Near miss and minor injury information--can it be used to plan and evaluate injury prevention programmes?

To assess the usefulness of collecting information on near miss and minor injuries for use in planning and evaluating injury prevention programmes for children aged under 5 years in the home environment.

The research was set within the context of a controlled intervention study based in 36 general practices across Nottingham. All parents of children aged between 3 and 12 months who had completed the intervention study questionnaire (n = 1594) were used as the sampling frame for the diary study. A diary, developed specifically for the main intervention study, was administered to a systematically assigned sample of 434 parents. Information provided by the Home Accident Surveillance System on 252 randomly selected children, of the same age and sex, who had attended an accident and emergency department, was used to compare the circumstances surrounding near miss and minor injuries with those of medically attended injuries. The children whose parents had completed a diary were followed over a two year time period. The children who had had a medically attended injury were identified from a search of the child's general practice records and the Queens Medical Centre accident and emergency records. The definition of a near miss used in the study was: A near miss incident is something your child does or that happened to your child which could have resulted in him/her being hurt, but fortunately it did not.

Overall two hundred and thirty one (53%) diaries were completed and returned. Three hundred and fifty incidents were recorded of which 207 were near misses and 143 minor injuries. The circumstances surrounding near miss and minor injuries, although not identical when compared to medically attended injuries, were very similar. The relationship between the occurrence of near miss, minor injuries and future medically attended injuries appeared weak, for all categories the negative predictive value was higher than the positive predictive value.

Although the circumstances surrounding all the incident categories were similar, the numbers were too small to see whether specific injury mechanisms predict future injuries of the same type. It appeared that near miss and minor injuries are of limited use in predicting medically attended injuries, however this hypothesis needs to be tested on a much larger sample.