title: Incidence of fall-related injuries in Iran: A population-based nationwide study.
abstract: BACKGROUND
  Fall-related injuries are considered to be a leading cause of morbidity and disability worldwide. The aim of this study was to investigate the incidence of fall-related injuries and its determinants in Iran.
  
  
  METHODS
  A cross-sectional household survey of a representative sample of 15-64 years old Iranians was carried out in 2011. A three-stage cluster sampling design was used. Total of 1525 clusters were randomly selected. Six households in each cluster were randomly selected, and one member of each household was interviewed. Data on the demographics and history of fall-related injury were obtained using the previously validated and reliability tested Short Form Injury Questionnaire 7 (SFIQ7). In all, 7886 subjects responded to the survey.
  
  
  RESULTS
  The incidence rate of all fall-related injuries was 59 (95%CI: 45-72) per 1000 person-year. The incidence rate of First Aid Fall-Related Injuries (FAFRIs) and Medical Attended Fall-Related Injuries (MAFRIs) were 30±5 and 28±12, respectively. Homes were the most common place of falls (52.5%). For all and MAFRIs, the most common activity leading to fall injury was walking (37.8% and 47.6%, respectively) whereas for FAFRIs was playing (31.9%). For all and FAFRIs, the most common description was as follows: upper limb as the injured organ (52.0% and 61.2%, respectively) and superficial wound as the most prevalent type of injury (39.0% and 61.8%, respectively). However, for MAFRIs, lower limb injuries (52.9%) and fracture (43.6%) were more pronounced. Risk factors for MAFRI were as follows: paid work activity (OR: 3.11; 95%CI: 2.07-4.67), playing (OR: 14.64; 95%CI: 6.34-33.80), walking (OR: 57.09; 95%CI: 28.95-112.59), driving (OR: 2.86; 95%CI: 1.23-6.63), and recreation activities (OR: 44.11; 95%CI: 14.04-138.54). Higher age and education were the other risk factors for MAFRI, as well as residing in rural areas.
  
  
  CONCLUSIONS
  This study revealed considerable incidence of fall injuries in Iranian population especially in rural regions who need access to protective equipment. People need to be warned about the constant risk of fall even during non-avoidable activities such as walking, playing, driving and paid/unpaid working especially in older ages. Implementation of fall prevention measures, home and behavioural modifications are recommended.
authors.affiliation: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
authors.forename: Soheil
authors.initials: S
authors.lastname: Saadat
authors.affiliation: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran; School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
authors.forename: Nima
authors.initials: N
authors.lastname: Hafezi-Nejad
authors.affiliation: School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
authors.forename: Yalda Soleiman
authors.initials: YS
authors.lastname: Ekhtiari
authors.affiliation: Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
authors.forename: Afarin
authors.initials: A
authors.lastname: Rahimi-Movaghar
authors.affiliation: Department of Public Health, Faculty of Public Health, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Motevalian
authors.affiliation: 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.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Amin-Esmaeili
authors.affiliation: Department of Psychiatry, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
authors.forename: Vandad
authors.initials: V
authors.lastname: Sharifi
authors.affiliation: Mental Health Research Centre, Tehran Psychiatric Institute, Iran University of Medical Sciences (IUMS), Tehran, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Hajebi
authors.affiliation: 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.
authors.forename: Reza
authors.initials: R
authors.lastname: Radgoodarzi
authors.affiliation: 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.
authors.forename: Mitra
authors.initials: M
authors.lastname: Hefazi
authors.affiliation: Students Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
authors.forename: Vahid
authors.initials: V
authors.lastname: Eslami
authors.affiliation: Students Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
authors.forename: Hasti
authors.initials: H
authors.lastname: Karimi
authors.affiliation: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
authors.forename: Kazem
authors.initials: K
authors.lastname: Mohammad
authors.affiliation: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran. Electronic address: v_rahimi@yahoo.com.
authors.forename: Vafa
authors.initials: V
authors.lastname: Rahimi-Movaghar
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D016000:Cluster Analysis; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000534:rehabilitation / Q000706:statistics & numerical data; D004779:Environment Design; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D055815:Young Adult
keywords: Epidemiology; Fall-related injury; Falls; Incidence; Iran; Risk factors