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3303.0 - Causes of Death, Australia, 2007 Quality Declaration 
Previous ISSUE Released at 11:30 AM (CANBERRA TIME) 18/03/2009   
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EXPLANATORY NOTES


INTRODUCTION

1 This publication contains statistics on causes of death for Australia.

2 In order to complete a death registration, the death must be certified by either a doctor using the Medical Certificate of Cause of Death, or by a coroner. Approximately 80-90% of deaths each year are certified by a doctor. The remainder are reported to a coroner. Although there is variation in what constitutes a death that is reportable to a coroner across jurisdictions, they are generally reported in circumstances such as:

  • where the person died unexpectedly and the cause of death is unknown;
  • where the person died in a violent or unnatural manner;
  • where the person died during or as a result of an anaesthetic;
  • where the person was 'held in care' or in custody immediately before they died; or
  • where the identity of the person who has died is unknown.

3 All coroner certified deaths registered after 1 January 2007 will be subject to a revision process. This is a change from previous years where all ABS processing of causes of death data for a particular reference period was finalised approximately 13 months after the end of the reference period. Where insufficient information was available to code a cause of death (e.g. a coroner certified death was yet to be finalised by the Coroner), less specific ICD codes were assigned as required by the ICD coding rules. The revision process will enable the use of additional information relating to coroner certified deaths as it becomes available over time. This will result in increased specificity of the assigned ICD-10 codes.

4 Causes of death data for 2007 coroner certified deaths will be updated as more information becomes available to the ABS. Revised data for 2007 will be published both on a year registration basis and a year of occurrence basis in the 2008 Causes of death publication, due to be released in March 2010, and again in the publication relating to the 2009 collection due for release in 2011. Revisions will only impact on coroner certified deaths, as further information becomes available to the ABS about the causes of these deaths.

5 In prior years, statistics on perinatal deaths have been included in this publication. However, for 2007 these data will be published in a separate publication, Perinatal Deaths, Australia (cat.no. 3304.0), which will be released in June 2009.

6 Statistics on suicide deaths for years prior to 2006 were published separately in Suicides, Australia (cat. no. 3309.0)

7 The data presented in this publication are also included in a series of spreadsheets that are available on the ABS website <http://www.abs.gov.au>. Any references to tables in the Explanatory Notes also refers to these spreadsheets.

8 A glossary is also provided detailing definitions of terminology used.


SCOPE AND COVERAGE

9 The statistics in this publication relate to the number of deaths registered, not those which actually occurred, in the years shown. The exception is the Year of Occurrence section (Chapter 7) which relates to deaths by year of occurrence.


Scope of the causes of death collection

10 The ABS causes of death collection includes all deaths that occurred and were registered in Australia, including deaths of persons whose usual residence is overseas. Deaths of Australian residents that occurred outside Australia may be registered by individual Registrars, but are not included in ABS deaths or causes of death statistics.

11 The scope of the collection includes:
  • all deaths being registered for the first time;
  • deaths in Australia of temporary visitors to Australia;
  • deaths occurring within Australian Territorial waters;
  • deaths occurring in Australian Antarctic Territories or other external territories (excluding Norfolk Island);
  • deaths occurring in transit (i.e. on ships or planes) if registered in the State of "next port of call";
  • deaths of Australian Nationals overseas who were employed at Australian legations and consular offices (i.e. deaths of Australian diplomats while overseas) where able to be identified; and
  • deaths that occurred in earlier reference periods that have not been previously registered (late registrations).

12 The scope of the collection excludes:
  • still births/ foetal deaths
  • repatriation of human remains of decedents whose death occurred overseas;
  • deaths overseas of foreign diplomatic staff (where these are able to be identified); and
  • deaths occurring on Norfolk Island.

13 From the 2007 reference year, the scope of the collection is:
  • all deaths registered in Australia for the reference year and are received by the ABS by the end of the March quarter of the subsequent year; and
  • deaths registered prior to the reference year but not previously received from the Registrar nor included in any statistics reported for an earlier period.

14 Up to and including the 2006 issue of Causes of Death, Australia (cat. no. 3303.0), the scope for each reference year of the Death Registrations collection included:
  • all deaths registered in Australia for the reference year and received by the ABS in the reference year;
  • deaths registered during the two years prior to the reference year but not received by the ABS until the reference year; and
  • deaths registered in the reference year and received by the ABS in the first quarter of the subsequent year.

15 Under these rules, it was possible for a death registration to not be recorded in the collection if it had been registered more than two years before the record was received by the ABS. The scope was changed for the 2007 reference year to ensure all registrations were included in ABS collections.


Coverage of Causes of Death Statistics

16 Ideally, for compiling annual time series, the number of events (deaths) should be recorded and reported as those occurring within a given reference period such as a calendar year. However, due to lags in registration of events and the subsequent delays in the provision of that information to the ABS, not all deaths are registered in the year that they occur. this ideal is unlikely to be met under the current legislation and registration business processes. Therefore, the occurrence event is approximated by addition of the event on a state/territory register of deaths. Also, some additions to the register can be delayed in being received by the ABS from the Registrar (processing or data transfer lags). In effect there are 3 dates attributable to each death registration:
  • the date of occurrence (of the death),
  • the date of registration or inclusion on the State/Territory register, and
  • the month in which the registered event is lodged with the ABS.

17 Approximately 4-6% of deaths occurring in one year are not registered until the following year or later. These are included with the count of registered deaths published for that year.


CLASSIFICATIONS

Socio-Demographic Classifications

18 A range of socio-demographic data is available from the causes of death collection. Standard classifications used in the presentation of causes of death statistics include age, sex, birthplace, marital status, multiple birth, occupation and Indigenous status. Statistical standards for social and demographic variables are those developed and published by the ABS.


Marital Status

19 Within ABS causes of death statistics marital status relates to registered marital status which refers to formally registered marriages or divorces for which the partners hold a certificate.

20 For further information about Marital Status refer to Family, Household and Income Unit Variables, 2005 (cat. no. 1286.0)


Indigenous Status

21 The term Indigenous is used to refer to Aboriginal and Torres Strait Islander Australians. Those who are identified as being of Aboriginal and/or Torres Strait Islander origin through the death registration process are classified as Indigenous persons.

22 For further information about Indigenous Status refer to Standards for Statistics on Cultural and Language Diversity, 1999 (cat. no. 1289.0)


Occupation

23 The occupation classification used in ABS causes of death statistics is the Australian and New Zealand Standard Classification of Occupations (ANZSCO) First Edition 2006. The ABS however has not published causes of death data with an occupation variable since the 2002 reference year. The ABS considers the quality of the data able to be produced for this variable to be insufficient for reasonable analysis.

24 For further information on ANZSCO First Edition, refer to ANZSCO: Australian and New Zealand Standard Classification of Occupation, First Edition (cat. no. 1220.0).


Geographic Classifications

Australian Standard Geographical Classification (ASGC)

25 The ASGC is a hierarchical classification system consisting of six interrelated classification structures. The ASGC provides a common framework of statistical geography and thereby enables the production of statistics which are comparable and can be spatially integrated. Cause of death statistics are coded to SLA and can be produced for aggregates of these, for example, Statistical Division, Statistical Sub-Division and State.

26 For further information about the ASGC refer to Australian Standard Geographical Classification (ASGC), Jul 2006 (cat. no. 1216.0)

Standard Australian Classification of Countries (SACC)

27 The SACC groups neighbouring countries into progressively broader geographic areas on the basis of their similarity in terms of social, cultural, economic and political characteristics.

28 Birthplaces within Australia are coded to the state/territory level where possible. The supplementary codes contain the relevant state and territory 4-digit codes.

29 For further information about the classification, refer to Standard Australian Classification of Countries (SACC), 1998 (Revision 2.03) (cat. no. 1269.0)


Health Classifications

International Classification of Diseases (ICD)

30 The International Classification of Diseases (ICD) is the international standard classification for epidemiological purposes and is designed to promote international comparability in the collection, processing, classification, and presentation of causes of death statistics. The classification is used to classify diseases and causes of disease or injury as recorded on many types of medical records as well as death records The ICD has been revised periodically to incorporate changes in the medical field. Currently ICD 10th revision is used for Australian causes of death statistics

31 ICD-10 is a variable-axis classification meaning that the classification does not group diseases only based on anatomical sites, but also on the type of disease. Epidemiological data and statistical data is grouped according to:
  • epidemic diseases;
  • constitutional or general diseases;
  • local diseases arranged by site;
  • developmental diseases; and
  • injuries.

32 For example, a systemic disease such as septicaemia is grouped with infectious diseases; a disease primarily affecting one body system, such as a myocardial infarction is grouped with circulatory diseases or a congenital condition such as spina bifida is grouped with congenital conditions.

33 For further information about the ICD, including an online version of the classification, refer to the WHO website < www.who.int>.


DATA SOURCES

34 The registration of deaths is the responsibility of the individual state and territory Registrars of Births, Deaths and Marriages. As part of the registration process, information about the causes of death is supplied by the medical practitioner certifying the death or by a coroner. Other information about the deceased is supplied by a relative or other person acquainted with the deceased, or by an official of the institution where the death occurred. This information is provided to the Australian Bureau of Statistics (ABS) by individual Registrars for coding and compilation into aggregate statistics shown in this publication. In addition, the ABS supplements this data with information from the National Coroners Information Service (NCIS). Further information regarding causes of death data sources is available in Information Paper: ABS Causes of Death Statistics: Concepts, Sources, and Methods, 2008 (cat. no. 3317.0.55.002)


MORTALITY CODING

35 The tenth revision of the International Classification of Diseases (ICD-10) was adopted for Australian use for deaths registered from 1 January 1999. However, to identify changes between the ninth and tenth revisions, deaths for 1997 and 1998 were coded to both revisions. See Appendix: Comparability of statistics over time for concordances.

36 The extensive nature of the ICD enables classification of causes of death at various levels of detail. For the purpose of this publication, data is presented according to the ICD at the chapter level, with further disaggregation for major causes of death.

37 To enable the reader to see the relationship between the various summary classifications used in this publication, all tables show in brackets the ICD codes which constitute the causes of death covered.


Updates to ICD-10

38 The Updating and Revision Committee (URC), a WHO advisory group on updates to ICD-10, maintains the cumulative and annual lists of approved updates to the ICD-10 classification. The updates to ICD-10 are of numerous types including addition and deletion of codes, changes to coding instructions and modification and clarification of terms.

39 The cumulative list of ICD-10 updates can be found online at the WHO website <www.who.int>.


Automated coding

40 The ABS implemented a new version of the automated cause of death coding software (Medical Mortality Data System (MMDS)) for 2006 data. This version has also been used for coding of 2007 data. The MMDS coding software incorporates coding algorithms to ensure that updates to ICD-10 are implemented in the production of the statistics


Acquired Immune Deficiency Syndrome (AIDS)

41 As ICD-9 did not directly accommodate the coding of Acquired Immune Deficiency Syndrome (AIDS) and AIDS-related deaths, cases where AIDS was the underlying cause were coded to ICD-9 deficiency of cell-mediated immunity (279.1), from 1988 to 1995. In 1996, ABS adopted ICD-9 Clinically Modified (CM) for coding of AIDS and AIDS-related deaths. Hence, for 1996 to 1998, all AIDS-related deaths (i.e. deaths where AIDS was mentioned in any place on the death certificate) were coded to HIV infection (042-044). ICD-10, adopted from 1999, allows for the coding of AIDS and AIDS-related deaths (B20-B24).


External Causes of Death

42 Where an accidental or violent death occurs, the underlying cause is classified according to the circumstances of the fatal injury, rather than the nature of the injury, which is coded separately.


LEADING CAUSES OF DEATH

43 Ranking causes of death is a useful method of describing patterns of mortality in a population and allows comparison over time and between populations. However, different methods of grouping causes of death can result in a vastly different list of leading causes for any given population. A ranking of leading causes of death based on broad cause groupings such as 'cancers' or 'heart disease' does not identify the leading causes within these groups, which is needed to inform policy on interventions and health advocacy. Similarly, a ranking based on very narrow cause groupings or including diseases that have a low frequency, can be meaningless in informing policy.

44 Tabulations of leading causes presented in this publication are based on research presented in the Bulletin of the World Health Organisation, Volume 84, Number 4, April 2006, 257-336 . The determination of groupings in this list is primarily driven by data from individual countries representing different regions of the world. Other groupings were based on prevention strategies, or to maintain homogeneity within the groups of cause categories.

45 A number of organisations publish lists of leading causes of death, however the basis for determining the leading causes may vary. For example, many lists are based on Years of Potential Life Lost (YPLL) and are designed to present data based on the burden of mortality and disease to the community. The basis of the ABS listing of leading causes is based on the numbers of deaths and is designed to present information on incidence of mortality rather than burden of mortality.


YEARS OF POTENTIAL LIFE LOST (YPLL)

46 Years of Potential Life Lost (YPLL) measures the extent of 'premature' mortality, which is assumed to be any death at ages of 1-78 years inclusive, and aids in assessing the significance of specific diseases or trauma as a cause of premature death.

47 Estimates of YPLL were calculated for deaths of persons aged 1-78 years based on the assumption that deaths occurring at these ages are untimely. The inclusion of deaths under one year would bias the YPLL calculation because of the relatively high mortality rate for that age, and 79 years was the median age at death when this series of YPLL was calculated using 2001 as the standard year. As shown below, the calculation uses a standard population which is the 2001 census. This standard is revised every 10 years.

48 YPLL is derived from:
      Equation: Cx Age correction factor 2006
      where:
      Ax = adjusted age at death. As age at death is only available in completed years the midpoint of the reported age is chosen (e.g. age at death 34 years was adjusted to 34.5).
      Dx = registered number of deaths at age due to a particular cause of death.

49 YPLL is standardised for age using the following formula:
      Equation: YPLLs Age standardised YPLL 2006
      where the Cx is an age correction factor for age Equation: X.

50 The age correction factor Cx is defined for age Equation: Xas:
      Equation: Cx Age Correction Factor 2006
      where:
      N = estimated number of persons in the study population aged 1-78 years
      Nx = estimated number of persons in the study population aged Equation: Xyears
      Nxs = estimated number of persons resident in Australia aged Equation: Xyears at 30 June 2001 (standard population)
      Ns = estimated number of persons resident in Australia aged 1-78 years 30 June 2001 (standard population)


STATE AND TERRITORY DATA

51 Causes of death statistics for states and territories in this publication have been compiled in respect of the state or territory of usual residence of the deceased, regardless of where in Australia the death occurred and was registered. Deaths of persons usually resident overseas are included in the state/territory in which their death was registered.

52 Statistics compiled on a state or territory of registration basis are available on request.


DATA QUALITY

53 In compiling causes of death statistics, the ABS employs a variety of measures to improve quality, which include:
  • providing certifiers with certification booklets for guidance in reporting causes of death on medical certificates. See Information Paper:Certification of Death (cat. no. 1205.0.55.001);
  • seeking detailed information from the National Coroners Information Service (NCIS); and
  • editing checks at the individual record and aggregate levels.

54 The quality of causes of death coding can be affected by changes in the way information is reported by certifiers, by lags in completion of coroner cases and the processing of the findings. While changes in reporting and lags in coronial processes can affect coding of all causes of death, those coded to Chapter XVIII: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified and Chapter XX: External causes of morbidity and mortality are more likely to be affected. This is because the code assigned within the chapter may vary depending on the coroner's findings.

55 Care should be taken in interpreting results in recent years for several groups of causes within Chapter XX: External causes of morbidity and mortality. See Causes of Death, Australia 2005 (cat. no. 3303.0) Explanatory Notes for further information. See also Information Paper: Causes of Death Statistics, 2006 (cat. no. 3317.0.55.001)

56 Further detail on issues regarding deaths certified by a Coroner can be found in Technical Note: Coroner Certified Deaths.

57 One measure of causes of death statistics quality is the proportion of deaths coded to Chapter XVIII: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (ICD-10 codes R00-R99). Although deaths occur for which the underlying causes are impossible to determine, this proportion indicates the specific causes of death which are listed on the Medical Certificate of Causes of Death as completed by the certifier (i.e. Doctor or Coroner). The proportion of deaths coded to Chapter XVIII has increased steadily over the last 10 years from 0.5% (635 deaths) in 1998 to 1.4% (1,895 deaths) in 2007. A major reasons for the increase in the number of deaths coded to non-specific causes relate to a change in ABS processes for obtaining information regarding coroner certified deaths. Since 2006, the ABS relied totally on information available on the National Coronial Information System( NCIS) for information related to deaths certified by a Coroner. Prior to this, the ABS had sought additional information on coroner certified deaths were information was not available on NCIS by undertaking personal visits to Coroner offices to extract information from paper records.


Indigenous deaths

58 While it is considered likely that most deaths of Indigenous Australians are registered, a proportion of these deaths are not identified as Indigenous in the death registration process. That is, while data is provided to the ABS for the Indigenous status question for 99% of all deaths, this data may not be accurate in all cases.

59 In the death registration process, the Indigenous status of the deceased person is usually provided by relatives or friends of the deceased in interview with a funeral director or health worker. There are two main reasons why a person may be incorrectly identified as Indigenous or non-Indigenous in this process.

60 Firstly, in some cases, the Indigenous status question may not be asked by the person collecting information. This may be because of fear of offending grieving family members, or because a person's Indigenous status is assumed based on appearance or other factors.

61 The second reason for incorrect identification is whether the family member or friend correctly identifies a person as Indigenous. Propensity to identify as Indigenous is determined by a range of factors, including how the information is collected; who completes the form; the perception of how the information will be used; education programs about identifying as Indigenous; and cultural issues associated with identifying as Indigenous.

62 As a result of these issues, an Indigenous person may be incorrectly identified as either non-Indigenous or unknown Indigenous status. In 2007 there were 1,400 deaths registered in Australia for whom Indigenous status was not stated, representing 1.0% of all deaths registered. Despite these relatively low numbers, it is likely that some Indigenous deaths are included in the not stated category, contributing to the under-identification of Indigenous deaths.

63 From 2007, Indigenous status recorded for deaths registered in South Australia, Western Australia, Tasmania, the Northern Territory and the Australian Capital Territory was sourced from both the Death Registration Form (DRF) and the Medical Certificate of Cause of Death (MCCD). Prior to 2007, Indigenous status was sourced only from the DRF. This new method resulted in an additional 18 deaths recorded as Indigenous in 2007, representing a 0.7% increase in the number of deaths recorded as Indigenous for Australia overall. In addition, a further 682 records were reclassified from 'not stated' Indigenous status to 'non-Indigenous'.

64 This publication and associated datacubes includes data on the number of registered Indigenous deaths and selected causes of death. However, because of the data quality issues outlined above, more detailed breakdowns of Indigenous deaths are not available for those states/territories with a relatively small Indigenous population. As such, the datacubes associated with this publication only include data for New South Wales, Queensland, South Australia, Western Australia and the Northern Territory.

65 Further information on issues associated with Indigenous status in deaths data can be found in Deaths, Australia 2007 (cat. no. 3302.0).


SPECIFIC ISSUES FOR 2007 DATA

66 A number of issues should be taken into account by users when analysing the 2007 causes of death data. These are outlined below.


Dementia (F01-F03)

67 Since 2006, there has been a significant increase in the number of deaths coded to Dementia (F01-F03). Updates to the coding instructions in ICD-10 has resulted in the assignment of some deaths shifting from Cerebrovascular diseases (I60-I69) to Vascular Dementia (F01). In addition changes to the Veterans’ Entitlements Act 1986 and Military Rehabilitation and Compensation Act 2004, and a subsequent promotional campaign targeted at health professionals, now allow for death from vascular dementia of veterans or members of the defence forces to be related to relevant service. No changes to ABS coding or query practices were made with regard to 2006 or 2007 data which would impact on the number of deaths coded as Dementia.


Secondary Cancers (C78-C79)

68 The number of doctor certified deaths due to both Secondary malignant neoplasm of respiratory and digestive organs (C78) and Secondary malignant neoplasm of other sites (C79) have decreased substantially from 2006 to 2007. In 2007, an analysis of these codes was undertaken as secondary cancers should rarely be the underlying cause of death. Improved coding and editing practices were instigated for 2007 to ensure correct assignment of a more appropriate primary neoplasm code.


Chronic Obstructive Airways Disease (J44)

69 In 2007, Chronic Obstructive Airways disease (COAD, J44) increased for the first time since 2003. This increase is largely due to an improvement in coding practices. It was noted that in some jurisdictions the practice is to provide the term Chronic Airways Limitation instead of COAD. Investigations undertaken during coding supported this finding. All records with the term Chronic Airways Limitation have been correctly coded as COAD.


Unspecified Causes of Mortality (R99)

70 The introduction of a new version of the MMDS software in 2006 has corrected a previous coding error. Prior to 2006, deaths due to natural causes with no further information were coded to Unattended Death (R98). From 2006, these records are now coded to Other ill-defined and unspecified causes of mortality (R99).

71 Information regarding coroner certified deaths prior to 2006 was obtained by ABS staff visiting coronial offices and investigating case files in order to determine causes of death. In 2003, in order to make most effective and efficient use of ABS resources, the National Coronial Information System (NCIS) was progressively introduced as the main source of information on coroner certified deaths, however visits by ABS staff continued to be made in a number of jurisdictions. From 2006, the NCIS has been the only source of data used by the ABS for coroner certified deaths. This has resulted in an increase in the number of deaths assigned to Other ill-defined and unspecified causes of mortality (R99) due to the unavailability of information on the NCIS, particularly for New South Wales and Queensland. For further information see Technical Note: Coroner Certified Deaths. It is important to note that the number of deaths attributed to Other ill-defined and unspecified causes of mortality for 2007 is expected to decrease as data is revised. See Explanatory Notes 3 - 4.


Falls (W00-W19)

72 To reduce risk factors for falls in nursing homes in Victoria, all deaths where the medical certificate mentions falls are now referred to the coroner for verification, and the Coroner Clinical Liaison Service implemented a falls awareness campaign mid 2003. The number of deaths due to falls recorded in Victoria increased significantly in 2003 (up 50%), 2004 (over 100%), 2005 (14.1%) and 2006 (2.8%), whereas in previous years the deaths may have been attributed to other causes such as Hypostatic pneumonia (J18.2). In 2007, deaths due to Falls recorded in Victoria decreased for the first time since the introduction of this campaign, down 9.5%.


Transport Accidents (V01-V99, Y85)

73 In 2007, the coding process for open coroners cases was altered such that in the absence of a legal ruling of intent, deaths have been coded as "undetermined intent". For further information, Technical Note: Coroner Certified Deaths. This change has meant an decrease in the number of Transport Accidents (V00-V99) in 2007, down from 1,652 in 2006 to 1,340 in 2007, a decrease of 19%. Where a legal ruling of accident was not available at the time ABS processing ceased, a number of deaths have been coded to Crashing of a motor vehicle, undetermined intent (Y32). As further information becomes available, it is likely that these deaths will be revised as accidental. See Explanatory Notes 3 - 4

74 The Australian Transport Safety Bureau has published data in Road Deaths Australia 2007, Statistical Summary for the number of deaths due to road traffic accidents in 2007 (1,616 deaths). According to 2007 Causes of death data, there were 1,200 deaths due to road traffic accidents (V00-V79). A further 110 deaths were coded as Crashing of a motor vehicle, undetermined intent (Y32). The remaining difference in the numbers (306 deaths) between the two collections are explained by the different scope and coverage rules for each collection. In addition, a number of road traffic-related deaths may be coded to Other ill-defined and unspecified causes of mortality (R99) due to the unavailability of information on the NCIS, particularly for New South Wales and Queensland. It is important to note that the number of deaths attributed to transport accidents for 2007 will change as data is revised. See Explanatory Notes 3 - 4.


Assault (X85-Y09, Y87.1)

75 The number of deaths recorded as assault (murder/manslaughter) have decreased significantly over the last 11 years, from 307 in 1998 to 162 in 2007. The number of deaths due to murder published in the Causes of Death publication vary from those previously published by the ABS in Recorded Crime - Victims, Australia, 2006 (cat. no. 4510.0). Whilst there are differences in the scope and coverage of the two collections, this is not sufficient to explain the differences in numbers. A reluctance by Coroners to make a final determination of Assault until legal proceedings have been finalised and the high number cases with a status of "open" on the NCIS may also impact on the causes of death statistics. It is important to note that the number of deaths attributed to assault for 2007 is expected to increase as data is revised. See Explanatory Notes 3 - 4.

Comparison of deaths caused by assault - 2007

NSW
Vic.
Qld
SA
WA
Tas.
NT
ACT
Australia

Recorded Crime-Victims
103
49
58
13
33
6
17
3
282
Causes of Death
60
26
21
12
20
7
12
3
162



76 The following codes may include cases which could potentially have been assaults but for which the intent was determined to be other than Assault. Such cases cannot be separately identified in the final causes of death statistics;
  • Falls (W13, W15, W17)
  • Striking, contact and exposure (W20-W22, W25, W27, W40, W49, W50, W51, W81)
  • Firearm discharge (W32, W33, W34)
  • Accidental strangulation/hanging/suffocation (W75, W76, W83, W84)
  • Contact with knife, sword or dagger (W26)
  • Exposure to unspecified factor (X59)
  • Events of Undetermined Intent (Y20-Y34)
  • Other ill-defined and Unspecified Causes of Mortality (R99)


Suicide(X60-X84, Y87.0)

77 The number of deaths recorded as intentional self harm (suicide) has decreased over the last 10 years, from 2683 in 1998 to 1,881 in 2007. A reluctance by Coroners to make a determination of "suicide" and the high number cases with a status of "open" on the NCIS have impacted on the 2007 suicide data. Where coroners' cases are not finalised and the findings are not available to the ABS in time for publication of causes of death statistics, deaths are coded to other accidental, ill-defined or unspecified causes rather than suicide. See Technical Note: ABS Coding of Suicide Deaths for further details. It is important to note that the number of deaths attributed to suicide for 2007 is expected to increase as data is revised. See Explanatory Notes 3 - 4.

78 Suicide deaths in children are an extremely sensitive issue for families and coroners. The number of child suicides registered each year is low in relative terms and is likely to be underestimated. For that reason this publication does not include detailed information about suicides for children aged under 15 years. There was an average of 10.1 suicide deaths per year of children under 15 years over the period 1998 to 2007; the highest number was registered in 1999 (17), the lowest in 2006 (7). For boys the average number of suicides per year was 6.9, while for girls the average number was 3.2. These correspond to rates of approximately 0.3 per 100,000 boys and 0.2 per 100,000 girls in this age group over this period.


Undetermined Intent (Y10-Y34, Y87.2)

79 Previous versions of ICD-10 clearly provided an indication for coders in the use of the undetermined intent categories via a Note at the beginning of the Y10-Y34 categories. The note indicates that these codes can only be assigned "where available information is insufficient for the medical or legal authority to make a distinction between accident, self harm and assault ". The 2007 version of ICD10 has altered the instructions for undetermined intent categories to : "This section covers events where available information is insufficient to enable a medical or legal authority to make a distinction between accident, self-harm and assault. It includes self-inflicted injuries, but not poisoning, when not specified whether accidental or with intent to harm (X40-X49). Follow legal rulings when available."

80 A change in coding processes was implemented by the ABS for 2007 data affecting codes with an intent of "Undetermined Intent". Up to and including 2006, only where there had been an official coronial finding of "Undetermined Intent" were deaths allocated to these codes. Other deaths where either intent was "not known" or "blank" on the NCIS record, were coded with an intent of "accidental".

81 From 2007, where the NCIS intent field is "could not be determined", "unlikely to be known" or "blank", the death will be coded to an "Undetermined Intent" code. This change in coding practice has resulted in a significant increase in deaths allocated to these codes in 2007. It is important to note that the number of deaths attributed to "Undetermined Intent" codes for 2007 is expected to decrease as data is revised. See Explanatory Notes 3 - 4.


CONFIDENTIALISATION OF DATA

82 From 2007 data cells with small values have been randomly assigned to protect confidentiality. As a result some totals will not equal the sum of their components. It is important to note that cells with 0 values have not been affected by confidentialisation.


EFFECTS OF ROUNDING

83 Where figures have been rounded, discrepancies may occur between totals and sums of the component items.


ACKNOWLEDGEMENT

84 The ABS publications draw extensively on information provided freely by individuals, businesses, governments and other organisations. Their continued cooperation is very much appreciated: without it, the wide range of statistics published by the ABS would not be available.


RELATED PRODUCTS

85 Other ABS publications which may be of interest are outlined below. Please note, older publications may no longer be available through ABS bookshops but are available through ABS libraries. All publications released from 1998 onwards are available on the ABS website <http://www.abs.gov.au>
86 ABS products and publications are available free of charge from the ABS website <http://www.abs.gov.au>. Click on Statistics to gain access to the full range of ABS statistical and reference information. For details on products scheduled for release in the coming week, click on the Future Releases link on the ABS homepage.


ADDITIONAL STATISTICS AVAILABLE

87 As well as the statistics included in this and related products, additional information is available from the ABS web site at <http://www.abs.gov.au> by accessing the topics listed at Themes>People. The ABS may also have other relevant data available on request. Inquiries should be made to the National Information and Referral Service on 1300 135 070 or by sending an email to client.services@abs.gov.au.


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