HSC 4624 Lecture Notes - Lecture 15: Iceberg, Seat Belt, Pesticide
Module 15 part 2
Unintentional injuries
• In 2010, more than 3 million people died of unintentional injuries worldwide
• Cause 7% of deaths worldwide, 9% DALYs
• Injury: result of an act that damages, harms, or hurts
• Unintentional injuries: that subset of injuries for which there is no evident of
predetermined intent
o Excludes injuries due to war, violence, or abuse
o Accounted for 5 million deaths worldwide in 2014
o More than 90% of these deaths were in low and middle-income countries
o Low and middle income countries of Europe have the highest injury
mortality rates
▪ Young children in the developing world are more at risk for and most
affected by unintentional injuries
o Injuries include road injuries, poisonings, falls, fires, drownings, exposure to
forces of nature, exposure to mechanical forces, adverse effects of medical
treatment, animal contact, other transport injuries, other unintentional
injuries not classified elsewhere, natural disasters (floods and earthquakes)
• Burden of unintentional injuries
o In 2010, about 90% of deaths from unintentional injuries were in low and
middle income countries
▪ Unintentional injuries have the greatest impact in low and middle
income contries
o About 4.2% of total deaths in high-income countries compared to 7.9% in
low and middle income countries
▪ Cause a large proportion of deaths in developing countries than in the
developing world due to poor road infrastructure, lax regulations and
poor driving in the developed world
o Two thirds of deaths among men
o The number of people who suffer disability annually is greater than those
who actually die
o Reality is that fatalities are the tip of the iceberg
▪ Pyramid describes the concept that for each death due to a specific
injury, there are considerably more who required hospitalizations, a
visit to the ER or clinic, or are not treated at all
▪ Exact shape of the pyramid is determined to some extent by factors
such as access to medical care and quality of care, among others
▪ Pyramid includes fatal injuries, injuries resulting in hospitalization,
injuries resulting in visits to emergency departments, injuries
resulting in visits to primary care facilities, and injures treated outside
of the health care system, not treated or not reported
o Proportion of DALYs lost to unintentional injuries by region as compared to
the losses incurred by NCD’s (type 2) and communicable, maternal, neonatal
and nutritional causes (type 1)
▪ Proportion of DALYs lost are quite similar in most areas of the world,
but is highest in Latin America and the Caribbean
o Road accidents are by far the most important cause of unintentional injury
both in terms of deaths caused and in terms of DALYs lost
• Childhood unintentional injury
o About 98% of childhood injury deaths are in low and middle income
countries as this is where the bulk of people in this age group live
▪ Injuries leading cause of death of kids 9-18
o About 5% of total deaths for children ages 0-4 and 23% of total deaths for
children ages 5-14 in low and middle income countries
o For children aged 10-14, road traffic injuries are the 2nd leading cause of
death
o Why:
▪ Development factors – poverty – absence of protective factors –
surrounding environment
▪ Road accidents are the second most important cause of death in the
10-14 age group
• 22.3%
▪ Drowning and burns follow road accidents as injury related cause sof
death among kids
• Drowning: 16.8%
• Burns: 9.1%
▪ Falls: 4.2%
▪ Poisoning: 3.9%
▪ Homicide: 5.8%
▪ Self-inflicted injuries: 4.4%
▪ War: 2.3%
▪ Other intentional: 31.1%
• Highest
• Road traffic accidents
o 1.3 million people die each year due to road traffic injuries
o Predicted to become the 5th leading cause of death by 2030
▪ 2.4 million deaths per year
▪ 48% of registered motor vehicles are in low and middle income
countries
• Disproportionate burden in low and middle income countries
▪ 90% of all deaths on the road are in low and middle income countries
▪ “Vulnerable road users: 46% of all road deaths
• Includes cyclists and motorcycles and their passengers
▪ Prevention includes helmets, seat belts use, child restraint, pre-
hospital care
o Seatbelt laws by country/area
▪ Incidence of road accident fatalities can be reduced by implementing
seat belt and helmet laws
▪ Seat belt laws are not unifom
