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NOTES


INTRODUCTION

This article provides a brief overview of the prevalence of recent injuries with reference to events which resulted in injuries where medical treatment or some other form of action being taken. Risk factors, long term consequences of injury, hospitalisation, health system costs and mortality information are also discussed.


DATA SOURCES

Unless otherwise stated, this article presents information on injuries received in the four weeks prior to the interview from the 2004-05 ABS National Health Survey (NHS). The 2004-05 NHS collected information on the type of injury, the damage caused by the injury, the activity and location at the time of injury, the part of the body affected and the action taken, as well as long term conditions resulting from injury.

It should be noted that the 2004-05 NHS excluded persons in hospitals, nursing and convalescent homes and hospices and hence the data relates only to persons in private dwellings.

The article also draws on data from the 1998 and 2003 ABS Survey of Disability, Ageing and Carers and the annual ABS Causes of Death collection.


INQUIRIES

For further information about these and related statistics, contact the National Information and Referral Service on 1300 135 070 or email client.services@abs.gov.au.


INJURY

• An injury is a trauma, poisoning or other condition of rapid onset to which factors and circumstances external to the person contributed significantly (AIHW & DHFS 1998).
• Injury prevention and control was first recognised as a national health priority for Australia in 1986.
• Although the average impact of less severe injuries is relatively low, they are so numerous that the aggregate burden due to them is considerable, in terms of costs of providing treatment and time lost from work (SIPP 2004).

• The 2004-05 NHS indicated that 18% of the population (3.6 million persons) had sustained a recent injury (in the previous four weeks).
• The proportion of people reporting a recent injury in 2004-05 may have been affected by changes to the survey questions which are likely to have encouraged reporting of cuts, reported by 5% of Australians and exposure to fire/heat (0.9%) (footnote 1).

• The age group most likely to sustain a recent injury was the 0-14 years age group with a reported prevalence of 25% (males 24%, females 25%).The likelihood of sustaining an injury within the previous four weeks declines with age to 10% of those aged 65 and over.
• Males reported a slightly higher prevalence of recent injury overall (19%) compared to females (18%), although this pattern varied across age groups.

Proportion of persons recently injured (a), 2004-05

• The most common events which led to an injury were cuts (28% of all events) and falls of one metre or less (21% of all events).
• The proportion of males who received a recent injury from cuts (31% of all males with injuries) was higher than the proportion of females (25% of all females with injuries). Injuries from bites or stings occurred more frequently to females (12% of all females with injuries) than males (7% of all males with injuries).
• Recent injuries from vehicle accidents which occurred were most likely to occur in the 25-34 years age group (34% of all vehicle accidents).
• Many types of recent injuries were more likely to happen to those in the 0-14 years age group. For example, 55% of all falls below one metre and 51% of falls of more than one metre, 51% of all attacks by another person resulting in injury, and 37% of injuries from bites or stings.

Type of injury event (a), 2004-05

• The most common form of recent injury was that of an open wound (49% of all persons with recent injuries). Open wounds were a more common form of injury for males (53%) than for females (44%).
• Nearly half (47%) of the 0-14 years age group who experienced an injury had an open wound. Bruising was also a common injury in this age group (37% of persons).
• The age group most likely to suffer dislocations, sprains or torn muscles/ligaments was the 25-34 years age group, where 20% of recently injured persons received these forms of injury.
• In the 65 years and over age group, the common forms of injury were that of an open wound (53% of persons) and bruising (24%).
• Over one third (39%) of persons who were injured in the four weeks prior to interview injured their legs or feet, while one third (34%) of persons received injuries to the hands or fingers. Other common places of injury were arms and wrists (16% of persons) and the head (8%).

• Leisure activities were the most common activity being undertaken when a person was injured (27% of all persons recently injured were undertaking leisure activity at the time of injury).
• In the 0-14 years age group, 54% of injuries occurred during leisure activities. Sports activities accounted for 15% of injuries, while 12% of injuries received in this age group occurred while attending school.
• In persons aged 15 years and over, leisure activities (27%) was the most common activity being undertaken when an injury occurred in the four weeks prior to interview.

Activity at time of injury (a), Persons aged 15 years and over, 2004-05

• Persons who received recent injuries were most likely to experience them inside (30%) or outside (25%) their own or someone else's home.
• Females were nearly twice as likely to be inside their home or someone else's home when they had an injury (39%) compared to males (21%).
• Males were much more likely to be injured at a sports facility, athletics field or park (13%) compared to females (9%).
• Persons working for an income were injured in a variety of locations, such as commercial places (43%), industrial places (26%) and farms (5%).

• In 2004-05, 16% of those persons who received an injury in the four weeks prior to interview visited a doctor or other health professional regarding their injury. Only 5% of those injured visited a hospital.
• Of those who experienced a recent injury, 22% cut back on their usual activities because of the injury.

Action taken after an injury event (a), 2004-05

• Adults at high risk of long-term health problems due to a risky/high risk level of alcohol consumption (footnote 2) were more likely to report one or more injuries in the four weeks before interview than adults who never consumed alcohol (18% compared to 11%).
• Drinking alcohol has been associated with risk of injury in many settings, including vehicle and cycling accidents, incidents involving pedestrians, falls, fires, sports and recreational injuries, and violence. The presence of alcohol in the body at the time of injury may also be associated with greater severity of injury and less positive outcomes (NHMRC 2001).
• In 2004-05, 3% of recently injured persons reported being under the influence of alcohol or other substances at the time of injury. Of these, more males than females reported being under the influence of alcohol or other substances at the time of injury (55% and 45% respectively.)

• As reported in the 2004-05 NHS, one quarter (25%) of recently injured persons aged 15 years and over were injured while they were working for an income. Of all employed persons aged 15 years and over, 7% had received an injury while working for income in the four weeks prior to interview
• More than half (63%) of persons in the 2004-05 NHS who received an injury while working for an income had injuries in the form of open wounds.
• Of adults employed in all industry groups, those in the construction industry were most likely to receive a recent injury while working for income. 13 % of construction workers were recently injured while working for income compared to 7% of all employed adults.
• Similarly, employed tradespersons and related workers (aged 18 years and over) were the occupation group most likely to receive a recent injury while working for an income (15% were recently injured while working for income). The majority of tradespersons injured were in three industries - the construction industry (36%), the manufacturing industry (19%) and the retail trade industry (17%).

• Long term injuries are long term conditions resulting from injury. In the 2004-05 NHS, 11% of persons of all ages reported a long term condition which resulted from injury.
• In persons 15 years and over, musculoskeletal conditions were the most commonly reported long-term condition due to an injury. Musculoskeletal conditions accounted for a quarter (25%) of all long-term conditions due to injury.
• Injury was reported (for those 15 years and over) as the cause for 31% of those with back/pain problems, or disc disorders; 16% of those with rheumatism and other soft issue disorders; and 12% of those with arthritis.

• In the Survey of Disability, Ageing and Carers, people reported that injuries, poisoning and other external causes were the reason for approximately 8% of all physical disabilities in both 1998 and 2003 (ABS 1999, ABS 2004a).
• One in ten of those with a disability because of injury, poisoning and other external causes had a profound core-activity limitation (footnote 3) in 2003, while 28% had a mild core-activity limitation. Nearly half (45%) reported having a schooling or employment restriction.

• Injury accounted for over one in twenty hospital separations (footnote 4) in 2003-04 with more than 370,000 inpatient episodes that year (AIHW 2006).
• Age is an important factor in the number of separations for injury. Young adults produce the most separations, late middle aged the least, while those in advanced old age again produce many separations (AIHW 2006).
• The rate of hospitalised injury among those 85 years or over in 2003-04 was more than 8,900 per 100,000 persons. This high rate is almost entirely due to injury following a fall (AIHW 2006).

• In 2000-01, 8% of total allocated health expenditure ($4.0 billion) was spent on persons who experienced injuries (AIHW 2004b).
• The majority of expenditure on injuries in 2000-01 took place in hospitals (70%), with 15% of expenditure being used on out-of-hospital medical expenses. Costs associated with professionals such as physiotherapists and chiropractors accounted for 7% of expenditure (AIHW 2004b).
• Falls accounted for 41% of expenditure on unintentional injuries in 2000-01. Adverse events in surgical or medical care, such as infections after treatment and inappropriate medication (18%) (footnote 5), and road traffic accidents (11%) were the other major events leading to expenditure on unintentional injury (AIHW 2004b).
• Injuries due to homicide and violence accounted for 60% ($223.3 million) of total allocated health expenditure on intentional injuries in 2000-01 with $149.2 million (40%) being spent on suicide and self-inflicted injuries (AIHW 2004b).

• Injury deaths are conventionally defined as those where the underlying cause of death was determined to be an external cause. The ABS Causes of Death Collection includes information on these deaths. The most common external causes of death are suicide, transport accidents, falls, accidental poisoning, suffocation, drowning and assault (Footnote 6).
• Deaths from external causes have decreased markedly over the last 30 years in Australia, mainly due to decreasing death rates from transport accidents. Prior to 1991, the leading external cause of death was motor vehicle accidents, but after 1991 the death rate from motor vehicle accidents became lower than the death rate from intentional self-harm (suicide) (ABS 2004b).
• For the total population death rates from injuries increase with remoteness (from 1.2 times higher than Major Cities rates in Inner Regional areas to 2.4 times in Very Remote areas) (AIHW2003). There is a strong pattern of increasing mortality from injury with increasing remoteness, particularly for males (AIHW 1998).
• In 2004, external causes accounted for 6% of total registered deaths (all ages). In younger age groups, however this proportion was far greater. For example, in the 15-24 year age group, external causes (mainly transport accidents and suicide), accounted for 71% of total deaths (ABS 2006d).
• Boys are more likely than girls to both experience and die as a result of an injury. While half of all children are boys (at 30 June 2001, 51% of 1-14 year olds were boys), nearly two-thirds of injury deaths for this age group between 1999 and 2003 were boys (62%) (ABS 2005).