State Advocacy Issue

 A Community Approach to Dog Bite Prevention (abstract)

A Model Community Approach to Dog Bite Prevention
(abst) in proceedings 140th Annual Convention
American Veterinary Medical Association
June 2001

The following notes are adapted from "A community approach to dog bite prevention," published in the Journal of the American Veterinary Medical Association.1

Dog bites are a serious public health problem inflicting considerable physical and emotional damage on victims and incurring immeasurable hidden costs to communities. Bites have been tolerated as a job-related hazard for utility and postal workers, but for many communities the problem may be more encompassing. Following a severe attack, there is usually an outcry to "do something" and the "something" that is done often reflects a knee-jerk response. Only later do officials realize that the response was not effective and, in fact, may have been divisive for the community. To assist communities in avoiding such ineffective responses, the AVMA convened a Task Force on Canine Aggression and Human-Canine Interactions. Although the number of injuries will never be reduced to zero, Task Force members agreed that a well-planned, proactive community approach could make a substantial impact. The information contained in their report,1 which will be described during this presentation, is intended to help leaders find effective ways to address their community's dog bite concerns.

Scope of the problem
Dogs have shared their lives with humans for more than 12,000 years,2 and that coexistence has contributed substantially to humans' quality of life. In the United States, there are 61.6 million dogs sharing the human-canine bond3; more dogs per capita than in any other county in the world. Unfortunately, a few dogs do not live up to their image as mankind's best friend, and an estimated 4.5 million people are bitten each year,4, 5 although the actual number injured is unknown.6 Approximately 334,000 people are admitted to US emergency departments annually with dog bite-associated injuries, and another 466,000 are seen in other medical settings.6 An unknown number of other people who have been bitten do not sustain injuries deemed serious enough to require medical attention. Still another group of individuals is not represented by these data—those that incur other types of injuries secondary to a bite or attempted bite. For example, a jogger may trip and break an arm while fleeing from a threatening dog.

Of concern too are the demographics of typical dog bite victims. Almost half are children younger than 12 years old.6-8 People more than 70 years old comprise 10% of those bitten and 20% of those killed.9,10

Direct costs of dog bite injuries are high. The insurance industry estimates it pays more than $1 billion/y in homeowners' liability claims resulting from dog bites.11 Hospital expenses for dog bite-related emergency visits are estimated at $102.4 million.6 There are also medical insurance claims, workmen's compensation claims, lost wages, and sick leave-associated business costs that have not been calculated.

Which dogs bite?
An often-asked question is what breed or breeds of dogs are most "dangerous"? This inquiry can be prompted by a serious attack by a specific dog, or it may be the result of media-driven portrayals of a specific breed as "dangerous."12,13 Although this is a common concern, singling out one or two breeds for control can result in a false sense of accomplishment.14 Doing so ignores the true scope of the problem and will not result in a responsible approach to protecting a community's citizens.

Dog bite statistics are not really statistics, and they do not give an accurate picture of dogs that bite.7 Invariably the numbers will show that dogs from popular, large breeds are a problem. This should be expected because big dogs can physically do more damage if they do bite and any popular breed has more individuals that could bite. Dogs from small breeds also bite and are capable of causing severe injury. There are several reasons why it is not possible to calculate a bite rate for a breed or to compare rates between breeds. First, the breed of the biting dog may not be accurately recorded, and mixed-breed dogs are commonly described as if they were purebreds. Second, the actual number of bites that occur in a community is not known, especially if they did not result in serious injury. Third, the number of dogs of a particular breed or combination of breeds in a community is not known because it is rare for all dogs in a community to be licensed and existing licensing data is then incomplete.7 Breed data likely vary between communities, states, or regions, and can even vary between neighborhoods within a community.

Wolf hybrids are just that: hybrids between wild and domestic canids. Their behavior is unpredictable because of this hybridization and they are usually treated as wild animals by local or state statutes. Wolf hybrids are not addressed by the Task Force's report.

Sex differences do emerge from data on various types of aggression. Intact (unneutered) male dogs represented 90% of dogs presented to veterinary behaviorists for dominance aggression, the most commonly diagnosed type of aggression.2 Intact males are also involved in 70 to 76% of reported dog bite incidents.7,15 The sex distribution of dogs inflicting unreported bites is not known. Unspayed females that are not part of a carefully planned breeding program may attract free-roaming males, which increases bite risk to people through increased exposure to unfamiliar dogs. Dams are protective of their puppies and may bite those who try to handle the young. Unspayed females may also contribute to the population of unwanted dogs that are often acquired by people who do not understand the long-term commitment they have undertaken, surrendered to animal shelters where many are destroyed, or turned loose under the misconception they can successfully fend for themselves.16

Dog bite costs to a community
Costs associated with dog bite injuries cannot be readily measured because so many intangible quality of life issues are involved. This makes it more difficult for community councils to justify the time, effort, and expense necessary to institute a bite reduction program when compared to a new fire truck, street paving, or city park. Intangible costs include time spent by volunteer and paid community officials on animal-related issues, deterioration of relationships between neighbors, building appropriate medical support, citizens' concerns about neighborhood safety for children, homeowners' insurance costs within the community, and animal shelter support for unwanted pets. These are quality of life issues that ultimately determine the desirability of a community to its citizens and that can motivate proactive community officials to institute a prevention program.

The program: A community approach to dog bite prevention

Reducing the incidence of dog bites requires active community involvement; passive attention or a token commitment is not sufficient. By actively focusing on dog bite prevention, the State of Nevada was able to reduce the incidence of bites by approximately 15%.a Members of the AVMA Task Force represented a broad range of disciplines and designed the program described during this presentation and published1 in the Journal of the American Veterinary Medical Association (also available on the AVMA Web site at www.avma.org). It was recognized that a community approach must be multidisciplinary, and that different communities will have different needs based on their level of commitment, preexisting programs, and available resources. Although the best results will be obtained by adopting the entire prevention program, the program is designed so that it may be adopted as a whole or in part. Either way, the goal remains to reduce the incidence of dog bites within communities and improve quality of life for their citizens.

Footnotes
a. Anderson RD, Nevada Department of Public Health, Reno, Nev: Personal communication, 1999. 

References
1. Task Force on Canine Aggression and Human-Canine Interactions. A community approach to dog bite prevention. J Am Vet Med Assoc 2001;218:1732-1749.
2. Beaver BV. Canine behavior: a guide for veterinarians. Philadelphia: WB Saunders Co, 1999.
3. Division of Membership and Field Services. US pet ownership and demographics sourcebook. Schaumburg, Ill: American Veterinary Medical Association, 2002.
4. Sacks JJ, Kresnow M, Houston B. Dog bites: how big a problem? Inj Prev 1996;2:52-54.
5. Quinlan KP, Sacks JJ. Hospitalizations for dog bite injuries. JAMA 1999;281(3):232-233.
6. Weiss HB, Friedman DI, Coben JH. Incidence of dog bite injuries treated in emergency departments. JAMA 1998;2711(1):51-53.
7. Wright JC. Canine aggression toward people: bite scenarios and prevention. Vet Clin North Am Sm Ani Pract 1991;21(2):299-314.
8. Parrish HM, Clack FB, Brobst D, et al. Epidemiology of dog bites. Pub Health Rep 1959;74(10):891-903.
9. Sacks JJ, Sattin RW, Bonzo SE. Dog bite-related fatalities from 1979 through 1988. JAMA 1989;262(1):1489-1492.
10. Sacks JJ, Lockwood R, Hornreich J, et al. Fatal dog attacks, 1989-1994. Pediatrics 1996;97(6):891-895.
11. Beaver BV. Human-canine interactions: a summary of perspectives. J Am Vet Med Assoc 1997;210:1148-1150.
12. Lockwood R. Vicious dogs: communities, humane societies, and owners struggle with a growing problem. Comm Ani Control Mar/Apr 1996:12-14.
13. Podberscek AL. Dog on a tightrope: the position of the dog in British society as influenced by press reports on dog attacks (1988 to 1992). Anthrozoos 1994;7(4):232-241.
14. Sacks JJ, Sinclair L, Gilchrist J, et al. Breeds of dogs involved in fatal attacks in the United States between 1979 and 1998. J Am Vet Med Assoc 2000;217:836-840.
15. Gershman KA, Sacks JJ, Wright JC. Which dogs bite? A case-control study of risk factors. Pediatrics 1994;93(6):913-917.
16. Line SW. Factors associated with surrender of animals to an urban humane society, in Proceedings, 135th AVMA Annual Convention, 1998;345-348.