Elsevier

Public Health

Volume 119, Issue 10, October 2005, Pages 919-924
Public Health

Unintentional home-related injuries in the Islamic Republic of Iran: findings from the first year of a national programme

https://doi.org/10.1016/j.puhe.2005.01.012Get rights and content

Summary

Background

As elsewhere, unintentional injuries are a leading cause of death in Iran, but non-fatal injuries occurring in the home environment have not been analysed.

Objectives

The primary purposes of this study were to describe the pattern of home-related injuries and to obtain incidence rates for their determinants in order to monitor intervention programmes for preventive purposes.

Methods

A surveillance system for home-related injuries in selected rural and urban areas was established for the systematic collection of data. The information obtained covers emergency department visits and health services provided between March 1998 and March 1999.

Results

In total, 79 723 unintentional home-related injuries were reported, primarily burns (49%, incidence of 19/10 000 rural and 13/10 000 urban inhabitants) and lacerations/cuts caused by contact with sharp instruments (30%, incidence of 8.4/10 000 rural and 11/10 000 urban inhabitants). Injury rates were highest among children aged 0–4 years and lowest among the elderly (60 years or over). Rates varied between the sexes; among children under 15 years of age, most patients were male, but the opposite applied to all groups >15 years of age. Leading causes of death were burns, falls and poisoning among 628 people who died because of home-related injuries.

Conclusions

The injury pattern found in this study is generally similar to that of many other countries, with the striking exception of burns. Other reports focus on the same problem, particularly with regard to Iran. The prevention of burns should be an important feature of any national injury prevention programme. Due to the varied causes of home-related injuries in Iran, interventions should be targeted at people at the greatest risk, namely children. Home visitation as a tool for face-to-face training with a sharper focus on burns, falls and poisoning prevention can be recommended as a part of primary healthcare policy. Greater investment in surveillance also provides a way of reducing the threat of injury in the community.

Introduction

The injury panorama has been well described in high-income countries and, in recent years, even in low-income countries.1, 2, 3, 4 However, middle-income countries have not recognized injuries as a major public health problem to a sufficient extent, and very few have actually studied the magnitude of the problem.5, 6 Still more troublesome is the fact that it is mainly traffic and work-environment injuries that have been surveyed, but injuries within the home environment remain largely neglected. This certainly applies to Iran, a middle-income country where there has been little policy recognition, as in many countries at the same income level. In Vietnam, Hang et al. showed that most injuries are incurred during unpaid household tasks-with cuts and crushes as the main cause.7

Nordberg et al. stated that, in Kenya, only one in 25 home-related injuries were brought to a health facility for attention.8

A recent study of burns patients attending an emergency burns centre in southern Iran found that most burns occur in the home environment.9 The home has also been found to be the most frequent location of injury, especially for younger people, in some Latin American countries.10

The primary purposes of this study were to describe the pattern of home-related injuries and to obtain incidence rates for their determinants in order to monitor intervention programmes for preventive purposes.

It is intended to provide a new focal point for the national injury prevention programme that was embarked upon in 1997.

Section snippets

Materials and methods

The surveillance system has its base in the so-called ‘health house’. This is the most peripheral of health facilities in Iran and is run by community health workers known as the ‘Behvarz’. Surveillance is based on completing a form, and there are also forms available for hospital emergency wards and medical centres (in both rural and urban areas). The items or variables for injury recording are the same on all the forms. The surveillance system was initiated in 1998, and covered 35% of the

Results

The total number of registered cases was 79 723 (65% in rural areas and 35% in urban areas). The breakdown by variable was as follows.

  • Sex. Forty-eighty percent of all injured people were female.

  • Age. Children under 5 years old formed the largest group of injured people in the home environment, with 18 057 cases (22% of the total). The oldest group (over 60 years) made a contribution of just 5.6%, with 4464 cases. Fifty-six percent of the injured children under 5 years of age were boys, whereas

Discussion

Analysis of the data shows that 51 559 (65%) of the total cases (79 723) were registered in rural areas.

The study population in rural areas was 13 202 316 and in the urban areas was 7 342 779 in 1998. Accordingly, the annual incidence rate of healthcare-reported home-related injuries in rural areas of Iran in 1998 was 39 per 10 000 population, and the fatality rate was 0.31 per 10 000 population (with an absolute number of 418 deaths). The estimated figures for urban areas were 39 and 0.28 per

Acknowledgements

The authors wish to thank all the staff in the Departments of Medical Sciences, Health Services and Injury Prevention at the universities in the Islamic Republic of Iran, and also the Iranian Centre for Health Networks in the Ministry of Health and Medical Education. We acknowledge their help and efforts in implementation of the national programme.

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