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Unintentional injury mortality in the European Union: How many more lives could be saved?

Unit of Preventive Medicine, Department of Hygiene and Epidemiology, University of Athens, School of Medicine, Athens, Greece, epetrid{at}med.uoa.gr, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

Spyros Kyllekidis

Unit of Preventive Medicine, Department of Hygiene and Epidemiology, University of Athens, School of Medicine, Athens, Greece

Susanne Jeffrey

Paediatric Epidemiology and Community Health (PEACH) Unit, University of Glasgow, Glasgow, Scotland

Parveen Chishti

Paediatric Epidemiology and Community Health (PEACH) Unit, University of Glasgow, Glasgow, Scotland

Nick Dessypris

Unit of Preventive Medicine, Department of Hygiene and Epidemiology, University of Athens, School of Medicine, Athens, Greece

David H. Stone

Paediatric Epidemiology and Community Health (PEACH) Unit, University of Glasgow, Glasgow, Scotland

Aims: The wide variation of unintentional (accidental) injury mortality rates in the European Union (EU) member states suggests that there is high potential for prevention. This paper attempts to quantify the potential for saving lives in this part of the world if all 25 member states were to learn from the experience of countries with advanced injury prevention records. Methods: Unintentional injury mortality data (latest three available years), including denominator population estimates, were obtained from the World Health Organization (WHO) mortality database for all 22 EU countries with a population of more than one million. Annual average age-adjusted injury mortality rates were used to derive the potential for saving of lives under two scenarios: (a) if all EU member states matched the country with the lowest unintentional rate for all causes of injury combined; (b) if the benchmark was alternatively the country with the lowest unintentional injury cause-specific rate. Separate calculations were performed for children (0—14), adults (15—64), and the elderly (65 and over). Results: Under the first scenario, over 73,000 lives could have been saved in the EU 25 in a single year, notably nearly half (47.4%) fewer unintentional injury deaths could be observed in children, over half in adult (54%), and two-fifths (38%) in the elderly. Under the second, more optimistic, scenario 59% of childhood and adult and 75% of unintentional injury deaths among the elderly would have been avoided. Conclusions: A substantial proportion of lives lost due to unintentional injury might be saved if all countries were to achieve the lowest unintentional injury mortality rates in the EU. The above calculations are based on a simple theoretical model but there is increasing evidence on the array of existing effective preventive interventions and improved trauma care calls for public health action in each member state that could in practice halt, to the extent possible, the unintentional injury epidemic.

Key Words: Benchmark • mortality • preventable fraction • unintentional injury

Scandinavian Journal of Public Health, Vol. 35, No. 3, 278-287 (2007)
DOI: 10.1080/14034940600996662


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