Abstract

PIP: The WHO has a special office to coordinate global injury epidemiology and prevention; 2 world Bank policy and planning projects identified injuries as a priority area. The epidemiology of unintentional injuries based on the International Classification of Diseases, Ninth Revision, external causes codes: E800-E949, in developing countries is reviewed. Developing countries are those with an annual gross national product/capita of US$2500, based on 1986 figures form the World Bank. It includes countries generally with a population greater than 1 million. Only Sri Lanka, Thailand, Egypt, and Mauritius reported injury data to the WHO between 1977-87. There were no data available from the Caribbean and Central and South America. Information included here was obtained from a review of world literature on injuries indexed in 3 computer databases: Medlars, Biosis, and Excerpta Medica for the period 1966-90. 2500 reference titles and abstracts were reviewed. Those focusing on risk factors for and causes of injuries were selected for inclusion. Injury mortality is discussed in terms of its health impact and local population based studies. Injury morbidity discussion refers to the Gordon study on the rural Indian population and rates of injuries, urban studies in Brazil, Chile, Cuba, and Venezuela on causes of injury, and longterm disability from a Nepal study, and a Brazilian study on costs of injuries. The discussion of risk factors common to many injuries identifies age and sex particularly for the elderly, and alcohol or kola nuts as leading to higher accidents rates. Poverty, urban residence, and race are also suggested, but there is little evidence to support this. Specific attention is given to the following injuries: drowning, burns and fires, falls, poisoning, animal bites and wounds, machinery or tool or sharp objects, bicycles, eye, and disasters. Emergency medical services have been found to decrease trauma; it is suggested, that for those unable to afford mobile medical units, households and primary health care units need to be able to use simple treatments to control hemorrhage and prevent infection. Treatment and rehabilitation are also considered as well as future needs for research to identify the most significant injuries and risk factors from good quality data.