"To survey or to register" is that the question for estimating population incidence of injuries?

BACKGROUND: Measuring 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. METHODS: Data 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). RESULTS: Among 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. CONCLUSION: The 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.

Call for cross governmental leadership to strategic cooperation among multiple stakeholders in preventing injuries in Europe: conclusions of the 2nd European Conference on Injury Prevention and Safety Promotion, 9-10 October 2008.

In this paper the conclusions of the 2nd European Conference on Injury Prevention are being presented. The conference aims were to promote the development of national plans, infrastructures and capacities for safety promotion at the regional, national and local levels and to facilitate government departments, non-governmental organisations and other stakeholders in enhancing inter-sectoral collaboration and actions on injury prevention. Session moderators reported in a standardised format on the sessions they facilitated and their recommendations were given to European and national authorities and other stakeholders. The increasing European recognition of injuries as an important health and consumer protection issue is evidenced by the adoption of important policy documents, such as the Council Recommendation on the prevention of injuries and the promotion of safety and the WHO Regional Committee Resolution. Currently, there is a substantial knowledge base in injury prevention and some capacity available in various regions in Europe to act on that knowledge. The field has generated momentum that must now be harnessed and leveraged to create greater visibility for this important societal issue in health and other relevant policy at the national and EU levels. Member States and national governments should provide leadership to strategic cooperation among multiple stakeholders and ensure sustained political commitment and financing.

Injury data needs and opportunities in Europe.

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.

Parents' perceptions, attitudes and behaviours towards child safety: a study in 14 European countries.

Injury is the leading cause of death for children 0- 19 years of age in Europe, accounting for 3.1 deaths per 10 000 children per year. The youngest children of the ages 0-4 years require the most protection in this age group, with 2.5 injury-related deaths per 10 000 children in Europe annually. As parents are the primary caregivers of children, it is necessary to learn more about parents' perceptions, attitudes and behaviours towards child safety. This study presents the findings of a 14-country study in Europe on this theme. A quantitative survey of parents of children aged 5 years or under was performed in 14 EU member states in order to enable better targeting of prevention efforts aimed at educating parents. The total sample size was 2088. The results show that 95% of parents reported that they personally take measures to avoid accidental injury to their children. Their top concern with regard to safety of their children was children being hit by a car. The most common response, when asked why some parents find it difficult to protect their children from accidental injury, was not being able to watch their children constantly. Lack of awareness or knowledge about the causes of accidents was the second response. Two-thirds of parents would like to see more help from the government to prevent childhood injuries. Three-quarters of parents agreed that child injuries can be avoided. It was concluded that parents want to be better informed about the causes of child accidents and about actions they and society can take to reduce injury-related risks to children.