Strengthening data to inform building code improvements: time for an international dialogue: Editorial for the European Journal of Public Health

Strengthening data to inform building code improvements: time for an international dialogue:... European Journal of Public Health, Vol. 0, No. 0, 1–1 The Author(s) 2018. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. ......................................................................................................... Commentary ......................................................................................................... Strengthening data to inform building code improvements: time for an international dialogue Editorial for the European Journal of Public Health In many countries, the process for developing model codes that how these questions can be used within both injury surveillance govern the design, construction and alteration of buildings and longitudinal cohort studies. involves weighing the evidence about the cost-effectiveness of The injury data caveat we have identified is not unique to Canada; we think the slate of questions our working group develops will also proposed changes while ensuring the long-term durability and be useful for European colleagues. We would welcome an interna- structural integrity of buildings. In some countries, such as tional dialogue about this. It’s going to take a concerted effort in Canada, these codes are based on minimum standards in the areas many countries to gather the data needed to better inform code of safety, health, accessibility, energy efficiency and fire protection. development and to create a built environment that is more likely They provide passive protection for the population. to prevent injuries for people of all ages. Perhaps the 16th World These codes are not only important determinants of health; but Congress on Public Health (to be held in Rome in October 2020) also critical policies that can potentially decrease fatal and non-fatal will provide an opportunity to co-convene a session on how injury injuries. In Canada, injuries due to falls account annually for over 1 surveillance systems can be enhanced to provide robust data that million emergency room visits, 128 000 hospitalizations, more better inform building codes. than 4000 deaths and 25 000 people with disability. The most recent estimate of the total direct and indirect cost of falls-related Conflicts of interest: None declared. injury in Canada exceeded CAD$8.6 billion. Although injury surveillance systems provide important data References about the prevalence rates and location of injuries, certain population sub-groups may be under-represented in these 1 Canadian Commission on Building and Fire Codes. Review of the Coordinated Code databases and details about falls with less serious injuries may go Development System. Report on Phase 1 – The System. Joint CCBFC/PTPACC Task unreported. For example, the Canadian Hospitals Injury Reporting Group – Code Development System Review. Ottawa, Canada: National Research and Prevention Program relies on data collected for patients Centre of Canada, 2016. Available at: https://www.nrc-cnrc.gc.ca/obj/doc/solutions- presenting to emergency rooms in urban hospitals. As a result, solutions/advisory-consultatifs/codes_centre-centre_codes/commission/JTG_CDSR_ injuries among those living in rural and remote areas, including Approved_System_Report.2016-06-27.pdf (26 February 2018, date last accessed). indigenous peoples, are under-represented. Furthermore, surveil- 2 Parachute. The Cost of Injury in Canada. Toronto, ON: Parachute, 2015. Available lance systems do not provide the kind of data required to at: http://www.parachutecanada.org/downloads/research/Cost_of_Injury-2015.pdf adequately inform modifications to the specific technical require- (26 February 2018, date last accessed). ments of building codes. For instance, the US Consumer Product 3GovernmentofCanada[Internet]. Canadian Hospitals Injury Reporting and Prevention Safety Commission’s National Electronic Injury Surveillance System Program. Ottawa, Canada: Public Health Agency of Canada. Available at: https://www. contains data that identifies the location of the injury and the canada.ca/en/public-health/services/injury-prevention/canadian-hospitals-injury- reporting-prevention-program.html (26 February 2018, date last accessed). product involved (e.g. stairway, bathtub/shower, toilet), but not the building design characteristics implicated (e.g. tread width or 4 United States Government [Internet]. National Electronic Injury Surveillance System riser height of stairs, handrail design or slope and diameter of (NEISS). Bethesda, Maryland, USA: Consumer Product Safety Commission. https://www. cpsc.gov/Research–Statistics/NEISS-Injury-Data (26 February 2018, date last accessed). installed bathroom grab bars). Therefore, injury surveillance data generally lack the technical specificity needed to inform code 5 Edwards N. Knowledge translation for intersectoral action: the case of Canada’s changes. This data gap is a major barrier to developing evidence- building codes. In: Bourgeault IL, Labonte R, Packer C, Runnels V, editors. Population Health in Canada: Issues, Research, and Action, Chapter 15. Toronto, ON: based positions and advocacy on code-related issues. Canada Scholars Press, 2017. Over the past several years public health researchers and organ- izations, including the Canadian Public Health Association (CPHA), 1 2 James Chauvin , Nancy Edwards have advocated to the government of Canada for improvements in 1 Independent public health consultant and advocate, Gatineau, QC, Canada the country’s injury surveillance systems and to strengthen links to 2 School of Nursing, University of Ottawa, Ottawa, ON, Canada code-related issues. In January of this year the Public Health Agency of Canada encouraged us to develop a slate of questions that might Correspondence: James Chauvin, 21 rue James-Byrne, Gatineau, QC J9H be integrated into the injury data surveillance system to address this 7J9, Canada, Tel: +1 (819) 918 2963, e-mail: jamesbchauvin@gmail.com data gap. A working group hosted by CPHA and co-chaired by us is tasked with developing these questions, using recent scoping and doi:10.1093/eurpub/cky063 systematic reviews to help guide the process. We are examining Downloaded from https://academic.oup.com/eurpub/advance-article-abstract/doi/10.1093/eurpub/cky063/4971516 by Ed 'DeepDyve' Gillespie user on 07 June 2018 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The European Journal of Public Health Oxford University Press

Strengthening data to inform building code improvements: time for an international dialogue: Editorial for the European Journal of Public Health

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© The Author(s) 2018. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
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Abstract

European Journal of Public Health, Vol. 0, No. 0, 1–1 The Author(s) 2018. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. ......................................................................................................... Commentary ......................................................................................................... Strengthening data to inform building code improvements: time for an international dialogue Editorial for the European Journal of Public Health In many countries, the process for developing model codes that how these questions can be used within both injury surveillance govern the design, construction and alteration of buildings and longitudinal cohort studies. involves weighing the evidence about the cost-effectiveness of The injury data caveat we have identified is not unique to Canada; we think the slate of questions our working group develops will also proposed changes while ensuring the long-term durability and be useful for European colleagues. We would welcome an interna- structural integrity of buildings. In some countries, such as tional dialogue about this. It’s going to take a concerted effort in Canada, these codes are based on minimum standards in the areas many countries to gather the data needed to better inform code of safety, health, accessibility, energy efficiency and fire protection. development and to create a built environment that is more likely They provide passive protection for the population. to prevent injuries for people of all ages. Perhaps the 16th World These codes are not only important determinants of health; but Congress on Public Health (to be held in Rome in October 2020) also critical policies that can potentially decrease fatal and non-fatal will provide an opportunity to co-convene a session on how injury injuries. In Canada, injuries due to falls account annually for over 1 surveillance systems can be enhanced to provide robust data that million emergency room visits, 128 000 hospitalizations, more better inform building codes. than 4000 deaths and 25 000 people with disability. The most recent estimate of the total direct and indirect cost of falls-related Conflicts of interest: None declared. injury in Canada exceeded CAD$8.6 billion. Although injury surveillance systems provide important data References about the prevalence rates and location of injuries, certain population sub-groups may be under-represented in these 1 Canadian Commission on Building and Fire Codes. Review of the Coordinated Code databases and details about falls with less serious injuries may go Development System. Report on Phase 1 – The System. Joint CCBFC/PTPACC Task unreported. For example, the Canadian Hospitals Injury Reporting Group – Code Development System Review. Ottawa, Canada: National Research and Prevention Program relies on data collected for patients Centre of Canada, 2016. Available at: https://www.nrc-cnrc.gc.ca/obj/doc/solutions- presenting to emergency rooms in urban hospitals. As a result, solutions/advisory-consultatifs/codes_centre-centre_codes/commission/JTG_CDSR_ injuries among those living in rural and remote areas, including Approved_System_Report.2016-06-27.pdf (26 February 2018, date last accessed). indigenous peoples, are under-represented. Furthermore, surveil- 2 Parachute. The Cost of Injury in Canada. Toronto, ON: Parachute, 2015. Available lance systems do not provide the kind of data required to at: http://www.parachutecanada.org/downloads/research/Cost_of_Injury-2015.pdf adequately inform modifications to the specific technical require- (26 February 2018, date last accessed). ments of building codes. For instance, the US Consumer Product 3GovernmentofCanada[Internet]. Canadian Hospitals Injury Reporting and Prevention Safety Commission’s National Electronic Injury Surveillance System Program. Ottawa, Canada: Public Health Agency of Canada. Available at: https://www. contains data that identifies the location of the injury and the canada.ca/en/public-health/services/injury-prevention/canadian-hospitals-injury- reporting-prevention-program.html (26 February 2018, date last accessed). product involved (e.g. stairway, bathtub/shower, toilet), but not the building design characteristics implicated (e.g. tread width or 4 United States Government [Internet]. National Electronic Injury Surveillance System riser height of stairs, handrail design or slope and diameter of (NEISS). Bethesda, Maryland, USA: Consumer Product Safety Commission. https://www. cpsc.gov/Research–Statistics/NEISS-Injury-Data (26 February 2018, date last accessed). installed bathroom grab bars). Therefore, injury surveillance data generally lack the technical specificity needed to inform code 5 Edwards N. Knowledge translation for intersectoral action: the case of Canada’s changes. This data gap is a major barrier to developing evidence- building codes. In: Bourgeault IL, Labonte R, Packer C, Runnels V, editors. Population Health in Canada: Issues, Research, and Action, Chapter 15. Toronto, ON: based positions and advocacy on code-related issues. Canada Scholars Press, 2017. Over the past several years public health researchers and organ- izations, including the Canadian Public Health Association (CPHA), 1 2 James Chauvin , Nancy Edwards have advocated to the government of Canada for improvements in 1 Independent public health consultant and advocate, Gatineau, QC, Canada the country’s injury surveillance systems and to strengthen links to 2 School of Nursing, University of Ottawa, Ottawa, ON, Canada code-related issues. In January of this year the Public Health Agency of Canada encouraged us to develop a slate of questions that might Correspondence: James Chauvin, 21 rue James-Byrne, Gatineau, QC J9H be integrated into the injury data surveillance system to address this 7J9, Canada, Tel: +1 (819) 918 2963, e-mail: jamesbchauvin@gmail.com data gap. A working group hosted by CPHA and co-chaired by us is tasked with developing these questions, using recent scoping and doi:10.1093/eurpub/cky063 systematic reviews to help guide the process. We are examining Downloaded from https://academic.oup.com/eurpub/advance-article-abstract/doi/10.1093/eurpub/cky063/4971516 by Ed 'DeepDyve' Gillespie user on 07 June 2018

Journal

The European Journal of Public HealthOxford University Press

Published: Apr 16, 2018

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