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- Understand the global impact of injuries and their relative importance as a cause of morbidity and mortality worldwide
- Know the most common categories of intentional and nonintentional injuries, and their relative importance in the global burden of disease
- Identify recommended focus areas for future research in injury prevention
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Injury is a leading cause of mortality worldwide, resulting in more than 5 million deaths annually.1 Global mortality due to injury exceeds that of HIV/AIDS, tuberculosis, and malaria combined.2 Deaths due to injury represent only the tip of the injury iceberg, however. For every person who dies from an injury, several thousand injured persons survive with permanent disability. Additional adverse consequences spill over to affect multiple individuals within the family and community of each injured person.
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In 2004, injuries accounted for approximately 10% of the world’s deaths and over 12% of the global burden of disease.3 The relative importance of injuries within the global burden of disease is expected to rise even further, with injury becoming the third leading cause of death and disability by 2020.4
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Accident versus Injury
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In the past, the term accident was used to describe various categories of unintentional injuries, including those associated with road traffic collisions, falls, burns, and other causes. This traditional view implies that the events leading to injury are random, unavoidable, and unpredictable. Public health officials now recognize that injuries are preventable nonrandom events. After years of historical neglect, injury prevention has become a major area of emphasis within the public health arena. In 2000, the World Health Organization (WHO) established a Department for Injuries and Violence Prevention to promote global initiatives in injury prevention and control. The phenomenon of injury has now been taken out of the realm of chance “accident” and placed squarely within the framework of scientific study, where research is being conducted to design effective injury control interventions.
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Classification of Injuries
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Using the accepted conventions of the WHO,5 injuries can be divided into two broad categories: intentional injuries and unintentional injuries. Intentional injuries are subdivided into self-inflicted injuries (i.e., suicide attempt or completion), interpersonal violence (i.e., homicide or intentional injury to others), and war-related violence. Unintentional injuries are further subdivided into road traffic injuries, poisoning, falls, fires, and drowning. Most public health experts and organizations, including the WHO, use this classification scheme in discussions of global injury surveillance and prevention.
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Mortality versus Disability-Adjusted Life Years
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Mortality due to injuries is a very important indicator of the magnitude of the problem. However, nonfatal outcomes with associated disability and other adverse sequelae must also be considered to fully appreciate the impact of injuries on global health. The disability-adjusted life year (DALY) is an epidemiologic indicator that has been developed to quantify the combined impact of disability and premature death due to illness or injury. ...