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Injuries

Working together to make Europe a safer place

in the European Union

Summary 2003-2005

ISSUE II

INJURIES IN THE EUROPEAN UNION

Statistics summary 2003 – 2005

featuring the EU Injury Database (IDB)https://webgate.ec.europa.eu/idb

Vienna, October 2007

Supported by the European Commission / Health and Consumer Protection (DG Sanco)

ABOUT THIS REPORT

The second edition of “Injuries in the European Union” is an up-to-date summary of the main results of current injury statistics and surveys at the EU level. European injury data made publicly accessible through international data providers such as Eurostat or the World Health Organization (WHO) is combined with recent hospital-based data of the EU Injury Database (IDB) on home and leisure accidents in order to give a comprehensive view of injuries in Europe at a glance.

As a standard, data is used from the years 2003 to 2005 (in most cases a 3 year average) of the 27 EU Member States. Exceptions and information about the data sources are stated in the Annex. Data were extracted May 2007.

More information on European injury statistics can be found at:- Home and Leisure: https://webgate.ec.europa.eu/idb/- Work Place, Road Traffic, General: http://epp.eurostat.ec.europa.eu/

Editorial

Authors: Andrea Angermann, Robert Bauer, Georg Nossek, Nina Zimmermann

Kuratorium für Verkehrssicherheit (Austrian Road Safety Board)Schleiergasse 18, 1100 Vienna, Austriawww.kfv.at, [email protected]

Reviewers: Saakje Mulder (Consumer Safety Institute, Amsterdam), Nadia Minicuci (ULSS20, Verona)

ISBN: 978-3-7070-0081-8

© KfV, 2007

Photos: EUROSAFE

Layout: Rafael Budka; Melanie Musseg

Printed in AustriaSupported by the European Commission / Health and Consumer Protection (DG Sanco)

1Quoted from “Health in Europe”, Eurostat Pocket Books, EC 2006

Please note that despite the harmonisation efforts undertaken by the respective data centres and data providers in the Member States, injury statistics may not always be comparable and may overlap. There are many reasons for this, ranging from differences in the organisation of the national health care systems to cultural differences in the reporting of injury causes. 1


PREFACEProviding health information at the community level is one of the core responsibilities of the European Union in the field of public health. One part of this task is to provide information on injuries (intenti-onal and unintentional) with specific information about circumstances and causes, such as settings, activities, products and services involved.

In June 2006 the first report on “Injuries in the European Union” was published. It was a first attempt to give a comprehensive view of injuries in Europe at a glance and to combine the majority of the available injury data and statistics at an EU level. It was very well received by the community working in the field of injury research, prevention and health policy makers. The main findings of this report were part of a Communication from the Commission to the European parliament and the Council on ‘Actions for a Safer Europe’ (June 2006) and a consequent Council Recommendation on ‘The prevention on injury and the promotion of safety’ (May 2007).

These findings are increasingly alarming health administrations that are seeking opportunities to ensure the health and safety of their citizens.

This second report “Injuries in the European Union” provides updated figures and additional information not previously published, such as pilot data on intentional injuries.

In summary:

Injuries in the European Union account for about 250 000 fatalities.

Injuries are the fourth most common cause of death in the community.

In children, adolescents and young adults injuries due to accidents and violence are the leading cause of death.

The risk of an injury is unequally distributed in Member States and in social groups, and varies by age and gender as well. The risk of dying from an injury is five times greater in the Member State with the highest injury rate then in the one with the lowest rate.

The report is based on the tremendous work of members in the EuroSafe network on injury data and the IDB network, the strong support of DG Sanco units, and the dedicated team in my institute: Robert Bauer, Nina Zimmermann, Andrea Angermann, Georg Nossek and the international reviewers Saakje Mulder and Nadia Minicuci. Thanks are also due to Joanne Vincenten, Justin Cooper and Jagruti Haas from EuroSafe. Also, I express my gratitude to the many other colleagues who assisted with organisational and scientific support.

This report has become a valuable instrument for placing injury prevention higher on the health policy agenda of the European Union.

Rupert KisserHead of Division Home, Leisure & Sports in the Austrian Road Safety Board (Kuratorium für Verkehrssicherheit)Chairman of the European Association for Injury Prevention and Safety Promotion (EuroSafe)


LIST OF FIGURES AND TABLES

Figure 1: Injury death rates and injury deaths by country, EU27 7Figure 2: Unintentional and intentional fatal injuries, EU27 9Figure 3: Unintentional fatal injuries by sector, EU27 9Figure 4: Fatal injuries by causes of death, all ages, EU27 10Figure 5: Fatal injuries by causes of death, 1 – 4 years, EU27 10Figure 6: Fatal injuries by causes of death, 15 – 24 years, EU27 11Figure 7: Fatal injuries by causes of death, 65+ years, EU27 11Figure 8: Selected causes of fatal injuries, Standardised Death Rates (1995 – 2004, Index = 1995), EU27 12Figure 9: Injury deaths per 100 000 by sex and age group, EU27 12Figure 10: Hospital discharges due to injuries, EU27 13Figure 11: Injury Pyramid – overall injury counts, EU27 14Figure 12: Road fatalities and injured road users, EU27 15Figure 13: Fatalities by road user type 15Figure 14: Fatalities and injured due to work-related accidents, EU27 16Figure 15: Fatalities at work by economic activity (according to NACE branches), EU15 16Figure 16: Fatalities and injured due to home and leisure accidents by country, EU27 17Figure 17: Non fatal Home & Leisure Accidents by activity at the time of injury 17Figure 18: Home & leisure accidents by age group and sex 18Figure 19: Home & leisure accidents by injured body part 19Figure 20: Home & leisure accidents by type of injury 19Figure 21: Home & leisure accidents by injury mechanism 20Figure 22: Injured in home & leisure accidents by activity at time of injury and age group 21Figure 23: Injured in home & leisure accidents by activity at time of injury and sex 21Figure 24: Play and leisure activity by injury mechanism 22Figure 25: Domestic work by injury mechanism 23Figure 26: Do-it-yourself work by injury mechanism 24Figure 27: Sports practiced at the time of injury 25Figure 28: Sports practiced at the time of injury by age group 25Figure 29: Sports practiced at the time of injury by sex 26Figure 30: Sports practiced at the time of injury by injured body part 26Figure 31: Home & leisure accidents by place of occurrence at the time of injury 27Figure 32: Place of occurrence of home & leisure accidents at the time of injury by age group 27Figure 33: Intentional and unintentional injuries in IDB pilot countries 28Figure 34: Unintentional injuries by activity (IDB, all injuries - pilot data) 28Figure 35: Injuries by activity and place of occurrence (IDB, all injuries - pilot data) 29

Table 1: Injury deaths in % of all causes of death by age group, EU27 7Table 2: Leading causes of death by age group, EU27 8Table 3: Fatal injuries by causes of death, all ages, EU27: Minimum and maximum values by country 10Table 4: Hospital discharges due to injuries, EU27: Minimum and maximum values by country 13Table 5: Comprehensive view of injuries by sector, EU27 14Table 6: Top 10 consumer products involved in home and leisure accidents and most reported injury type 20Table 7: Top 10 consumer products involved in play and leisure activity and most reported injury type 22Table 8: Top 10 consumer products involved in domestic work activity and most reported injury type 23Table 9: Top 10 consumer products involved in do-it-yourself activity and most reported injury type 24Table 10: Data providers and data sources 30Table 11: Time reference - Injury data used in this report to compile a comprehensive view of injuries by country 32

TABLE OF CONTENTS

INTRODUCTION 6

1. INJURIES IN THE EUROPEAN UNION – MORTALITY 7

2. BURDEN OF DISEASE IN THE EUROPEAN UNION – MORBIDITY 13

3. COMPREHENSIVE VIEW OF INJURIES 14

3.1 TRANSPORT 15

3.2 WORK PLACE 16

3.3 HOME AND LEISURE 17

4. HOME AND LEISURE ACCIDENTS – SELECTED IDB RESULTS 18

4.1 IDB - OVERALL OUTCOMES 18

4.2 ACTIVITY AT THE TIME OF INJURY 21

4.2.1 PLAY AND LEISURE 22

4.2.2 DOMESTIC WORK 23

4.2.3 DO-IT-YOURSELF WORK 24

4.3 SPORTS 25

4.4 PLACE OF OCCURRENCE 27

5. IDB “ALL INJURY” PILOT DATA 28

ANNEX 30

A1 – DATA PROVIDERS AND SOURCES 30

A2 – AVAILABILITY OF DATA SOURCES BY COUNTRY AND YEAR 32

A3 – DATA SOURCES OF FIGURES AND TABLES 33


6

INTRODUCTION

Firstly, this report quantifies the detrimental impact of injuries on the public’s health within the EU:

injuries in the EU are killing over 250 000 people each year

injuries are the leading cause of death in children, adolescents and young adults

injury mortality greatly varies between EU Member States

injuries consume almost 10% of hospital resources

This information is not entirely new, but has not been regularly reported at the EU level thus far. Whereas these “superficial” key figures are useful for overall country benchmarking and monitoring changes, they are not sufficient for guiding injury prevention.

Secondly, this report and its underlying database provide unique information for assisting injury prevention - numbers about what injuries occur, when, where, how, why, and to whom – especially for the growing domain of home and leisure injuries. This kind of detailed information is new and provided only by the Injury Database (IDB) - publicly and online accessible since June 2006.

Did you know, for instance, that in terms of injuries:

homes are quite unsafe places?

unpaid work – housekeeping and do it yourself activities - yield more hospital admissions than paid work?

sports injuries are mainly affecting males?

football (soccer) is the most injury prone type of sports?

Thirdly, this report introduces a cross-sectoral approach (“comprehensive view”) to injury reporting. This is new. Traditionally, injury prevention in EU Member States was separated into independent sectors – traffic, work, consumers, violence - and so were the data sources on injuries. The comprehensive view of injuries in this report allows for a comparison of major injury outcomes by injury sector, providing added value for public health and cross-sector injury prevention. For example:

one fatal injury is accompanied by over 200 non-fatal cases, comprising a rising number of disabled persons;

traffic injuries account for approximately 20% of fatal injuries but only for 6% of non-fatal injuries;

“home and leisure” is the setting in which happen most injuries by far, but provides the lowest insurance cover for its victims;

EU-wide, two thirds of all injuries are treated in hospitals, making them an important setting for injury surveillance;

Roughly 60 million out of 500 million EU citizens are medically treated for injuries each year. This report shall contribute to raising awareness about this epidemic and to facilitate the reduction of these injuries.

7

Source: Eurostat, 3 year average of latest available years (mostly 2003-2005). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007Values for CY were derived from WHO Health for all Database (no values available at Eurostat). For a detailed explanation of the sources, please see Annex.

Huge disparities among EU Member States – well known, well accepted?

There are huge disparities among EU Member States in the number of injuries: the risk of dying from an injury in Lithuania is over five times higher than in the Netherlands. These differences indicate a high potential for reducing injury mortality that has not yet been adequately addressed. If every country in the EU27 equaled the performance of those reporting the lowest mortality rate, almost 100 000 lives could be saved each year in the Community. Solely reducing the injury mortality rate in the new EU Member States to the EU15 average would save more than 20 000 lives a year in these countries. These inequalities are ethically unacceptable taking into account the strong evidence that prevention works (Figure 1 and Table 1).

Accidents and injuries place a huge burden on societies and individuals globally and also in the EU. One of the main contributing factors to that record is the enormous human cost of premature death. During the years 2003 to 2005 accidents and injuries accounted “only” for 5% of all deaths, but for 18% of all deaths before the age of 60, and for an alarming two thirds of all deaths in the 15 to 24 year-olds (Table 1 and Table 2).

All ages < 1 year* 1 - 4 years* 5 - 14 years* 15 - 24 years 25 - 44 years 45 - 64 years 65+

All countries EU27 5% 3% 27% 37% 65% 34% 8% 3%

Minimum 3.5% (UK) 0.7% (DK) 16.8% (IT) 29.1% (IE) 39.3% (CY) 26.2% (BG) 5.4% (UK) 1.4% (BG ,EL)

Maximum 12.6% (LT) 12.0% (EE) 51.9% (LV) 65.7% (CY) 77.4% (EE) 51.6% (LT) 21.2% (LT) 5.0% (FR)

Source: Eurostat, 3 year average of latest available years (mostly 2003-2005). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007* MT and LU were excluded as the data is only available for the age group of 0-14 yearsValues for CY were derived from WHO Health for all Database (no values available at Eurostat)

Table 1: Injury deaths in % of all causes of death by age group, EU27

INJURIES IN THE EUROPEAN UNION – MORTALITY

1. INJURIES IN THE EUROPEAN UNION – MORTALITY

Figure 1: Injury death rates and injury deaths by country, EU27

Injury deaths in % of all causes of death

<5%5-8%>8%

Country Standardised Injury Death Rate

Injury deaths in % of all causes of

death

LT 149.0 12.6%LV 132.4 10.1%EE 123.4 9.9%HU 74.8 6.6%FI 69.2 8.8%SI 65.8 8.0%CZ 64.2 6.3%RO 63.6 5.2%PL 62.3 6.8%PT 57.6 5.0%SK 56.0 5.9%BE 54.9 6,1%FR 52.7 7.6%DK 48.7 5.7%LU 46.1 6.3%BG 45.4 3.5%AT 43.6 5.7%CY 41.1 6,2%SE 40.9 5.2%IT 34.1 4.7%EL 33.0 3.9%IE 32.9 4.9%ES 32.7 4.4%DE 31.9 4.0%UK 28.6 3.5%MT 28.3 4.1%NL 27.7 3.8%

EU25 43.9 5.3%EU27 45,4 5.2%

8

Source:

Rank

All ages < 1 year 1 - 4 years 5 - 14 years

Cause

ICD-10 Code

Absolute number

Fatalities per

100 000 Cause

ICD-10 Code

Absolute number

% on all

causes of

death

Cause

ICD-10 Code

Absolute number

% on all

causes of

death

Cause

ICD-10 Code

Absolute number

% on all

causes of

death % on all causes

of death

1

Diseases of the circulatory systemI00-I99n=2 113 088

431Certain conditions originating in the perinatal periodP00-P96n=13 046

48%

External causes of injury and poisoningV01-Y89n=1 508

27%


37%

43%

2NeoplasmsC00-D48n= 1 244 590

254Congenital malformations and chromosomal abnormalitiesQ00-Q99n=7 121

26%

Congenital malformations and chromosomal abnormalitiesQ00-Q99n=862

15%NeoplasmsC00-D48n=1 834

22%

25%

3

Diseases of the respiratory systemJ00-J99n=368 198

75 Symptoms, signs, abnormal findings, ill-defined causesR00-R99n=2 007

7%NeoplasmsC00-D48n=801

14%

Diseases of the nervous system and the sense organsG00-H95n=877

10%

8%

4

External causes of injury and poisoningV01-Y89n= 257 252

53 Diseases of the respiratory systemJ00-J99n=1 722

6%


10%


7%

5%

5

Diseases of the digestive systemK00-K93n=226 023

46 External causes of injury and poisoningV01-Y89n=782

3%

Diseases of the respiratory systemJ00-J99n=471

8%

Diseases of the circulatory systemI00-I99n=474

6%5%

6

Symptoms, signs, abnormal findings, ill-defined causesR00-R99n=163 012

33 Diseases of the nervous system and the sense organsG00-H95n=729

3%

Infectious and parasitic diseasesA00-B99n=328

6%


5%3%

7

Endocrine, nutritional and metabolic diseasesE00-E90n=130 731

27 Infectious and parasitic diseasesA00-B99n=615

2%

Symptoms, signs, abnormal findings, ill-defined causesR00-R99n=297

5%

Infectious and parasitic diseasesA00-B99n=355

4%3%

All causes of death n=4 913 837

1003 All causes of deathn=27 292

All causes of deathn=5 620

All causes of deathn=8 536100%

Rank

15 - 24 years 25 - 44 years 45 - 64 years 65 + years

Cause

ICD-10 Code

Absolute number

% on all causes

of death

Cause

ICD-10 Code

Absolute number

% on all

causes of

death

Cause

ICD-10 Code

Absolute number

% on all

causes of

death

Cause

ICD-10 Code

Absolute number

% on all

causes of

death

1


65%



41%

Diseases of the circulatory systemI00-I99n=1 862 718

48%

2NeoplasmsC00-D48n=3 218


21%

Diseases of the circulatory systemI00-I99n=220 204


23%

3


6%


16%


8%


8%

4

Diseases of the nervous system and the sense organsG00-H95n=1 480

4%


7%


8%


4%

5


4%


5%


4%


3%

6


2%

Infectious and parasitic diseasesA00-B99n=6 990

4%


3%


3%

7


2%


3%


2%


3%




All causes of deathn=3 892 463

Source: Eurostat, 3 year average of latest available years (mostly 2003-2005). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007

Injury is the leading cause of death in children, adolescents and young adults

Every year more than 250 000 inhabitants of the European Union die due to external causes of injuries and poisoning. This equates to more than 700 fatalities a day. Moreover, injuries are the most common cause of death in the age group 1 to 44 years, resulting in an enormous sum of years of life lost and an overall reduced life expectancy. All age groups taken together, injuries are the fourth leading cause of death after cardiovascular diseases, cancer and diseases of the respiratory system (Table 2).

Table 2: Leading causes of death by age group, EU27

9

Unintentional injuries are more common than intentional injuries and are often preventable

Distinguished by intent, unintentional injuries are responsible for about two thirds of injury deaths and intentional injuries (mainly suicide and homicide) for about one third (Figure 2).

Distinguished by sector, work place accidents account for 4% of unintentional fatalities, transport accidents for 33%, and almost two thirds of fatalities are attributed to the “residual category” of home, leisure and sports accidents. This categorisation is not completely clear-cut but provides a useful orientation for cross-sector injury prevention by linking the strong vertical sectors of work place and road safety with the horizontal WHO approach to injury prevention (Figure 3).

Figure 2: Unintentional and intentional fatal injuries, EU27

Intentional injuries incl. injuries

of undetermined intent 32%

Unintentional injuries 68%

Source: WHO Mortality Database, 3 year average of latest available years (mostly 2002-2004). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007

Figure 3: Unintentional fatal injuries by sector, EU27

Transport 33% Home, Leisure and Sports 63%

Work Place 4%

Source: WHO Mortality Database (Transport Area and Home, Leisure and Sports), 3 year average of latest available years (mostly 2002-2004); WHO Health for all Database (Work Place area), 3 year average of latest available years (mostly 2003-2005). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007


Suicide, Traffic, Falls – clear priorities for the prevention of fatal injuries

Distinguished by cause of death, suicides are the main cause of injury mortality in the EU27 (24% of all cases; almost 61 000 persons a year), followed by motor vehicle traffic accidents (21%; 51 000) and accidental falls (19%; 50 000). These three causes make up two thirds of all injury fatalities (Figure 4).Similar to the overall number of fatal injuries (Figure 1) there are also wide disparities among EU Member States in individual causes of fatal injuries: e.g. the share of accidental falls ranges from 7% of all injury deaths in Bulgaria to 44% in Malta (Table 3).

SuicideMotor

vehicle traffic accidents

Accidental falls Accidental poisoning

Accidental drowning and

submersionHomicide

Other transport accidents

Accidents caused by fire

and flamesOther causes

EU27 excl. CY 24% 21% 19% 4% 3% 2% 2% 2% 23%

Minimum 8.6% (EL) 9.3% (FI) 7.2% (BG) 0.6% (AT) 1.1% (UK) 1.2% (FR) 0.7% (FR) 0.6% (SI) 9.9% (EL)

Maximum 35.2% (SI) 45.2% (EL) 44.2% (MT) 15.8% (EE) 9.4% (EL) 7.2% (EE) 5.7% (MT) 8.1% (EE) 36.5% (FR)

Table 3: Fatal injuries by causes of death, all ages, EU27: Minimum and maximum values by country

Figure 4: Fatal injuries by causes of death, all ages, EU27

Accidental falls 19%

Other causes 23%

Accidental poisoning 4%

Accidental drowning and submersion 3%

Accidents caused by fire and flames 2%

Homicide and injury purposely inflicted by other persons 2%

Other transport accidents 2%

Suicide and selfinflicted injuries 24%

Motor vehicle traffic accidents 21%



Figure 5: Fatal injuries by causes of death, 1 – 4 years, EU27

Accidental falls 7%







Other causes 25%


10

11

Two good reasons for focussing on children and elderly

The share of fatal injuries is highest in very young ages (Table 1). Deaths of children and teenagers are a catastrophe, both for the families and the aging EU societies. Motor vehicle accidents, drowning and accidents caused by fire and flames are the top three causes of injury deaths in children (Figure 5).

In absolute numbers, most of the fatal injuries in the EU affect the elderly (Table 1). At an advanced age “simple falls” often trigger a sequence of lengthy and costly treatments, and often lead to death. Thus, the main cause of injury death in the elderly are falls. The demographic development in the EU adds further relevance to fall prevention measures (Figure 7).

Figure 6: Fatal injuries by causes of death, 15 – 24 years, EU27




Suicide and selfinflicted injuries 21%


Accidental falls 3%

Other causes 11%



Figure 7: Fatal injuries by causes of death, 65+ years, EU27

Accidents caused by fire and flames 2%Accidental drowning and submersion 2%

Motor vehicle traffic accidents 10% Suicide and selfinflicted injuries15%


Homicide and injury purposely inflicted by other persons 1%Other transport accidents 1%

Other causes 31%

Accidental falls 36%




12

Figure 8: Selected causes of fatal injuries, Standardised Death Rates (1995 – 2004, Index = 1995), EU27

0.60

0.70

0.80

0.90

1.00

1.10

1995 1996 19999 7 19999 8 19999 9 20000 0 20000 1 20000 2 20000 3 20000 4

All injn uriesHome and leie surerr *WorkTrarr ffff iff cSuicideHomicide

Figure 9: Injury deaths per 100 000 by sex and age group, EU27

0

50

100

150

200

250

300

350

400

450

500

550

600

<1 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ All

Injury deaths per 100 000 - male Injury deaths per 100 000 - female

Source: WHO Health for all Database. Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007*Estimation of the standardised death rate for home and leisure accidents is calculated as the remainder to all external causes of injury and poisoning minus the defined injury sectors.

EU Injury mortality declines – but not as fast as possible

Recent trends indicate that injury mortality in the 27 Member States of the European Union is on the decline. Over the last ten years (given data availability) the standardised death rate for all injuries in the EU experienced a reduction of 20%. This decrease can be reported for all injury areas except for home and leisure, mostly falls in the elderly. This shows that further prevention efforts are required in elderly fall prevention in order to save more lives from injury death and to accelerate the decline of injury mortality (Figure 8).

Males at risk

When looking at gender, injuries affect males and females disproportionately. The risk of dying from an injury is almost twice as high for males (72 injury deaths per 100 000 males) than it is for females (35 per 100 000 females). As a result, 66% of EU injury fatalities are male, 34% female (Figure 9).


12

13

BURDEN OF DISEASE IN THE EUROPEAN UNION – MORBIDITY

2. BURDEN OF DISEASE IN THE EUROPEAN UNION – MORBIDITY

Figure 10: Hospital discharges due to injuries, EU27

Hospital discharges due to injurie in % of all

<8%8-10%>10%

Hospital discharges, injury and poisoning per 100 000

Hospital discharges due to injuries in % of all hospital discharges

Hospital days due to injuries in % of all hospital days Average length of stay due to injuries

EU27 1 452 8.7% 8.3% 7.9 days

Minimum 540 (MT) 5.9% (HU) 5.1% (RO) 5.2 days (EL)

Maximum 2 858 (AT) 15.6% (CY) 13.2% (CY) 11.4 days (FI)


2 Source: “A surveillance based model to calculate the direct medical costs in Europe” – Final Report. DG Sanco Public Health / Consumer Safety Institute, Amsterdam 2004.

Table 4: Hospital discharges due to injuries, EU27: Minimum and maximum values by country

Country Hospital discharges due to injury

In % of all hospital discharges

BE 167 569 9.9%BG 85 629 7.1%CZ 189 108 8.1%DK 83 737 9.1%DE 1 623 443 10.2%EE 17 119 6.5%IE 50 880 10.1%EL 151 071 9.3%ES 371 924 8.3%FR 937 344 8.5%IT 819 462 9.0%CY 7 517 15.6%LV 52 075 10.5%LT 73 427 8.7%LU 6 061 7.7%HU 145 895 5.9%MT 2 473 6.2%NL 129 466 8.2%AT 231 815 10.0%PL 416 627 7.9%PT 73 573 7.6%RO 302 441 6.6%SI 30 204 9.5%SK 80 789 7.4%FI 102 706 8.0%SE 124 218 8.6%UK 720 862 9.1%

EU27 6 997 435 8.7%


Millions of injury admissions each year – billions of avoidable health care costs!

Hospital admissions due to accidents and injuries in the EU27 sum up to almost 7 million - which is almost the population of Bulgaria and nearly nine percent of all hospital admissions in the EU (Figure 10).The cost per capita for an injury admission in the former EU15 has been estimated to be approximately 30 Euros2; a cautious extrapolation of this cost to 490 million inhabitants in the EU27 yields at least 15 billion Euros for the treatment of injury inpatients.

On average about 1 500 hospital discharges due to injuries per 100 000 inhabitants in the EU27 are reported per year. A wide range of discharges exists between Member States, from 540 in Malta to 2 858 in Austria, which reflects differences in national hospital admissions. Less variation is shown in the share of hospital discharges due to injuries from all hospital discharges: the EU average is about 9% and it ranges from 6% in Hungary to 16% in Cyprus (Table 4).

3. COMPREHENSIVE VIEW OF INJURIES

Source: WHO Mortality Database, WHO Health for all Database, Eurostat, EU Injury Database (IDB, Home and leisure accidents) and “Comprehensive View of European Injury Data” CVI – Final Report; 3 year average of latest available years (mostly 2003-2005). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007

Injuries by numbers – only a weak reflection of the human costs of injuries

The EU injury pyramid indicates that statistically each injury fatality (out of the total of 250 000) corresponds to 28 hospital admissions (7 million in total) and 140 hospital outpatient treatments (34 million in total). Also, 75 injury patients per one injury fatality receive other medical treatment outside the hospital (18 million in total; Figure 11).

Annually in the EU 60 million people – or 12% of the EU27 population - seek medical treatment for an injury. This corresponds to 50 million hospital days annually and a prevalence of more than 3 million disabled people to date, an enormous economic and public health toll (Table 5). No numbers exist so far for the indirect and human costs of injuries.

Source:

Figure 11: Injury Pyramid – overall injuries, EU27

Fatal Injuries252 000

Hospital Admissions7 000 000

Hospital Outpatients34 200 000

Other medical Treatment18 300 000

» Injuries consume more than 50 million hospital days a year (9% of all hospital days) » Injuries to date have left more than 3 million persons permanently disabled

Table 5: Comprehensive view of injuries by sector, EU27

Injury counts and outcomes Transport Workplace Home, Leisure, Sports, School

Total of unintentional

injuries

Homicide, assault, other

violence

Suicide (attempt)

Total of intentional

injuries

Total of all injuries

Fatal Injuries 56 412 6 216 109 512 172 140 6 146 61 368 67 514 252 494*

23% 2% 43% 68% 3% 24% 27% 100%*

Hospital Admissions 860 000 310 000 5 200 000 6 370 000 590 000 100 000 690 000 7 000 000

Hospital Outpatients 1 800 000 3 000 000 27 000 000 31 800 000 2 200 000 200 000 2 400 000 34 200 000

Other medical treatment 1 200 000 1 500 000 14 300 000 17 000 000 1 200 000 100 000 1 300 000 18 300 000

All medically treated cases 3 860 000 4 810 000 46 500 000 55 170 000 3 990 000 400 000 4 390 000 59 560 000

6.5% 8.1% 78.1% 92.6% 6.7% 0.7% 7.4% 100%

Disabled (prevalence 16-64) 750 000 1 300 000 900 000 2 950 000 – – – > 3 000 000

Hospital bed days 7 200 000 2 400 000 39 000 000 48 600 000 3 000 000 600 000 3 600 000 52 200 000

14

* incl. injuries of undetermined intent, not displayed

Source: WHO Mortality Database, WHO Health for all Database, Eurostat, EU Injury Database (IDB, Home and Leisure Accidents) and “Comprehensive View of European Injury Data” CVI – Final Report; 3 year average of latest available years (mostly 2003-2005). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007

Table 5 combines hospital data (e. g. admissions and outpatients by sector) of the European Injury Database (IDB) with routine hospital discharge and cause of death data into a “comprehensive view of injuries in the EU” by different sectors of injury prevention. Projections of national surveys to EU level in this overview anticipate also the incidence information that will be available in future through the EU Health Interview Surveys for injuries treated outside the hospital (“All medically treated cases”). Also indicators of health care consumption (hospital bed days) and long term consequences (prevalence of injury disability) of injuries by sector are given.

15

COMPREHENSIVE VIEW OF INJURIES - TRANSPORT

3.1 TRANSPORT

Figure 12: Road fatalities and injured road users, EU27

Road fatalities per 100 000 inhabitants

< 8

8-12

>12

Figure 13: Fatalities by road user type

Unknown traffic participation 0,23%

Pedestrians 17%

Motorcycles and Scooters 12%

Other road users excluding unknown 7%

Mopeds and Mofas 4%

Bicyclists 7%Passenger cars 53%

Country Road fatalities

Injured road users

Road fatalities

per 100 000 inhabitants

Injured road users per 100 000

inhabitants

BE 1 155 65 066 11 624BG 953 – 12 –CZ 1 372 33 968 13 332DK 377 7 515 7 139DE 5 939 445 246 7 540EE 167 – 12 –IE 370 9 230 9 227EL 1 630 20 988 15 190ES 4 864 140 609 11 329FR 5 642 110 911 9 178IT 5 728 328 538 10 565CY 105 – 14 –LV 497 – 21 –LT 740 – 22 –LU 50 1 047 11 231HU 1 300 26 703 13 264MT 15 – 4 –NL 861 34 043 5 209AT 859 55 324 11 677PL 5 599 63 251 15 166PT 1 361 52 172 13 497RO 2 431 – 11 –SI 258 16 858 13 844SK 603 10 551 11 196FI 375 8 954 7 171SE 483 26 715 5 297UK 3 454 286 698 6 479

EU27 47 187 1 744 386* 10 356*

The toll of mobility– almost 50 000 road fatalities in the EU per year

Road transport is one of the most complex and most dangerous systems people have to deal with on a daily basis. According to police records, almost 50 000 road fatalities and 1.7 million injured road users are the recent toll of road traffic in the EU. Road fatalities in the EU27 range from 4 per 100 000 inhabitants in Malta to 22 in Lithuania which indicates the potential for further reduction of road traffic mortality in some Member States (Figure 12).

Source: European Commission / Directorate-General Energy & Transport in cooperation with Eurostat and IRTAD (International Road Traffic and Accident Database), 3 year average of latest available years (2003-2005). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007 * excl. BG, EE, CY, LV, LT, MT, RO due to missing/data in IRTAD

Source: IRTAD (International Road Traffic and Accident Database), 3 year average of latest available years (mostly 2003-2005). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007

Detailed information about circumstances and external causes of road accidents can be obtained from the European Road Accident Database (CARE) and International Road Traffic and Accident Database (IRTAD), and in the future also from the EU Injury Database, (see Chapter 4 and Annex). For example, more than half of road fatalities are passengers or drivers of cars, but vulnerable road users (pedestrians, cyclists and motorcyclists) account for at least 40% of road fatalities (Figure 13).

16

3.2 WORK PLACE

Figure 15: Fatalities at work by economic activity (according to NACE branches), EU15

Manufacturing 20%

Agriculture, hunting and forestry 14%

Transport, storage and communication 18%

Wholesale and retail trade; repair of motorvehicles, motorcycles and personal and household goods 9%

Financial intermediation; real estate, renting and business activities 7%

Hotels and restaurants 1% Electricity, gas and water supply 1%

Construction 30%

Figure 14: Fatalities and injured due to work-related accidents, EU27

Work related fatalities per 100 000

<11-2>2

Country

Deaths due to work related

accidents

Injured due to work related

accidents

Work related

fatalities per

100 000 inhabitants

Work related

injured per100 000

inhabitants

BE 114 173 526 1.1 1 673BG 122 5 448 1.6 69CZ 183 82 250 1.8 805DK 62 47 167 1.2 884DE 1 016 1 179 406 1.2 1 430EE 30 3 285 2.2 243IE 59 22 967 1.5 578EL 103 16 529 0.9 151ES 734 895 310 1.8 2 133FR 692 740 261 1.2 1 241IT 947 586 595 1.6 1 019CY 12 2 149 1.5 282LV 53 1 405 2.3 61LT 97 2 657 2.8 77LU 6 25 139 1.4 5 547HU 143 25 031 1.4 248MT 10 4 256 2.5 1 061NL 73 82 667 0.4 510AT 118 136 741 1.5 1 673PL 492 79 561 1.3 208PT 323 230 112 3.2 2 249RO 423 5 994 1.9 28SI 27 40 149 1.4 2 009SK 83 14 573 1.5 271FI 41 57 437 0.8 1 104SE 60 32 291 0.7 359UK 192 162 139 0.3 273

EU27 6 216 4 655 044 1.5 970

Source: WHO Health for all Database, 3 year average of the latest available years (mostly 2003-2005). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007

Work place safety progresses – still 6 000 occupational fatalities in the EU remain

According to data aggregated by WHO more than 6 000 work place fatalities are recorded per year in the EU27. They range from 0.3 per 100 000 inhabitants in United Kingdom to 3.2 in Portugal. Also the rate of non-fatal work place accidents shows a significant variation between Member States due to differences in national definitions and registration practices (Figure 14).

Source: Eurostat / ESAW (European statistics on accidents at work), 3 year average of 2002 – 2004. Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007

Detailed information about the socio-demography and circumstances of work place accidents can be found in the European statistics on accidents at work (ESAW) and WHO Health for all databases (HFA-DB). Half of all work place fatalities occur in two branches: the construction (30%) and manufacturing branch (20%). These two “leading” branches are followed by the transport sector (18% of all work place fatalities) which indicates the need for a close cooperation of work place and traffic safety (Figure 15).

COMPREHENSIVE VIEW OF INJURIES - WORK PLACE

17

COMPREHENSIVE VIEW OF INJURIES - HOME AND LEISURE

3.3 HOME AND LEISURE

Figure 16: Fatalities and injured due to home and leisure accidents by country, EU27

Fatalities per 100 000

<=15>15-30>30

no data available

Country

Fatal injured in home

and leisure accidents

Hospital treated

injuries due to home

and leisure accidents

Fatalities per

100 000inhabitants

Hospital treated injuries

per 100 000

inhabitants

BE 2 156 – 21 –BG 1 402 – 18 –CZ 3 285 – 32 –DK 1 748 449 000 32 8 300DE 12 214 – 15 –EE 967 – 72 –IE 469 – 12 –EL 1 623 – 15 –ES 6 060 – 14 –FR 21 685 3 815 000 35 5 000IT 12 579 – 22 –

CY* – – – –LV 1 654 – 72 –LT 2 192 – 64 –LU 111 – 25 –HU 4 421 – 44 –MT 77 – 19 –NL 2 406 604 000 15 4 000AT 1 723 577 000 21 7 100PL 9 204 – 24 –PT 1 431 608 000 14 5 800RO 6 255 – 29 –SI 521 – 26 –SK 1 097 – 20 –FI 2 340 – 45 –SE 2 310 516 000 26 5 700UK 9 594 5 569 000 16 9 400

EU27* 109 512 32 200 000** 22 6 471**

Source: Eurostat, WHO Mortality Database, WHO Health for all Database, EU Injury Database (IDB, Home and Leisure Accidents), 3 year average of latest available years. Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007 * Value for Cyprus for V00-X59 is not available ** Estimation based on the available IDB data.

Over 100 0000 home and leisure fatalities in the EU – a reason to bother

The average rate of fatal home and leisure accidents in the EU27 is 22 per 100 000 inhabitants, this is more than twice the rate of fatal road traffic accidents (10 per 100 000) and more than ten times the rate of fatal work place accidents (1.5 per 100 000). Every year more than 100 000 EU citizens die from home and leisure injuries (Figure 16).

Other specified activity 18%

Do-it-yourself work 3%

Unspecified activity 16%

Vital (basic) activity 4%

Sports, athletics, exercise 18%

Domestic work 4%

Play and leisure activity 36%

Educational activity 1%

Source: EU Injury Database (IDB, Home and Leisure Accidents - https://webgate.ec.europa.eu/idb/), data of latest available years (mostly 2003-2005). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007

Figure 17: Non fatal home and leisure accidents by activity at the time of injury Injury surveillance in the home and leisure area is still neglected in most EU Member States. The EU Injury Database (IDB) aims at closing this gap by providing unique information about the external causes of home and leisure accidents. For the participating IDB countries the rate of hospital treated home and leisure accidents ranges from 4 000 per 100 000 inhabitants (Netherlands) to 9 400 (United Kingdom; Figure 16). Sport injuries account for about 18% of this injury sector (Figure 17).

18

4. HOME AND LEISURE ACCIDENTS – SELECTED IDB RESULTS

Almost all European countries use the official cause of death statistics according to the WHO International Classification of Diseases to mo-nitor fatal injuries (Figure 4). Also, in most EU countries official data systems for recording causes of traffic and occupational injuries are in place (Figures 12 and 14). These statistics provide important key figures but not for all injuries. A prevention-oriented „all injury“ surveillance system in the form of the EU Injury Database (IDB) is currently operated by only twelve European countries. This is surprising as the establish-ment of specially designed injury surveillance systems is widely advocated as a prerequisite for the development and evaluation of injury prevention strategies. The IDB provides a variety of indicators on hospital treated injuries - for both inpatients and outpatients - solely for the purpose of injury prevention. The IDB focus is still on home and leisure accidents but first data on „all injuries“ are already available for some IDB countries.An EU-wide implementation of the IDB would provide detailed and comparable injury information across all sectors of injury prevention - work, school, traffic, home and leisure, and violence and suicide - for all countries. Currently, only an EU estimate can be produced based on projections from the available „all injury“ IDB pilot data (Table 5).

4.1 IDB - OVERALL OUTCOMES

The IDB data contains unique details on the mechanism of the accident, the activity of the victim, the place of occurrence and involved products. These details can be analysed in relation to type and severity of the actual injury for each record.

Source: EU Injury Database (IDB, Home and Leisure Accidents), data of latest available years (mostly 2003-2005). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007

Distribution of injuries in males and females

Overall, males and females are almost equally distributed among the hospital treated injuries. However, more males sustain an injury in child-hood and adolescence whereas the situation is inverted in older age groups (50+; Figure 18).

Figure 18: Home and leisure accidents by age group and sex

0%

2%

4%

6%

8%

10%

12%

14%

16%

00

-04

05

-09

10

-14

15

-19

20

-24

25

-29

30-3

4

35

-39

40-4

4

45-

49

50

-54

55

-59

60

-64

65

-69

70

-74

75

-79

80

-84

85

+

MaleFemale

19

Figure 20: Home and leisure accidents by type of injury

0.0. 1%

0.0. 4%

0.0. 5%

0.1%

0.1%

0.1%

0.1%

0.2%

0.2%

1%

2%

2%

2%

3%

4%

13%

20%

21%

31%

0% 5% 10% 15% 20% 25% 30% 35%

Frostbitii e

Electrocution

Radiatioii n (sunlight,t X-XX rays, etc.)

Suffocation (asphyxia)

Lesion of nerve(s )

A mputation

Lesion of blood vessel(s)

Corrosion (chemical)

Crushing

PoPP isoning

Burns, scalds (thermal)

Luxation, dislocation

A brasion

Lesion of tendon (s) and/or muscle(s )

Concussion

Distorsion, sprain

Fr actur e

Open wound

Contusion, bruise


Extremities at risk

Upper extremities (arm, fingers etc.) are more often injured in home and leisure accidents than any other body part, followed by lower extremities. Upper and lower extremities combined result in 70% of all injured body parts. Injuries to the head account for almost one fourth of injuries (Figure 19).

Severe consequences of injuries

Most of the victims were hospitalised for contusions and bruises (31%), open wounds (21%) or fractures (20%; Figure 20).

Figure 19: Home and leisure accidents by injured body part

2%

2%

3%

23%

32%

38%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45%

Neck, throat

Thorax

lumbar spine and pelvis

Head

Lower extremities

Upper extremities

Abdomen, lower back,


HOME AND LEISURE ACCIDENTS – SELECTED IDB RESULTS

20


Falls and collisions are predominant

More than half of the injuries are falls (53%) followed by “being struck or hit by contact with other object, person or animal” (20%; Figure 21).

Consumer safety

Within IDB data collection the product involved in the accident and the product causing the injury are identified to provide information for consumer protection (e.g. child trips on toy and falls to floor, product involved is the toy and product causing the injury is the floor). Table 6 lists the top ten “consumer products” involved in home and leisure accidents (due to the very detailed coding level the percentage for the listed product from all accidents is low). Bicycles account for more than 3% of home and leisure accidents, mostly leading to contusions and bruises. Balls are involved in 3.2% of the accidents and cause distorsions and sprains in 31% of the cases.

Rank Consumer product % Most reported injury type% of injury type on all injury types with this

product

1 Bicycle and accessories 3.3% Contusion, bruise 29%

2 Ball 3.2% Distorsion, sprain 31%

3 Door 2.3% Contusion, bruise 36%

4 Ski 2.0% Fracture 37%

5 Chair, bench 2.0% Contusion, bruise 32%

6 Bed 1.9% Contusion, bruise 35%

7 Stationary equipment in playground 1.7% Fracture 36%

8 Rolling sports equipment 1.6% Fracture 34%

9 Ladder, scaffold 1.3% Fracture 36%

10 Gymnastic and body-building equipment 1.2% Contusion, bruise 31%


Table 6: Top 10 consumer products involved in home and leisure accidents and most reported injury type

Figure 21: Home and leisure accidents by injury mechanism

0.1%

0.2%

1%

1%

3%

8%

13%

20%

53%

0% 10% 20% 30% 40% 50% 60%

Suffocation

Electric/radiation and effect of other energy-waves

Chemical effect

Thermal effect

Foreign body in natural orifice

Acute overexertion of body or part of body

Crushing, cutting, piercing

Struck, hit by contact with other object, person or animal

Struck, hit by fall

21


Figure 22: Injured in home and leisure accidents by activity at time of injury and age group

Educational activity

Sportrr s, athletics, exercrr ise

Play and leisurerr activity

Vital (basic) activity

DoDD mestic woww rk

Do-it-y- oursrr elf woww rk

10%

20%

15%

4%%

63%

35%55

32%

10%

4%%

23%

32%

12%

10%00

11%

12%

3%%%%33

30%

23%

30%

52%

68%

2%%%

14%

35%

29%

18%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

0 - 4 5 - 14 15 -24 25 -59 60+

Figure 23: Injured in home and leisure accidents by activity at time of injury and sex

Domestic work

Vital (basic) activity

Play and leisure activity

Educational activity

Sports, athletics,exercise

Do-it-yourself work

62%

56%

47%

41%

35%

12%

38%

44%

53%

59%

65%

88%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

MaleFemale


The IDB item “activity at the time of injury” by age group and sex allows for the identification of groups at risk (Figures 22 and 23).

For young people the dangers lie within play and sports activity, for adults within domestic and do-it-yourself work

As reported in Figure 17 most injuries occur during play and leisure activity (36%) or sports (18%). Within these two categories, approximately two thirds of the victims are below the age of 25. In domestic work and do-it-yourself-work the situation is different; more than 80% of the injured persons are older than 25 years. Classically, more than 60% of the injured persons during domestic work are female, whereas almost 90% of the victims sustaining an injury while do-it-yourself-work are men (Figure 23).


22

4.2.1 PLAY AND LEISURE

Figure 24: Play and leisure activity by injury mechanism

0.1%

0.2%22

1%

1%

2%

2%

8%%

12%

20%

54%

0% 10%00 20% 30% 40%00 50% 60%

Suffff off cation

Electric/rarr diation and effff eff ct of other energrr y-w- avevv s

Chemical effff eff ct

Thermal effff eff ct

Mechanism of injuryrr , other and unspecififf ed



Crushing, cutting, piercrr ing

Struck, hit by contact with other objb ect, person or animal

Struck, hit by faff ll

Rank Consumer product % Most reported injury type % of injury type on all injury types with this product

1 Bicycle and accessories 4.9% Contusion, bruise 27%

2 Stationary equipment in playground 4.3% Fracture 36%

3 Door 3.1% Contusion, bruise 38%

4 Rolling sports equipment 2.9% Fracture 33%

5 Chair, bench 2.7% Contusion, bruise 32%

6 Toys 2.5% Open wound 23%

7 Table 1.6% Open wound 43%

8 Bed 1.5% Contusion, bruise 41%

9 Ball 1.4% Contusion, bruise 33%

10 Gymnastic and body-building equipment 1.2% Distorsion, sprain 29%

Table 7: Top 10 consumer products involved in play and leisure activity and most reported injury type

Falls while playing

Focussing on the different activity items, they can be analysed at a detailed level by using cross-tabulations of the variables available in the IDB. For play and leisure activities the most frequent accident mechanisms are falls (54%), collisions (20%) and crushing, cutting, piercing (12%; Figure 24).

In particular bicycles (almost 5%) and stationary equipment in playgrounds (e.g. swings, climbing frames etc.; more than 4 %) were frequently reported as the products involved in the accidents during play and leisure activity (due to the detailed coding level the percentage for the listed product from all accidents is low). They mostly resulted in contusions, bruises or fractures (Table 7).



23


The own household – a dangerous place to work?

Falls (41%) are reported as the most frequent accident mechanism during domestic work, followed by crushing, cutting, piercing (30%) and collisions (14%; Figure 25).

Kitchen utensils (10.7%, mainly kitchen knives), cutlery and tableware (5%) and household machines (4.2%) can be found on the top of the list displaying the most dangerous utensils in the sense of “consumer products” used in the domestic area (Table 8).

Rank Consumer product % Most reported injury type% of injury type on all injury types with

this product

1 Kitchen utensils (not electric) 10.7% Open wound 88%

2 Cutlery and tableware 5.0% Open wound 88%

3 Household machines 4.2% Open wound 42%


5 Chair, bench 3.1% Fracture 39%

6 Garden tool, mechanical 2.8% Open wound 49%

7 Fats and hot liquids (excl. boiling water) 2.2% Burns, scalds (thermal) 89%

8 Packaging of metal 2.1% Open wound 87%

9 Garden tool, manual 2.0% Open wound 50%

10 Shop furniture 1.6% Contusion, bruise 57%

Figure 25: Domestic work by injury mechanism

0.1%

0.1%

1%

1%

2%

4%

6%

14%

30%

41%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45%


Suffocation

Mechanism of injury, other and unspecified

Chemical effect



Thermal effect



Struck, hit by fall

Table 8: Top 10 consumer products involved in domestic work activity and most reported injury type



24

Where wood is chopped, splinters must fall

The most frequent injury mechanism during do-it-yourself work is crushing, cutting, piercing (40%), after falls and collisions (19% and 18%; Figure 26).Table 9 lists the top ten “consumer products” involved in do-it-yourself accidents (due to the detailed coding level the percentage for the listed product from all accidents is low). Ladders/ scaffolds, handheld drilling/grinding machines and sawing tools rank at the top of the list. Injuries with ladders involved result in 39% of the cases in fractures.

Rank Consumer product % Most reported injury type% of injury type on all injury types with

this product


2 Drilling/grinding machine, hand-held 7.0% Open wound 23%

3 Sawing tool/implement, mechanical, hand-held 5.3% Open wound 66%

4 Motor vehicle / part of motor vehicle 3.9% Open wound 32%

5 Striking/hewing tool/implement, manual 3.6% Open wound 44%

6 Cutting/clipping tool/implement, manual 3.1% Open wound 85%

7 Welding and heating tool/implement 2.2% Burns, scalds (thermal) 17%

8 Saw, fixed 2.1% Open wound 61%

9 Structural element of metal 1.7% Open wound 59%

10 Screwing tool/implement, manual 1.2% Open wound 77%

4.2.3 DO-IT-YOURSELF WORK

Figure 26: Do-it-yourself work by injury mechanism

1%

1%

1%

2%

3%

15%

18%

19%

40%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45%

Mechanism of injury, other and unspecified

Chemical effect


Thermal effect




Struck, hit by fall


Table 9: Top 10 consumer products involved in do-it-yourself activity and most reported injury type



25

Figure 27: Sports practiced at the time of injury

Figure 28: Sports practiced at the time of injury by age group

6%

3%

3%

8%

49%

46%

38%

20%

54%

14%

25%

44%

25%

22%

38%

39%

69%

30%

17%

15%

20%

33%

36%

24%

14%

17%

39%

40%

24%

28%

36%

19%

40%

68%

32%

24%

29%

42%

21%

62%

44%

17%

34%

46%

32%

25%

7%

30%

6%

4%

4%

2%

10%

10%

6%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Jogging / Walking

Ice skating sports

Swim sports

Asian combat sports

Volleyball

Roller skating/ Skateboarding

Badminton & Tennis

Cycling

Basketball

Hockey

Ski sports

Horse riding

Handball

Gymnastics & Aerobics

Football

0 - 4 5 - 14 15 -24 25 -59 60+

Sport is healthy – but holds a risk of injury

Injuries related to sports activities amount to 18% of all home and leisure injuries. Broken down into types of sports, football (soccer) can be identified as the sport most reported as leading to hospital-treated injuries (Figure 27). Almost 70% of persons injured while playing football are below the age of 25. More than 90% of persons injured in gymnastics and aerobics are also in this age group (Figure 28).

1%

2%

2%

2%

3%

3%

3%

3%

4%

5%

6%

6%

7%

7%

36%

0% 5% 10% 15% 20% 25% 30% 35% 40%

Jogging / Walking

Ice skating sports

Swim sports

Asian combat sports

Volleyball


Badminton & Tennis

Cycling

Basketball

Hockey

Ski sports

Horse riding

Handball


Football




26

Statistics represent gender stereotypes

Accidents in football (soccer) mostly affect males (87%) and 90% of the injuries occurring while horse riding affect females (Figure 29).

Swimming-related sports, e.g. diving from height into water, account for the highest share of head injures among all types of sports (Figure 30).

Figure 29: Sports practiced at the time of injury by sex

Jogging / Walking

Ice skating sports

Swim sports

Asian combat sports

Volleyball


Badminton & Tennis

Cycling

Basketball

Hockey

Ski sports

Horse riding

Handball


Football

Male

43%

55%

41%

27%

50%

36%

37%

26%

39%

26%

40%

90%

63%

59%

13%

57%

45%

59%

73%

50%

64%

63%

74%

61%

74%

60%

10%

37%

41%

87%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Female

Figure 30: Sports practiced at the time of injury by injured body part

4%

4%

9%

6%

19%

30%

9%

3%

10%

8%

22%

8%

25%

7%

15%

8%

6%

9%

77%

22%

34%

42%

46%

22%

68%

22%

37%

33%

38%

29%

39%

43%

56%

4%

5%

5%

14%

54%

27%

41%

48%

63%

21%

45%

53%

36%

43%

38%

51%

43%

31%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Jogging / Walking

Ice skating sports

Swim sports

Asian combat sports

Volleyball


Badminton & Tennis

Cycling

Basketball

Hockey

Ski sports

Horse riding

Handball


Football

Abdomen, lower back, lumbar spine and pelvis Head

Lower extremities Multiple body parts/whole body affected

Neck, throat Other and unknown body part

Thorax Upper extremities



27

Figure 32: Place of occurrence of home and leisure accidents at the time of injury by age group

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Sports area

Sea, lake and river

Open nature

Transport area

Place, other and unspecified

School, institutional area andpublic premises

Residential area

area

Amusement, entertainment andpark area

Retail, commercial and service

Production and workshop area

2%

3%

4%

4%

9%

12%

13%

17%

19%

33%

19%

12%

22%

18%

17%

36%

59%

15%

10%

34%

21%

15%

17%

15%

17%

23%

10%

10%

8%

31%

47%

49%

41%

37%

41%

24%

4%

35%

31%

2%

10%

22%

16%

25%

16%

6%

14%

23%

31%

0 - 4 5 - 14 15 -24 25 -59 60+



Figure 31: Home and leisure accidents by place of occurrence at the time of injury

Transport area 9%

Open nature 4%

Sports area 15%

Place, other and unspecified 15%

School, institutional area and public premises 10%

Retail, commercial and service area 1%Amusement, entertainment and park area 3% Sea, Lake and river 1%

Residential area 41%

Production and workshop area 1%


Setting oriented injury prevention is required

Risk environments can be identified with the help of the IDB variable “place of occurrence” which allows a setting oriented development of injury prevention policies and measures. More than 40% of all home and leisure accidents occur within the home (in the residential area, e.g. bathroom, staircase, kitchen, etc.) and almost 9% “on the streets” (transport areas; Figure 31). Injuries and accidents in the transport area and shopping area affect the elderly above average (Figure 32). 70% of the injuries in the amusement, entertainment and park area affect people under the age of 25. Traditionally for young children (0 - 4 years) the residential area and the retail and commercial area seem to be dangerous places.

28

5. IDB “ALL INJURY” PILOT DATA

Figure 33: Intentional and unintentional injuries in IDB pilot countries

Unint e ntional92.4%

Int ent ional s e lf -harm1%

As s ault6%

Ot he r viole nce0.1%

Int e nt ional injurie s7.1%

Unde te r m ine d, othe r + uns pe cified int e nt

0.5%

Figure 34: Unintentional injuries by activity (IDB, all injuries - pilot data)

21%

20%

13%

10%

7%

5%

4%

0.4%

Leisure or play

Unpaid work

Sports and exercise during

leisure time

Paid work

Travelling to/from leisure

facilities*

Vital activity

Education

Being taken care of

0% 5% 10% 15% 20% 25%

* incl.travelling to/from sports and excercise during leisure time, to/from entertainment, recreational activity; walking to/from school;

Source:

Launch – first IDB data on all injuries available

From 2007 onwards some of the countries reporting data on hospital treated patients to the IDB extend their data collection from “home and leisure accidents” to “all injuries”. To provide a short preview on the new breadth and depth of the data collected, pilot data from Belgium, Czech Republic, Cyprus, Estonia, Latvia and Malta for the year 2005 and/or 2006 were included in this report. Additional variables to the already established ones (as mentioned in the sections above) were introduced to also capture work and traffic accidents as well as intentional injuries (homicide, suicide). In the newly available injury data a clear distinction between unintentional and intentional injuries can be drawn. Most of the intentional injuries reported to the IDB were results of assaults (Figure 33).

Source: EU Injury Database (IDB, All injuries – pilot data 2005-2006). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007. *Underreporting in the case of intentional injuries due to complications arising from the sensitivity of the topic.

Source: EU Injury Database (IDB, All injuries – pilot data 2005-2006). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007

*

29

Figure 35: Injuries by activity and place of occurrence (IDB, all injuries - pilot data)

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Being taken care of

Education

Paid work

tim e

Unpaid work

Leisure or play

Sports and exercise during leisure

Travelling to/from leisure facilities*

Vital activity

Home

Sports and recreational, cultural areaTransport Area

Industrial/ construction and commercial areaSchool, educational area

Other areas

45%

82%

31%

6%

76%

56%

7%

78%

9%

6%

61%

21%

5%

12%

18%

54%

4%

7%

84%

5%

5%

43%

3%

7%

5%

16%

9%

9%

8%

Source: EU Injury Database (IDB, All injuries – pilot data 2005-2006). Data presentation: Kuratorium für Verkehrssicherheit (KfV), 2007* incl. travelling to/from sports and excercise during leisure time, to/from entertainment, recreational activity; walking to/from school;

IDB “ALL INJURY” PILOT DATA

30

ANNEXA1 DATA PROVIDERS AND DATA SOURCES

This report aims to provide basic characteristics of injuries in the European Union 27 Member States, mostly for the period 2003 to 2005. The data sources described below in alphabetical order were used in order to compile a “Comprehensive View of Injuries” for all relevant levels of injury outcomes, from minor to fatal, as summarized in Table 10.

Injury sector/ Injury outcome Transport/ Traffic Workplace Home, Leisure

and Sports

Total of unintentional

injuriesHomicide, assault Suicide, Suicide

attempt

Total of intentional

injuries

Total of all injuries

Deaths EUROSTAT, WHO, IRTAD, CARE ESAW, WHO -HFA WHO, EUROSTAT WHO, EUROSTAT EUROSTAT, WHO EUROSTAT, WHO EUROSTAT, WHO EUROSTAT, WHO

Disabled

EUROSTATLabour

Force Survey(prevalence)

EUROSTATLabour


EUROSTATLabour


EUROSTATLabour


- - - -

Hospital Discharges: Cases

available (e.g. IRTAD)

IDB All injuries - Pilot data

current IDB countries




IDB All injuries - Pilot data EUROSTAT, WHO

Hospital Outpatient Treatments



current IDB countries






All killed and injured persons IRTAD, WHO ESAW, WHO -HFA National sources National sources National sources National sources National sources National sources

*Injury data sources which were used in this report to complete the matrix are marked in red.

CARE (Community Road Accident Database) - http://ec.europa.eu/transport/care/index_en.htmCARE is a Community database on road accidents resulting in death or injury (no statistics on damage - only accidents). The major difference between CARE and most other existing international databases is the high level of disaggregation, i.e. CARE comprises detailed data on indi-vidual accidents as collected by the Member States. The purpose of CARE system is to provide a powerful tool which would make it possible to identify and quantify road safety problems throughout the European roads, evaluate the efficiency of road safety measures, determine the relevance of Community actions and facilitate the exchange of experience in this field.

Comprehensive View of European Injury Data (CVI) - Final report is available at: http://ec.europa.eu/health/ph_projects/2000/injury/injury_project_2000_full_en.htmThe aim of the study “Comprehensive View of European (Home and Leisure Accidents - HLA) Injury Data” was twofold: first to put the availa-ble HLA data in the context of other injury data, and second to give examples of national estimates for HLA sample data. The proposed Comprehensive View of Injuries is a patchwork and cross-sector approach in order to combine most of the available injury data on both the EU and national level into an EU Injury data model. This model provides key figures on unintentional injuries in the EU both for incidence rates and health care utilisation.

ESAW (European Statistics on Accidents at Work) – http://europa.eu.int/estatref/info/sdds/en/hsw/hsw_acc_work_sm.htmhttp://ec.europa.eu/employment_social/news/2002/apr/esaw_en.htmlThe harmonised data on accidents at work is collected within the framework of the European Statistics on Accidents at Work (ESAW), on the basis of a methodology developed in 1990. The data refers to accidents at work resulting in more than 3 days’ absence from work (serious accidents) and fatal accidents. The national ESAW sources are the declarations of accidents at work, either to the public (Social Security) or private specific insurance for accidents at work, or to other relevant national authority (Labour Inspection, etc.) for countries which have a « universal » Social Security system. For accidents at work data is available for all old EU-Member States (EU 15) and Norway. The methodology is being implemented in the New Member States and in the Candidate Countries with first data to deal with the reference year 2004.

Table 10: Data providers and data sources*

31

EU Injury Database (IDB) - https://webgate.ec.europa.eu/idb/ The IDB is the successor to the former EHLASS (European Home and Leisure Accidents Surveillance System) at DG SANCO (European Com-mission) within the current EU Public Health Programme. The IDB is a EU injury surveillance system based on Accident & Emergency depart-ment data from selected Member State hospitals. (e.g.: Face to face interviews with hospital patients or accompanying persons). This data is aggregated at the EU level in a standardised way and made accessible in a central database. IDB data covers detailed information on the where (Place of occurrence), what (Activity at the time of the injury), how (Mechanism of injury) of the accident and on the involved product, as well basic medical information about the injury (e. g. diagnosis and body part injured). The Injury Database is the only data source in the EU that contains sufficient detail for developing preventive action against the rising tide of home and leisure accidents in Europe. The purpose of the IDB is to facilitate injury prevention in the Member States and at EU level – through trans-national aggregation and harmo-nization of data, and through reporting and benchmarking. The IDB of the year 2007 consists of seven quite consolidated implementations in Austria, Denmark, France, Greece, The Netherlands, Portu-gal and Sweden, and pilot implementations in thirteen more Member States, mostly in the enlarged EU. From 2007 onwards most IDB coun-tries will extend data collection from “Home and Leisure Accidents” to “All Injuries”. Data limitations and biases when comparing different IDB data sets may be given due to different sampling methods and differences in heath care consumption and hospitalisation practices across Member States. Biases and comparability between IDB data sets can be assessed and/or improved through using indicators (e.g. certain types of fractures) and additional data sources (e.g. hospital discharge data) for crosschecks.

EUROSTAT (Statistical information service of the European Union) - http://epp.eurostat.ec.europa.eu/Data on causes of death (COD) provide information on mortality patterns and form a major element of public health information. COD data are derived from death certificates. The medical certification of death is an obligation in all Member States. Countries code the informa-tion of the death certificate into ICD codes. The causes of death are classified by the 65 causes of the “European shortlist” of causes of death. This shortlist is based on the International Statistical Classification of Diseases and Related Health Problems (ICD).The quality of the data is subject to the way in which the information on causes of death is reported and classified in each country (certifi-cation and coding procedures). Procedures for the collection of COD data are relatively homogenous between European countries (death certificate, use of ICD). However, important quality and comparability issues remain (e.g. common coding practices of certain external causes like long term consequences and fatalities of non-residents like tourists). Most health care data available at Eurostat are based on administrative data sources in the countries. Health care data, based on national administrative sources, reflect the country-specific way of organising health care, and may not always be completely comparable. Data on Hospital discharges by diagnosis and average length of stay from Eurostat was available by country, sex and selected ICD codes up to year 2004/2005. Labour Force Survey Data (LFS): The Labour Force Survey is a regularly conducted sample survey (legal basis: Council Regulations No 577/1998 and No 1575/2000) provides a unique source of information for comparable European data on the labour market. The LFS records demographic, social and economic variables for the employed, unemployed and inactive population.

IRTAD (International Road Traffic Accident Database) – http://cemt.org/IRTAD/ The International Road Traffic Accident Database provides detailed and comprehensive data on road accidents in order to provide interna-tionally comparable up to date statistics and consistent time series for the assessment of national developments in the area of traffic safety. IRTAD is now overseen by the Joint OECD/ECMT Transport Research Committee. IRTAD membership is open to all countries, including non OECD (Organization for Economic Co-operation and Development) or ECMT (European Conference of Ministers of Transport) countries.

WHO – Health For All Database - http://www.euro.who.int/hfadbThe European “health for all” database (HFA-DB) provides easy and rapid access to a wide range of basic health statistics for the 52 Member States of the WHO European Region. It was developed by the WHO Regional Office for Europe (WHO/Europe) in the mid-1980s to support the monitoring of health trends in the Region. The database is a helpful tool for international comparison and for assessing the health situ-ation and trends in any European country in an international context. Especially Standardised Death Rates per 100.000 persons are calculated on EU level. SDR is the age-standardized death rate calculated using the direct method, i.e. represents what the crude rate would have been if the population had the same age distribution as the standard European population.HFA-DB occupational injuries include deaths, personal injuries and diseases resulting from work accidents. Work accidents are accidents occurring at or in the course of work which may result in death, personal injury or disease (ILO Yearbook of Labour Statistics). All industries are included. Commuting accidents on the way to or from work are excluded. It is understood that national definitions and registration practices vary significantly.

WHO – Mortality Database (part of the WHO Statistical Information System) - http://www.who.int/whosis/mort/en/The data available comprise deaths registered in national vital registration systems, with underlying cause of death as coded by the relevant national authority according to the rules of ICD. The data available in the WHO Mortality Database allows a more detailed analysis of the different causes of death due to injuries per country, sex and age structure. Data is available for the EU27 except Cyprus. In most cases the last available year is 2004.

ANNEX

32

Tim

e re

fere

nce

for u

sed

data

by

coun

try

EURO

STAT

ESAW

(Eur

osta

t)W

HO

-Mor

talit

y D

atab

ase

WH

O H

ealth

for A

ll D

atab

ase

(HFA

)EU

Inju

ry

Dat

abas

e (ID

B)EC

/ D

G T

REN

CARE

Dat

abas

eIR

TAD

Coun

try

Nam

eA

bbre

viat

ion

Caus

es o

f dea

th b

y re

gion

- A

bsol

ute

num

bers

1

Stan

dard

ised

dea

th

rate

s pe

r 100

000

in

habi

tant

s1

Hos

pita

l dis

char

ge

data

- A

bsol

ute

num

bers

and

ra

tes2

Hos

pita

l day

s an

d In

-pat

ient

ave

rage

le

ngth

of s

tay

(in

days

) of H

ospi

tal

days

due

to in

jury

(S

00-T

98)2

Popu

latio

n da

ta

Perc

enta

ge o

f fa

talit

ies

at w

ork

by

econ

omic

act

ivity

in

EU

-15

3

Caus

es o

f dea

th -

Abs

olut

e N

umbe

rs1

Dea

ths d

ue to

wor

k re

late

d ac

cide

nts

(incl

. kill

ed p

er 1

00

000

inha

bita

nts)

3

Pers

ons

inju

red

due

to w

ork

rela

ted

acci

dent

s (in

cl.

inju

red

per 1

00 0

00

inha

bita

nts)

3

SDR

(all

ages

pe

r 100

000

) of

exte

rnal

cau

ses

of in

jury

and

po

ison

ing1

Hos

pita

l tre

ated

pa

tient

s - A

bsol

ute

num

bers

5

Road

fata

litie

s -

Abs

olut

e nu

mbe

rs1

Road

fata

litie

s by

road

use

r ty

pe- A

bsol

ute

num

bers

1

Inju

red

road

use

rs -

Abs

olut

e nu

mbe

rs 4

Belg

ium

BE19

95 -

1997

1995

- 19

9720

01 -

2003

19

96 -

1998

2003

- 20

0520

02 -

2004

1995

- 19

9720

02 -

2004

2002

- 20

0419

95 -

1997

–20

03 -

2005

2003

- 20

0520

03 -

2005

Bulg

aria

BG20

03 -

2005

2003

- 20

0520

00 -

2002

2000

- 20

0120

03 -

2005

–20

02 -

2004

2001

- 20

0320

01 -

2003

2002

- 20

04–

2003

- 20

05–

–

Czec

h Re

publ

icCZ

2003

- 20

0520

03 -

2005

2001

- 20

03

2001

- 20

0320

03 -

2005

–20

02 -

2004

2003

- 20

0520

03 -

2005

2003

- 20

05–

2003

- 20

0520

03 -

2005

2003

- 20

05

Den

mar

kD

K19

99 -

2001

1999

- 20

0120

01 -

2003

2001

- 20

0320

03 -

2005

2002

- 20

0419

99 -

2001

1999

- 20

0119

99 -

2001

1999

- 20

0120

03 -

2005

2003

- 20

0520

03 -

2005

2003

- 20

05

Ger

man

yD

E20

03 -

2005

2003

- 20

0520

00 -

2002

2000

- 20

0220

03 -

2005

2002

- 20

0420

02 -

2004

2002

- 20

0420

02 -

2004

2002

- 20

04–

2003

- 20

0520

03 -

2005

2003

- 20

05

Esto

nia

EE20

03 -

2005

2003

- 20

0520

01 -

2003

2000

- 20

0220

03 -

2005

–20

03 -

2005

2003

- 20

0520

03 -

2005

2003

- 20

05–

2003

- 20

05–

–

Irela

ndIE

2003

- 20

0520

03 -

2005

2001

- 20

0320

01 -

2003

2003

- 20

0520

02 -

2004

2003

- 20

0520

03 -

2005

2002

- 20

0420

03 -

2005

–20

03 -

2005

2001

- 20

0320

01 -

2003

Gre

ece

EL20

03 -

2005

2003

- 20

0519

97 -

1999

1997

- 19

9920

03 -

2005

2002

- 20

0420

02 -

2004

2000

- 20

0220

00 -

2002

2002

- 20

04–

2003

- 20

0520

03 -

2005

2003

- 20

05

Spai

nES

2003

- 20

0520

03 -

2005

2001

- 20

0320

01 -

2003

2003

- 20

0520

02 -

2004

2002

- 20

0420

02 -

2004

2002

- 20

0420

02 -

2004

–20

03 -

2005

2003

- 20

0520

03 -

2005

Fran

ceFR

2002

- 20

0420

02 -

2004

2002

- 20

0420

02 -

2004

2003

- 20

0520

02 -

2004

2001

- 20

0320

01 -

2003

2001

- 20

0320

01 -

2003

2003

- 20

0520

03 -

2005

2003

- 20

0520

03 -

2005

Italy

IT20

00 -

2002

2000

- 20

0220

00 -

2002

2000

- 20

0220

03 -

2005

2002

- 20

0420

00 -

2002

2002

- 20

0420

02 -

2004

1999

- 20

01–

2003

- 20

0520

02 -

2004

20

02 -

2004

Cypr

usCY

––

2001

- 20

03

2001

- 20

0320

03 -

2005

––

2003

- 20

0520

03 -

2005

2004

–20

03 -

2005

––

Latv

iaLV

2003

- 20

0520

03 -

2005

2000

- 20

0220

00 -

2002

2003

- 20

05–

2002

- 20

0420

03 -

2005

2003

- 20

0520

03 -

2005

–20

03 -

2005

––

Lith

uani

aLT

2003

- 20

0520

03 -

2005

2002

- 20

0420

02 -

2004

2003

- 20

05–

2002

- 20

0420

02 -

2004

2002

- 20

0420

03 -

2005

–20

03 -

2005

––

Luxe

mbo

urg

LU20

03 -

2005

2003

- 20

0520

00 -

2002

2000

- 20

002

2003

- 20

0520

02 -

2004

2002

- 20

0420

03 -

2005

2003

- 20

0520

03 -

2005

–20

03 -

2005

2004

2004

Hun

gary

HU

2003

- 20

0520

03 -

2005

2000

- 20

02–

2003

- 20

05–

2001

- 20

0320

03 -

2005

2003

- 20

0520

03 -

2005

–20

03 -

2005

2003

- 20

0520

03 -

2005

Mal

taM

T20

03 -

2005

2003

- 20

0520

02, 2

004-

2005

2002

, 200

4-20

0520

03 -

2005

–20

02 -

2004

2003

- 20

0520

03 -

2005

2003

- 20

05–

2003

- 20

05–

–

Net

herla

nds

NL

2003

- 20

0520

03 -

2005

2002

- 20

0420

02 -

2004

2003

- 20

0520

02 -

2004

2002

- 20

0420

03 -

2005

2002

- 20

0420

02 -

2004

2003

- 20

0420

03 -

2005

2003

- 20

0520

03 -

2005

Aust

riaAT

2003

- 20

0520

03 -

2005

2002

- 20

0420

02 -

2004

2003

- 20

0520

02 -

2004

2003

- 20

0520

00 -

2002

2003

- 20

0520

03 -

2005

2003

- 20

0520

03 -

2005

2003

- 20

0520

03 -

2005

Pola

ndPL

2003

- 20

0520

03 -

2005

1995

-199

6, 2

001

1995

-199

6, 2

001

2003

- 20

05–

2002

- 20

0420

03 -

2005

2002

- 20

0420

02 -

2004

–20

03 -

2005

2003

- 20

0520

03 -

2005

Port

ugal

PT20

03 -

2005

2003

- 20

0520

00 -

2002

2000

- 20

0220

03 -

2005

2001

- 20

0320

01 -

2003

1999

- 20

0119

99 -

2001

2002

- 20

0420

03 -

2005

2003

- 20

0520

03 -

2005

2003

- 20

05

Rom

ania

RO20

03 -

2005

2003

- 20

0520

00 -

2002

2000

- 20

0220

03 -

2005

–20

02 -

2004

2002

- 20

0420

02 -

2004

2002

- 20

04–

2003

- 20

05–

–

Slov

enia

SI20

03 -

2005

2003

- 20

0520

02, 2

004-

2005

2002

, 200

4-20

0520

03 -

2005

–20

02 -

2004

2003

- 20

0520

03 -

2005

2003

- 20

05–

2003

- 20

0520

03 -

2005

2003

- 20

05

Slov

akia

SK20

03 -

2005

2003

- 20

0520

01 -

2003

20

01 -

2003

20

03 -

2005

–20

00 -

2002

2003

- 20

0520

03 -

2005

2003

- 20

05–

2003

- 20

05–

–

Finl

and

FI20

03 -

2005

2002

- 20

0420

02 -

2004

2002

- 20

0420

03 -

2005

2002

- 20

0420

02 -

2004

2002

- 20

0420

01 -

2003

2003

- 20

05–

2003

- 20

0520

03 -

2005

2003

- 20

05

Swed

enSE

2002

- 20

0420

02 -

2004

2001

- 20

03

2001

- 20

03

2003

- 20

0520

02 -

2004

2000

- 20

0220

03 -

2005

2003

- 20

05 (r

ate:

20

02 -

2004

)20

00 -

2002

2003

- 20

0520

03 -

2005

2003

- 20

0520

03 -

2005

Uni

ted

King

dom

UK

2003

- 20

0520

03 -

2005

2001

- 20

03

2001

- 20

03

2003

- 20

0520

02 -

2004

2002

- 20

0420

01 -

2003

2001

- 20

0320

02 -

2004

2002

2003

- 20

0520

03 -

2005

2003

- 20

05

EU25

EU25

2002

- 20

0420

02 -

2004

calc

ulat

ed fr

om a

vaila

ble

data

of

coun

trie

s20

03 -

2005

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from

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calc

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vaila

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data

of c

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ries

EU27

EU27

2002

- 20

0420

02 -

2004

calc

ulat

ed fr

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vaila

ble

data

of

coun

trie

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03 -

2005

–ca

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ava

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ta o

f cou

ntrie

s–

calc

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ed fr

om a

vaila

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of c

ount

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Sour

ce: h

ttp:

//pu

blic

atio

ns.e

urop

a.eu

/cod

e/pd

f/37

0000

en.h

tm

Abb

revi

atio

ns a

re u

sed

by ra

nkin

g or

by

this

sug

gest

ed o

rder

.

1.

The

med

ical

cer

tifica

tion

of d

eath

is a

n ob

ligat

ion

in a

ll M

embe

r Sta

tes.

Coun

trie

s co

de th

e in

form

atio

n of

the

deat

h ce

rtifi

cate

into

ICD

cod

es.

2. H

ealth

car

e da

ta o

n pa

tient

s ar

e la

rgel

y ba

sed

on a

dmin

istr

ativ

e da

ta s

ourc

es in

the

coun

trie

s.

3 . T

he n

atio

nal E

SAW

/ HFA

sou

rces

are

the

decl

arat

ions

of a

ccid

ents

at w

ork,

eith

er to

the

publ

ic (S

ocia

l Sec

urity

) or p

rivat

e sp

ecifi

c in

sura

nce

for a

ccid

ents

at w

ork,

or t

o ot

her r

elev

ant n

atio

nal a

utho

rity

(Lab

our I

nspe

ctio

n, e

tc.)

for c

ount

ries

havi

ng a

« u

nive

rsal

» S

ocia

l Sec

urity

sys

tem

4

. D

ata

avai

labl

e de

pend

ant o

n th

e IR

TAD

mem

bers

hip

of th

e co

untr

y. P

olic

e da

taba

ses

are

used

.

5. D

eliv

ery

of re

quire

d in

dica

tors

for t

he E

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33

ANNEX

A3 DATA SOURCES OF FIGURES AND TABLES

Figure 1: Injury data: Eurostat - Causes of death by region, Standardised Death Rate (per 100 000 inhabitants) and absolute numbers of all causes of death (A00-Y89) and External causes of injury and poisoning (V01-Y89), EU27, 3 year average of the latest available years. (Values of Cyprus were derived from WHO Health for all Database – no values available at Eurostat).

Figure 2: WHO Mortality Database - Causes of deaths, External causes of injury and poisoning (V01-Y89) registered by cause, sex and age, Absolute numbers, EU27 (excl. Cyprus: no data available), 3 year average of latest available years. Unintentional injuries include: Accidents and adverse effects (V01-X59, Y40-Y86, Y88); n = 172 140. Intentional injuries and injuries of undetermined intent include: Suicide and self-inflicted injury (X60-X84), Homicide and injury purposely inflicted by other persons (X85-Y09), Other external causes (Y10-Y36, Y87, Y89); n = 80 354.

Figure 3: Transport Area: WHO Mortality Database - Transport accidents (V01-V99), Absolute numbers, EU27 excl. Cyprus, 3 year average of latest available years. Work place Area: WHO Health for all Database - Number of deaths due to work-related accidents, EU27, 3 year average of latest available years. Home, Leisure and Sports: WHO Mortality Database - Causes of deaths, Remainder of Unintentional injuries (Accidents and adverse effects, V01 – Y88), Absolute numbers, EU27 excl. CY, 3 year average of latest available years, n = 172 140.

Figures 4 - 7: WHO Mortality Database - Causes of deaths, External causes of injury and poisoning (V01-Y89), Motor vehicle traffic accidents (V02-V04, V09, V12-V14, V19-V79, V86-V89), Accidental falls (W00-W19), All other accidents including late effects (W20-W23, W35-W64, W75-W99, X10-X39, X50-X59, Y85, Y86), Accidents caused by machinery and by cutting and piercing instruments (W24-W31), Accidents caused by firearm missile (W32-W34), Accidental drowning and submersion (W65-W74), Accidents caused by fire and flames (X00-X09), Accidental poisoning (X40-X49), Other transport accidents (V01, V05-V06, V10, V11, V15-V18, V80-V85, V90-V99); Suicide and self-inflicted injury (X60-X84), Homicide and injury purposely inflicted by other persons (X85-Y09); Drugs, medicaments causing adverse effects in therapeutic use (Y40-Y84, Y88); Other external causes (Y10-Y36, Y87, Y89). Absolute numbers, EU27 (excl. Cyprus: no data available), 3 year average of the latest available years, n(all ages) = 252 494; n(1-4) = 1 503; n(15-24) = 21 933; n(65+) = 104 390.

Figure 8: WHO Health for all database – Standardised Death Rate SDR (all ages per 100 000) of external causes of injury and poisoning (V00-V99, W00-W99, X00-X99, Y00-Y99), motor vehicle traffic accidents, suicide and self-inflicted injury, homicide and intentional injury. Deaths due to work-related accidents per 100 000 (Commuting accidents on the way to or from work are excluded). EU27, Index = year 1995. Estimation of the SDR for home and leisure accidents is calculated as the remainder to all external causes of injury and poisoning minus the defined injury sectors.

Figure 9: WHO Mortality Database - Causes of deaths, Absolute numbers of registered deaths by cause, sex and age, External causes of injury and poisoning (V01-Y89). 3 year average of latest available years, EU27 (excl. Cyprus: no data available), sum of male deaths: 171 880; sum of female deaths: 88 120.

Figure 10: Eurostat - Hospital discharges by diagnosis (ISHMT), Inpatients, Total number of hospital discharges due to injury, poisoning and certain other consequences of external causes (S00-T98) in comparison with all hospital discharges A00-Z99 (for Spain: all causes – excluding “healthy newborn babies, Z38”, average 2003-2005), EU27, 3 year average of latest available years.

Figure 11: see source of Table 5, rounded numbers of “Total of all injuries” are displayed.

Figure 12: European Commission / Directorate-General in cooperation with Eurostat - Pocket book „Energy & Transport in Figures 2006”. Road Fatalities (death within 30 days after the accident), Population (in order to calculate rates per 100 000), EU27, 3 year average of latest available years. IRTAD (International Road Traffic and Accident Database) - Injured in road traffic accidents (incl. mopeds and mofas, motorcycles & scooters, passenger cars & station wagons, pedestrians, bicyclists, other & unknown road users), 3 year average of latest available years (no data available of BG, CY, EE, LT, LV, MT, RO).

Figure 13: IRTAD (International Road Traffic and Accident Database) - Killed in road traffic accidents within 30 days, EU27 (excl. data from BG, CY, EE, LT, LV, MT, RO), 3 year average of available countries and latest available years, n = 42 071 (i.e. 89% of all Road Fatalities in EU27).

Figure 14: WHO Health for all Database - Deaths due to work related accidents (and fatalities per 100 000 inhabitants) & Persons injured due to work related accidents (and. injured per 100 000 inhabitants), EU27, 3 year average of the latest available years.

Figure 15: Eurostat / ESAW (European statistics on accidents at work) – Absolute number of fatal accidents at work by economic activity, severity and age, EU15, 3 year average of 2002 – 2004, n = 4 114.

Figure 16: Calculation of Fatal Home and Leisure Accidents: Difference between Eurostat data - Accidents and adverse effects (V01-X59) minus WHO Mortality Database - Transport accidents (V01-V99) and minus WHO Health for all Database-Data (see Figure 14, Injured and deaths due to work-related accidents in EU27). EU Injury Database (IDB): Injured in home and leisure accidents - Hospital episodes after home and leisure accidents, in most cases 3 year average of latest available years (AT, DK, FR, PT, SE: 2003-2005; NL: 2003-2004, UK: 2002). The identification of home and leisure accidents in the routine injury registers is not without controversy as they usually do not represent a category of their own. Here, their scope in the cause of death data is estimated by considering all unintentional fatalities that are neither traffic nor work place accidents.

Figure 17: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Activity at the time of injury (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 741 468.

34

Figure 18: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Age group and gender (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 741 266, n (female) = 335 724; n (male) = 405 542

Figure 19: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Injured body part (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 741 468, displayed categories n = 711 811 (other specified and not specified cases are excluded).

Figure 20: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Activity at the time of injury (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 741 468, displayed categories n = 675 910 (other specified, unspecified and cases with no injury diagnosed are excluded, n = 65 558).

Figure 21: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Injury mechanism (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 741 468, displayed categories n = 711 755 (other specified and not specified cases are excluded).

Figure 22: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Activity at the time of injury, age group and gender (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 492 370, sum of “other specified” and “unspecified activity” (n= 248 896) are not displayed (overall sum all cases: 741 266 cases).

Figure 23: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Activity at the time of injury and gender (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 492 370. Sum of „unspecified“ and „other specified activity“ (n=248 896) are not displayed, (overall sum all cases: 741 266 cases).

Figure 24: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Play and leisure activity and injury mechanism (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 264 774.

Figure 25: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Domestic work and injury mechanism at the time of injury (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 30 955.

Figure 26: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Do-it-yourself work and injury mechanism at the time of injury (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 18 985.

Figure 27: EU Injury Database (IDB): Hospital treated patients, absolute numbers. Sport practised and type of sport practised at the time of injury (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 145 657 (121 776 analysed cases – 11 % “other sports” are not displayed (n=13 378); excluded: „other and unspecified athletics, sports and exercise“ (n=23 881)).

Figure 28: EU Injury Database (IDB): Hospital treated patients, absolute numbers. Sport practised and type of sport practised at the time of injury (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 145 657 (108 397 displayed cases of „ordinary sports groups“; not displayed: „other sports“, n = 13 378; excluded category: „other and unspecified athletics, sports and exercise“ (n=23 881)).

Figure 29: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Sport practised and type of sport practised at the time of injury (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 145 657 (108 398 displayed cases of „ordinary sports groups“; not displayed: „other sports“, n=13 378; excluded category: „other and unspecified athletics, sports and exercise“ (n=23 881)).

Figure 30: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Sport practised and type of sport practised at the time of injury by injured body part (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 145 657 (108 398 displayed cases of „ordinary sports groups“; not displayed: „other sports“, n=13 378; excluded category: „other and unspecified athletics, sports and exercise“ (n=23 881)).

Figure 31: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Place of occurrence at the time of injury (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 741 286.

Figure 32: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Place of occurrence at the time of injury and age group (AT, DK, FR, PT, SE: 2003-2005, NL: 2003-2004), n = 741 286.

Figure 33: EU Injury Database (IDB) - All injuries, pilot data 2005/2006. BE, CY, CZ, EE, LV, MT (n=33 026), Data preparation: KfV, 2007. (Underreporting in the case of intentional injuries due to complications arising from the sensitivity of the topic may exist.)

Figure 34: EU Injury Database (IDB) - All injuries, pilot data 2005/2006. BE, CY, CZ, EE, LV, MT (n=30 562, other and unspecified activity n = 6 134; 20 %; is not displayed), Data preparation: KfV, 2007.

Figure 35: EU Injury Database (IDB) - All injuries, pilot data 2005/2006. BE, CY, CZ, EE, LV, MT (n=25 470, other and unspecified activity and place of occurrence n = 7 597; 23 %; is not displayed), Data preparation: KfV, 2007.

35

ANNEX

Table 1: Eurostat - Causes of death by region, absolute numbers of all causes of death (A00-Y89) and External causes of injury and poisoning (V01-Y89), EU27, 3 year average of the latest available years. (Values of Cyprus were derived from WHO Health for all Database – no values available at Eurostat).

Table 2: Eurostat - Causes of death by region, absolute numbers (3 year average - total numbers, EU27), absolute numbers, considering the ICD-10 main chapters (A00-Y89), 3 year average of the latest available years.

Table 3: WHO Mortality Database - Causes of deaths, External causes of injury and poisoning (V01-Y89), Motor vehicle traffic accidents (V02-V04, V09, V12-V14, V19-V79, V86-V89), Accidental falls (W00-W19), All other accidents including late effects (W20-W23, W35-W64, W75-W99, X10-X39, X50-X59, Y85, Y86), Accidents caused by machinery and by cutting and piercing instruments (W24-W31), Accidents caused by firearm missile (W32-W34), Accidental drowning and submersion (W65-W74), Accidents caused by fire and flames (X00-X09), Accidental poisoning (X40-X49), Other transport accidents (V01, V05-V06, V10, V11, V15-V18, V80-V85, V90-V99); Suicide and self-inflicted injury (X60-X84), Homicide and injury purposely inflicted by other persons (X85-Y09); Drugs, medicaments causing adverse effects in therapeutic use (Y40-Y84, Y88); Other external causes (Y10-Y36, Y87, Y89). Absolute numbers, EU27 (excl. Cyprus: no data available), 3 year average of the latest available years, n(all ages) = 252 494; n(1-4) = 1 503; n(15-24) = 21 933; n(65+) = 104 390.

Table 4: Eurostat - Hospital discharges by diagnosis (ISHMT), Inpatients per 100 000 inhabitants & Absolute numbers of hospital discharges by diagnosis and average length of stay & Hospital days due to injury, poisoning and certain other consequences of external causes (S00-T98) in comparison with total number of all hospital discharges and hospital days, EU27, 3 year average of latest available years. Inpatient average length of stay (ISHMT, in days) and Hospital days of inpatients: Excl. HU (no data available).

Table 5: Fatal Injuries – Transport: WHO Mortality Database – Absolute number of Transport accidents (V01-V99). Fatal Injuries – Work place: WHO Health for all Database - Number of deaths due to work-related accidents. Fatal Injuries – Total of unintentional injuries: WHO Mortality Database - Absolute number of Accidents and adverse effects, (V01 – Y88). Fatal Injuries – Home, Leisure, Sports, School: The home and leisure accidents can be estimated by considering all unintentional fatalities, that are neither transport nor work place accidents. Fatal Injuries – Homicide, assault, other violence: WHO Mortality Database - Absolute number of Suicide and self-inflicted injury (X60-X84), Homicide and injury purposely inflicted by other persons (X85-Y09). Total of all Injuries: incl. Injury fatalities of undetermined intent. Hospital Admissions: Eurostat - Absolute number of Hospital admissions due to injury, poisoning and certain other consequences of external causes (S00-T98); and Injury Database (IDB) pilot data (see “Hospital Outpatients”). Hospital Outpatients: EU Injury Database (IDB) – Home & Leisure Accidents (IDB HLA) 2005; IDB pilot data 2005 and 2006 from Belgium, Czech Republic, Estonia, Germany, Latvia, Malta and Poland (34 200 cases in total; preliminary results). Other medical Treatment: Comprehensive View of European Injury Data (CVI) – Final Report; DG Sanco Public Health / Institut Sicher Leben, Vienna 2003. Disabled (prevalence 16-64): Eurostat – Labour Force Survey 2002, Prevalence of disability and long-standing health problems (unintentional injuries only, population aged 15 to 64). Hospital bed days: Eurostat - Absolute number of hospital days of inpatients due to Injury, poisoning and certain other consequences of external causes (S00-T98); no data available of BG, EE, EL, HU, IT, LV, PT, PL, RO. A 3 year average of the latest available years is calculated for EU27; in most cases 2003 – 2005.

Table 6: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. All home and leisure injuries and products involved in accident plus injury type (AT, DK, FR, SE: 2003-2005), n = 818 315 (for calculation of percentages, „other and unspecified“ and „N.A.“ products are excluded, sum of analysed cases = 341 486), only consumer products are displayed.

Table 7: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Play and leisure activity, products involved in accident and injury type (AT, DK, FR, SE: 2003-2005), n = 288 896 (analysed cases: 133 350; „other and unspecified“ products and „N.A.“ products are excluded, n=155 546), only consumer products are displayed.

Table 8: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Domestic work activity, products involved in accident and injury type (AT, DK, FR, SE: 2003-2005), n = 35 374 (analysed cases: 14 426; „other and unspecified“ products and „N.A.“ products are excluded, n = 20 948), only consumer products are displayed.

Table 9: EU Injury Database (IDB) - Hospital treated patients, absolute numbers. Do-it-yourself activity, products involved in accident and injury type (AT, DK, FR, SE: 2003-2005), n = 20 464 (analysed cases: 10 711; „other and unspecified“ products and „N.A.“ products are excluded, n = 9 753), only consumer products are displayed.

This report is the second edition of a series of annual summaries of key figures on injuries in the European Union. It combines all available data on mortality and morbidity and those provide health policy makers, researchers and safety practitioners with a comprehensive view of this important public health problem.

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