India lost 4.30L lives due to unintentional injuries; WHO, MoHFW devise strategy to reduce fatalities by 30%

New Delhi: Nearly 4,30,504 people have lost their lives due to unintentional injuries in India in 2022. These include road traffic injuries, drowning, burns, falls, and occupational injuries. The number of lives lost in the same year due to intentional injuries stands at 1,70,924.

Given the number of lives lost and subsequent consequences including health issues and risk of substance abuse, besides the out-of-pocket expenditure (OOPE), a National Strategy for Prevention of Unintentional Injury has been framed by the WHO in collaboration with the Union Ministry of Health and Family Welfare (MoHFW).

The document proposes comprehensive measures to prevent unintentional injuries. The aim is to reduce 30% of the comprehensive injury burden by 2030. It includes a 30% reduction in fatalities, a 30% reduction in hospitalizations, and a 30% reduction in the burden associated with disabilities due to injuries,

Injury deaths, a global health crisis

Death due to injuries is considered a global health crisis, with a loss of 4.4 million lives per year, of which unintentional injuries account for 3.16 million deaths. The National Crime Records Bureau (NCRB) reveals a similar crisis prevailing in India.

Road traffic injuries account for 45.1% of unintentional injuries, making it the leading cause followed by drowning (8.9%), poisoning (5%), falls (5.5%), and burns (4.7%).

Such injuries lead to permanent disabilities, mental health crises, and an impact on the economic status of the individual and the country. The strategy paper points to an estimated cost of 0.29%-0.69% of the nation’s Gross Domestic Product (GDP) due to unintentional injuries.

Given the massive impact on multiple fronts, the document has detailed the strategies to reduce unintentional injuries and the subsequent impact, with a focus othe n road, drowning, burns, and fall injuries among three sections of the population namely children, workers, and older people.

Road traffic injuries

Road traffic injuries account for 20 to 50 million non-fatal injuries across the globe, affecting low-middle-income countries. Vulnerable road users, including pedestrians, cyclists, and motorcyclists account for more than 50% of road traffic injuries.

The data published by the Ministry of Road Transport and Highways reveals a decadal increase in the fatality rate from 11.1% in 2010 to 12.3% in 2022 per one lakh population. WHO Road Safety Status Report reveals a 15% increase in fatalities, from 1.34 lakh in 2010 to 1.54 lakh in 2021.

According to the MoRTH, 4,61,312 road accidents were reported in 2022, which included 1,68,491 fatalities and 4,43,366 injuries, which involved pedestrians, bullock carts, bicycles, rickshaws, motorized two-wheelers, cars, buses, trucks, etc.

Despite several measures, the mortality ratio is constant at 86% for males and 14% for females. Over-speeding accounts for 75.2% of fatalities, while driving on the wrong side of the road (5.8%) and driving under the influence of alcohol or drugs (2.5%).

Prevention of drowning

With 7,516 km of coastline, besides freshwater and backwater resources, water-related hazards including drowning are high in India.

Drowning accounts for 0.58% of deaths with 0.72% mortality among men and 0.41% mortality among women. The mortality is high (6.2%) among children in the age group of 5-15. Across the globe, the number of deaths due to drowning is 2,36,000 per year.

The number of fatalities between 2016 and 2022, among males has steadily increased, with accidental falls into water bodies accounting for 73.38% of drowning deaths. Deaths due to other incidents account for 25.8% of deaths, while boat capsizing forms 0.7%.

Burn injuries

Around 11 million people around the globe suffer burn injuries annually, with 1,11,000 deaths and over 8 million disabilities. Low and middle-income countries account for 70% of the total burn injuries.

As per the document, despite the lack of sufficient data, 20,789 deaths were reported in India during 2022 due to fire-related accidents. Women in the age group of 15 and 49 are facing three times the risk of men in the same age group.

Accidental fire, electrocution, and accidental explosion are major causes, leading to large financial strains, vocationally challenges, and even social exclusion.

In a major relief, the number of deaths has decreased drastically in 2022 when compared to 2016, but the lack of sufficient data on this is a point to ponder.

Fall incidents among the older and child population

Fall incidents account for the second-highest number of deaths after road traffic accidents. Around 6,80,000 people lose their lives due to falls, while 37.3 million fall incidents happen across the globe.

In India, the fatalities have increased from 1.34% in 1990 to 2.49% in 2019. Fall from trees and the workplace of men and children are considered major challenges in the country.

Several studies point to a 25% higher prevalence of injuries and falls in the 45-59 age group. Unintentional falls are the principal reason for injuries, with 70% of injury cases reported.

The number of falls is higher among women (27%) as compared to men (22%), while the incidents among widows (28%) and those living alone (29%) are worrisome.

Occupational injuries

Work-related causes account for 2 million annual deaths around the globe as per the reports of the WHO and International Labour Organisation (ILO). In India, 17 million nonfatal and 45,000 fatal injuries are reported annually.

As per the estimates of the ILO, 4% of the world’s annual GDP is lost due to occupational accidents and diseases.

Child injuries, a pressing concern

In India, 9.2 deaths per 1 lakh children are reported annually, which is higher than the 8.2 deaths per lakh children globally. Road accidents, drowning, falls, and fire form the principal reasons for fatalities among the child population.

Drowning (6.2%) and road accidents (4.52%) are the two leading causes of death among children, while animal contacts account for 4.39% of deaths, with rabies being the reason, are not reported to the police as per the document.

During 2022, 32,021 deaths under the age of 18 were reported, slightly lower than 32,828 deaths in 2016. Drowning (4360), road accidents (4121), poisoning (1595), burns (913), and falls (924) are the reasons for the deaths, with fatality higher in male children than female children.

Strengthening of health system essential

To ensure the prevention of unintentional injuries across all age groups, the strategy document provides several suggestions on creating awareness, modification of existing legislations, emergency care, increase in the healthcare workforce, allocation of funds for treatments, coordination among different government departments, and monitoring and reporting.