An epidemiological study of non-fatal injuries in a Swedish county

Abstract: An Epidemiological Study of Non-fatal Injuries in a Swedish County by Elsvig Eilert-Petersson, Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, SE-172 83 Sundbyberg, Sweden The main objective of this thesis is to describe the epidemiological injury pattern (including both oral and bodily injuries) in a defined Swedish population. Analysis is performed in three steps: a general overview; a focus on oral and bodily injuries, Paper I, and on the most exposed age groups for tooth injuries (children and adolescents), Paper II; and exemplifying situational analyses of bicycle (Paper III) and pedestrian injuries (Paper IV), and school injuries Paper V. Bodily injuries were far more common than oral injuries (95% and 5% respectively). The main environments in which both oral and bodily injuries were incurred were residential and sport areas. The risk of sustaining bodily injuries was highest in the ages 13-19 years. Incidence gradually decreased with age, up to the age of 80 years when it started to increase again. Oral injuries are most common in the age range up to 30, and tooth injuries more frequent up to the age of 19. About one-third of all oral injuries are classified as complicated, meaning that the pulpal tissue or periodontal membrane is severely damaged. Boys suffered more uncomplicated injuries to permanent teeth, while girls tended to sustain more uncomplicated injuries to primary teeth. Considerable differences were found between oral and bodily injuries with regard to patient's age, gender, injury environment, mechanism of injury, and time of injury. Unprotected road users (pedestrians and cyclists) sustained 78% of all traffic injuries. There are major differences between bicycle and pedestrian injuries related to age, gender, and time of the year. The highest incidence of bicycle injuries was for persons in the age range 10-19 (both males and females). Pedestrian injuries were sustained largely by women, often over 50. Bicycle injuries were usually incurred between May and August, and pedestrian injuries between November and January. Single-party events (where only one person was involved in an injury event) predominated. Of injured bicyclists 11% suffered oral injuries, while 10.4% of school injuries were oral injuries. A strategy for the analysis of surveillance data on school injuries is proposed. A typology comprising five injury patterns was obtained. Each pattern was described in quantitative terms, and its most significant characteristics were identified by means of two multivariate analysis. Injury surveillance is an extremely useful instrument for identifying risk groups, environments and situations, and also can have direct preventive applications. The latter require, however, that the data recorded are sufficiently informative to indicate clear safety targets. Key words: accident, injury, bicycle, pedestrian, school injury, epidemiology, incidence, bodily injury, oral injury, tooth, public health, surveillance, social medicine, multivariate analysis.