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An Ounce of Accident Prevention

Timothy B. McCall, M.D.

You may not feel that injury prevention fits into a doctor’s traditional duties. Many doctors feel the same way. When you consider how many blood tests and physical exams a doctor must do to save one life, however, it becomes clear why a minute or two devoted to preventing some of the leading causes of death and disability make sense.

Consider seatbelts. For people under 45 in the United States, car accidents are the number one cause of death. While your chance of getting in an accident any one time you drive is low, most of us drive so much that the average American has a one-in-three lifetime risk of getting in a disabling accident.

Some of the risk from car accidents is uncontrollable but one action, buckling up, can make a huge difference. Seatbelts cut the risk of death or serious injury in a car accident in half. Working in Emergency Rooms, I felt I could take one look at the people being wheeled in and predict whether they’d been wearing their seat belts or not. The people with the more serious injuries almost invariably hadn’t been. Even so, one third of Americans don’t wear their seat belts.

Most preventable deaths from car accidents happen at low speeds. In many high speed accidents, the G forces are simply too great for a seat belt or air bag to save you. Even low speed accidents generate tremendous force. A sudden stop from 30 miles per hour is the equivalent of falling from a three-story building. This is precisely the kind of accident where a seat belt is most likely to make a difference.

While airbags lower your risk of death or injury in a head-on accident, they are no substitute for seat belts. Early evidence suggests that an airbag alone may be less effective than a lap and shoulder belt alone. The combination of seat belts and airbags offers the best protection.

Since 40% of people killed in car accidents are intoxicated by alcohol, doctors ought to advise their patients who drink alcohol to avoid drinking and driving. The message should be Not even one. Drugs other than alcohol are implicated in 10-20 percent of crashes, so doctors should be talking about them too.

There are several other worthwhile measures to prevent accidental injury or death that doctors usually don’t have time to mention. Here are a few of them:

• Install smoke detectors in your house
• Wear bicycle and motorcycle helmets
• Don’t smoke in bed or near upholstery
• Turn hot water temperature down to 120 degrees F.
• Don’t keep a gun in the house. If you do, keep it unloaded and lock it up.

Accident prevention, perhaps more than any other area in medicine, is where an ounce of prevention really is worth a pound of cure.

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