Trends in child and adolescent injury mortality in Taiwan, 1986-2006

Objectives: To describe national trends in injury mortality rates for Taiwanese children aged 0-19 from 1986 to 2006. Methods: Data were obtained from the official Vital Statistics System of the Department of Health, Executive Yuan. Injuries were classified by intent and mechanism using ICD-9 criteria. Mortality rates were age-adjusted for each year's standard population. Simple linear regression was used to determine the trends. Results: From 1986 to 2006, the mortality rate per 100,000 for unintentional injuries at ages 0-19 declined by 63% (from 35.3 to 13.2) and the suicide rate declined by almost half (from 1.9 to 1.0). The homicide rate for ages 0-19 combined declined but the homicide rate for children under age 5 increased. Except for homicide in young children, all age groups showed decreasing trends. The 15-19 age group had the highest total death rate due to injury and accounted for 52% of all injury deaths. Motor vehicle injuries (MVI) were the most common cause of death (accounting for 50% of all injury deaths), followed by drowning (17%), suffocation (7%), fire and flames (4%), falls (4%) and poisoning (2%). Suffocation caused 68% of injury deaths in infants. Conclusions: After 1989, the mortality rates for unintentional injuries and suicide declined, but the homicide rate for young children increased. Laws to prevent violence in the home must be enforced, and drowning prevention programs implemented and incorporated into the Children and Adolescent Safety Implementation Program. Preventive efforts should also target MVI and suicide in the 15-19 age group, drowning at all ages, and suffocation and homicide for infants and children under 5 years of age.