Mortality due to unintentional injuries in the Netherlands, 1950-1995

Objective. To detect and explain changing trends in incidence, case fatalit y rates, and mortality for unintentional injuries in the Netherlands for th e years 1950 through 1995. Methods. Using national registry data, the authors analyzed trends in traff ic injuries, occupational injuries, and home and leisure injuries. Results. Between 1950 and 1970, mortality from unintentional injuries rose, reflecting an increasing incidence of injuries. This was followed by a sha rp decline in mortality due to a decreasing incidence combined with a rapid ly failing case fatality rate. Starting in the second half of the 1980s, th e decline in mortality leveled off as the incidence of several injury subcl asses once again rose. The observed trends reflect several background facto rs, including economic fluctuations (influencing exposure), preventive meas ures (reducing injury risk and injury severity), and improvements in trauma care (lowering the severity-adjusted case fatality rate). Conclusions. Injury mortality can be reduced through measures that lower in jury risk, injury severity, or severity-adjusted case fatality rates. Begin ning in the mid-1980s, such compensatory mechanisms have fallen short in th e Netherlands, New policies are needed despite the impressive reductions in mortality already reached.