Population-based incidence and cost of non-fatal injuries in Iran: a consistent under-recognized public health concern.
OBJECTIVE
To investigate the incidence and determinants of non-fatal injuries, and the cost imposed on victims in an Iranian population aged 15-64 years.


METHODS
Cross-sectional household survey.


METHODS
Three-stage probability sampling was conducted for selection of a representative sample of Iranians. Data on the demographics, history and cost of injury were obtained from face-to-face interviews and telephone calls.


RESULTS
In total, 7886 subjects were included in this study. The annual incidence rate of all injuries was 905 (95% confidence interval 853-957) per 1000 population (approximately nine injuries per ten Iranians). The mean (±standard error) incidence rates of first aid injuries (FAIs; medical care not required) and medical-attended injuries (MAIs; medical treatment sought) were 737 ± 24 and 168 ± 12 per 1000 population, respectively. Young, urban females were at highest risk for FAIs, and single males were at highest risk for MAIs. The most common injury description was as follows: non-paid work (activity), home (place), inanimate mechanical force (mechanism), upper limb (site of injury) and open wound (type of injury). For MAIs, the most common place of treatment was hospital. Traffic-related injuries had the highest total cost and the lowest out-of-pocket cost. Total and out-of-pocket costs of non-fatal injuries in Iran in 2011 have been estimated to be US$6,111,138,000 and US$1,480,411,000, respectively.


CONCLUSIONS
Non-fatal injuries are an under-recognized public health problem. Cost-control policies are essential to reduce the out-of-pocket cost of injuries.
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran; School of Public Health (SPH), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Nima
N
Hafezi-Nejad
Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Afarin
A
Rahimi-Movaghar
Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences (TUMS), Tehran, Iran; School of Public Health, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Abbas
A
Motevalian
Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Masoumeh
M
Amin-Esmaeili
Department of Psychiatry, and Psychiatry & Psychology Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Vandad
V
Sharifi
Mental Health Research Centre, Tehran Psychiatric Institute, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Ahmad
A
Hajebi
Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences (TUMS), Tehran, Iran; Department for Mental Health and Substance Use, Iranian Research Center for HIV/AIDS (IRCHA), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Reza
R
Radgoodarzi
Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences (TUMS), Tehran, Iran; Department for Mental Health and Substance Use, Iranian Research Center for HIV/AIDS (IRCHA), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Mitra
M
Hefazi
Students Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Vahid
V
Eslami
Students Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Hasti
H
Karimi
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Soheil
S
Saadat
School of Public Health (SPH), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Kazem
K
Mohammad
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran. Electronic address: v_rahimi@sina.tums.ac.ir.
Vafa
V
Rahimi-Movaghar
D000293:Adolescent; D000328:Adult; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011634:Public Health; D012307:Risk Factors; D014947:Wounds and Injuries / Q000191:economics* / Q000453:epidemiology*; D055815:Young Adult
Cost; Epidemiology; Incidence; Injury; Risk factors