title: Injuries associated with housing conditions in Europe: a burden of disease study based on 2004 injury data.
abstract: BACKGROUND
  The authors recently undertook a study for the World Health Organization estimating the European burden of injuries that can be attributed to remediable structural hazards in the home. Such estimates are essential for motivating injury prevention efforts as they quantify potential health gains, in terms of injuries prevented, via specific environmental interventions.
  
  
  METHODS
  We combined exposure estimates from existing surveys and scenarios with estimates of the exposure-risk relationship obtained from a structured review of the literature on injury in the home and housing conditions. The resulting attributable fractions were applied to burden of injury data for the WHO European Region.
  
  
  RESULTS
  This analysis estimated that two specific hazards, lack of window guards at second level and higher, and lack of domestic smoke detectors resulted in an estimated 7,500 deaths and 200,000 disability adjusted life years (DALYs) per year. In estimating the environmental burden of injury associated with housing, important deficiencies in injury surveillance data and related limitations in studies of injury risk attributable to the home environment were apparent. The ability to attribute proportions of the home injury burden to features of the home were correspondingly limited, leading to probable severe underestimates of the burden.
  
  
  CONCLUSIONS
  The burden of injury from modifiable home injury exposures is substantial. Estimating this burden in a comprehensive and accurate manner requires improvements to the scope of injury surveillance data and the evidence base regarding the effectiveness of interventions.
authors.affiliation: He Kainga Oranga/Housing and Health Research Programme, University of Otago, PO Box 7343, Wellington South, New Zealand. michael.keall@otago.ac.nz
authors.forename: Michael D
authors.initials: MD
authors.lastname: Keall
authors.forename: David
authors.initials: D
authors.lastname: Ormandy
authors.forename: Michael G
authors.initials: MG
authors.lastname: Baker
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D002056:Burns / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D004782:Environmental Health; D005060:Europe / Q000453:epidemiology; D005390:Fires / Q000706:statistics & numerical data; D006306:Health Surveys; D006798:Housing / Q000592:standards; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019057:Quality-Adjusted Life Years; D012306:Risk; D012307:Risk Factors; D014944:World Health Organization; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology* / Q000209:etiology
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