Epidemiological studies of risk factors for injuries in an adult population

Research output: ThesisDoctoral Thesis (compilation)


Injuries are often associated with long-term suffering and lowered functioning, and personal injuries impose a huge burden on medical care and health services in addition to the costs associated with impaired functional ability. Each year in Sweden, falling accidents are experienced by a third of those aged 60 or over and half of those aged 80 or over, while injuries from traffic accidents still account for many of the serious accidents in youths and younger adults. From a public health perspective an increased knowledge about risk factors for injuries is important to decisions influencing the focus of public health prevention strategies. In this thesis, risk factors for various types of injuries were investigated during 2006 and 2007, that is, its associations with sociodemographic variables, previous disease and psychotropic drug use in both men and women. Three of the studies in this thesis were longitudinal in that sense that the levels of the independent variables were measured before the onset of the injury and one study was a case-control study. The studies were register-based and comprised the whole adult population of the county of Scania, Sweden, with various restrictions in age. The results presented in this thesis showed that about one third of the middle-aged population and nearly half of the elderly population had used psychotropic drugs during a period of 1.5 years. Considering their high prevalence, side effects related to the use of psychotropic drugs may be a relevant risk factor for injuries that could be prevented by an increased rational medication use. Psychotropic drug use was also associated with increased odds of injuries from falling and transportation accidents in nearly all age groups in both men and women, even after adjustment for potential confounders. Studying the elderly general population and falling accidents, it was shown that such an effect was the largest immediately after initiating therapy. Psychotropic drug use was also related to increased odds of assault-related injuries and intentional self-injuries during the observation period, with a clear dose-response relationship with diagnosed intentional self-injury. The results further showed that sociodemographic factors generally had weaker associations with unintentional injuries such as falling accidents and transportation accidents, compared to intentional injuries such as assault-related injuries and intentional self-injury. A number of chronic diseases and conditions have in earlier studies been shown to be associated with a higher risk of injuries. In the studies presented in this thesis, psychiatric disease and neurological disease were associated with increased odds of unintentional as well as intentional injuries during the observation period. There were also associations between diseases related to drug- or alcohol abuse and intentional injuries. Such disease-related injuries might be reduced by early identification with correct treatment as well as restrictions with regard to driving. In conclusion, the results presented in this thesis expand the knowledge base on risk factors for injuries in adults. One strength of the results presented is that the data covers the total general population in Scania, which minimises the risk of selection bias. Considering the high prevalence and the often devastating consequences, the field of injury and its risk factors is an important topic for research. An increased awareness of such risk factors might be of help to reduce the number of injuries by affecting the planning of local, regional and national public health intervention programs and strategies.


Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Environmental Health and Occupational Health
  • Health Care Service and Management, Health Policy and Services and Health Economy


  • Epidemiologi, injury, accident, sociodemographic factors
Original languageEnglish
Awarding Institution
Supervisors/Assistant supervisor
  • Maria Rosvall, Supervisor
  • Juan Merlo, Supervisor
  • Henrik Ohlsson, Supervisor
Award date2012 Sep 21
  • Social Medicine and Health Policy
Print ISBNs978-91-87189-18-0
Publication statusPublished - 2012
Publication categoryResearch

Bibliographic note

Defence details Date: 2012-09-21 Time: 09:00 Place: Jubileumsaulan, Jan Waldenströms gata 5, Skånes Universitetssjukhus Malmö External reviewer(s) Name: Laflamme, Lucie Title: Professor Affiliation: Institutionen för folkhälsovetenskap, Karolinska Institutet, Stockholm ---

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Related research output

Birgit Modén, Henrik Ohlsson, Juan Merlo & Maria Rosvall, 2011, In: European Journal of Public Health.

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