. 2016 Feb;22(1):3-18.

doi: 10.1136/injuryprev-2015-041616. Epub 2015 Dec 3.

The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013

Juanita A Haagsma¹, Nicholas Graetz², Ian Bolliger², Mohsen Naghavi², Hideki Higashi², Erin C Mullany², Semaw Ferede Abera³, Jerry Puthenpurakal Abraham⁴, Koranteng Adofo⁵, Ubai Alsharif⁶, Emmanuel A Ameh⁷, Walid Ammar⁸, Carl Abelardo T Antonio⁹, Lope H Barrero¹⁰, Tolesa Bekele¹¹, Dipan Bose¹², Alexandra Brazinova¹³, Ferrán Catalá-López¹⁴, Lalit Dandona¹⁵, Rakhi Dandona¹⁶, Paul I Dargan¹⁷, Diego De Leo¹⁸, Louisa Degenhardt¹⁹, Sarah Derrett²⁰, Samath D Dharmaratne²¹, Tim R Driscoll²², Leilei Duan²³, Sergey Petrovich Ermakov²⁴, Farshad Farzadfar²⁵, Valery L Feigin²⁶, Richard C Franklin²⁷, Belinda Gabbe²⁸, Richard A Gosselin²⁹, Nima Hafezi-Nejad³⁰, Randah Ribhi Hamadeh³¹, Martha Hijar³², Guoqing Hu³³, Sudha P Jayaraman³⁴, Guohong Jiang³⁵, Yousef Saleh Khader³⁶, Ejaz Ahmad Khan³⁷, Sanjay Krishnaswami³⁸, Chanda Kulkarni³⁹, Fiona E Lecky⁴⁰, Ricky Leung⁴¹, Raimundas Lunevicius⁴², Ronan Anthony Lyons⁴³, Marek Majdan⁴⁴, Amanda J Mason-Jones⁴⁵, Richard Matzopoulos⁴⁶, Peter A Meaney⁴⁷, Wubegzier Mekonnen⁴⁸, Ted R Miller⁴⁹, Charles N Mock⁵⁰, Rosana E Norman⁵¹, Ricardo Orozco⁵², Suzanne Polinder⁵³, Farshad Pourmalek⁵⁴, Vafa Rahimi-Movaghar⁵⁵, Amany Refaat⁵⁶, David Rojas-Rueda⁵⁷, Nobhojit Roy⁵⁸, David C Schwebel⁵⁹, Amira Shaheen⁶⁰, Saeid Shahraz⁶¹, Vegard Skirbekk⁶², Kjetil Søreide⁶³, Sergey Soshnikov⁶⁴, Dan J Stein⁶⁵, Bryan L Sykes⁶⁶, Karen M Tabb⁶⁷, Awoke Misganaw Temesgen⁶⁸, Eric Yeboah Tenkorang⁶⁹, Alice M Theadom⁷⁰, Bach Xuan Tran⁷¹, Tommi J Vasankari⁷², Monica S Vavilala⁵⁰, Vasiliy Victorovich Vlassov⁷³, Solomon Meseret Woldeyohannes⁷⁴, Paul Yip⁷⁵, Naohiro Yonemoto⁷⁶, Mustafa Z Younis⁷⁷, Chuanhua Yu⁷⁸, Christopher J L Murray², Theo Vos²

Affiliations

¹ Institute for Health Metrics and Evaluation, Seattle, Washington, USA ErasmusMC, Rotterdam, Netherlands.
² Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
³ Mekelle University, College of Health Sciences, School of Public Health, Mekelle, Tigray, Ethiopia Kilte Awlaelo-Health and Demographic Surveillance Site, Mekelle, Tigray, Ethiopia.
⁴ University of Southern California (USC) Family Medicine Residency Program at California Hospital, a Dignity Health member, Los Angeles, California, USA Harvard School of Public Health/Harvard Institute for Global Health, Boston, Massachusetts, USA.
⁵ Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana.
⁶ Charité Universitätsmedizin, Berlin, Germany.
⁷ Ahmadu Bello University, Zaria, Kaduna State, Nigeria.
⁸ Ministry of Public Health, Beirut, Lebanon.
⁹ Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila, Manila, Philippines.
¹⁰ Department of Industrial Engineering, Pontificia Universidad Javeriana, Bogota, Cundinamarca, Colombia.
¹¹ Madawalabu University, Ethiopia, Bale Goba, Oromia, Ethiopia.
¹² World Bank, Washington DC, USA.
¹³ Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia.
¹⁴ Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency (AEMPS), Ministry of Health, Madrid, Spain.
¹⁵ Institute for Health Metrics and Evaluation, Seattle, Washington, USA Public Health Foundation of India, New Delhi, India.
¹⁶ Public Health Foundation of India, New Delhi, India.
¹⁷ Guy's and St. Thomas' NHS Foundation Trust, London, UK.
¹⁸ Griffith University, Brisbane, Queensland, Australia.
¹⁹ UNSW Australia, Sydney, Australia.
²⁰ Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand School of Public Health, College of Health, Massey University, Palmerston North, New Zealand.
²¹ University of Peradeniya, Peradeniya, Sri Lanka.
²² Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
²³ National Center for Chronic and Noncommunicable Disease Control and Prevention, China CDC, Beijing, China.
²⁴ The Institute of Social and Economic Studies of Population at the Russian Academy of Sciences, Moscow, Russia Federal Research Institute for Health Organization and Informatics of Ministry of Health of Russian Federation, Moscow, Russia.
²⁵ Non-Communicable Diseases Research Center, Endocrine and Metabolic Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
²⁶ National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, New Zealand.
²⁷ James Cook University, Townsville, Queensland, Australia.
²⁸ Monash University, Melbourne, Victoria, Australia.
²⁹ University of California in San Francisco, San Francisco, California, USA.
³⁰ Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.
³¹ Arabian Gulf University, Manama, Bahrain.
³² Fundacion Entornos AC, Cuernavaca, Morelos, Mexico.
³³ Central South University, School of Public Health, Changsha, Hunan, China.
³⁴ Virginia Commonwealth University, Richmond, Virginia, USA.
³⁵ Tianjin Centers for Diseases Control and Prevention, Tianjin, China.
³⁶ Jordan University of Science and Technology, Irbid, Jordan.
³⁷ Health Services Academy, Islamabad, Punjab, Pakistan Expanded Programme on Immunization, Islamabad, Punjab, Pakistan.
³⁸ Oregon Health and Science University, Portland, Oregon, USA.
³⁹ Rajrajeswari Medical College & Hospital, Bangalore, Karnataka, India.
⁴⁰ EMRiS, Health Services Research, University of Sheffield, Sheffield, South Yorkshire, UK.
⁴¹ SUNY-Albany, Rensselaer, New York, USA.
⁴² Aintree University Hospital NHS Foundation Trust, Liverpool, UK School of Medicine, University of Liverpool, Liverpool, UK.
⁴³ Swansea University, Swansea, UK.
⁴⁴ Faculty of Health Sciences and Social Work, Department of Public Health, Trnava University, Trnava, Slovakia.
⁴⁵ University of York, York, UK.
⁴⁶ South African Medical Research Council, Cape Town, South Africa University of Cape Town School of Public Health and Family Medicine, Cape Town, South Africa.
⁴⁷ Pereleman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA Children's Hospital of Philadelphia.
⁴⁸ Addis Ababa University, Addis Ababa, Ethiopia.
⁴⁹ Pacific Institute for Research & Evaluation, Calverton, Maryland, USA Curtin University Centre for Population Health, Perth, Western Australia, Australia.
⁵⁰ University of Washington, Seattle, Washington, USA.
⁵¹ Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
⁵² National Institute of Psychiatry, Mexico City, Distrito Federal, Mexico.
⁵³ ErasmusMC, Rotterdam, Netherlands.
⁵⁴ University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada.
⁵⁵ Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁵⁶ Suez Canal University, Ismailia, Egypt.
⁵⁷ Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain.
⁵⁸ BARC Hospital, HBNI University, Mumbai, Maharashtra, India Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
⁵⁹ University of Alabama at Birmingham, Birmingham, Alabama, USA.
⁶⁰ An-Najah University, Nablus, Palestine.
⁶¹ Tufts Medical Center, Boston, Massachusetts, USA.
⁶² Norwegian Institute of Public Health, Oslo, Norway.
⁶³ Stavanger University Hospital, Stavanger, Norway.
⁶⁴ Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation was founded in 1999 by the order of Ministry of Health of Russia, Moscow, Russia.
⁶⁵ University of Cape Town, Cape Town, Western Province, South Africa MRC Unit on Anxiety & Stress Disorders, Cape Town, Western Cape, South Africa.
⁶⁶ University of California, Irvine, USA.
⁶⁷ University of Illinois at Urbana-Champaign, Champaign, Illinois, USA.
⁶⁸ IHME, Seattle, Washington, USA.
⁶⁹ Memorial University, St. John's, Newfoundland, Canada.
⁷⁰ Auckland University of Technology, Auckland, New Zealand.
⁷¹ Johns Hopkins University, Baltimore, Maryland, USA Hanoi Medical University, Hanoi, Vietnam.
⁷² UKK Institute for Health Promotion Research, Tampere, Finland.
⁷³ Higher School of Economics, Moscow, Russia.
⁷⁴ Institute of Public Health, University of Gondar, Gondar, Amhara, Ethiopia.
⁷⁵ The University of Hong Kong, Hong Kong, China.
⁷⁶ National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
⁷⁷ Jackson State University, Jackson, Mississippi, USA.
⁷⁸ Department of Epidemiology and Biostatistics, School of Public Health, Wuhan, Hubei, China Global Health Institute, Wuhan University, Wuhan, China.

PMID: 26635210
PMCID: PMC4752630
DOI: 10.1136/injuryprev-2015-041616

The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013

Juanita A Haagsma et al. Inj Prev. 2016 Feb.

. 2016 Feb;22(1):3-18.

doi: 10.1136/injuryprev-2015-041616. Epub 2015 Dec 3.

Authors

Affiliations

¹ Institute for Health Metrics and Evaluation, Seattle, Washington, USA ErasmusMC, Rotterdam, Netherlands.
² Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
³ Mekelle University, College of Health Sciences, School of Public Health, Mekelle, Tigray, Ethiopia Kilte Awlaelo-Health and Demographic Surveillance Site, Mekelle, Tigray, Ethiopia.
⁴ University of Southern California (USC) Family Medicine Residency Program at California Hospital, a Dignity Health member, Los Angeles, California, USA Harvard School of Public Health/Harvard Institute for Global Health, Boston, Massachusetts, USA.
⁵ Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana.
⁶ Charité Universitätsmedizin, Berlin, Germany.
⁷ Ahmadu Bello University, Zaria, Kaduna State, Nigeria.
⁸ Ministry of Public Health, Beirut, Lebanon.
⁹ Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila, Manila, Philippines.
¹⁰ Department of Industrial Engineering, Pontificia Universidad Javeriana, Bogota, Cundinamarca, Colombia.
¹¹ Madawalabu University, Ethiopia, Bale Goba, Oromia, Ethiopia.
¹² World Bank, Washington DC, USA.
¹³ Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia.
¹⁴ Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency (AEMPS), Ministry of Health, Madrid, Spain.
¹⁵ Institute for Health Metrics and Evaluation, Seattle, Washington, USA Public Health Foundation of India, New Delhi, India.
¹⁶ Public Health Foundation of India, New Delhi, India.
¹⁷ Guy's and St. Thomas' NHS Foundation Trust, London, UK.
¹⁸ Griffith University, Brisbane, Queensland, Australia.
¹⁹ UNSW Australia, Sydney, Australia.
²⁰ Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand School of Public Health, College of Health, Massey University, Palmerston North, New Zealand.
²¹ University of Peradeniya, Peradeniya, Sri Lanka.
²² Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
²³ National Center for Chronic and Noncommunicable Disease Control and Prevention, China CDC, Beijing, China.
²⁴ The Institute of Social and Economic Studies of Population at the Russian Academy of Sciences, Moscow, Russia Federal Research Institute for Health Organization and Informatics of Ministry of Health of Russian Federation, Moscow, Russia.
²⁵ Non-Communicable Diseases Research Center, Endocrine and Metabolic Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
²⁶ National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, New Zealand.
²⁷ James Cook University, Townsville, Queensland, Australia.
²⁸ Monash University, Melbourne, Victoria, Australia.
²⁹ University of California in San Francisco, San Francisco, California, USA.
³⁰ Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.
³¹ Arabian Gulf University, Manama, Bahrain.
³² Fundacion Entornos AC, Cuernavaca, Morelos, Mexico.
³³ Central South University, School of Public Health, Changsha, Hunan, China.
³⁴ Virginia Commonwealth University, Richmond, Virginia, USA.
³⁵ Tianjin Centers for Diseases Control and Prevention, Tianjin, China.
³⁶ Jordan University of Science and Technology, Irbid, Jordan.
³⁷ Health Services Academy, Islamabad, Punjab, Pakistan Expanded Programme on Immunization, Islamabad, Punjab, Pakistan.
³⁸ Oregon Health and Science University, Portland, Oregon, USA.
³⁹ Rajrajeswari Medical College & Hospital, Bangalore, Karnataka, India.
⁴⁰ EMRiS, Health Services Research, University of Sheffield, Sheffield, South Yorkshire, UK.
⁴¹ SUNY-Albany, Rensselaer, New York, USA.
⁴² Aintree University Hospital NHS Foundation Trust, Liverpool, UK School of Medicine, University of Liverpool, Liverpool, UK.
⁴³ Swansea University, Swansea, UK.
⁴⁴ Faculty of Health Sciences and Social Work, Department of Public Health, Trnava University, Trnava, Slovakia.
⁴⁵ University of York, York, UK.
⁴⁶ South African Medical Research Council, Cape Town, South Africa University of Cape Town School of Public Health and Family Medicine, Cape Town, South Africa.
⁴⁷ Pereleman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA Children's Hospital of Philadelphia.
⁴⁸ Addis Ababa University, Addis Ababa, Ethiopia.
⁴⁹ Pacific Institute for Research & Evaluation, Calverton, Maryland, USA Curtin University Centre for Population Health, Perth, Western Australia, Australia.
⁵⁰ University of Washington, Seattle, Washington, USA.
⁵¹ Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
⁵² National Institute of Psychiatry, Mexico City, Distrito Federal, Mexico.
⁵³ ErasmusMC, Rotterdam, Netherlands.
⁵⁴ University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada.
⁵⁵ Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁵⁶ Suez Canal University, Ismailia, Egypt.
⁵⁷ Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain.
⁵⁸ BARC Hospital, HBNI University, Mumbai, Maharashtra, India Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
⁵⁹ University of Alabama at Birmingham, Birmingham, Alabama, USA.
⁶⁰ An-Najah University, Nablus, Palestine.
⁶¹ Tufts Medical Center, Boston, Massachusetts, USA.
⁶² Norwegian Institute of Public Health, Oslo, Norway.
⁶³ Stavanger University Hospital, Stavanger, Norway.
⁶⁴ Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation was founded in 1999 by the order of Ministry of Health of Russia, Moscow, Russia.
⁶⁵ University of Cape Town, Cape Town, Western Province, South Africa MRC Unit on Anxiety & Stress Disorders, Cape Town, Western Cape, South Africa.
⁶⁶ University of California, Irvine, USA.
⁶⁷ University of Illinois at Urbana-Champaign, Champaign, Illinois, USA.
⁶⁸ IHME, Seattle, Washington, USA.
⁶⁹ Memorial University, St. John's, Newfoundland, Canada.
⁷⁰ Auckland University of Technology, Auckland, New Zealand.
⁷¹ Johns Hopkins University, Baltimore, Maryland, USA Hanoi Medical University, Hanoi, Vietnam.
⁷² UKK Institute for Health Promotion Research, Tampere, Finland.
⁷³ Higher School of Economics, Moscow, Russia.
⁷⁴ Institute of Public Health, University of Gondar, Gondar, Amhara, Ethiopia.
⁷⁵ The University of Hong Kong, Hong Kong, China.
⁷⁶ National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
⁷⁷ Jackson State University, Jackson, Mississippi, USA.
⁷⁸ Department of Epidemiology and Biostatistics, School of Public Health, Wuhan, Hubei, China Global Health Institute, Wuhan University, Wuhan, China.

PMID: 26635210
PMCID: PMC4752630
DOI: 10.1136/injuryprev-2015-041616

Abstract

Background: The Global Burden of Diseases (GBD), Injuries, and Risk Factors study used the disability-adjusted life year (DALY) to quantify the burden of diseases, injuries, and risk factors. This paper provides an overview of injury estimates from the 2013 update of GBD, with detailed information on incidence, mortality, DALYs and rates of change from 1990 to 2013 for 26 causes of injury, globally, by region and by country.

Methods: Injury mortality was estimated using the extensive GBD mortality database, corrections for ill-defined cause of death and the cause of death ensemble modelling tool. Morbidity estimation was based on inpatient and outpatient data sets, 26 cause-of-injury and 47 nature-of-injury categories, and seven follow-up studies with patient-reported long-term outcome measures.

Results: In 2013, 973 million (uncertainty interval (UI) 942 to 993) people sustained injuries that warranted some type of healthcare and 4.8 million (UI 4.5 to 5.1) people died from injuries. Between 1990 and 2013 the global age-standardised injury DALY rate decreased by 31% (UI 26% to 35%). The rate of decline in DALY rates was significant for 22 cause-of-injury categories, including all the major injuries.

Conclusions: Injuries continue to be an important cause of morbidity and mortality in the developed and developing world. The decline in rates for almost all injuries is so prominent that it warrants a general statement that the world is becoming a safer place to live in. However, the patterns vary widely by cause, age, sex, region and time and there are still large improvements that need to be made.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

PubMed Disclaimer

Figures

**Figure 1**
Flowchart of Global Burden of Disease Injury years lived with disability (YLD) estimation.

**Figure 2**
Disability-adjusted life year (DALY) rates by cause of injury, sex and region, ages 0–14 years. For the purposes of these plots, all non-road unintentional injuries have been collapsed to “All Other Unintent” (other transport injury, animal contact categories, foreign body categories, and adverse effects of medical treatment).

**Figure 3**
Disability-adjusted life year (DALY) rates by cause of injury, sex and region, ages 15–49 years of injury, sex and region.

**Figure 4**
Disability-adjusted life year (DALY) rates by cause of injury, sex and region, ages 50–79 years of injury, sex and region.

**Figure 5**
Disability-adjusted life year (DALY) rates by cause of injury, sex and region, ages 80 years and above of injury, sex and region.

**Figure 6**
Percent change in age-standardised all-injury disability-adjusted life year (DALY) rates 1990–2013.

**Figure 7**
Percent change in age-standardised road injury disability-adjusted life year (DALY) rates 1990–2013.

**Figure 8**
Percent change in age-standardised falls disability-adjusted life year (DALY) rates 1990–2013.

**Figure 9**
Percent change in age-standardised fire injury disability-adjusted life year (DALY) rates 1990–2013.

**Figure 10**
Percent change in age-standardised poisoning injury disability-adjusted life year (DALY) rates 1990–2013.

**Figure 11**
Percent change in age-standardised interpersonal violence disability-adjusted life year (DALY) rates 1990–2013.

**Figure 12**
Percent change in age-standardised self-harm disability-adjusted life year (DALY) rates 1990–2013.

See this image and copyright information in PMC

Comment in

Effect of injuries worldwide has fallen by almost a third since 1990.
Kmietowicz Z. Kmietowicz Z. BMJ. 2015 Dec 3;351:h6548. doi: 10.1136/bmj.h6548. BMJ. 2015. PMID: 26637201 No abstract available.

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The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013

Affiliations

The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013

Authors

Affiliations

Abstract

Figures

Comment in

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical