title: Injury trends from envenoming in Australia, 2000-2013.
abstract: BACKGROUND
  Accidental injury is a major public health problem in developed countries with 20 years elapsed since a national overview of venomous bites undertaken in Australia.
  
  
  OBJECTIVE
  Provide the first contemporary epidemiological insight into venomous injuries based on demographics and geography nationally in Australia in the period 2000-2013.
  
  
  METHODS
  An analysis of national hospitalisation and mortality data was undertaken to examine the incidence of injury and death due to envenoming in Australia. Rates were calculated using the intercensal population for all Australian age groups.
  
  
  RESULTS
  Over the study period, deaths occurred due to an anaphylactic event (0.16 per 100 000), snake envenoming (0.13 per 100 000) or box jellyfish envenoming (0.01 per 100 000). Only 44% of cases involving anaphylaxis reached medical care prior to death, compared to 74% of those envenomed by snakes. Over half of all deaths (52%) occurred at home, and 64% of these occurred within a major city or inner regional area, with 48% of work-related anaphylaxis deaths. Hospital admission rates of 199 per 100 000 persons over the 11 years were caused by contact with wasps or bees (31%), spiders (30%) and snakes (15%), with a predominant age range of 30-44 years.
  
  
  CONCLUSIONS
  The greatest burden of injury due to envenoming was caused by arthropods and snakes. Causes of death were led by anaphylaxis subsequent to an arthropod bite or sting, followed by death from snake envenoming. Over half the incidents resulting in death occurred at home, in areas where healthcare is accessible. Operational data routinely collected are informative, with variations of injury incidence between the States and Territories, indicating a need for a more localised approach to the management of this injury.
authors.affiliation: Australian Venom Research Unit, Department of Pharmacology and Therapeutics, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: R E
authors.identifier: http://orcid.org/0000-0001-7333-2426
authors.initials: RE
authors.lastname: Welton
authors.affiliation: Australian Venom Research Unit, Department of Pharmacology and Therapeutics, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: D J
authors.initials: DJ
authors.lastname: Williams
authors.affiliation: Department of Epidemiology and Preventative Medicine, Monash Centre of Cardiovascular Research and Education in Therapeutics, Melbourne, Victoria, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Liew
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001315:Australia / Q000453:epidemiology; D001516:Bees; D001733:Bites and Stings / Q000175:diagnosis* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D037462:Cubozoa; D003710:Demography; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D017678:Sex Distribution; D012911:Snakes; D013112:Spiders; D055815:Young Adult
keywords: Australia; allergy; arthropod; envenoming; remoteness; snake