Injury Epidemiology - Child Injury Mortality in the European Union

Over 1.3 million European Union (EU) citizens died as a result of an unintentional injury between 1984 and 1993. Of these, 61,707 (5%) were children aged 0-14 years, of whom two thirds were male. By 1993, over 4,500 child fatalities were recorded, accounting for more than 30% of childhood mortality in the EU.

While child injury mortality rates decreased in all member states between 1984 and 1993 (Table 1), there were marked differences in rates between countries. Portugal experienced higher rates than other EU member states in both 1984 and 1993, despite a 40% decrease in rates, and a lessening of the gap between Portugal and other member states. Portugal, excepted, Belgium and Spain experienced the highest rates by the end of the study period. However, it should be noted that the latest available mortality data for Belgium as a whole is for 1989.

Sweden has the lowest mortality rates in both 1984 and 1993. By 1993, the UK and the Netherlands had rates only marginally higher than Sweden. The UK experienced the largest decline in childhood injury mortality rates, with a 47% reduction over the study period. In the period 1984-1993, almost half (45%) of child injury deaths were due to motor vehicle traffic accidents. Drowning was the second most frequent cause of death (12%), followed by fire and flame-related injuries (6%), falls (5%) and other transport accidents (2%). The remaining 30% were due to ‘other’ injuries. This includes deaths from poisoning and ingestions, choking, cutting and piercing injuries, firearms and adverse effects of medication. A decrease in mortality rates in the EU occurred for all major causes of childhood injury mortality. Mortality rates due to motor vehicle traffic accidents decreased by 33%, drowning by 32%, falls by 31% and fire and flames by 17%.

While motor vehicle traffic accidents were consistently the greatest single contributor to childhood injury mortality in every member state, the proportional contribution of injuries resulting from motor vehicle traffic accidents ranged from 35% to 52% of child injury mortality. At least half of childhood mortality in Greece, Finland, Portugal, the Netherlands and Belgium was due to motor vehicle traffic accidents. Drownings were the second most frequent cause of death in most member states, accounting for between 5% and 26% of injury mortality. The proportion of injuries caused by drowning was highest in Sweden and the Netherlands. The proportion of injuries due to fire and flames ranged from 3 to 14%, and 1 to 9% for falls.

In summary, decreases in mortality were experienced by all EU member states for all leading causes of child injury death between 1984 and 1993. This reflects research findings from elsewhere in the world (1,2). There were, however, substantial differences in rates between member states and mortality rates decreased at different rates in each country. The reasons for the differences in the rates of decline are unknown. Motor vehicle traffic accidents accounted for almost half of child injury deaths during the study period. MVTA’s are also the major cause of childhood injury deaths in many countries outwith the EU (2-5).

References

1. Fingerhut LA, Warner M. Injury Chartbook. Health, United States 1996-97. Hyattsville, Maryland: National Center for Health Statistics, 1997
2. Moller JN, Kreisfield R. Progress and current issues in child injury prevention. Australian Injury Prevention Bulletin 15, February 1997. Adelaide Australian Institute of Health and Welfare, National Injury Surveillance Unit.
3. Foltin E. Kindliche und jugendliche verkehrsopfer in Osterreich von 1980 bis 1989. Unfallchirurgie 1996; 22(3): 99-109
4. Fingerhut LA, Annest J, Baker SP, Kochanek KD, McLoughlin E. Injury mortality among children and teenagers in the United States, 1993. Injury Prevention 1996; 2: 93-94
5. Langley JD, Smeijers J. Injury mortality among children and teenagers in New Zealand compared with the United States of America. Injury Prevention 1997: 3: 195-199