International Classification of External Causes of Injuries ICECI

1. International Classification of External Causes of InjuriesICECI International Classification of External Causes of Injuries

2. Relevance of a standard injury classification - International comparability - Not re-inventing wheels - Centralised maintenance International Classification of External a of Injuries

3. ICD-10 and injuries - Conditions diagnoses, Chapter XIX - External causes circumstances, Chapter XX International Classification of External a of Injuries

4. Limitations of ICD - Development for mortality statistics - Not multi-dimensional - Not covering relevant areas of interest - Inadequate basis injury research International Classification of External a of Injuries

5. Design of ICECI • - Multi-axial • - Hierarchical • - Modular • - Pick and choose • Reference classification • All injury • Based on existing classifications • Not replace ICD external causes International Classification of External Causes of Injuries

6. Developers • Center for Disease Control (CDC, USA) • Flinders University (Aust) • Pan American Health Organisation (PAHO) • World Health Organization (WHO) • Health Canada • Testers • Consumer Safety Institute (Nl, secretariate) International Classification of External Causes of Injuries

7. State of affairs • Acknowledged by WHO as a related member of the Family of International Classifications (October 2003 • Installation of Co-ordination and Maintenance Group (April 2003) • Version 1.2 published (July 2004, including index) • Translations (Spanish and French) International Classification of External Causes of Injuries

8. Development of ICECI - Testing (review, case scanarios, field) - Taxonomic review - Index - Translations International Classification of External Causes of Injuries

9. Additional Modules CORE MODULE VIOLENCE Intent Mechanism - full TRANSPORT Mechanism - short Object/Substance Place PLACE Activity SPORTS Alcohol use OCCUP ATIONAL Drug use International Classification of External Causes of Injuries

10. Transport module - Mode of transport - Role of the injured person - Counterpart - Type of transport injury event International Classification of External Causes of Injuries

11. Violence module • - Proximal risk factor for intentional self-harm • Previous suicide attempt • Perpetrator/victim relationship • - Age and sex of perpetrator • Context of assault • Type of legal intervention • Type of conflict International Classification of External Causes of Injuries

12. Place module • Indoor/outdoor • Part of building or grounds • Type of home • Resident of home • Type of medical service area • Type of school • Inside/outside city limits International Classification of External Causes of Injuries

13. Sports module • Type of sports • Phase of activity • Personal countermeasures • Environmental countermeasures International Classification of External Causes of Injuries

14. Occupational module • Economic activity • Occupation International Classification of External Causes of Injuries

15. Hierarchy: a selection from Place of occurrence 1 Home 2 Residential institution 2.1 Home for the elderly 2.2 Nursing home 2.3 Prison 2.4 Shelter for battered women and their children 2.5 Military institution 2.8 Other specified residential institution area 2.9 Unspecified residential institution area 3 Medical service area 3.1 Hospital 3.2 Outpatient clinic, health centre 3.3 Health professional’s office 3.8 Other specified medical service area 3.9 Unspecified medical service area International Classification of External Causes of Injuries

16. Derivatives of ICECI - Less resourced countries - IDB Coding manual in Europe (EU) (ED) - Burn injuries - Spinal cord injuries - CDC’s short version - Minimum Data Sets in Europe (EU) International Classification of External Causes of Injuries

17. Use of ICECI for surveillance - Select data elements (incl. modules) - Select level of detail per data element - Add data elements not external cause related International Classification of External Causes of Injuries

18. ICECI and the IDB Coding Manual (1) • Core data set ICECI • - Intent (level 1) • Place of occurrence • Mechanism of injury (full) • Activity when injured • Object/substance producing injury • Excluded • - Alcohol + drug use International Classification of External Causes of Injuries

19. ICECI and the IDB Coding Manual (2) • Violence module • -Proximal risk factor (level 1) • Previous intentional self harm • Relation victim/perpetrator (level 1) • - Sex and age of perpetrator • - Context of assault (level 1) • Excluded • - Type of legal intervention • - Type of conflict International Classification of External Causes of Injuries

20. ICECI and the IDB Coding Manual (3) Transport module - Mode of transport - Role of injured person - Counterpart Excluded - Type of transport injury event

21. ICECI and the IDB Coding Manual (4) • Sportsmodule • - Type of sports • Excluded • Phase of activity • Personal countermeasures • Environmental countermeasures • Excluded • Place module • Occupational module International Classification of External Causes of Injuries

22. Use of ICECI - Emergency Department surveillance - Other surveillance - Surveys - …………... International Classification of External Causes of Injuries

23. Use of ICECI: some examples - Sport module NHIS data (USA) - Violence data (3 EU-countries) - Electronic Medical Record (Indonesia) - Research project Perth - Personal accidents (Insurance company, It) - Internat. course on surveillance (Sw) - EDs British Columbia (Can) International Classification of External Causes of Injuries

24. Future activities - Minor updates (per 1, 2 years) - Major updates (per 5, 10 years) - Translations - Training module - Additional data elements/modules - Technical development International Classification of External Causes of Injuries

25. International Classification of External Causes of Injuries

26. Website www.ICECI.org International Classification of External Causes of Injuries