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The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013
  1. Juanita A Haagsma1,60,
  2. Nicholas Graetz1,
  3. Ian Bolliger1,
  4. Mohsen Naghavi1,
  5. Hideki Higashi1,
  6. Erin C Mullany1,
  7. Semaw Ferede Abera2,3,
  8. Jerry Puthenpurakal Abraham4,5,
  9. Koranteng Adofo6,
  10. Ubai Alsharif7,
  11. Emmanuel A Ameh8,
  12. Walid Ammar9,
  13. Carl Abelardo T Antonio10,
  14. Lope H Barrero11,
  15. Tolesa Bekele12,
  16. Dipan Bose13,
  17. Alexandra Brazinova14,
  18. Ferrán Catalá-López15,
  19. Lalit Dandona1,16,
  20. Rakhi Dandona16,
  21. Paul I Dargan17,
  22. Diego De Leo18,
  23. Louisa Degenhardt19,
  24. Sarah Derrett20,21,
  25. Samath D Dharmaratne22,
  26. Tim R Driscoll23,
  27. Leilei Duan24,
  28. Sergey Petrovich Ermakov25,26,
  29. Farshad Farzadfar27,
  30. Valery L Feigin28,
  31. Richard C Franklin29,
  32. Belinda Gabbe30,
  33. Richard A Gosselin31,
  34. Nima Hafezi-Nejad32,
  35. Randah Ribhi Hamadeh33,
  36. Martha Hijar34,
  37. Guoqing Hu35,
  38. Sudha P Jayaraman36,
  39. Guohong Jiang37,
  40. Yousef Saleh Khader38,
  41. Ejaz Ahmad Khan39,40,
  42. Sanjay Krishnaswami41,
  43. Chanda Kulkarni42,
  44. Fiona E Lecky43,
  45. Ricky Leung44,
  46. Raimundas Lunevicius45,46,
  47. Ronan Anthony Lyons47,
  48. Marek Majdan48,
  49. Amanda J Mason-Jones49,
  50. Richard Matzopoulos50,51,
  51. Peter A Meaney52,53,
  52. Wubegzier Mekonnen54,
  53. Ted R Miller55,56,
  54. Charles N Mock57,
  55. Rosana E Norman58,
  56. Ricardo Orozco59,
  57. Suzanne Polinder60,
  58. Farshad Pourmalek61,
  59. Vafa Rahimi-Movaghar62,
  60. Amany Refaat63,
  61. David Rojas-Rueda64,
  62. Nobhojit Roy65,66,
  63. David C Schwebel67,
  64. Amira Shaheen68,
  65. Saeid Shahraz69,
  66. Vegard Skirbekk70,
  67. Kjetil Søreide71,
  68. Sergey Soshnikov72,
  69. Dan J Stein73,74,
  70. Bryan L Sykes75,
  71. Karen M Tabb76,
  72. Awoke Misganaw Temesgen77,
  73. Eric Yeboah Tenkorang78,
  74. Alice M Theadom79,
  75. Bach Xuan Tran80,81,
  76. Tommi J Vasankari82,
  77. Monica S Vavilala57,
  78. Vasiliy Victorovich Vlassov83,
  79. Solomon Meseret Woldeyohannes84,
  80. Paul Yip85,
  81. Naohiro Yonemoto86,
  82. Mustafa Z Younis87,
  83. Chuanhua Yu88,89,
  84. Christopher J L Murray1,
  85. Theo Vos1,
  86. Shivanthi Balalla28,
  87. Michael R Phillips90
  1. 1Institute for Health Metrics and Evaluation, Seattle, Washington, USA
  2. 2Mekelle University, College of Health Sciences, School of Public Health, Mekelle, Tigray, Ethiopia
  3. 3Kilte Awlaelo-Health and Demographic Surveillance Site, Mekelle, Tigray, Ethiopia
  4. 4University of Southern California (USC) Family Medicine Residency Program at California Hospital, a Dignity Health member, Los Angeles, California, USA
  5. 5Harvard School of Public Health/Harvard Institute for Global Health, Boston, Massachusetts, USA
  6. 6Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
  7. 7Charité Universitätsmedizin, Berlin, Germany
  8. 8Ahmadu Bello University, Zaria, Kaduna State, Nigeria
  9. 9Ministry of Public Health, Beirut, Lebanon
  10. 10Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila, Manila, Philippines
  11. 11Department of Industrial Engineering, Pontificia Universidad Javeriana, Bogota, Cundinamarca, Colombia
  12. 12Madawalabu University, Ethiopia, Bale Goba, Oromia, Ethiopia
  13. 13World Bank, Washington DC, USA
  14. 14Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
  15. 15Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency (AEMPS), Ministry of Health, Madrid, Spain
  16. 16Public Health Foundation of India, New Delhi, India
  17. 17Guy's and St. Thomas’ NHS Foundation Trust, London, UK
  18. 18Griffith University, Brisbane, Queensland, Australia
  19. 19UNSW Australia, Sydney, Australia
  20. 20Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
  21. 21School of Public Health, College of Health, Massey University, Palmerston North, New Zealand
  22. 22University of Peradeniya, Peradeniya, Sri Lanka
  23. 23Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  24. 24National Center for Chronic and Noncommunicable Disease Control and Prevention, China CDC, Beijing, China
  25. 25The Institute of Social and Economic Studies of Population at the Russian Academy of Sciences, Moscow, Russia
  26. 26Federal Research Institute for Health Organization and Informatics of Ministry of Health of Russian Federation, Moscow, Russia
  27. 27Non-Communicable Diseases Research Center, Endocrine and Metabolic Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  28. 28National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, New Zealand
  29. 29James Cook University, Townsville, Queensland, Australia
  30. 30Monash University, Melbourne, Victoria, Australia
  31. 31University of California in San Francisco, San Francisco, California, USA
  32. 32Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
  33. 33Arabian Gulf University, Manama, Bahrain
  34. 34Fundacion Entornos AC, Cuernavaca, Morelos, Mexico
  35. 35Central South University, School of Public Health, Changsha, Hunan, China
  36. 36Virginia Commonwealth University, Richmond, Virginia, USA
  37. 37Tianjin Centers for Diseases Control and Prevention, Tianjin, China
  38. 38Jordan University of Science and Technology, Irbid, Jordan
  39. 39Health Services Academy, Islamabad, Punjab, Pakistan
  40. 40Expanded Programme on Immunization, Islamabad, Punjab, Pakistan
  41. 41Oregon Health and Science University, Portland, Oregon, USA
  42. 42Rajrajeswari Medical College & Hospital, Bangalore, Karnataka, India
  43. 43EMRiS, Health Services Research, University of Sheffield, Sheffield, South Yorkshire, UK
  44. 44SUNY-Albany, Rensselaer, New York, USA
  45. 45Aintree University Hospital NHS Foundation Trust, Liverpool, UK
  46. 46School of Medicine, University of Liverpool, Liverpool, UK
  47. 47Swansea University, Swansea, UK
  48. 48Faculty of Health Sciences and Social Work, Department of Public Health, Trnava University, Trnava, Slovakia
  49. 49University of York, York, UK
  50. 50South African Medical Research Council, Cape Town, South Africa
  51. 51University of Cape Town School of Public Health and Family Medicine, Cape Town, South Africa
  52. 52Pereleman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  53. 53Children's Hospital of Philadelphia
  54. 54Addis Ababa University, Addis Ababa, Ethiopia
  55. 55Pacific Institute for Research & Evaluation, Calverton, Maryland, USA
  56. 56Curtin University Centre for Population Health, Perth, Western Australia, Australia
  57. 57University of Washington, Seattle, Washington, USA
  58. 58Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
  59. 59National Institute of Psychiatry, Mexico City, Distrito Federal, Mexico
  60. 60ErasmusMC, Rotterdam, Netherlands
  61. 61University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
  62. 62Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  63. 63Suez Canal University, Ismailia, Egypt
  64. 64Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain
  65. 65BARC Hospital, HBNI University, Mumbai, Maharashtra, India
  66. 66Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
  67. 67University of Alabama at Birmingham, Birmingham, Alabama, USA
  68. 68An-Najah University, Nablus, Palestine
  69. 69Tufts Medical Center, Boston, Massachusetts, USA
  70. 70Norwegian Institute of Public Health, Oslo, Norway
  71. 71Stavanger University Hospital, Stavanger, Norway
  72. 72Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation was founded in 1999 by the order of Ministry of Health of Russia, Moscow, Russia
  73. 73University of Cape Town, Cape Town, Western Province, South Africa
  74. 74MRC Unit on Anxiety & Stress Disorders, Cape Town, Western Cape, South Africa
  75. 75University of California, Irvine, USA
  76. 76University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
  77. 77IHME, Seattle, Washington, USA
  78. 78Memorial University, St. John's, Newfoundland, Canada
  79. 79Auckland University of Technology, Auckland, New Zealand
  80. 80Johns Hopkins University, Baltimore, Maryland, USA
  81. 81Hanoi Medical University, Hanoi, Vietnam
  82. 82UKK Institute for Health Promotion Research, Tampere, Finland
  83. 83Higher School of Economics, Moscow, Russia
  84. 84Institute of Public Health, University of Gondar, Gondar, Amhara, Ethiopia
  85. 85The University of Hong Kong, Hong Kong, China
  86. 86National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
  87. 87Jackson State University, Jackson, Mississippi, USA
  88. 88Department of Epidemiology and Biostatistics, School of Public Health, Wuhan, Hubei, China
  89. 89Global Health Institute, Wuhan University, Wuhan, China
  90. 90Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine and Department of Psychiatry, Emory University
  1. Correspondence to Dr Juanita A Haagsma, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; jhaagsma{at}uw.edu

Abstract

Background The Global Burden of Diseases (GBD), Injuries, and Risk Factors study used the disability-adjusted life year (DALY) to quantify the burden of diseases, injuries, and risk factors. This paper provides an overview of injury estimates from the 2013 update of GBD, with detailed information on incidence, mortality, DALYs and rates of change from 1990 to 2013 for 26 causes of injury, globally, by region and by country.

Methods Injury mortality was estimated using the extensive GBD mortality database, corrections for ill-defined cause of death and the cause of death ensemble modelling tool. Morbidity estimation was based on inpatient and outpatient data sets, 26 cause-of-injury and 47 nature-of-injury categories, and seven follow-up studies with patient-reported long-term outcome measures.

Results In 2013, 973 million (uncertainty interval (UI) 942 to 993) people sustained injuries that warranted some type of healthcare and 4.8 million (UI 4.5 to 5.1) people died from injuries. Between 1990 and 2013 the global age-standardised injury DALY rate decreased by 31% (UI 26% to 35%). The rate of decline in DALY rates was significant for 22 cause-of-injury categories, including all the major injuries.

Conclusions Injuries continue to be an important cause of morbidity and mortality in the developed and developing world. The decline in rates for almost all injuries is so prominent that it warrants a general statement that the world is becoming a safer place to live in. However, the patterns vary widely by cause, age, sex, region and time and there are still large improvements that need to be made.

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