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ACCIDENTS
AND THE HEALTH OF PRIMARY SCHOOL PUPILS
CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND TO THE STUDY
Accidents
are commonly regarded as intrinsically different from causal sequences that
lead to disease and to any other event. As a result accident remains the only
major source of morbidity and mortality which many continue to view in
extra-rational terms such as ‘luck’, ‘chance’ and ‘act of God’. If accidents
are of such unique nature that its causation defies human understanding,
control and prediction, it might be argued that it should be analysed not only
by scientists and theologians and philosophers but by astrologers and
soothsayers as well. On the other hand, if the causation of accidents does not
differ substantially from other events, it is important that it should be
subjected to rigorous and sophisticated scientific methodology. In fact, accident
research is a branch of study that has evolved out of such lack of conceptual
clarity (Anderson, 2005).
An accident
is a happening that is not intended, foreseen or expected that can cause an
injury and sometimes death. Accidents sometimes result from negligence.
Accidents and injuries are common, especially among young children aged 1 – 4
years of age. Accidents are happening that are usually unintended and
unforeseen. It is therefore important that you, the health workers, are aware
of these possible unpleasant and unintended happenings and should play a big
role first in the prevention and secondly in their management. We shall discuss
both accidental and Non-accidental injuries. Accidents are a major cause of
death and disability. About 14,000 people die in the UK, most of them in
England and more than 700,000 will be seriously injured in England alone. They
cost the UK an estimated £150 billion every year. For children and young
people, accidents are the greatest threat to life (UNICEF, 2008).
A review of
literature of accident research reveals that inadequately trained professionals
whose nature of work made them deal with accident phenomenon largely
contributed in the early period of accident research (Anderson, 2005; Boden,
2014). Consequent to this ‘much of the accident research and theorisation are
based on primitive rather than sophisticated methodology. Gradually, terms like
chance, luck or act of God failed to find any mention in the accident
literature and safety professionals proposed various theories and models of
accident causation.
However,
according to Robertson (2015), an accident is an undesirable incidental and
unplanned event that could have been prevented had circumstances leading to the
accident been recognized, and acted upon, prior to its occurrence. Most
scientists who study unintentional injury avoid using the term “accident” and
focus on factors that increase risk of severe injury and that reduce injury
incidence and severity. Primary school people are most times exposed to road
traffic accidents, school accidents, and home accidents. It is on record that
every year more than 67,000 children experience an accident in the kitchen and
43,000 of these are aged under four. (Merrill, 2013).
There are
basically two classifications of accident – physical and non-physical examples.
Physical examples of accidents include unintended motor vehicle collisions or
falls, being injured by touching something sharp, hot, electrical or ingesting
poison. Non-physical examples are unintentionally revealing a secret or
otherwise saying something incorrectly, forgetting an appointment, etc.
According to the International Labour Organization (ILO, 2014), more than 337
million accidents happen on the job each year, resulting, to occupational diseases,
in which more than 2.3 million deaths annually.
In contrast, leisure -related accidents are mainly sports injuries.
Predisposing
factors to the causation of accidents are of two types: Environmental factors
and Childhood factors. Environmental Factors are things in the child’s
environment at home and outdoor that may predispose or lead the child to get an
accident. For example; poorly arranged furniture in the house can make a child
fall and injure his or herself, unprotected cooking place can lead to child
burns. Fruit trees or ladders in homes may attract a child to climb and result
in a fall. Similarly pools of water outdoor including unfilled quarry with
accumulation of water may lead to drowning. A final example is the overcrowded
city slums are particularly bad environment for children. Childhood factors on
the order hand, are factors centred on the child. They include the normal
curiosity, exploration nature and imitation of a child, a child still learning
and has no experience that can land them into accidents. Boys are more
explorative and get into accidents more frequently than girls. But girls are
more affected by accidents in cooking place at home than boys. Abnormal factors
in a child that can lead into accidents include: a child with epilepsy, a child
with a handicap (Royal Society for the Prevention of Accidents, 2012).
The
prevention of childhood accidents is identified as one of the key indicators in
the 2013-2016 Public Health Outcomes Framework. Three published guidance
documents from the National Institute for Health and Care Excellence (NICE)
outline recommendations for all those with a strategic role to play in injury
prevention, including clinical commissioning groups (CCGs), local authorities
and their partners (Kendrick , Hayes &
Ward, 2012). Unlike safeguarding, there is currently no requirement for primary
healthcare teams to undergo training in unintentional injury prevention. This
is an important recommendation of the NICE guidance (NICE, 2010).
The
following are some of the concepts in accident prevention:
Primary
prevention: removal of circumstances causing injury – eg, traffic speed
reduction, fitting stair gates for young children, reducing alcohol
consumption.
Secondary
prevention: reduces severity of injury should an accident occur – eg, use child
safety car seats, bicycle helmets, smoke alarms.
Tertiary
prevention: optimal treatment and rehabilitation following injuries – e.g.
effective first aid, appropriate hospital care.
Clinical
roles for health professionals in accident prevention include advice to
patients: health workers are well placed to identify accident risks or medical
conditions conferring risk and to advise accordingly. Accidents are one of the
main causes of death among children aged 1-5 years. About 100,000 children are
admitted to hospital annually in the UK and 2 million attend emergency
departments. In a typical CCG with a population of 100,000, this equates to
approximately 3,300 emergency departments visits and 200 hospital admissions
for child injuries.
In terms of
numbers of people killed or injured, this is an important area for accident
prevention in Nigeria and worldwide. Although the figures are still high,
statistics for Great Britain suggest that the situation is gradually improving.
For the year ending June 2013:
1,730 people
were killed, a 3% drop from 1,785 in the previous year.
185,540
people were injured, 7% fewer than the previous year.
Total
reported child casualties (ages 0-15) fell by 12% to 15,920 for the year ending
June 2013 with those killed or seriously injured down 11% to 2,080.
Common
causes of these accidents included speeding, drink driving, not wearing seat
belts or careless driving. Around a third involved someone driving during their
work. About 10% of those killed were inexperienced drivers. Higher speed both
increases the risk of collision and the risk of serious injury to the driver or
others. Even a modest speed reduction helps reduce both the number and the
severity of accidents, e.g. pedestrians hit at speeds below 30 mph receive
mainly survivable injuries but this changes to mainly fatal injuries at speeds
of between about 30 mph and 40 mph (Royal Society for the Prevention of
Accidents, 2011).
Children
commonly drink poisonous substances or drugs left in their reach. The more
attractive colours of the substance or drug the more the risk of being taken
and ingested by the curious, explorative learning children. The effect of the
poisoning material depends upon the quantity drunk or ingested and the chemical
nature of substance or drug. And also to some extent the size or age of the
child, nutritional status and when the stomach is empty in a hungry child or a
child who has some food contents in his or her stomach. Large amounts are
dangerous, while an empty stomach allows easy absorption of the poison and a
stomach with food delays absorption of the poisonous substance or drugs
(UNICEF, 2008)
For health
workers, important points when advising on child accident prevention are:
Offer
practical advice, not just general education – e.g. advise about car seats or
home safety equipment.
Use an evidence-based
approach where possible and dispel myths – e.g. some parents wrongly believe
that cooker guards and baby walkers are safe.
Promoting
safety does not require overprotection (‘wrapping children in cotton wool’) –
this would delay development and increase the risk of obesity.
Promote
sensible precautions in line with the child’s level of development.
This work
will however investigate accidents and the health of primary school pupils in
Erei, Biase Local Government Area of Cross River State, Nigeria.
STATEMENT OF
THE PROBLEM
Accidents
constitute a major health challenge amongst primary school children. According
to World Health Organization (2016), every year the lives of approximately 1.25
million people are cut short as a result of road traffic crash. Between 20 and
50 million more people suffer non-fatal injuries, with many incurring a
disability as a result of their injury. Other statistics on road accident are
as follows: About 1.25 million people die each year as a result of road traffic
crashes; road traffic injuries are the leading cause of death among young
people, aged 15–29 years; 90% of the world’s fatalities on the roads occur in
low- and middle-income countries, even though these countries have
approximately half of the world’s vehicles; Half of those dying on the world’s
roads are “vulnerable road users”: pedestrians, cyclists and motorcyclists;
without action, road traffic crashes are predicted to rise to become the 7th
leading cause of death by 2030; the newly adopted 2030 Agenda for Sustainable
Development’s has set an ambitious road safety target of halving the global
number of deaths and injuries from road traffic crashes by 2020.
More than
90% of deaths that result from road traffic injuries occur in low- and
middle-income countries. Road traffic injury death rates are highest in the
low- and middle-income countries of the African region including Nigeria. Even
within high-income countries, people from lower socioeconomic backgrounds are
more likely to be involved in a road traffic crashes.
Over the
years, efforts have been directed by individuals, communities, government and
international bodies towards the prevention of accidents amongst primary school
pupils. There is no prove of the contrary that all effort put in place to
prevent accidents among school children is still not enough as cases of road,
school and home accidents still prevail among primary school pupils.
It therefore
becomes imperative to investigate deeply into the underlying causes of
accidents among school pupils in order to arrive at possible solutions to the
problem, thus this work on accidents and the health of primary school pupils in
Erei, Biase Local Government Area of Cross River State, Nigeria.
1.4 OBJECTIVES OF THE STUDY
The major
objective of the study is to examine accidents and the health of primary school
pupils in Erei, Biase Local Government Area of Cross River State, Nigeria. The
specific objectives of this study are:-
To examine
road traffic accident and the health of primary school pupils in Erei
To ascertain
school accident and the health of primary school pupils in Erei
To
investigate home accident and the health of primary school pupils in Erei
1.5 SIGNIFICANCE OF THE STUDY
Findings of
this study will be significant to the following group of people: Parents, mothers,
children, health and health related organizations, individuals, public and
private, school authority.
To parents,
findings of this study will create awareness and raise critical consciousness
of the people on the need to confront the occurrence of accidents among primary
school children.
To
individuals, especially primary school pupils, this work will provide proper
information and advice on how to prevent road, school and home accidents.
Above all,
to school authority, information gathered from the study will serve as a guide
on policy making and training of their pupils on the three major forms of
accidents and their prevention.
To other
researchers and scholars, this work will provide current information on
accident and the health of primary school children, thus serving as a reference
material.
1.6 RESEARCH QUESTIONS
To guide this study, the following
research questions were formulated:
To what
extent does road traffic accident affect the health of primary school pupils?
How does
school accident affect the health of primary school pupils?
To what
extent does home accident affect the health of primary school pupils?
1.7 DELIMITATION (SCOPE OF STUDY)
The study is
limited in scope to accidents and the health of primary school pupils in Erei,
Biase Local Government Area of Cross River State, Nigeria. It is also limited
to the three sub-variables adopted for this study thus:
Road traffic
accident and the health of primary school pupils in Erei
School
accident and the health of primary school pupils in Erei
Home
accident and the health of primary school pupils in Erei
1.8 LIMITATIONS
The
following factors posed limitations to the research study:
The
uncompromising attitude of some respondents in giving candid opinion set a
limitation to the research study.
The project
was self-sponsored and money was needed to type the questionnaire, travel to
the research area and meet other needs.
Another
constraint of the study was inadequate time allotted for the completion of the
research study. The researcher worked under the College time framework that was
not enough for a coherent research.
Difficulty
in reaching respondents residing in some sampled villages within Erei Community
was another challenge. The research had to cover some distance before getting
in contact with her respondents.
1.9 OPERATIONAL DEFINITION OF TERMS
HEALTH:
Health is a state of complete physical, mental and social well being of an
individual and not merely the absence of disease or infirmity (WHO)
SCHOOL
AUTHORITY: These are the board of management of a particular school who gives
guidelines of expected standards of behaviour, dressing, academics integrity
and attendance as well as consequences for violating those standards.
EFFECT: This
refers to a strong impression, result or impact of something.
ACCIDENTS:
happenings that are usually unintended and unforeseen.
ROAD TRAFFIC
ACCIDENT: Accidents occurring on the road.
SCHOOL
ACCIDENT: Accident involving school pupils while in school.
HOME
ACCIDENT: Accidents that takes place at home.
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