Non-occupational accidents in Switzerland : updated extrapolation and cost calculation. Prevention work is based on a knowledge of the extent of the accidents that occur. Since existing data sources do not cover all accident areas or the entire Swiss residential population, it is impossible to determine conclusively just how many accidents happen in the areas of road traffic, sports, home and leisure. To close any gaps in the data and to identify the full extent of the accidents that occur in Switzerland, an initial extrapolation was made of the accidents in 1997 and then updated annually until 2010. The cost to society incurred as a result of accidents is also a key criterion when evaluating the importance of accident prevention in the field of public health. The economic cost of accidents in the areas of traffic, sports, home and leisure was last calculated in 2007. In 2008, the bfu decided to update the outdated databases and to create a revised extrapolation. This revision of the extrapolation meant that the material and economic costs also had to be recalculated. The extrapolation of the people injured is based on a household survey commissioned by the bfu and conducted from January to December 2011 using computer-assisted telephone interviews. The survey was based on a random sample stratified proportionately by household size and agglomeration size and disproportionately by economic region. The gross sample included 30,000 Swiss households. In each case, the interview focused on one person per household who provided information on all household members. The response rate amounted to 50% (15,064 households). On completion of the fieldwork, data on more than 34,500 people had been collected. A combined weight based on various factors was calculated for data analysis. The study design (disproportional stratification) was thus taken into account and corrected for non-response at household level. In addition, a individual weight based on the structure of the Swiss population by major region, gender and age was created. A «calibration weight» compensated for any clearly noted memory effects. For the extrapolation, the sample was finally extrapolated for the entire Swiss population by means of a population weight based on the following characteristics: major region, age group and gender. In the household survey, the questions focused on the activities at the time of the accident, the accident location, the mechanism of the accident and any objects and substances involved for all accidents. The involvement of a vehicle in the accident is a key criterion for traffic accidents. These vehicles may have been used by the injured persons themselves or by other parties in the accident. To ensure that traffic accidents are allocated to road traffic accidents, they must have happened on a public road. If a cyclist crashes at home on his driveway, this is indeed a traffic accident but not a road traffic accident. An accident of this type is classified as part of the home and leisure sector and recorded as a «transportation accident». If no means of transport is involved in the accident, this is not considered to be a traffic accident. A pedestrian who falls on a public street or pavement has thus not had a road traffic accident. Such accidents are likewise allocated to home and leisure accidents. To classify sports injuries, the activity at the time of the accident is key: if victims specify that they were playing sports, the accident is classified as a sports accident. The definition of sports injuries is very broadly, ranging from sports to physical activity. For example, «going for a walk» or «using a kickboard scooter» is classified as sports. Sports injuries can also occur on the road. To avoid these “sports accidents in road traffic” being counted twice, they are counted only in the road traffic accidents. To determine the number of fatally injured accident victims, information from the Swiss mortality statistics of the Federal Statistical Office are combined with the bfu’s statistics on fatal sports accidents. In the latter, fatal sports accidents have been systematically recorded since 2000. The data sources used are from the data collected by various accident prevention partners (e.g. the Swiss Alpine Club SAC and the Swiss Life-Saving Society SLRG) as well as press releases from the Swiss News Agency sda. The economic costs consist of material costs, to which market prices apply, and intangible costs for which no market prices are available (Figure 1). Material costs include medical treatment costs, loss of production, cost of refilling vacant positions, administrative costs, property damage, as well as police and legal costs. For the calculation of material costs, the sum total of the work done by the absentee including consumption losses are taken into account as part of the costs (gross loss of production). Intangible costs are determined by the population’s willingness to avoid the intangible c onsequences of accidents (especially pain, suffering and loss of quality of life). Since the loss in personal consumption is included in the willingness to pay, only the collectively supported production loss is taken into account when calculating the economic costs (net loss of production). For the calculation of material and economic costs, the quantity structure (bfu’s extrapolation of accident figures) and the value structure (cost per accident victim) are combined. According to the revised extrapolation, over 1 million people were injured in 2010. 38,000 of these were severely injured; unfortunately, there were also approximately 1,800 disability cases and 2,156 deaths (Table 1 ). More than half of all accidents resulting in injuries occurred in home and leisure (53%), around 40% in sport and 8% in road traffic. The highest proportion of serious injuries and disability cases, however, can be found in road traffic (8%), the lowest in sports accidents (3%). 4 out of 5 deaths occur in the field of home and leisure. Half of the 2,156 fatalities were men (51%). If the accident areas are viewed separately, other proportions become apparent: in road traffic, 75% of the fatalities are men, the figure in sports is as high as 80%. Only in the home and leisure accidents among senior citizens (65 and older) do women clearly outweigh men with 881 fatalities compared to 616 men. Among those injured, 53% of the victims are male. The highest percentage of men is found in sports injuries (64%), the lowest in the home and leisure accident sector (44%). Around 2% of all fatalities are children and young people below the age of 16. As age increases, so does the number of fatal accidents. Senior citizens had the highest share of fatalities at 75%. The percentage is even as high as 86% for home and leisure accidents. In 2010, the material cost of non-occupational accidents amounted to CHF 10.4bn (Table 2). Since material damage was calculated only for road traffic accidents, 42% (or CHF 4.4bn) of the material-cost totals is attributable to road traffic, followed by home and leisure accidents with 37% (or CHF 3.9bn) and sports accidents with 21 % (or CHF 2.2bn). With regard to material costs, property damage and severe injuries are the most significant. The economic costs amount to CHF 47.5bn and largely comprise the intangible costs as a result of pain and suffering (Table 2). The economic costs are mostly due to home and leisure accidents (47% or CHF 22.5bn), while sports and road traffic accidents account for only 31 % (or CHF 14.6bn) and 22% (or CHF 10.5bn) respectively of the costs incurred. In relation to economic costs, the cost of severe, slight or moderately severe injuries are particularly relevant. This study has updated key basic elements for the bfu’s prevention work. The accident figures and accident costs pinpoint where action is required and what prevention goals must be determined. Based on economic costs, a comparison can be made between the extent to which accidents impact society as opposed to other health problems such as tobacco and alcohol consumption. Furthermore, these costs enable the cost-effectiveness of prevention measures to be assessed in the context of cost-benefit analyses. (Author/publisher)
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