Injury prevention and safety promotion in the local community - 20 years experience from Norway

Aim: A multifactorial injury prevention programme started in 1981 and ran for about 10 years in an island community in Norway with a population of about 1000. A study was undertaken to evaluate effects of the programme over a period of 20 years. Methods: Injuries were recorded by the one medical doctor on the island several years during the period 1970-2001. The programme was carried out with high intensity from 1981 to 1987. The intensity gradually decreased to a medium level that lasted until about 1994, when it was further reduced to a low level. Results: The injury incidence rate was reduced from 17.7% in 1980 (N=188) to 9.7% in 1987 (N=97) with relative risk reduced to 0.55 (95% CI: 0.44-0.70, pN=91). An even higher reduction was observed for serious injuries. The age groups 15-24 and 65+ showed the most distinct reductions from 1980-2001 while minor reduction was observed in children (0-14 years). The incidence rate of traffic injuries was reduced by 77% in spite of an increase in the number of motor vehicles. Occupational, home and other injuries were reduced by 38, 35, and 49% respectively. The incidence rates were 2.6-3.0 times higher for men than for women through the 20 years observation period. Conclusion: This study indicates that a long lasting multifactorial community-based intervention in a small community with defined aims may lead to a considerable and long lasting reduction in injuries.