In 2016, unintentional injuries were the third most common cause of death in men above the age of 20, ranking just behind heart disease and cancer (www.cdc.gov). Further, unintentional injuries are the number one cause of death among people between ages 1 and 44 years and cost over $70 billion a year. For urologists, decreasing risk for unintentional injuries is one of the most impactful moments of a patient visit.
Unintentional injuries are generally preventable and fall into two categories: nonfatal or fatal (www.hhs.gov). Men are about twice as likely as women to die from an unintentional injury, with the most common causes of fatal injuries being overdose, motor vehicle accidents (MVA), and falls. By contrast, the most common causes of nonfatal injuries are falls, inadvertent strike, and overexertion. We review the rates and trends of unintentional injury in men and provide simple recommendations for urologists—many of whom see a disproportionate number of male patients—to implement in their practice.
Yearly, an estimated 11 million men are treated in the emergency department for nonfatal unintentional injuries. The rate of nonfatal injury in adult men remained steady at between 9% and 10% from 2001 to 2015. Younger men had the most drastic decreases in nonfatal injuries, while men above the age of 45 experienced an increase in nonfatal injury rates, due to a number of causes including falls. This represents a large area for urologists to make an impact, as elderly patients are commonly seen for conditions such as nocturia, which is a risk factor for falls.
By comparison, increases in drug-related deaths resulted in an increase in the rate of fatal injury in adult men nearly every year from 2009 to 2016, when 98,462 men died secondary to unintentional injury. The rate of fatal unintentional injuries in men from 2001 to 2016 increased.
The rate of occupational injuries has steadily decreased since 2003, with overexertion and falls being the most common causes of nonfatal injury leading to disability. The industries with the highest rates of nonfatal occupational injury in 2016 were health care, construction, public safety, and manufacturing, according to the Bureau of Labor Statistics (www.bls.gov). Industries with the highest rates of fatal occupational injuries include agriculture, construction, transportation, and warehousing. Occupational injury deaths were most common in the 45- to 54-year-old and 55- to 64-year-old age groups.
Men are more likely than women to use nearly every illicit drug and, as such, screening is vital (www.hhs.gov). Moreover, overdose is the number one cause of unintentional home death in almost every male age group (www.cdc.gov). Overdose deaths were most likely to be caused by opioids, heroin, and cocaine (www.cdc.gov). Rates of death were highest in Caucasians, followed by Native Americans and African-Americans (www.cdc.gov).
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