The Evolution of Unintentional Injury Mortality Among Elderly in Europe

Objectives: To compare cause-specific unintentional injury mortality trends among elderly (65+) in the European Union over a 10-year period. Method: Overall and cause-specific data for 23 out of the 29 EU and European Free Trade Association countries with population ≥ 1,000,000 were retrieved from the World Health Organization (WHO), and age-standardized mortality rates for the first and last 3 available years of the study period were calculated. Proportional mortality changes were estimated through linear regression. Results: Circa 1993, country-specific rates varied widely (>fourfold), but this gap is closing and a statistically significant downward trend in overall mortality is noted circa 2002, in about half of the countries. Rates from falls were reduced by 4.3%, from motor vehicle traffic by 3.1%, and from smoke, fire, and flames by 3.1%. Discussion: A large proportion of EU countries enjoys steady declining trends by major unintentional injury mortality category. Success factors and barriers underlying these benchmarking patterns should be further explored to accelerate the process of injury reduction.

[1]  A. Campbell,et al.  Psychotropic Medication Withdrawal and a Home‐Based Exercise Program to Prevent Falls: A Randomized, Controlled Trial , 1999, Journal of the American Geriatrics Society.

[2]  H M Rosenberg,et al.  Comparability of cause of death between ICD-9 and ICD-10: preliminary estimates. , 2001, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[3]  G E Dallal,et al.  Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. , 1997, The New England journal of medicine.

[4]  R. Doll,et al.  trial community : randomised double blind controlled and mortality in men and women living in the ( cholecalciferol ) supplementation on fractures 3 Effect of four monthly oral vitamin D , 2003 .

[5]  D. Pollock,et al.  Validity of death certificates for injury-related causes of death. , 1989, American journal of epidemiology.

[6]  François Duboeuf,et al.  Vitamin D3 and Calcium to Prevent Hip Fractures in Elderly Women , 1992 .

[7]  P. McFeeley,et al.  Increased pedestrian mortality among the elderly. , 1989, The American journal of emergency medicine.

[8]  E. McAuley,et al.  Tai Chi: improving functional balance and predicting subsequent falls in older persons. , 2004, Medicine and science in sports and exercise.

[9]  F. Racioppi,et al.  Preventing road traffic injury : a public health perspective for Europe , 2004 .

[10]  J. Langley,et al.  International comparisons of injury mortality in the elderly: issues and differences between New Zealand and the United States. , 1995, International journal of epidemiology.

[11]  R. Cumming,et al.  Interventions for preventing falls in the elderly. , 2000 .

[12]  Pekka Kannus,et al.  Exercise in the Prevention of Falls in Older People , 2001, Sports medicine.

[13]  E. Stalioraitytė,et al.  Reliability of cause-specific mortality rate statistics: case of Lithuania. , 2005, Public Health.

[14]  M. Schlichting,et al.  Combined Calcium and Vitamin D3 Supplementation in Elderly Women: Confirmation of Reversal of Secondary Hyperparathyroidism and Hip Fracture Risk: The Decalyos II Study , 2002, Osteoporosis International.

[15]  R. Schwesig,et al.  The effect of cataract surgery on postural control. , 2005, Investigative ophthalmology & visual science.

[16]  Elizabeth Eckstrom,et al.  Tai Chi and fall reductions in older adults: a randomized controlled trial. , 2005, The journals of gerontology. Series A, Biological sciences and medical sciences.

[17]  Gordon S. Smith,et al.  Drowning surveillance: how well do E codes identify submersion fatalities , 1998, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[18]  M. Mckee.  The mortality crisis in transitional economies , 2002 .

[19]  Melonie P. Heron,et al.  Deaths: preliminary data for 2004. , 2006, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[20]  A. Silman,et al.  Falls explain between-center differences in the incidence of limb fracture across Europe. , 2002, Bone.

[21]  R. Harwood,et al.  Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial , 2004, British Journal of Ophthalmology.

[22]  Stephen R Lord,et al.  The Effect of Group Exercise on Physical Functioning and Falls in Frail Older People Living in Retirement Villages: A Randomized, Controlled Trial , 2003, Journal of the American Geriatrics Society.

[23]  E. Arias,et al.  Deaths: preliminary data for 2011. , 2012, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[24]  R. Bertollini,et al.  Reducing inequalities from injuries in Europe , 2006, The Lancet.

[25]  M. Holick,et al.  Elderly women in northern New England exhibit seasonal changes in bone mineral density and calciotropic hormones. , 1994, Bone and mineral.

[26]  Etienne G Krug,et al.  Injury surveillance is key to preventing injuries , 2004, The Lancet.

[27]  P. Kannus,et al.  Prevention of falls and consequent injuries in elderly people , 2005, The Lancet.

[28]  E. Petridou,et al.  Intentional injury mortality in the European Union: how many more lives could be saved? , 2006, Injury Prevention.

[29]  I. Scott.  FALLS AND HEALTH STATUS IN ELDERLY WOMEN FOLLOWING FIRST EYE CATARACT SURGERY: A RANDOMIZED CONTROLLED TRIAL , 2005 .

[30]  François Duboeuf,et al.  Vitamin D3 and Calcium to Prevent Hip Fractures in Elderly Women , 1993 .

[31]  L A Fingerhut,et al.  International comparative analysis of injury mortality. Findings from the ICE on injury statistics. International Collaborative Effort on Injury Statistics. , 1998, Advance data.

[32]  L A Fingerhut.  International Collaborative Effort on Injury Statistics: 10 year review , 2004, Injury Prevention.

[33]  R. Cumming,et al.  WITHDRAWN: Interventions for preventing falls in elderly people. , 2009, The Cochrane database of systematic reviews.

[34]  Bess Dawson-Hughes,et al.  Effect of Vitamin D on falls: a meta-analysis. , 2004, JAMA.

[35]  M. Leinsalu,et al.  Increasing ethnic differences in mortality in Estonia after the collapse of the Soviet Union , 2004, Journal of Epidemiology and Community Health.

[36]  Marcel Haegi,et al.  A new deal for road crash victims , 2002, BMJ : British Medical Journal.

[37]  E Itoi,et al.  Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women. , 2002, Bone.

[38]  T. Miller,et al.  Accurately Assessing Elderly Fall Deaths Using Hospital Discharge and Vital Statistics Data , 2006, The American journal of forensic medicine and pathology.

[39]  E. Petridou,et al.  Unintentional injury mortality in the European Union: How many more lives could be saved? , 2007, Scandinavian journal of public health.

[40]  J. Pasco,et al.  Seasonal Periodicity of Serum Vitamin D and Parathyroid Hormone, Bone Resorption, and Fractures: The Geelong Osteoporosis Study , 2004, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[41]  D. Grabowski,et al.  State motor vehicle laws and older drivers. , 2005, Health economics.

[42]  T. Kaasik,et al.  The effects of political and economic transitions on health and safety in Estonia: an Estonian-Swedish comparative study. , 1998, Social science & medicine.