Nontransport Unintentional Injuries

Excerpt

Injuries are most commonly categorized as unintentional or intentional, based on the injured party’s presumed intent (Norton and Kobusingye 2013). Unintentional injuries comprise both transport and nontransport injuries. This chapter examines in detail the leading causes of nontransport unintentional injuries, namely falls, drowning, burns, and poisoning.

The chapter also briefly discusses the burden of injuries resulting from the other two main categories of nontransport unintentional injuries, namely exposure to forces of nature and all other unintentional injuries combined. All other unintentional injuries combined constitute approximately 38 percent of nontransport unintentional injuries. However, because the numbers of deaths for each cause-specific injury within this group are comparatively small, and because the nature of, risk factors for, and interventions for each cause are unique, this chapter does not include a detailed examination of risk factors or interventions for this group as a whole, nor for any individual cause-specific injury.

Individuals in low- and middle-income countries (LMICs) sustain a higher proportion of deaths and disability-adjusted life years (DALYs) from nontransport unintentional injuries compared with those in high-income countries (HICs). The mortality rates for almost all of these injuries are higher in LMICs than in HICs. The best available evidence suggests that the numbers of deaths from most nontransport unintentional injuries are decreasing globally, with the exception of deaths from falls and possibly from burns, which are increasing.

This chapter places injuries in a global context but documents the burden and known risk factors for nontransport unintentional injuries in LMICs. It also provides an overview of the best available evidence about interventions and policies that are shown to effectively reduce such injuries in those countries. The key focus of the chapter is preventive strategies, although the importance of acute care and rehabilitation is clear, as discussed elsewhere in this volume. Where data are available, the costs and economic benefits of these interventions are outlined.

A consistent theme for every category of cause-specific, nontransport unintentional injury is the dearth of reliable evidence from LMICs on risk factors, interventions, and cost-effective approaches to prevention. This theme reflects the limited availability of human and other resources that would enable researchers to access such information, and it also reflects the low priority key stakeholders place on addressing the burden of such injuries.

The final section makes recommendations about what policy makers need to do to continue the trend of declines in the burden of death and disability from nontransport unintentional injuries; to achieve similar declines for falls; and to reduce the disparities in injury rates between HICs and LMICs.

This chapter follows the World Health Organization (WHO) classification of regions: Africa, the Americas, South-East Asia, Europe, the Eastern Mediterranean, and the Western Pacific.