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Unintentional injuries in the home in the United States: Part I: Mortality

https://doi.org/10.1016/j.amepre.2004.09.010Get rights and content

Background

Unintentional injuries are a leading cause of death in the United States. It is unclear, however, what proportion of these injuries occur in the home. The purpose of this paper is to quantify and describe fatal unintentional injuries that take place in the home environment.

Methods

Data from the National Vital Statistics System (NVSS) were used to calculate average annual rates for unintentional home injury deaths, with 95% confidence intervals from 1992 to 1999 for the United States overall, and by mechanism of injury, gender, and age group.

Results

From 1992 to 1999, an average of 18,048 unintentional home injury deaths occurred annually in the United States (6.83 deaths per 100,000). Home injury deaths varied by age and gender, with males having higher rates of home injury death than females (8.78 vs 4.97 per 100,000), and older adults (≥70 years) having higher rates than all other age groups. Falls (2.25 per 100,000), poisoning (1.83 per 100,000), and fire/burn injuries (1.29 per 100,000) were the leading causes of home injury death. Rates of fall death were highest for older adults, poisoning deaths were highest among middle-aged adults, and fire/burn death rates were highest among children. Inhalation/suffocation and drowning deaths were important injury issues for young children.

Conclusions

Unintentional injury in the home is a significant problem. Specific home injury issues include falls among older adults, poisonings among middle-aged adults, fire/burn injuries among older adults and children, and inhalation/suffocation and drowning among young children. In addition, recommendations are presented for improvements to the NVSS.

Introduction

Unintentional injury was the leading cause of death for people aged 1 to 34 years, and the fifth leading cause of death for all ages combined in the United States from 1992 to 1999.1 In this same time period, unintentional injuries were the leading cause of years of potential life lost before age 65, accounting for 2 million years of life lost annually.1 Motor vehicle crashes accounted for nearly half (47.5%) of all unintentional injury deaths.1 Following motor vehicle crashes, falls and poisoning were responsible for the largest proportions of unintentional injury deaths.

A substantial proportion of unintentional injuries are transportation related, taking place primarily on roadways. Few studies have focused on the location of unintentional injury occurrence. However, homes also represent an important setting for unintentional injuries, the national prevalence of which is largely unknown.2, 3, 4 Specific characteristics of the home environment may contribute to the likelihood that an injurious event will occur; for example, the presence of unsecured poisonous substances in the home or the absence of railings on stairways. Characteristics of the home environment may also increase the severity of injury events. For example, the flammability of mobile homes or the absence of adequate exits may increase the lethality of a fire in that environment.5

The objectives in this study were to estimate the prevalence of fatal unintentional injury in the home environment in the United States, and to describe the circumstances surrounding these injury events. Additionally, information gaps were identified in available data to inform surveillance systems. The ultimate goal was to identify high-risk populations that can be targeted for prevention.

Section snippets

Methods

Data came from the National Center for Health Statistics’ National Vital Statistics System (NVSS).6 The NVSS mortality data set contains information from death certificates compiled in each state and combined nationally. Data were used from 1992 to 1999 to calculate average annual counts and rates of unintentional home injury death. Injury incidents were classified from NVSS as occurring in the home, in a location other than the home, or in an unknown location. The home environment was defined

Fatal unintentional injuries in the home

From 1992 to 1999, there was an average of 146,970 injury-related deaths annually in the United States, with an average annual injury death rate of 54.90 per 100,000 persons. Injury deaths represented nearly 4% of all U.S. deaths, and nearly two thirds (61.8%) were classified as unintentional.

Information on the location of injury was available for 33% (home 20%; location other than home 13%) of all fatal unintentional injuries (Table 2). Of those with known location, an average of 18,048

Discussion

Falls, poisonings, and fire/burn injuries were the leading causes of unintentional home injury death in the United States. Older adults and young children experienced the highest rates of home injury death. Their stages of physical development make them vulnerable population groups for fatal injury. Children may become injured while engaging in normal exploratory behaviors, lacking the judgment to avoid dangers. Older adults may experience more injuries as a result of balance or limited

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