Statistics Canada Catalogue no. 82-624-X
by Jean-Michel Billette and Teresa Janz
Who is most at risk of injury?
Where do injuries happen?
What types of injuries do people have?
What are the consequences of injuries?
When are people more likely to be injured?
Why do injuries occur?
Injuries affect almost everyone at some point in their life. The severity can range from bumps and scrapes to those requiring medical attention or even causing death. In fact, in 2007, 15,064 people died of injury-related causes (6% of all fatalities). Of these deaths, 24% were suicides, 21% were transport-related deaths, 18% were the result of a fall, 9% were due to poisoning, and 3% were homicides. Injury is the leading cause of death for young people aged 1 to 341 and an important cause of hospitalization, impairment and disability for children, young adults and seniors2.
Estimates of the economic burden to society that results from both unintentional and intentional injuries amounted to $19.8 billion in 2004 including direct health-care costs and indirect costs arising from reduced productivity due to hospitalization, disability and premature death3.
This article explores injuries among Canadians aged 12 or older living in households, using the Canadian Community Health Survey (CCHS). Two years of data were combined in order to produce an average annual estimate for 2009–2010. The three age groups examined are adolescents aged 12 to 19, working-age adults aged 20 to 64, and seniors aged 65 or older, because each of these age groups has different injury experiences. The estimates in this article are based on data for the single most serious activity-limiting injury reported in the past year, so they do not reflect all injuries. Injuries causing death or institutionalization were also not included. Nevertheless, the CCHS is a unique source of data on the nature and context of injuries among Canadians.
An estimated 4.27 million Canadians aged 12 or older suffered an injury severe enough to limit their usual activities in 2009–2010 (Appendix 1). This represents 15% of the population in this age range, up from 13% in 2001. A closer look at the injury trends in Chart 1 reveals different patterns related to age and sex. Overall, young people aged 12 to 19 had the highest likelihood of injury (27%) – twice as high as all other age groups (13%). Adolescents have experienced an increase in injuries over the past decade, especially among girls (from 18% to 23%).
Although males, in general, were more likely than females to be injured, young males (aged 12 to 19) were most at risk (30%). Likewise for females, it was the youngest age group (12 to 19) who were most likely to be injured (23%).
In Canada, 35% of injuries occurred during participation in some type of sports or exercise. Two–thirds (66%) of injuries among young people (aged 12 to 19) were related to sports. This was more than twice as high as working-age adults (29%) and about seven times higher than seniors (9%) (Chart 2 and Appendix 2).
For seniors, everyday activities like household chores (27%) and walking (28%) accounted for over half of their injuries. Not surprisingly, work injuries were highest in the population of working-age adults, accounting for about 18% of all their injuries. Other research has found that one-third of all on-the-job injuries occurred among workers in trades, transport and equipment operation4.
Injuries that resulted from being a driver or passenger in a motor vehicle represented about 5% of all injuries. This estimate, however, does not take into account individuals who died or were institutionalized as a consequence of the injury.
Sprains and strains were, by far, the most common type of injury (51%), followed by fractures and broken bones (17%) (Chart 3 and Appendix 3). For some types of injuries, there were clear differences according to age. Scrapes, bruises and blisters represent 14% of all injuries among seniors, double what was reported among those aged 12 to 64 (6%). About 26% of seniors and 21% of adolescents sustained fractures and broken bones, compared with 14% of working-age adults.
The most commonly injured body part among young people (aged 12 to 19) was their feet or ankles (33%). This was more than double the proportion reported by seniors (14%). A similar pattern occurred for injured wrists or hands, which accounted for 22% of injuries in adolescents compared to 14% for seniors (See Box 1 – Protective equipment use). In contrast, injuries of the upper body (e.g., shoulders, elbows and arms) accounted for 18% of injuries for seniors, compared with 11% in adolescents. Lower-back injuries were more common among working-age adults (16%) than among seniors (11%) and adolescents (5%) (Appendix 4).
Although head injuries occur relatively less often, they are noteworthy because they may have serious consequences. In 2009–2010, an estimated 98,440 people, 2.4% of the population aged 12 and over, sustained a head injury. Of those, 57% (55,910) were working-age adults, 23% (22,720) were adolescents, and 20% (19,810) were seniors (Appendix 4).
About 2.29 million Canadians sought medical treatment within 48 hours of their injury in 2009–2010 (Appendix 5). This represents 54% of the injured population aged 12 and older, down from 64% in 2001. Just over half of these people went to a hospital emergency room, about one in six (17%) consulted their doctor, 13% went to a clinic, and 17% sought other types of treatment (e.g., physiotherapist, massage therapist or chiropractor). About 6% of those who needed treatment were admitted to the hospital overnight. Eighteen percent were still receiving follow-up care at the time of interview. This percentage ranges from 9% (adolescents) to 25% (seniors).
Type of treatment received, among people who sustained at least one activity-limiting injury during the past 12 months and who received treatment within 48 hours of the most serious activity-limiting injury, population aged 12 and over, Canada, 2009–2010
The likelihood of injury changed with the season and was slightly higher in the summer, when 30% of all injuries occurred. People also reported that 25% of their most serious injuries occurred in winter, 23% in spring, and 22% in fall (Appendix 6). Injury risk varied over the course of the day. Nearly half of the injuries occurred in the afternoon (from noon to 6:00 p.m.). The second-most common time of day when people were injured varied by age group. Among seniors, nearly one third of injuries (31%) occurred in the morning from 6:00 a.m. to noon, compared with 14% for adolescents. In contrast, a different pattern emerged in the evening (from 6:00 p.m. to midnight), when 30% of adolescent injuries occurred, compared with 18% of seniors’ injuries (Chart 4 and Appendix 7).
Season during which the most serious activity-limiting injury occurred, among people who sustained at least one activity-limiting injury during the past 12 months, population aged 12 and over, Canada, 2009–2010
Time of day during which the most serious activity-limiting injury occurred, among people who sustained at least one activity-limiting injury during the past 12 months, population aged 12 and over, Canada, 2009–2010
The main causes of injuries were falls and overexertion (Chart 5). This is noteworthy since falls are the most common cause of injury hospitalizations in Canada5. While about half (50%) of injuries among adolescents resulted from a fall, this proportion was even higher among seniors (63%). Injuries that occurred during sports activities were mainly caused by falls. Sports accounted for three in five falls among adolescents.
Falls in seniors, on the other hand, were more often the result of tripping or stumbling while walking or doing household chores (See Box 2 – Seniors and falls). Injuries caused by overexertion or strenuous movements were almost twice as frequent in working-age adults (27%) as in seniors (14%) and adolescents (15%) (Appendix 8).
Injuries represent an important public health issue for Canadians of all ages. Most of the trends described in this article are consistent with findings from the 2001 CCHS6,7. The most important note is that the injury context is strongly related to age. For instance, adolescent males are the group injured most often, and these injuries occur mainly while participating in sports. Overexertion is an important cause of injury in the working-age population and seniors are injured most often from falls while doing household chores or walking.
Jean-Michel Billette and Teresa Janz are analysts with the Health Statistics Division.