7.4. Data discussion

The survey of the previous chapter clearly shows the public health relevance and impact of accidents and injuries. The huge burden of accidents and injuries to societies and individuals can be qualified as follows :

•          The number one killer among young people: Accidents and injuries are the leading cause of death in children, adolescents and young adults. The burden of premature deaths is particularly high in such seemingly diverse areas as traffic accidents, drowning and suicides.

•          A major cause of disability: Many survivors of severe injuries suffer lifelong impairment. Although not accurately quantified, accidents and injuries are assumed to be the main cause of chronic disability among young people, leading to an enormous loss of life years in good health.

•          A major cause of morbidity and healthcare costs: On average, in all age groups, injuries account for about 8% of all hospital admissions. In addition to the huge financial burden on health and welfare systems, injuries often affect the whole family, emotionally, organisationally and financially.

•          Detrimental to Community productivity: There is little data available on the causes of sick leave and disability due to injuries. Both are important factors in reduced productivity. National data indicate that up to 8% of retirement on the grounds of disability and 20% of sick leave days are the result of injuries.

•          Unequal in its impact on social groups: The risk of dying from an injury is five times greater in the Member State with the highest injury rate than in that with the lowest rate. There are also inequalities in exposure to injury risks according to sex, age and social status.

The European Community Health Indicator system (ECHI) is a proposal for health indicators which can be calculated in a reliable and comparable manner in most Member States and which are considered as helpful for policy making. The so called “short list” defines about 40 readily available and reasonably comparable indicators (mostly based on assessment by EuroStat). The additional ECHI “long list”, should be seen as a structured inventory of important indicators , which are not yet widely available e.g. due to a lack of reliable data or due to lack of common definition. Subsets of this list could be selected for further development under various arrangements. These two lists also contain several injury indicators defining the European standard of injury indicators.

(See: http://ec.europa.eu/health/ph_information/dissemination/echi/echi_en.htm)

Injury surveillance systems in the different countries of the European Union Union are designed to collect data in order to calculate the standard injury indicators. Only some of the data presented in the previous section meet the European standards  (e.g. road traffic injuries and, work place injuries). In other areas, further development and research is needed (e.g. calculation of costs, calculation of Potential Years of Life Lost (PYLL), Quality Adjusted Life Years (QALYs), and Disability Adjusted Life Years (DALYs) .

In order to address the high impact of injuries on health and to develop the role of the health sector in making Europe a safer place to live in, the Council Recommendation of 2007 calls upon Member States to ensure an effective resource allocation for injury prevention by setting priorities. The following criteria have been used to identify priority areas:

·          Social impact of injuries in terms of number, severity and consequences of the various categories of injury, such as loss of productive years, disability and human suffering;

·          Evidence regarding the effectiveness of interventions and the cost-effectiveness of alternative interventions in relation to the various priority options;

·          Feasibility of successful implementation of interventions in the European context and given the great diversity of infrastructures within Member States (gaps in prevention and political demand for action);

·          Time frame and measurability of intermediate outcomes of actions and impacts in terms of injury reduction.

This has led to the identification of the following seven priority areas for injury prevention, analysed more in detail later on in this chapter:

·                      Children and adolescents;

·                      Elderly citizens and disabled;

·                      Vulnerable road users;

·                      Sports injuries;

·                      Injuries caused by products and services;

·                      Self-harm; and

·                      Interpersonal violence.