The evolution of the disability-adjusted life year (DALY)

The disability-adjusted life year (DALY) is a summary health measure that combines mortality and morbidity into a single measure as a way to estimate global disease burden and the effectiveness of health interventions. We review the methodological progression of the DALY, focusing on how the use of life expectancy estimates, disability weights, age weighting, and discounting has evolved since the first DALY reports were published in 1993. These changes have generally improved the metric but have made it difficult for researchers to interpret, compare, and conduct DALY studies.     

The burden of road traffic injuries in Kermanshah Province,Iran, in 2010–2011: GBD 2010 method

Deaths, injuries and disabilities resulting from road traffic injuries (RTIs) are a public health major concern. This study aims to calculate the burden of RTIs in Kermanshah Province in Iran. In this study to determine the years of life lost (YLL) related to RTIs, the National Death Registration and Forensics Medicine census data were employed. We use forensic medicine data to calculate the incidence of non-fatal injuries and years lost due to disability (YLD). The cause of death and non-fatal injuries was classified using ICD-10 codes and 23 groupes of global burden of diseases (GBD) 2010. The disability-adjusted life year (DALY) estimated on the guidelines of the GBD 2010 and age and sex structure was taken from the National Statistic Center for the year 2010. Overall, 70.8% of the subjects were males. The fatal and non-fatal injury rates of RTI were 51.3 and 283.6 per 100,000 persons, respectively. YLLs and YLDs were 46613 (24.5 per 1000) and 3405 (1.8 per 1000) in both sexes, respectively. The disability adjusted life years were 40711 in males, 9306 in females and 50018 in both sexes (42.5, 9.8 and 26.3 per 1000, respectively). More than 93% of DALY was from YLL (24.5 per 1000), with a small proportion for YLD (1.8 per 1000). Accounting for more than 50,000 DALY attributed to RTIs, traffic injuries is a major public health and socioeconomic problem in Kermanshah. Designing cost-effective interventions based on comprehensive and multi-sectoral programmes at the national and provincial levels can save many lives and resources that are lost every year. Undoubtedly, establishing a surveillance system at the sub-national level and measuring the burden of injuries, as in this study, can help policy-makers and planners in lessening the burden of RTIs.     

Injuries and their burden in insured construction workers in Iran, 2012

The present study used disability adjusted life years (DALY) to estimate the burden of external cause of injuries in construction workers insured in Iran in 2012. The Global Burden of Disease method (2010) was used to estimate the years of life lost due to death (YLL) and years of life lost due to disability (YLD). DALY was calculated as the sum of YLL and YLD. There were 5352 injured construction workers in Iran (11.25 individuals per 1000). Falling was the most common incidence and included 2490 individuals (46.53%). Totally, DALY was estimated 18,557 years for all age groups and both genders including 17,821 YLD (96%) and 736 YLL (4%). The DALY related to construction work is high in Iran and it has notably affected the young. Hence more preventive methods should be applied to reduce the overall burden of specific external cause of injuries especially in young and inexperienced workers.