Injury: A leading cause of the burden of disease

An injury is a bodily lesion at the organic level, resulting from acute exposure to energy (mechanical, thermal, electrical, chemical or radiant) in amounts that exceed the threshhold of physical tolerance. In some cases (e.g., in drowning, strangulation, or freezing), the injury results from an insufficiency of a vital element. Most traffic injuries, falls, drownings, fire-related injuries and poisonings are classified as unintentional injuries; injuries due to assaults, self-inflicted injuries, and war are classified as intentional injuries. Injuries, intentional and unintentional, are a large and neglected public health problem all over the world. Injuries have traditionally been regarded as unavoidable accidents. This explains in part why the burden of injuries is high everywhere irrespective of age, gender, geographic region and income of the countries. During the past decades, public health officials and other professionals have recognized that injuries are preventable. As for any health problem, the public health approach to injury prevention involves, as a first step, the determination of the magnitude, scope and characteristics of the problem. Regional and international comparisons provide an important insight into the magnitude of and risk factors for a health problem. These factors can be further studied and may lead to new or improved prevention strategies. For long, only mortality rates were used to describe the magnitude of the problem. However, it is important to realise that for each death from an injury, there are many more injuries that result in hospitalization, treatment in emergency departments or by general practitioners, and treatment outside hospital. Injuries often result in long-term disability. Hence, non-fatal outcomes must also be measured to characterize the burden of injury accurately. The Disability Adjusted Life Year (DALY) takes account of this by combining the number of years of life lost from premature death with the loss of health from disability. The DALY expresses the number of years of life lost (YLLs) summed with a comparatively adjusted measure of years living with disability (YLDs) and duration of disease. The objective of this brief report is to describe the global importance of injuries as a leading cause of death and disability. Global and regional rates and rankings of leading causes of death and burden of disease and injuries are provided. We expect that this information will assist in informed priority setting. This will also provide information for advocacy for allocation of sufficient resources and attention for injury prevention. Contributions should be submitted to JICSP.shortreports@consafe.nl