Worldwide Injuries
All types of injuries account for an estimated 5 million deaths annually.*
Cause more than 3.5 million deaths, 6 percent of all deaths, and two-thirds of all injury deaths during a typical year
Unintentional injuries are:
Often preventable
Linked with env
Unintentional Injuries in the United States
Fifth leading cause of mortality in the population as a whole
Leading cause of death for the population aged 1 to 44 years
Standardized Classification of Injuries
Helps in making international and domestic comparisons
Provides helpful information for policy makers
Improves accuracy and reliability of information
Standardized Classification of Injuries (continued)
One of the methods for classifying injuries uses the International Classification of Diseases (ICD) Injury Matrices
The ICD organizes injury data into helpful groupings in order to make international and national comparisons.
ICD: Two Main Dimensions
External cause (e.g., car crash)
Nature of the injury or diagnosis (e.g., fracture)
Injury
injury refers to "the physical damage [to the person] that results when a human body is suddenly or briefly subjected to intolerable levels of energy."
Generally, time between exposure to cause and manifest of injury is short
Injuries by Type of Energy
Mechanical force
Radiant energy from light or shock waves
Extremes of temperature
Electrical energy
Chemical energy
Mechanism of Injury
The cause (mechanism) of injury denotes "the way in which the person sustained the injury; how the person was injured; or the process by which the injury occurred.... The underlying cause is what starts the chain of events that leads to an injury.
Examples of Causes of Injury
Cut/pierce/stab
Inhalation/ingestion/suffocation
Natural/environmental
Poisoning
Struck by/against or crushed
Transportation-related causes
Pedal cyclist
Intent of Injury
Cut/pierce/stab
Inhalation/ingestion/suffocation
Natural/environmental
Poisoning
Struck by/against or crushed
Transportation-related causes
Pedal cyclist
Classifying Intent of Injuries: Three Terms
Unintentional injuries
Intentional injuries
Undetermined injuries
Unintentional Injury
An "injury or poisoning that is not inflicted by deliberate means
Intentional Injury
Includes those that result from self-harm (e.g., suicide), legal intervention (e.g., action of the police), interpersonal actions (e.g., assault), and acts of war
Unintentional Injury versus Accident
The use of the term unintentional injury is preferred to accident; the latter implies a random event that cannot be prevented.
The National Center for Health Statistics has added the term "unintentional injuries" in parentheses next to the category of acc
Injury Epidemiology
A branch of epidemiology that studies the distribution and determinants of injuries in the population
Used for prevention and control of injuries
Used for policy development
Injury Research Data
Performing descriptive studies
Performing analytic studies
Planning prevention programs
Educating community
Significance of Injuries
Direct harm to people
Injuries burden the health care system and rehabilitation facilities
Impact a person's family members
Can lead to permanent disability
May create stress and severe emotional responses
Severe economic cost
Injuries Internationally
Persons between the ages of 5 and 44 years are at special risk of injuries of all types.
About half of injury-related mortality occurs in the group aged 15 to 44 years.
Mortality from injuries among men is double that among women.
Injuries Internationally
Injuries account for approximately one-third of deaths among children aged 1 to 14 years in Europe, although death rates differ greatly between Eastern and Western European countries.
Disproportionately affects the poor
90% unintentional injury deaths tra
Unintentional Injury Deaths in the U.S., 2006
Number of deaths: 121,599
Three leading causes:
Transport-related
Poisonings
Falls
Economic Impacts of Unintentional Injuries
Include direct medical costs for treatment and indirect costs such as those due to:
Lost productivity at work and home
Charges for rehabilitative therapies
(for physical and mental health)
Coverage of caregiver expenses
Personal injury lawsuits and other
Economic Impacts of Unintentional Injuries
Estimates of medical expenditures for treatment of injuries were $117 billion in 2000.
Table 14-2: costs were highest among the 45-64 age group and women in this age group had higher costs than men
Motor Vehicle Injuries
In the U.S., motor vehicle crashes were the leading cause of unintentional deaths in 2006.
Since the early 2000s, the number of such fatalities has not declined over time.
Motor-vehicle fatalities and injuries vary according to the demographic characteris
Seat Belts
Primary Seat Belt Law
Allows law enforcement to stop drivers and passengers for noncompliance
Secondary Seat Belt Law
Allows for citations when motorists stopped for other violations
All-Terrain Vehicles (ATV)
In the 1990s, West Virginia had death rates from ATV crashes that were about eight times higher than the national average.
The state enacted several laws to reduce ATV fatalities.
Nevertheless, between 1999 and 2006, fatal ATV crashes increased by about 1
Pedestrian Safety
Ample cross walks
Increase awareness through signs, speed limits
Design of safe sidewalks
Helmet Laws
Bicycle: New Jersey: Under the age of 17 required to wear approved helmet when cycling, roller skating, in-line skating or skateboarding (ANSI/Snell Memorial)
Ski/Snowboard : Under age of 17 required (ASTM)
Older Adult Drivers Aged 65 Years and Older
Rate of traffic fatalities shows a declining trend in this group
2007: 31 million licensed drivers (almost one-fifth increase in number over the previous decade)
2007: 15% of all licensed drivers
2008: 183,000 older persons injured
Prevention of Motor Vehicle Crashes among Older Drivers
Maintaining regular exercise regimen
Reviewing personal use of medications that may impair driving
Annual vision checks
Creating a safe environment within the car's interior by eliminating distractions, e.g., turning down the radio and not using a cell ph
Older Adult Drivers: Who Is Most at Risk?
Motor vehicle crash deaths per capita among males and females begin to increase markedly starting at ages 70-74.
Per mile traveled, fatal crash rates increase starting at age 75 and increase notably after age 80. This is largely due to increased susceptib
Older Adult Drivers: Who Is Most at Risk? (continued)
Age-related declines in vision and cognitive functioning (ability to reason and remember), as well as physical changes, may affect some older adults' driving abilities.
Across all age groups, males had substantially higher death rates than females.
Motor Vehicle Traffic Fatalities and Crashes among Teen Drivers
Approximately 3,500 teenagers (ages 15 to 19) died from crashes in 2008.
As many as 100 times more teenagers were treated in hospital emergency rooms for crashes.
Risk factors for crashes among teen drivers are:
*Inexperience in driving a vehicle
*Failure
Teen Drivers Fatalities Reduction
Reduction of motor vehicle fatalities can be accomplished through increased use of educational programs for teenage drivers and their parents.
Graduated drivers licensing programs are highly effective in reducing crashes among drivers who are 16 years old
Child Safety Seats
Protect infants and young children during a car crash or sudden stop.
Should not be placed in the front seat because of the risk of injury from air bags.
When transporting infants who are younger than one year old and weight less than 20 pounds, the seats
NJ Child Safety Seats
Any child under the age of 8 and a height of 57" shall be secured in the rear seat of a motor vehicle:
*< 2 years and 30 lbs shall be secured in a rear facing seat equipped with 5pt harness
*<4 years and 40 lbs shall be secured as above until they reach t
Unintentional Injuries among Children, U.S.
The top source of mortality and morbidity among children
Injuries tend to be an under-recognized public health issue.
Death rate for unintentional injuries was 15.0 per 100,000 (2000-2005).
Key Facts about Unintentional Injury Deaths among Children, United States�2000-2006
On average, 12,175 children 0 to 19 years of age died each year in the U.S. from an unintentional injury.
Males had higher injury death rates than females.
Injuries due to transportation were the leading cause of death for children.
The leading causes of
Key Facts about Unintentional Injury by Race
Risk for injury death varied by race.
Highest: American Indian and Alaska Natives
Lowest: Asian or Pacific Islanders
Whites and African Americans had similar rates.
Injury death rates varied by state depending upon the cause of death.
For injury causes wi
Sports- and Recreation-Related Traumatic Brain Injuries
In the U.S., almost 40 million children and adolescents take part in organized sports; about 170 million adults engage in physical activity not connected with work.
Participation in these activities incurs the risk of traumatic brain injury (TBIs), which
NJ Student Athlete Safety Act
NJ Dept. of Education: Public Law 2013, c.071
Requires physical exam for athletes grades 6-12
Distribution of information pamphlet
Injuries among the Elderly
Increased risk of numerous types of injuries.
Persons over the age of 64 years have the highest risk of fatal injuries and injuries that lead to a hospital stay.
Mortality and morbidity from falls, motorcycle crashes, machinery, poisoning, and drowning in
Types of Injury and Violence that Pose the Greatest Threat to Older Adults, U.S.
Elder abuse and maltreatment
Falls among older adults
Injuries among older adult drivers
Residential fire-related injuries
Sexual abuse among older adults
Suicide among older adults
Traumatic brain injury (especially among
persons 75 years of age and olde
Injuries and Fatalities from Falling
Leading cause of fatal and nonfatal injuries for persons aged 65 years and older.
16,650 persons in this age group succumbed to falls during 2006.
Greatest prevalence of falling occurred among American Indian/Alaska natives.
Highest prevalence of injuries
The public health approach to injury prevention
Define the term
Identify the risk and Protective factors
Develop and test Prevention Strategies
Assured Widespread adoption
Problem Health Approach: Problem Definition
Refers to gathering data and analyzing datasets for patterns and trends
Injury specialists define subgroups of the population that have the highest prevalence of specific types of injuries.
For example, the higher rate of motor vehicle fatalities among me
Problem Health Approach: Risk and Protective Factors-- Risk Factors
Variables that increase the probability of the occurrence of an injury
Personal behavior and environmental components contribute to the risk of unintentional injuries.
Examples of behavioral risk factors for motor vehicle fatalities:
**Alcohol consumption
Problem Health Approach: Risk and Protective Factors-- Protective Factors
Reduce the probability of an injury
Examples for motor vehicle crashes:
**Child safety seats
**Air bags
**Seat belt use among older drivers
**Driving when the weather and other conditions are safest
**Avoiding the use of alcohol when driving
Problem Health Approach: Prevention Strategies
Methods to prevent the occurrence of future injuries
Example related to falling:
**Identify risk factors for falls among the elderly
**Modify the environment to reduce the incidence of falling
Problem Health Approach: Widespread Adoption
Disseminate successful prevention strategies widely
Implement safety laws