Accidents and injuries statistics

Data extracted in December 2016. Most recent data: Further Eurostat information, Main tables and Database. Planned article update: January 2018.

This article presents an overview of European Union (EU) statistics related to accidents and injuries as well as assault. It focuses on four aspects: deaths from accidents and assault, the extent of accidents, healthcare for injuries and the availability of specialist healthcare personnel.

Unintentional injuries result typically from transport, workplace, home and leisure time accidents. Intentional injuries result from interpersonal violence (assault) and self-harm: note that statistics on self-harm can be found in an article on mental health and are not covered here. Injuries include superficial injuries (such as abrasions, blisters, bruises, splinters and bites), open wounds, open and closed fractures, dislocations, ruptures, tears, sprains and strains, as well as injuries to nerves, the spinal cord, blood vessels, muscles, tendons and internal organs, and also crushing injuries and traumatic amputation.

This article is one of a set of statistical articles concerning health status in the EU which forms part of an online publication on health statistics.

Table 1: Causes of death — accidents
(including the sequelae of transport and other accidents), residents, 2013
Source: Eurostat (hlth_cd_aro) and (hlth_cd_asdr2)
Table 2: Standardised death rates — accidents and assault, 2013
(per 100 000 male/female inhabitants)
Source: Eurostat (hlth_cd_asdr2)
Figure 1: Share of all deaths caused by accidents, EU-28, 2013
(%)
Source: Eurostat (hlth_cd_aro)
Figure 2: Share of the population reporting that they had an accident at home, school or leisure resulting in injury, by sex, 2014 or nearest year
(%)
Source: Eurostat (hlth_ehis_ac1e)
Figure 3: Share of the population reporting that they had a road traffic accident resulting in injury, by sex, 2014 or nearest year
(%)
Source: Eurostat (hlth_ehis_ac1e)
Figure 4: Hospital discharge rates for in-patients with injuries, poisoning and certain other consequences of external causes, 2014
(per 100 000 inhabitants)
Source: Eurostat (hlth_co_disch2)
Table 3: In-patient average length of stay for injury, poisoning and certain other consequences of external causes, 2009 and 2014
(days)
Source: Eurostat (hlth_co_inpst)
Figure 5: Number of accident and emergency medicine physicians, 2009 and 2014
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_spec)

Main statistical findings

Deaths from accidents, injuries and assault

In 2013, there were 151 thousand deaths in the EU-28 resulting from accidents, equivalent to 3.0 % of all deaths. Table 1 shows that the proportion of deaths from accidents in Lithuania, Finland, Luxembourg and Slovenia, as well as in Norway, was over 4.5 %, while accidents accounted for less than 2.0 % of all deaths in Portugal and Bulgaria, as well as in Serbia.

A higher share of men (than women) in the EU-28 died from accidents (3.6 % compared with 2.5 %). This pattern was repeated across all of the EU Member States and was most pronounced in the Baltic Member States where the difference between the sexes was at least 3.8 percentage points.

Men more likely than women to die from all types of accidents

The EU-28’s standardised death rate for accidents was 30 deaths per 100 000 inhabitants in 2013. The death rate for men (42 per 100 000 inhabitants) was just over double that for women (21 per 100 000 inhabitants) — see Table 1. In all EU Member States the standardised death rate for men was higher than that for women, most notably in the Baltic Member States where the difference was at least 67 deaths per 100 000 inhabitants.

While accidents were a more common cause of death at advanced ages, the difference between the rates for people aged less than 65 years and those aged 65 and over was relatively narrow compared with other causes of death. The EU-28’s standardised death rate from accidents for those aged 65 and over was seven times as high as the rate for persons aged less than 65; for all causes of death the standardised death rate for those aged 65 and over was 20 times as high as for the younger generations.

A more detailed analysis of causes of death is presented in Table 2 for a selection of accidents as well as assault. Among men and women the three leading causes of death from accidents were the miscellaneous category of other accidents (including for example burns, electrocution, crushing and overexertion), falls and transport accidents. For each of these causes of death the standardised death rates for men were higher than for women in all EU Member States.

There were some particularly high standardised death rates for some of these types of accidents. Among men standardised death rates for falls were more than double the EU-28 average in Hungary, Malta, Finland, Croatia and Slovenia (as well as Switzerland) and more than treble the EU-28 average in Slovakia; among women the rates were more than double the EU-28 average in Hungary (as well as in Liechtenstein and Switzerland), and more than treble in Slovakia, Slovenia and Croatia. For transport accidents, standardised death rates for men and women were more than double the EU-28 average in Romania and for men only in Lithuania. For accidental poisoning and exposure to noxious substances, the rates for men were more than four times as high as the EU-28 average in Finland, almost seven times as high in Lithuania, and nearly eight times as high in Estonia; among women, rates were more than four times as high as the EU-28 average in Finland, and close to five times as high in Estonia. For accidental drowning and submersion the standardised death rates for men were around six times as high as the EU-28 average in Latvia and Lithuania, while among women the rates in these two countries were around four times as high as the EU-28 average.

The highest standardised death rates for assault were in the Baltic Member States and the lowest in the United Kingdom

In 2013, 4.0 thousand people died from assaults in the EU-28, equivalent to 0.08 % of the total number of deaths. In 2013, the standardised death rate for assault was 0.77 per 100 000 inhabitants for the EU-28, with the rate for men approximately twice as high as for women (1.00 deaths per 100 000 male inhabitants compared with a ratio of 0.55 per 100 000 female inhabitants).

The highest standardised death rates for assaults among the EU Member States were recorded for the Baltic Member States, each recording a rate that was around two to three times as high as that observed in any other EU Member State, peaking in Latvia at 9.2 per 100 000 male inhabitants and 3.1 per 100 000 female inhabitants. The lowest standardised death rate from assault was in the United Kingdom, where the rate was approximately half that in any other EU Member State. Germany and Austria were the only EU Member States where the standardised death rates for assault for men were lower than for women in 2013.

Age matters for death from accidents and assaults

The impact of accidents is important both for younger and older people. On the one hand, accidents and injuries may trigger a fatal deterioration in the health of older people: close to three fifths of all deaths from accidents in the EU-28 in 2013 were among people aged 65 or over. On the other hand, a relatively high proportion of people under the age of 65 die from accidents: the proportion of the total number of deaths that were caused by accidents was almost three times as high for people aged less than 65 than it was for people aged 65 or over.

Between the ages of 1 and 4 and for all five-year age groups between the ages of 10 and 34, accidents were the single most common cause of death (when comparing with the other major categories in the International Statistical Classification of Diseases and Related Health Problems (ICD)). Among the five-year age groups between the ages of 10 and 34, accidents accounted for one fifth or more of all deaths, with this share peaking at 36 % for people aged 15–19 (see Figure 1). Looking across the age groups from youngest to oldest, there is a large jump in the number (and also the share) of deaths from accidents when moving from the age group 10–14 to the age group 15–19: there were almost five times as many deaths from accidents in the older of these two age groups than in the younger one. This large jump can, in part, be attributed to deaths from transport accidents, which alone accounted for nearly one quarter (24.3 %) of all deaths among people aged 15–19.

Compared with accidents, the age profile of people in the EU-28 dying from assaults was even more skewed away from older people: more than four fifths of people killed by assaults were aged less than 65. The five-year age range with the highest number of deaths from assaults was for people aged 45–49, with almost 400 deaths from assaults in 2013. Nevertheless, as a share of all deaths, deaths from assaults were most common in the age groups 1–4 through to 30–34, having one peak at 2.0 % of all deaths for those aged 1–4 and the second peak at 1.9 % of all deaths for those aged 25–29.

The extent of accidents

Figures 2 and 3 present data from the second wave of the European health interview survey (EHIS) which was conducted between 2013 and 2015 and which covered persons aged 15 and over. The survey included questions asking about injuries — resulting from transport accidents or accidents at home, school or while undertaking leisure activities — in the previous 12 months. Data for accidents are available for 27 EU Member States, Norway and Turkey (see Figures 2 and 3). The next wave of the survey will be conducted in 2019 and it will be run at regular five-year intervals afterwards.

The proportion of people who answered that they had been injured in an accident at home, school or while undertaking leisure activities was less than 3.5 % in Croatia, Poland, Cyprus and Romania, with Bulgaria reporting the lowest proportion (1.8 %). By contrast, the proportion was close to 12 % in Luxembourg, Slovenia and Finland, around 14 % in Germany and the Netherlands, and it peaked in the Czech Republic at 15.8 %. About three fifths of EU Member States observed higher proportions of men reporting injuries with the largest gender differences in the Netherlands, Austria and Finland, while 8 Member States observed higher proportions of women reporting injuries, which was the case notably in Malta and Spain.

Accidents at home, school or while undertaking leisure activities more frequently reported by the youngest and oldest generations than by those in middle age

An analysis by 10-year age ranges for the same 27 EU Member States shows that the proportion of people who answered that they had been injured in an accident at home, school or while undertaking leisure activities tended to fall as the age group studied increased from youth (15–24) through to middle age: the proportion was generally lowest in one of the age groups 35–44, 45–54 or 55–64, although in Bulgaria, Croatia, Romania and the United Kingdom the lowest proportions were recorded for those aged 25–34 and in the Netherlands, Slovenia and Finland for those aged 65–74. From middle age onwards the proportion increased again, peaking in all participating Member States — except in Denmark, Germany, Lithuania, Luxembourg, the Netherlands and Finland — in the highest age group 75 or over.

Road traffic accidents most frequently reported by younger people

Across all EU Member States for which data are available (see Figure 3), the proportions of people reporting that they had been injured in road traffic accidents was systematically lower — for both men and women — than the proportion reporting they had been injured following accidents at home, school or while undertaking leisure activities. The proportion of people reporting a road traffic accident was lowest in Bulgaria and Romania (0.4 % and 0.2 % for men and women combined, respectively). For most of the other Member States this share ranged between 0.6 % and 2.1 %, with higher proportions in Hungary, Italy (both 2.2 %) and Malta (2.3 %). There was a clear gender difference for road traffic accidents across the EU Member States, with men more likely than women to report that they had an injury from such an accident; the only exception was France where the proportions of men and women reporting a road traffic accident were the same.

An analysis by age for road traffic accidents showed a different pattern than for accidents at home, school or while undertaking leisure activities. For most EU Member States (for which data are available) the highest proportion of people reporting that they had been injured in a road traffic accident tended to be reported in one or other of the 10-year age groups up to the age group covering those who were 35–44, although in Latvia, Hungary and Romania the highest proportions were registered in one of older age groups. By contrast, the lowest shares tended to be reported in one or other of the 10-year age groups from 55–64 upwards, although Bulgaria, the Netherlands and Slovakia were exceptions, with their lowest proportion recorded for younger age groups (those aged 25–34 or 35–44).

Healthcare for injuries, poisoning and other consequences of external causes

Austria and Germany had the highest number of in-patient discharges for patients treated for accidents and injuries

There were around 7.0 million in-patients with injuries, poisoning and certain other consequences of external causes (ICD codes S00-T98; hereafter referred to as accidents and injuries) discharged from hospitals in the EU (2014 data except: 2013 data for Belgium, 2012 data for the Netherlands; no data for Greece). In-patient discharges of those treated for accidents and injuries accounted for 10.0 % or more of the total number of in-patient hospital discharges in Finland, Belgium, Austria and Cyprus, while these accounted for just 5.1 % of all in-patient discharges in Bulgaria and 4.8 % in Romania.

Relative to population size, Austria, Germany and the Czech Republic recorded the highest number of in-patient discharges for those treated for accidents and injuries, with 3.0 thousand, 2.4 thousand and 1.8 thousand per 100 000 inhabitants respectively, while in Portugal, Cyprus and Spain the ratio was below 900 per 100 000 inhabitants (see Figure 4); this was also the case in Iceland, Serbia and Turkey (2011 data).

Particularly long average length of stay for in-patients with a fracture of the femur

Across the EU (2014 data except: 2013 data for Belgium, 2012 data for the Netherlands; no data for Greece), in-patients with accidents and injuries spent a total of 52.5 million days in hospital.

An analysis of the average length of hospital stays for in-patients treated for accidents and injuries shows that in 2014 (see Table 3) this average ranged from 4.5 days in Denmark up to 8.5 days in Belgium (2013 data), with Luxembourg, Italy, Portugal, the Czech Republic and Finland above this range, averaging between 9.3 and 10.2 days. Comparing the average length of stay in 2009 with that in 2014, most EU Member States reported increases of less than 0.5 days or decreases of less than 0.7 days; Croatia, the Netherlands (2009 to 2012) and Austria recorded larger decreases, while Cyprus recorded larger increases.

The remainder of Table 3 provides a more detailed analysis of the average length of hospital stays for in-patients diagnosed with five different types of accidents and injuries. In-patients with a fracture of the femur (code S72) tended to spend the highest average number of days in hospital, whereas those poisoned by drugs, medicaments and biological substances or treated for toxic effects (codes T36–T65) generally spent the lowest average number of days in hospital.

Healthcare personnel

Increasing numbers of accident and emergency medicine physicians

Accident and emergency medicine physicians are medical doctors who specialise in emergency medicine, acute medicine, traumatology, accident surgery, traumatic surgery or paediatric emergency medicine. A few EU Member States — Denmark, Cyprus, Germany, Luxembourg and Portugal — reported no accident and emergency medicine physicians, suggesting that physicians working in this area are classified as general practitioners or under other specialisations. Leaving these aside, the remaining 20 Member States for which data are available (France and Slovakia, not available; no recent data for Hungary) can be arranged into three groups based on the number of accident and emergency medicine physicians per 100 000 inhabitants (see Figure 5): nine reported ratios of 4.7 per 100 000 inhabitants or lower; six reported ratios in the range of 6.6 to 10.8 per 100 000 inhabitants; and five reported ratios that were 12.4 per 100 000 inhabitants or higher, reaching 25.5 per 100 000 inhabitants in Spain. Between 2009 and 2014 (subject to data availability — see Figure 5), most Member States recorded an increase in this ratio, although decreases were recorded in Bulgaria, Latvia and Estonia, although the latter may have been influenced to some extent by a break in series.

Data sources and availability

Key concepts

An in-patient is a patient who is formally admitted (or ‘hospitalised’) to an institution for treatment and/or care and stays for a minimum of one night or more than 24 hours in the hospital or other institution providing in-patient care. An in-patient or day care patient is discharged from hospital when formally released after a procedure or course of treatment (episode of care). A discharge may occur because of the finalisation of treatment, signing out against medical advice, transfer to another healthcare institution, or because of death.

The number of deaths from a particular cause of death can be expressed relative to the size of the population. A standardised (rather than crude) death rate can be compiled which is independent of the age and sex structure of a population: this is done as most causes of death vary significantly by age and according to sex and the standardisation facilitates comparisons of rates over time and between countries.

Healthcare resources and activities

Statistics on healthcare resources (such as personnel) and healthcare activities (such as information on hospital discharges) are documented in this background article which provides information on the scope of the data, its legal basis, the methodology employed, as well as related concepts and definitions.

For hospital discharges and the length of stay in hospitals, the International Shortlist for Hospital Morbidity Tabulation (ISHMT) is used to classify data from 2000 onwards; Chapter XIX covers injury, poisoning and certain other consequences of external causes:

  • Intracranial injury (1901);
  • Other injuries to the head (1902);
  • Fracture of forearm (1903);
  • Fracture of femur (1904);
  • Fracture of lower leg, including ankle (1905);
  • Other injuries (1906);
  • Burns and corrosions (1907);
  • Poisonings by drugs, medicaments and biological substances and toxic effects of substances chiefly nonmedicinal as to source (1908);
  • Complications of surgical and medical care, not elsewhere classified (1909);
  • Sequelae of injuries, of poisoning and of other consequences of external causes (1910);
  • Other and unspecified effects of external causes (1911).

For country specific notes on this data collection, please refer to this background information document.

Health status (extent of injuries)

Self-reported statistics covering the health status of the population for road traffic and other accidents are provided by the European health interview survey (EHIS). This source is documented in more detail in this background article which provides information on the scope of the data, its legal basis, the methodology employed, as well as related concepts and definitions. The data presented in this article refer to the share of the population aged 15 and over reporting to have been injured through transport accidents or accidents at home, school or while undertaking leisure activities during the 12 months prior to the survey.

Causes of death

Statistics on causes of death provide information on mortality patterns, supplying information on developments over time in the underlying causes of death. This source is documented in more detail in this background article which provides information on the scope of the data, its legal basis, the methodology employed, as well as related concepts and definitions.

Causes of death are classified according to the European shortlist (86 causes), which is based on the International Statistical Classification of Diseases and Related Health Problems (ICD). Chapter XX of the ICD covers external causes of morbidity and mortality, including:

  • V01–X59 Accidents;
    • V01–V99 Transport accidents;
    • W00–X59 Other external causes of accidental injury;
      • W00–W19 Falls;
      • W65–W74 Accidental drowning and submersion;
      • X40–X49 Accidental poisoning by and exposure to noxious substances;
      • Other accidents
        • W20–W49 Exposure to inanimate mechanical forces;
        • W50–W64 Exposure to animate mechanical forces;
        • W75–W84 Other accidental threats to breathing;
        • W85–W99 Exposure to electric current, radiation and extreme ambient air temperature and pressure;
        • X00–X09 Exposure to smoke, fire and flames;
        • X10–X19 Contact with heat and hot substances;
        • X20–X29 Contact with venomous animals and plants;
        • X30–X39 Exposure to forces of nature;
        • X50–X57 Overexertion, travel and privation;
        • X58–X59 Accidental exposure to other and unspecified factors;
  • X85–Y09 Assault;
  • Y85–Y89 Sequelae of external causes of morbidity and mortality;
    • Y85 Sequelae of transport accidents;
    • Y86 Sequelae of other accidents;
    • Y87 Sequelae of intentional self-harm, assault and events of undetermined intent;
      • Y87.1 Sequelae of assault.

Important note: for the purposes of the statistics presented in this article, deaths from the sequelae of transport accidents are included under transport accidents, deaths from the sequelae of other accidents are included under other accidents. Equally, deaths from the sequelae of assault are included under assault. Sequelae denotes a chronic condition resulting from a certain disease or injury.

For country specific notes on this data collection, please refer to this background information document.

Context

The importance of action to prevent accidents and injuries can be seen from an overview of the causes of death statistics. Leading to 151 thousand deaths in 2013 (3.0 % of all deaths), accidents were the one of the most common causes of death within the EU-28.

In June 2006, the European Commission adopted a Communication on Actions for a safer Europe (COM(2006) 0328 final) emphasising prevention measures. In May 2007, a Council Recommendation on the prevention of injury and the promotion of safety was adopted, targeting seven key priority areas, namely the safety of children and adolescents, elderly citizens, and vulnerable road users, as well as the prevention of sports injuries, injuries caused by products and services, self-harm, and interpersonal violence.

One of the actions conducted as part of the under EU’s health programme for 2008–13 was a joint action on monitoring injuries in Europe (JAMIE). The overall objective of JAMIE was, by the end of 2013, to have a common hospital based injury surveillance system in operation in the majority of EU Member States. JAMIE aimed to refine the methodology for collecting hospital based injury data with a view to facilitate data collection and incorporate countries into the European injury database (IDB) monitoring system and exchange mechanism. The joint action offered assistance such as standardised training for national data administrators, twinning programmes, on-site consultations and country specific coaching for Member States which needed to start or restart a system, as well as continuous supervision and joint monitoring actions concerning the level of implementation in each Member State.

See also

Online publications

Causes of death

Healthcare activities

Methodology

General health statistics articles

Further Eurostat information

Publications

Main tables

Database

Injuries from accidents (hlth_ifa)
People reporting having had an accident by sex, age and educational attainment level (%) (hlth_ehis_st2)
Health care resources (hlth_res)
Health care staff (hlth_staff)
Health care activities (hlth_act)
Hospital discharges and length of stay for inpatient and curative care (hlth_co_dischls)
Hospital discharges - National data (hlth_hosd)
Length of stay in hospital (hlth_hostay)
General mortality (hlth_cd_gmor)
Causes of death - Deaths by country of residence and occurrence (hlth_cd_aro)
Causes of death - Standardised death rate by residence (hlth_cd_asdr2)

Dedicated section

Methodology / Metadata

Source data for tables and figures (MS Excel)

External links