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Assessing global risk factors for non-fatal injuries from road traffic accidents and falls in adults aged 35–70 years in 17 countries: a cross-sectional analysis of the Prospective Urban Rural Epidemiological (PURE) study
  1. Parminder Raina1,
  2. Nazmul Sohel1,
  3. Mark Oremus2,
  4. Harry Shannon1,
  5. Prem Mony3,
  6. Rajesh Kumar4,
  7. Wei Li5,
  8. Yang Wang5,
  9. Xingyu Wang6,
  10. Khalid Yusoff7,
  11. Rita Yusuf8,
  12. Romaina Iqbal9,
  13. Andrzej Szuba10,
  14. Aytekin Oguz11,
  15. Annika Rosengren12,
  16. Annamarie Kruger13,
  17. Jephat Chifamba14,
  18. Noushin Mohammadifard15,
  19. Ebtihal Ahmad Darwish16,
  20. Gilles Dagenais17,
  21. Rafael Diaz18,
  22. Alvaro Avezum19,
  23. Patricio Lopez-Jaramillo20,
  24. Pamela Seron21,
  25. Sumathy Rangarajan22,
  26. Koon Teo22,
  27. Salim Yusuf22
  28. on behalf of the PURE Investigators
    1. 1Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
    2. 2School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
    3. 3Division of Epidemiology and Population Health, St. John's Research Institute, Bangalore, India
    4. 4PGIMER School of Public Health, Chandigarh, India
    5. 5National Centre for Cardiovascular Diseases, Cardiovascular Institute & Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
    6. 6Beijing Hypertension League Institute, Beijing, China
    7. 7Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor and UCSI University Kuala Lumpur, Kuala Lumpur, Malaysia
    8. 8School of Life Sciences, Independent University, Dhaka, Bangladesh
    9. 9Departments of Community Health Sciences and Medicine, Aga Khan University, Karachi, Pakistan
    10. 10Department of Internal Medicine, Wroclaw Medical University, Borowska, Wroclaw, Poland
    11. 11Faculty of Medicine, Department of Internal Medicine Istanbul, Istanbul Medeniyet University, Turkey
    12. 12Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
    13. 13Faculty of Health Science North-West University, Potchefstroom Campus, Potchefstroom, South Africa
    14. 14Physiology Department, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe
    15. 15Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
    16. 16Family Medicine Department, Dubai Medical College, Dubai, UAE
    17. 17Laval University Heart and Lungs Institute, Quebec City, Canada
    18. 18Estudios Clinicos Latinoamerica ECLA, Rosario, Santa Fe, Argentina
    19. 19Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
    20. 20Fundacion Oftalmologica de Santander (FOSCAL), Medical School, Universidad de Santander, Floridablanca-Santander, Colombia
    21. 21Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
    22. 22Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
    1. Correspondence to Dr Parminder Raina, McMaster University, Department of Clinical Epidemiology and Biostatistics, MIP-Suite 309A, 1280 Main Street West, Hamilton, Ontario, Canada L8S 4K1; praina{at}


    Objectives To assess risk factors associated with non-fatal injuries (NFIs) from road traffic accidents (RTAs) or falls.

    Methods Our study included 151 609 participants from the Prospective Urban Rural Epidemiological study. Participants reported whether they experienced injuries within the past 12 months that limited normal activities. Additional questions elicited data on risk factors. We employed multivariable logistic regression to analyse data.

    Results Overall, 5979 participants (3.9% of 151 609) reported at least one NFI. Total number of NFIs was 6300: 1428 were caused by RTAs (22.7%), 1948 by falls (30.9%) and 2924 by other causes (46.4%). Married/common law status was associated with fewer falls, but not with RTA. Age 65–70 years was associated with fewer RTAs, but more falls; age 55–64 years was associated with more falls. Male versus female was associated with more RTAs and fewer falls. In lower-middle-income countries, rural residence was associated with more RTAs and falls; in low-income countries, rural residence was associated with fewer RTAs. Previous alcohol use was associated with more RTAs and falls; current alcohol use was associated with more falls. Education was not associated with either NFI type.

    Conclusions This study of persons aged 35–70 years found that some risk factors for NFI differ according to whether the injury is related to RTA or falls. Policymakers may use these differences to guide the design of prevention policies for RTA-related or fall-related NFI.

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