The Statistics Netherlands (CBS) statistic on causes of death shows the primary cause of death of the inhabitants of the
Figuur 1 Causes of death 1969-2005 by cause and age group.
If we look at the distribution of death causes within each age group, we get the following picture:
The above graph shows that the cause of death of the 'younger than 40' is often a traffic accident. The average age of a road death is 42 years. The number of years of life lost (YLL) as a result of a road crash is large in comparison with other causes of death (VTV2006, appendix 8).
CBS obtains the data via the obligatory reporting system. In this system the doctor or autopsist sends the cause of death form, known in the Netherlands as the B Form, together with the death certificate (the A certificate) to the Registrar of Births, Marriages, and Deaths of the municipality where the death occurred. The cause of death form, which the doctor only fills in for the statistics, is then sent to Statistics Netherlands).
The classification and coding follow the guidelines of the World Health Organisation (WHO) as much as possible. Only primary causes of death are reported. A maximum of three secondary causes of death are ascribed to each deceased.
The WHO coding involves only reporting one sickness or event as primary cause of death, i.e. the sickness or event that initiated the chain of events leading to death.
Their consequences or complications are generally coded as secondary causes, which is also the case for other sicknesses that someone had at the time of death and that may have contributed to the death. In what is known as an unnatural death, i.e. death by external causes, the event is nearly always indicated as primary cause and the sustained injury as secondary cause. The distinction made between primary and secondary causes can be especially difficult if there were various causes. A justified choice is made with the WHO guidelines in mind. The information provided by the doctor is determinant. When there is lack of clarity, written or telephone enquiries are made.
The cause of death statistic contains data on deaths that are included in the municipal basic registration of population data. In principle, everybody living in the
With regard to road crash data, it is important to realize that road deaths among non-residents that have occurred on Dutch roads are excluded. However, those who live in the
Accuracy and validity
The information that CBS receives is not always complete. In such cases CBS makes an estimate of the missing data.
The ICD, International Classification of Diseases, is the international classification used by the World Health Organisation.
The classification list ICD-8 was used in the 1969 - 1978 period, the ICD-
Although the classifications according to the classification lists ICD 8, 9 and 10 are not comparable in details, Statistics Netherlands has been successful in constructing a consistent time series of the important primary causes of death. The series contains 72 classes of death causes, ten of which are deaths by unnatural causes. These include road crashes.
Since 1996, detailed data that is based on the ICD-10 is available. See Statline.
NB: the ICD publication are
Classificatie van ziekten 1980 (ICD-9), 1986. SIG Informatiecentrum voor de Gezondheidszorg, Utrecht
Internationale statistische classificatie van ziekten en met gezondheid verband houdende problemen ICD-10. Geneve, Wereldgezondheidsorganisatie WHO, 1992/1993 / Zeist, Coördinatiepunt Standaardisatie Informatievoorziening in de Gezondheidszorg CSIZ, 1997.
Hollander, A.E.M. de Hoeymans, N. Melse, J.M. Oers, J.A.M. van & Polder, J.J. (eindred.), 2006. Zorg voor gezondheid : volksgezondheid toekomst verkenning 2006, RIVM. Bilthoven.