Assessing the burden of injury in six European countries

Abstract

Objective To assess injury-related mortality, disability and disability-adjusted life years (DALYs) in six European countries. Methods Epidemiological data (hospital discharge registers, emergency department registers, mortality databases) were obtained for Austria, Denmark, Ireland, Netherlands, Norway, and the United Kingdom (England and Wales). For each country, the burden of injury was estimated in years lost due to premature mortality (YLL), years lived with disability (YLD), and DALYs (per 1000 persons). Findings We observed marked differences in the burden of injury between countries. Austria lost the largest number of DALYs (25 per 1000 persons), followed by Denmark, Norway and Ireland (17-20 per 1000 persons). In the Netherlands and United Kingdom, the total burden due to injuries was relatively low (12 per 1000 persons). The variation between countries was attributable to a high variation in premature mortality (YLL varied from 9-17 per 1000 persons) and disability (YLD varied from 2-8 per 1000 persons). In all countries, males aged 25-44 years represented one third of the total injury burden, mainly due to traffic and intentional injuries. Spinal cord injury and skull-brain injury resulted in the highest burden due to permanent disability. Conclusion The burden of injury varies considerably among the six participating European countries, but males aged 15-24 years are responsible for a disproportionate share of the assessed burden of injury in all countries. Consistent injury control policy is supported by high-quality summary measures of population health. There is an urgent need for standardized data on the incidence and functional consequences of injury.Bulletin of the World Health Organization 2007;85:27-34.Voir page 33 le résumé en français. En la página 33 figura un resumen en español. Assessing the burden of injury in six European countries IntroductionInjuries are a major cause of morbidi i ity and mortality in developing and in industrialized regions.1,2 Rational choices for injury prevention need to rely on comparable indicators relating the burden of injury to other diseases, and determining the most prevailing and incapacitating types of injury. Summary measures of population health, such as the disabilityiadjusted life year (DALY) are designed for the comparative analysis of burden. 3 The value of the DALY as a tool for health policy and planning puri i poses has been increasingly recognized. 4 The DALY combines information on premature mortality and disability due to nonifatal health outcomes. It is a soicalled 'health gap measure' of which the quantitations can be interpreted as the gap between the current population health status and an ideal situation in which everyone would live into old age free of disease and disability. 5 The DALY was designed to assess the burden of disease beyond mortality and was aimed for national and international health policies, to develop unbiased epidemioi i logical assessments for major disorders, and to provide an outcome measure that could also be use...

Demographic profile and epidemiology of injury in Mthatha, South Africa

“…The burden of injury in the most impoverished province of South Africa was invisible before the present study. The incidence rate of injury was estimated at 32 for 1000 persons, a finding higher than 5.2 -21.7 per 1000 persons admitted to casualty units in six developed European Countries 15 , but similar to those from developing countries 16 . This large difference between countries reflects different levels of knowledge and control of injury clearly pointing to the poor injury surveillance, coupled with high rates of injury in developing countries 17 .…”

“…Interpersonal violence is increasingly being seen as a public health priority (11); as such violence is a major cause of mortality and morbidity resulting not only in physical but also in psychological trauma. Furthermore, the absence of a valid injury surveillance system is a source of concern in South Africa [11][12][13][14] . Therefore, the objective of this study was to determine the magnitude and the sociodemographic and epidemiological characteristics of injury.…”

Burden of spinal cord injury in Tehran, Iran

“…The DALY is of value as a means for health policy and planning. 2 Injuries are a major cause of morbidity and mortality in developing and developed countries. 2 Injuries, which account for 10% of global mortality, are often ignored as a major cause of death and may require innovative strategies to reduce their burden.…”

“…2 Injuries are a major cause of morbidity and mortality in developing and developed countries. 2 Injuries, which account for 10% of global mortality, are often ignored as a major cause of death and may require innovative strategies to reduce their burden. However, according to a report from Iran in 2003, among disease groups, injuries has the highest burden of disease (DALY) which includes 28% of DALYF36.5% in male and 18% in female patients; and the first cause of years of life lost because of premature mortality (YLL).…”

“…4 Among all causes of injury-related morbidities, spinal cord injury (SCI) has one of the highest burdens because of permanent disability. 2 Moreover, it is associated with relatively high rates of mortality. Saunders et al 5 have reported that among all injury-related deaths, traumatic SCI accounts for 8% of deaths.…”