Assessing global risk factors for non-fatal injuries from road traffic accidents and falls in adults aged 35–70 years in 17 countries: a cross-sectional analysis of the Prospective Urban Rural Epidemiological (PURE) study

Objectives To assess risk factors associated with non-fatal injuries (NFIs) from road traffic accidents (RTAs) or falls. Methods Our study included 151 609 participants from the Prospective Urban Rural Epidemiological study. Participants reported whether they experienced injuries within the past 12 months that limited normal activities. Additional questions elicited data on risk factors. We employed multivariable logistic regression to analyse data. Results Overall, 5979 participants (3.9% of 151 609) reported at least one NFI. Total number of NFIs was 6300: 1428 were caused by RTAs (22.7%), 1948 by falls (30.9%) and 2924 by other causes (46.4%). Married/common law status was associated with fewer falls, but not with RTA. Age 65–70 years was associated with fewer RTAs, but more falls; age 55–64 years was associated with more falls. Male versus female was associated with more RTAs and fewer falls. In lower-middle-income countries, rural residence was associated with more RTAs and falls; in low-income countries, rural residence was associated with fewer RTAs. Previous alcohol use was associated with more RTAs and falls; current alcohol use was associated with more falls. Education was not associated with either NFI type. Conclusions This study of persons aged 35–70 years found that some risk factors for NFI differ according to whether the injury is related to RTA or falls. Policymakers may use these differences to guide the design of prevention policies for RTA-related or fall-related NFI.

[1]  A. Kalache,et al.  Epidemiology in old age , 1996 .

[2]  M. Naghavi,et al.  Injury incidence, healthcare consumption and avenues for prevention: a household survey on injury in rural Twiserkan, Iran. , 2009, Public health.

[3]  D. Umberson,et al.  Social Relationships and Health: A Flashpoint for Health Policy , 2010, Journal of health and social behavior.

[4]  Laura A Talbot,et al.  Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury , 2005, BMC public health.

[5]  Ivar Heuch,et al.  Injury morbidity in an urban and a rural area in Tanzania: an epidemiological survey , 2005, BMC public health.

[6]  Salim Yusuf,et al.  The Prospective Urban Rural Epidemiology (PURE) study: examining the impact of societal influences on chronic noncommunicable diseases in low-, middle-, and high-income countries. , 2009, American heart journal.

[7]  R. McClure,et al.  Ten-year health service use outcomes in a population-based cohort of 21,000 injured adults: the Manitoba injury outcome study. , 2006, Bulletin of the World Health Organization.

[8]  Ronan A Lyons,et al.  Measuring the population burden of fatal and nonfatal injury. , 2012, Epidemiologic reviews.

[9]  E. Owoaje,et al.  Incidence and pattern of injuries among residents of a rural area in South-Western Nigeria: a community-based study , 2007, BMC public health.

[10]  A. Uusküla,et al.  Non-fatal injuries resulting in activity limitations in Estonia—risk factors and association with the incidence of chronic conditions and quality of life: a retrospective study among the population aged 20–79 , 2013, BMJ Open.

[11]  S. Yusuf,et al.  Prospective Urban Rural Epidemiology (PURE) study: Baseline characteristics of the household sample and comparative analyses with national data in 17 countries. , 2013, American heart journal.

[12]  Martin McKee,et al.  Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. , 2013, JAMA.

[13]  A. Zwi,et al.  Injuries in developing countries: policy response needed now. , 1996, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[14]  Sarah A. Avellar,et al.  The Effects of Marriage on Health: A Synthesis of Recent Research Evidence (Issue Brief) , 2007 .

[15]  C. Todd,et al.  World Health Organisation Global Report on Falls Prevention in Older Age , 2007 .

[16]  S. Forjuoh.  Intervention in Low-Income Countries , 2012 .

[17]  Christopher JL Murray,et al.  Health metrics and evaluation: strengthening the science , 2008, The Lancet.

[18]  Epidemiological analysis of injury in Shandong Province, China , 2008, BMC public health.

[19]  L. Chambers,et al.  Patterns of self-reported health care use in injured and uninjured older adults. , 1999, Age and ageing.

[20]  R. Dandona,et al.  Population-based estimates of injuries in Sri Lanka , 2009, Injury Prevention.

[21]  J. Sprey.  The Case for Marriage: Why Married People Are Happier, Healthier, and Better off Financially , 2001 .

[22]  Masters MINI-THESIS.  FACULTY OF COMMUNITY AND HEALTH SCIENCES , 2010 .

[23]  R. Andersson,et al.  The epidemiology of moderate and severe injuries in a Nicaraguan community: a household-based survey. , 2006, Public health.

[24]  J. Guillemont,et al.  Alcohol as a risk factor for injury: lessons from French data , 2009, International journal of injury control and safety promotion.

[25]  M. Trevisan,et al.  Alcohol-Related Morbidity and Mortality , 2003, Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism.

[26]  Tami Toroyan,et al.  Global Status Report on Road Safety: Time for Action , 2009 .

[27]  L. Stallones,et al.  Comparison of urban and rural non-fatal injury: the results of a statewide survey , 2003, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[28]  F. Lecky,et al.  A review of injury epidemiology in the UK and Europe: some methodological considerations in constructing rates , 2009, BMC public health.

[29]  R. McClure,et al.  Long term health outcomes after injury in working age adults: a systematic review , 2006, Journal of Epidemiology and Community Health.

[30]  Perianayagam Arokiasamy,et al.  Prevalence, risk factors and disability associated with fall-related injury in older adults in low- and middle-incomecountries: results from the WHO Study on global AGEing and adult health (SAGE) , 2015, BMC Medicine.

[31]  K. Kozaki.  [Fall prevention in the elderly]. , 2010, Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics.

[32]  S. Yusuf,et al.  Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey , 2011, The Lancet.

[33]  J. Crandall,et al.  Vulnerability of female drivers involved in motor vehicle crashes: an analysis of US population at risk. , 2011, American journal of public health.