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The Haddon Matrix

  • If injuries are viewed as a disease similar to infection rather than an accident that is random and unpreventable, one can reasonably suspect that influencing predisposing factors may reduce the chance of injury.

  • Haddon was one of the pioneers of injury prevention and described a two-dimensional model for approaching injury and its causes.

    The first dimension is the three factors of injury: host, agent or vector and environment.

    The second dimension is the phase of injury divided into pre-event, event and post-event.

  • Using this model, any injury can be broken down into both its phases and contributing factors. A typical Haddon matrix using motor vehicle collision as an example is as follows. Note the bold text highlighting at first glance the identified relationship of gender to the matrix.

A Typical Haddon Matrix [2]

 

Host

Agent/Vector

Environment

Pre-event

Alcohol use

Brake condition

Visibility of hazards

 

Fatigue

Tire quality

Road curvature and gradient

 

Experience and Judgement

Center of gravity

Shoulder height

 

Risk-taking behaviour

Jackknife tendency

Surface coefficient of friction

 

Amount of Travel

Ease of control

Divided highways, one-way streets

 

Stature

Load weight

Intersections, access control

 

Medications

Speed capability

Weather

 

Motor Skills

Ergonomic controls

Signalization

 

Cognitive Function

Mirrors

Speed limits

 

 

Visual obstructions

Drunk driving laws

Event

Seatbelt use

Speed at impact

Speed limits of traffic

 

Age

Direction of impact

Recovery areas

 

Sex

Vehicle size

Guard rails

 

Bone Density

Automatic restraints

Characteristics of fixed objects

 

Stature

Airbag

Median barriers

 

 

Character of contact surfaces

Roadside embankments

 

 

Load containment

 

 

 

Deformation zones

 

 

 

Fuel system integrity

 

Post-event  

Age

 

911 access

 

Sex

 

EMS response

 

Medications

 

Triage and transfer protocols

 

Preexisting medical conditions/physical condition

 

EMS training

 

Social situation

 

Quality of emergency care

 

 

 

Location of appropriate ED

 

 

 

Access to definitive care

 

 

 

Access to rehabilitation services

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2. Hargarten, J.W.R.a.S.W. (2002). Principles of the Disease of Injury. Rosen's Emergency Medicine. J.A. Marx. St. Louis, Missouri, Mosby Inc. 1:821-828.

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