A total of 24,438 participants of all ages completed the survey. No significant differences were found on the age and sex distribution between the sample and population (Table
2). The response rate of the survey was 97.75%. In the survey, 1,655 respondents reported suffering an injury, resulting in an incidence of 67.7 per 1,000 per year. Among the injuries reported, 17 cases were fatal, leading to a fatality rate of 69.56/100,000.
Table 2
Demographic composition of the sample and population
Gender | | |
Male | 50.6 | 50.4 |
Female | 49.4 | 49.6 |
| X2 = 0.47, P > 0.05 |
Age group | | |
0- | 5.1 | 3.9 |
5- | 15.7 | 10.2 |
15- | 50.3 | 50.1 |
45- | 17.3 | 22.0 |
60+ | 11.6 | 13.8 |
| X2 = 2.29, P > 0.05 |
Distribution of injury incidence
Injury incidence broken down by demographic factors and mechanisms is shown in Table
3. The incidence of total injury was higher for males (81.1 per 1,000) than females (54.1 per 1,000) (X
2 = 70.6, P < 0.01). Injuries for males predominated at all ages, except for those over age 60. Males were characterized by a high incidence of traffic injuries (17.5 per 1,000) and females by a high incidence of falls (12.3 per 1,000). The fatality rate for males (105.57/100,000) was also higher than for females (32.99/100,000) (X
2 = 72.4, P < 0.01).
Table 3
Demographic and injury mechanism distribution of individuals suffered injury (N/1 000)*
Sex | | | | | | |
Male | 39(69.3) | 140(109.1) | 497(80.9) | 216(81.0) | 107(64.6) | 999(81.1) |
Female | 20(40.7) | 94(78.1) | 237(39.2) | 171(63.2) | 134(79.9) | 656(54.1) |
| | | | | | X2 = 70.6, P < 0.01 |
Area | | | | | | |
Urban | 11(28.5) | 45(53.2) | 206(40.5) | 92(45.0) | 66(46.5) | 420(42.9) |
Rural | 48(71.9) | 189(115.2) | 528(74.4) | 295(88.6) | 175(91.4) | 1235(84.3) |
| | | | | | X2 = 158.9, P < 0.01 |
Mechanism | | | | | | |
Traffic accident | 3(2.8) | 24(9.7) | 182(14.9) | 72(13.4) | 30(9.0) | 311(12.7) |
Fall | 19(18.0) | 46(18.5) | 82(6.7) | 78(14.5) | 92(27.6) | 317(13.0) |
Collision | 4(3.8) | 47(18.9) | 93(7.6) | 50(9.3) | 17(5.1) | 211(8.6) |
Strain | 4(3.8) | 27(10.9) | 131(10.7) | 45(8.4) | 44(13.2) | 251(10.3) |
Cut | 2(1.9) | 21(8.4) | 83(6.8) | 30(5.6) | 8(2.4) | 144(5.9) |
Squeeze | 1(0.9) | 13(5.2) | 41(3.4) | 25(4.7) | 7(2.1) | 87(3.6) |
Burn | 10(9.5) | 7(2.8) | 38(3.1) | 23(4.3) | 11(3.3) | 89(3.6) |
Poisoning | 1(0.9) | 2(0.8) | 14(1.1) | 19(3.5) | 14(4.2) | 50(2.0) |
Animal bite | 14(13.3) | 44(17.7) | 54(4.4) | 37(6.9) | 16(4.8) | 165(6.8) |
Total | 59(56.0) | 234(94.1) | 734(60.2) | 387(72.0) | 241(72.3) | 1,655(67.7) |
Age-specific incidence of injury was the highest among males aging 5 to 14 and was the lowest among females aged 15 to 44. A high incidence of falls and collisions was observed in the 5 to 14 age group. Injuries in the 15 to 44 age group accounted for 44.3% of all injuries occurred.
The five leading causes of injury were falls (13.0 per 1,000), traffic injuries (12.7 per 1,000), strains (10.3 per 1,000), collisions/wounds (8.6 per 1,000), and bites by insects or animals (6.8 per 1,000).
Injury incidence by social economic factors is shown in Table
4. There are significant differences of injury incidence among different educational levels (X
2 = 85.8, P < 0.01), with lower injury incidence among those with higher educational attainment. Injuries were more frequently observed among those who were illiterate (99.4 per 1,000) compared to others.
Table 4
Social economic composition of individuals suffered injury (N/1,000)*
Education | | | |
Illiterate | 181(101.5) | 61(93.7) | 242(99.4) |
Elementary school | 168(58.4) | 271(98.6) | 439(78.0) |
Junior high school | 170(40.2) | 429(88.0) | 599(65.8) |
Senior high school | 88(42.8) | 148(61.3) | 236(52.8) |
College and above | 17(31.4) | 35(39.9) | 52(36.6) |
| | | X2 = 85.8, P < 0.01 |
Occupation | | | |
Government employee | 12(47.8) | 17(38.7) | 29(42.0) |
Labourer | 72(40.7) | 209(79.5) | 281(63.9) |
Professional | 24(45.2) | 66(77.1) | 90(64.9) |
Farmer | 217(59.5) | 275(79.0) | 492(69.0) |
Business and service | 32(35.3) | 66(89.6) | 98(59.6) |
Student | 129(70.0) | 217(104.7) | 346(88.4) |
Retired | 49(67.4) | 45(63.3) | 94(65.4) |
Housework | 78(55.5) | 22(101.4) | 100(61.6) |
Unemployed | 8(34.8) | 16(67.8) | 24(51.5) |
Others | 4(22.5) | 13(64.0) | 17(44.6) |
| | | X2 = 43.9, P < 0.01 |
Average income (RMB yuan/year) | | | |
< 2000 | 304(71.9) | 432(101.7) | 736(86.8) |
2000- | 192(48.1) | 332(81.5) | 524(65.0) |
5000+ | 155(43.0) | 218(59.0) | 373(51.1) |
| | | X2 = 80.8, P < 0.01 |
A difference in injury incidence by occupation was observed (X2 = 43.9, P < 0.01). Students (8.8%), farmers (6.9%), retired individuals (6.5), professionals (6.5%) and labourers (6.4%) show a high incidence of injury, accounting for 82.9% of total injuries. Government employees were most likely to be affected by traffic injuries, followed by labourers and those in the business and service industry, while the retired and preschool children were mainly affected by falls.
Injury incidence also varied (X2 = 80.8, P < 0.01) among different levels of income. Respondents with lower income tended to have a higher incidence of injury. Among those with the lowest income (2,000 yuan or below), incidence of a fall was observed most frequently. Sprain was the leading mechanism among those with the highest income (5,000 yuan or above).
Injury incidence in rural areas (84.3 per 1,000) was higher than in urban areas (42.9 per 1,000) (X2 = 158.9, P < 0.01), with the majority of injuries occurring in rural areas (74.6%).
Logistic regression analysis shows that sex, area, education, income, and occupation are significantly associated with injury incidence (Table
5). Males are 60% more likely to incur an injury compared with females. Rural residents have an injury incidence rate 1.99 times that of urban residents. Analysis by level of education shows a tendency for those with higher education levels to have a lower risk of injury incidence. The odds of injury for the illiterate group are 3.17 times that of the college and above group. Among different income levels, those with the lowest income (< 2,000) show the highest risk of injury incidence, while the middle level (2,000–4,999) show the lowest risk. Analysis of occupation shows that farmers have the lowest risk of injury incidence, while students and professionals face a higher risk.
Table 5
Multivariate logistic regression analysis of injury incidence
Sex (Male vs Female) | 0.47 | 0.06 | < 0.01 | 1.60 | 1.43 | 1.79 |
Area (Rural vs Urban) | 0.69 | 0.08 | < 0.01 | 1.99 | 1.69 | 2.34 |
Education
| | | < 0.01 | | | |
Illiterate | 1.15 | 0.18 | < 0.01 | 3.17 | 2.23 | 4.51 |
Elementary school | 0.69 | 0.17 | < 0.01 | 2.00 | 1.44 | 2.77 |
Junior high school | 0.53 | 0.16 | < 0.01 | 1.70 | 1.23 | 2.34 |
Senior high school | 0.38 | 0.17 | < 0.01 | 1.47 | 1.06 | 2.03 |
College and above | | | | 1 | | |
Average Income
| | | | | | |
< 2000 | 0.23 | 0.06 | < 0.01 | 1.26 | 1.12 | 1.43 |
2000- | | | | 1.00 | | |
5000+ | 0.16 | 0.09 | > 0.05 | 1.17 | 0.99 | 1.38 |
Occupation
| | | | | | |
Farmer | | | | 1 | | |
Government employee | 0.19 | 0.21 | > 0.05 | 1.21 | 0.81 | 1.82 |
Labourer | 0.40 | 0.09 | < 0.01 | 1.49 | 1.26 | 1.77 |
Professional | 0.55 | 0.13 | < 0.01 | 1.74 | 1.34 | 2.25 |
Business and service | 0.19 | 0.12 | > 0.05 | 1.21 | 0.97 | 1.53 |
Student | 0.61 | 0.08 | < 0.01 | 1.84 | 1.57 | 2.14 |
Retired | 0.42 | 0.13 | < 0.01 | 1.52 | 1.18 | 1.95 |
Housework | 0.13 | 0.12 | > 0.05 | 1.14 | 0.90 | 1.44 |
Unemployed | 0.45 | 0.22 | < 0.05 | 1.57 | 1.02 | 2.43 |
Others | 0.22 | 0.26 | > 0.05 | 1.24 | 0.75 | 2.07 |
Characteristics of injury occurrence
Injuries occurred mostly at home (31.7%), in a highway/street (31.2%), or at the workplace (22.5%). Injuries at these three places accounted for 85.5% of the total injuries. For males, the injuries were likely to occur in a street or highway, while females were most likely to be injured at home. Injuries in the street/highway generally resulted from traffic injuries (56.3%), while those sustained at home mainly involved falls (26.4%). Injuries at the workplace were diverse, involving collisions (18.3%), strains (17.8%), cuts (16.8%), and falls (16.0%).
Injuries were most likely to happen during work hours or housework. Injuries occurring during work hours mainly involved falls (17.5%), collisions (17.1%), cuts (15.4%), and strains (15.2%). During housework time, incidences of falls (24.7%), strains (19%), and cuts (17.3%) were higher. A high incidence of traffic injuries (57.7%) was observed while shopping and commuting to and from work.
Severity of injury
Of all injuries, 75.0% were minor and did not need inpatient care, 20.3% were moderate and required hospitalization but did not disable the patient, and 4.7% were serious injuries that left the patient disabled, yielding a disability rate of 3.4 per 1,000 (2.6 per 1,000 for male, 0.8 per 1,000 for female). Disabling injuries were mainly caused by traffic injuries (34.9%), falls (21.7%), and strains (13.4%).
On average, injuries led to 13.6 days (14.9 for male, 11.7 for female) of rest, and 5.4 days (6.1 for male, 4.4 for female) of hospitalization. Explosions, traffic injuries, and falls caused longer periods of both hospitalization and rest.
Life lost caused by injury
In the survey, 17 persons died of injury, and injuries caused 662 YPLL, 534 WYPLL, and 411 VYPLL. For each fatal injury, the average YPLL, WYPLL, and VYPLL were 38.9, 31.4 and 24.2 mean years, respectively. Traffic injuries and falls were the two major causes of YPLL, leading to 251 and 136 mean years of YPLL, and accounting for 37.9% and 20.5% of the total, respectively.
Economic loss caused by injury
In the survey, the 1,772 total injuries caused 2,080,156 and 4,000,251 RMB yuan of direct and indirect economic loss, averaging 1,174 and 2,257 RMB yuan for each injury (Table
6). The contribution of males was more than three times that of females. Injuries in rural and urban areas caused economic losses of 3,275,661 and 2,804,746 RMB yuan, respectively. The economic costs of injury in rural areas was slightly higher than that in urban areas. Traffic injuries led to an economic cost of 2,723,713 RMB yuan, accounting for 44.79% of the total.
Table 6
Economic loss* caused by injury
Traffic injury | 881235 | 42.4 | 146675 | 35.0 | 1695802 | 47.4 | 2723713 | 44.8 |
Fall | 496011 | 23.8 | 108324 | 25.9 | 857164 | 23.9 | 1461499 | 24.0 |
Struck | 179766 | 8.6 | 34833 | 8.3 | 351619 | 9.8 | 566219 | 9.3 |
Cut | 122883 | 5.9 | 26095 | 6.2 | 340112 | 9.5 | 489090 | 8.0 |
Animal bite | 23836 | 1.2 | 5453 | 1.3 | 260249 | 7.3 | 289538 | 4.8 |
Strain | 99517 | 4.8 | 44157 | 10.5 | | | 143674 | 2.4 |
Burn | 83515 | 4.0 | 19006 | 4.5 | | | 102520 | 1.7 |
Squeeze | 71967 | 3.5 | 17055 | 4.1 | | | 89021 | 1.5 |
Explosion | 48501 | 2.3 | 5659 | 1.4 | | | 54160 | 0.9 |
Poisoning | 43264 | 2.1 | 7378 | 1.8 | | | 50642 | 0.8 |
Others | 29661 | 1.4 | 4153 | 1.0 | 76516 | 2.1 | 110330 | 1.8 |
Total | 2080156 | 100 | 418789 | 100 | 3581462 | 100 | 6080407 | 100 |