Quarterly Digest
Volume 8 - Number 1 & 2 December 1998

• Preface
  
  
• Map: B.C. Local Health Areas
  
  
• British Columbia: Local Health Areas (LHA) within Health Regions
  
  
• Vital Event Statistics - January 1, 1998 - March 31, 1998
  (Population, Livebirth, Death, Marriage, Stillbirth, Infant Deaths)
  
  
• Selected Birth Statistics - January 1, 1998 - March 31, 1998
  (Low Birthweight, Preterm, Teenage Mother, Elderly Gravida, Cesarean Section)
  
  
• External Causes of Death - January 1, 1998 - March 31, 1998
  (Accidents - [Motor Vehicle Accidents, Poisoning, Falls Burns/Fire, Drowning, Other], Suicide, Homicide, Other External Causes)
  
  
• Neoplasm Deaths - January 1, 1998 - March 31, 1998
  (Lung, Female Breast, Colorectal, Other G.I., Female Reproductive, Prostate, Blood/Lymph, Other Malignancy, Nonmalignant and Unspecified)
  
  
• Heart Disease Deaths - January 1, 1998 - March 31, 1998
  (Rheumatic/Valvular, Hypertension, Ischemic, Conductive & Dysrhythmic, Heart Failure, Congenital, Other)
  
  
• Respiratory Disease - January 1, 1998 - March 31, 1998
  (Emphysema, COPD, Pneumonia, Influenza, Asthma, Lung Disease from External Agents, Pulmonary Fibrosis, Other Respiratory)
  
  
• Other Selected Death Statistics - January 1, 1998 - March 31, 1998
  (Diabetes, Alcohol-Related, AIDS, Other Infectious Disease, Cerebral and Other Vascular, Liver Disease, Amyotrophic Lateral Sclerosis and Multiple Sclerosis, Alzheimer's Disease, Parkinson's Disease)
  
  
• Vital Event Statistics - April 1, 1998 - June 30, 1998
  (Population, Livebirth, Death, Marriage, Stillbirth, Infant Deaths)
  
  
• Selected Birth Statistics - April 1, 1998 - June 30, 1998
  (Low Birthweight, Preterm, Teenage Mother, Elderly Gravida, Cesarean Section)
  
  
• External Causes of Death - April 1, 1998 - June 30, 1998
  (Accidents - [Motor Vehicle Accidents, Poisoning, Falls Burns/Fire, Drowning, Other], Suicide, Homicide, Other External Causes)
  
  
• Neoplasm Deaths - April 1, 1998 - June 30, 1998
  (Lung, Female Breast, Colorectal, Other G.I., Female Reproductive, Prostate, Blood/Lymph, Other Malignancy, Nonmalignant and Unspecified)
  
  
• Heart Disease Deaths - April 1, 1998 - June 30, 1998
  (Rheumatic/Valvular, Hypertension, Ischemic, Conductive & Dysrhythmic, Heart Failure, Congenital, Other)
  
  
• Respiratory Disease - April 1, 1998 - June 30, 1998
  (Emphysema, COPD, Pneumonia, Influenza, Asthma, Lung Disease from External Agents, Pulmonary Fibrosis, Other Respiratory)
  
  
• Other Selected Death Statistics - April 1, 1998 - June 30, 1998
  (Diabetes, Alcohol-Related, AIDS, Other Infectious Disease, Cerebral and Other Vascular, Liver Disease, Amyotrophic Lateral Sclerosis and Multiple Sclerosis, Alzheimer's Disease, Parkinson's Disease)
  
  
• Summary Article:
  Animal Caused Fatalities
  British Columbia, 1969 to 1997.
  by R. Armour, J. Macdonald
  • Glossary
    
    
  • Contributors' Note
    
    
  • Readers' Note
    
    
  
  

Preface

This Quarterly Digest marks the eighth year of providing current vital event data through the British Columbia Vital Statistics Agency. This "Quarterly's" standard tables are for the first and second quarters of 1998 and represent the first 1998 British Columbia birth, death, marriage and stillbirth statistics to be provided in publication.

This first issue for 1998 is editions one and two in order to "close the gap" in delayed publication. This Agency has now accomplished the development of our new system - VISION. Research staff generally involved in "Quarterly" production have had to turn instead to conversion of historical data, and edit rules for data quality necessary to move from old system to new. It was necessary as well to wait for delayed 1998 data that had backed-up during the transitional period. Adding to publication delay was the need to adjust programs and population files to reflect new "small" Local Health Areas - also a first as provided in this publication. Apologies to our readers for any inconvenience this delay may have caused.

In response to our reader survey, there are several new features and conditions that have been added to this year's death summary tables. As noted above, all counts are now provided for new "small" areas. In addition, respiratory disease mortality now has its own table with pneumonia and influenza reported separately, and new categories of asthma, lung disease due to external agents, and pulmonary fibrosis. Male reproductive cancers now only report cancer of the prostate and other infectious diseases (in addition to AIDS), amyotrophic lateral sclerosis & multiple sclerosis, Alzheimer's, and Parkinson's disease have been added to the "other selected death statistics" table.

Due to the fact that Vital Statistics Agency files are continually being updated, totals compiled by addition of the annual quarters will not correspond exactly to year-to-date and year-end figures. For the same reason, depending on the date the data are extracted, there will be differences in numbers presented in this year's Quarterly Digests and those eventually reported in the Vital Statistics 1998 Annual Report. Therefore, the numbers provided in this report should be considered provisional. Finally, the usual cautions regarding random fluctuations in values, particularly those involving small numbers, must be noted.

A large proportion of British Columbia's economy is land-based. As well, this province is blessed with an abundance of natural beauty, parks, relatively undeveloped wilderness, and a rich array of wildlife. Recreational, transportation, and commercial pursuits bring may people into contact with animals - domesticated and wild, sometimes with fatal results. These fatalities often draw a considerable amount of public interest that results in queries to this agency that are not straightforwardly met. The article in this issue examines deaths that were caused by animals from 1969 to 1997 and implicates horses (the most frequently dangerous), bears, cougars, moose, deer, orca, bees, wasps, unspecified insects, snakes, mules, dogs, and cattle/cows in human fatalities. Although relatively few in number (133), these deaths raise issues around prevention and safety that might stimulate additional review.

Requests for changes, suggestions for article topics or contributions continue to be welcome. Your support and input into this publication is greatly appreciated.

British Columbia
Local Health Areas

British Columbia:
Local Health Areas (LHA)
within Health Regions

Animal Caused Fatalities
British Columbia, 1969 to 1997

Introduction

The province of British Columbia is known around the world as an area of natural bounty. Much of its landbase remains in an undeveloped state, or is developed only to the extent required for the agricultural, logging or mining purposes, which comprise a substantial proportion of the province's economy. Each year, thousands of people venture into B.C.'s great outdoors for recreational or commercial activities. Inevitably, in these pursuits, humans, at times, will come into contact with the animal inhabitants of British Columbia (both domesticated and wild). The outcome of these encounters sometimes prove to be lethal for human beings. These fatalities often draw a considerable level of public attention and consequently, this agency frequently receives requests for statistics on animal caused deaths. Consolidating this data into the following report may assist readers in gaining a new perspective on these events.

Methodology

The data for this study were compiled initially through an electronic search of death records maintained by the British Columbia Vital Statistics Agency, for all animal caused deaths in B.C. for the years 1969 to 1997. The search was conducted by looking for underlying causes of death that included human involvement with animals. These are distinguishable as external cause codes (or "E-codes"), meaning that death occurred as the result of an external force or circumstance rather than from an internal disease process. For the years 1969 to 1978, E-codes were drawn from the then-current American adaptation of the 8th revision of the International Classification of Diseases (ICDA-8). From 1979 to the present, the 9th revision of ICD has been in use. The following E-codes were electronically marked:

ICDA-8:	E815. - ;	E820. - ;	E905. - ;	E906. - ;	E929. - ;
ICD-9:	E815. - ;	E821. - ;	E822. - ;	E828. - ;	E827. - ;	E905. - ;	E906.0 - E906.8

Since most of the selected ICD codes that are specific to animal involvement do not differentiate by species, all original documents were identified and examined. Likewise, codes to identify vehicular accidents resulting from hitting an animal do not differentiate the animal from a hydro pole, rock, median, etc. Thus, it was necessary to manually examine hundreds of death records. Through this process, the 133 records that are the basis of this report were identified.

Animal Caused Fatalities by Species

The following animals were implicated in human fatalities in the province of British Columbia: bears (black and grizzly), cougars, moose, deer, orca, bees, wasps, unspecified insects, snakes, horses, mules, dogs and cattle. For the purposes of this study, cattle were further subdivided into bulls and cows/steers in order to more accurately reflect the injuries involved. Additionally, there were 2 incidents in which the animal involved was not identified (in these 2 situations, cars swerved to avoid an unknown/unspecified animal on the road, resulting in a fatal MVA).

• In the 29 years from 1969 to 1997, 133 people died as a result of encounters with animals.

• Since 1969, there was at least one death in every year with the highest annual counts being 10 (in 1987 and 1992).

• The most dangerous animal, in terms of fatalities, was the horse, accounting for slightly over 35% of animal caused deaths.

• The 133 deaths were equally divided between domestic and wild animals (49.6% and 50.4% respectively).

Wildlife Fatalities

• The victim of an animal-caused death was 2.5 times more likely to be male.

• With the exception of infants less than one year of age and age 80-84 seniors, animals were involved in the death of individuals of all other ages.

• The highest rates and numbers occurred among people age 15 to 24.

Bears

"British Columbia has about one-quarter of all black bears in Canada and half of all grizzly bears". Both species are found throughout the province with the exception of Vancouver Island and the Queen Charlottes where there are no grizzlies. Grizzlies are also few or none in the heavily settled Lower Mainland or in the dry southern areas of the province (Wildlife Branch, Ministry of the Environment, Lands and Parks).

In the 29 years between 1969 and 1997, 19 people were killed in B.C. due to encounters with bears. One of these "encounters" was not actually a bear attack, but a motor vehicle accident resulting from a collision with a bear on the highway. Seven deaths were attributed to grizzly bears, 5 to black bears, and in the case of 7 other deaths, the species was not specified or identified.

Unlike cougars, where all deaths involved children, bears killed people of all ages - the youngest was 5 years of age and the oldest was 77. Of the 19 deaths, only 2 were children, 2 more were in their teens, and all others were adults. Not surprisingly, because men are more likely to be working or participating in recreational activities in the wilderness, they were the overwhelming majority of deaths (16 of 19).

According to the Wildlife Branch (Ministry of Environment, Parks and Recreation), bear attacks are most likely to occur when the animals are active - usually from May to October and especially during August and September. With the exception of 1 death in January from grizzly attack, deaths closely conformed to this expected pattern. All others occurred between May and November. There appeared to be a seasonal difference among the attacks in which the bear species was identified, with black bear attacks earlier in the year - primarily May to July, and grizzly-caused deaths most frequent in September to November.

Deaths from bear encounters were scattered throughout the north-south length of the province between the central interior and the Alberta border. There were no deaths in coastal areas (see map). With the exception of 3 deaths (rural community, Native reserve, mining camp), all others occurred in uninhabited wilderness.

Cougars

In the past twenty-nine years there have been a total of 5 deaths resulting from encounters with cougars. There was a noticeable similarity in these events in that they all involved children (the one adult fatality began as an attack on a child and the victim attempted to intervene). Provincial wildlife management experts note that this is the common pattern in cougar attacks, and speculate that a child's small size, voice pitch and rapid, sudden movements may mimic the triggers that attract cougars to their animal prey.

All incidents occurred in rural areas and again, this follows the usual pattern of human encounters with cougars. While there have been several well-publicized examples of cougars wandering into urban areas, no fatal human-animal encounters have ever resulted from these episodes.

According to the B.C. Ministry of the Environment, the cougars of British Columbia inhabit predominantly the southern third of the province. All of the cougar-related fatalities on record fell within this range. Three of the 5 deaths from cougar attacks occurred in the northwest region of Vancouver Island. The remaining 2 deaths occurred inland in the area bounded by Princeton, Merritt and Lytton (see map). One death took place in January; this was one of the inland fatalities, and one might speculate that the animal involved in this incident was seeking prey in a season when game is relatively scarce. The remainder of the fatal attacks occurred in early to late summer. There are probably two factors involved in this timing. First, this is the time of year when humans often venture into cougar habitat (i.e. wilderness areas). Second, it is during this time of year that "adolescent" cougars separate from their mothers and wander, seeking unoccupied territories in which to establish themselves. Wildlife specialists note that this is commonly the time in a cougar's life-cycle when it will come into conflict with humans.

Other Wildlife Species

Combined, deaths due to bear and cougar encounters comprise the greatest number of wildlife-related fatalities and probably draw the greatest amount of public attention.

However, as previously noted, other species are implicated and of these, moose were involved in the next largest group of fatalities - 19 in total during the time period under study. Uniformly, these deaths were the result of moose-motor vehicle collisions. The average weight of an adult male (bull) moose ranges from 542 kg. - 725 kg. Females (cows) can weigh between 364 kg. and 591 kg. It is not difficult to envision a collision with one of these animals having drastic consequences for both humans and moose. In B.C., the majority of these accidents occurred in or around Prince George; of the 19 deaths, 11 were registered in Prince George (59%). Two events were registered in Smithers and 2 more in Terrace. These three adjacent areas accounted for 79% of all moose related fatalities. The remainder occurred in other scattered regions of the province, most at approximately the same latitude or further north. There was one anomalous more southern incident that occurred west of Princeton on Highway 5.

These fatalities were seasonally scattered throughout the year. The only months in which there were no recorded events were January, March and April. The majority of the accidents occurred between May and December (18), with July and August alone accounting for almost half of the total (6 in July and 3 in August). The remaining fatality occurred in February. Moose are known to wander from the bush onto roads and railway beds to escape deep snow in the winter and bugs in the spring and summer. This may account for the high number of incidents clustered in the summer months.

Deer were the cause of only 5 fatalities from 1969 to 1997. These all resulted from motor vehicle accidents. All of them occurred in the southern regions of the province, no further north than Peachland in the Okanagan Valley. The lower number of fatal injuries is likely not indicative of deer being more "streetwise", but rather, probably reflects the much smaller bulk of a deer as compared to that of a moose (the weight of an adult buck will generally not exceed 136 kg.). Additionally, one of these individuals was riding on a motorcycle which increased the victim's level of vulnerability. These fatalities were more clustered seasonally, occurring in the spring and early summer.

For the purposes of this study, we have included insects as "wildlife" and they figured fairly significantly in the overall numbers. Over the 29 years, there were 16 fatalities as the result of anaphylactic reactions to insect venom. Of these, 7 were wasp stings, 5 were bee stings and the remaining 4 were unidentified insects. Not surprisingly, all of these episodes were clustered in the period from July to October when insects are most active. Half of all the incidents occurred in August and another 25% occurred in September.

Interestingly, although stinging insects are found throughout the province, 7 (44%) of the 16 fatalities occurred in or relatively close (e.g. Kamloops) to the Okanagan area; the next largest group of deaths occurred in the south coastal area including Vancouver and the Saanich Peninsula on Vancouver Island (3 in total). The remaining 6 episodes were scattered further north around the province, but not noticeably grouped in any one area.

Another venomous inhabitant of B.C. is the rattlesnake. In the 29 years of this study, there was 1 fatal rattlesnake bite. A farmhand working in the Okanagan Valley was bitten and died in hospital 10 hours later. It is unclear whether the victim sought immediate medical assistance or not. The Maryland Poison Center notes that some 25% of pit viper (of which the rattle snake is one) bites are "dry" (i.e. there is no envenomation) so it is possible that the victim chose not to seek help. Antivenin is specific to the particular type of snake involved, and is most effective if administered within the first 4 hours after the bite has occurred; it is possible that this individual delayed treatment too long.

Usually multiple doses of antivenin are required to fully treat an envenomation and for snakes indigenous to the local area, most emergency treatment centers should have access to an adequate amount of the appropriate preparation. A problem arises when an individual is bitten by a non-indigenous species. The second death due to a snakebite in our study was the result of just such a situation. The victim was bitten by a cobra being kept as a pet . Predictably, the local hospitals in the Lower Mainland of B.C. did not have ready access to cobra antivenin, and by the time an adequate supply was located (in the U.S.), it was too late. The advice offered by the Maryland Poison Center is that venomous snakes should not be kept as household pets.

Another fatality involving wild animals being kept in close contact with humans, was the highly publicized death of a public aquarium employee who drowned while working with orcas.

Domesticated Animal Fatalities

Horses

Deaths resulting from human interaction with horses comprised the largest group of animal caused fatalities in both the wild and domesticated groupings. From 1969 to 1997, there were a total of 47 events involving horses with the preponderance of victims being male (30 deaths).

Of these deaths, 35 (74%) were the result of work or recreational use of these animals. The following list inventories the types of fatal injuries sustained in these incidents:

• Head injuries - 20 (57%)
• Internal injuries - 8 (23%)
• Fractures - 2 (6%)
• Other - 1 (3%)
• Unspecified - 4 (11%)

The vast majority of this group of horse related fatal injuries were sustained in falls from horses; there were 25 such incidents in the 35 cases examined. The next most numerous accidents involved being kicked by horses; there were 7 of these accidents detailed in the documents examined. The remaining 3 fatalities involved a variety of circumstances including being run over by a vehicle that collided with a horse ridden by the victim; drowning while riding a horse in or near water; and being crushed between a team of work horses and a stationary object. Unfortunately, there was no mention made in any of these records as to whether the victims were wearing protective headgear or vests at the time of the accidents, thus it is not statistically possible to extrapolate a relationship between lack of proper safety attire and fatal injuries. Suffice to say that these figures indicate activities involving horses are not without significant risk and should be undertaken with due caution. The remaining 12 horse-related fatalities (26%) were the result of MVAs caused by vehicles hitting horses that were loose on the road or highway.

Throughout the period, no horse caused deaths occurred in Coast Garibaldi, Upper Island/Central Coast, or Richmond Health Regions. All other regions experienced 1 to 6 deaths. The Regions with the highest number were Peace Liard (with 6 deaths), Cariboo (5 deaths), followed by South Okanagan and Thompson with 4 deaths each.

Similar to the deaths involving horses, was the single incident involving a mule. The male victim was riding the animal when it fell over an embankment. The victim sustained internal injuries which subsequently resulted in his demise.

Fatalities involving bovine species comprise the next largest group of deaths due to encounters with domesticated animals. This grouping has been further subdivided into incidents where bulls were implicated and those where the animal was either a cow or a steer. In the former group, there were 5 fatalities and in the latter, 7. With one exception, all of the victims were male.

What distinguishes the two groupings was the nature of the injuries involved . The fatalities from cows or steers were the result of a variety of circumstances. Five of the victims were in motor vehicles that struck cows wandering loose on the road. The one female victim was a dairy worker who was crushed against a wall by a cow. The final fatality in this group was kicked in the chest by a steer.

In contrast, all but one of the deaths involving bulls resulted from being gored or "charged" by the animals, reflecting their more aggressive nature. The one exception was as the result of an off-road MVA in which the driver of a motorcycle sustained lethal injuries after impacting a bull in a pasture.

Unfortunately, "man's best friend", the dog is not exempt in this review of animal-related fatalities. There have been 4 incidents involving dogs in the past 29 years. Two of these deaths were caused by dog bites either directly (lethal injuries resulting from the attack) or indirectly (septic shock from infected dog bites). There were no other commonalities in these 2 events - 1 victim was male, 1 female; 1 was an adult (49 years) and 1 was a child (5 years). The third fatality was as the result of an MVA which occurred after the driver hit a dog and lost control of the vehicle. The one remaining death was as the result of tripping over a dog. The elderly victim sustained a fractured hip and subsequently succumbed to pneumonia during hospitalization for this injury.

Animal Caused Motor Vehicle Accidents

An unexpected commonality among animal-related fatalities was the occurrence of fatal MVAs as the result of encountering animals while operating a motor vehicle or motorcycle: 50 (38%) of the 133 fatalities examined were due to this circumstance. In fact, the only animals included in this study that were not implicated were insects, snakes, cougars and orcas. On average, 2 people per year die on our highways because of animals on the road.

Moose were far and away the animal most often involved in fatal car accidents (19 deaths) for the reasons discussed previously. The stretches of Highways 97 and 16 in the vicinity of Prince George, Smithers and Terrace seemed to be particularly hazardous (see map), with 79% of all moose related fatalities occurring there.

Once again, horses figured notably (2nd most frequent) in deaths that resulted when animal and motor vehicle came in contact. Of the 47 horse involved deaths from 1969 to 1997, 16 were because of a lethal combination of horse and vehicle which hit an unattanded/riderless horse. 5 other deaths were riders whose horse was struck or who were thrown into the path of traffic. Cows and deer on the highway each accounted for 5 MVA deaths. There were single incidents each for dogs, bears and bulls (although the bull was in a field at the time of the accident). Lastly, there were 2 unidentified animals implicated.

While most of these accidents occurred on highways in isolated areas of the province, several did take place in more settled areas such as Langley, Surrey and Abbotsford. Thus, one cannot assume that urbanization excludes the chance of encountering wildlife or loose livestock wandering on the road. Time of day as a factor in the incidence of animal-related MVAs could not be established as this data were inconsistently recorded on the documents examined for this study.

Summary/Discussion

In the 29 years from 1969 to 1997, there were 133 animal caused fatalities in British Columbia. Of these fatalities, even when one includes MVA deaths, wild animals/snakes/insects contributed equally to overall mortality (66 deaths) as did domesticated animals (67 deaths). The victim of an animal caused death was 2.5 times more likely to be male (95 deaths) and most frequently between the ages of 15 to 24. There were differences in age distribution - deaths from cougar attacks only involved children, bears killed mostly males (16 of 19) and people of all ages except infants. Deaths caused by horses were also predominantly male (30 of 47) and occurred within all age groups from 1 to 74. Female victims of horse caused death were most likely to be age 15 to 19 while male fatalities were more common among men in their 20s through 40s.

Notably, as related to certain wild animals, there were seasonal elements in which deaths occurred that were probably related to peak human-animal contact and life habits of some animal species. When examined overall, there was an evident seasonal pattern with 105 or 80% of deaths occurring in the six months between May and October. In the 29 year period only 2 deaths occurred in each of January and February. The peak month was August (29 deaths) followed by July with 21 deaths.

While there is a tendency to focus on and sensationalize fatalities caused by wild animal attacks, this study found that in fact, this type of incident comprised a relatively small percentage (18%) of all animal involved deaths. Likewise, animals wandering or being ridden onto our highways and causing MVA fatalities were equally likely to be a wild animal as a domesticated animal. The number of deaths due to bear attacks was equal to the number caused by motor vehicles hitting moose alone. If all species, both wild and domesticated, are taken into account, the number of animal caused MVAs is more than twice as great as non-vehicle deaths caused by any single species.

Examination of Wildlife Encounter Reports (1984 to 1994) produced by the Problem Management Wildlife System of the Ministry of Environment, Lands and Parks found that in addition to deaths, a reported average of 6 people per year were injured by a wild animal. The last available year (1994) was the highest reported with 12 injuries - 4 by grizzly, 6 by black bear, 1 from an encounter with a moose, and 1 from a raccoon. It would appear that both injury and death from wild animals is less than one would expect given a probably high frequency of encounters.

The species associated with the greatest number of human fatalities (47) was the horse. These incidents outnumbered the next largest groups of bears and moose (19 each) by almost 2.5 times. With 16 deaths, the third most lethal of animals was the tiniest - bees/wasps.

It is likely that people will continue to work and play in BC's great outdoors for years to come. As relates to our interaction with this Province's wild animals, it is important to be aware of the inherent risks associated with these activities and to protect oneself from harm as much as is humanly possible. BC's Ministry of Environment, Lands and Parks provides excellent information free of charge, dealing with safety measures that can be taken to minimize the chance of fatal encounters with wildlife. Keep in mind that "prevention is better than confrontation." Individuals known or suspected of having allergic responses to bee/wasp venom should carry or have anti-reaction medication available especially when in high risk areas and at certain times of the year.

As this study has shown, even domesticated animals are unpredictable to an extent and humans must accord due respect in their contacts with them. Examination of issues relating to safety practices/equipment when horse riding for work, recreation or sport, and proper confinement of horses and livestock may suggest some ways of reducing mortality resulting from our interaction with domesticated animals.

Glossary

[Return to Table of Contents]

Alcohol-Related:

This category includes all deaths stated as being directly or indirectly related to alcohol. It should be noted that where alcohol is an indirect cause of death (i.e. not primary) and the direct underlying cause of death falls within one of our selected causes (e.g. motor vehicle accidents), then this death may be counted in both columns. That is, not all of "alcohol related" are exclusive. This category includes ICD-9 codes - 291, 303, 305.0, 357.5, 425.5, 535.3, 571.0-571.3, 571.5, 577.1, 648.4, 760.7, E860, 790.3.

Assignment of Health Region:
Cases are assigned to Health Regions by the aggregation of appropriate LHAs.

Assignment of Local Health Area (LHA):
Allocation of LHA, in the case of births and deaths is based upon the usual residence (by postal code) of the mother and deceased respectively. Marriages are assigned to LHAs according to the place of event. Standard Geographical Code (SGC), derived from community name, is used in the absence of postal code.

Elderly Gravida:
Any mother who was 35 years of age or older at the time of delivery of a live born infant.

External Causes of Death:
Deaths due to environmental events, circumstances and conditions as the cause of injury, poisoning, and other adverse effects. Broad categories include accidents, suicide, medical or abnormal reactions, homicide, legal intervention, misadventures and injury from war operations. Standard tables under this heading include deaths due to accidents, suicide, homicide and other. Accidents are subdivided by the following categories; motor vehicle accidents (MVA) (ICD-9 E810-E825, E929.0), poisoning (E850-E869, E929.2), falls (E880-E888, E929.3), burns/fire (E890-E899, E924, E929.4), drowning (E830, E832, E910), other accidents - all codes from E800-E949 not already noted. Suicide ICD-9 codes are E950-E959; homicide (E960-E969); "other" consists of legal intervention (E970-E978), undetermined if accidental or purposely inflicted (E980-E989) and war operations (E990-E999).

Heart Disease:
Tables under this heading include deaths due to:

• rheumatic/valvular: 391-398, 424
• hypertension: 401-405
• ischemic: 410-414, 429.2
• conductive & dysrythmic: 426-427
• heart failure: 428
• congenital: 745-746
• other: pulmonary - 415-417, inflammatory - 420-423, 429.0, cardiomyopathy - 425, 429.3, degenerative - 429.1, other, ill-defined or unspecified - 429.4-429.9

ICD-9:
The ninth revision of International Classification of Diseases, World Health Organization, Geneva, 1977. An internationally used system of approximately 12,000 four digit numbers representing a system of categories to which morbid entities are assigned according to an established criteria. ICD provides a common basis of disease and injury classification that facilitates storage, retrieval, and tabulation of statistical data.

Infant Deaths:
Deaths of children under one year of age.

Low Birth Weight:
Any liveborn infant weighing less than 2500 grams.

Neoplasms (ICD-9 140-239):
Although the vast majority of deaths in this category are due to malignant cancer, also included are benign, in-situ, and unspecified "tumours". Detailed ICD-9 breakdown used in "Neoplasm Deaths" tables are;

• lung: includes trachea, bronchus, lung (162) and pleura (163).
• female breast: (174).
• colorectal: includes colon (153) and rectum, rectosigmoid junction and anus (154).
• other G.I. (Gastrointestinal): includes esophagus (150), stomach (151), small intestine and duodenum (152), liver & intrahepatic bile ducts (155), gallbladder and extra-hepatic ducts (156), pancreas (157), peritoneum (158), other and ill-defined within digestive organs (159).
• female reproductive: includes uterus (179), cervix (180, 182), placenta (181), ovary and adnexa (183), vagina & external genitalia (184).
• prostate (185).
• blood lymph: includes lymphatic and haematopoietic tissue (200-208).
• other malignancy: includes malignant neoplasms of other (e.g. lip, oral cavity, pharynx, nose, ear, larynx, heart, bone and connective tissue, urinary tract, eye, brain, endocrine glands), ill-defined or unspecified sites (140-149, 160, 161, 164, 165, 170-173, 175, 186-199).
• non-malignant & unspecified: includes benign (210-229), in-situ (230-234), and neoplasms of unspecified nature (e.g. "tumor" - 239).

Other Selected Death Statistics:
Tables under this heading include deaths due to:

• diabetes (250)
• alcohol related - see above.
• AIDS: includes AIDS and HIV infections (042-044).
• other infectious diseases (0010 to 0419, 0450-1398).
• cerebro and other vascular: includes cerebrovascular disease (430-438), disease of arteries and veins (440-456), hypotension (458), and other circulatory system disease (459).
• liver disease: (570-573)
• ALS/MS: amyotrophic lateral sclerosis and multiple sclerosis (3352 & 340).
• Alzheimer's disease (3310).
• Parkinson's disease (3320).

Premature / Pre-term:
Any live born infant less than 37 weeks gestation at delivery.

Respiratory Disease Death Statistics:
Tables under this heading include deaths due to the following:

• emphysema (492).
• COPD - chronic obstructive pulmonary disease (496).
• pneumonia (480-486).
• influenza (4870-4879).
• asthma (4930-4939).
• lung disease due to external agents, e.g. aspiration pneumonia, asbestosis, silicosis (500-5089).
• pulmonary fibrosis (515).
• other respiratory diseases (460-4789, 490-4919, 494-4959, 5100-514, 5160-5199).

Stillbirth:

The complete expulsion or extraction from its mother after at least 20 weeks of pregnancy or after attaining a weight of at least 500 grams, of a product of conception in which, after expulsion or extraction, there is no breathing, beating of the heart, pulsation of the umbilical cord or unmistakable movement of voluntary muscle.

Teenage Mother:
Any mother who was age 19 or less at the time of delivery.

UCOD:

Underlying cause of death - based upon application of standard international coding rules for determining consequential relationships of conditions and diseases from immediate cause backwards to underlying cause.

Contributors' Note:

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The editorial staff would like to invite any readers who wish to contribute an article or paper summary for publication in this Quarterly Digest to contact the Information and Resource Management Branch of the British Columbia Vital Statistics Agency. Articles should focus on health status issues in British Columbia. It is preferable that submissions be in "electronic media" format (e.g. Word, Word Perfect, Excel, Power Point, Corel, Pagemaker, etc.). Article presentation will be subject to space allowances and publishing deadlines.

Readers' Note:

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