Population-based incidence and cost of non-fatal injuries in Iran: a consistent under-recognized public health concern

Abstract

Objectives: To investigate the incidence and determinants of non-fatal injuries, and the cost imposed on victims in an Iranian population aged 15-64 years.

Design: Cross-sectional household survey.

Methods: Three-stage probability sampling was conducted for selection of a representative sample of Iranians. Data on the demographics, history and cost of injury were obtained from face-to-face interviews and telephone calls.

Results: In total, 7886 subjects were included in this study. The annual incidence rate of all injuries was 905 (95% confidence interval 853-957) per 1000 population (approximately nine injuries per ten Iranians). The mean (±standard error) incidence rates of first aid injuries (FAIs; medical care not required) and medical-attended injuries (MAIs; medical treatment sought) were 737 ± 24 and 168 ± 12 per 1000 population, respectively. Young, urban females were at highest risk for FAIs, and single males were at highest risk for MAIs. The most common injury description was as follows: non-paid work (activity), home (place), inanimate mechanical force (mechanism), upper limb (site of injury) and open wound (type of injury). For MAIs, the most common place of treatment was hospital. Traffic-related injuries had the highest total cost and the lowest out-of-pocket cost. Total and out-of-pocket costs of non-fatal injuries in Iran in 2011 have been estimated to be US$6,111,138,000 and US$1,480,411,000, respectively.

Conclusion: Non-fatal injuries are an under-recognized public health problem. Cost-control policies are essential to reduce the out-of-pocket cost of injuries.

Keywords: Cost; Epidemiology; Incidence; Injury; Risk factors.