Burden of injury in childhood and adolescence in 8 European countries

BMC Public Health, Jan 2010

Background Injury is the major cause of death and suffering among children and adolescents, but awareness of the problem and political commitment for preventive actions remain unacceptably low. We have assessed variation in the burden of injuries in childhood and adolescence in eight European countries. Methods Hospital, emergency department, and mortality databases of injury patients aged 0-24 years were analyzed for Austria, Denmark, Ireland, Latvia, Netherlands, Norway, Slovenia and the United Kingdom (England, Wales). Years lost due to premature mortality (YLL), years lived with disability (YLD), and disability adjusted life years (DALYs) were calculated. Results Differences in the burden of injury in childhood and adolescence are large, with a fourfold gap between the safest countries (Netherlands and UK) in western-Europe and the relatively unsafe countries (Latvia and Slovenia) in the east. Variation between countries is attributable to high variation in premature mortality (YLL varied from 14-58 per 1000 persons) and disability (YLD varied from 3-10 per 1000 persons). Highest burden is observed among males ages 15-24. If childhood and adolescence injuries are reduced to the level of current best injury prevention practices, 6 DALYs per 1000 child years can be avoided. Conclusions Injuries in childhood and adolescence cause a high disability and mortality burden in Europe. In all developmental stages large inequalities between west and east are observed. Potential benefits up to almost 1 million healthy child years gained across Europe are possible, if proven ways for prevention are more widely implemented. Our children deserve action now.

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Burden of injury in childhood and adolescence in 8 European countries

BMC Public Health Burden of injury in childhood and adolescence in 8 European countries Suzanne Polinder 0 Juanita A Haagsma 0 Hidde Toet 1 Marco JP Brugmans 1 Ed F van Beeck 0 the EUROCOST APOLLO reference groups 0 Department of Public Health, Erasmus Medical Centre, University Medical Centre Rotterdam , The Netherlands 1 Consumer Safety Institute , Amsterdam , The Netherlands Background: Injury is the major cause of death and suffering among children and adolescents, but awareness of the problem and political commitment for preventive actions remain unacceptably low. We have assessed variation in the burden of injuries in childhood and adolescence in eight European countries. Methods: Hospital, emergency department, and mortality databases of injury patients aged 0-24 years were analyzed for Austria, Denmark, Ireland, Latvia, Netherlands, Norway, Slovenia and the United Kingdom (England, Wales). Years lost due to premature mortality (YLL), years lived with disability (YLD), and disability adjusted life years (DALYs) were calculated. Results: Differences in the burden of injury in childhood and adolescence are large, with a fourfold gap between the safest countries (Netherlands and UK) in western-Europe and the relatively unsafe countries (Latvia and Slovenia) in the east. Variation between countries is attributable to high variation in premature mortality (YLL varied from 14-58 per 1000 persons) and disability (YLD varied from 3-10 per 1000 persons). Highest burden is observed among males ages 15-24. If childhood and adolescence injuries are reduced to the level of current best injury prevention practices, 6 DALYs per 1000 child years can be avoided. Conclusions: Injuries in childhood and adolescence cause a high disability and mortality burden in Europe. In all developmental stages large inequalities between west and east are observed. Potential benefits up to almost 1 million healthy child years gained across Europe are possible, if proven ways for prevention are more widely implemented. Our children deserve action now. - Background All over the globe, injuries in childhood and adolescence have a major impact on individual and population health. Each day, the ideals of thousands of our vivid and promising youth are suddenly destroyed by road traffic crashes, injuries at home or during leisure time, or acts of violence. This is largely unnecessary, since an abundance of simple and effective countermeasures are available (e.g. use of bicycle helmets, reduced speed limits, barrier fencing on swimming pools, lower tap water temperatures), but these are underused[1]. For this reason, even in high-income countries, injury is still the leading cause of death and disability among children and adolescents[2,3]. In Europe, each year more than 40,000 children die from injury, [4] and for every child fatality, there are several thousand victims of injury or violence who live with varying degrees of disability or psychological scarring[1]. According to WHO, awareness of the problem and its preventability, as well as political commitment to act to prevent child injury, remain unacceptably low[1]. Therefore, as a first step in addressing this problem, among health policy makers awareness should be raised and priority areas with the highest potential health gains should be identified. This can be accomplished by providing decision makers with summary measures of population health, such as the disability-adjusted life year (DALY)[5]. The DALY is the sum of years lost due to premature mortality (YLL) and years lived with disability (YLD). A high number of DALYs reflects a greater burden of death and disability. The DALY was aimed at national and international health policies, to develop unbiased epidemiological assessments for major disorders, and to provide an outcome measure that could also be used for cost-effectiveness analysis[6]. The human impact of childhood and adolescence injury in terms of DALYs in Europe by country, age, sex, injury type and external cause specifically has not been addressed yet. Expected variation in the burden of injury among the European countries may be caused by differences in exposure, injury risk and type of sustained injury, differences in demography, (socio)economic and cultural factors, safety technology, injury-prevention strategies, and the effectiveness of trauma care. Assessment of the variation of the burden of injury and its separate components can be used to identify high-risk groups in Europe as well as in specific European countries, and it can be used to prioritise injury-prevention programmes. In this paper we assess the impact and variation in the burden of injury in childhood and adolescence in eight European countries. This is expressed in the summary measure of DALYs and its components, namely premature mortality (years of life lost, YLL) and disability (years lived with disability, YLD). To show potential health gains, we estimate the impact on mortality and ( (...truncated)


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Suzanne Polinder, Juanita A Haagsma, Hidde Toet, Marco JP Brugmans, Ed F van Beeck, . Burden of injury in childhood and adolescence in 8 European countries, BMC Public Health, 2010, pp. 45, 10, DOI: 10.1186/1471-2458-10-45