Epidemiology of poisonings, fractures and burns among 0–24 year olds in England using linked health and mortality data

Baker, Ruth; Orton, Elizabeth; Tata, Laila J.; Kendrick, Denise

Abstract

Background:
Understanding patterns of injury in England is challenging due to a lack of national injury surveillance data. Through recent linkage of a large primary care research database to hospitalization and mortality data, we describe the epidemiology of poisonings, fractures and burns over a 14-year period.

Methods:
We used linked English primary care, hospitalisation and mortality data from the Clinical Practice Research Datalink, Hospital Episode Statistics and Office for National Statistics between 1998 and 2011 to establish a cohort of 2,106,420 0–24 year olds. Incidence rates, per 10 000 person-years (PY) were estimated by age, sex, calendar year and socioeconomic status. Using Poisson regression we estimated incidence rate ratios, adjusting for age and sex.

Results:
Age patterns of injury incidence varied by injury type, with peaks at age 2 (74.3/10 000 PY) and 18 (74.7/10 000 PY) for poisonings, age 13 for fractures (305.1/10 000 PY) and age 1 for burns (116.8/10 000 PY). Over time, fracture incidence increased, whereas poisoning incidence increased only among 15–24 year olds and burns incidence reduced. Poisoning and burns incidence increased with deprivation, with the steepest socioeconomic gradient for poisonings among 20–24 year olds (IRR 2.63, 95% confidence interval 2.24–3.09).

Conclusion:
Differing patterns according to age and injury type reflect differences in underlying injury mechanisms, highlighting the importance of developing tailored preventative interventions across the life course. Inequalities in injury occurrences support the targeting of preventative interventions to children and young people living in the most deprived areas.

Citation

Baker, R., Orton, E., Tata, L. J., & Kendrick, D. (2016). Epidemiology of poisonings, fractures and burns among 0–24 year olds in England using linked health and mortality data. European Journal of Public Health, 26(6), 940-946. https://doi.org/10.1093/eurpub/ckw064

• Journal Article Type: Article
• Acceptance Date: Apr 16, 2016
• Online Publication Date: May 31, 2016
• Publication Date: 2016-12
• Deposit Date: Jun 27, 2016
• Publicly Available Date: Jun 27, 2016
• Journal: The European Journal of Public Health
• Print ISSN: 1101-1262
• Electronic ISSN: 1464-360X
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 26
• Issue: 6
• Pages: 940-946
• DOI: https://doi.org/10.1093/eurpub/ckw064
• Keywords: Epidemiology, Poisonings, Fractures, Burns, Children
• Public URL: https://nottingham-repository.worktribe.com/output/787629
• Publisher URL: http://eurpub.oxfordjournals.org/content/early/2016/05/30/eurpub.ckw064
• Additional Information: This is a pre-copyedited, author-produced PDF of an article accepted for publication in The European Journal of Public Health following peer review. The version of record Baker R, Orton E, Tata LJ, Kendrick D. Epidemiology of poisonings, fractures and burns among 0–24 year olds in England using linked health and mortality data. The European Journal of Public Health 2016; First published online: 31 May 2016: doi: 10.1093/eurpub/ckw064] is available online at: http://eurpub.oxfordjournals.org/content/early/2016/05/30/eurpub.ckw064
• Contract Date: Jun 27, 2016