sou · GRB3127d1 · 2004-01-01 00:00:00 — Data on different characteristics of environments, such as distance to schools and play and recreation areas, traffic volume on roads, the design of school and pre-school environments, the condition of playgrounds and play equipment etc., also enhance our understanding of the risks and development opportunities associated with these environments. Continuous surveillance of injuries can help to identify different types of risks and the causes of injuries, and offer a picture of how injuries are distributed in the population, providing a basis for health promotion and injury prevention activities. This chapter gives a brief account of recurring national data collection programmes which provide a knowledge base for the task of ensuring the right of children and young people to safe environments which promote their development. The Commission considers it important to strengthen the detailed, sample-based component of the existing national hospital discharge register. We propose that the current arrangement, whereby in-depth data on injuries are collected from a sample of hospitals representing just under 6 per cent of population, should be expanded to cover some 15 per cent of the population. The sample-based part of the system includes information on where, how and when injuries have occurred and on their causes. detailed information about the background factors behind events leading to deaths and personal injuries provides a better basis for effective injury prevention efforts. Such a system also gives us an improved understanding of the causes of childhood and youth injuries. The Child Safety Commission underlines the importance of a long-term financial solution to safeguard the system that has been developed and to permit further development of what is a powerful tool for effective injury prevention. The information contained in this part of the hospital discharge register sheds light on the external causes of injuries and provides a clearer link with injury prevention measures and the agencies and organizations responsible for them. We propose that a national reference group be set up to support the development of the national information system. It should include members with a special brief to ensure that the quality of data on childrens and young peoples injuries is improved. The Commission regards it as essential to make full use of, collate and regularly publish the information provided by certificates of cause of death, and we propose that arrangements to do this should be established. This will provide a fuller picture of the sequences of events leading to deaths among children and young people, and could among other things identify where responsibility for preventive action lies. Not enough is known at present about the nature and extent of childrens movements and the environments in which they take place – for example, where children play and how they move from place to place. Information on these subjects is something children themselves can supply us with. Equally, only youngsters themselves can tell us whether or not they feel secure. This sense of security is important for both the safety and the development of a child, and can be linked to the different environments involved: the road traffic environment, the school environment etc. As provided in legislation and national goal and framework documents, the various sectoral authorities are responsible for producing knowledge in their respective fields, inter alia by means of monitoring. Since documents of these kinds make reference to the right of children and young people to environments conducive to their development, national responsibility for this area is not clearly assigned to any specific body. This means that there is no national driving force for monitoring and systematic development relating to these issues. Several of the proposals advanced in this report will therefore require questions concerning the right of children and young people to development-friendly environments to be incorporated in legislation and national goal and framework documents, in order to create incentives to develop monitoring. Chapter 7 In the home To a large extent, child safety efforts in have focused on young children and on measures in the home, an approach that has in fact reduced the number of injuries occurring in the domestic environment. There are many successful examples of modifications to this environment or to products found there, aimed at reducing incidents in which children are injured at home; these include window stops, childproof medicine containers and childproof electric sockets. Among younger children, the majority of injuries occur in the home and in residential areas. Different types of falls are the commonest cause of domestic injuries. Injuries resulting from scalding and poisoning are common among young children, as are crushing and cutting injuries up to the age of 6. Damage to teeth has also been observed to be a frequently occurring type of injury, especially in the younger age groups. The home environment poses different types of injury risk for a child, and these risks change as the child grows and develops. For the parent, it can be difficult to discover the dangers in time. Credible and accessible information for parents is therefore an important injury prevention measure. Since there will always be newcomers to parenthood, such information has to be provided on a continuous basis. The regulations of , and Planning include safety standards that apply to new and to alterations to existing ones. To what extent these regulations are adhered to, however, is unclear. If a is altered, it is the owners responsibility to ensure that the work complies with the child safety standards in force when the alterations are carried out. Despite this, new windows without stops or other safety devices are still fitted in homes, and new cookers are installed without their anti-tipping devices being secured. We therefore propose that , and Planning should conduct a review of compliance with safety standards. Most of the existing child safety standards for new were incorporated into the legislation in 1973, and those for alterations in 1976. constructed before 1973 or altered before 1976 usually lack the protection against injuries that is now included in new and altered . This means, for one thing, that much of the housing built as part of the million homes programme (1964–75) is not covered by the child safety standards laid down in , and Plannings regulations. has expertise regarding the different child safety devices and other measures that can be installed and introduced to improve safety in the home. We therefore propose that , and Planning should be given the task of producing and disseminating information on ways of enhancing child safety in older . The principal role of the () is to provide information about risks and symptoms and to give advice on treatment in the event of acute poisoning incidents, both to the general public and to practitioners. than half the enquiries the Centre receives relate to children under the age of 10. Often, the children concerned have drunk chemical products or ingested medicines by mistake, and such incidents mainly occur in the home. At present, information on the composition of chemical products is supplied to voluntary basis. We propose that all companies manufacturing and/or selling chemical products which could entail a risk of poisoning should be required to supply the with data on the chemical composition of those products. Children and young people constantly come into contact with products which in one way or another can pose a risk of injury. Globally, the range of products available is enormous, and increasingly free movement of goods and services within the EU, where producers themselves are responsible for product safety, means that the question of the safety of products to consumers needs to be carefully monitored. The aim of making products safe is being pursued through work on various product directives at level and through standardization on both a national and an international basis. Existing rules in this field need to be continuously reviewed and improved, since new products are constantly appearing on the market. Chapter 9 Pre-schools, after-school centres, pre-school and schools Children today spend the largest part of their everyday lives at pre- school, at an after-school centre, in a pre-school class or at school. The outdoor environments in the immediate vicinity of pre-schools and schools are therefore very important for their development and health. To raise standards in terms of secure, safe and stimulating outdoor environments, we propose that the Education Act should be supplemented to include a requirement that both and outdoor school environments are suited to their purpose. For pre-school children, outdoor spaces are an important developmental environment. It has been drawn to our attention that staffing cuts at pre-schools have reduced the scope for visits to parks and other green spaces, at the same time as the pre-schools own outdoor environments have not been developed so as to offer corresponding amenities. We therefore propose that, as part of its inspection of local authorities, the for Education should be asked to review the way in which authorities are discharging their responsibilities for the outdoor environments of pre-schools. for School Improvement, too, should be an important driving force and source of inspiration when it comes to developing the outdoor environments of pre-schools and schools. We therefore propose that this Agency should give priority to the outdoor environment of pre-schools in its development work. The Pre-School Curriculum (Lpfö 98), as currently worded, supports the view that the outdoor environment of pre-schools falls within the remit of both national education agencies, and it is our opinion that a more proactive approach to this question is called for. In 1990 the application of parts of the Work Environment Act was extended to include individuals undergoing education, and since 1998 these rules have also applied to children in pre-school (aged 6–7). The Act applies on school premises during school hours, and covers some 1.5 million children and young people. The Commissions view is that the Work Environment Act and the systematic working environment programmes which it requires could be a valuable means of improving the overall environment of child day care and school education. Several surveys suggest that compliance with the Act in schools is very poor as far as pupils are concerned. Studies show that many pupils sustain injuries in the school environment. According to the data emerging from these studies, the number of children and young people injured at school (between 19 and 30 pupils per 1,000) is higher than the number of adults who, according to the Swedish Work Environment Authority, are injured at work (roughly 6 to 8 workplace accidents per 1,000). Younger pupils are mostly injured during breaks and older ones during physical education lessons. boys than girls are injured. Most of the injuries occur outdoors. Body contact (unintentional or intentional), e.g. collisions, hitting, pushing or kicking, accounts for some 30 per cent of all injuries to pupils. The Commission is of the opinion that a review of the entire Work Environment Act from the standpoint of the pupil should be commenced immediately, also taking into account children at pre- schools and after-school centres. Pending the outcome of such a review, the Commission is presenting several proposals aimed at improving the working environment of pre-schools, after-school centres, pre-school and schools. We consider it very important to give pupils the opportunity to influence and assume responsibility for their own working environment at school by involving them in work environment issues. Schools should make use of the resource which their knowledge and participation represent. In addition, working environment activities in schools provide a preparation for the world of employment. School students do not have the same opportunities as employees representatives to influence the environment in which they work, and need extra support in this context. We therefore propose that supervision by the Work Environment Authority of the working environment of pupils in schools should be developed and improved. It is our view that more effective supervision will improve compliance with the relevant legislation and thereby reduce the number of pupil injuries resulting from accidents. From our contacts with their organizations, it emerges that pupils are often unaware of their right to appoint their own safety representatives. In a report entitled Pupil involvement in schools work environment activities through pupil safety representatives, the for Education proposes, among other things, that head teachers should be required to inform pupils of their right to elect such representatives, and that the Work Environment Authority and the Agency for Education should together draw up guidelines on what training for pupil safety representatives should include and who should be responsible for it. The Commission welcomes and supports these measures to improve pupil participation in working environment activities. We assume that the proposals of the for Education will be implemented. The Child Safety Commission feels that the position of pupil safety representatives on schools safety committees needs to be strengthened. To give these representatives a greater say and more scope to influence the working environment of their schools, we propose that they should also have the right to present proposals and to vote at safety committee meetings. We propose that working environment training should be included in the new state education programme for school heads, so as to improve the school working environment of both pupils and staff. We also propose that the provisions of the Work Environment Act should apply to children at pre-schools and after- school centres. From the vantage point of the child, pre-school, after-school centre, pre-school class and school form a coherent whole and constitute the environment in which they spend the greater part of their everyday lives. Children at pre-schools and after-school centres have the same need of a good working environment as older children and adults. We propose that children from pre-school up to year 6 should be given the right to appoint pupil safety representatives. We propose that the Work Environment Authority, in consultation with the for Education, should be asked to deliberate on appropriate arrangements for reporting of schools work environment activities, and that the general provisions chapter of the new Education Act should include a making it clear that the Work Environment Act and its provisions apply to the school system as a whole. The Commission takes the view that, to achieve an effective injury prevention programme, injuries occurring in schools need to be continuously reported and recorded at a national level. We propose that the Work Environment Authority should collect, analyse and publish data on injuries occurring in pre-school and schools in the same as it does for occupational injuries in general. Chapter 10 The working environment of minors Although the working conditions of minors are carefully regulated, serious injuries and deaths nevertheless occur every year in conjunction with the employment of young people. The Child Safety Commission considers the existing legislation on the working environment of minors to be adequate. We propose that the information given to those responsible for the working conditions of young people should be broadened and improved, so as to reduce occupational injury rates among this group. It is also important to ensure that workplace injuries affecting minors are reported, so as to improve the basic data for injury prevention efforts. The social partners, responsible authorities and schools must work together to disseminate information about the working conditions of minors to employers, children and young people and their parents. Chapter 11 The road traffic environment Injuries on the roads are the principal cause of death among children and young people. Road traffic affects young peoples lives in many ways. It opens up greater opportunities in terms of mobility, but may also be an obstacle to children wishing to discover and explore their immediate surroundings. The Government has emphasized that the needs of children, especially in terms of access, traffic safety and a good environment, should guide the way the transport system is designed and operates. The Commissions proposals are above all intended to enhance the safety and independent mobility of all children and young people. They should not, though, be seen as a substitute for other measures designed to promote alternative modes of transport. It is important for example, in line with government objectives in the areas of transport and environment policy, to develop public transport at the local and regional levels. Particular attention should be paid to transport for young people in the evenings and at weekends, a factor that could also help to reduce the occurrence of drink-driving. In several countries, injuries to child pedestrians have decreased, despite an increase in traffic. To establish whether this is because conditions for children have become safer or because they are spending less and less time in traffic, we need to know the nature and extent of childrens and young peoples movements in the road traffic environment. We therefore propose that the should be given the task of further developing studies of childrens/young peoples exposure to road traffic. These days, vulnerable road users and vehicular traffic are increasingly having to share the space available on roads and streets. In our opinion, this trend could have consequences for the safety and mobility of children and young people. To avoid any adverse impacts for the young generation, we propose that the and , and Planning, in consultation with the Authorities, should develop criteria to ensure the safety and development of children and young people in road and street environments with mixed traffic. Many local authorities have achieved a great deal in terms of promoting safe environments for pedestrians and cyclists in built- up areas. On the state road network, on the other hand, pedestrian and cycle traffic has not been given the same priority. We therefore propose that the should be charged with developing the pedestrian and cycling infrastructure along state roads, to make it safer for children to to school. School transport services are provided by local authorities to ensure that children who live a long way from school are also able to attend. In many cases, therefore, they offer a safer means of transport than if the children were to walk or cycle on their own. However, certain problems with these services have emerged in recent years. The Commission consequently wishes to draw attention to three areas in which improvements need to be made. Reporting of incidents and injuries in conjunction with the use of school transport services must be improved, and we therefore propose that the should examine ways of including data on such occurrences in its system for recording road traffic injuries. When local authorities award school transport contracts, they have an opportunity to improve both safety and security by laying down requirements concerning contractors, vehicles and drivers (e.g. a requirement that alcohol ignition interlock devices be fitted). We propose that the , in consultation with the Authorities, should prepare national advice and guidelines concerning the road safety requirements to be imposed when purchasing school transport services. The transport situation for children with disabilities is not satisfactory at present, and the guidelines should take particular account of this. Several groups are affected by school transport services, and closer dialogue among them would make for a better understanding of their respective situations, as well as making it easier to deal with problems that arise. We propose that the , in consultation with the Association of and the for Education, should develop methods for consultation between children, drivers, schools, local authorities and parents, with a view to improving the safety of school transport services. Bicycles are an important mode of transport for children and young people, and they have a right to the independent mobility which being able to cycle to school and to recreational activities entails. This is touched on in several national and international documents. The extent to which children will actually be allowed to cycle on their own and young people will be able to make use of the mobility afforded by the bicycle depends above all on their having access to a safe network of cycle tracks, linking places that are important to them, such as schools, sports facilities, central shopping streets and market places. A good cycling infrastructure is therefore crucial, and we propose that , and Planning and the , in close consultation with the Association of , should develop models that will enable a good infrastructure of safe cycleways to be created. Head injuries account for a significant proportion of serious cycling-related injuries. This is also true of children and young people. In the framework of the National Coalition for Road Safety, launched by the , a rule requiring children to wear cycle has been discussed. However, we propose that the Government should include a provision in the Road Traffic Ordinance requiring all cyclists to wear . The arguments in favour of this proposal are that use of seems to increase among children and young people, too, when there is a law that applies to everyone; that adults attitudes and behaviour are a major influence on children; that cycle should be linked to cycling, not to age; and that the obligation to wear a can easily be perceived as a right to stop wearing one when a young person is no longer covered by the requirement. emphasized that, whatever age limit were to be chosen, those still required to wear a would find it more difficult to do so when their older friends no longer had to. Last but not least, the stressed that children and young people need their parents and that they, too, are affected if adults close to them are injured or killed. Increased use of cycle could be a step in the direction of narrowing social differences in injury rates among children. International experience shows that increased use has a bigger impact in terms of reducing injury rates in low-income areas than in high-income neighbourhoods. This is why it is important to make as widely available as possible. In this regard, price is a significant factor. We propose that the should develop a system to subsidize cycle for a limited period, as a complement to the information and education campaign which it intends to launch to coincide with cycle becoming compulsory. The moped has seen a new rise in popularity in and, as well as increasing young peoples mobility and independence, this means that youngsters are beginning their careers as motorized road users on a vehicle which, apart from the they are required to wear, leaves them completely unprotected. This creates a significant risk of serious injury. The minimum age for moped riders in is currently 15. Riders of Class I mopeds must hold a licence, which they can obtain after passing a theory and a practical test. Similar training for Class II (low-performance) mopeds would prepare young people better for their motor vehicle debut in the complex system which road traffic represents.