The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study

Juanita A Haagsma¹, Periklis Charalampous², Filippo Ariani³, Anne Gallay⁴, Kim Moesgaard Iburg⁵, Evangelia Nena⁶, Che Henry Ngwa^{7

8}, Alexander Rommel⁹, Ausra Zelviene¹⁰, Kedir Hussein Abegaz^{11

12}, Hanadi Al Hamad¹³, Luciana Albano¹⁴, Catalina Liliana Andrei¹⁵, Tudorel Andrei¹⁶, Ippazio Cosimo Antonazzo¹⁷, Olatunde Aremu¹⁸, Ashokan Arumugam¹⁹, Alok Atreya²⁰, Avinash Aujayeb²¹, Jose Luis Ayuso-Mateos^{22

23}, Luchuo Engelbert Bain^{24

25}, Maciej Banach^{26

27}, Till Winfried Bärnighausen^{28

29}, Francesco Barone-Adesi³⁰, Massimiliano Beghi³¹, Derrick A Bennett³², Akshaya S Bhagavathula^{33

34}, Félix Carvalho³⁵, Giulio Castelpietra³⁶, Ledda Caterina³⁷, Joht Singh Chandan³⁸, Rosa A S Couto³⁹, Natália Cruz-Martins^{40

41

42}, Giovanni Damiani^{43

44}, Anna Dastiridou⁴⁵, Andreas K Demetriades⁴⁶, Diana Dias-da-Silva⁴⁷, Adeniyi Francis Fagbamigbe⁴⁸, Seyed-Mohammad Fereshtehnejad^{49

50}, Eduarda Fernandes⁵¹, Pietro Ferrara¹⁷, Florian Fischer⁵², Urbano Fra Paleo⁵³, Silvia Ghirini⁵⁴, James C Glasbey⁵⁵, Ionela-Roxana Glavan¹⁶, Nelson G M Gomes^{51

56}, Michal Grivna³³, Netanja I Harlianto⁵⁷, Josep Maria Haro^{58

59}, M Tasdik Hasan^{60

61}, Sorin Hostiuc^{62

63}, Ivo Iavicoli⁶⁴, Milena D Ilic⁶⁵, Irena M Ilic⁶⁶, Mihajlo Jakovljevic^{67

68}, Jost B Jonas^{69

70}, Jacek Jerzy Jozwiak⁷¹, Mikk Jürisson⁷², Joonas H Kauppila^{73

74}, Gbenga A Kayode^{75

76}, Moien A B Khan^{77

78}, Adnan Kisa^{79

80}, Sezer Kisa⁸¹, Ai Koyanagi^{82

83}, Manasi Kumar^{84

85}, Om P Kurmi^{86

87}, Carlo La-Vecchia⁸⁸, Demetris Lamnisos⁸⁹, Savita Lasrado⁹⁰, Paolo Lauriola⁹¹, Shai Linn⁹², Joana A Loureiro⁹³, Raimundas Lunevicius⁹⁴, Aurea Madureira-Carvalho^{42

95}, Enkeleint A Mechili^{96

97}, Azeem Majeed⁹⁸, Ritesh G Menezes⁹⁹, Alexios-Fotios A Mentis^{100

101}, Atte Meretoja^{102

103}, Tomislav Mestrovic^{104

105}, Tomasz Miazgowski¹⁰⁶, Bartosz Miazgowski¹⁰⁷, Andreea Mirica¹⁶, Mariam Molokhia¹⁰⁸, Shafiu Mohammed^{28

109}, Lorenzo Monasta¹¹⁰, Francesk Mulita¹¹¹, Mukhammad David Naimzada^{112

113}, Ionut Negoi^{114

115}, Subas Neupane^{116

117}, Bogdan Oancea¹¹⁸, Hans Orru^{72

119}, Adrian Otoiu¹⁶, Nikita Otstavnov¹¹², Stanislav S Otstavnov^{112

120}, Alicia Padron-Monedero¹²¹, Songhomitra Panda-Jonas⁶⁹, Shahina Pardhan¹²², Jay Patel¹²³, Paolo Pedersini¹²⁴, Marina Pinheiro⁵⁶, Ivo Rakovac¹²⁵, Chythra R Rao¹²⁶, Salman Rawaf^{98

127}, David Laith Rawaf^{128

129}, Violet Rodrigues¹³⁰, Luca Ronfani¹¹⁰, Dominic Sagoe¹³¹, Francesco Sanmarchi¹³², Milena M Santric-Milicevic^{66

133}, Brijesh Sathian^{13

134}, Aziz Sheikh^{135

136}, Rahman Shiri¹³⁷, Siddharudha Shivalli¹³⁸, Inga Dora Sigfusdottir^{139

140

141}, Rannveig Sigurvinsdottir¹³⁹, Valentin Yurievich Skryabin¹⁴², Anna Aleksandrovna Skryabina¹⁴³, Catalin-Gabriel Smarandache¹¹⁴, Bogdan Socea¹¹⁴, Raúl A R C Sousa¹⁴⁴, Paschalis Steiropoulos¹⁴⁵, Rafael Tabarés-Seisdedos^{23

146}, Marcos Roberto Tovani-Palone¹⁴⁷, Fimka Tozija¹⁴⁸, Sarah Van de Velde¹⁴⁹, Tommi Juhani Vasankari¹⁵⁰, Massimiliano Veroux¹⁵¹, Francesco S Violante^{152

153}, Vasiliy Vlassov¹⁵⁴, Yanzhong Wang¹⁵⁵, Ali Yadollahpour¹⁵⁶, Sanni Yaya^{157

158}, Mikhail Sergeevich Zastrozhin^{159

160}, Anasthasia Zastrozhina¹⁶¹, Suzanne Polinder¹, Marek Majdan¹⁶²

Affiliations

¹ Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
² Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. p.charalampous@erasmusmc.nl.
³ Epidemiology Unit, Central Tuscany Local Health Authority, Florence, Italy.
⁴ Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France.
⁵ Department of Public Health, Aarhus University, Aarhus, Denmark.
⁶ Laboratory of Social Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
⁷ School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁸ Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
⁹ Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
¹⁰ Institute of Hygiene, Health Information Center, Kaunas, Lithuania.
¹¹ Department of Biostatistics, Near East University, Nicosia, Cyprus.
¹² Department of Biostatistics and Health Informatics, Madda Walabu University, Bale Robe, Ethiopia.
¹³ Geriatrics and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar.
¹⁴ Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
¹⁵ Cardiology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
¹⁶ Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania.
¹⁷ Research Center On Public Health, University of Milan-Bicocca, Monza, Italy.
¹⁸ Department of Public Health, Birmingham City University, Birmingham, UK.
¹⁹ Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
²⁰ Department of Forensic Medicine, Lumbini Medical College, Palpa, Nepal.
²¹ Northumbria Healthcare NHS Foundation Trust, Cramlington, UK.
²² Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain.
²³ Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain.
²⁴ Lincoln International Institute for Rural Health (LIIRH), University of Lincoln, Lincoln, UK.
²⁵ Global South Health Services and Research, GSHS, Amsterdam, The Netherlands.
²⁶ Department of Hypertension, Medical University of Lodz, Lodz, Poland.
²⁷ Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland.
²⁸ Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany.
²⁹ T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
³⁰ Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
³¹ Department of Mental Health, AUSL Romagna, Cesena, Italy.
³² Clinical Trials Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
³³ Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates.
³⁴ Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Prague, Czech Republic.
³⁵ Research Unit On Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal.
³⁶ Outpatient and Inpatient Care Service, Central Health Directorate, Friuli Venezia Giulia Region, Trieste, Italy.
³⁷ Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
³⁸ Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
³⁹ Department of Chemical Sciences, University of Porto, Porto, Portugal.
⁴⁰ Faculty of Medicine, University of Porto, Porto, Portugal.
⁴¹ Institute for Research & Innovation in Health (i3S), University of Porto, Porto, Portugal.
⁴² Institute of Research and Advanced, Training in Health Sciences and Technologies (INFACTS), Gandra, Portugal.
⁴³ Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, University of Milan, Milan, Italy.
⁴⁴ Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA.
⁴⁵ Department of Ophthalmology, University Hospital of Larissa, Larissa, Greece.
⁴⁶ Edinburgh Spinal Surgery Outcome Studies Group, Department of Neurosurgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
⁴⁷ Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal.
⁴⁸ Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
⁴⁹ Division of Neurology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
⁵⁰ Division of Clinical Geriatrics, Department of Neurobiology, Karolinska Institute, Stockholm, Sweden.
⁵¹ Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal.
⁵² Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany.
⁵³ Research Institute for Sustainable Land Development (Interra), University of Extremadura, Caceres, Spain.
⁵⁴ National Center On Addictions and Doping, Istituto Superiore Di Sanità, Rome, Italy.
⁵⁵ NIHR Global Health Research Unit On Global Surgery, University of Birmingham, Birmingham, UK.
⁵⁶ Department of Chemistry, University of Porto, Porto, Portugal.
⁵⁷ Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands.
⁵⁸ Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain.
⁵⁹ Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain.
⁶⁰ International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
⁶¹ Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK.
⁶² Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
⁶³ Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania.
⁶⁴ Department of Public Health, University of Naples Federico II, Naples, Italy.
⁶⁵ Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia.
⁶⁶ Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
⁶⁷ N. A. Semashko Department of Public Health and Healthcare, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.
⁶⁸ Department of Global Health, Economics and Policy, University of Kragujevac, Kragujevac, Serbia.
⁶⁹ Department of Ophthalmology, Heidelberg University, Mannheim, Germany.
⁷⁰ Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China.
⁷¹ Department of Family Medicine and Public Health, University of Opole, Opole, Poland.
⁷² Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
⁷³ Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
⁷⁴ Surgery Research Unit, University of Oulu, Oulu, Finland.
⁷⁵ International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria.
⁷⁶ Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands.
⁷⁷ Department of Family Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates.
⁷⁸ Primary Care Department, NHS North West London, London, England.
⁷⁹ School of Health Sciences, Kristiania University College, Oslo, Norway.
⁸⁰ Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA.
⁸¹ Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
⁸² Biomedical Research Networking Center for Mental Health Network (CiberSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain.
⁸³ Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.
⁸⁴ Department of Psychiatry, University of Nairobi, Nairobi, Kenya.
⁸⁵ Division of Psychology and Language Sciences, University College London, London, UK.
⁸⁶ Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada.
⁸⁷ Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
⁸⁸ Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
⁸⁹ Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus.
⁹⁰ Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India.
⁹¹ Institute of Clinical Physiology, National Research Council, Pisa, Italy.
⁹² School of Public Health, University of Haifa, Haifa, Israel.
⁹³ Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), University of Porto, Porto, Portugal.
⁹⁴ Department of General Surgery, School of Medicine, Liverpool University Hospitals NHS Foundation Trust, University of Liverpool, Liverpool, UK.
⁹⁵ Laboratório de Farmacognosia, Departamento de Química, Faculdade de Farmácia, Universidade Do Porto, Porto, Portugal.
⁹⁶ Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece.
⁹⁷ Department of Healthcare, Faculty of Public Health, University of Vlora, Vlora, Albania.
⁹⁸ Department of Primary Care and Public Health, Imperial College London, London, UK.
⁹⁹ Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
¹⁰⁰ Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece.
¹⁰¹ Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
¹⁰² School of Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
¹⁰³ Neurology Unit, Helsinki University Hospital, Helsinki, Finland.
¹⁰⁴ Clinical Microbiology and Parasitology Unit, Dr Zora Profozic Polyclinic, Zagreb, Croatia.
¹⁰⁵ University Centre Varazdin, University North, Varazdin, Croatia.
¹⁰⁶ Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland.
¹⁰⁷ Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland.
¹⁰⁸ Faculty of Life Sciences and Medicine, King's College London, London, UK.
¹⁰⁹ Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria.
¹¹⁰ Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy.
¹¹¹ Department of General Surgery, University General Hospital of Patras, Patras, Greece.
¹¹² Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia.
¹¹³ Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russia.
¹¹⁴ Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
¹¹⁵ Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania.
¹¹⁶ Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.
¹¹⁷ Gerontology Research Center, Tampere University, Tampere, Finland.
¹¹⁸ Administrative and Economic Sciences Department, University of Bucharest, Bucharest, Romania.
¹¹⁹ Department of Public Health and Clinical Medicine, Sustainable Health, Umea University, Umea, Sweden.
¹²⁰ Department of Project Management, National Research University Higher School of Economics, Moscow, Russia.
¹²¹ National School of Public Health, Institute of Health Carlos III, Madrid, Spain.
¹²² Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK.
¹²³ Faculty of Medicine and Health, University of Leeds, Leeds, UK.
¹²⁴ IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
¹²⁵ World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation.
¹²⁶ Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
¹²⁷ Academic Public Health Department, Public Health England, London, UK.
¹²⁸ World Health Organization (WHO) Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK.
¹²⁹ University College London Hospitals, London, UK.
¹³⁰ Community Nursing Unit, Ireland Hospital, Abbeyleix, Ireland.
¹³¹ Department of Psychosocial Science, University of Bergen, Bergen, Norway.
¹³² Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
¹³³ School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia.
¹³⁴ Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK.
¹³⁵ Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK.
¹³⁶ Division of General Internal Medicine, Harvard University, Boston, MA, USA.
¹³⁷ Finnish Institute of Occupational Health, Helsinki, Finland.
¹³⁸ Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.
¹³⁹ Department of Psychology, Reykjavik University, Reykjavik, Iceland.
¹⁴⁰ Icelandic Centre for Social Research and Analysis (ICSRA), Reykjavik, Iceland.
¹⁴¹ Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA.
¹⁴² Department No.16, Moscow Research and Practical Centre On Addictions, Moscow, Russia.
¹⁴³ Therapeutic Department, Balashiha Central Hospital, Balashikha, Russia.
¹⁴⁴ Professional Association of Licensed Optometry Professionals, Linda-a-Velha, Portugal.
¹⁴⁵ Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, Alexandroupolis, Greece.
¹⁴⁶ Department of Medicine, University of Valencia, Valencia, Spain.
¹⁴⁷ Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil.
¹⁴⁸ Institute of Public Health of Republic of North Macedonia, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia.
¹⁴⁹ Centre for Population, Family and Health, Department of Sociology, University of Antwerp, Antwerp, Belgium.
¹⁵⁰ UKK Institute, Tampere, Finland.
¹⁵¹ Department of Medical, Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy.
¹⁵² Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
¹⁵³ Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy.
¹⁵⁴ Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia.
¹⁵⁵ School of Population Health and Environmental Sciences, King's College London, London, UK.
¹⁵⁶ Psychology Department, University of Sheffield, Sheffield, UK.
¹⁵⁷ School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada.
¹⁵⁸ The George Institute for Global Health, University of Oxford, Oxford, UK.
¹⁵⁹ Laboratory of Genetics and Genomics, Moscow Research and Practical Centre On Addictions, Moscow, Russia.
¹⁶⁰ Addictology Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia.
¹⁶¹ Pediatrics Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia.
¹⁶² Department of Public Health, Institute for Global Health and Epidemiology, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia.

PMID: 35590340
PMCID: PMC9121595
DOI: 10.1186/s13690-022-00891-6

The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study

Juanita A Haagsma et al. Arch Public Health. 2022.

. 2022 May 20;80(1):142.

doi: 10.1186/s13690-022-00891-6.

Authors

Affiliations

¹ Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
² Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. p.charalampous@erasmusmc.nl.
³ Epidemiology Unit, Central Tuscany Local Health Authority, Florence, Italy.
⁴ Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France.
⁵ Department of Public Health, Aarhus University, Aarhus, Denmark.
⁶ Laboratory of Social Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
⁷ School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁸ Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
⁹ Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
¹⁰ Institute of Hygiene, Health Information Center, Kaunas, Lithuania.
¹¹ Department of Biostatistics, Near East University, Nicosia, Cyprus.
¹² Department of Biostatistics and Health Informatics, Madda Walabu University, Bale Robe, Ethiopia.
¹³ Geriatrics and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar.
¹⁴ Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
¹⁵ Cardiology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
¹⁶ Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania.
¹⁷ Research Center On Public Health, University of Milan-Bicocca, Monza, Italy.
¹⁸ Department of Public Health, Birmingham City University, Birmingham, UK.
¹⁹ Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
²⁰ Department of Forensic Medicine, Lumbini Medical College, Palpa, Nepal.
²¹ Northumbria Healthcare NHS Foundation Trust, Cramlington, UK.
²² Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain.
²³ Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain.
²⁴ Lincoln International Institute for Rural Health (LIIRH), University of Lincoln, Lincoln, UK.
²⁵ Global South Health Services and Research, GSHS, Amsterdam, The Netherlands.
²⁶ Department of Hypertension, Medical University of Lodz, Lodz, Poland.
²⁷ Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland.
²⁸ Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany.
²⁹ T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
³⁰ Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
³¹ Department of Mental Health, AUSL Romagna, Cesena, Italy.
³² Clinical Trials Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
³³ Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates.
³⁴ Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Prague, Czech Republic.
³⁵ Research Unit On Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal.
³⁶ Outpatient and Inpatient Care Service, Central Health Directorate, Friuli Venezia Giulia Region, Trieste, Italy.
³⁷ Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
³⁸ Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
³⁹ Department of Chemical Sciences, University of Porto, Porto, Portugal.
⁴⁰ Faculty of Medicine, University of Porto, Porto, Portugal.
⁴¹ Institute for Research & Innovation in Health (i3S), University of Porto, Porto, Portugal.
⁴² Institute of Research and Advanced, Training in Health Sciences and Technologies (INFACTS), Gandra, Portugal.
⁴³ Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, University of Milan, Milan, Italy.
⁴⁴ Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA.
⁴⁵ Department of Ophthalmology, University Hospital of Larissa, Larissa, Greece.
⁴⁶ Edinburgh Spinal Surgery Outcome Studies Group, Department of Neurosurgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
⁴⁷ Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal.
⁴⁸ Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
⁴⁹ Division of Neurology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
⁵⁰ Division of Clinical Geriatrics, Department of Neurobiology, Karolinska Institute, Stockholm, Sweden.
⁵¹ Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal.
⁵² Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany.
⁵³ Research Institute for Sustainable Land Development (Interra), University of Extremadura, Caceres, Spain.
⁵⁴ National Center On Addictions and Doping, Istituto Superiore Di Sanità, Rome, Italy.
⁵⁵ NIHR Global Health Research Unit On Global Surgery, University of Birmingham, Birmingham, UK.
⁵⁶ Department of Chemistry, University of Porto, Porto, Portugal.
⁵⁷ Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands.
⁵⁸ Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain.
⁵⁹ Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain.
⁶⁰ International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
⁶¹ Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK.
⁶² Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
⁶³ Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania.
⁶⁴ Department of Public Health, University of Naples Federico II, Naples, Italy.
⁶⁵ Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia.
⁶⁶ Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
⁶⁷ N. A. Semashko Department of Public Health and Healthcare, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.
⁶⁸ Department of Global Health, Economics and Policy, University of Kragujevac, Kragujevac, Serbia.
⁶⁹ Department of Ophthalmology, Heidelberg University, Mannheim, Germany.
⁷⁰ Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China.
⁷¹ Department of Family Medicine and Public Health, University of Opole, Opole, Poland.
⁷² Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
⁷³ Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
⁷⁴ Surgery Research Unit, University of Oulu, Oulu, Finland.
⁷⁵ International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria.
⁷⁶ Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands.
⁷⁷ Department of Family Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates.
⁷⁸ Primary Care Department, NHS North West London, London, England.
⁷⁹ School of Health Sciences, Kristiania University College, Oslo, Norway.
⁸⁰ Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA.
⁸¹ Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
⁸² Biomedical Research Networking Center for Mental Health Network (CiberSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain.
⁸³ Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.
⁸⁴ Department of Psychiatry, University of Nairobi, Nairobi, Kenya.
⁸⁵ Division of Psychology and Language Sciences, University College London, London, UK.
⁸⁶ Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada.
⁸⁷ Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
⁸⁸ Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
⁸⁹ Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus.
⁹⁰ Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India.
⁹¹ Institute of Clinical Physiology, National Research Council, Pisa, Italy.
⁹² School of Public Health, University of Haifa, Haifa, Israel.
⁹³ Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), University of Porto, Porto, Portugal.
⁹⁴ Department of General Surgery, School of Medicine, Liverpool University Hospitals NHS Foundation Trust, University of Liverpool, Liverpool, UK.
⁹⁵ Laboratório de Farmacognosia, Departamento de Química, Faculdade de Farmácia, Universidade Do Porto, Porto, Portugal.
⁹⁶ Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece.
⁹⁷ Department of Healthcare, Faculty of Public Health, University of Vlora, Vlora, Albania.
⁹⁸ Department of Primary Care and Public Health, Imperial College London, London, UK.
⁹⁹ Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
¹⁰⁰ Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece.
¹⁰¹ Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
¹⁰² School of Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
¹⁰³ Neurology Unit, Helsinki University Hospital, Helsinki, Finland.
¹⁰⁴ Clinical Microbiology and Parasitology Unit, Dr Zora Profozic Polyclinic, Zagreb, Croatia.
¹⁰⁵ University Centre Varazdin, University North, Varazdin, Croatia.
¹⁰⁶ Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland.
¹⁰⁷ Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland.
¹⁰⁸ Faculty of Life Sciences and Medicine, King's College London, London, UK.
¹⁰⁹ Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria.
¹¹⁰ Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy.
¹¹¹ Department of General Surgery, University General Hospital of Patras, Patras, Greece.
¹¹² Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia.
¹¹³ Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russia.
¹¹⁴ Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
¹¹⁵ Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania.
¹¹⁶ Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.
¹¹⁷ Gerontology Research Center, Tampere University, Tampere, Finland.
¹¹⁸ Administrative and Economic Sciences Department, University of Bucharest, Bucharest, Romania.
¹¹⁹ Department of Public Health and Clinical Medicine, Sustainable Health, Umea University, Umea, Sweden.
¹²⁰ Department of Project Management, National Research University Higher School of Economics, Moscow, Russia.
¹²¹ National School of Public Health, Institute of Health Carlos III, Madrid, Spain.
¹²² Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK.
¹²³ Faculty of Medicine and Health, University of Leeds, Leeds, UK.
¹²⁴ IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
¹²⁵ World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation.
¹²⁶ Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
¹²⁷ Academic Public Health Department, Public Health England, London, UK.
¹²⁸ World Health Organization (WHO) Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK.
¹²⁹ University College London Hospitals, London, UK.
¹³⁰ Community Nursing Unit, Ireland Hospital, Abbeyleix, Ireland.
¹³¹ Department of Psychosocial Science, University of Bergen, Bergen, Norway.
¹³² Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
¹³³ School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia.
¹³⁴ Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK.
¹³⁵ Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK.
¹³⁶ Division of General Internal Medicine, Harvard University, Boston, MA, USA.
¹³⁷ Finnish Institute of Occupational Health, Helsinki, Finland.
¹³⁸ Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.
¹³⁹ Department of Psychology, Reykjavik University, Reykjavik, Iceland.
¹⁴⁰ Icelandic Centre for Social Research and Analysis (ICSRA), Reykjavik, Iceland.
¹⁴¹ Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA.
¹⁴² Department No.16, Moscow Research and Practical Centre On Addictions, Moscow, Russia.
¹⁴³ Therapeutic Department, Balashiha Central Hospital, Balashikha, Russia.
¹⁴⁴ Professional Association of Licensed Optometry Professionals, Linda-a-Velha, Portugal.
¹⁴⁵ Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, Alexandroupolis, Greece.
¹⁴⁶ Department of Medicine, University of Valencia, Valencia, Spain.
¹⁴⁷ Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil.
¹⁴⁸ Institute of Public Health of Republic of North Macedonia, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia.
¹⁴⁹ Centre for Population, Family and Health, Department of Sociology, University of Antwerp, Antwerp, Belgium.
¹⁵⁰ UKK Institute, Tampere, Finland.
¹⁵¹ Department of Medical, Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy.
¹⁵² Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
¹⁵³ Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy.
¹⁵⁴ Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia.
¹⁵⁵ School of Population Health and Environmental Sciences, King's College London, London, UK.
¹⁵⁶ Psychology Department, University of Sheffield, Sheffield, UK.
¹⁵⁷ School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada.
¹⁵⁸ The George Institute for Global Health, University of Oxford, Oxford, UK.
¹⁵⁹ Laboratory of Genetics and Genomics, Moscow Research and Practical Centre On Addictions, Moscow, Russia.
¹⁶⁰ Addictology Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia.
¹⁶¹ Pediatrics Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia.
¹⁶² Department of Public Health, Institute for Global Health and Epidemiology, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia.

PMID: 35590340
PMCID: PMC9121595
DOI: 10.1186/s13690-022-00891-6

Abstract

Background: Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries.

Methods: We performed a secondary database descriptive study using the GBD 2019 results on injuries in 44 European countries from 2000 to 2019. Inequality in DALY rates between these countries was assessed by calculating the DALY rate ratio between the highest-ranking country and lowest-ranking country in each year.

Results: In 2019, in Eastern Europe 80 [95% uncertainty interval (UI): 71 to 89] people per 100,000 died from injuries; twice as high compared to Central Europe (38 injury deaths per 100,000; 95% UI 34 to 42) and three times as high compared to Western Europe (27 injury deaths per 100,000; 95%UI 25 to 28). The injury DALY rates showed less pronounced differences between Eastern (5129 DALYs per 100,000; 95% UI: 4547 to 5864), Central (2940 DALYs per 100,000; 95% UI: 2452 to 3546) and Western Europe (1782 DALYs per 100,000; 95% UI: 1523 to 2115). Injury DALY rate was lowest in Italy (1489 DALYs per 100,000) and highest in Ukraine (5553 DALYs per 100,000). The difference in injury DALY rates by country was larger for males compared to females. The DALY rate ratio was highest in 2005, with DALY rate in the lowest-ranking country (Russian Federation) 6.0 times higher compared to the highest-ranking country (Malta). After 2005, the DALY rate ratio between the lowest- and the highest-ranking country gradually decreased to 3.7 in 2019.

Conclusions: Injury mortality and DALY rates were highest in Eastern Europe and lowest in Western Europe, although differences in injury DALY rates declined rapidly, particularly in the past decade. The injury DALY rate ratio of highest- and lowest-ranking country declined from 2005 onwards, indicating declining inequalities in injuries between European countries.

Keywords: Burden of disease; Disability adjusted life years; Europe; Injuries; Mortality.

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Conflict of interest statement

None declared.

Figures

**Fig. 1**
Map figure with age-standardised DALY rate of injury per 100,000 per country, 2019. *Countries in grey indicate that they do not belong to the GBD European sub-regions

**Fig. 2**
Pyramid figure with DALY rate by sex, country and cause of injury (Level 3), 2019

**Fig. 3**
Age-standardized injury DALY rates, by European sub-region, 2000 – 2019

**Fig. 4**
Ratio of DALY rate per 100,000 in the highest to lowest ranking country, for all countries in Europe (Europe) and for European sub-regions (Central, Eastern, Western) between 2000 and 2019

See this image and copyright information in PMC

References

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The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study

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The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study

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