Health policy needs effective public health surveillance systems. In o
rder to support injury control in the Netherlands we established a sur
veillance system which monitors trends in the epidemiology of injuries
due to traffic accidents, occupational accidents and home and leisure
accidents. We introduced the combination of traditional monitoring me
thods with a new tool: the use of future health scenarios. Trends in t
he epidemiology of injuries since 1985 were compared with observations
from the preceding period (1970-1985) and to future health scenarios
(1985-2000). These scenarios were based on the opinions of 80 Dutch ex
perts, which had been collected with the help of a Delphi-study. We id
entified interruptions of the actual injury mortality trends in the Ne
therlands. In the second half of the 1980s the rapidly declining injur
y mortality trends of the period 1970-1985 slowed down (traffic accide
nts), slightly reversed (occupational accidents) or stabilised (home a
nd leisure accidents). The transitions into less favourable developmen
ts were already foreseen by Dutch experts. The future health scenarios
appear to have added value for health policy. They offer a well-defin
ed conceptual framework for monitoring and facilitate the early detect
ion of trend interruptions. Moreover, they provide information on the
most likely future development and on the feasibility of health policy
goals. The results of our study show that health policy goals of the
Dutch government will not be reached and that new initiatives in injur
y control are needed. (C) 1997 Elsevier Science Ireland Ltd.