Health Evidence Bulletins - Wales
Team Leader: Dr. Ronan Lyons

Date of Completion: 02.04.98

6:General Environment

This document is a supplement to, not a substitute for, professional skills and experience. Users are advised to consult the supporting evidence for a consideration of all the implications of a recommendation

The Statements The Evidence
6a. There is laboratory and observational evidence that toughened beer glasses are safer and their widespread use will result in fewer facial injuries in assaults and accidental hand injuries in bar staff i.
(Health Gain Notation -1 " beneficial")
i. Shepherd J. Preventing injuries from bar glasses. British Medical Journal 1994; 308: 932-933.
(Types III and IV evidence - observational and laboratory studies)
6b. Compulsory use of smoke detectors will reduce burn injuriesi .
A reduction in smoking prevalence would reduce deaths from firesii.
A study of legislatively compulsory smoke detectors demonstrated a small reduction in fire fatalities. The free distribution of smoke detectors has been shown to reduce fire deaths by 80%iii.
(Health Gain Notation - 2 "likely to be beneficial")
i. Health Education Authority. "Health promotion in childhood and young adolescence for the prevention of unintentional injuries".Health promotion effectiveness reviews, bulletin 2 London: HMSO, 1996.
(Type III evidence - non randomised trials)
ii. Runyan CW, Bangdiwla SI, Linzer MA.Risk factors for fatal residential fires. New England Journal of Medicine 1992; 327(12): 859-863.
(Type III evidence - non randomised trials)
iii. Mallonee S, Istre GR, Rosenburg M. Surveillance and prevention of residential fire injuries. New England Journal of Medicine 1996; 335: 27-31.
(Type IV evidence - observational study)
6c. A statutory reduction in the maximum temperature of domestic water to 50 degrees centigrade would reduce scald injuries. Thermostatic control of tap water has been demonstrated to reduce scalds. Legislation is more effective than educationi.
(Health Gain Notation - 1 "beneficial")
i. Erdman TC, Feldman KW, Rivera FP. Tap water burn prevention: the effect of legislation.
Paediatrics 1991; 88: 572-7.
(Type III evidence - non randomised trials)

6d. Less guns in society result in less injuries and death. There is compelling type III and IV evidence for this.
Restrictive legislation in the U.S. and Australia reduced murders and suicides caused by firearms by 25% and 36%i,ii.
(Health Gain Notation - 1 " beneficial")

i. Loftin C. Effects of restrictive licensing of handguns on homocide and suicide in the district of Columbia. New England Journal of Medicine 1991; 325: 615-620. (Type III evidence- non randomised trials)
ii. Cantor CH, Slater PJ. The impact of firearm control legislation in Queensland:
preliminary findings. Medical Journal of Australia 1995;62: 583-585
(Type IV evidence-observational studies)


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Health Evidence Bulletins: Wales, Duthie Library, UWCM, Cardiff CF14 4XN. e-mail: