Trends in injury mortality among young people in the European union: a report from the EURORISC working group

doi:10.1016/S1054-139X(99)00112-3

Journal of Adolescent Health

Volume 27, Issue 2, August 2000, Pages 130-135

https://doi.org/10.1016/S1054-139X(99)00112-3 Get rights and content

Abstract

Purpose: To examine the trends in injury mortality among young people aged 15–24 years residing in the 15 current member states of the European Union between 1984 and 1993.

Methods: As part of a European Commission–funded project entitled European Review of Injury Surveillance and Control (EURORISC), mortality data for all externally caused physical injuries (International Classification of Disease Codes E800–999) were obtained from the World Health Organization. Data were analyzed to generate age-specific injury mortality rates and proportional differences in rates over the study period. Linear regression was used to represent the linear component of the mortality profile.

Results: Almost a quarter of a million young people died as a result of sustaining an externally caused physical injury (either unintentional or intentional) in the study countries between 1984 and 1993. Injury accounted for two-thirds of all deaths in this age group. Over three-quarters (76%) of deaths were due to unintentional injury, a further 17% to self-inflicted injuries, and the remaining 7% to homicide and other violent causes. Motor vehicle traffic fatalities accounted for 84% of unintentional injury deaths. Although a decline in injury mortality was observed throughout Europe, rates of mortality owing to both unintentional injuries and suicide varied widely among study countries at both the beginning and end of the study period.

Conclusions: Whereas injury mortality rates in young people in most European countries are lower than in other parts of the world (including the United States), injuries represent a major public health problem in the European Union. The death toll from motor vehicle traffic crashes is a particular cause for concern.

Section snippets

Methods

Mortality data for young people aged 15–24 years who died as a result of an injury between 1984 and 1993 in the 15 current members of the EU were obtained from the World Health Organization (WHO). These countries were Austria, Belgium, Denmark, Finland, France, Germany, Greece, Italy, Ireland, Luxembourg, the Netherlands, Portugal, Spain, Sweden, and the United Kingdom.

Deaths preclassified by the WHO as E47–56 of the basic tabulation list of the Ninth Edition of the International Classification

Results

Over 368,000 young people aged 15–24 years died from all causes in the 15 study countries between 1984 and 1993. Of these, 242,421 (66%) died as a result of sustaining an externally caused physical injury (either unintentional or intentional). This represents a mean annual age-specific injury mortality rate of 45/100,000. Over three-quarters (76%) of these deaths were unintentional, a further 17% were due to self-inflicted injuries, and the remaining 7% were due to homicide and other violent

Discussion

Compared with rates of injury among young people in the United States and elsewhere in the industrialized world, EU countries appear to have relatively low, and declining, rates of injury mortality 3, 4. However, injury was the leading cause of death among young people aged 15–24 years in the EU between 1984 and 1993, accounting for almost two-thirds of all deaths. Despite an overall decrease of 12% in injury mortality and a decrease in both unintentional injury mortality (−15%) and suicide and

References (26)

G.B. Slap et al.
Risk factors for injury during adolescence
J Adolesc Health
(1991)
J.J. Fraser
Nonfatal injuries in adolescents, 1988
J Adolesc Health
(1996)
L. Herrstedt
Traffic calming designA speed management method
Accident Anal Prevent
(1992)
A. Spirito
Relationship between substance use and self-reported injuries among adolescents
J Adolesc Health
(1997)
A. Tursz
Problems in conceptualizing adolescent risk behaviorsInternational comparisons
J Adolesc Health
(1997)
Murray CJL, Lopez AD. The global burden of disease: A comprehensive assessment of mortality and disability from...
L.R. Berger et al.
Injury controlA global view
(1996)
World Health Organization. World Health Statistics Annual. Geneva, Switzerland: World Health Organization,...
Fingerhut LA, Warner M. Injury Chartbook. Health, United States, 1996–1997. Hyattsville, MD: National Center for Health...
L. Fingerhut et al.
Injury mortality among children and teenagers in the United States, 1993
Injury Prevent
(1996)

J.D. Langley et al.

Injury mortality among children and teenagers in New Zealand compared with the United States of America

Injury Prevent

(1997)

S.N. Ameratunga et al.

Adolescent injury hospitalisations in Auckland, New Zealand

J Adolesc Health

(1997)

M. Barker et al.

Disability in young adultsThe role of injuries

J Epidemiol Commun Health

(1993)

Cited by (19)

ER visits predict premature death among teenagers
2012, Accident Analysis and Prevention
Citation Excerpt :
Much effort has been made to reduce the number of casualties among the young. The number of teenagers killed by injury decreased in northern Sweden over the past 20 years (Johansson et al., 2005) as well as in Sweden as a whole (Ekman et al., 2005) and in 13 out of 14 European countries (Morrison and Stone, 2000); however, more work is needed to further reduce these unnecessary deaths. Alcohol and drugs contribute to both fatal and non-fatal injuries among the young and those under the influence also often sustain more severe injuries, require more hospital care, and have a worse outcome (Draus et al., 2008).
The purpose of this study was to investigate if teenagers visiting an emergency room because of injury have an increased risk of premature death ahead and, if so, identify possible risk factors and suggest preventive measures.
In January 2010, the personal identity numbers of 12,812 teenagers who had visited the emergency room at the University Hospital in Umeå, Sweden, during 1993 through 2006 because of injury were checked against the National Cause of Death Register in Sweden. Standardised mortality ratio and confidence intervals were calculated. For the unnatural deaths that took place in Sweden, the police report, autopsy protocol, and hospital records, if present, were studied.
Thirty-eight fatalities were included giving a standardised mortality ratio of 1.44 (95% CI: 1.02–1.98). A majority of the decedents were males (n = 32, 84%) and the median age at the time of death was 21 years. Twenty-three deaths were caused by unintentional injuries and ten by intentional injuries (all suicides), while five deaths were categorised as undetermined whether intentional or not. Seventy-four percent tested positive for either alcohol or drugs or a combination at the post mortem examination. Nine males and one female committed suicide, five tested positive for alcohol (one also for drugs), while four tested negative at the post mortem examination. One died abroad and in this case we lack information on alcohol and drugs.
Teenagers visiting an emergency room due to injury experience an increased risk of premature death by unnatural cause and those at risk are especially males. The use of alcohol and drugs often seems to contribute to their untimely deaths. Identifying those at risk when they visit the emergency room for an injury and to take preventive actions at this stage could be a way to reduce the number of fatalities.
Risky attitudes towards road use in pre-drivers
2008, Accident Analysis and Prevention
Citation Excerpt :
It is well known that young people have an increased risk of both intentional and unintentional injuries and that, globally, motor vehicle accidents are one of the principal causes of adolescent disability or mortality (Morrison and Stone, 2000).
Motor vehicle accidents are one of the principal causes of adolescent disability or mortality and male drivers are more likely to be involved in road accidents than female drivers. In part such associations between driver age and sex have been linked to differences in risky behaviour (e.g. speed, violations) and individual characteristics (e.g. sensation seeking, deviant behaviour). The aim of this research is to determine whether associations between risky road user behaviour and individual characteristics are a function of driver behaviour or whether they are intrinsic and measurable in individuals too young to drive.
Five hundred and sixty-seven pre-driver students aged 11–16 from three secondary schools completed questionnaires measuring enthusiasm for speed, sensation seeking, deviant behaviour and attitudes towards driver violations. Boys reported more risky attitudes than girls for all measures. Associations between sensation seeking, deviant behaviour and attitudes towards risky road use were present from early adolescence and were strongest around age 14, before individuals learn to drive.
Risky attitudes towards road use are associated with individual characteristics and are observed in adolescents long before they learn to drive. Safe attitudes towards road use and driver behaviour should be promoted from childhood in order to be effective.
Prevention and health promotion in school and community settings: A commentary on the international perspective
2003, Journal of Adolescent Health
The injury pattern to children involved in lethal traffic accidents in Berlin
2003, Legal Medicine
A statistical investigation of causes of death of children in Berlin, as well as in the rest of Germany shows, that ‘accidents’ are the most frequent causes of death in children. Nearly 50% of all child fatalities (0–15 years old) are due to traffic accidents. The reports of 30 children (19 boys, 11 girls) that were investigated in one of the three Institutes of Legal Medicine in Berlin over a period of 5 years were studied. In nearly 40% of all cases the children were pedestrians, in ten cases they died as passengers in cars, five children were bicyclists and in one case the child was a skateboarder. In 60% of all cases the principal injuries were severe injuries of the skull and brain; skull and brain trauma was the most frequent cause of death. In the group pedestrians (n=11), the cause of death in ten cases was the severe head-injury. Over 60% of all injured children died at the scene or in the first 24 h after the accident, none of the children survived more than 30 days.
Fighting among Jerusalem adolescents: Personal and school-related factors
2000, Journal of Adolescent Health
%Purpose: To study the prevalence of physical fighting among youth and its association with personal and school-related factors.
Methods: Pupils in the 8th and 10th grades (n = 1182, ages 13–16 years) in 11 Jerusalem secular and religious schools anonymously completed the World Health Organization questionnaire from the Health Behavior in School Children study. The unit of analysis was defined as the number of times the student was involved in physical fighting during the past year. The independent variables studied were sociodemographic characteristics, personal, and school-related factors including teachers, peers, and family.
Results: Fighting at least once was reported by 76% of boys and 26% of girls; 6% of boys who were involved in fights at least once and 16% more than once required medical treatment. For boys, bullying others, poor health and mental health score, and perception of teachers that the pupil was a below-average student significantly increased the odds ratio (OR) for fighting more than once in the past year. Among girls, poor mental health, poor parental support on school matters, bullying, and being bullied by others increased the OR for fighting.
Conclusions: Fighting is a highly prevalent behavior among adolescents irrespective of their socioeconomic background. Determinants differ by gender, and intervention programs should focus on the gender-specific determinants.
Analysis of Trend of Death Rate and Leading Cause of Death among Young People in Eastern Mediterranean Countries during 1990-2019
2022, Iranian Journal of Epidemiology

View all citing articles on Scopus

²: The full text of this article is available via JAH Online at http://www.elsevier.com/locate/jahonline.

¹: Members of the EURORISC Working Group are: Lars Gunnar Horte, Department of Public Health Services, Stockholm, Sweden; Geoff Holman, Produkt-Og Elektrisitetstilsynet, Oslo, Norway; Richard Smithson, Western Health & Social Services Board, Londonderry, Northern Ireland; Anne Kilgallen, North Western Health Board, Co Donegal, Ireland; Elizabeth Towner and Stephen Jarvis, University of Newcastle, Newcastle, England; Christopher Birt, University of Birmingham Collaboration for Public Health in Europe, Birmingham, England; Wim Rogmans and Saajke Mulder, Consumer Safety Institute, Amsterdam, the Netherlands; Anne Tursz, Centre de Recherche Medecine Sciences, Paris, France; Rosa Gofin, Hadassah University Hospital, Jerusalem, Israel; Vita Barell, Ministry of Health, Tel Hashomer, Israel; Leonilda De Santis, Gaslini Children’s Hospital, Genova, Italy; Madalena Cabecadas, Universidade Nova de Lisboa, Lisbon, Portugal; Alberto G. Marchi, IRCCS Burlo Garofolo, Trieste, Italy; and Eleni Petridou, University of Athens School of Medicine, Greece.

View full text

International articleTrends in injury mortality among young people in the European union: a report from the EURORISC working group2

Abstract

Section snippets

Methods

Results

Discussion

J Adolesc Health

J Adolesc Health

Accident Anal Prevent

J Adolesc Health

J Adolesc Health

Injury controlA global view

Injury mortality among children and teenagers in the United States, 1993

Injury Prevent

Injury mortality among children and teenagers in New Zealand compared with the United States of America

Injury Prevent

Adolescent injury hospitalisations in Auckland, New Zealand

J Adolesc Health

Disability in young adultsThe role of injuries

J Epidemiol Commun Health

International article
Trends in injury mortality among young people in the European union: a report from the EURORISC working group²