UK burden of injury is 2.6 times higher than previously thought

December 06, 2011

When using data and information derived from patient experiences, combined with additional morbidity data on patients treated in emergency departments and those admitted to hospital, the absolute burden of injury in the UK is much higher than previously estimated, according to a study published in this week's PLoS Medicine.

The authors of the study, led by Ronan Lyons from Swansea University, in Wales, UK, say: "Whilst considerable uncertainties remain, our best estimate is that injury-related DALYs [disability-adjusted life years] are 2.6 times greater than previously thought, and even if we accept a very conservative approach of assuming no residual disability in all losses to follow-up the population estimate would be 1.6 times earlier estimates."

Furthermore, the authors also found that the vast majority of injuries were unintentional and that the home was the most frequent location of injury.

The authors recruited patients aged over 5 years with a wide range of injuries (including fractures and dislocations, lacerations, bruises and abrasions, sprains, burns and scalds, and head, eye, chest and abdominal injuries) from hospitals in four English cities--Swansea, Nottingham, Bristol, and Guildford--between September 2005 and April 2007.

In the four study sites, a total of 1,517 injured people (median age of 37.4 years and 53.9% male) participated in the study. Using the data and information collected from patient questionnaires about their injuries and the effect on their lives, the authors found that in 2005, there were an estimated 750,999 injury-related hospital admissions, 7,982,947 emergency department attendances, and 22,185 injury-related deaths, translating to a rate per 100 000 of 1,240, 13,339, and 36·8 respectively. Putting all the information together, the authors estimated that the disability life adjusted years (DALYs) related to injury was 1,771,486 in 2005.

The authors say: "Whilst this study was carried out in the UK, the principal findings are relevant across the globe." They continue: "Our results suggest that if the pattern of underestimation seen in the UK was mirrored across the world then injuries may account for up to a quarter of global DALYs rather than a sixth as previously estimated...undoubtedly the global proportion of DALYs from injury is larger than previously estimated."

The authors conclude: "There is already evidence that policy and research responses to injury are grossly inadequate, based upon the previous estimates of the burden."
Funding: This work is based on independent research commissioned and funded by the Policy Research Programme in the Department of Health (reference number 0010009: Moving from Observation to Intervention to reduce inequalities in injuries, H_533). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: DK's research is/has been funded by the NIHR, The Department of Health, the MRC, the US Dept of Health and Human Services, the Nottinghamshire, Derbyshire and Lincolnshire Research Alliance. Nottingham Fire and Rescue Service, the Royal Society for the Prevention of Accidents, the European Commission, the Office of the Deputy Prime Minister and the Royal College of General Practitioners. DK was a co-opted member of the National Institute for Health and Clinical Excellence guideline development group for public health guidance 29 - strategies to prevent unintentional injury in children aged under 15 years and provided expert testimony to the guideline development group on inequities in child injury. All other authors have declared that no competing interests exist.

Citation: Lyons RA, Kendrick D, Towner EM, Christie N, Macey S, et al. (2011) Measuring the Population Burden of Injuries--Implications for Global and National Estimates: A Multi-centre Prospective UK Longitudinal Study. PLoS Med 8(12): e1001140. doi:10.1371/journal.pmed.1001140


Ronan Lyons

Professor of Public Health
Center for Health Information Research and Evaluation

Swansea University
Singleton Park
Swansea, SA2 8PP
United Kingdom
+44 (0)1792 513485


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