Perspectives in Disease Prevention and Health Promotion Premature Mortality Due to Unintentional Injuries -- United States, 1984

Unintentional injuries are the leading cause of years of potential life lost (YPLL) before the age of 65. In 1985, unintentional injuries (E800-949)* accounted for over 2.2 million YPLL, or 19% of all YPLL. Unintentional injuries were also the leading cause of YPLL in 1983 and 1984 (1).

For this analysis, National Center for Health Statistics (NCHS) mortality data for 1984, the latest year for which detailed data are available, were used to determine the number of deaths associated with unintentional injury and the related YPLL. Population data, based on the 1984 U.S. Bureau of the Census estimates, were used to calculate age- and cause-specific YPLL rates.

In 1984, motor vehicle traffic crashes (E810-819), which caused 39,228 deaths, were the leading cause of both YPLL and deaths resulting from unintentional injuries. Injuries to passenger vehicle occupants are the major cause of deaths due to motor vehicle crashes and cause one out of every three deaths from all causes among 15-to 19-year-old males (2). Deaths from drowning (E910), fire and flames (E890-899), poisoning (E850-869), falls (E880-888), unintentional discharge of firearms (E922), and choking on food or objects (E911-912) were also leading causes of YPLL in 1984.

Fatalities caused by nontraffic motor vehicle crashes involving off-the-road vehicles, such as snowmobiles and all-terrain vehicles, and fatalities due to air and water transportation remained among the ten unintentional injuries that cause the largest number of deaths and YPLL (Table 1). For all unintentional injuries, the rate of YPLL for males was between 1.7 and 8.9 times greater (depending on the unintentional injury) than that for females. This difference was greatest for fatal injuries involving air transportion.

In 1984, fatalities involving pedestrians were the second leading cause of motor vehicle traffic deaths and constituted about 14% of all fatalities associated with motor vehicle traffic incidents. A total of 5,652 persons were killed in pedestrian incidents, and a resultant 195,586 years of potential life were lost. White males had a YPLL rate of 120.7/100,000 population for pedestrian fatalities, and black males had a rate of 225.3/100,000. The rates for white and black females showed a similar difference. Although the age-specific fatality rate for pedestrians was high for children under age 5, it was highest for adults 15-29 years of age and for those over 50. Children under 10 contributed 26% of the YPLL due to pedestrian fatalities. Reported by: Program Development and Implementation Br, Div of Injury Epidemiology and Control, Center for Environmental Health and Injury Control, CDC.

Editorial Note

Editorial Note: Alcohol is the single most frequently found human factor in fatal crashes (3,4). A 1982 study of 46 motor vehicle crashes in Fulton County, Georgia, in which the drivers' blood alcohol concentrations (BACs) were measured showed that, in 39 (85%) of the crashes, at least one of the drivers involved was legally intoxicated. Drivers who had been drinking were involved in 42 (91%) of the crashes. Thirty-two (82%) of the legally intoxicated drivers were at least 25 years old, and 30 (77%) were male (5).

Deaths involving pedestrians represent the second largest category of motor vehicle deaths. Males account for 70% of pedestrian fatalities in all age groups. Two-thirds of all pedestrian deaths occur in urban areas. Alcohol plays a major role in adult pedestrian fatalities (3,4). Almost half of all fatally injured adult pedestrians have BACs greater than or equal to0.1%, and more than 50% of all fatally injured pedestrians in the 20- to 64-year age group have BACs greater than or equal to0.1%. For persons killed in motor vehicle crashes, the percentage of elevated BAC declines after age 40.

Reductions of motor vehicle occupant and pedestrian fatalities depend on a variety of interventions designed to alter the human and environmental factors affecting motor vehicle crashes. Interventions that could reduce human factors in motor vehicle crashes include public awareness and legal enforcement actions designed to deter alcohol use by drivers and pedestrians and special educational efforts directed toward these two groups. Studies of the cost-effectiveness of possible engineering changes, such as altering vehicle and highway design and constructing barriers to physically separate pedestrians and vehicles, may reveal some other important interventions. References

1. Centers for Disease Control. Premature mortality due to unintentional injuries--United States, 1983. MMWR 1986;35:353-6.

2. Baker SP, O'Neill B, Karpf RS. The injury fact book. Lexington, Massachusetts: Lexington Books, 1984.

3. Waller JA. Injury control: a guide to the causes and prevention of trauma. Lexington, Massachusetts: Lexington Books, 1985:211.

4. Haddon W Jr, Valien P, McCarroll JR, Umberger CJ. A controlled investigation of the characteristics of adult pedestrians fatally injured by motor vehicles in Manhattan. J Chronic Dis 1961;14:655-78.

5. Centers for Disease Control. Alcohol and fatal injuries--Fulton County, Georgia, 1982. MMWR 1983;32:573-6. *Based on the International Classification of Diseases, 9th Revision, Supplementary Classification of External Causes of Injury and Poisoning.

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