Quarterly Digest
Volume 9 - Number 1 & 2 October 1999

• Preface
  
  
• Map: B.C. Local Health Areas

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

• Vital Event Statistics - January 1, 1999 - March 31, 1999 and Year-to-date Totals
  (Population, Livebirth, Death, Marriage, Stillbirth, Infant Deaths)

• Selected Birth Statistics - January 1, 1999 - March 31, 1999 and Year-to-date Totals
  (Low Birthweight, Preterm, Teenage Mother, Elderly Gravida, Cesarean Section)

• External Causes of Death - January 1, 1999 - March 31, 1999 and Year-to-date Totals
  (Accidents - [Motor Vehicle Accidents, Poisoning, Falls, Burns/Fire, Drowning, Other], Suicide, Homicide, Other External Causes)

• Neoplasm Deaths - January 1, 1999 - March 31, 1999 and Year-to-date Totals
  (Lung, Female Breast, Colorectal, Other G.I., Female Reproductive, Prostate, Blood/Lymph, Other Malignancy, Nonmalignant and Unspecified)

• Heart Disease Deaths - January 1, 1999 - March 31, 1999 and Year-to-date Totals
  (Rheumatic/Valvular, Hypertension, Ischemic, Conductive & Dysrhythmic, Heart Failure, Congenital, Other)

• Respiratory Disease Death Statistics - January 1, 1999 - March 31, 1999 and Year-to-date Totals
  (Emphysema, COPD, Pneumonia, Influenza, Asthma, Lung Disease from External Agents, Pulmonary Fibrosis, Other Respiratory)

• Other Selected Death Statistics - January 1, 1999 - March 31, 1999 and Year-to-date Totals
  (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, 1999 - June 30, 1999 and Year-to-date Totals
  (Population, Livebirth, Death, Marriage, Stillbirth, Infant Deaths)
  
  
• Selected Birth Statistics - April 1, 1999 - June 30, 1999 and Year-to-date Totals
  (Low Birthweight, Preterm, Teenage Mother, Elderly Gravida, Cesarean Section)
  
  
• External Causes of Death - April 1, 1999 - June 30, 1999 and Year-to-date Totals
  (Accidents - [Motor Vehicle Accidents, Poisoning, Falls, Burns/Fire, Drowning, Other], Suicide, Homicide, Other External Causes)
  
  
• Neoplasm Deaths - April 1, 1999 - June 30, 1999 and Year-to-date Totals
  (Lung, Female Breast, Colorectal, Other G.I., Female Reproductive, Prostate, Blood/Lymph, Other Malignancy, Nonmalignant and Unspecified)
  
  
• Heart Disease Deaths - April 1, 1999 - June 30, 1999 and Year-to-date Totals
  (Rheumatic/Valvular, Hypertension, Ischemic, Conductive & Dysrhythmic, Heart Failure, Congenital, Other)
  
  
• Respiratory Disease Death Statistics - April 1, 1999 - June 30, 1999 and Year-to-date Totals
  (Emphysema, COPD, Pneumonia, Influenza, Asthma, Lung Disease from External Agents, Pulmonary Fibrosis, Other Respiratory)
  
  
• Other Selected Death Statistics - April 1, 1999 - June 30, 1999 and Year-to-date Totals
  (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:
  Drowning and Other Water-Related Accidental Fatalities, British Columbia, 1990 to 1998
  by Z. Kashaninia, J. Macdonald and R. Armour.

• Glossary

• Contributors' Note

• Readers' Note

Preface

The current table format which began in 1998, provides expanded cause of death categories and counts for recent "small" Local Health Areas (LHA).

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 1999 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.

In addition to extensive coastal waters, British Columbia is blessed with an abundance of fresh water lakes and waterways. The province's bounty of water has also meant a relatively high number of people (especially young adult males) have died from drowning or from other injuries while engaging in water-related activities. This issue's feature article, "Drownings and Other Water-Related Accidental Fatalities," provides an overview of circumstances, age, gender, regional differences, and alcohol involvement for the 1,157 drowning and water-related deaths that occurred in BC from 1990 to 1998. The data provided in this report are unique in that, in addition to "traditional" drowning statistics (791 deaths), information is also provided for non-drowning in water-related activities (84 deaths) and for drowning in non-water-related activities (282 deaths).

As always, requests for changes and suggestions or contributions for articles continue to be welcome. Your support and input into this publication is greatly appreciated.

R.J. Danderfer	Soo-Hong Uh
Director	Manager
British Columbia	Information and Resource
Vital Statistics Agency	Management Branch
	Vital Statistics Agency

[Return to Table of Contents]

British Columbia
Local Health Areas

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

Drowning and Other Water-Related Accidental Fatalities,
British Columbia, 1990 to 1998

Introduction

As well as an extensive and rugged Pacific coastline, British Columbia is blessed with an abundance of fresh water rivers, lakes and major waterways. Whether for sport, recreation, commerce, sight-seeing, transport, or simply driving BC's roads and highways, human proximity or contact with water is probably inevitable. It is this contact with water in nature that accounts for the majority of fatal drownings and other water-related deaths with a relatively small contribution from drownings in private or public swimming pools and in bathtubs.

Accidental drowning fatality statistics generally only count events in which both the circumstances and the injury sustained involve submersion and water in the lungs. In addition to examining these "traditional" drowning deaths, this report will also provide counts and rates for other water-related fatalities, which includes non-drowning injury in water-related activities and drowning injuries in non-water-related activities or due to epilepsy or cardiac incident. Using these criteria, there were 791 drowning deaths between 1990 and 1998 in BC. In addition, 84 died of non-drowning injuries while scuba diving, boating or diving. Another 282 people drowned when, for example, their car or plane crashed into water, or when they experienced loss of consciousness from epilepsy, heart attack or accidental overdose while around water. Over the nine year period, there were 1,157 (including 143 non-BC residents) drowning and water-related accidental deaths in BC. Of these total deaths, 307 involved a watercraft.

In addition to providing summary data about water-related deaths, drowning fatalities will be examined for gender, age, regional differences, proportion involving alcohol, and over time. Text on original death records (1994 to 1998) describing occupation and industry of the deceased as well as the geographic location of the drowning were also examined for any patterns.

Methodology

ICD-9 codes for drowning were deaths in which the underlying cause of death (UCOD) was an external cause code of:

E8300-E8309		accident to watercraft causing drowning (e.g. boat capsizing)
E8320-E8329		drowning in other watercraft accident (e.g. fall overboard)
E9100		drowning while waterskiing
E9101		drowning while recreational skin diving (with equipment)
E9102		drowning in other sport/recreation (e.g. swimming/playing in water, surf boarding)
E9103		drowning during commercial or rescue skin diving
E9104		drowning in bathtub
E9108		drowning in swimming pool
E9109		accidental fall into water (not from boat); drowning NOS

In order to identify the location of drowning and information relating to occupation of the deceased, 393 (1994 to 1998) records in this group were retrieved and manually examined.

The following UCOD codes were used to identify non-drowning injury in water-related activity:

E8310-E8319, E8330-E838		water transport accident with non-drowning injury
E8830		accident from diving or jumping into water [swimming pool]
E9022		divers' disease (bends)

A drowning injury ("N") code of N9941 occurring anywhere on a death record, was used to identify deaths in which accidental drowning had occurred but the UCOD described non-water-related activities or diseases. 1990 to 1998 death records identified with this "N" code excluded those with UCOD codes as noted above and those due to suicide, homicide, or of undetermined intent. The 282 deaths thus identified were then grouped on the basis of their UCOD as follows:

E8010, E8102		railway accident
E8110-E8199		motor vehicle traffic accident
E8200-E8299		motor and other vehicle non-traffic accident
E8403-E8427		aircraft accident
E8500-E8609		accidental overdose - drugs or alcohol
E882, E8839-E888		accidental falls
E908, E909		storms/floods/avalanche
3450-3459		epilepsy
4140, 4149, 4151, 4275		embolism/cardiac incident
E9068, E916, E9197, E9199		other

Regional differences in drowning fatalities are based on Standardized Mortality Ratios (SMRs) and trends over the nine year period are represented by Age Standardized Mortality Rates (ASMRs). ASMRs in this report are per 100,000 standard population (1991 Canada Census). ASMRs for males and females were both standardized to the same non-gender specific standard total population. This means that the genders are directly comparable and that the total ASMRs are not gender standardized.

It should be noted that counts provided include non BC residents but population-based rates are derived using deaths of BC residents only.

Note: Includes non-BC residents.

• The 791 drowning fatalities in BC from 1990 to 1998 equate to an average of 87 deaths per year.

• Since 1992, there was a decline in the overall number of drowning fatalities with the largest number (106) in 1992 and the lowest (61) in 1998.

• There were 5.3 times more male drowning fatalities than female.

• In terms of numbers, males exceeded females in all categories except for drowning in bathtubs where the victim was 2.3 times more likely to be female.

• 77.5% (613) of drowning fatalities occurred in "natural" waters and 22.5% (178) in swimming pools or bathtubs.

• Including 6 deaths from divers' disease (see Table 9), there were 43 deaths (36 men and 7 women) while underwater diving.

• Including 60 deaths from non-drowning watercraft accidents (see Table 9), there were 307 deaths while boating.

Note: Rate per 100,000 Standard Population using 1991 Canada Census Standard.

• Overall, from 1990 to 1998, there was a decline in the rate of drowning mortality with the highest rate (2.82) in 1992 and the lowest (1.28) in 1998.

• This overall decline was primarily due to a drop in the male rate which in 1998 was less than half the 1992 peak rate. The female rate fluctuated over the period and demonstrated no clear trend.

• In all years, the male rate exceeded the female rate. On average, the male rate was 6.0 times greater than the female rate with the differential varying from 3.8 to 7.5 times.

Note: Includes non-BC residents (93 deaths).

• In the nine year study period, there were a total of 791 drowning fatalities with 665 male victims and 126 female victims.

• Of male drowning fatalities, 55.6% occurred between the ages of 15 and 39. The group with the greatest number of male drowning deaths was aged 30-34 with a total of 78 deaths over the period (11% of all male drowning deaths).

• Female drownings were more evenly distributed across all 19 standard age groups. The most at risk group for females were children age 1-4 with a total of 14 deaths (11% of all female drowning deaths).

• The most numerous drowning deaths in any single category were due to accidental falls into water for both genders (182 males and 35 females). This does not include the drowning deaths that occurred falling off a boat or falling into a pool or bathtub.

• For females, the second and third most frequent manner of drowning was in swimming pools (33 deaths) and bathtubs (27 deaths). Corresponding categories for males were drowning due to an accident to a watercraft (146 deaths) and while engaged in other "natural" water activity (e.g. swimming or wading) or in a swimming pool (106 deaths in each category).

• The first three categories listed in Table 3 denote drownings involving boats. For males, 228 drowned while engaged in boating. This accounted for 34.3% of male deaths and was the leading cause of male drowning fatalities. Drowning deaths while boating involved males 12 times more often than females and, most frequently, males between their late teens and mid-forties.

• The only category, in which female fatalities consistently equaled or outnumbered male fatalities across all age groups, was drowning in bathtubs. The female 85+ age group seemed to be particularly vulnerable in this regard, (6 deaths) accounting for 22.2% of female bathtub drownings and 15.4% of total bathtub drownings.

Note: Excludes non-BC residents.
Rate per 100,000 age and gender specific population.

• In the nine year period, accidental drowning fatalities occurred in all age groups to both males and females.

• The male rates of drowning deaths were higher than the female rates in all age groups except for infants less than 1 year of age.

• Although the largest number of drowning deaths were young adult males, the highest rate occurred in men (6.0 per 100,000 population) and women (3.0 per 100,000 population) over age 84. The age 85+ group also had the highest rate overall (4.0).

• Without regard for gender, the second highest rate was among those age 15 to 24 (3.2).

• The second highest rate for males was among teenagers age 15 to 19 (5.6) and for females, among infants less than one year of age (2.0).

• Children age 10-14 were least likely to die from accidental drowning - lowest rate for both males (0.5) and females (0.1).

Note: Includes non-BC residents (93 deaths).

• Overall, drowning fatalities occurred in all months of the year.

• The largest proportion (35.1%) of drowning fatalities occurred in July (18.3%) and August (16.8%).

• For accidental drownings, which involved a boat (e.g. either capsizing or falling overboard), the greatest number of deaths (43) occurred in July while the second most fatal month was May (39 deaths). There were fewer fatalities per month in the period of November through to February.

• Drowning deaths while commercial or recreational skin-diving were most likely to occur in March (8 deaths). No deaths occurred from recreational skin diving in the nine-year period in the summer months of June, July or August.

• As one would expect, "drowning in other sport/recreation..." (mostly swimming/playing in water) and drowning in swimming pools were highest in July and August (62 deaths in each of both months). Of the total deaths in these two categories (251), slightly over 49% occurred in these two summer months.

Note: SMR - standardized mortality ratio (Observed/Expected). (see glossary)
Cells that are shaded Blue indicate a statistically significantly high difference between the observed and expected deaths and cells that are shaded GREY indicate a statistically significantly low difference between the observed and expected deaths (p<0.05, two tailed).
Excludes non-BC residents.
Drowning death shown by usual residence of deceased, and not by place of drowning.

• Based on Standardized Mortality Ratios (SMRs), 13 Local Health Areas (LHAs) showed statistically significantly more drowning deaths than were expected. These were: Central Coast (11.33), Bella Coola Valley (6.87), Queen Charlotte (6.33), Nechako (5.56), Prince Rupert (5.42), Lillooet (4.39), Burns Lake (3.55), Vancouver Island North (3.46), Southern Okanagan (3.17), Alberni (2.62), Kootenay Lake/Nelson (2.61), Ladysmith (2.52), and Campbell River/Vancouver Island West (2.42).

• The areas that showed significantly fewer deaths than were expected were: Vancouver West Side (0.45), Coquitlam (0.46), Vancouver South (0.51), Abbotsford (0.53), Surrey (0.54), North Vancouver (0.56) and Burnaby (0.64).

• Between 1994 and 1998, alcohol was involved in 18.8% of all drowning deaths.

• The percentage of male drowning fatalities involving alcohol was more than twice that of women (20.9% vs 9.0%). 32.1% of all male accidental falls into water and 26.7% of all male drownings in swimming pools were alcohol related.

• The highest female alcohol related drowning death (18.2%) was due to drowning in a bathtub. The only other two female drowning death categories which involved alcohol were drowning in swimming pool (13.3%) and accidental fall into water (8.3%).

Note: Includes non-BC residents.

• Alcohol was a factor in drowning deaths for those aged 15 to 74 from 1994 to 1998.

• Drowning deaths involving alcohol were substantially higher for males than females in every age group except for those aged 20-24 and 40-44. The highest proportion of drowning deaths involving alcohol was for those aged 50-54 (47.4%) for males and those aged 40-44 for females (50%).

• Among males, those between 60-64 had the lowest involvement of alcohol at 7.7%. The lowest figure for females was at 10% for those 50-54. There were no alcohol related drowning deaths for females in the age groups 15-19, 25-39 and 60 and over.

Note: Includes non-BC residents (50 deaths).

• In addition to the 791 drowning fatalities from 1990 to 1998, there were 366 water-related deaths (including 50 non-BC residents) during the same period in British Columbia. 84 were due to non-drowning injury in water-related activity and 282 were due to drowning in non-water-related activity.

• There was an overall decline in water-related deaths from 56 deaths in 1990 to 35 deaths in 1998.

• Over 3 times more males died from water-related fatalities than females.

• More than half of the water-related deaths were caused by motor vehicle traffic accidents (162 deaths, 117 males and 45 females).

Note: Includes non-BC residents (50 deaths).

• The highest number of water-related deaths for males was 42 for those aged 20-24. The highest number for females was 13 for those aged 15-19.

• A majority of water-related fatalities occurred to relatively young individuals - slightly over 67% of males and 60% of females were between the ages of 15 to 44.

• The highest number of deaths were due to motor vehicle traffic accidents for both males and females (162 deaths). More than half of these deaths occurred to those between the ages of 15 to 44 (83 males, 29 females).

• During the 9-year period, there were no female deaths from water-related railway accidents, storms/flood or avalanches, embolism or cardiac incidents.

Note: Excludes non-BC residents.

• From 1990 to 1998, males had higher water-related death rates than females in every age group except those 65 to 69.

• The highest age specific death rate for males was 3.0 per 100,000 for those aged 20 to 24. For females, the highest rate was 1.1 per 100,000 for those aged 15-19.

• For those between the ages of 20 to 60, males were more than four times more likely to die in a water-related accident than females.

• There were no water-related deaths among females under the age of one.

Note: Rate per 100,000 Standard Population using 1991 Canada Census Standard.

• There was an overall decline in Age Standardized Mortality Rates (ASMRs) of all water-related deaths (from 1.37 in 1990 to 0.72 in 1998).

• In all years, ASMRs for males exceeded females by more than 3 times. The highest ASMR for males was 2.12 in 1990 while the highest rate for females was 0.78 in 1994.

^* eg. boat capsizing
^** eg. fall overboard
^*** eg. explosion on board, no drowning

Summary and Conclusion

For further investigation into the location of drownings and water-related accidents and their relationship to the occupation of individuals, all "traditional" drowning and non-drowning watercraft and diving accidents from 1994 to 1998 were closely examined. During this 5 year period, over half of all drowning deaths were due to boat related accidents. More than 90% of victims were males, 75.5% of whom were under 50 years of age. Out of 121 boat-related drowning deaths, 23 records indicated occupations associated with coastal waters such as fishing, working on docks, and diving while the rest appeared to have been involved in boating for recreational purposes. In addition to the boat related drownings, there were 37 non drowning deaths due to boating accidents. In over 80% of these accidents, the victim was a male under the age of 50.

In at least one study, it was reported that in over one third of boating related deaths, no personal floatation devices were used. Since most bodies of water in British Columbia have a temperature of near freezing, the likely contributor to fatal drowning is the cold water or hypothermia. Once the individual is in cold water, their muscular coordination will be reduced. Consequently, swimming, climbing and resisting head submersion will become extremely difficult. In these cases, those with personal floatation devices have a much higher chance of survival. (Canadian Medical Association Journal, Vol 159, No.3, 1998).

The second highest cause of drowning deaths in the same 5-year period was due to swimming. In total 110 individuals lost their lives while enjoying swimming or other related activities. As expected, the majority of these were males (83%). 27 of these deaths occurred in swimming pools at home or at hotels, while the rest occurred in rivers, lakes, the ocean, and other bodies of water in different parts of the province. In addition, 18 more people (14 males and 4 females) died as a result of an accident from jumping or diving into water. Aside from 2 deaths, which occurred at the home of the individuals, all the other deaths occurred at rivers, lakes and other bodies of water.

The vast majority of fatal drowning in swimming pools occurred in residential and hotel/motel pools. In fact, examination of death records unearthed no such deaths since 1994 in a public pool - where lifeguards are likely present and alcohol is not a significant factor.

Alcohol was a factor for over 20% of all male drowning deaths and 9% of all female drowning deaths. The victim of a boating or diving accident involving alcohol was likely to be a male under the age of 59. Female drownings involving alcohol were more likely to occur to those between the ages of 40 and 59 while swimming or taking a bath.

In 1997, the Canadian Medical Association General Council, led by a BC delegation, made recommendations to more stringently regulate training, licensing, and age of powered watercraft operators. As a result, additional boat safety rules were introduced in April and September of 1999. The goal, with additional regulations in 2002, is for mandatory proof of competency by all powerboat operators by September 15, 2009 (Canadian Medical Assoc., CMA News, 1999).

It is hoped that some of the information provided here can serve as a benchmark for the assessment of the efficacy of recent and future boat safety regulations.

References

Canadian Medical Association. "New boat safety rules follow in wake of General Council resolution" in CMA NEWS. Vol. 9, No. 5, May 4, 1999.

Chochinov, A., 'Alcohol "on board", man overboard-boating fatalities in Canada' in CMAJ. JAMC, Canadian Medical Association Journal, Vol. 159, No. 3, Aug. 11, 1998, p. 259.

The Canadian Red Cross Society. "Drowning Among Recreational Boaters in Canada" June, 1994.

Glossary

Age Standardized Mortality Rate (ASMR):
A summary of age adjusted death rates by gender which have been standardized to a specific population for the purpose of rate comparisons of different time periods or different geographical locations. ASMRs in this report are per 100,000 standard population (1991 Canada Census).

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. 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).
  

Standardized Mortality Ratio (SMR):
The ratio of the number of deaths occurring to residents of a geographic area (e.g. LHA) to the expected number of deaths in that area based on provincial age specific mortality rates.

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.

[Return to Table of Contents]

Contributors' Note:

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.

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