Traumatic occupational fatalities in South Carolina, 1989-90.

Death certificates for South Carolina for 1989 and 1990 were examined to identify deaths resulting from injury incurred in the workplace. There were 277 deaths in that category in the 2-year period, an average yearly rate for traumatic occupational fatalities of 8.84 per 100,000 workers. The groups of industries with the highest fatality rates were transportation-communication-utilities, construction, and agriculture-fishing-forestry. The leading causes of death were injuries from motor vehicle crash, homicide, and falls. The traumatic occupational fatality rate for men was about 13 times greater than that for women; however, a much higher proportion of women died from homicide on the job. The findings in general reflect trends reported in other studies. The death rates for workers in South Carolina for 1989-90, however, were higher than national averages for 1980-88. National data for 1989-90 were not available for comparison. The data suggest that more effective injury prevention efforts need to be applied to such causes of on-the-job injury as motor vehicle crash, homicide, and falls. Those three categories accounted for more than 56 percent of all traumatic occupational fatalities in South Carolina in 1989 and 1990. Motor vehicle crash prevention efforts particularly are needed in the transportation-communication-utilities industries. The findings show that particular efforts need to be directed to the retail trade category for prevention of homicide and to the construction industry for prevention of falls.     

Injury mortality in American Indian, Hispanic, and non-Hispanic white children in New Mexico, 1958-1982

Childhood fatalities from injuries are a serious public health problem in New Mexico, a state which ranks second in the nation in injury-related mortality rates. To determine the extent of injury mortality in children in this state, and to examine time trends and differences in mortality rates in New Mexico's American Indian, Hispanic, and non-Hispanic white children aged 0-14 years, we analyzed vital records collected from 1958 to 1982. American Indian children experienced the highest mortality rates from all external causes combined. Among all three major ethnic groups, children aged 0-4 years were at the highest risk for injury fatalities. Unintentional injuries accounted for 85% of all injury-related deaths. Motor vehicle crashes and drowning were the first and second leading causes of death in all three groups, while other important causes of death included fire, choking on food or other objects, poisoning, and homicide. Although the fatality rates on most types of injuries decreased over the 25-year period, childhood fatality rates for motor vehicle crashes and homicide increased in each ethnic group. Despite the overall decrease in injury mortality rates in New Mexican children, the rates are excessively high compared to other states, especially in American Indian children.     

A comparison of injury death rates in China and the United States, 1986.

BACKGROUND: The importance of injury as a public health problem is not well recognized in many developing countries. Data have recently become available on injury mortality in China. METHOD: We compared Chinese injury data based on a 100 million population segment for 1986 with data for the United States. RESULTS: The age-adjusted death rate from all injuries for China exceeds the rate for the US (69.0 vs 61.3 per 100,000). The US has higher death rates from motor vehicle crashes, fires, and homicide; China has greater mortality from drowning, poisoning, falls, and suicide. Especially noteworthy in China are the high drowning rates among young children and the elderly and the high suicide rates in rural areas among young adults and the elderly. CONCLUSION: Injury is an important public health problem in China, exceeding in many respects the problem in the United States. It is urgent for China to place high priority on injury research and prevention.     

Traumatic deaths during U.S. Armed Forces basic training, 1977-2001

BACKGROUND: A Recruit Mortality Registry, linked to the Department of Defense Medical Mortality Registry, was created to provide comprehensive medical surveillance data for deaths occurring during enlisted basic military training. METHODS: Recruit deaths from 1977 through 2001 were identified and confirmed through redundant sources. Complete demographic, circumstantial, and medical information was sought for each case and recorded on an abstraction form. Mortality rates per 100,000 recruit-years were calculated by using recruit accession data from the Defense Manpower Data Center. RESULTS: There were 276 recruit deaths from 1977 through 2001 and age-specific recruit mortality rates were less than half of same-age U.S. civilian mortality rates. Only 28% (77 of 276) of recruit deaths were classified as traumatic (suicide, unintentional injury, and homicide), in comparison to three quarters in both the overall active duty military population and the U.S. civilian population (ages 15-34 years). The age-adjusted traumatic death rates were highest in the Army (four times higher than the Navy and Air Force, and 80% higher than the Marine Corps). The majority (60%) of traumatic deaths was due to suicide, followed by unintentional injuries (35%), and homicide (5%). The overall age-adjusted traumatic mortality rate was more than triple for men compared with women in all military services (rate ratio=3.9; p=0.01). CONCLUSIONS: There was a lower proportion of traumatic deaths in recruits compared to the overall active duty military population and same-age U.S. civilian population. This finding could be attributed to close supervision, emphasis on safety, and lack of access to alcohol and motor vehicles during recruit training.     

2013-2015年高唐县60岁及以上老年人意外伤害死亡原因分析

目的 了解2013-2015年高唐县60岁及以上老年人意外伤害死亡原因和流行特征,为制定预防控制措施和行为干预策略提供科学依据。方法 对2013-2015年高唐县60岁及以上老年人意外伤害死亡资料利用描述性流行病学方法进行统计分析。结果 2013-2015年高唐县60岁以上老年人伤害年均死亡率为140.78/10万,标化死亡率93.93/10万,其中男性死亡率167.54/10万,标化死亡率120.51/10万,女性死亡率114.71/10万,标化死亡率69.28/10万,男性高于女性;死亡率随年龄的增长呈上升趋势,各年龄组死亡率男性均高于女性。前五位死亡原因为自杀、机动车交通事故、意外跌落、意外中毒和火灾,占伤害总死亡的90.79%,死亡率分别为43.50/10万、37.57/10万、23.33/10万、12.65/10万、9.49/10万;男性首位死因为机动车交通事故,死亡率为56.92/10万,占伤害总死亡的33.97%;女性和男女合计首位死因为自杀,死亡率分别为43.70/10万、43.50/10万,占人群死亡的38.09%、30.90%;男性和女性前五位死因相同,死因顺位不同,且不同年龄段首位死因不同。结论 自杀和机动车交通事故作为主要死因严重影响老年人的身体健康和生命安全,全社会应高度重视预防控制和行为干预工作,以降低死亡率,提高老年人生存质量。     

Death resulting from motor vehicle immersions: the nature of the injuries, personal and environmental contributing factors, and potential interventions.

We present an epidemiologic characterization of deaths from motor vehicle immersions, based on 77 deaths in 63 motor vehicle immersions in Sacramento County, CA, during 1974-85. All persons were autopsied; all but one of the deaths were due to drowning. Average annual mortality rates per million person years were 12 for males, four for females, 30 for Hispanics, six for White non-Hispanics, Blacks and Asians. Seventy-one percent of drivers and 60 percent of passengers had a blood alcohol concentration greater than or equal to 22 mmol/L. Most cases (57 percent) had an Injury Severity Score of 1 (minor injury) or 0 (no injury). Alcohol use was associated with higher Injury Severity Scores. Road curvature of 20 degrees or greater was far more common at crash sites than at matched control sites one mile away (OR = 6.57, 95% CI = 2.93, 14.71). Guard rail placement along highly curved sections of roadway may be an effective preventive measure.     

Romance with the automobile in the 20th century: implications for adolescents in a new millennium

Nearly three-fourths of deaths among American adolescents and young adults result from only four causes: motor vehicle accidents, other unintentional injuries, homicide, and suicide. Thirty percent of those deaths result from motor vehicle accidents, the number one cause of death among adolescents. A number of factors that influence the morbidity and mortality are associated with driving. Compared to other countries, it is easier for American adolescent to obtain a relatively inexpensive license and gain access to a car. For the young driver, adolescent development and increased risk taking, inexperience, dangerous driving behavior, and alcohol-related factors are of special significance. In this article, we review recent crash statistics as well as effectiveness of various preventive measures, including driver education, graduated licensing, alcohol-related measures, and vehicle-related factors. Graduated licensing and alcohol-related measures have been the most effective measures so far.     

Adolescent and young adult mortality by cause: age, gender, and country, 1955 to 1994.

PURPOSE: To compare mortality rates from motor vehicle accidents (MVA), homicide, and suicide across countries, age groups, and time. METHODS: The World Health Organization Mortality Database was used to construct age- and gender-specific rates in 26 countries for individuals aged 15 to 34 years during the period 1955 to 1994. The rates were adjusted for differences among countries in the age-and-gender distributions of their populations. Cause-specific rates were compared by country, 4-year age groups, 8-year time blocks, and male/female ratios. RESULTS: The proportion of deaths in 15-34-year-olds owing to MVA, homicide, and suicide increased from 26% to 43% over the 40-year study period. Mortality rates differ by country more than time block, peak at ages 15-29 years, and are higher in males than females. Compared to the United States, 24 countries had lower homicide rates and 23 had lower MVA-death rates. CONCLUSIONS: Despite declining rates of death from other causes, the rates of adolescent and young adult death from MVA, homicide, and suicide remain high in countries throughout the world. The proportion of deaths attributable to these causes increased steadily during the latter half of the 20th century. Fatal risk behaviors begin to increase during adolescence but do not peak until age 30 years, suggesting that the target population for prevention extends well beyond the teenage years.     

Alaska native mortality, 1979-1998

OBJECTIVES: This study compares mortality patterns for the Alaska Native population and the U.S. white population for 1989-1998 and examines trends for the 20-year period 1979-1998. METHODS: The authors used death certificate data and Indian Health Service population estimates to calculate mortality rates for the Alaska Native population, age-adjusted to the U.S. 1940 standard million. Data on population and mortality for U.S. whites, aggregated by 10-year age groups and by gender, were obtained from the National Center for Health Statistics, and U.S. white mortality rates were age-adjusted to the U.S. 1940 standard million. RESULTS: Overall, 1989-1998 Alaska Native mortality rates were 60% higher than those for the U.S. white population for the same period. There were significant disparities for eight of 10 leading causes of death, particularly unintentional injury, suicide, and homicide/legal intervention. Although declines in injury rates can be documented for the period 1979-1998, large disparities still exist. Alaska Native death rates for cancer, cerebrovascular disease, chronic obstructive pulmonary disease, and diabetes increased from 1979 to 1998. Given decreases in some cause-specific mortality rates in the U.S. white population, increased rates among Alaska Natives have resulted in new disparities. CONCLUSIONS: These data indicate that improvements in injury mortality rates are offset by marked increases in chronic disease deaths.     

Differential mortality in New York City (1988-1992). Part One: excess mortality among non-Hispanic blacks.

To determine the distribution of mortality for non-Hispanic blacks and non-Hispanic whites in New York City, death certificates issued in New York City during 1988 through 1992, and the relevant 1990 US census data for New York City, have been examined. Age-adjusted death rates for blacks and whites by gender and cause of death were computed based on the US population in 1940. Also, standard mortality ratios and excess mortality were calculated using the New York City mortality rate as reference. The results showed that New York City blacks had higher age-adjusted death rates than whites regardless of cause, including stroke, AIDS, homicide, and diabetes. The rate for New York City blacks was also higher than the US total for both genders. Using New York City mortality rates as a reference, more than 80% of excess deaths in blacks occurred before age 65. Injury/poisoning was the leading cause of excess death (20.1%) in black males, while in black females, cardiovascular disease was the largest single cause of excess deaths (24.8%). The higher death rates, especially premature death, of blacks in New York City are related to conditions such as violence, substance abuse, and AIDS, for which prevention rather than medical care is the more likely solution, as well as to cardiovascular diseases, where both prevention through behavioral change, and health and medical care, can influence outcome.     

The effect of legal drinking age on fatal injuries of adolescents and young adults.

This study examined the effect of legal drinking age (LDA) on fatal injuries in persons aged 15 to 24 years in the United States between 1979 and 1984. Effects on pre-LDA teens, adolescents targeted by LDA, initiation at LDA, and post-LDA drinking experience were assessed. A higher LDA was also associated with reduced death rates for motor vehicle drivers, pedestrians, unintentional injuries excluding motor vehicle injuries, and suicide. An initiation effect on homicides was identified. Reductions in injury deaths related to drinking experience were not found. In general, a higher LDA reduced deaths among adolescents and young adults for various categories of violent death.     

Injury fatalities among young children

Injuries and violence are the primary causes of death among young children in the United States. In particular, in 1982-84 motor vehicle injuries, fires, drowning, and homicide were the leading external causes of death at ages 1-4 years and 5-9 years, accounting for nearly 80 percent of all deaths from external causes. The purpose of this article is to analyze race and sex differentials in injury fatalities among young children. Race and sex differentials in injury mortality were measured in terms of relative risks, that is, race (black to white) and sex (male to female) mortality ratios. Race ratios for external causes ranged from 1.7 to 1.9 for children 1-4 and 5-9, while sex ratios were somewhat lower, 1.4 to 1.8. Although race and sex ratios were relatively small for passenger-related motor vehicle fatalities (0.8 to 1.2) the ratios for pedestrian-related injuries were considerably greater (1.5 to 2.0). Race ratios for deaths caused by fires and homicide were particularly large (3.4 to 4.3). Mortality differences were also measured in terms of excess mortality. For each age-race group more than 65 percent of the overall excess deaths among males were due to external causes of death. Pedestrian-related motor vehicle injuries and drownings accounted for the largest proportion of excess deaths among males. At ages 1-4, 53 percent of the overall excess deaths among blacks were due to external causes. Deaths caused by fires and homicide accounted for more than two-fifths of the excess in this age group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Homicide, suicide, motor vehicle crash, and fall mortality: United States'' experience in comparative perspective.

US mortality data on motor vehicle crashes, falls, suicide, and homicide for 1980 are compared with corresponding data for France, Japan, West Germany, and the United Kingdom. Unadjusted and age-specific death rates are presented, together with age-adjusted rates of years of life lost (YLL). A large male excess in rates is typical outside the fall category. Motor vehicle crashes are the predominant cause of YLL, and the United States manifests the highest YLL rates for each sex. US fall death rates at the older ages are exceeded by those of France and West Germany. The elderly generally manifest the greatest risk of suicide; American females exhibit a unique rate decline after ages 45-54 years, however. Beyond early adulthood, US suicide rates are lower than those of France, Japan, and West Germany. US homicide rates dwarf those of the comparison countries with 16- to 29-fold differentials separating prime-risk American males aged 25-34 years from their foreign counterparts.     

Surveillance for injuries and violence among older adults.

PROBLEM/CONDITION: Injuries and violence are major causes of disability and death among adults aged > or =65 years in the United States. Injuries impair older adults' quality of life and result in billions of dollars in health-care expenditures each year. REPORTING PERIOD: This report reviews 1987-1996 data regarding fall-related deaths, 1988-1996 data on hospitalizations for hip fracture, 1990-1997 data regarding motor vehicle-related injuries, 1990-1996 data on suicides, and 1987-1996 data on homicides. DESCRIPTION OF SYSTEMS: Data on fall-related deaths, suicides, and homicides are from the National Center for Health Statistics annual mortality data tapes for 1987-1996. Homicide data are supplemented with information from the Federal Bureau of Investigation's Supplemental Homicide Reports for 1987-1996. Data on hospitalizations for hip fracture are from the 1988-1996 National Hospital Discharge Surveys. Information regarding motor vehicle-related injuries for 1990-1997 is from the National Highway Traffic Safety Administration's Fatality Analysis Reporting System and General Estimates System. RESULTS: Rates of fall-related deaths for older adults increased sharply with advancing age and were consistently higher among men in all age categories. Men were 22% more likely than women to sustain fatal falls. A trend of increasing rates of fall-related deaths was observed from 1987 through 1996 in the United States, although rates were consistently lower for women throughout this period. Rates of hospitalizations for hip fracture differed by age and were higher for white women than for other groups. Rates increased with advancing age for both sexes but were consistently higher for women in all age categories. U.S. hospitalization rates for hip fracture increased for women from 1988 through 1996 while the rates for men remained stable. Rates of motor vehicle-related injuries increased slightly from 1990 through 1997, and marked variations in state-specific death rates were observed; in most states, older men had death rates approximately twice those for older women. Although suicide rates remain higher among older adults than among any other age group, rates of suicide among adults aged > or =65 years decreased 16% during the study period. Suicide rates among older adults varied by sex and age group. Homicide rates declined 36% among older adults. Homicide rates were highest for black men, followed by black women and white men; the homicide risk for blacks relative to whites decreased from 4.8 to 3.9 per 100,000 persons, indicating that the gap between rates for blacks and whites is closing. Half of the older homicide victims were killed by someone they knew. INTERPRETATION: The increase in rates of fall-related deaths and hip fracture hospitalizations from 1988 through 1996 might reflect a change in the proportion of adults aged > or =85 years compared with those aged 65-84 years - a change that results, in part, from reduced mortality from cardiovascular and other chronic diseases. Fall-related death rates might be higher among older men because they often have a higher prevalence of comorbid conditions than women of similar age. Racial differences in hospitalization rates might have some underlying biologic basis; the prevalence of osteoporosis, a condition that contributes to reduced bone mass and increased bone fragility, is greatest among older white women. Compared with whites aged > or =65 years, blacks of comparable ages have greater bone mass and are less likely to sustain fall-related hip fractures. Additional studies are needed to determine why rates of motor vehicle-related injury have increased slightly among older adults and why these rates vary by state. Declining rates of suicide among older adults might be related to changes in the effect or type of risk factors traditionally observed in this age group. Research is needed to identify reasons for variations in suicide rates among older persons. Homicides among olde     

The injury mortality burden in Guinea

ABSTRACT: BACKGROUND: The injury mortality burden of Guinea has been rarely addressed. The paper aimed to report patterns of injury mortality burden in Guinea. METHODS: We retrieved the mortality data from the Guinean Annual Health Statistics Report 2007. The information about underlying cause of deaths was collected based on Guinean hospital discharge data, Hospital Mortuary and City Council Mortuary data. The causes of death are coded in the 9th International Classification of Diseases (ICD-9). Multivariate Poisson regression was used to test the impacts of sex and age on mortality rates. The statistical analyses were performed using Statatm 10.0. RESULTS: In 2007, 7066 persons were reported dying of injuries in Guinea (mortality: 72.8 per 100,000 population). Transportation, fire/burn, falls, homicide and drowning were the five leading causes of fatal injuries for the whole population, accounting for 37%, 22%, 12%, 10% and 6% of total deaths, respectively. In general, age-specific injury causes displayed similar patterns of the whole population except that poisoning replaced falls as a leading cause among children under five years old. Males were at 30-50% more risk of dying from six commonest causes than females and old age groups had higher injury mortality rates than younger age groups. CONCLUSION: Transportation, fire/burn, falls, homicide, and drowning accounted for the majority of total injury mortality burden in Guinea. Males and old adults were high-risk population of fatal injuries and should be targeted by injury prevention. Lots of work is needed to improve weak capacities for injury control in order to reduce the injury mortality burden.     

Occupation, industry, and fatal motor vehicle crashes in 20 states, 1986-1987.

BACKGROUND: Motor vehicles are a leading cause of injury on and off the job. METHODS: To describe the occurrence of fatal motor vehicle crashes in the working-age population, a case-control study was conducted among persons 15-64 years old who died in 1986 or 1987 in any of 20 states reporting death certificate occupational data to the National Center for Health Statistics. Cases were occupants of motor vehicles (excluding motorcycles) who died of injuries sustained in a crash (E810-E825, 9th revision International Classification of Diseases), and controls died of any other cause. RESULTS: Transportation-related occupations had more than the expected number of deaths for men (odds ratio = 1.6, 95% confidence interval = 1.4-1.9) and women (odds ratio = 2.1, 95% confidence interval = 1.0-4.5), as did managerial occupations (odds ratio = 1.3 and 1.7, 95% confidence interval = 1.1-1.5 and 1.3-2.2 for men and women, respectively). Men in mining and oil drilling occupations and the wholesale trade industry also had excess crash deaths. Among women, additional excesses were observed among professional specialists and in several groups with few deaths, including agriculture, construction, and the military, whereas homemakers had markedly fewer vehicle crash deaths than expected. CONCLUSIONS: These findings encourage further investigation of this important safety hazard, but also call attention to a need for more detailed studies and improved data.     

The Decrease in the Unintentional Injury Mortality Disparity Between American Indians/Alaska Natives and Non–American Indians/Alaska Natives in New Mexico, 1980 to 2009

Objectives. We tracked the unintentional injury death disparity between American Indians/Alaska Natives and non–American Indians/Alaska Natives in New Mexico, 1980 to 2009.Methods. We calculated age-adjusted rates and rate ratios for unintentional injury deaths and their external causes among American Indians/Alaska Natives and non–American Indians/Alaska Natives. We tested trend significance with the Mann–Kendall test.Results. The unintentional injury death rate ratio of American Indians/Alaska Natives to non–American Indians/Alaska Natives declined from 2.9 in 1980–1982 to 1.5 in 2007–2009. The rate among American Indians/Alaska Natives decreased 47.2% from 1980–1982 to 1995–1997. Among non–American Indians/Alaska Natives, the rate declined 25.3% from 1980–1982 to 1992–1994, then increased 31.9% from 1992–1994 to 2007–2009. The motor vehicle traffic and pedestrian death rates decreased 57.8% and 74.6%, respectively, among American Indians/Alaska Natives from 1980–1982 to 2007–2009.Conclusions. The unintentional injury death rate disparity decreased substantially from 1980–1982 to 2007–2009 largely because of the decrease in motor vehicle crash and pedestrian death rates among American Indians/Alaska Natives and the increase in the poisoning death rate among non–American Indians/Alaska Natives.New Mexico had the highest unintentional injury death rate in the nation for the years 2006 through 2008.1 The unintentional injury death rate in the state, 67.1 deaths per 100 000 population, was 1.7 times higher than the US unintentional injury death rate, 39.7 per 100 000 population. In New Mexico, unintentional injuries are the third leading cause of death for all ages and are the leading cause of death for persons aged 1 to 44 years. From 2007 through 2009, poisoning was the leading cause of unintentional injury death. Motor vehicle crashes and falls were the second and third leading causes of unintentional injury death, respectively. These 3 leading causes of unintentional injury death accounted for 85% of all unintentional injury deaths in the state.Nationally, the unintentional injury death rate among the American Indian/Alaska Native (AI/AN) population in the Indian Health Service Area from 2004 to 2006 was 2.4 times higher than the rate for all races in the United States in 2005.2 Whereas American Indians/Alaska Natives in New Mexico have lower rates of death from heart disease, cancer, chronic obstructive pulmonary disease, and stroke than non–American Indian/Alaska Natives, their unintentional injury death rate is higher than the rate among non–American Indians/Alaska Natives.3 Among New Mexico residents, American Indians had the highest total injury mortality rate from 1958 to 1982.4 However, the trend in the disparity in the unintentional injury death rate between American Indians/Alaska Natives and non–American Indians/Alaska Natives in New Mexico has not been examined.The 2007–2009 AI/AN population in New Mexico averaged 201 952, which represented 10.2% of the state’s population.5 The non–AI/AN population averaged 1 786 436, which represented 89.8% of the state’s population.5 By comparison, American Indians/Alaska Natives comprised 1.1% of the US population for 2007 through 2009.5The purpose of this study was to track the disparity in unintentional injury death and external causes of unintentional injury death between the AI/AN population and the non-AI/AN population in New Mexico from 1980 to 2009.     

The role of race/ethnicity in alcohol-attributable injury in the United States

A substantial proportion of injuries worldwide are attributable to alcohol consumption, and US estimates indicate that the drinking patterns of racial/ethnic groups vary considerably. The authors reviewed evidence from 19 publications regarding racial/ethnic differences in overall alcohol-attributable injury as well as percent blood alcohol content positivity for injury deaths in the United States. They found that Native Americans evidence higher rates of alcohol-attributable motor vehicle crash fatality, suicide, and falls compared with other racial/ethnic groups; conversely, Asians evidence lower rates of alcohol-attributable injury than other racial/ethnic groups. The rate of alcohol positivity and intoxication among Hispanics is disproportionately high relative to estimates of alcohol use. Black subgroups also evidence higher rates of alcohol positivity than would be expected given estimates of alcohol use, including for alcohol positivity among drivers of fatally injured black children and homicide. These findings highlight the continued need for public health focus on Native American populations with respect to alcohol consumption and injury. Further, the disparity in alcohol-attributable injury mortality among black and Hispanic groups relative to their reported rates of alcohol consumption is an overlooked area of research. The authors review potential social determinants of racial/ethnic disparities in alcohol-attributable injuries and identify directions for further research on these patterns.