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Drowning in Finland: "external cause" and "injury" codes
P Lunetta1, A Penttilä, A Sajantila
1Department of Forensic Medicine, University of Helsinki, Finland. philippe.lunetta@helsinki.fi
Summary
International Classification of Diseases (ICD) external codes (E codes) for drowning underestimate drowning rates. Many drowning deaths are misclassified as traffic accidents, highlighting a need for improved prevention strategies.
Area of Science:
- Public Health
- Epidemiology
- Injury Prevention
Background:
- The International Classification of Diseases (ICD) external codes (E codes) are used to identify the primary event leading to drowning.
- However, E codes alone may not accurately reflect overall drowning rates.
- This study investigates the accuracy of E codes in capturing drowning fatalities.
Purpose of the Study:
- To assess the sensitivity of ICD E codes for drowning.
- To describe drowning deaths misclassified under non-drowning E codes.
- To analyze trends in drowning classifications over time.
Main Methods:
- Utilized mortality data from Finland spanning 1969-2000.
- Electronically searched injury (I) codes and E codes for drowning fatalities.
- Performed cross-analysis of I and E coded drownings and calculated time trends using Poisson regression.
Main Results:
- Out of 13,705 drowning deaths, 644 (4.7%) were not coded as drowning.
- The majority of these misclassified deaths (84.9%) were associated with traffic accidents.
- No significant time trends in drowning classification were observed, even after the ICD 10th revision implementation.
Conclusions:
- Underestimation of drowning rates using E codes alone in Finland is less severe than in other nations.
- A significant proportion of drowning deaths are linked to transport accidents, indicating a critical area for preventive interventions.
- Improved classification and targeted prevention are crucial for reducing drowning fatalities.