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Health & the Hierarchy of Controls.

Some things kill you quickly.

Some things take a little longer.

Drowning, electrocution, car accidents are sudden events. One day you're as fit as a fiddle. The next, you're not. Other hazards, such as cancer, cardiovascular disease, and diabetes, take longer.

In How Not to Accidentally Die, we look at both types of hazards and show you the ways you can reduce your likelihood of suffering. One way we do this is to apply a well-known control approach called the 'Hierarchy of Controls'. If you work in certain industries, you're probably familiar with it. The 'Hierarchy of Controls' is represented by an inverted triangle with the most effective controls being up the top and the least effective being down the bottom.


Perhaps you never knew that your passion for wrestling crocodiles every weekend put you in harm's way. The most effective control for getting eaten by a crocodile whilst wrestling it, is to eliminate the activity (or the crocodile). If you can, you want to eliminate a hazard completely.

However, it's not always possible to eliminate health hazards completely. Nevertheless, there is a lot you can do that's essentially 'set and forget' that'll improve your health and even save your life.

How's it work?

The 'Hierarchy of Controls' is particularly effective for hazards that will kill or harm quickly. Eg if you don't want children to drown in your backyard pool,

  1. Not having a pool (elimination) is the most effective control. If it's not there, you can't drown in it. But what if you really want a pool (and still don't want random children to drown in it)?

  2. Substitution is not really an option (there's nothing remotely similar you can swap with a pool. Maybe you can try a ball pit.)

  3. Erecting a pool fence (engineering), therefore, is the most practical solution.

  4. Administrative controls - watching the pool whenever you have children around and telling children not to drown - while important, are not going to be as protective as a decent fence.

  5. Personal Protective Equipment - in this case, floaties, require children to a) wear them, and b) not take them off.

In a case like the above, the hazard of drowning doesn't go away, but a combination of the above controls helps having a pool much safer. The most effective practical solution in this case is an engineering one - the pool fence - but as every parent knows, you need to always watch children around pools, hence, the administrative controls are also necessary.

Long term hazards

You can also think of creative ways to apply the 'Hierarchy of Controls' for more long-term hazards. How could it work for alcohol?

  1. Can you eliminate the hazard? In some ways, yes. You can stop purchasing it so it's not in your home. That's a good step. But you won't be able to remove alcohol completely as it exists in nearly every restaurant you enter, every shopping mall, and in a lot of your friends' homes.

  2. How about substitution? Absolutely. In addition to the proliferating abundance of very low or zero alcohol 'drinks' there are many other things available you could drink.

  3. What engineering controls are available to you? This is a little more difficult. You could remove any apps on your phone that sell alcohol (if you have them). You could have a friend persuade all the local bottle shops to bar you (not entirely practical). You could lobby the government to reduce the times venues serving alcohol can operate (good luck with that).

  4. Administrative controls rely on voluntary behaviour change and this is usually most unreliable. People forget, give into temptation and peer pressure. You know the story.

With a long-term hazard like alcohol (we're thinking of the harm done to the body by alcohol directly, not through alcohol-related violence), elimination - the most effective control - can be adopted in many situations. In others, substitution will be necessary. Over time, the administrative controls (the willing change in behaviour) will become more and more effective.

Throughout How Not To Accidentally Die, where it's applicable, we'll show you how to apply the 'Hierarchy of Controls' to help you reduce or remove health hazards.

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