Bulletin of the World Health Organization

Assessing the burden of injury in six European countries

Suzanne Polinder, Willem Jan Meerding, Saakje Mulder, Eleni Petridou, Ed van Beeck


To assess injury-related mortality, disability and disability-adjusted life years (DALYs) in six European countries.


Epidemiological data (hospital discharge registers, emergency department registers, mortality databases) were obtained for Austria, Denmark, Ireland, Netherlands, Norway, and the United Kingdom (England and Wales). For each country, the burden of injury was estimated in years lost due to premature mortality (YLL), years lived with disability (YLD), and DALYs (per 1000 persons).


We observed marked differences in the burden of injury between countries. Austria lost the largest number of DALYs (25 per 1000 persons), followed by Denmark, Norway and Ireland (17–20 per 1000 persons). In the Netherlands and United Kingdom, the total burden due to injuries was relatively low (12 per 1000 persons). The variation between countries was attributable to a high variation in premature mortality (YLL varied from 9–17 per 1000 persons) and disability (YLD varied from 2–8 per 1000 persons). In all countries, males aged 25–44 years represented one third of the total injury burden, mainly due to traffic and intentional injuries. Spinal cord injury and skull–brain injury resulted in the highest burden due to permanent disability.


The burden of injury varies considerably among the six participating European countries, but males aged 15–24 years are responsible for a disproportionate share of the assessed burden of injury in all countries. Consistent injury control policy is supported by high-quality summary measures of population health. There is an urgent need for standardized data on the incidence and functional consequences of injury.