Home Safe Home. Report on Home Accidents in Scotland. Art work courtesy of North Lanarkshire Council

Transcription

1 Home Safe Home Report on Home Accidents in Scotland Art work courtesy of North Lanarkshire Council December 2010

2 Home Safe Home Report on Home Accidents in Scotland Contents Page Home Safe Home Summary and Key Facts 3 Home Safety Scotland 4 Introduction to unintentional injuries in the home in Scotland Definitions, 6 Source of Data 7 Unintentional Injuries Scotland Background 9 Key statistics 9 Deaths from unintentional injury 10 Emergency admissions to hospital as result of an unintentional 12 injury Home Safe Home - Home Accident Report Introduction 14 Cost of home accidents 16 Emergency admissions as result of an unintentional home injury 17 Analysis by age 18 o Over 75 s 19 o Under 5 s 21 Analysis By Health Board 23 Analysis By Local Authority 27 Sources of information 33 Appendix Statistical tables

3 Home Safe Home Summary and Key Facts Every year in the UK almost 4,000 people die in accidents in the home and 2.7 million turn up at accident and emergency departments seeking treatment. But, because the accidents happen behind closed doors in isolated incidents they rarely attract public and media attention. (Royal Society for the Prevention of Accidents) This report has been produced by Home Safety Scotland to provide statistics on unintentional injuries as a result of a home accident, to highlight the scale of home accidents in Scotland and the key issues. Currently there is no national system for collation of data on all home accidents that covers all injuries. The only source of valid data is the hospital admission data which deals with only the most acute injuries. The Information Services Division (ISD), part of NHS National Services Scotland has been tasked by the Scottish Government to improve data and information available nationally on injury related attendances at Emergency Departments. ISD will be visiting all health boards in Scotland before the end of the financial year to discuss the data that they currently collect regarding people who present at Emergency Departments with an injury. Key Facts In 2009 there were 236 people who died as result of an injury sustained in the home accounting for 1 in 6 accidental deaths in Scotland. This is almost the same as the number of deaths on the road which were 245. In 2009/10 16,119 people were emergency admission to hospital (i.e. suffered a serious injury) from an unintentional injury in the home (almost 4 times the number of serious injuries on the roads, which were 3,656). Deaths from home accidents account for 17% of all deaths from unintentional injury. Injuries from home accidents account for 26% of all unintentional injuries that result in an emergency admission to hospital. It is estimated that the number of minor injuries requiring some form of medical treatment as a result of an unintentional injury in the home is over 250,000 per year in Scotland. Costs The estimated cost of home accidents per year in Scotland is about 4 Billion. o Average cost of a fatal home accident is:- 1,611,400 o Average cost of a serious injury is :- 45,600 o Average cost of a slight injury is:- 8,300 o Average of all non fatal injuries is:- 16,900 The age groups most at risk of home accidents are; Over 75 s (over 5 times the national average rate) 3

4 Under 5 s (over twice the national rate). Over 75 s In 2009/10, there were 6,931 over 75 s were emergency admissions to hospital as result of a unintentional injury in the home (almost twice as many than all serious injuries, to all ages on Scotland s roads) 90% (6,242) of the injuries were as result of a fall in the home. 1 in 20 of all emergency hospital admissions to over 75 s is as a result of a fall Between 2003 and 2010 the numbers of emergency admissions of over 75 s as a result of an injury in the home rose by 6%. Under 5 s 1 in 16 child deaths in 2009 were due to an unintentional injury. This is similar to the rate during five years spanning Emergency admissions to hospital as a result of an unintentional injury in the home account for 1 in 19 of all emergency hospital admissions for children aged under 15. They also account for over a third of those emergency admissions which are as a direct result of an unintentional injury. In 2009/10 there were 2,093 emergency admissions to hospital of children under the age of five as result of a home accident. Children under 5 are more susceptible to having an unintentional injury in the home. During the period the number of children under the age of five seriously hurt in the home fell by 11% and the 2009/10 figures were 10% below the five year baseline average. 4

5 Home Safety Scotland Home Safety Scotland provides a forum for professionals working in the field of home safety in Scotland, and undertakes specific campaigns and projects to raise public awareness. Membership of Home Safety Scotland consists of home safety officers, community safety officers, health promotion officers and others from various local authorities and health boards, representatives from national organisations and private companies. The group meets regularly to: Develop and implement a home safety action plan. Exchange information and best practice. Organisation of home safety campaigns. Organise seminars. Organise home safety training More information is available through the Home Safety Scotland Website Introduction to unintentional injuries in the home in Scotland Definitions Some useful definitions to items within this report. "Unintentional injury" - The term "unintentional injury" is generally preferred to "accidents" as the latter implies events are inevitable and unavoidable whereas 5

6 a high proportion of these incidents are now regarded as being preventable. Unintentional injuries can occur in any age group, but children and the elderly are more vulnerable. Home Accident - " any accident, injury or poisoning that takes place in the patient's own home or in the garden or grounds of that home, provided that there was no intention (determined by medical staff) on the part of the patient. Other refers to injuries that do not occur in the home or on the road and covers a wide range of causes. It involves injuries that occur in the workplace, sport, leisure, play, and in other buildings that are not a home such shops and schools and non RTA transport accidents. RTA - Road Traffic Accident. Exposure with inanimate mechanical forces this refers to injuries usually in homes resulting from people colliding with fixed fixtures and furniture. Five year baseline average this refers to a five year period from the years 2003/04 to 2007/08 which have been selected by Home Safety Scotland as the established baseline to compare with future trends in injuries. The baseline provides a measurement to establish future targets for injury reduction. As the number of hospital admissions from an unintentional injury can fluctuate from one year to the next, it is important when considering the data to avoid making year to year comparisons. Comparing 3 or 5 year averages is likely to give clearer picture of trends in the data. Whilst no specific targets have been agreed to date, it is likely that setting a specific percentage reduction in emergency admissions to hospital as result of an unintentional injury in the home is likely to assist national and local government, health boards and safety organisations in ensuring resources are targeted most effectively. Source of data: ISD Scotland. ISD Information Services Division is part of NHS Scotland National Services Division. For more information go to the following web link html ISD provide a data base of hospital admissions as result of an unintentional injury. This is the only database which provides a comprehensive comparison of unintentional injuries in Scotland. Whilst there is a national system for the collection of data on road accidents, there is no comparative collection of data for unintentional injuries in the home. The ISD data only covers unintentional injuries that result in a hospital admission in other words the most acute or serious injuries. There is no comparable data base that 6

7 measures the numbers of slight injuries as a result of an unintentional injury. Such injuries treated as out patients or at local surgeries or at home. Analysis of road accident data and the Home Accident Surveillance System (HASS) data collected prior to 2002 suggests that there are between 6 to 8 times as many minor injuries than serious injuries which require hospital admission. Information that is recorded in GP Practice is not specific enough to identify unintentional injuries. Information is recorded on the number of attendances at Accident and Emergency Departments (A&E), however this is limited and does not is not record the reason. Work is underway at ISD to look at how an A&E dataset could be developed. Data project Scotland The Information Services Division has been tasked by the Scottish Government to improve data and information available nationally on injury related attendances at Emergency Departments. ISD will be visiting all health boards in Scotland before the end of the financial year to discuss the data that they currently collect about people who present at Emergency Departments with an injury. In addition to the standard data items that are currently submitted monthly, it is hoped that the following data can also be submitted: Intent of Injury Place of Incident Time & Date of Injury Nature of Injury Cause of Injury Activity when Injured Objects involved in Injury Alleged Perpetrator of Violence By the end of this project (early 2012) they aim to have injuries information from at least 5-10 emergency departments across Scotland routinely submitted. NHS Tayside has volunteered to be the pilot board and they will establish routine data submission from them in the next 3 months. They are keen to realise the benefits of injury surveillance. The team is also working with partnership agencies (e.g. RoSPA, Violence Reduction Unit, Scottish Resilience) to ensure that the injuries information collected by the health boards will be of use to the National Agendas and that any information that ISD produces as a result will be relevant and useful. Indicators The early years Data and Indicators working group (set up to take forward the commitment in the Early Years framework for the Scottish Government) has identified the outcomes that are crucial to all measures of success in the early years and has identified and defined a set of appropriate indicators. A variety of topics have been included such as dental health, obesity and living with parents who smoke. Also 7

8 included at No 34a is: the number of hospital admissions for under-9s due to unintended injuries in the home. Home Accident Surveillance System (HASS) HASS - the Home Accident Surveillance System - and LASS - the Leisure Accident Surveillance System - are two linked databases holding details of home and leisure accidents that caused a serious enough injury to warrant a visit to hospital. They do not include road or workplace accidents. The aim of HASS and LASS is to gain an in-depth understanding of how and why home and leisure accidents occur so that interventions can be put into place to prevent them happening in future. The data is taken from a sample of accident and emergency departments in the UK and national estimates are then calculated using multipliers set for each data year. The smaller the number of HASS/LASS cases for a particular combination of variables, the less statistical confidence we have in the national estimate derived from it. On 2nd May 2003 it was announced that the Department of Trade and Industry (DTI) would no longer fund the collection and publication of HASS/LASS data. To ensure that the existing data will continue to be made available to users, a complete copy of the database up to 2002 has been handed over to the Royal Society for the Prevention of Accidents (RoSPA). For more information go to Unintentional injuries in Scotland Background Across Scotland unintentional injury is one of the main causes of death and emergency hospital admissions (Source ISD Scotland Website Unintentional injury is one of the main causes of death and is one of the more common causes of emergency hospital admissions in children. Unintentional injuries are also a common cause for emergency hospital admissions and deaths among adults. Unintentional injuries may occur at home, on the roads in other activities, work, sport, recreation and leisure activities,. Key statistics In 2009/2010, there were approximately 514,217 patients admitted to hospital in Scotland as an emergency. 8

9 Out of these patients, approximately 12% (61,997) were admitted as a result of an unintentional injury. Approximately 1 in 7 emergency hospital admissions in children is as a result of an unintentional injury. 1 in 9 emergency hospital admissions in adults is as a result of an unintentional injury. 1 in 16 childhood deaths are due to an unintentional injury, This is similar to the average between 2004 and 2008 of 1 in 17 deaths. 1 in 40 deaths in adults is due to an unintentional injury Please note, some patients will present more than once during the year, so the number of patients admitted is slightly lower than the total number of admissions reported above. Source ISD Scotland The numbers of unintentional injuries for both deaths (see table 1, graphs 1a and 1b) and emergency hospital admissions (see table 2 and graphs 2a and 2b) has been decreasing over the last decade. Deaths from unintentional injury The number of deaths as a result of an unintentional injury decreased by 1.5% from 1,367 in 2000 to 1,347 in The rate of fall was higher in the period 1985 to 1995 when the numbers of deaths fell by 27%, since the mid 1990 s the rate of fall has been lower at 8% Table 1 - Deaths as a result of an unintentional injury, all ages, by type of injury, year ending 31 December Total deaths 1,996 1,808 1,456 1,367 1,379 1,340 1,350 1,410 1,310 1,288 1,313 1,283 1,347 Road Home Other Source: General Register Office for Scotland Causes of unintentional injury Deaths in Other unintentional injuries 60% Road Traffic accidents 23% Home accidents 17% 9

10 Graph 1a - Deaths as a result of an unintentional injury 1985 to 2009 result of an unintentional injury 1985 to 2009 by cause. Graph 2 b Deaths as a The numbers of deaths as a result of road and home accidents fell sharply in the late 1980 s and early 1990 s however since the late 1990 s the rate of a fall has flattened. In both cases the number of deaths follows a similar pattern. Of note the number of deaths as result of other causes has shown no decline over the period in question and in fact has show an increase in the last couple of years. 10

11 Emergency admissions to hospital as result of an unintentional injury The number admitted as an emergency to hospital decreased by 6.1% from 66,087 in 1999/2000 to 61,997 in 2009/2010. Table 2 Emergency hospital admissions as a result of an unintentional injury 1999/ / / / / / / / / / /10 Total 66,087 66,249 67,196 64,676 61,070 59,748 59,048 60,832 62,367 62,415 61,997 Road 4,940 4,904 4,883 4,700 4,426 4,373 4,389 4,304 3,902 3,656 3,546 Home 18,809 17,962 17,970 17,329 16,836 16,733 16,441 16,711 16,413 16,890 16,119 Other 42,338 43,383 44,343 42,647 39,808 38,642 38,218 39,817 42,052 41,869 42,332 Scotland 2000 to 2010 Causes of serious unintentional injuries that result in emergency hospital admissions Other unintentional injuries 66% Road Traffic accidents 7% Home accidents 27% Graph 2a Emergency hospital admissions as result of an unintentional injury 2000 to

12 Graph 2b Emergency hospital admissions as result of an unintentional injury 2000 to 2010 by cause. Road Accidents Over this period the number of serious injuries from road accidents resulting in an emergency admission to hospital have decreased year on year. There has been a 28.2% reduction between 2000 and Home accidents Over this period the number of serious injuries from home accidents resulting in an emergency admission to hospital has shown a steady fall. 12

13 There has been a 14.3% reduction between 2000 and Other accidents Over this period the number of serious injuries from other accident causes resulting in an emergency admission to hospital has fluctuated with the most recent figure showing a rise. There has been no real change between 2000 and 2010 figures. 13

14 Introduction Home Safe Home - Home Accident Report Every year in the UK almost 4,000 people die in accidents in the home and 2.7 million turn up at accident and emergency departments seeking treatment. But, because the accidents happen behind closed doors in isolated incidents they rarely attract public and media attention. (Royal Society for the Prevention of Accidents) The only source of national data on accidents in the home in Scotland is the information on deaths and emergency hospital admissions is the NHS Scotland information on home injuries which can be seen at html Here you will find information on deaths and injuries requiring at least one overnight stay in hospital. The data contained in this report is based on this information which is dealing with only the most acute injuries. This is illustrated by the home injury iceberg below. At present there is no collated data available on minor injuries as result of a home accident. This however is only the tip of the iceberg though, as many, many more people will visit their local GP or Accident & Emergency Department. According to RoSPA, based on HASS and LASS data, proportionately in Scotland, almost 1,000 people are seeking some sort of medical attention EVERY DAY, following a home accident. Deaths Home Safety Iceberg 236 (*2009) Emergency Hospital admissions (serious injuries) 16,119 Minor or Slight injuries? Not known Estimated at 250,000 The benefits of taking preventative measures are clear and quantifiable in terms of both health and economic costs, resulting in: The potential to save lives Improved quality of life for all Reductions in the cost of acute care Reduction in medical costs 14

15 Reductions in the cost of continued community support required after hospital discharge. Traditionally, home accidents statistics have been very difficult to find, especially on a local basis. For the UK, you can now get detailed statistical information on Accident and Emergency attendances from the DTI's Home and Leisure Accident Surveillance System (HASS and LASS). However this data base is only up to the year 2002 when HASS and LASS were closed. New statistics are no longer being collected, although RoSPA hosts the database from 1978 to You can now search the HASS and LASS database on-line at Costs of home accidents In 1994 the Transport Research Laboratory (TRL) carried out research to value home accidents using the costs associated with road accidents (Hopkin and Simpson 1996). In 2009 RoSPA commissioned (TRL) to use the most recent data on home accidents casualties to update the figures presented in the earlier study (Walter 2010). The best estimate of the cost of a home accident fatality is the same as that of a road accident fatality. This was based on evidence that the willingness to pay to avoid fatalities is the same in the home as on the road. Table 3. Estimated costs of home accidents. Severity Lost output Value of Avoidance of Medical & Total injury Support Fatal 547,500 1,063,000 1,000 1,611,400 Serious 6,700 35,100 3,800 45,600 15

16 Slight (hospital treated) 3,200 4, ,300 Slight (GP treated) Average no fatal (hospital treated) 4,000 11,300 1,600 16,900 Average no fatal 3,000 8,400 1,200 12,600 Average 3,800 10,000 1,200 15,000 (Values rounded to nearest 10.) It is estimated across the UK that the cost of seriously and slightly injured home accidents (not including deaths and GP treated Casualties is 45.6 billion. The cost proportionately for Scotland will be around 4 billion for serious and slight injuries, with an additional cost of 350 million for home accident fatalities. Table 4. Emergency hospital admissions as a result of an unintentional injury in the home in Scotland / / / / /08 Five year average 2008/ /10p Scotland 16,836 16,733 16,441 16,711 16,413 16,627 16,998 16,119 The number of emergency hospital admissions resulting from a home accident has shown small reduction over the last 6 years. The baseline average is 16,627. The last 2 year average 2008/09 and 2009/10 figure was 16,559 a reduction of 0.4% on the baseline. Graph 4. Emergency hospital admissions as a result of an unintentional injury in the home in Scotland

17 The principal cause was falls in the home, which accounted for 72% of all serious injuries resulting in an emergency hospital admission Table 4a. Principal cause of serious injuries in the home which resulted in an emergency hospital admission in 2009/10. Cause of injury 2009/10 p % Falls 11, Exposure to inanimate mechanical forces 1, Poisoning Other Burns and Scalds Accidental exposure to other and unspecified causes Exposure to animate mechanical forces Overexertion, travel and privation Non RTA Transport Accidents Choking Drowning/Submersion Total 16,179 Analysis by Age The age groups most of risk of a serious injury in the home resulting in an emergency hospital admission are; Over 75 s Under 5 s Both age groups show rates more than twice the Scottish average. Table 6. and graph 6 below show the casualty rates per 1,0000 head of population by age in Scotland 2009/10. Cause of Injury Under all ages 17

18 Home 439 1, ,334 2,372 1,988 6,931 16,119 Population estimate 59, , , , ,260 1,390,615 1,399, , ,684 5,194,615 rate per Population data based on 2009 mid year estimates The red line shows the average rate for Scotland of 31 per 1000) head of population. Over 75 s In the year there were 6,931 emergency admissions to hospital of those over 75 years as result of a unintentional injury in the home (more than twice as many than all serious injuries to all ages on Scotland s roads 2,269 in 2009 Reported Road Casualties Scotland 2009) Between 2003 and 2010 the numbers of emergency admissions rose by 6%. The figures for were 6,931, 4% above the 5 year average base line of 6,

19 46% of all unintentional injuries to over 75 s, is as a result of an injury in the home. 90% (6,242) of these injuries were as result of a fall in the home. 1 in 20 emergency hospital admissions to over 75 s is as a result of a fall. Table 7 and Graph 7. Number of emergency hospital admissions as result of an unintentional injury in the home 2002 to five year average p Table 7a. Principal cause of serious injuries to over 75 s in the home which resulted in an emergency hospital admission in Cause of injury % Falls 6, Exposure to inanimate mechanical forces Accidental exposure to other and unspecified causes Other Poisoning Burns and Scalds Overexertion, travel and privation Choking Exposure to animate mechanical forces Drowning/Submersion Non RTA Transport Accidents HEAT Target As emergency admissions for the elderly population are of particular interest, the Scottish Government has developed a HEAT target which relates to the number of occupied bed days for patients aged 65 and over, who were admitted as an emergency: 19

20 By 2010/11, NHS Boards will reduce the emergency inpatient bed days for people aged 65 and over, by 10% compared with 2004/05. Table 8 Emergency hospital admissions to over 65 s as a result of an unintentional injury in the home five year average over 75's Total over 65 s Over the period the numbers of admissions rose by 6% and the figure of 8919 was 2.4% above the five year average baseline The increasing numbers of older people being admitted to hospital following an unintentional injury in the home is likely to mitigate against achieving the HEAT target. Long term demographic projections. As the make up of the population of Scotland continues to grow older, with increasing numbers of over 75 s in the population, then the long term effect of serious injuries in the home and in particular those resulting from falls, is likely to have a significant impact on heath and social support services for older people in future years. Preventing older people being seriously injured as a result of a fall is likely to be a continuing priority in the next few decades Under fives Children under school age, in particular, spend a lot of time playing at home, inside and outside in the garden. As a result of this, children under 5 are more susceptible to having an unintentional injury in the home. Graph 9 20

21 In there were 2,093 emergency admissions of children under 5 to hospital as a result of home accident. During the period the number of under fives seriously hurt fell by 11% and the figures were 10% below the five year baseline average Table 9 and Graph 9. Emergency hospital admissions to under 5 s as result of an unintentional injury in the home five year average under 5's The main causes of serious injury were as follows; Falls (48%) note- Falls account for 63% of serious injuries to children under 1 year of age 21

22 Exposure to inanimate mechanical forces (21%) Accidental Poisoning (16%) Burns and scalds (9%) Table 10. Emergency hospital admissions to under 5 s as result of an unintentional injury in the home, Scotland. Cause of injury Under all under 5's % Falls , Exposure to inanimate mechanical forces Poisoning Burns and Scalds Exposure to animate mechanical forces Accidental exposure to other and unspecified causes Other Choking Drowning/Submersion Non RTA Transport Accidents Overexertion, travel and privation Analysis by Health Board. 22

23 Table 11. Emergency hospital admissions as a result of an unintentional injury in the home. 2003/ / / / / average 2008/ /10p Scotland 16,836 16,733 16,441 16,711 16,413 16,627 16,998 16,119 The number of emergency hospital admissions resulting from a home accident has shown small reduction over the last 6 years. The baseline average is 16,627. The last average for the last two years is 16,558 approx 0.5% below the five year baseline average. Table 11a. Emergency hospital admissions as a result of an unintentional injury in the home, by NHS board of residence, ranked by reductions data compared with five year average baseline year average 2008/ /10 % change on 5 year average NHS Board of Residence 2003/ / / / /08 Forth Valley 1,172 1,204 1,077 1, , Lanarkshire 1,384 1,349 1,228 1,102 1,077 1,228 1, Grampian 2,267 2,092 2,050 1,982 1,900 2,058 1,814 1, Ayrshire and Arran 1,873 1,825 1,778 1,747 1,805 1,806 1,875 1, Highland 1,460 1,439 1,361 1,320 1,310 1,378 1,390 1, Orkney SCOTLAND 16,836 16,733 16,441 16,711 16,413 16,627 16,890 16, Tayside 1,579 1,662 1,656 1,650 1,648 1,639 1,697 1, Greater Glasgow & Clyde 2,742 2,787 2,746 2,651 2,441 2,673 2,835 2, Dumfries & Galloway Lothian 1,797 1,927 2,083 2,654 2,910 2,274 2,568 2, Borders Shetland Fife 1,172 1,073 1,233 1,128 1,033 1,128 1,214 1, Western Isles p. Provisional Source: ISD Scotland (SMR01) Date: November

24 Analysis by Health Board. (Continued) Across Scotland there would seem to be some wide divergence of trends in the numbers of emergency admissions from an unintentional injury in the home. Overall the numbers of Emergency admissions in Scotland from an injury in the home in 2009/10 was -3.1% below the five year average baseline. Based on the 2008/09 data compared against the five year baseline average: The following areas are showing reductions on the five year average; Forth Valley (-35.7%), Lanarkshire (-19.7%) Grampian (-11.9%), The following areas are showing increases on the five year average; Western Isles (+55.6%), Fife (+8.9%) Shetland (+8.9%) Borders (+8.3%) Lothian (+7.4%) Note of Caution. The data compares one year s data with the longer term 5 year average. There is likely to be, especially in some of the smaller health board areas, a degree of random fluctuation from year to year in the data. The medium term aim of Home Safety Scotland will be to be in a position to compare the latest five years of data with the established five year baseline data to determine more accurate trends in the data. 24