@2024 Afarand., IRAN

---

ISSN: 1027-1457    Scientific Journal of Forensic Medicine 2019;25(1):9-15

Background
Nowadays, intentional and unintentional injuries are a health concern worldwide and of the leading causes of death globally … [1, 2].
Previous Studies
The unintentional injuries around the world are the second leading cause of the years of life lost (YLL) in the age range of 10-19 years [3]. Injuries and violence have grown dramatically in low- and middle-income countries, which could be followed by population and epidemiological and economic transition in these countries [4]. About 95% of the mortality due to injury is in people between the ages of 15-44, as well as in low- and middle-income countries, with only 40% occurring in high-income countries [2, 5, 6]. On the other hand, the World Bank estimates that 10% of the disability-adjusted life year (DALY) worldwide is due to injury and, according to the World Health Organization (WHO), this figure will increase to 20% by 2020 [2, 3] and 5.1 million deaths in 1990 would reach 8.4 million deaths in 2020 [3]. As one of the intentional injuries, murder and homicide are the 4th leading cause of death in the 10-24 age group, with an estimated 200,000 deaths annually in this age group, in which 83% of the victims are men [7]. Intentional injuries are associated with many different aspects of health, such as family health and social well-being; for example, Malawian children, who are more under violence in family or community may have experienced more psychological distress and they are more susceptible in cases of violence, smoking, drug abuse, and self-harm [8]; also, many high-risk behaviors in Zahedan's youth that resulted in intentional and unintentional accidents were more common among students, whose relatives or their families were reported to have the history of drug use [9].
Aim(s)
The aim of this study was to investigate the epidemiological pattern of d intentional and unintentional injuries reported to the forensic medicine center of Zahedan during 2007-2015.
Research type
This research is a descriptive cross sectional study.
Research society, place and time
This study was performed on records in the forensic medicine center of Zahedan, Sistan-Baluchestan province, in the south-east of Iran during 2007-2015.
Sampling method and number
In this center, the information of intentional and unintentional injuries was monthly recorded in live and dead sections. Firstly, after coordinating with the general director of forensic medicine in Zahedan, information of 1,400 records was extracted from the center by systematic sampling during 2007-2015 to determine some factors related to the cause of the accident, demographic information, and information about incidents at the individual level that was extracted from the center and entered into the information form.
Used devices&materials
The study was approved by the Ethics Committee of Zahedan University of Medical Sciences with the code 8351. An information form including demographic information, as well as information on the time, period, cause, and the location of the injury. The classification of the injuries as intentional and unintentional was done according to the International Classification of Diseases (ICD) and health-related problems. In the next stage, the data were coded and entered into the Stata 14 software and analyzed by descriptive statistics (frequency distribution) and Chi-square test.
Findings by Text
The information of 1,400 records of intentional and unintentional injuries was investigated during 2007-2015, of which 40.3% (564 cases) were related to intentional injuries and 59.7% (836 cases) were related to unintentional injuries. Among the intentional injuries, the most common mechanism of injury was quarrel with 74.3%, followed by homicide with 16.1% and suicide with 5.5%, respectively (Diagram 1). Among the unintentional injuries, accidents (71.3%) followed by burns (14.2%) were the most frequent (Diagram 2). The group with age range of 15-29 years had the highest frequency of intentional and unintentional injuries followed by the group with age range of 30-44 and the least frequent was the group above 60 years. The burns in women were higher than in men, but the frequency of other injuries in men was higher than in women. Accidents in illiterate people as well as in Iranian people were more frequent than in non-Iranian people. Burn and suicide were observed more in urbanites. Accidents in in Iranian people were more frequent. Most of the injuries were seen in married people, with the exception of suicide and poisoning that they were more frequent in singles than married ones. The frequency of injuries was more in holidays than other days. The season for accidents and violence was summer and it was winter for other injuries. In terms of injury outcome (die, not die), only 0.9% of the quarrels and violence resulted in death. No significant difference was observed in terms of outcome, so that half of them (45.6%) died and 54.4% survived, which did not show significant difference. Regarding poisoning and suicide, 100% of cases died. In the case of burns, most of the cases died (Table 1). Among the various types of accidents, riding vehicles with 80.6% had the highest number of accidents, and there was a significant relationship between the vehicle used and how the accident occurred (p=0.001). 68.6% of those who used their vehicles was reported as overturning, while the type of accidents of people using heavy vehicles or motorcycles were more likely to collide with each other’s vehicles or with a fixed object. 55.3% of the accidents occurred at night and 35.1% at day and 9.6% at other times such as sunrise or sunset (Table 2).
Main comparison to the similar studies
The results of this study were consistent, in terms of prioritization of injuries, with the results of a study conducted in Kashan [9] as well as Akbari et al.’s research [10] carried out in Semnan, Kermanshah, Ilam, Fars, Markazi, and Bushehr. The frequency of the road accidents in most parts of the world [11-15] and Iran [16-20] are high and according to WHO, it ranks first among other accidents [1] that is confirmed by the results of this study. In a study conducted in Qom [21], more accidents were observed in single people, as well as by motorcyclists with 6%. In the study of Zargar, the most accidents were seen in pedestrians [10], the results of which are different from the results of the present study. According to WHO, most of the road accidents were at the age of 20-29 years [2], which confirmed the results of this study, as well as studies performed in Arak [22] and Hamadan [23]. The distribution of accidents showed that, firstly, the incidence of this injury was higher in men than in women, and secondly, in people, who had the lowest level of education and in terms of the economic and social status were unemployed or at least the simple worker; these results were in line with studies conducted in Yazd [24] and Hamedan [23] province as well as Mobaleghi and Molani’s research conducted in Sanandaj [25] and the forensic organization of Iran [26, 27]. ... [28]. In the present study, the ratio of male-to-female injuries was 4 to 1; it is 2.9 to 1 and 3.26 to 1 in developed countries such as Denmark and Australia, respectively, while it is 4.6 to 1 and 6 to 1 in developing countries such as Singapore and Pakistan, respectively [29-32]. ... [33-38].
Suggestions
It is suggested that in future studies, several sources, such as hospitals, police, and health centers should be used to obtain injury data, so that by overlapping the information, the external credibility and generalizations of the findings to the society will be either increased or less serious and mild events that did not refer to forensic medicine centers will be discovered and traced, and comprehensive and more useful information will obtained.
Limitations
Given that this study only covers the reported accidents to the forensic medicine and does not involve less serious and mild injuries, the results cannot be generalized to the general population of society.
Conclusions
The most commonly injury reported to the forensic medicine of Zahedan during 2007-2015 are accidents and quarrels that occur in most cases at a young age.
Acknowledgments
The authors of this article express their gratitude to the Vice-Chancellor for Research in Zahedan University of Medical Sciences and forensic medicine of Zahedan, Dr. Abdi and Mr. Hadinia, who helped us to conduct this study.
Conflict of interest
There is no conflict of interest.
Ethical Permissions
The current study was approved by the Ethics Committee of Zahedan University of Medical Sciences under the code 8351.
Funding Sources
This research is the result of a research project approved by Zahedan University of Medical Sciences sponsored by Vice-Chancellor for Research of Zahedan University of Medical Sciences.

TABLES and CHARTS

Show attach file