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

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

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

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

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

6. International Classification of External Causes of Injuries 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)

7. International Classification of External Causes of Injuries 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)

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

9. CORE MODULE Intent Object/Substance Place Activity Alcohol use Drug use Mechanism - short Mechanism - full VIOLENCE TRANSPORT PLACE OCCUPATIONAL SPORTS Additional Modules

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

11. International Classification of External Causes of Injuries 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

12. International Classification of External Causes of Injuries 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

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

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

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

16. International Classification of External Causes of Injuries 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)

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

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) Sports module -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)

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

25. International Classification of External Causes of Injuries

26. Website www.ICECI.org