Accidents in daily life account for just over half of these deaths (approximately 50%), representing more than 3.5% of total mortality.

Given the continuing high number of deaths, trauma remains a major public health problem.

Source

Mortality statistics in France are derived from the national database of medical causes of death, compiled by the Center for Epidemiology of Causes of Death (CépiDc, Inserm) based on death certificates.

Coding of causes of death

The underlying cause is determined for each death according to the coding rules of the WHO’s International Classification of Diseases (ICD). This is defined as: the disease or injury that triggered the pathological process leading directly to death, or the circumstances of the accident or violence that resulted in the fatal injury. Medical causes of death are coded by CépiDc according to the ICD, Ninth Revision (ICD-9) between 1979 and 1999, and Tenth Revision (ICD-10) starting in 2000. 

Coding is done in two steps. First, the ICD-10 code corresponding to all causes of death listed on the death certificate is assigned. Second, the underlying cause of death is selected and coded.

Analysis of deaths due to trauma

The analyses were conducted based on the underlying cause of death—the event that triggered the chain of events leading to death and which can be addressed to prevent it.

As an exception, deaths from accidental falls, which are underestimated by this type of analysis due to the structure of the ICD-10, were analyzed as “multiple causes,” by adding to deaths with the underlying cause “falls ” (codes W00-W19) deaths coded both as the underlying cause “exposure to unspecified factors” (code X59) and as the associated cause “fracture of the femur” (code S72).

Methodological Limitations

The main limitations of these results stem from the accuracy of the death certificate and the difficulties associated with coding causes of death due to trauma:

• whether the trauma was accidental or intentional is not always specified on the death certificate. Thus, it has been agreed that drownings and poisonings without an indication of intentionality have been coded as accidental since 2000, which likely leads to an overestimation of these accidents.

• The lack of precision in death certificates regarding accidents—affecting nearly one in five CVDs—leads to an underestimation of CVD-related deaths. Furthermore, the circumstances of the accident (location, activity being performed, product involved) are not recorded in the CépiDc database. 

• Work-related accidents cannot be distinguished from AcVCs and are therefore included in these results, which likely corresponds to a few hundred deaths.

Definitions

Most of the definitions below were established by the World Health Organization (WHO).

Injuries are divided into two groups:

• unintentional injuries, i.e., accidents, which include transport accidents (including road traffic accidents) and other accidents (accidents of daily life and work-related accidents);

• intentional injuries or violence, which include suicides, homicides, law enforcement interventions, and acts of war.

Accidents: events beyond human control, characterized by the sudden release of an external force, which may result in bodily injury. They include transportation accidents, accidents of daily life, and workplace accidents.

Land transport accidents: accidents involving a land vehicle occurring on or off public roads. They include railway accidents, motor vehicle traffic accidents, and accidents involving vehicles off public roads.

Accidents of daily life (AcVC): unintentional injuries that are neither traffic accidents nor workplace accidents. AcVCs are generally classified by location or activity:

• domestic accidents, occurring at home or in the immediate vicinity: garden, yard, garage, and other outbuildings.

• accidents occurring outdoors: in a store, on a sidewalk, near the home, etc. 

• school accidents, including accidents occurring on the way to or from school, during physical education classes, and on school grounds.

• Sports accidents. 

• Vacation and recreational accidents.

Accidental fall: an accident occurring when a person falls suddenly due to the force of gravity and strikes a surface at the same level or a lower level.

Accidental suffocation: mechanical asphyxia caused by internal or external obstruction of the airways. Internal obstruction can occur in various ways: by the ingestion of a foreign object or food into the pharynx or trachea, or by aspiration of stomach contents. External obstruction may be due to the covering of the nose and mouth, a lack of oxygen in the room, or strangulation.

Accidental drowning: respiratory failure resulting from accidental submersion or immersion in a liquid environment. This definition does not include drownings and submersions resulting from a boating accident or a natural disaster.

Accidental poisoning: a harmful physiological effect resulting from ingestion of or exposure to medicinal substances, illicit drugs, chemicals, or gases and vapors. Accidental drug poisoning includes incidents related to the use of medications and biological products during medical and surgical procedures, accidental drug overdose, prescription errors, or inadvertent ingestion. This definition does not include adverse effects of medications that were prescribed and administered correctly at therapeutic or prophylactic doses.

Fire-related accident: an accident caused by fires and by exposure to the ignition of a substance, flames, and smoke. Fire-related deaths include deaths from burns and asphyxiation caused by fire.

Intentional trauma or violence: the intentional threat or use of physical force against oneself, another person, a group, or a community that results in trauma, death, psychological injury, impaired development, or deprivation.
These can be divided into several categories: self-inflicted violence (suicide or self-harm), interpersonal violence (against children, partners, the elderly, or strangers), collective violence (acts of war), and other intentional trauma (law enforcement intervention).

Suicide or self-inflicted injury: traumatic injuries or poisoning deliberately inflicted by an individual.

Homicide or assault: traumatic injuries inflicted by a third party with the intent to injure or kill, by any means.

Injuries of undetermined intent: all injuries for which the accidental or intentional nature has not been determined.