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Abstract. Background: People who have mental illness are at increased risk of suicide. Therefore, identifying "typical" trajectories to suicide in this population has the potential to improve the effectiveness of suicide prevention strategies. Aim: The aim of this study was to explore the pathways to suicide among a sample of Victorians with a diagnosed mental illness. Method: Victorian Suicide Register (VSR) data were used to generate life charts and identify typical life trajectories to suicide among 50 Victorians. Results: Two distinct pathways to suicide were identified: (1) where diagnosis of mental illness appeared to follow life events/stressors; and (2) where diagnosis appeared to precede exposure to life events/stressors. Some events acted as distal factors related to suicide, other events were more common as proximal factors, and still others appeared to act as both distal and proximal factors. Limitations: The data source might be biased because of the potential for incomplete information, or alternatively, the importance of some factors in a person's life may have been overstated. Conclusion: Strategies to reduce suicide need to consider the chronology of exposure to stressors in people's lives and clearly need to be different depending on whether proximal or distal risk factors are the target of a given strategy or intervention.

Abstract. Background: Mental illness is an established risk factor for suicide. To develop effective prevention interventions and strategies, the demographic characteristics and stressors (other than, or in addition to, mental illness) that can influence a person's decision to die by suicide need to be identified. Aim: To examine cases of suicide by the presence or absence of a diagnosed mental illness (mental illness status) to identify differences in factors associated with suicide in the groups. Method: Logistic regression analyses were used to investigate mental illness status and exposure to stressors among 2,839 persons who died by suicide in Victoria, Australia (2009–2013), using the Victorian Suicide Register. Results: Females, metropolitan residents, persons treated for physical illness/injury, those exposed to stressors related to isolation, family, work, education, and substance use and those who had made a previous suicide attempt had increased odds of having a diagnosed mental illness. Employed persons had decreased odds of having a diagnosed mental illness. Limitations: The retrospectivity of data collection as well as the validity and reliability of some of the data may be questionable owing to the potential for recall bias. Conclusion: The point of intervention for suicide prevention cannot always be a mental health professional; some people who die by suicide either do not have a mental illness or have not sought help.

Objective: This study aimed to identify stressors over‐represented in the 12 months prior to death among 553 Victorian adults who died by suicide. Methods: Age‐ and sex‐specific suicide rates and relative risks of suicide were calculated using numerator data on suicides occurring in 2013 by people with a given exposure sourced from the Victorian Suicide Register and denominator data on the total Victorian population with that exposure sourced from the 2014 Australian Bureau of Statistics General Social Survey. Results: Mental illness was associated with increased suicide risk among people of all age groups and both sexes. Alcohol and/or other drug problems were associated with increased risk for males and females of all ages, with the exceptions of the oldest males and females, and the youngest females. Trouble with the police was associated with increased risk among all but the oldest males, whereas among females it was associated with elevated risk in those aged 25–44 years and 65+ years. Conclusions and Implications for public health: Males experiencing mental illness and alcohol and other drug problems should be a particular priority for suicide prevention initiatives but people exposed to other stressors such as contact with the police and divorce/relationship separation also warrant attention.

The objective of the study was to determine whether people who died by suicide form groups based on demographic, psychosocial, mental and physical health factors and exposure to stressors. A retrospective case series review of 2,839 individuals who died by suicide in Victoria, Australia over the period 2009-2013 was conducted. A two-stage cluster analysis was performed. Diagnosis of mental illness was present in 52% of cases and initial cluster analysis determined two groups with the main predictor of group membership being the presence of diagnosed mental illness. Further analysis identified four subgroups within the mental illness group and two within the non-mental illness group. The study demonstrates that suicide does not always occur in the context of mental illness; people who die by suicide cannot be considered a homogenous group.

To determine the incidence rate and changes over time for ice and snow sports injury in Victoria, Australia, from 2003 to 2012 and describe the most common types and causes of these injuries.Retrospective data from the Victorian Injury Surveillance Unit describing hospital admissions and emergency department presentations were extracted for the 10-year period of 2003 to 2012 for all ice- and snow-related injury. Descriptive injury data and participation-adjusted trend analyses using log-linear regression modelling of data (statistical significance, P0.05) from the Exercise, Recreation and Sport Survey 2003 to 2010 are presented.Overall, there were 7387 ice- and snow-related injuries, with a significant increase in hospital-treated snowboard injuries and a (nonsignificant) decline in hospital-treated ski injuries over the 10 years. Skiing (39%) and snowboarding (37%) had the highest incidence of hospital-treated injury, with males aged 15 to 24 years injured most frequently in both sports. Falls were the most common cause of injury in both skiing (68%) and snowboarding (78%).Patterns of snow sports injury in Australia during 2003 to 2012 remain similar to findings of national studies conducted decades earlier. More importantly, however, Australian injury patterns are comparable to international statistics and thus may be generalizable internationally. Head injuries, although infrequent, are associated with great injury severity due to a high frequency of hospitalization. Furthermore, research into the use of personal protective equipment and other injury prevention measures among Australian participants, particularly by young, male snowboarders, is required. Given the similar injury patterns, injury prevention measures implemented internationally could reasonably translate to an Australian setting.

In this ecological study, we attempt to quantify the extent to which differences in homicide and suicide death rates between three countries, and among states/provinces within those countries, may be explained by differences in their social, economic, and structural characteristics. We examine the relationship between state/province level measures of societal risk factors and state/province level rates of violent death (homicide and suicide) across Australia, Canada, and the United States. Census and mortality data from each of these three countries were used. Rates of societal level characteristics were assessed and included residential instability, self-employment, income inequality, gender economic inequity, economic stress, alcohol outlet density, and employment opportunities). Residential instability, self-employment, and income inequality were associated with rates of both homicide and suicide and gender economic inequity was associated with rates of suicide only. This study opens lines of inquiry around what contributes to the overall burden of violence-related injuries in societies and provides preliminary findings on potential societal characteristics that are associated with differences in injury and violence rates across populations., Highlights • This study opens lines of inquiry around what contributes to the overall burden of violence-related injuries in societies. • Differences in homicide and suicide death between and within countries may be explained by social, economic, and structural characteristics. • Residential instability, self-employment, and income inequality were associated with rates of both homicide and suicide. • Gender economic inequity was associated with rates of suicide only.

Objective: To describe recent trends in opioid prescribing and prescription opioid poisoning resulting in hospitalisation or death in Victoria, Australia. Method: This is a population-based ecological study of residents of Victoria, 2006 – 14. Australian Bureau of Statistics residential population data were combined with Pharmaceutical Benefits Scheme (PBS) opioid prescription data, Victorian Admitted Episodes Data (VAED) and cause of death data. Results: Annual opioid dispensings increased by 78% in 2006 – 13, from 0.33 to 0.58 per population. Opioid use increased with age: in 2013, 14% of Victorian residents aged ≥65 years filled at least one oxycodone prescription. In 2006 – 14, prescription opioid related hospital admissions increased by 6.8% per year, from 107 to 187 /1,000,000 person-years; 56% were due to intentional self-poisoning. Annual deaths increased from 21 to 28 /1,000,000 persons, in 2007 – 11. Admissions and deaths peaked at 25–44 years. Conclusions: Although both opioid prescribing and poisoning have increased, there is discrepancy between the exposed group (dispensings increased with age) and those with adverse consequences (rates peaked at ages 25–44 years). Implications: A better understanding is needed of drivers of prescribing and adverse consequences. Together with monitoring of prescribing and poisoning, this will facilitate early detection and prevention of a public health problem.

Objective: To identify how Culturally and Linguistically Diverse (CALD) communities are defined in epidemiological research in Australia and provide a definition of CALD status that aids the consistency and interpretability of epidemiological studies. Methods: Peer-reviewed literature from January 2015 to May 2020 was searched via four databases (Ovid Medline combined with PubMed, Embase, Emcare, and CINAHL) to identify quantitative studies of CALD people in Australia. Results: A total of 108 studies met the criteria for inclusion in the review. Country of birth was the most commonly used CALD definition (n = 33, 30.6%), with combinations of two or more components also frequently used (n = 31, 28.7%). No studies used all the components suggested as core to defining CALD status. including country of birth, languages other than English spoken at home, English proficiency, and indigenous status. Conclusions: There was considerable inconsistency in how CALD status was defined. The review suggests that CALD status would best be defined as people born in non-English speaking countries, and/or who do not speak English at home. Additionally, indigenous peoples should be considered separately. This recommended definition will support the better identification of potential health disparity and needs in CALD and indigenous communities.

This research investigated the presence and nature of mental illness among persons who died by suicide in Victoria, Australia and explored the pathways to suicide in this same population. The research aimed to examine mental illness and suicide in the context of other distal and proximal factors and stressors. The research demonstrated people exposed to stressors other than mental illness are dying by suicide and this is, at least sometimes, in the absence of any diagnosed mental illness. Additionally, even within the population who have a diagnosed mental illness, the pathways or life trajectories to suicide are complex and varied.

The aim of this study was to determine whether people who have been hospitalised as the result of non-fatal self-harm form meaningful groups based on mechanism of injury, and demographic and mental health-related factors. A retrospective analysis of 18,103 hospital admissions for self-harm in Victoria, Australia over the 3-year period 2014/2015–2016/2017 recorded on the Victorian Admitted Episodes Dataset (VAED). The VAED records all hospital admissions in public and private hospitals in Victoria. The primary analysis used a two-step method of cluster analysis. Initial analysis determined two distinct groups, one composed of individuals who had a recorded mental illness diagnosis and one composed of individuals with no recorded mental illness diagnosis. Subsequent cluster analysis identified four subgroups within each of the initial two groups. Within the diagnosed mental illness subgroups, each subgroup was characterised by a particular mental disorder or a combination of disorders. Within the no diagnosis of mental illness groups, the youngest group was also the most homogenous (all females who self-poisoned), the oldest group had a high proportion of rural/regional residents, the group with the highest proportion of males also had the highest proportion of people who used cutting as the method of self-harm, and the group with the highest proportion of metropolitan residents also had the highest proportion of people who were married. Preventative interventions need to take into account that those who are admitted to hospital for self-harm are a heterogeneous group.

OBJECTIVES: Previous sports injury is a known risk factor for subsequent osteoarthritis, but population-based rates of sports injury are unknown. The aims of this study were to: i) describe the trends in the population incidence and burden of all hospital-treated sports injury in Victoria, Australia in adults aged 15+ years; ii) determine the incidence of lower limb and knee injuries; and iii) quantify their population health burden as average direct hospital costs per injury and lengths of stay. METHODS: Health sector data relating to adults aged 15+ years, for 2004-2010 inclusive, was extracted from the Victorian Admitted Episodes Dataset and Victorian Emergency Minimum Dataset. Data relating to sports injuries were identified using activity codes in each dataset Trends in injury frequency and rates were determined, and economic burden was calculated. RESULTS: The overall annual rate of hospital treated sports injuries increased by 24% (p=0.001), and lower limb injuries by 26% (p=0.001) over the seven years. The associated accumulated economic burden was $265 million for all sports injuries and $110 million for lower limb injuries over the 7-years. CONCLUSIONS: The findings of this study show a significant increase in sports injuries in the state of Victoria, Australia over a 7-year period. As previous sports injury is a risk factor for the development of osteoarthritis, the future incidence of osteoarthritis will escalate, placing an even greater burden on health care systems. Population-wide preventative strategies that reduce the risk of sports injury are urgently required in order to reduce the future burden of osteoarthritis. Language: en

OBJECTIVES: The aim of this study was to highlight the differences in injury rates between populations through a descriptive epidemiological study of population-level trends in injury mortality for the high-income countries of Australia, Canada and the United States. METHODS: Mortality data were available for the US from 2000 to 2014, and for Canada and Australia from 2000 to 2012. Injury causes were defined using the International Classification of Diseases, Tenth Revision external cause codes, and were grouped into major causes. Rates were direct-method age-adjusted using the US 2000 projected population as the standard age distribution. RESULTS: US motor vehicle injury mortality rates declined from 2000 to 2014 but remained markedly higher than those of Australia or Canada. In all three countries, fall injury mortality rates increased from 2000 to 2014. US homicide mortality rates declined, but remained higher than those of Australia and Canada. While the US had the lowest suicide rate in 2000, it increased by 24% during 2000–2014, and by 2012 was about 14% higher than that in Australia and Canada. The poisoning mortality rate in the US increased dramatically from 2000 to 2014. CONCLUSION: Results show marked differences and striking similarities in injury mortality between the countries and within countries over time. The observed trends differed by injury cause category. The substantial differences in injury rates between similarly resourced populations raises important questions about the role of societal-level factors as underlying causes of the differential distribution of injury in our communities.

Objective To investigate differences and similarities between three sources of work-related injury information: workers compensation claims, emergency department (ED) presentation data and hospital admissions data. Methods This population-based, retrospective descriptive analysis of non-fatal, work-related injuries of workforce participants in Victoria, Australia, has compared data from workers compensation claims and ED presentation and hospital admission data sets for the period 2004–2011. Work-related injury case frequency and rate were compared across study years according to gender, age, geographical location and injury type. Injury rates were expressed as cases per million hours worked. Results Rates of hospital admissions for treatment of work-related injury increased over the study period, compared with decreasing rates of injury in compensation claims and ED data. The highest rate of injuries to younger workers was captured in ED data. There was greater capture of musculoskeletal injuries by workers’ compensation data, and of open wound and burn injury by the ED data. Broad similarities were noted for temporal trends according to gender, for the distribution of cases across older age groups and for rates of fracture injuries. Conclusions These study findings inform use of workers’ compensation, ED presentation and hospital admission data sets as sources of information for surveillance of work-related injuries in countries where these types of data are routinely collected. Choice of data source for investigation of work-related injury should take into consideration the population and injury types of interest.

OBJECTIVE: To enumerate and describe fatal and hospital-treated injury associated with quad bike use in Victoria. DESIGN: Retrospective descriptive analysis of coronial records and hospital-treated injury data (2002-03 to 2010-11). MAIN OUTCOME MEASURES: Number of quad bike-related fatalities, hospital admissions, emergency department (ED) presentations, and results of a trend and severity analysis (International Classification of Disease-based Injury Severity Score; ICISS). RESULTS: There were 19 fatalities, 766 hospital admissions and 816 ED presentations. The peak age group for fatalities and admissions was 15-29 years (26.3% and 27.9%, respectively), with children 0-14 years being the most common group presenting to EDs (32.2%). Males were strongly overrepresented (84.2% of fatalities, 73.8% of admissions and 71.2% of ED presentations). Intracranial injury (26.3%), fractures (15.8%) and traumatic asphyxiation (15.8%) were the most common injuries among fatal cases. Fractures accounted for half all admissions. Twenty-eight per cent of admissions were classified as "serious" (ICISS, ≤ 0.941) and, over the 9-year study period, the frequency of admissions increased significantly by an estimated 41.4% (95% CI, 9.6%-78.9%). This was significant for males (53.2%; 95% CI, 11.5%-104.4%) and people aged 15-29 years (163.1%; 95% CI, 75.2%-253.7%). CONCLUSION: Quad bikes are imposing a significant injury burden in Victoria. Fatalities are frequent, while the number of admissions, often serious, increased over the study period. Children were involved across all levels of severity. A range of prevention approaches, such as mandatory fitting of crush protection devices to protect riders in the event of a roll over, are required. Language: en

OBJECTIVE: To describe trends in hospitalisation for sport-related concussion. DESIGN, SETTING AND PATIENTS: Analysis of routinely collected hospital admissions data from all Victorian hospitals (public and private) over the 2002-03 to 2010-11 financial 2013s for patients aged ≥ 15 2013s with a diagnosis of concussion and an ICD-10-AM external cause activity code indicating sport. MAIN OUTCOME MEASURES: Number and cost of hospitalisations; rate of hospitalisation per 100 000 participants overall and for specific sports; and percentage change in frequency and hospitalisation rate per 100 000 participants over 9 2013s. RESULTS: There were 4745 hospitalisations of people aged ≥ 15 2013s for sport-related concussion, with a total hospital treatment cost of $17 944 799. The frequency of hospitalisation increased by 60.5% (95% CI, 41.7%-77.3%) over the 9 2013s, but could only partially be explained by increases in sports participation, as the rate per 100 000 participants also increased significantly, by 38.9% (95% CI, 17.5%-61.7%). After adjustment for participation, rates were highest for motor sports, equestrian activities, Australian football, rugby and roller sports. The greatest significant increases in rates were seen in roller sports, rugby, soccer and cycling. CONCLUSIONS: The frequency and participation-adjusted rate of hospitalisation for sport-related concussion, both overall and across several sports, increased significantly over the 9 2013s. These findings, along with high levels of public concern, make prevention of head injury in sport a population health priority in Australia. Language: en

The connection between divorce and suicide risk in Asia is unclear. To understand the contribution of cultural transitions to suicide among the divorced, we compare age- and sex-specific suicide rates among divorced men and women from five Pacific Rim populations: Hong Kong, Taiwan, Japan, South Korea and the state of Victoria in Australia. On a cultural spectrum, we consider Hong Kong and Taiwan to lie between the more individualistic Australian culture and the more collectivistic Japanese and Korean cultures. Coefficients of aggravation (COA) are also compared. Suicide rates were found to be higher among the divorced than among other marital status groups in all five populations, but this difference was small in Victoria. The effect of divorce was significantly greater for men than for women only in Japan and South Korea. In the other populations, divorced men and women were at equal risk. Age trends in suicide rates for the divorced groups differed across populations. The COAs for the divorced group aged 40 or younger in the East Asian populations were higher than the COAs for older divorced groups, though this was not the case in the Victorian population. Suicide patterns among the divorced in the East Asian populations can be understood in terms of the legacy of Confucian traditions. Gender differences in Japan and South Korea may reflect either gender inequality (male dominance in formal interactions and emotional dependence in domestic life within a deteriorating Confucian family support system) or unique socio-cultural factors among married women. Divorced East Asian groups aged 40 or younger may be at a higher risk of suicide due to individual-level cultural ambivalence combined with a desire for systemic-level emotional interdependence. Social welfare regimes in the four East Asian populations need to fill the vacancy left by retreating traditional family systems. Research implications are discussed.

Summary In Victoria, Australia, the age-standardised incidence of fall-related hip fracture hospitalisations decreased significantly by 25% over the period 1998/1999–2008/2009. Significant decreases in fall-related hip fractures were observed in males and females, across all 5-year age groups, in Australian-born and overseas-born Victorians, in all socio-economic quintiles and in community-dwelling older people.

Objectives To describe presentation characteristics of burn leading to death or hospital treatment (i.e. inpatient admissions and emergency department [ED] presentations) across the state of Victoria, Australia, for the years 2000–2006 inclusive. Methods Data were provided by the Victorian Injury Surveillance Unit (VISU) from three different datasets pertaining to burn deaths, hospital inpatient admissions and non-admitted ED presentations. Population estimates were derived from census data provided by Australian Bureau of Statistics. Results During the 7-year period, 178 people died and 36,430 were treated for non-fatal burn injury, comprising 7543 hospital admissions and 28,887 non-admitted ED presentations. Males, children aged less than 5 years of age, and the elderly (≥65 years of age) were at the highest risk of injury. Contact with heat and hot substances represented the major aetiological factor contributing to thermal injuries accounting for 64% of all hospital admissions and 90% of ED presentations. Temporal trends indicate no change in the population rate of burn deaths or hospital admissions during the study period. Conclusions ED presentations and hospital admissions and deaths have remained the same over this study period, but rates of burn remain high in males, children and the elderly. This could be due to variations in the implementation of government prevention and control programs and the divergence in efficient treatments and clinical practices amongst hospital care providers. Therefore, educational efforts for prevention should be the keystone to minimise the incidence of burns.

This study describes motorized mobility scooter (MMS) rider-related fatalities in the older Australian population during the years 2000–2011, identified from the National Coronial Information System. Seventy-seven fatalities were identified, most aged 80 years or older (74.1%) and males predominated (76.6%). Most deaths (88.3%) resulted from collisions with motor vehicles or falling from the MMS. These findings are consistent with the reported morbidity data. Challenges to MMS case identification included lack of specification in reports to Coroners and inadequate codes. Improved specificity and coding are necessary to fully describe the extent of MMS-related injury. This study raises the issue of emerging largely unregulated consumer products. Further research is required to understand the uptake and use of MMS in the ageing population. Strategies are needed to decrease rider injuries whilst meeting community mobility needs.

Objectives: To examine trends in rates of firearm related deaths in Victoria, Australia, over 22 years in the context of legislative reform and describe and investigate impact measures to explain trends. Design: Mortality data were extracted from vital statistics for 1979–2000. Data on firearm related deaths that were unintentional deaths, assaults, suicides, and of undetermined intent were analyzed. Rates were calculated with population data derived from estimates by the Australian Bureau of Statistics. A quasi-experimental design that used a Poisson regression model was adopted to compare relative rates of firearm related deaths for Victoria and the rest of Australia over three critical periods of legislative reform. The Wilcoxon signed ranks test was used to assess changes in the types of firearm related deaths before and after 1998. Results: In Victoria, two periods of legislative reform related to firearms followed mass shooting events in 1988 and 1996. A national firearm amnesty and buyback scheme followed the latter. Victorian and Australian rates of firearm related deaths before reforms (1979–86) were steady. After initial Victorian reforms, a significant downward trend was seen for numbers of all firearm related deaths between 1988 and 1995 (17.3% in Victoria compared with the rest of Australia, p

Objective To determine the population-level burden of sports injuries compared with that for road traffic injury for children aged

Objective: To develop a comprehensive estimate of the burden of fall-related injury among older people in New South Wales. Methods: Fall injuries in 2006/07 were estimated using information from several datasets and the literature. Healthcare costs were calculated using Australia-Refined - Diagnostic-Related Group costs for hospital episodes of care and average costs for Emergency Department presentations, ambulance transport and residential aged care (RAC). Ratios of the cost of inpatient care relative to other health services, derived from the literature, were used to estimate the costs associated with these services. Results: In 2006/07, in NSW, there were almost 143,000 falls, among older people, resulting in injuries requiring medical treatment. The total cost of healthcare associated with these falls was estimated at $558.5 million. Although accounting for only 6% of the NSW population aged 65 years and older, persons in RAC accounted for 15% of the total cost of falls injury and 21% of hospital inpatient costs. Conclusion and implications: This study demonstrates the extremely high economic cost of falls in older persons and highlights the disproportionate impact of falls in RAC. The study underscores the urgent need for significant investment in fall-injury prevention efforts in both the community and RAC settings. Language: en

Availability of ICD-10 cause of death codes in the National Coroners Information System (NCIS) strengthens its value as a public health surveillance tool. This study quantified the completeness of external cause ICD-10 codes in the NCIS for Victorian deaths (as assigned by the Australian Bureau of Statistics (ABS) in the yearly Cause of Death data). It also examined the concordance between external cause ICD-10 codes contained in the NCIS and a re-code of the same deaths conducted by an independent coder. Of 7,400 NCIS external cause deaths included in this study, 961 (13.0%) did not contain an ABS assigned ICD-10 code and 225 (3.0%) contained only a natural cause code. Where an ABS assigned external cause ICD-10 code was present ( n=6,214), 4,397 (70.8%) matched exactly with the independently assigned ICD-10 code. Coding disparity primarily related to differences in assignment of intent and specificity. However, in a small number of deaths ( n=49, 0.8%) there was coding disparity for both intent and external cause category. NCIS users should be aware of the limitations of relying only on ICD-10 codes contained within the NCIS for deaths prior to 2007 and consider using these in combination with the other NCIS data fields and code sets to ensure optimum case identification.

OBJECTIVE: To test the potential of wrist guards to prevent wrist injury in recreational activities that require good grip strength and hand dexterity. METHODS: Forty eight children aged 5-8 years from one Melbourne school volunteered for tests chosen or devised following a review of the literature on the effects of orthoses use and hand function. RESULTS: Wrist guard wearing significantly degraded grip strength, bicycle steering, and performance on a monkey bar. Micro scooter steering was not significantly affected by their use. CONCLUSION: Wrist guards designed for skating are not recommended for bicycle riding and playing on climbing apparatus, and their suitability for scooter riding requires further investigation.

Dear editor, We analysed the trends in fall-related hip fracture incidence for men and women separately by 10-year age groups (65 to 74, 75 to 84 and 85 years and older) to compare our results for Victoria [1] to those reported for the USA by Stevens and Rudd in their letter [2]. Our results showed that, from 1998/9 to 2008/9, fallrelated hip fracture rates for men and women decreased significantly in all 10-year age groups (range −43.1 to −20.8 %). However, in contrast to the pattern found for the USA, the sharpest decline in hip fracture rates was in males aged 65– 74 years (−43.1 %, 95 % confidence interval −51.2 to −35.5), then in females in the same age group (−28.1 %, 95 % confidence interval −39.4 to −15.7).

Background Recent Global Burden of Disease estimates highlight the high burden associated with injury, especially road trauma. However, these estimates, based on the International Classification of Diseases (ICD-9/ICD-10), did not specifically identify sports injuries. Objective To compare the public health burden of sport and road traffic injury, for children Design Analysis of data for non-fatal hospital-treated sports injuries and road traffic injury cases for children aged Main outcome Mmeasurements Trends in injury frequency were analysed by log-linear Poisson regression. Population-level injury burden was assessed in terms of years lived with disability (YLDs), hospital bed-days and direct hospital costs. Results Over the 7-year period, the annual frequency of hospital-treated sports injury increased significantly by 29% (N=7405 to N=9923; P Conclusions The significant 7-year increase in frequency of hospital-treated sports injury and significantly higher injury population-health burden for sports injury, compared with road traffic injury, for children aged

This study aimed to establish comprehensive estimates of the cost of fall-related injury among older people in NSW. A health service utilisation approach was used to estimate the cost of hospital treatment, residential care and ambulance transport. Other costs were estimated by deriving ratios of inpatient costs to other services from the literature. In the 2006–07 financial year, 251 000 (27%) of older people fell at least once and suffered, in total, an estimated 507 000 falls. An estimated 143 000 medically treated fall-related injuries among older people resulted in lifetime treatment costs of $558.5 million. Although only 18% of these injuries resulted in hospital admission, the cost of care associated with these cases accounted for 84.5% of the total cost. The cost of fall-related injury among older people in NSW in 2006–07 is a significant increase over earlier estimates and underscores the urgent need for effective preventive efforts across the state.

Social factors such as socioeconomic status (SES) are increasingly being viewed as fundamental causes of premature death and illness and there is a growing body of evidence linking residential location with health outcomes. The aim of this study was to investigate the relationship between the SES of the area in which a person lives and their risk of hospitalisation for injury. Local government areas (LGAs) in Victoria are assigned to SES deciles by the Australian Bureau of Statistics based on a composite measure of SES devised by the Bureau. For this research the deciles were combined to form quintiles. All individuals living in an LGA were assigned the same SES ranking ranging from 1 to 5 (1=most disadvantaged through 5=least disadvantaged) and their risk of injury compared overall and in broad age groups. The effect of area SES on injury risk varied substantially by age, gender and injury cause. Injury hospital admission rates were generally lowest in the least disadvantaged quintile of LGAs but not often highest in the most disadvantaged quintile of LGAs. The regression analysis showed that, overall, persons living in the more disadvantaged areas were significantly more likely to be hospitalised than persons in the least disadvantaged areas for transport injury (incident rate ratio range 1.18–1.36), machinery-related injury (1.50–1.83), fire/burns/scalds (1.25–1.61) and assaultive injury (1.20–1.77). These injury causes account for 20% of injury hospital admissions.

Aim Examine the trend in fall-related hip fracture hospital admission rates among Victorian seniors aged 65 years and older over the decade 1998/9 to 2007/2008. Method Data Source Victorian Admitted Episodes Dataset (VAED) General case inclusion criteria: Age 65 years and older First (left-most) external cause code indicates a fall (W01-W19) AND Primary Diagnosis is injury or poisoning Cases transferred from another acute care hospital and deaths in hospital were excluded Analysis Rates were age-adjusted and trends were determined using a log-linear regression model of the rate data assuming a Poisson distribution of cases. Results Over the decade 1998/1999 to 2007/2008: falls increased by an estimated 22.5% hip fractures decreased by an estimated 23.4% all fractures showed a non-significant downward trend fractures excluding the hip increased significantly by 12% pelvic fractures increased significantly by 12% * open wounds (57%), superficial injury (25%), dislocations, sprains, strains (24%) and intracranial injury (106%) all increased significantly. Discussion The observed decrease in the hip fracture is a welcome development, but caution should be exercised when interpreting/using this finding as it requires further investigation and confirmation. There is some confirmatory evidence from New South Wales, New Zealand and elsewhere where reports indicate that hip fracture hospitalisation rates for persons aged 65 years and over have stabilised, or decreased slightly in some age or gender groups, through the 1990s (Boufous et al , 2004; Fielden et al , 2001) .

The objective and aim of the study was to compile empirical data to quantify the underestimation of the true burden of drowning and to compare drowning rates using commonly reported codes compared with those revealed by use of the full range of drowning codes in ICD version 10. The authors reviewed mortality data (1999 – 2002) from Australia and the USA and compiled data to compare the burden of ‘unintentional drowning’ with that of ‘all drowning’. In both Australia and the USA, drowning mortality is more than 35% higher when a full range of codes is examined. A more comprehensive representation of the drowning problem is needed to assist in strengthening prevention activities.