The promotion of physical exercise is an essential strategy of health promotion. However, a sizeable proportion of health gains are lost due to sport injuries. As safety concerns are a factor in the decision to participate in sports, reducing the injury risk is also an essential strategy of public health policies. Prerequisite for targeted programmes is the assessment of injury risks associated with certain activities, facilities, products and services. Usual health statistics (deaths, hospital discharges, medical treatments) do not contain this kind of information. In order to compensate for this shortcoming, 12 EU-countries have implemented a monitoring system with the focus on external circumstances, based on samples of hospitals (A+E departments) – the European Injury Data Base (IDB). It allows for rough but comparable estimates of incidence rates. In the course of an ongoing EU project a survey on sport injuries in the European Union (500 million inhabitants) has been derived, for the first time. According to the IDB definitions of sports, annually about 4.5 million people aged 15 years and older have to be treated in EU hospitals for sport injury. Team ball sports account for 40% of all hospital treated sport injuries, uncontestedly led by football (soccer). Two third of injuries affects men, although with huge differences in the various types of sport. IDB data allow also for more detailed analyses of injury mechanisms. The potential of the IDB system for guiding prevention programmes will also be illustrated in an exemplary way.
Targeted injury prevention needs information, and the basis is data. The EU Council Recommendation on injury prevention of 2007 recommends that Member States make better use of the existing data, and that they implement additional injury surveillance, when appropriate, in order to obtain comparable information. In almost all Member States, some data on injuries are available: on deaths, hospital discharges, external causes of injuries, traffic accidents and workplace accidents. It is examined how far these data meet the information needs of key stakeholders in injury prevention. General information about the health burden of injury, based on mortality and hospital discharges, is available and sufficient for identifying injury as a priority for health policy. Health indicators like lost life years, rates of hospitalisation, estimated rates of disabilities or health care costs could be derived, but are not widely available yet. Information about external circumstances (causes) of injuries is indispensible for targeted prevention, but only 12 countries have a harmonised surveillance system on external causes in place (European Injury Database IDB 2009). It is recommended that the harmonised collection of data on fatalities, hospital discharges and external causes of injuries should become compulsory within the new European health information system. The provision of harmonised injury indicators should be promoted. The surveillance system on external causes (IDB) should be implemented in countries without such system. National injury data administrators ('clearing houses') should be established for the provision of comprehensive injury reports and for serving the needs of key stakeholders in injury prevention.
The implementation of the IDB has proven to be feasible and useful for the participating countries, especially for data-based accident prevention in the important areas of home, leisure, and sports accidents. In the framework of the EU project JAMIE (2011-2014, Joint Action for Injury Monitoring in Europe), the IDB partners are currently working on further improving the IDB standards and quality criteria as well as the recruitment of further IDB countries. The medium-term goal is to integrate the EU IDB in the Eurostat Statistical System and to put the collection of IDB data on a statutory footing.
BackgroundMeasuring the true incidence of injury or medically attended injury is challenging. Population surveys, despite problems with recall and selection bias, remain the only source of information for injury incidence calculation in many countries. Emergency department (ED) registry based data provide an alternative source.The aim of this study is to compare the yearly incidence of hospital treated Home and Leisure Injuries (HLI), and Road Traffic Injuries (RTI) estimated by survey-based and register-based methods and combine information from both sources in to a comprehensive injury burden pyramide.MethodsData from Luxemburg’s European Health Examination Survey (EHES-LUX), European Health Interview Survey (EHIS) and ED surveillance system Injury Data Base (IDB) collected in 2013, were used. EHES-LUX data on 1529 residents 25–64 years old, were collected between February 2013–January 2015. EHIS data on 4004 other residents aged 15+ years old, were collected between February and December 2014. Participants reported last year’s injuries at home, leisure and traffic and treatment received. Two-sided exact binomial tests were used to compare incidences from registry with the incidences of each survey by age group and prevention domain. Data from surveys and register were combined to build an RTI and HLI burden pyramide for the 25–64 years old. This project was part of the European Union project BRIDGE-Health (BRidging Information and Data Generation for Evidence-based Health Policy and Research).ResultsAmong 25–64 years old the incidence of hospital treated injuries per thousand population was 60.1 (95% CI: 59.2–60.9) according to IDB, 62.1 (95% CI: 50.6–75.4) according to EHES-LUX and 53.2 (95% CI: 45.0–62.4) according to EHIS. The incidence of hospital admissions was 3.7 (95% CI: 3.5–4.0) per thousand population from IDB-Luxembourg, 12.4 (95% CI: 7.5–19.3) from EHES-LUX and 18.0 (95% CI: 13.3–23.8) from EHIS. For 15+ years-old incidence of hospital treated HLI was 62.8 (95% CI: 62.1–63.5) per thousand population according to IDB whereas the corresponding EHIS estimate was lower at 46.9 (95% CI: 40.4–54.0). About half of HLI and RTI of the 25–64 years old were treated in hospital.ConclusionThe overall incidence estimate of hospital treated injuries from both methods does not differ for the 25–64 years old. Surveys overestimate the number of hospital admissions, probably due to memory bias. For people aged 15+ years, the survey estimate is lower than the register estimate for hospital treated HLI injuries, probably due to selection and recall biases. ED based registry data is to be preferred as single source for estimating the incidence of hospital treated injuries in all age groups.
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