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Abstract
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BACKGROUND: Annual global travel reached an all-time high of 1.4 billion international tourist visits in 2019. It is estimated that injury accounts for close to 25% of deaths in travelers, most of which are theoretically preventable. However, there are limited data available on injury occurrence and outcomes in travelers. Our objective was to better understand the relative risk of dying from injury that arises from the novel environments and behavioral changes associated with foreign travel.
METHODS: A systematic literature review was conducted (PubMed, Embase, Scopus) according to PRISMA guidelines that included studies published in English since 1990 that reported injury deaths in tourists per 100,000-person years or as a proportion of total tourist deaths in comparison to a non-traveler population. We also included studies that reported data allowing calculation of these rates. Relative rates or proportions of overall injury mortality, mortality due to traffic accidents, drowning, and homicide were summarized.
RESULTS: 1847 articles were identified, 105 underwent full-text review, and 10 articles were suitable for data extraction. There was great variability of relative risk reported, but overall, travelers appear to have a higher risk of injury mortality than domestic populations, with relative rates of injury death ranging from 1.04 to 16.7 and proportionate mortality ratios ranging from 1.43 to 3.
CONCLUSIONS: Tourists should be aware of the increased risk of dying from road traffic hazards, drowning, and homicide while traveling abroad. Specific geographies and activities associated with higher risk should be emphasized. Travel medicine practitioners and organizations that send people abroad should counsel travelers regarding these risks and seek ways to reduce them, including encouraging potential risk-mitigating behaviors. There is a need to improve systems of data collection and reporting on injury deaths in travelers and to study the impact of pre-travel and institutional interventions aimed at reducing this risk.
Language: en |