Active or passive approaches
Approaches to injury prevention are classified as active (behavioural) or passive (structural). Active approaches are those that require individuals to play a role in protection, for example by always replacing household chemicals out of the reach of young children. Such approaches are subject to variation in compliance between individuals and are more likely to be adversely influenced by factors such as stress, tiredness or unexpected events.
Passive approaches operate independently of individual action and can provide a level of general protection for the whole population. They may involve changes to products or modification of the environment. An example of a passive intervention is the lowering of the temperature setting on a domestic water heater as a means of preventing tap water scalds. Others include automatic sprinkler systems within buildings and structural modifications to vehicle design that improve safety.
For many injury types no passive interventions exist. For example, only adult vigilance will prevent small children from drowning in the bath, and only safe adult behaviour with hot drinks will prevent children from being scalded.
The relative merits of active and passive approaches have been subject to some debate. Currently there is a growing awareness of the benefits of integrating strategies, referred to by Christoffel and Gallagher as ‘an active approach to passive prevention’. This acknowledges the need for human interaction in passive approaches, such as the correct replacement of a child resistant closure on medications every time these are used.