Replies to LegCo questions

Legislative Council Question No. 2 (Oral Reply)

Date of Sitting: 10 May 2000

Asked by: Dr. Hon LEONG Che-hung
Replied by: Secretary for Health and Welfare

Question:

The Public Health Report No. 3 on Viral Hepatitis & Liver Cancer and Unintentional Injuries in Children published by the Department of Health in 1998 contained 27 recommendations on actions that should be taken to reduce injuries and deaths of children. In this connection, will the Govenrment inform this Council :

(a) of the actions taken and tasks achieved in respect of each of the recommendations; and

(b) of the annual reduced figures since 1998 in respect of each of the following aspects, namely, childhood deaths from unintentional injuries, childhood deaths caused by motor vehicle crashes, reported childhood road casualties and childhood deaths from falls, and how they compare to the relevant baseline figures set in the Report for these aspects over the period 1990-95?

Reply :

Madam President,

(a) The series of Public Health Reports is compiled jointly by the Department of Health (DH) and tertiary institutions to study prevailing health care problems and how they may be addressed. The Public Health Report No. 3, published in 1998, contained 27 recommendations on how to reduce unintentional injuries and deaths of children. At Annex I is a description of the present progress made in implementing these recommendations. A summary is at below :

(1) To support data collection, the DH, the Hospital Authority and other concerned departments will start to use, from 2001 onwards, the ICD-10 coding system for recording deaths and diseases. A four-character ICD-10 code will be used for recording deaths while a three-character ICD-10 code will be used for recording hospital discharges based on disease types.

(2) A range of preventive and assistance schemes has been introduced to improve the safety of children at home. These include enhanced public education on the risk of leaving young children unattended at home and the provision of different types of child care facilities to support working parents. Window guards have been provided in some public housing projects.

(3) Transport Department will provide safety facilities, such as pedestrian railings and traffic calming facilities, in the vicinity of schools.

(4) Legislation stipulating special requirements of seats belts for children is currently in place and enforced. The legally permissible prescribed blood alcohol limit for drivers has been lowered from 80 mg/dl to 50 mg/dl since October 1999. Provision of more cycling paths and other amenities facilities for children and youngsters will be considered in the planning of new area developments.

(b) The rates of childhood deaths from unintentional injuries, falls, and motor vehicle and road accidents have decreased as illustrated by the comparison between the relevant figures for 1990-95 and 1996-98 as set out at Annex II. The relevant figures since 1998 are not yet available. While at present the rates are generally at a low level, we shall not be complacent and will continue to monitor the situation and implement improvement measures to minimise the casualty rates.

Annex I

Recommendation 1 - A lead agency should be established to provide leadership and coordination across disciplines involved in injury prevention, and to adopt and monitor targets.

Given that injury prevention in children is closely related to the safety issues for the population at large, and that there is established cooperation among government departments and non-government organisations (NGOs), the Department of Health, on behalf of Health and Welfare Bureau, will co-ordinate the actions of injury prevention for children.

Recommendation 2 - Suitable studies should be conducted to investigate specifically the incidence of childhood injuries, circumstances and contributing factors, severity and long term outcome, as well as economic costs.

The academics are encouraged to undertake studies on these areas. The Health Services Research Fund has provided financial grants to individual academics for conducting studies on surveillance of childhood injuries.

Recommendation 3 - A four-digit ICD-9 E code should be used to record deaths and hospital discharges.

A four character ICD-10 code for recording deaths and a three-character ICD-10 code for recording hospital discharges are planned to be implemented in 2001.

Recommendation 4 - Hospitals and clinics should develop a system for data collection on childhood unintentional injuries

Regular surveys are conducted in the Department of Health’s general out patient clinics for data collection on childhood unintentional injuries. A pilot study was also conducted in some major hospitals. The study will be repeated when necessary.

Recommendation 5 – The feasibility of setting up a Product-related Surveillance System should be studied

Legislation ensuring the safety of consumer products, including toys and children’s products, are in place. Trade and Industry Bureau, Customs and Excise Department and the Consumer Council work closely in ensuring the safety of consumer products and consumer protection.

Recommendation 6 – Injury prevention should be given more emphasis in the medical curriculum

The current medical curriculum covers comprehensive issues related to human health. This recommendation will be further examined.

Recommendation 7 – More training and career development

This recommendation will be further examined.

Recommendation 8 - Non-government organisations (NGOs) should engage in childhood injury prevention projects at the community level

Prevention of childhood unintentional injuries is one of the issues of concern among NGOs. A number of NGOs specialising in child health are engaged in the promotion of prevention work.

Recommendation 9 - Laws should be enacted to prevent children from being left at home unattended

The act of leaving a child unattended is considered as a form of neglect in the context of the child’s general well-being and is dealt with by existing legislation. Preventive approaches by enhancing public education and strengthening child care support e.g. occasional child care service and extended hours service of child care centres, are adopted by the Social Welfare Department in addressing the problem.

Recommendation 10 - Adequate child care facilities should be provided to support working parents

To support working parents who cannot look after their children at home, a range of child care services is provided by NGOs. These include child care centres (including day nurseries and day creches), occasional child care service and extended hours service to suit parents’ needs. A Fee Assistance Scheme is also available to help needy families who cannot afford the child care centre fees.

Meanwhile, the Social Welfare Department encourages and supports non-governmental organizations such as women's groups and church bodies to set up mutual help child care centres which provide easily accessible and flexible child care services for parents in need.

Recommendation 11 - Every school should set up a School Safety Patrol

Road safety patrol teams in schools are organized on a need basis and are supervised and trained by the Police.

Recommendation 12 - Safety fences, pedestrian railings and traffic calming facilities should be put up near schools

At school exits, where sudden large pedestrian flows might be expected, railings are generally provided by the Transport Department to prevent pedestrian spilling onto the carriageway. Transport Department is considering putting up traffic calming facilities near schools.

Recommendation 13 - All drivers should adjust the lighting of the vehicles appropriate to the external environment

The Transport Department has continuously advised and educated motorists to use their headlamps during periods of darkness. The mandatory requirement for the use of headlamps during periods of darkness is being considered.

Recommendation 14 – The use of bicycle helmets should be promoted

Messages on safe cycling, including the use of helmets, are continuously conveyed to the public through various channels.

Recommendation 15 - More cycling paths, arenas and facilities should be provided

Provision of cycling paths and facilities is a general consideration in the planning of new area developments in the New Territories by the Planning Department and the Territory Development Department.

Recommendation 16 - Laws mandating the use of safety seats and child restraints should be enacted

Legislation requiring the use of seat belts, including special requirements of seat belts for children, is currently in place and is being enforced.

Recommendation 17 - The legally permissible blood alcohol limit should be lowered to not greater than 50 mg/dl.

In October 1999 an amendment to the Road Traffic Ordinance (Cap. 374) was introduced which in effect has lowered the prescribed blood alcohol limit for drivers from 80 mg/dl to 50 mg/dl.

Recommendation 18 - Random testing for drink driving should be carried out

Drink driving enforcement is currently carried out by the Police for all motorists involved in traffic accidents, drivers who commit moving traffic offences, and those motorists who are suspected to be driving under the influence of alcohol.

Recommendation 19 – APIs on safe swimming should be strengthened in summer

Leisure and Cultural Services Department has arranged Announcements of Public Interest (APIs) on TV and radio, especially in summer months, to disseminate water safety messages.

Recommendation 20 – Installation of window guards

Window guards have now been provided in some public housing blocks.

Recommendation 21 - Tight enforcement of banning wax boiling should be carried out

Tight enforcement of banning wax boiling is being carried out by the Leisure and Cultural Services Department in the public pleasure grounds (e.g. during the Mid-Autumn Festival).

Recommendation 22 - The fire hazards of old residential buildings should also be examined and appropriate preventive measures be instituted

The Fire Services Department (FSD) carried out a territory-wide survey of private multi-storey buildings including old residential buildings in 1998 and subsequently took action to abate the fire hazards identified. FSD will continue to inspect buildings on a regular basis and take appropriate measures to deal with fire hazards proactively.

Recommendation 23 - Fire sprinklers and smoke detectors should be installed in new residential buildings

The FSD will keep this recommendation under constant review. To better protect children and the public, the present emphasis is placed on educating the public on the importance of fire prevention and the safety measures to be followed in case of fire.

Recommendation 24 - Smoking should not be allowed in country parks

This recommendation has been examined. It is considered that wider publicity and education on the damages of hill fires would be more effective in the long term. We will monitor developments.

Recommendation 25 – The usefulness of temperature regulators on tap water should be studied

This recommendation will be further examined.

Recommendation 26 – Childproof packaging laws should be introduced in Hong Kong

Legislation ensuring the safety of all consumer products are in place to ensure that goods and services available are safe, of reasonable quality and offered on fair terms.

Recommendation 27 – Poison centres should be established

A Drug and Poison Information Bureau has been established in the Chinese University of Hong Kong, providing 24-hour service on advice and information regarding management of poisoning and drug overdose.

Annex II

	Number of deaths/Casualties of Children (aged <15)
	1990-95	1996-98
Childhood death from unintentional injuries(per 100 000 children)	4.1	2.7
Childhood deaths caused by motor vehicle accidents (average per year)	15	7
Childhood road casualties (average per year)	2 700	2 130
Childhood deaths from falls (per 100 000 children)	0.8	0.4