The community safety approach in Falun, Sweden - is it possible to characterise the most effective prevention endeavours and how long-lasting are theresults?

The safe community concept was put into practice in order to reduce the num ber of unintentional injuries occurring in the Falun municipality. A commun ity-based injury prevention programme was initiated in 1989 and has been gr adually built up since that time. The prevention endeavours were based prim arily on active intervention strategies through the provision of informatio n, supervision, education and training. After 5 years of an active interven tion programme, a significant effect was found as regards the injury rates for both outpatients as well as patients discharged from hospitals. The obj ectives of this study were: to examine whether the character of the prevent ion endeavours was a determining factor on the outcome (recorded as in-pati ent injury cases); to evaluate the effects of this programme, which is stil l in practice, compared to long-term historical trends; and to draw compari sons with other community-based programmes. A category of 'most targeted ri sks' was identified as being different with respect to how the injury mecha nisms involved were targeted through the programme activities. The developm ent within the injury rates for this group, comprised predominantly of inju ries caused by falls at the same level, was significantly different than th ose for the groups categorized as 'less targeted' and 'non-targeted'. The g eneral effect of the programme appeared to be a neutralization of an otherw ise upward trend in the injury rates. A particular effect was demonstrated in the number of fall injuries, including femoral fractures. It was also no ted that there was still a reduction in injuries after 7 years. However, it was possible to surmise a waning effect during the last 2 years of the pro gramme while still in progress. This observation suggests that a community- based injury prevention programme must be continuously renewed and reinforc ed. (C) 2000 Elsevier Science Ltd. All rights reserved.