educate yourself.

Step 2: Share your story or read the story of other individuals involved in these types of injuries.

Step 3: Use the hashtags #ParachuteNIPD or #TurnSafetyOn on any social media pages including Twitter, Facebook, Instagram, and TikTok to raise awareness.

Stay safe and educated!

Abdalla, S., Apramian, S. S., Cantley, L. F., Collen, M. R. (2017). Injury prevention and environmental health, 3^rd edition. Mock CN, Nugent R, Kobusingye O, et al., editors. Washington (DC). doi: 10.1596/978-1-4648-0522-6_ch6

Ballinger, C., & Brooks, C. (2013, May). An overview of best practice for falls prevention from an occupational therapy perspective. The Health Foundation. http://patientsafety.health.org.uk/sites/default/files/resources/an_overview_of_best_practice_for_falls_prevention_from_an_occupational_therapy_perspective_0.pdf

Doyle, G. R., McCutcheon, J. A. (2015). Clinical procedures for safer patient care. BCcampus. https://opentextbc.ca/clinicalskills/

Edet, U. (2021). 13 Most common workplace injuries you must prevent. HSEWATCH, Your health and safety encyclopedia. https://hsewatch.com/workplace-injuries

Freburger, J. K., Holmes, G. M., Agans, R. P., Jackman, A. M., Darter, J. d., Wallace, A. S., Castel, L. D., Kalsbeek, W. D., Carey, T. S. (2009). The rising prevalence of chronic low back pain. JAMA Internal Medicine, 169(3), 251-258.

Government of Canada (2022, June). Injury and poisoning deaths in Canada. https://www.canada.ca/en/public-health/services/injury-prevention/facts-on-injury.html

Howell, D. R. (2020). 7 Most common workplace injuries. Organisational Psychology. https://www.psychreg.org/most-common-workplace-injuries/

Kilbourne, C. (2009). Trip hazards Do’s and Don’t’s. EHS Daily Advisor. https://ehsdailyadvisor.blr.com/2009/03/trip-hazards-do-s-and-don-ts/

Leland, N. E., Elliott, S. J., O’Malley, L., & Murphy, S. L. (2012, March). Occupational Therapy in Fall Prevention: Current Evidence and Future Directions. American Journal of Occupational Therapy March/April 2012, 66, 149-160. doi:10.5014/ajot.2012.

Owes, B. D. (2000). Preventing injuries using an ergonomic approach. AORN Journal, 72(6), 10316.10.1016/s0001-2092(06)61908-x.

Tajuddin, A. (2021). What is a trip hazard and how do you prevent them? Safety Rules are Your Best Tools. https://www.safetynotes.net/trip-hazards-and-control-measures/

(n.d.). Home Safety and Accessibility Assessments American Occupational Therapy Association. https://www.aota.org/Practice/Productive-Aging/Home-Mods/Rebuilding-Together/assessments.aspx

 (2010, July). Improve Public Policy Response and Medicare Coverage for Fall Prevention and Intervention. American Occupational Therapy Association. https://www.aota.org/-/media/Corporate/Files/Practice/Aging/Resources/Focus-On-Falls-Prevention-Home-Mod-Booklet.pdf

(n.d.). In-Home Occupational Performance Evaluation (I-HOPE) Kit. Washington University School of Medicine in St. Louis, Program in Occupational Therapy. https://starklab.wustl.edu/i-hope-kit/#order

(2020). 5 Common tripping hazards in the workplaces. Safety Company. https://www.safetycompany.com/safetyblog/5-common-tripping-hazards-in-the-workplaces/