Mortalidade e carga do câncer de laringe atribuíveis aos riscos ocupacionais no Brasil: estudo da Carga Global de Doença, 2019 / Laryngeal cancer mortality and burden attributable to occupational risks in Brazil: 2019 Global Burden of Disease

Resumo Objetivo: descrever a mortalidade e os anos de vida ajustados pela incapacidade disability-adjusted life years - DALYs) para câncer de laringe no Brasil atribuíveis a fatores de risco ocupacionais e comportamentais. Métodos: estudo ecológico com dados do estudo Global Burden of Disease 2019. Foram obtidas taxas de mortalidade e de DALYs para o câncer de laringe atribuíveis aos riscos ocupacionais (ácido sulfúrico e amianto) e comportamentais (tabaco e álcool), de 1990 e 2019. Resultados: no Brasil, em 2019, a taxa de mortalidade por câncer de laringe atribuível aos riscos ocupacionais (ácido sulfúrico e amianto) foi 0,28 (II95%: 0,17;0,43) no sexo masculino e 0,03 (II95%: 0,02;0,04) no feminino, e a de DALYs foi 7,33 (II95%: 4,28;11,44) e 0,64 (II95%: 0,35;0,03), respectivamente. O ácido sulfúrico foi o principal risco ocupacional para a doença. Houve redução das taxas atribuíveis ao tabaco (mortalidade:-45,83%; DALYs:-47,36%) e aos riscos ocupacionais (mortalidade:-23,20%; DALYs:-26,31%), no Brasil, com aumento em alguns estados das regiões Norte e Nordeste. Conclusão: houve redução na mortalidade e na carga do câncer de laringe atribuível aos fatores ocupacionais no período, porém menor em comparação ao tabagismo, reforçando a importância de ações para reduzir o impacto dos riscos ocupacionais, como as medidas regulatórias aplicadas ao tabaco.

Abstract Objective: to describe mortality and disability-adjusted life years (DALYs) due to laryngeal cancer attributable to occupational and behavioral risk factors in Brazil. Methods: this is an ecological study with data from the 2019 Global Burden of Disease. Mortality and DALY rates for laryngeal cancer attributable to occupational (sulfuric acid and asbestos) and behavioral (tobacco and alcohol) risks were obtained from 1990 and 2019. Results: in 2019, the mortality rate from laryngeal cancer attributable to occupational hazards (sulfuric acid and asbestos) totaled 0.28 (95%UI: 0.17; 0.43) and 0.03 (95%UI: 0.02; 0.04), whereas and DALY rates, 7.33 (95%UI: 4.28; 11.44) and 0.64 (95%UI: 0.35; 0.03) in men and women in Brazil, respectively. Sulfuric acid configured the main occupational risk for the disease. The rates attributable to tobacco (mortality: −45.83%; DALYs: −47.36%) and occupational hazards (mortality: −23.20%; DALYs: −26.31%) decreased in Brazil but increased in some Northern and Northeastern states. Conclusion: laryngeal cancer mortality and burden attributable to occupational factors decreased in the period (although less than that for smoking), reinforcing the importance of actions to reduce the impact of occupational risks, such as the regulatory measures applied to tobacco.

Death and life loss of malignant tumors in Xicheng District from 2014 to 2021 / 预防医学

Objective@#To investigate the mortality and life loss of malignant tumors among residents in Xicheng District, Beijing from 2014 to 2021, so as to provide the evidence for formulating the control strategy for malignant tumors.@*Methods@#Data pertaining to dead cases of malignant tumors in Xicheng District from 2014 to 2021 were collected from Beijing Integrated and Analysis Platform for Health and Disease Prevention Monitoring Information Resources. The crude mortality, standardized mortality, years of potential life lost (YPLL), years of potential life lost rate (YPLLR), rate of standardized years of potential life lost (SYPLLR), average years of life lost (AYLL) and annual percent change (APC) of malignant tumors were measured to analyze the trends in mortality of malignant tumors and life loss.@*Results@#A total of 23 202 residents died from malignant tumors in Xicheng District from 2014 to 2021, and the crude and standardized mortality rates of malignant tumors were 198.09/105 and 101.46/105, respectively. The standardized mortality of malignant tumors was 117.36/105 among men and 85.97/105 among women. The standard mortality of malignant tumors appeared a tendency towards a decline among all cases (APC=-1.515%, t=-4.289, P=0.005) and women (APC=-1.629%, t=-3.046, P=0.023), and the crude mortality of malignant tumors appeared a tendency towards a rise with age (χ2trend=49.324, P<0.001). The five most deadly malignant tumors included lung cancer, colorectal cancer, liver cancer, stomach cancer and pancreatic cancer, and lung cancer, liver cancer and colorectal cancer were the three malignant tumors with the three highest life loss, with YPLL of 18 054 person-years, 9 446 person-years and 8 179 person-years, respectively. Leukemia had the highest AYLL (15.95 years per person).@*Conclusions@#The standardized mortality of malignant tumors appeared a tendency towards a decline among residents in Xicheng District from 2014 to 2021, and men and the elderly people were at high risk of malignant tumors. Lung cancer, colorectal cancer and liver cancer were leading causes of death, leukemia was the major cause of life loss.

Death and life loss due to female breast cancer in Suzhou City from 2007 to 2021 / 预防医学

Objective@#To investigate the trends in mortality and life lost due to female breast cancer among in Suzhou City from 2007 to 2021, so as to provide insights into improvements of breast cancer control strategy in Suzhou City.@*Methods@#The epidemiological and clinical data pertaining to dead female breast cancer cases in Suzhou City from 2007 to 2021 were collected from Suzhou Municipal Chronic Disease Surveillance System, including gender, age and cause of death. The crude mortality, standardized mortality, years of potential life lost (YPLL), years of potential life lost rate (YPLLR), standardized YPLL (SYPLL), standardized YPLLR (SYPLLR) and average years of life lost (AYLL) due to female breast cancer were calculated. All data were standardized by the Fifth National Population Census in 2000, and the trends in mortality of breast cancer were estimated using average annual percent change (AAPC). @*Results@#Totally 4 425 death occurred due to female breast cancer in Suzhou City from 2007 to 2021, with a crude mortality rate of 8.67/105, which appeared a tendency towards a rise (AAPC=1.83%, t=5.080, P=0.001), and the standardized mortality was 4.68/105, which appeared no significant changes (AAPC=0.13%, t=0.356, P=0.727). The crude mortality rates of female breast cancer were 0.62/105, 10.33/105 and 21.69/105 among women at ages of 15 to 34, 35 to 64 years and 65 years and older, respectively, which appeared a tendency towards a rise (χ2trend=2 315.683, P=0.001). The crude mortality of female breast cancer was 8.66/105 in urban areas and 8.86/105 in rural areas, both appearing a tendency towards a rise (urban areas: AAPC=1.73%, t=3.290, P=0.006; rural areas: AAPC=2.68%, t=6.565, P=0.001). The YPLL, SYPLL, YPLLR, SYPLLR and AYLL of female breast cancer were 44 485 person-years, 30 387 person-years, 0.99‰, 0.68‰ and 14.94 years per person, and both YPLLR (AAPC=-1.06%, t=-2.193, P=0.047) and AYLL (AAPC=-1.53%, t=-4.783, P=0.001) appeared a tendency towards a reduction, respectively. @*Conclusion@#The crude mortality of female breast cancer appeared a tendency towards a rise and the life loss appeared a tendency towards a decline in Suzhou City from 2007 to 2021. The elderly population should be given a high priority for breast cancer control.

Trends in mortality and life lost due to cancer in Ouhai District from 2013 to 2020 / 预防医学

Objective@#To investigate the trends in mortality and life lost due to cancer among residents in Ouhai District, Wenzhou City from 2013 to 2020, so as to provide the evidence for formulating the cancer control strategy. @*Methods@#The mortality data of cancer patients in Ouhai District from 2013 to 2020 were collected through Zhejiang Provincial Information Management System for Surveillance of Chronic Diseases. The crude mortality, standardized mortality, years of potential life lost ( YPLL ), years of potential life lost rate ( YPLLR ), standardized years of potential life lost ( SYPLL ), standardized years of potential life lost rate ( SYPLLR ), average years of life lost ( AYLL ) and annual percent change ( APC ) were estimated to analyze the trends in mortality and life lost due to cancer.@*Results@#Totally 5 435 deaths occurred due to cancer in Ouhai District from 2013 to 2020, and the crude and standardized mortality rates were 154.10/105 and 119.41/105, respectively. The crude mortality of cancer was higher in men than in women ( 196.26/105 and 111.09/105; χ2=415.623, P<0.001 ). The standardized mortality of cancer among whole populations, the crude mortality in men and the standardized mortality in men showed a tendency towards a reduction ( P<0.05 ), with APC of -3.25%, -2.18% and -4.78%, respectively. The crude mortality of cancer showed an upward trend with age ( χ2trend=9 260.583, P<0.001 ). Lung cancer, liver cancer, stomach cancer, colorectal cancer and esophagus cancer were the five leading causes of cancer-related mortality, which accounted for 66.68% of all cancer mortality. Liver cancer, lung cancer, stomach cancer, colorectal cancer and brain cancer were the five leading causes of life lost, with YPLL of 11 191.50, 8 231.00, 6 000.00, 3 892.00 and 2 693.50 person-years, respectively. Leukemia was the primary cause of AYLL ( 25.17 years per person ).@*Conclusions@#Both the standardized mortality and the life lost due to cancer showed a tendency towards a reduction in Ouhai District from 2013 to 2020, and men and the elderly were high-risk populations. Lung cancer, liver cancer, stomach cancer, colorectal cancer, leukemia, brain cancer, and female breast cancer should be listed among cancers in Ouhai District prioritized for control

Trends in mortality and life lost due to drowning in Huzhou City from 2012 to 2021 / 预防医学

Objective@#To investigate the mortality and years of life lost due to drowning in Huzhou City from 2012 to 2021, so as to provide insights into drowning prevention and control.@*Methods@#The mortality surveillance data on drowning in Huzhou City from 2012 to 2021 were collected from the Zhejiang Chronic Disease Surveillance Information Management System. The crude mortality and standardized mortality of drowning by the 2010 population census data in 2010, years of potential life lost (YPLL) and working years of potential life lost (WYPLL) due to drowning were calculated. In addition, the annual percent change (APC) was used to analyze the trends in drowning mortality and the rate of YPLL and WYPLL in Huzhou City from 2012 to 2021.@*Results@# A total of 1 681 deaths occurred due to drowning in Huzhou City from 2012 to 2021, accounting for 9.11% of total injury deaths. The overall mortality and standardized mortality of drowning were 6.35/105 and 4.70/105, respectively, and mortality and standardized mortality of drowning were 6.95/105 and 5.44/105 in men and 5.76/105 and 3.98/105 in women, respectively. The highest mortality of drowning was found in residents at ages of 65 years and older (16.04/105 to 27.02/105), followed by in residents at ages of less than 5 years (2.54/105 to 16.37/105). The overall mortality of drowning was 5.29/105 to 7.21/105 among residents in Huzhou City from 2012 to 2021, and no significant change tendency was seen (APC=-2.18%, t=-2.085, P=0.071). The standardized mortality of drowning reduced from 6.10/105 to 3.69/105 (APC=-4.88%, t=-4.215, P=0.003). In addition, the YPLL and rate of YPLL, and WYPLL and the rate of WYPLL due to drowning mortality were 22 620.50 person-years, 0.10%, 17 956.50 person-years and 0.08% in Huzhou City from 2012 to 2021, respectively, and the rates of YPLL (APC=-6.95%, t=-3.203, P=0.016) and WYPLL (APC=-7.60%, t=-3.126, P=0.014) both appeared a tendency towards a decline from 2012 to 2021. @*Conclusions@#The standardized mortality of drowning and rate of YPLL appeared a tendency towards a decline among residents living in Huzhou City from 2012 to 2021, and residents at ages of 65 years and older and less than 5 years are high-risk populations for management of drowning mortality.

Años potenciales de vida perdidos y análisis espacial de incidentes viales en peatones de Medellín 2015-2020 / Years of potential life lost and spatial analysis of road accidents in medellin pedestrians between 2015-2020

Resumen Objetivo: Describir los años potenciales de vida perdidos (APVP) y la distribución espacial de la mortalidad por incidente vial en peatones de Medellín durante el período 2015-2020. Métodos: Se realizó estudio descriptivo con fuente de información secundaria, se analizaron la totalidad de registros de peatones muertos en incidente vial. El cálculo de los APVP fue realizado por grupos quinquenales y eligiendo como edad límite la esperanza de vida al nacer de Colombia, estimada por el DANE para el período 2015-2020. Para conocer la distribución geográfica de las muertes se creó mapa de puntos y densidad de Kernel con clasificación estándar-cuantil. El análisis de proximidad se realizó por el método búfer de anillos múltiples, con distancias de 100, 200 y 300 metros. Resultados: En Medellín, durante los años 2015-2020, se registraron 696 muertes de peatones, 514(73,9%) hombres y 182 (26,1%) mujeres. Las comunas de mayor mortalidad fueron Candelaria con 217(31,2%) muertes y Castilla con 61(8,8%). Las lesiones más frecuentes fueron politraumatismos 401 (57,6%) y lesiones en cabeza 231 (33,2%). En total los peatones de la ciudad perdieron 14.553 APVP por incidente vial. Del total de incidentes fatales en peatones, 400 (57,5%) ocurrieron en un radio de distancia de 300 metros de un puente peatonal. Conclusión: Peatones hombres presentaron las tasas de APVP más altas del período, y son quienes más mueren en la vía. Lesiones en cabeza y cráneo son las más fatales, especialmente si son adultos mayores quienes las sufren. La pérdida de fuerza laboral y económica es alta para la ciudad, pero la social y familiar es incalculable.

Abstract Objective: To describe the Years of Potential Life Lost (YPLL), and the spatial distributions of mortality caused by road accidents in Medellin pedestrians between the periods of 2015-2020. Methods: A descriptive study with a secondary source of information was carried out, and all the records of pedestrians killed in road accidents were analyzed. The calculation of the YPLL was carried out by five-year age groups and the Life Expectancy at Birth of Colombia as the age limit estimated by DANE for the period 2015-2020 was chosen. To know the geographical distribution of the deaths, point maps, and kernel density estimation with a standard quantile classification were created. The proximity analysis was performed by the multiple ring buffer method, with distances of 100, 200 and 300 meters. Results: During the years 2015-2020, 696 pedestrian deaths were registered in Medellin, from which 514 (73.9%) were men and 182 (26.1%) were women. The neighborhoods with the highest mortality were Candelaria with a percentage of 31.2% (217 deaths), and Castilla with a percentage of 8.8% (61 deaths). The most frequent injuries were polytrauma with a total of 401 cases (57.6%), and head injuries in 231 cases (33.2%). In total, the city's pedestrians lost 14,553 YPLL due to road accidents. From the total number of fatal pedestrian accidents, 400 (57.5%) of them occurred within a 300-meter radius of a pedestrian bridge. Conclusion: Male pedestrians had the highest YPLL rates of the period, and they are the ones who die the most on the road. Head and skull injuries are the most fatal, especially if they are suffered by older adults. The loss of labor and economic power is high for the city, but the social and family loss is incalculable.

Carga de enfermedad por lesiones de causas externas en Bucaramanga, Colombia 2017 / Burden of disease by external causes of injury in Bucaramanga, Colombia 2017

Resumen Introducción: Las lesiones por causa externa son uno de los principales problemas de salud pública en el mundo, y la metodología estandarizada de carga de enfermedad a través de los años de vida saludable perdidos (AVISAS) permite conocer el estado de salud poblacional y priorizar acciones. Objetivo: Determinar la carga de enfermedad en términos de discapacidad y muerte como consecuencia de lesiones por causas externas en Bucaramanga, 2017. Diseño metodológico: Estudio descriptivo de carga de la enfermedad. Se estimó los AVISAS producidos por LCE utilizando las bases de datos del Departamento Administrativo Nacional de Estadísticas, Sistema de Nacional de Vigilancia en Salud Pública y Registro Individual de la Prestación de Servicios de Salud, del año 2017, de la ciudad de Bucaramanga. Resultados: Se estimó una carga global de enfermedad por LCE de 12,04 AVISAS por cada 1000 personas; 0,51 AVISAS atribuibles a discapacidad y 11,53 AVISAS, a mortalidad. Las agresiones y accidentes de tránsito (AT) son las dos principales LCE con mayor número de AVISAS. En la población de 5-59 años las agresiones y AT presentan AVISAS por mortalidad de mayor peso; los AT son la principal causa externa en la población de 60 a 79 años y la segunda en mayores de 80 años. Conclusiones: Considerando que los AT fueron la causa externa con las más altas AVISAS atribuidas a mortalidad prematura, se recomienda implementar o intensificar estrategias de alto impacto que contribuyan a disminuir los AT.

Abstract Introduction: Injuries due to external causes are one of the main worldwide public health problems. The standardized methodology to evaluate burden diseases through the disability-adjusted life years (DALYs) allows us to know the health condition in a population and prioritize actions. Objective: To determine the burden of disease in terms of disability and death as consequence of injuries due to external causes in Bucaramanga, 2017. Methodology: Descriptive study was conducted. The DALYs produced by injuries due to external causes were estimated using information from the National Administrative Department of Statistics, the National Public Health Surveillance System and the Individual Registry of Service Provision of Health databases from 2017 for the city of Bucaramanga, Colombia. Results: The global burden of diseases due to external causes was estimated at 12.04 DALYs per 1000 inhabitants; 0.51 DALYs were attributed to disability and 11.53 DALYs to mortality. Assaults and road traffic accident injuries (RTAI) were the main external causes with higher DALYs. In the population between 5 and 59 years old, assaults and RTAI had the highest DALYs attributed to mortality. RTAI were the first external cause of DALYSs in the population between 60 and 79 years old, and the second cause in the population older than 80 years. Conclusion: Considering that RTAI was the external cause with the highest DALYs attributed to premature mortality, it is recommended to implement or intensify high-impact strategies to reduce RTAI.

Trend analysis of mortality and early death burden of cardiovascular diseases from 2009 to 2018 in Ningbo / 预防医学

Objective@#To understand the trend of cardiovascular diseases death and disease burden caused by early death from 2009 to 2018 in Ningbo, so as to provide evidence for the prevention and control of cardiovascular disease.@*Methods@#The monitoring data of cardiovascular diseases death from 2009 to 2018 was collected from Ningbo death cause surveillance system. The mortality rate, early death probability, years of life lost ( YLL ) and working years of potential life lost ( WYPLL ) were calculated, and the mortality rate and YLL rate were standardized by 2010 national standard population. The annual percentage change ( APC ) was used to measure the time trend. @*Results@#From 2009 to 2018, there were 42 961 deaths from cardiovascular diseases in Ningbo, with a mortality rate of 7.35/104, a standardized mortality rate of 4.25/104, and an early death probability of 0.84%. The APC of cardiovascular disease mortality and standardized mortality were 57.488% and 6.004%, both showing an upward trend ( P<0.05 ); the APC of the probability of early death was -1.253%, showing a downward trend ( P<0.05 ). The male mortality rate was 4.16×104, which was lower than the female's 4.36/104 ( P<0.05 ). The YLL, standardized YLL rate, and WYPLL for cardiovascular diseases were 329 266.65 person-years, 3.82‰, and 18 355.63 person-years, respectively. The overall APC of YLL is 1.700%, showing an upward trend ( P<0.05 ). The standardized YLL rate of cardiovascular diseases increased with age ( P<0.05 ). with the APC of 1.503%. Ischemic heart disease and hypertensive heart disease were dominant, their YLLs were 105 949.75 and 46 015.68 person-years, respectively. @*Conclusion@#From 2009 to 2018, the mortality of cardiovascular diseases show an increasing trend, while the burden caused by early death in Ningbo reverses. Women and the elderly are high-risk groups, and ischemic heart disease and hypertensive heart disease are high-risk diseases.

Años de vida saludable perdidos a causa de trastornos mentales y enfermedades del sistema nervioso de la población de Medellín, 2006-2012 / Disability-Adjusted Life Years Due to Mental Disorders and Diseases of the Nervous System in the Population of Medellin, 2006-2012

RESUMEN Objetivo: Determinar la pérdida de años de vida saludables (AVISA) por trastornos mentales y enfermedades del sistema nervioso en Medellín, de 2006 a 2012. Métodos: Estudio descriptivo, con fuente de información secundaria bajo lineamientos teóricos del Estudio la Carga Global de la Enfermedad (CGE). Para calcular los Años Potenciales de Vida Perdidos (APVP), se empleó información de las estadísticas vitales; para los Años de Vida Ajustados por Discapacidad (AVD), la de morbilidad de los Registros Individuales de Prestación de Servicios de Salud (RIPS), de consulta externa y otras investigaciones. Los AVISA se obtuvieron de sumar los APVP y AVD. Resultados: En Medellín, durante el septenio, de 1.242.407 AVISA por trastornos mentales y enfermedades del sistema nervioso, la mayor carga se debió a discapacidad (99,39%). Las mujeres aportaron más AVISA (70,22%). El 81% de los AVISA se concentraron en el grupo de 15 a 59 años. Los trastornos que mayor carga representaron fueron, en este orden, el trastorno depresivo unipolar (81%), el Alzheimer y otras demencias (4,82%), la esquizofrenia (3,45%) y los trastornos por consumo de drogas (2,78%). Conclusiones: Se sustenta un importante incremento de la carga de la enfermedad por trastornos mentales y enfermedades del sistema nervioso, lo que debe llamar la atención de los tomadores de decisiones sobre la política pública del municipio, ya que estos problemas de salud pueden significar un gran aumento en los costos de atención en salud.

ABSTRACT Objective: To determine the healthy life years (HLY) lost as a result of mental disorders and nervous system diseases in Medellin from 2006 to 2012. Methods: Descriptive study using a secondary information source according to the Global Burden of Disease (GBD) framework. To calculate the years of potential life lost (YPLL), we used vital statistics data; to calculate disability-adjusted life years (DALY), we used morbidity data from individual records managed by health service providers, outpatient clinics and other research studies. HLY are the sum of YPLL and DALY. Results: In Medellin, from 2006 to 2012, out of 1,242,407 HLY related to mental disorders and nervous system diseases, the vast majority (99.39%) were due to disability. Most HLY were found in females (70.22%) and 81% were found in people aged 15 to 59. The disorders representing the greatest burden were unipolar depressive disorder (81%), Alzheimer's disease and other types of dementia (4.82%), schizophrenia (3.5%) and drug use disorders (2.78%). Conclusions: Our results indicate a significant increase in the disease burden due to mental disorders and nervous system diseases. Public policy decision-makers in the city of Medellin should take note, as health problems of this type can result in a substantial rise in healthcare costs.

Epidemiological characteristics of injury deaths in Taizhou / 预防医学

Objective @#To understand the epidemiological characteristics of injury deaths among residents in Taizhou,and to provide evidence for prevention and control of injury death. @*Methods @#The monitoring data of injury deaths in Taizhou residents from 2010 to 2016 were derived from the Chronic Disease Surveillance Information Management System of Zhejiang Province. Descriptive epidemiological methods were used to analyze injury mortality,cause of death,population characteristics and life lost due to injury. @*Results @#From 2010 to 2016,a total of 26 313 injury death cases were reported in Taizhou,with an average annual injury mortality rate of 63.61/100 000 and a standardized rate of 56.64/100 000; the mortality rate of injury from 2010 to 2016 showed a downward trend year by year（P<0.05）,and the annual change percentage（APC）was -7.1%. The mortality rates of 0-14 years old,15-44 years old,45-64 years old,65 years old and above group were 15.37/100 000,22.45/100 000, 69.64/100 000 and 315.69/100 000. There were statistically significant differences in the mortality rates of residents between different age groups （P<0.05）. Except for there were no statistically significance differences between the mortality rates of 15-44 years old and 0-14 years old in 2013 and 2014（both P>0.008 3）. The mortality rate in each year from 2010 to 2016 were decreased by 0-14 years old,15-44 years old,45-64 years old,65 years old and above group （all P<0.008 3）. The mortality rate of all age groups showed a downward trend year by year（P<0.05）. The top five injury death causes were accidental falls（17.97/100 000）,motor vehicle traffic accidents（13.97/100 000）,drowning（5.59/100 000）,suicide （5.25/100 000）,other accidents and harmful effects（4.50/100 000）,accounting for 84.35% of the total number of deaths. The injury death causes of the 0-14 years old group were mainly drowning,which was 407 cases,accounting for 1.55% of the total number of deaths; for 15-44 years old group and the 45-64 years old group,the main causes were motor vehicle traffic accidents,which were 1 373 and 2 354 cases,accounting for 5.22% and 8.95%,respectively; for 65 years old and above group,the main cause was mainly accidental falls,which was 6 777 cases,accounting for 25.76%. The years of potential life lost （PYLL） due to injury was 328 678 person-years and the years of potential life lost rate （PYLLR） was 7.95‰.@*Conclusion @#The injury mortality rates of Taizhou residents were declined from 2010 to 2016. The mortality rate of elderly residents due to injury were high and accidental falls was the main cause of injury deaths.

Costo de los accidentes de moto en menores de 19 años atendidos en un hospital de referencia

Introducción: Los accidentes de tránsito constituyen un grave problema de salud pública, sin embargo, su impacto socioeconómico no se conoce en el Paraguay. Objetivos: determinar el impacto socioeconómico de los accidentes de moto en <19 años en el año 2016. Materiales y Métodos: estudio descriptivo, observacional, retrospectivo. Se incluyeron todos los pacientes ≤19 años que acudieron al Hospital de Trauma (HT) con antecedente de accidente de moto en el año 2016. Los datos y los costos fueron obtenidos de la base de datos del Dpto. de Estadísticas y del Dpto. de Ingresos del HT, respectivamente. Resultados: se incluyeron 700 pacientes que acudieron al HT por accidente de moto. La edad media de los pacientes fue de 15,6 ± 4.33 años. El 78% (546/700) era de sexo masculino. De los accidentados 450 (64,2%) era conductor y 250 (35,7%) acompañante. La media de edad de los conductores fue de 17 ± 4,3 años (rango 11 - 19 años) y de los acompañantes 12,3 ± 4,4 (rango <1 - 19 años). Entre los conductores solo el 50.4% (227/450) tenía la edad reglamentaria para obtener licencia de conducir. Solo el 7,7% (54/695) de los accidentados usaba casco al momento del accidente. Requirió hospitalización por 2 o más días el 89,2% (625/700) de los pacientes, de los cuales el 7.6% requirió ser hospitalizado en UCIP. La media de días de hospitalización en sala y UCIP fue de 11.04 días (DS 14,85 días) y 16.57 (DS 23 días). El 25,1% (176/700) tuvo algún grado de discapacidad o secuela y el 5,4% (38/700) falleció. Los costos directos por hospitalización por día en sala y en UCIP fueron de 275,4 y 737,2 $, respectivamente. Los costos directos por accidentes de moto en el año 2016 fue de 2.587.179,2$. Los años de vida potencialmente perdidos (AVPP) en el año 2016, fueron de 2159 años. Conclusiones: El impacto socioeconómico de los accidentes de motos, representa un costo social extremo derivado de una causa de muerte que podría prevenirse.

Introduction: Traffic accidents are a serious public health problem, however, their socio-economic impact has not been described in Paraguay. Objectives: to determine the socioeconomic impact of motorcycle accidents in victims <19 years of age in 2016. Materials and Methods: this was a descriptive, observational, retrospective study. All patients aged ≤19 years who were admitted to the Trauma Hospital (TH) with a history of a motorcycle accident in 2016 were included. The data and costs were obtained from the Statistics Department and the Admissions Department of the TH. Results: 700 patients were included, all of whom were admitted to the TH due to a motorcycle accident. The average age of the patients was 15.6 ± 4.33 years. 78% (546/700) were male. Of those injured, 450 (64.2%) were drivers and 250 (35.7%) were passengers. The average age of the drivers was 17 ± 4.3 years (range 11-19 years) and that of the passengers was 12.3 ± 4.4 years (range <1-19 years). Among the drivers, only 50.4% (227/450) were of the legal age to obtain a driver's license. Only 7.7% (54/695) of the victims wore a helmet at the time of the accident. 89.2% (625/700) of patients required hospitalization stays of 2 or more days of length, of which 7.6% required PICU admission. The mean number of regular ward hospitalization days and PICU days were 11.04 days (SD 14.85 days) and 16.57 days (SD 23 days), respectively. 25.1% (176/700) had some degree of disability or long-term effects and 5.4% (38/700) died. The direct costs per hospitalization per day in the ward and in the PICU were US$ 275.4 and 737.2, respectively. The direct costs for motorcycle accidents in 2016 was US$ 2,587,179.2. The years of potential life lost (YPLL) in 2016 were 2159 years. Conclusions: The socioeconomic impact of motorcycle accidents represents an extremely high social cost, stemming from a preventable cause of death.

Análisis de la mortalidad por cáncer de próstata en pacientes de la provincia de Holguín / Analysis of the Prostate Cancer Patients Mortality in Holguín Province

Introducción: el cáncer de próstata presenta alta tasa de mortalidad y ocupa el segundo lugar en Cuba, sólo superado por los tumores de laringe, tráquea y pulmones; de forma similar se comporta en la provincia de Holguín. Objetivos: analizar los factores sobre los que se puede actuar para la disminución de la mortalidad por cáncer de próstata en pacientes de la provincia de Holguín. Método: relacionamos las estadísticas, desde 2001 hasta el 2013, sobre mortalidad por cáncer de próstata e incidencia por etapa clínica en pacientes de la provincia de Holguín. Se utilizó el Anuario Estadístico de Cuba y los datos del Departamento de Registros Médicos y Estadísticas de Salud en la provincia (2013). Las variables empleadas fueron tasa de mortalidad por 100 000 habitantes, incidencia según etapa clínica, mortalidad 2007-2013 en pacientes diagnosticados con cáncer de próstata en los municipios, años de vida potencialmente perdidos (AVPP) por grupos de edades y tendencia de la mortalidad. Resultados: la tasa de mortalidad en el 2013 fue de 42,8 por cada 100 000 habitantes, sólo superada en la provincia por los tumores de pulmón (49,8 por cada 100 000 habitantes). La incidencia en estadios avanzados III predominó durante los últimos años. Los municipios de Gibara, Cueto, Sagua, Frank País y Urbano Noris tuvieron altas tasas de mortalidad y los de Moa, Banes y Antilla los de menor tasa promedio en los últimos cinco años. Los AVPP en los grupos de 60-64 años obtuvieron mayor tasa de 6,7 en el 2007 y fue desplazado por el grupo de 65-69 en el 2013 con tasa de 6,4. Conclusiones: existe clara tendencia al aumento de la mortalidad por cáncer de próstata en Holguín.

Introduction: prostate cancer has high mortality rate, ranking second in Cuba, surpassed only by tumors of the larynx, trachea and lungs, a similar prevalence is observed in Holguin province. Objective: to analyze mortality from prostate cancer in the province of Holguin and the factors that can influence in decreasing this mortality. Method: statistics rate of mortality for prostate cancer from 2001 to 2013 was considered, as well as its incidence taking into account the clinical stage. Statistical Yearbook of Cuba and the data of the Department of Medical Records and Health Statistics in the province (2013) were used. The statistics from 2001 to 2013, mortality from prostate cancer incidence and clinical stage in patients in the province of Holguin were considered. The variables: mortality rate per 100 000 population, incidence, clinical stage according to mortality in patients diagnosed with prostate cancer (2007-2013) in the municipalities, years of potential life lost (YPLL) by age group and mortality trends were analyzed. Results: the mortality rate in 2013 was 42.8 per 100,000 inhabitants in the province, surpassed only by lung tumors (49.8 per 100,000 inhabitants). The incidence in advanced stages III prevailed in recent years. Gibara, Cueto, Sagua, Frank País and Urbano Noris municipalities had high mortality rates and Moa, Banes, Antilla had lower average rate over the past five years. YPLL in groups of 60-64 years had the higher rate of 6.7 in 2007 being displaced by the 65-69 age group in 2013 with a rate of 6.4. Conclusions: there is a clear trend towards increased mortality from prostate cancer in Holguin.

Burden of traffic accidents among pedestrians of Fars province, southern Iran; estimate of years of life lost in a sample of Iranian population from 2009 to 2013 / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Traffic injuries are among the leading causes of mortality and morbidity worldwide. Pedestrians have been considered as a high-risk group among road users, especially in middle- or low-income communities. This study attempted to determine the burden of pedestrians' fatalities in Fars, the southern province of Iran using years of life lost (YLL) approach.</p><p><b>METHODS</b>The data used in this study were retrieved from Fars Forensic Medicine Organization database on pedestrian traffic accidents. The YLL from 2009 to 2013 was estimated using the method presented by World Health organization. Some epidemiological characteristics of pedestrians' fatalities were analyzed by SPSS.</p><p><b>RESULTS</b>Although YLL among 1000 male pedestrians decreased from 2.5 in 2009 to 1.5 in 2013, it increased from 0.9 to 2.1 among 1000 females during the same period. Higher proportion of death was found in female, illiterate, and married pedestrians (p < 0.001). In addition, mortality was higher in pedestrians living the cities, during daytime, at home, and in hospitals (p < 0.001).</p><p><b>CONCLUSION</b>Consistent with the global trends, burden of pedestrian accidents in Fars was also exceptionally high. Considering the national and cultural aspects of different countries, improving the safety of pedestrians demands a multi-dimensional approach with interventional factors concerning policies, rules, pedestrians, motor vehicles and environmental conditions taken into consideration.</p>

Mortalidad y años de vida potenciales perdidos por enfermedades aterotrombóticas en el municipio Cerro / Mortality and years of potential life lost from atherothrombotic disease in Cerro municipality

Introducción: los datos de mortalidad son base para una amplia gama de indicadores de diversa complejidad. No solo representan las herramientas para evaluar el riesgo de muerte en una población y la repercusión de las enfermedades en la salud, sino también la gravedad de las enfermedades y la sobrevivencia experimentada por la población. Objetivo: estimar la mortalidad y los años de vida potenciales perdidos por enfermedades aterotrombóticas en el municipio Cerro. Métodos: se realizó un estudio observacional, descriptivo, retrospectivo de las defunciones por enfermedades aterotrombóticas en el municipio Cerro en el período comprendido entre el 2000 y el 2006 y se analizaron por edad, sexo, sitio y causa de defunción. Para el análisis estadístico se procedió al cálculo de las tasas brutas y tipificadas de mortalidad y por años de vida potenciales perdidos por mortalidad. Resultados: se observó una tendencia a la disminución de la mortalidad y un aumento en los años de vida potenciales perdidos a lo largo de este período. Se constató una mayor tasa de mortalidad y una mortalidad prematura en las mujeres de 65 años y más. Hubo un mayor porcentaje de fallecidos por aterotrombosis periférica dentro de una institución hospitalaria. Conclusiones: el municipio Cerro mostró una tendencia a la disminución de la mortalidad por enfermedades aterotrombóticas, y un aumento en los años de vida potenciales perdidos por esta causa, donde las mujeres de la tercera edad fueron las más afectadas(AU)

Introduction: mortality data are the pillars of a wide range of indicators of varying complexity; they do not only represent tools for evaluation of the risk of dying in a population and the impact of diseases on health but also the severity of diseases and the survival rate of that population. Objective: to estimate mortality and the years of potential life lost from atherothrombotic diseases in Cerro municipality. Methods: retrospective, descriptive and observational study was conducted on deaths occurred in Cerro municipality due to atherothrombotic diseases in the period of 2000 through 2006 and were analyzed by age, sex, location and causes. For the statistical analysis, the gross and typed mortality rates and the years of potential life lost rates were also estimated. Results: downward trend in mortality and upward trend in the years of potential life lost were observed in this period. The mortality rate and the premature mortality were higher in women aged 65 and over. The percentage of deaths from peripheral atherothrombotic disease in a hospital center was higher. Conclusions: Cerro municipality showed a downward trend in mortality from atherothrombotic disease but an upward trend in the years of potential life lost due to this cause, being the older women the most affected(AU)

Analysis on main death causes and potential life lost among residents in Chongqing Wansheng Economic Development Zone during 2014 / 重庆医学

Objective To understand the death level and main death causes among residents in the Wansheng Economic De‐velopment Zone to provide the basis for comprehensive prevention and control .Methods According to the ICD‐10 international classification of diseases ,the death causes were classified and coded for statistically analyzing the crude mortality rate ,standardized mortality rate and the death causes constituents in this surveyed population .Results The crude mortality rate of residents in Wan‐sheng Economic Development Zone during 2014 was 650 .57/100 000 and the standardized mortality rate was 413 .35/100 000 .The sequence of death causes was circulatory system disease ,respiratory system disease ,tumor ,injury and poisoning and digestive sys‐tem diseases .The death number for these 5 kinds of death causes accounted for 93 .21% of the total death number .The top five of potential life loss years were injury and poisoning ,tumor ,circulatory system disease ,respiratory system disease and digestive system diseases .The rates of potential years of life loss were 13 .76‰ ,10 .19‰ ,8 .35‰ ,4 .84‰ and 2 .69‰ respectively .Conclusion Chronic noncommunicable diseases ,injury and poisoning become the main causes of death in the Wansheng Economic Development Zone and disease burden .

Analysis of two period in Three Gorges Reservoir area after the impoundment of county residents death surveillance / 重庆医学

Objective To analysis residents'death causes in the Three Gorges Reservoir Area,and analysis the distribution of causes of death and age,gender characteristics,therefore provide basis for governments at all levels to develop disease prevention. Methods Data for classification of death cause was analyzed by Excel 2003,according to the ICD-10 classification,the years of po-tential life lost(YPLL)was calculated by SPSS1 7.0.Results Totally 62 702 death date of resident population in Three Gorges Reservoir Area from July,2003 to December,2013 were collected.The crude death rate for males and standardized mortality rate was significantly higher than that in female;Cause of death of the top five were:circulatory system disease,respiratory system dis-ease,malignant tumor,injury and poisoning and digestive system diseases;Chronic disease was the main cause of death which ac-counting for 87.76%;years of potential life lost rate of top five were:injury and poisoning,tumor,circulatory system disease,respir-atory system diseases and perinatal diseases.Conclusion The main cause of death in Three Gorges Reservoir area is a county in the circulatory system diseases,malignant tumor,respiratory system disease,and show a younger trend.Therefore,prevent premature death has become one of the focal points of disease prevention and control.

Injury deaths in children under 5 years and disease burden in Sichuan Province / 中国小儿急救医学

Objective To analyze the status and the distribution of causes of injuries as well as disease burden in children under 5 years old in Sichuan Province.Methods The death information cards of children who died because of injuries in Sichuan Province in 2012 were analyzed,and the years of potential life lost and working years of potential life lost were calculated to evaluate the disease burden.Results 22.87％ (1 502/6 567) of children lost their lives because of injuries,the mortality of injury was 4.13‰,63.45％ of children died at the age between l and 4,and most of the children died at home or on the road; The top 3 causes of children death of injuries below 5 years old were drowning,accidental suffocation and traffic accidents.The years of potential life lost and working years of potential life lost were 73.05 years and 58.30 years.Conclusion Injury is one of the most mainly risk factor of health and life of children,the government should further prevent and control children injuries.

Gender disparities in mortality: challenges for health equity in Puerto Rico / Disparidades de género en mortalidad: retos para la equidad en salud en Puerto Rico / Disparidades de gênero em mortalidade: desafios para a equidade na saúde em Porto Rico

The aim of this study is to deepen the analysis of mortality indicators by sex in Puerto Rico. The gender perspective is used to identify the differentials and inequalities that generate disparities in mortality among women and men in that country. In 2008-2010, life expectancy at birth for both sexes reached 78.83 years, with a gap of 7.71 years among women and men, which is higher in the group of very low mortality countries, internationally. The years of potential life lost (YPLL) by age and external causes of death and natural death are used, among other indicators, for further analysis of male mortality from a gender perspective. Young men have a very high premature mortality because many deaths are due to by external causes: homicides, suicides and accidents. In the case of women's, premature deaths are prevalent due natural causes in all age groups. The result of the study is to promote gender mainstreaming to achieve health equity for women and men. Puerto Rico requires health plans, programs and policies that take into account gender disparities in order to achieve a longer life span-free of preventable disease, disability, injury and premature death- which currently affects more men than women.

El objetivo de este estudio es profundizar en el análisis de indicadores de mortalidad por sexos en Puerto Rico, desde la perspectiva de género, con el propósito de conocer diferenciales y desigualdades que generan disparidades en la mortalidad de mujeres y hombres en ese país. En 2008-2010 la esperanza de vida al nacer de ambos sexos alcanzó 78.83 años, con una brecha de 7.71 años entre mujeres y hombres, la más elevadas en el conjunto de países de mortalidad muy baja, a escala internacional. Se utilizan los años potenciales de vida perdidos (APVP) por edades y causas de muerte externas y naturales, entre otros indicadores de mortalidad, para profundizar en el análisis de la sobre mortalidad masculina, desde una perspectiva de género. La mortalidad prematura reporta pérdidas elevadas de años de vida, en hombres jóvenes, por causas de muerte externas -homicidios, suicidios y accidentes; en el caso de las mujeres, prevalecen las causas de muerte natural en la mortalidad prematura de todas las edades. Los resultados del estudio promueven la incorporación de la perspectiva de género para lograr la equidad en salud de mujeres y hombres. En Puerto Rico se requieren planes, programas y políticas de salud, que tomen en cuenta las disparidades de género para lograr una vida más larga, libre de enfermedades evitables, invalidez, lesiones y muerte prematura, que en la actualidad afectan más a los hombres que a las mujeres.

O objetivo deste estudo é aprofundar na análise de indicadores de mortalidade por sexos em Porto Rico, desde a perspectiva de gênero, com o propósito de conhecer diferenciais e desigualdades que geram disparidades na mortalidade de mulheres e homens nesse país. Em 2008-2010 a expectativa de vida ao nascer de ambos os sexos alcançou 78,83 anos, com uma diferença de 7,71 anos entre mulheres e homens, a mais elevadas no conjunto de países de mortalidade muito baixa, na escala internacional. Utilizam-se os anos potenciais de vida perdidos (APVP) por idades e causas de morte externas e naturais, entre outros indicadores de mortalidade, para aprofundar na análise da mortalidade masculina, desde uma perspectiva de gênero. A mortalidade prematura reporta perdas elevadas de anos de vida, em homens jovens, por causas de morte externas - homicídios, suicídios e acidentes; no caso das mulheres, prevalecem as causas de morte natural na mortalidade prematura de todas as idades. Os resultados do estudo promovem a incorporação da perspectiva de gênero para obter a equidade em saúde de mulheres e homens. Em Porto Rico requerem-se planos, programas e políticas de saúde, que levem em consideração as disparidades de gênero para conseguir uma vida mais longa, livre de doenças evitáveis, invalidez, lesões e morte prematura, que na atualidade afetam mais aos homens que às mulheres.

Edad de ocurrencia de los fallecimientos por diabetes en Cuba / Age of occurrence of deaths from diabetes in Cuba

Introducción: el incremento de la tasa bruta de mortalidad en Cuba durante los últimos años, unido al acelerado proceso de envejecimiento poblacional, nos encauzó en el presente estudio. Objetivo: identificar diferencias en la edad de ocurrencia de las defunciones por diabetes en Cuba del año 1990 a 2010. Métodos: se incluyeron todas las defunciones por diabetes ocurridas en el país durante los años 1990, 1995, 2000, 2005 y 2010. A partir de estas se calcularon: las tasas de años de vida potencial perdidos por mortalidad por 1 000, los años de vida potencial perdidos por cada defunción, la media de la edad de los fallecidos, los cuartiles de la distribución de la edad de la muerte, y el porcentaje del total de fallecidos por diabetes por grupos quinquenales de edad. Resultados: la tasa de años de vida potencial perdidos se elevó en el sexo masculino de 2,44 a 2,63 por 1 000, mientras que en las mujeres tuvo un comportamiento discretamente descendente (de 4,54 a 4,46 por 1 000). Los años de vida potencial perdidos por cada defunción disminuyeron en ambos sexos (de 15,98 a 14,83 en hombres, y de 16,31 a 15,27 en mujeres). Esto último se relaciona directamente con el incremento de la media de la edad de los fallecidos, de 67,51 y 69,31 en 1990, a 70,24 y 72,33 en 2010 en hombres y mujeres respectivamente, así como con que los tres cuartiles se correspondieron con una mayor edad en los años 2005 y 2010, en relación con 1990 en ambos sexos. El porcentaje del total de defunciones perteneciente al grupo de 85 años y más fue de 9,9 y 16,2 por ciento en 1990 y 2010 respectivamente. Las defunciones en las mujeres ocurrieron más tardíamente, a pesar de mostrar mayores tasas de años de vida potencial perdidos. Conclusiones: la mortalidad por diabetes en Cuba durante los últimos años se ha desplazado a los grupos de edades más avanzadas(AU)

Introduction: the increase of the gross mortality rate in Cuba in the last few years, together with the accelerated process of population aging, encouraged us to conduct the present study. Objective: to set the differences in the age of occurrence of deaths from diabetes in Cuba from 1990 to 2010. Methods: all the deaths occurred from diabetes in 1990,2000, 2005 and 2010 throughout the country were included, and on this basis, the following rates were estimated: rates of years of potential life lost from death per 1 000 pop; the years of potential life lost per each death, the mean of the age of the deceased people; the age of death distribution quartiles and the percentage of the total number of deceased from diabetes per five-year age groups. Results: the rate of years of potential life lost increased in males from 2.44 to 2.63 per 1 000 pop, whereas that of females experienced a very slight decrease (4.54 to 4.46 per 1 000 pop). The years of potential life lost per each death were reduced in both sexes (15.98 to 14.83 for men and 16.31 to 15.27 for women). The latter was directly related to the increased mean of the age of the dead people, from 67.51 and 69.31 in 1990 to 70.24 and 72.33 in 2010 for men and women, respectively, and to the fact that the three quartiles corresponded to an older age in the years 2005 and 2010 compared to the situation in 1990 in both sexes. The percentages of the total number of death in the 85 y and over age group were 9,9 and 16,2 percent in 1990 and 2010, respectively. Death occurred later in females than in men, despite their higher rates of years of potential life lost. Conclusions: mortality from diabetes in Cuba in the last few years has shifted to older age groups(AU)

Analysis on the long-term trend of injury related deaths in Macheng of Hubei province,1974-2008 / 中华流行病学杂志

Objective To study the long-term trend of injury related deaths, the distribution of causes of injuries as well as disease burden in Macheng city, Hubei province, in 1974-2008.Methods Data was gathered from vital statistics and registration system of Macheng city which was established in 1974. Data related to Cause Eliminated Life Expectancy(CELE), years of potential life lost(YPLL)and proportion of YPLL on total deaths were calculated. Results The injury death rates varied between 62.64/100 000 and 154.97/100 000 during that 35 years. In males and females, injury death rates varied between 69.16/100 000-163.86/100 000 and 55.34/100 000-157.35/100 000,respectively. Death rates on injury in males exceeded those of females. The average infant injury mortality was 770.13/100 000, stayed the highest in all of the age groups. In terms of geographic region, death rate showed the highest in the hilly area(37.03/100 000), followed by mountainous area (33.66/100 000)and the rate was lowest in the plain area(31.43/100 000). In terms of causes of deaths, suicide, drowning, suffocation, traffic accident and fall were the five top causes of injury,accounting for 84.26% of all the injury mortality. The mortality of suicide showed highest in the injury mortality accounting for 48.14% of all the injury mortality. Injury was the main causes of death among children and youths. The mortality of injury was the highest in people aged from 15 to 29 years, with 59.38% in males and 62.26% in females. Injury eliminated life expectancy increased while the YPLL due to injury decreased, annually. Conclusion Although the trends of mortality rates on injuries were declining over the past 10 years, it remained high in figures. The main causes of injury shifted around, but suicide had always been the main cause over the years, in different age groups, sex or terrains. The death rate of traffic accident was increasing. Effective control strategies should be formulated based on the caused of death related to injuries and among the high-risk populations.