The mortality, morbidity and disability caused by injuries are emerging health problems in the developing world. Surveillance is essential to the design of sound injury prevention efforts. The objective of this study was to record detailed information, from six hospital emergency departments (ED), on all accidents and injuries occurring in the Al Qassim region of Saudi Arabia (KSA) during the 3- month period of February 21, 1999 to May 20, 1999.
Methodology
All the hospitals in the Al Qassim region with a capacity of 100 beds or more were selected for the study. The data was collected in the EDs of these hospitals for all the cases presenting with injuries due to road traffic accidents (RTAs), falls, fire (burns), assaults, and drowning. Separate questionnaires were used for each type of injury. Assigned nursing or reception staff of the ED who received training on accurate completion and usage of the forms filled out the questionnaires. EPI INFO was used for data entry and analysis.
Results
A total of 1175 cases were seen in the ED of the six hospitals included in the study. The case break down was: Road Traffic Accidents (RTAs) 705 (59.9%); Falls 249 (21.2%); Assaults 182 (15.5%); Burns 39 (3.3%); and Drowning 1 (0.1%). In-depth analysis was performed for each type of injury. RTAs: The mean (±SD) time of RTAs was 3:30 pm, with most of the accidents occurring between 3:00 to 8:00 pm. Another vehicle was involved in 50.0% of RTAs; pedestrians were involved in 16.5% of RTAs. About 37% of the victims received head injuries. Only 1.6% of the victims wore seat belts. The mean age was 21.6 years; 70% were between the ages of 10 to 39 years and the majority were males (88.8%). Falls: falling accounted for 69.1% of the injuries and slipping for 3 0.9%. For location of falls, staircases topped the list (34.9%) followed by a high place (18.6%). Head injury accounted for 33.7% of the injuries from falls and 10.8% suffered back injury. Improper use of or defective safety harnesses were the main cause of back injuries among workers falling from date trees. Assaults: strangers accounted for 63.7% and acquaintances for 32.4% of assault cases. About 41% of injuries were caused by a heavy object, 26.9% by a part of the body, 22.0% by a sharp metal instrument, and 5.5% by a knife. The majority of the incidents (61.5%) took place in the house, others in a car (15.4%). Burns: A majority (61.5%) of burns took place in the house. The source of fire was equally distributed between a short circuit and the kitchen, at 35.9% each. Males constituted 74.4% of burn victims and females 25.6%. Forty one percent of the cases suffered third-degree burns.
Conclusion
Injuries represent a substantial public health problem in Al Qassim region; RTAs and falls being the most common cause of injuries. More than 40% received serious injuries requiring hospital admission. Use of car seat belts by passengers and safety belts by date tree workers can prevent such injuries. A hospital emergency department based, injury surveillance system can be instituted in other regions of the country as well. Such programs are needed to monitor the trends, and evaluate effectiveness of preventive programs.