Prepared by
Child Injury Division,
Bureau of Reproductive and Child Health, Laboratory Centre for Disease Control,
Health Protection Branch, Health Canada October, 1999

Table of Contents

Introduction

1. Leading causes of death 1997
2. Injury mortality trends 1980-1997
3. Injury mortality 1997
4. Injury hospitalizations fiscal year 1996-1997
5. Injury mortality 1997 - mechanism by intent

Introduction

This document has been prepared to make recent Canadian data on the occurrence of injuries readily available to public health officials, researchers, and others who need up to date information in their work. Most of the tables and charts are based on Child Injury Division analysis of data from Statistics Canada (mortality data for 1997) and the Canadian Institute for Health Information (CIHI) (hospitalization data for fiscal year 1996-1997).

Throughout the report the International Classification of Disease - ninth revision (ICD-9)1 is used to classify deaths and hospitalizations. Events associated with injuries are classified using the codes for external cause of injury and poisoning (E-codes). Adverse events occurring in medical treatment, which are included in the injury chapter of the ICD-9, are excluded from the injuries considered in this document*.

The first section of the report presents the eight leading causes of death in Canada in 1997 by age group. It highlights the importance of injuries, both unintentional and intentionally self-inflicted, as a cause of death at many ages. The ICD-9 code groupings for the causes of death are listed below.

In the second to fourth sections of the report injury events (deaths or hospitalizations) are classified into the following sub-groups: unintentional injuries, motor vehicle traffic crashes ^† , falls ^a , other unintentional injuries, suicide or self-inflicted injuries, homicide or injuries due to assault, injuries of undetermined intent, and other violence ^‡ . The second section presents trends in injury mortality rates from 1980 to 1997 by age group and sex. The third section provides information on injury mortality for 1997. The data are presented by age group and sex; they include the numbers and rates of deaths due to injuries as well as the percentages of all deaths that are associated with injuries. The same approach is used in section four to present information on hospitalizations associated with injuries for the period from April 1st, 1996 to March 31st, 1997.

It should be noted that the hospitalization data represent the numbers of hospitalizations for treatment of injuries – not the numbers of injuries requiring hospitalization or the numbers of injured people admitted to hospital. Also, since a small proportion of the records sent to CIHI are not subject to verification that all injury records include an E-code, the data provided in this document should be considered a minimum estimate of the number of hospitalizations for treatment of injuries.

The fifth section presents more detailed summaries of injury cause and intent for the 1997 mortality data, by age group and sex. The design of these tables was based on the framework for presenting injury mortality data that was developed by the U.S. Centers for Disease Prevention and Control (National Center for Injury prevention and Control) in collaboration with the American Public Health Association (Injury Control and Emergency Health Services Section)2 . The E-codes for the additional categories that were used for presentation of the Canadian data are presented on page 4.

Notes

* Three groups of events that are assigned E-codes in the ICD-9 are excluded from the report. They are very different from most injuries, both in their nature and in the types of preventive measures that might be considered appropriate.

ICD-9 codes	Description
E870-E876	Misadventures to patients during medical and surgical care.
E878-E879	Surgical and medical procedures as the cause of abnormal reaction of patient or later complication, without mention of misadventure at time of procedure.
E930-E949	Drugs, medicinal and biological substances causing adverse effects in therapeutic use.

† The motor vehicle traffic crash category includes only unintentional injuries. The few events due to intentional motor vehicle traffic crashes are included in the group of intentionally self-inflicted injuries.

a In sections two to four, Falls include all events classified to the ICD external cause codes E880-E888. This is particularly important in section two (injury mortality trends) because changes on the classification of falls were not consistently applied immediately in 1979 when ICD-9 came into use. During the early 1980s increasing proportions of events were classified to E887 (fracture cause unspecified) and there were corresponding decreases in the numbers of events classified to E880-E886 and E888 (other unintentional falls).
In section five (tables of mechanism by intent for 1997 injury mortality) fracture cause unspecified is not included with the other unintentional falls. The numbers and rates of events classified to E887 are presented separately under Unspecified near the bottoms of the tables. This was done to be consistent with the handling of falls in the Recommended framework for presenting injury mortality data upon which the tables in section five are based.

‡ Injuries due to other violence include those due to legal intervention, operations of war, and terrorism.

[Injury Section] [Health Surveillance and Epidemiology Division]