In response to the Final Report by the Select Committee on Personal Choice and Community Safety titled Community safety: for the greater good, but at what cost? released in May 2020, Injury Matters affirms the submission put forth on 5 October 2018 by Injury Matters and its partners.1
Below outlines Injury Matters position concerning specific findings and recommendations of the report.
Injury Matters upholds its position that bicycle helmet laws are of critical importance in the reduction of road trauma and do not impinge upon individuals’ liberties. Therefore, helmets should be enforced for all cyclists, both on and off the road with no exemptions. Evidence demonstrates that not wearing a helmet can be the difference between a minor or fatal head injury.2 A 2017 Australian review assessing bicycle helmet effectiveness found that helmet use reduced the odds of head injuries by 51% and fatal head injuries by 65%.3
Injury Matters supports Findings 2 through 5 of the report.
- Measures such as improved road infrastructure, lower speed limits and greater driver awareness and education are effective tools to increase cycling participation in Western Australia.
- Head and neck injuries accounted for 25.9 per cent of the cycling injuries between 1999-00 and 2015-16 (and 48 per cent between 2013-14 and 2015-16). Bicycle helmets are an effective safety measure to decrease the risk of such injuries when cycling.
- While bicycle helmets are effective for reducing the risk of serious or fatal head injuries, they cannot be relied upon as the only method of protecting cyclists. Governments must also ensure that effective bicycle infrastructure, such as separate shared paths or dedicated bicycle lanes, are part of any cycling policy.
- While the current legislative regime, that mandates the wearing of bicycle helmets while cycling, restricts personal choice for individuals, this regime is clearly an effective safety measure for the prevention of head and brain injuries.
Injury Matters does not support either of the proposed Recommendations 1 or 2. The recommendation to trial no helmet use at Rottnest Island is unrealistic in nature and is not considerate of potential delays medical treatment. This setting does not offer outcomes that are transferable to a real-world setting where road traffic is present.
E-cigarette use poses risk to nicotine poisoning and long-term health consequences. Evidence demonstrates that the effects of nicotine exposure range from being relatively mild, including irritation of the eyes and skin, nausea and vomiting, to severe life-threatening illness, and in some cases, death.4 In July 2018, the Medical Journal of Australia published results that revealed from 2009-2016 there were 200 cases of nicotine related poisonings in Western Australia, of which 40% involved children under 15 years of age.5
Injury Matters maintains its position that efforts should be made to increase public awareness of nicotine toxicity and maintain legislation to restrict access.
Injury Matters does not support Recommendation 3 to lift the prohibition on the sale of e-cigarette devices. Should the Tobacco Products Control Act 2006 be amended, then significant regulation would be required to ensure the safety of Western Australians, in particular children and young people.
Safety in water
Injury Matters supports the existing legislation of mandatory pool fencing to prevent toddler drowning. No findings or recommendations were provided in the report relating to pool fencing legislation. Injury Matters maintains the position that mandatory pool fencing should remain legislated in Western Australia in combination with other effective interventions such as public awareness and education when around water. Mandatory pool fencing does not hinder, restrict or impact on pool user wellbeing or enjoyment.
Evidence demonstrates that lifejackets are effective drowning prevention strategies for rivers, adults, older people, young people, weak swimmers and those who fish from rocks or boats.6
Injury Matters reserves comment on Recommendation 10 until the Recreational Vessel Safety Equipment Review is complete.
Injury Matters supports Finding 24 of the report:
- Mandatory lifejackets may be an appropriate safety measure for areas identified as ‘black spots’, subject to the outcomes of the trial at Salmon Holes.
The reduction and removal of regulations that safeguard against poor health fail to consider the complexities of society that influence health behaviours. Multiple factors, including individual awareness, knowledge, costs, environmental influences, policy regulations and cultural factors, influence injury prevention and safety promotion decision-making.7
Empowering people to make healthy choices through awareness-raising and education interventions are important approaches, however some health issues must be complemented with policy levers such as infrastructure and legislation to make the healthy choice the easy choice.8
A range of injury prevention interventions are cost-saving in that they cost less to implement then the resource costs they save.9 Injury prevention interventions can therefore represent significant value for money, including bicycle helmets, prohibition of sales of e-cigarette devices and use of lifejackets for safety in water.
Injury Matters continues to support health-driven, evidence-based legislation and policies and supports appropriate legislation and regulations that enable safer people and places, which focus on improving their health by preventing injury.
Injury Matters recommendations in response to the Final Report of the Select Committee on Personal Choice and Community Safety are:
- Maintain mandatory bicycle helmet legislation in WA.
- Maintain current prohibition of e-cigarette devices in WA.
- Maintain mandatory pool barrier legislation in WA.
- Injury Matters. Injury Matters Submission to the Inquiry on Personal Choice and Community Safety. (2018).
- Gill, T. Bike helmets: an emergency doctor’s perspective. The Conversation (2013).
- Ding Yee Lee, J. The epidemiology of severe and fatal injury among Western Australian cyclists: a linked data analysis. (The University of Western Australia, 2017).
- Eggleston, W., Nacca, N., Stork, C. M. & Marraffa, J. M. Pediatric death after unintentional exposure to liquid nicotine for an electronic cigarette. Clinical toxicology (Philadelphia, Pa.) 54, 890—891 (2016).
- Huynh, A. et al. Retrospective review of Australian PICs data from 2009 to 2016. Patterns of poisoning exposure at different ages. 2015 annual report of the Australian Poisons Information Centres.
- Peden, A. E., Demant, D., Hagger, M. S. & Hamilton, K. Personal, social, and environmental factors associated with lifejacket wear in adults and children: A systematic literature review. PLoS One 13, e0196421–e0196421 (2018).
- Injury Matters. Intervention components and types. Know Injury https://knowinjury.org.au/learn/interventions/
- World Health Organization. Ottawa Charter for Public Health. (1986).
- Pacific Institute for Research Evaluation. Injury prevention: What works? A summary of cost-outcome analysis for injury prevention programs (2014 update). https://www.childrenssafetynetwork.org/publications/whatworks2014 (2014).