External Cause of Injury Mortality Matrix Lois A

Current WHO Tabulation Lists • Not ideal for the analysis of injury data •

External Cause Categories from the WHO Special Tabulation Lists External causes of morbidity and

External Causes in the WHO Mortality Database Tabulation List Accidents and adverse effects Motor

What if we need to look at specific mechanisms of injury? • Firearms? –

Proposed Modifications and Additions to Current Lists • Current lists modified to include all

Proposed Modifications and Additions to Current Lists (cont. ) • Add External Cause of

External Cause of Injury Mortality Matrix

External Cause of Injury Mortality Matrix Intent of death

External Cause of Injury Mortality Matrix Mechanism of death

Two Proposed Levels of Detail • Level 1 – Based on mechanism or cause

Injury deaths by mechanism: US, 2002 (Level 1)

Injury Deaths according to matrix: US, 2002 (Level 2)

Relationship between ICECI and ICD-10 Chapter XX Bridge Intent, Mechanism, Transport module Intent Mechanism

Questions? Lois Fingerhut US National Center for Health Statistics LFingerhut@cdc. gov

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External Cause of Injury Mortality Matrix Lois A. Fingerhut on behalf on the ICE on Injury Statistics October 2004 Centers for Disease Control and Prevention National Center for Health Statistics

Current WHO Tabulation Lists • Not ideal for the analysis of injury data • Mechanisms missing for intentional deaths – Suicides • Firearm, poisoning, suffocation – Homicides • Firearm, cut/pierce • Undetermined intent not included

External Cause Categories from the WHO Special Tabulation Lists External causes of morbidity and mortality Transport accidents Falls Accidental drowning and submersion Other accidental threats to breathing Exposure to smoke, fire and flames Accidental poisoning by and exposure to noxious substances Intentional self-harm Assault All other external causes

External Causes in the WHO Mortality Database Tabulation List Accidents and adverse effects Motor vehicle traffic accidents Other transport accidents Accidental poisoning Accidental falls Accidents caused by fire and flames Accidental drowning and submersion Accidents caused by firearm missile All other accidents, including late effects Drugs, medicaments causing adverse effects in therapeutic use Suicide and self-inflicted injury Homicide and injury purposely inflicted by other persons Other external causes

What if we need to look at specific mechanisms of injury? • Firearms? – No categories in the special tabulation lists – Only accidental firearm deaths in the Mortality Database list • Poisonings? – Only accidental poisonings shown in both lists

Proposed Modifications and Additions to Current Lists • Current lists modified to include all intent categories – Add undetermined intent – Add legal intervention/operations of war – Ensure unintentional categories sum to total unintentional deaths

Proposed Modifications and Additions to Current Lists (cont. ) • Add External Cause of Injury Mortality Matrix as additional list – Developed by the ICE on Injury Statistics – Internationally accepted

External Cause of Injury Mortality Matrix

External Cause of Injury Mortality Matrix Intent of death

External Cause of Injury Mortality Matrix Mechanism of death

Two Proposed Levels of Detail • Level 1 – Based on mechanism or cause only • Level 2 – Includes each combination of mechanism and intent

Injury deaths by mechanism: US, 2002 (Level 1)

Injury Deaths according to matrix: US, 2002 (Level 2)

Relationship between ICECI and ICD-10 Chapter XX Bridge Intent, Mechanism, Transport module Intent Mechanism ICECI External cause matrix categories ICD Chapter XX – External causes

Questions? Lois Fingerhut US National Center for Health Statistics LFingerhut@cdc. gov