Global Threats From Preventable Injuries

Abstract

Preventable injuries kill thousands of the world’s population every day and injure millions each year. Road traffic crashes and opioid drug misuse are major causes of these injuries. Increased efforts are needed to promote strong policies, develop new prevention strategies, and protect workers from these global public health threats.

Workers represent half the world’s population and are vital to economic and social development, yet thousands die each day from preventable injuries. Globally, an estimated 350,000 fatal occupational injuries occur annually from exposure to occupational hazards (National Institute for Occupational Safety and Health, 2011). Other risk factors, lack of seat belt or motorcycle helmet use, unsafe consumer products, drug and alcohol misuse, and unsafe home and community environments, also contribute to unintentional injuries, the fourth leading cause of death in the United States (National Center for Injury Prevention and Control, 2016). Nearly 5 million individuals worldwide died from injuries in 2015, with 1.3 million deaths (27%) due to road traffic injuries (World Health Organization [WHO], 2017). The majority (59%) of traffic deaths occur between ages 15 and 44, a prime age for working adults (WHO, 2015). Traffic fatalities are the leading cause of death among individuals under age 29 years and are now the 10th leading cause of global deaths (WHO, 2017). Millions more, some estimated as high as 50 million, are injured each year in roadway traffic incidents (WHO, 2015).

Another rapidly growing preventable hazard among working-age adults is prescription opioid misuse. Drug overdose is the leading cause of fatal injuries in the United States. In 2015, 52,404 lethal drug overdoses were reported; overdose deaths increased by 5,349 cases (11.4%) from 2014 to 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths from prescription pain relievers in 2015 (Rudd, Seth, David, & Scholl, 2016). Opioid products (e.g., morphine, codeine, methadone, oxycodone, and hydrocodone) contribute to nearly half of these overdose deaths and an estimated 1,000 emergency department visits daily in the United States (Centers for Disease Control and Prevention, 2017). Worldwide, prescription opioid use has also markedly increased. An estimated 15 million individuals are opioid dependent; worldwide, about 69,000 opioid users die annually from overdose (WHO, 2014). Prescription opioid abusers also commonly misuse illicit opioids, including heroin (Rudd et al., 2016).

Widespread implementation of strategies to prevent fatal roadway crashes and opioid prescription overdoses is crucial to protect worker populations. In addition to educating workers, families, and communities about these hazards, occupational health nurses can provide worksite campaigns to promote vehicle restraint and motorcycle helmet use; avoid driving when distracted, impaired, or sleep deprived; and stop opioid prescription misuse. Worksite programs on anger management, stress reduction, and alternative pain management could discourage erratic driving or excessive speeding while angry or stressed and decrease reliance on opioids to reduce or eliminate fatal outcomes. Legislation promoting stronger roadway traffic laws and enforcement, along with increased funding for public safety, mental health interventions, and drug rehabilitation programs, is needed universally. Supporting increased availability of naloxone and training in its use for individuals likely to witness opioid overdose could reduce fatal overdoses, as could advocating to improve prescription opioid dependence treatment options, reduce inappropriate opioid prescribing, and promote nonopioid pain management (WHO, 2014). Occupational health nurses in international settings can lead efforts to reduce hazard exposure, particularly among vulnerable populations. Collaboration among nurses, physicians, employers, health systems, and governments is needed to promote strong policies, develop new prevention strategies, and protect workers from these global public health threats.