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Injury and Safety

Safety is one of the basic needs in human life. Nevertheless, injuries are the principalcause of death and disability for people younger than 45 years. Our research group aims at quantifying the public health and economic consequences of injuries, with a strong focus on methodological advances in quality-of-life measurement and assessment of the burden of acute onset disorders. Secondly, we analyse determinants of injuries and adverse events in several settings (e.g., healthcare associated infections) and evaluate the (cost-)effectiveness of preventive and curative interventions.


We conduct our research in close collaboration with other sections of our department and various clinical groups at Erasmus MC, with the Consumer and Safety Institute Amsterdam, the Dutch Burn Centres, Aafje Zorginstellingen and the Municipal Health Service Rotterdam, with partners from industries, and within international research networks. We are building bridges between science and practice aiming to significantly contribute to the safety of the population.

Research highlights in 2012-2013 included the development and publication of methodological improvements in burden of injury estimations which have been adopted by national and international bodies for health surveillance and policy advice. Another highlight is a national study on the behavioural determinants of hand hygiene, which led to the development of a multi-modal intervention package, ACCOMPLISH, which was evaluated in a multi-centre trial. The ACCOMPLISH package, consisting of team training, e-learning, performance feedback and novel alcohol-based hand rub dispensers developed in collaboration with industry, was able to improve the hand hygiene behaviour of physicians and nurses and proved to be cost-effective. In the on-going collaboration with industry, the aforementioned dispenser and feedback will be developed further for market production. A final highlight concerns childhood safety. By conducting field observations, we demonstrated that car transport of young children (0-4 years) is very often not safe. This work was conducted within the framework of the Task Force Childhood Safety and led to improved instruction materials (including animations) for professionals and parents.

We are nationally and internationally at the forefront of generating high-quality research on methodology development of quality-of-life and burden of disease measurement in the injury field. This is illustrated by two important studies. The first is an international state-of-the-art paper on measuring the population burden of fatal and nonfatal injury (Polinder, Haagsma et al., Epid Reviews 2012). This paper, written in collaboration with a prominent international group of injury researchers, provides an overview of methods and existing knowledge on the population burden of injury. Recommendations are given for methodological refinements to improve the validity and comparability of burden of injury studies. Following this, we published a paper in which an improved and standardised method to assess the burden of disease for people with injuries is described and applied to Dutch, South African and Thai data to assess the burden of disease of injury (Haagsma, Polinder et al., Bulletin WHO 2012). This novel method for calculating burden after injury can be applied in different settings and overcomes some limitations of the previous methods. With this approach, we can more accurately determine the burden of injuries worldwide.

Examples of active projects

  • Assessment of health related quality of life and recovery patterns after trauma: methodological advances
  • Health utility indices and population health after TBI
  • Validating and Improving Injury Burden Estimates Study: the Injury-VIBES study
  • Psychotrauma model: Psychosocial consequences of and the effect on quality of life
  • Cost-effectiveness study on laser Doppler imaging in burn care in the Netherlands
  • The European disability weights study
  • Epidemiology and costs of acute burn care in the Netherlands
  • Burden of Road Traffic Injuries: Disability-Adjusted Life Years
  • Hemiarthroplasty versus conservative treatment for comminuted fractures of the proximal humerus in the elderly
  • Hand and wrist injuries: trends, quality of life and costs
  • Medication withdrawal and falls prevention at the emergency department
  • Problem behavior and safety in nursing homes
  • Transport safety: bicycle injuries children 2-5 years
  • Effect of management team training on patient safety trough culture change
  • Implementation of hand hygiene improving interventions in Dutch hospitals
  • Towards optimal hospital hygiene in the Rotterdam Rijnmond area