Page 106 - JSOM Winter 2017

An Ongoing Series

Tools to Assess and Reduce Injury Risk (Part 2)

Joseph J. Knapik, ScD

ABSTRACT
Research has shown that many injuries are preventable if the Several useful tools have been developed that can assist in as-
operational environment is understood. Useful tools are avail- sessing injury risk and in developing methods to reduce risk.
able to assist in assessing injury risks and in developing meth- The purpose of this article is to review these tools and provide
ods to reduce risks. This is part 2 of a two-part article that examples to illustrate how they can be used. Part 1 of this
discusses these tools, which include the Haddon Matrix, the series reviewed and provided examples of the Haddon Matrix,
2
10 Countermeasure Strategies, the Injury Prevention Process, and the 10 Countermeasure Strategies. Part 2 concludes this
and the US Army Risk Management Process. Part 1 covered series by reviewing and providing examples of the Injury Pre-
the Haddon Matrix and the 10 Countermeasure Strategies; vention Process and the US Army Risk Assessment Process.
part 2 outlines and provides examples of the Injury Preven-
tion Process and the US Army Risk Management Process. The Injury Prevention Process
Injury Prevention Process is largely oriented to systematic re-
search and involves (1) surveillance and survey to document Besides the Haddon Matrix and the 10 Countermeasure Strat-
2
the size of the injury problem, (2) identification of the causes egies, another way of assessing and controlling injuries is
3
of and risk factors for injuries, (3) intervention to identify simply called the Injury Prevention Process. It is another sys-
what works to prevent injuries, (4) program implementation tematic method involving the five steps shown in Table 1. It is
based on documented research, and (5) program evaluation to more technically involved in that it requires access to surveil-
see how well the program works in the operational environ- lance and research assets, as will be described.
ment. The US Army Risk Management Process involves (1)
identifying hazards, (2) assessing hazards, (3) developing con- Table 1 Key Steps in the Injury Prevention Process
trols for reducing hazards, (4) implementing controls, and (5) Steps Reasons and Actions
supervising and evaluating controls. There is overlap among Surveillance/ Document injury problem and size of the
the four approaches, but each has unique aspects that can be surveys problem
useful for thinking about and implementing injury prevention Research Identify causes and risk factors for injury
and control measures. Intervention Identify what prevents injuries and get
information to policy makers
Keywords: US Injury Control Process; US Army Risk Manage- Program
ment Process; injury prevention implementation Action based on research and intervention
Program Determine effectiveness of injury prevention
evaluation strategy in operational environment
Introduction
The first step in this process is to use surveillance, surveys,
In the past, injuries were often associated with “accidents” or studies to document the size of the injury problem. This is
that were viewed as random, unpredictable, and unavoidable important because injuries involving larger numbers of Sol-
events. When injuries did occur, they were often ascribed to in- diers or critical operations are more urgent to address than
dividual carelessness and the individual was told to pay more those involving fewer Soldiers or less critical operations. This
attention to what they were doing. However, research has is not to say that minor hazards or minor training injuries
shown that, to a large extent, injuries can be prevented by un- can be ignored, but the larger problems should be targeted
derstanding not only the individual but also the environment first for the largest impact on injury reduction. One readily
in which the individual is operating, and by assessing ways of available surveillance asset is the Defense Medical Epidemi-
changing that environment. 1 ological Database (DMED) developed by the Armed Forces

Address correspondence to joseph.j.knapik.ctr@mail.mil
MAJ (Ret) Knapik was a wheel vehicle mechanic, medic, Medical Service Corps officer, and DoD civilian with the military. He currently serves
as a senior epidemiologist/research physiologist with the Henry M. Jackson Foundation and as an adjunct professor at Uniformed Services Uni-
versity (Bethesda, MD) and Bond University (Robina, Australia).

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