A call for action to declare trauma as a disease

Acute injuries have been considered the “number one killer and major cause of disability of children and young people” for more than 20 years[1] and the “neglected disease of modern society” for more than 50 years[2]. In those countries that have replaced the concept of “accident” by “facts and injuries” and focused on acute injury/trauma as an integral, inclusive and undivided entity, significant progress has been made in the reduction of deaths and disability[3,4]. However, in most countries, acute injuries (trauma) are still typically considered as “accidents” with little research effort committed to studying and reducing this disease. Considering trauma as a disease with an integrated comprehensive approach in the health agenda will allow countries not only to control but to prevent trauma. It is time for all countries to make this transition and declare trauma as a disease.


Trauma (acute injury) has been the leading cause of death in young people for the last 50 years[2]. However, it has received limited attention from the medical community[5] and when reported[6], it is still described by category (vehicle crashes, homicides, suicides, falls, drowning, etc.). Consequently, the healthcare community fails to consider trauma as a single disease. In contrast, while cancer has many different manifestations and aetiologies, healthcare systems have unified their prevention and control strategies. Acute injury (trauma) is defined as the physical damage that results when a human body is exposed to levels of energy (kinetic, thermal, chemical, electrical or radiant, the causal physical agents) in amounts that exceed the threshold of mechanical/physiological tolerance and/or the impairment of normal function resulting from a lack of oxygen (drowning, smoke inhalation or strangulation) or heat resulting in hypothermia (trench foot, environmental hypothermia, freezing, etc.)[7]. This definition of trauma remains valid[8] and there is a clear need to consider the diverse categories of acute injury not as different entities, but as particular aspects of the same disease model. Injuries have been neglected within the global health agenda for many years, despite being largely predictable and preventable[9]. There have been significant improvements in some countries and even though they have not redefined trauma as a disease, they have acted as though it is. For instance, Canada, Germany and the USA have given prominent status to this concept in their health and development agendas. The experience of “zero preventable deaths” from the USA[4] is another good example of this endeavour.

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