Injuries and the risk of disability in teenagers and young adults.

OBJECTIVE To examine the risk of disability from unintentional injury in teenagers and young adults. METHODS Analyses of data from the National Child Development Study, a follow up study of 98% of all children born in England, Scotland, and Wales in one week in March, 1958. In 1981, 12,537 study participants, 76% of the original cohort, were asked about unintentional injuries since age 16 years requiring hospital treatment, and whether these injuries resulted in permanent disability. RESULTS 62% of men and 26% of women reported at least one accident since age 16 resulting in injury that required hospital treatment. Of these accidents, 3.2% caused permanent disability. The risk of disability increased with accident frequency. Injuries requiring hospital admission carried the highest risk of disability (9.7%). However, 54% of permanent disability reported by men and 74% reported by women resulted from injuries treated as outpatients. Road traffic accidents caused 42% of admissions and 31% of disability. Fractures constituted 21% of all injuries but were responsible for 32% of permanent disabilities. Of the permanent disabilities resulting from work related accidents, 82% involved the hand. Of the permanent disabilities resulting from accidents in the home, 32% involved the hand. CONCLUSIONS The targeting of prevention strategies towards the major causes of injury mortality may have a smaller impact on population levels of injury related disability. Non-life threatening injuries, in particular injuries to the hand and limb fractures, resulting from accidents in the workplace, the home, and during sports, make a significant contribution to the prevalence of permanent injury related disability in young adults.