CLINICAL & BASIC RESEARCH

SQU Med J, May 2011, Vol. 11, Iss. 2, pp. 244-251, Epub. 15th May 11
Submitted 24th Aug 10
Revision ReQ. 27th Sept & 14th Dec 10, Revision recd. 24th Oct & 22nd Dec 10
Accepted 23rd Feb 11

1Department of Medical Statistics & Epidemiology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; 2Evidence 
for Population Health Unit, School of Epidemiology & Health Sciences, University of Manchester, Manchester, U.K.; 3Hamad Trauma 
Center, Hamad Medical Corporation, Doha, Qatar; 4Accident and Emergency Department, Hamad Medical Corporation, Doha, 
Qatar.
*Corresponding Author email: abener@hmc.org.qa

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10
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
: كلمات البحث 

aBstract: Objectives: The aim of this retrospective descriptive hospital-based study was to determine the trend 
in the number, incidence and pattern of head and neck injuries involved with falls. Methods: A retrospective 
analysis was carried out of 1,952 patients who were treated at the Accident and Emergency and Trauma centres of 
Hamad Medical Corporation, Qatar, for head (n = 1,629), neck (n = 225) and both (n = 98) injuries during the period 
2001–2006. Head and neck injuries were determined according to the International Classification of Disease, ICD-
10 criteria. Details of all the trauma patients who were involved in falls were extracted from the database of the 
Emergency Medical Services (EMS), Hamad Medical Corporation. Results: The majority of the victims were non-
Qataris (78.6%), men (86.6%) and in the age group 20–29 years (26.8%). There was a disproportionately higher 
incidence of head and neck injuries from falls during weekends (27.1%). Nearly half of the head and neck injuries 
from falls occurred at work (49.4%). Neck injuries (10.2%) were more severe than head injuries (7.3%). The incidence 
rate of head and neck injuries per 10,000 population increased from 2.1 in the year 2001 to 5.5 in 2006, particularly 
among the elderly population above 60 years of age (13.1 in 2003 to 18.6 in the year 2006). Superficial injury to the 
head (29.4%) was more common among trauma patients. Conclusion: The present study findings revealed that the 
incidence of head and neck injuries was higher among young adults and the elderly population. 

Keywords: Head injury; Neck injury; Occupational falls; Home falls; Incidence; Morbidity; Trauma; Qatar

Trends and Characteristics of Head and Neck 
Injury from Falls

A hospital based study, Qatar
*Abdulbari Bener,1,2 Yassir S. Abdul Rahman,3 Eltayib Y. Abdel Aleem,4 Muayad K. Khalid4

CLINICAL & BASIC RESEARCH

Advances in Knowledge
1. This is the first study in Qatar to investigate the number, incidence and trends of head and neck injuries from falls.  
2. The high risk groups of fallers were elderly people and younger workers. 
3. This study highlighted the emerging trend of traumatic morbidity from fall induced head and neck injuries in the general population.  

Application to Patient Care
1. The findings of this study emphasise the need for urgent steps to be taken in Qatar for injury prevention, especially among workers and 

those in the elderly population.



Abdulbari Bener, Yassir S. Abdul Rahman, Eltayib Y. Abdel Aleem and Muayad K. Khalid

Clinical and Basic Research | 245

Falls and fall-induced injuries are a major public health problem in modern societies with ageing populations.1 As a 
measure of burden, disability adjusted life years 
(DALYs) quantify the total amount of healthy life 
lost because of disease or injury. In high income 
countries, injuries due to falls are the fourteenth 
leading cause of DALYs for all age groups  
combined.2 In industrialised countries like the USA, 
Canada and Japan, injuries caused by falls have 
increased dramatically.3 Falls are the second leading 
cause of unintentional injury deaths in the USA.  
It was reported that an estimated 3.4 million non-
fatal injuries occurred among workers of all ages  
and were treated in US hospital emergency 
departments in 2004.4 

Falls are the most common cause of head 
injuries in children and adolescents, followed by 
motor vehicle crashes, pedestrian and bicycle 
accidents, sports-related trauma, and child abuse.5 

Falls are a common source of traumatic injuries, 
and it was revealed that fall injury patterns differ 
between adults and children. Fall rates are highest 
for children age 0 to 4 years and adults aged 75 years 
and older. Falls are usually the most common cause 
of injury seen in hospitals, accounting for 25–52% 
of all treated child injuries.6 Falls and subsequent 
head injuries among the elderly are the result of a 
complex interaction between physical changes due 
to ageing, disease, lifestyle and environment related 
and social factors.  Also, older fallers are more likely 
to fall indoors than outdoors.7

Head injury is a common and serious 
consequence of falling among older adults, and 
a great majority of elderly people’s non-fatal and 
fatal head injuries are caused by falls.8 Although the 
head, face and neck comprise only 12% of the total 
body surface area exposed during impact, injuries 
sustained in these areas are more likely to be fatal.9 
Head and neck injuries from falls are a common 
cause of occupational morbidity and mortality, 
resulting in significant losses of life and wages, as 
well as significant medical expenses. Males are at 
greater risk of sustaining a fall-related injury while 
at work and during recreational activities.

Although fall injuries comprise a major health 
burden, the risk factors for such injuries have not 
been examined in a systematic and comprehensive 
manner. In practice, knowledge of risk factors for 
head and neck injuries from falls can assist injury 

practitioners, programme developers, and policy 
makers in determining appropriate intervention. 
Only two previous studies have been conducted in 
Qatar to document trends in traumatic brain injury10 
and traumatic spinal injury.11 Both of these studies 
were very preliminary and neither study specifically 
focused on head and neck injuries as a result of 
falls. In fact, to our knowledge, no nationwide 
study investigating the number, incidence and 
trends of head and neck injuries from falls has been 
published from Qatar. Therefore, this study aimed 
to determine the trends of head and neck injuries 
from falls in absolute number, incidence and pattern 
of injuries during the period 2001 to 2006.

Methods
This is a retrospective, descriptive hospital based 
study. This study included a total of 1,952 patients 
with head and neck injuries who were treated in the 
Accident & Emergency Department of the Hamad 
General Hospital (HGH) and other 8 Trauma 
Centres of the Hamad Medical Corporation (HMC) 
following fall incidents during the period 2001 to 
2006. All trauma cases occuring in the State of 
Qatar are treated in the Accident and Emergency 
Department of the HGH and the 8 trauma centres 
of the HMC. Hence, the data collected in this study 
not hospital based, but covers all head and neck 
injuries occurring in Qatar during the period of the 
study.The electronic Emergency Medical Service 
database has complete information on trauma cases 
year by year. We took the frequency of head and 
neck injury from falls by year and population of the 
respective year.  Then, we calculated the incidence 
of the head and neck injury per 10,000 of the 
population based on the population of the country 
for the respective year.  

This is a retrospective, descriptive hospital based 
study. This study included a total of 1,952 patients 
with head and neck injuries who were treated in the 
Accident & Emergency Department of the Hamad 
General Hospital and other 8 Trauma Centres of 
the Hamad Medical Corporation following fall 
incidents during the period 2001 to 2006. The 
population in Qatar was estimated to be 838,065 
in the year 2006 and has a unique distribution of 
population according to gender and ethnicity.12 
Only about 30% of the total population are nationals 
and the majority of the total population (66.7%) are 



Trends and Characteristics of Head and Neck Injury from Falls 
A hospital based study, Qatar

246 | SQU Medical Journal, May 2011, Volume 11, Issue 2

males.12   
Hamad General Hospital is the main tertiary 

care centre in the country; all major and most of the 
minor trauma cases are treated in this hospital. The 
study was based on the Emergency Medical Services 

(EMS) registry, an electronic database in Qatar. 
This registry records complete information of the 
patients who had accidents and were brought to the 
Accident & Emergency Department and Trauma 
centres for treatment. The details of the falls were 

Table 1: Characteristics of patients with head and neck injuries resulting from falls in the period 2001–2006 

Variables Head n = 1,629, n (%) Neck n = 225, n (%) Both n = 98, n (%) Total N = 1,952, n (%) 

Age (Mean ± 
Standard deviation) 30.4 ±18.1 29.8 ± 15.0 32.2 ± 17.6 30.4 ± 17.6

Age groups in years §

 < 10 243 (14.9) 19 (8.4) 5 (5.1) 267 (13.7)

10–19 150 (9.2) 29 (12.9) 13 (13.3) 192 (9.8)

20–29 419 (25.7) 71 (31.6) 33 (33.7) 523 (26.8)

30–39 368 (22.6) 53 (23.6) 19 (19.4) 440 (22.5)

40–49 225 (13.8) 25 (11.1) 16 (16.3) 266 (13.6)

50–59 104 (6.4) 20 (8.9) 6 (6.1) 130 (6.7)

≥60 120 (7.4) 8 (3.6) 6 (6.1) 134 (6.9)

Ethnicity

Qatari 343 (21.1) 52 (23.1) 22 (22.4) 417 (21.4)

Non Qatari 1,286 (78.9) 173 (76.9) 76 (77.6) 1,535 (78.6)

Gender

Male 1,415 (86.9) 192 (85.3) 84 (85.7) 1,691 (86.6)

Female 214 (13.1) 33 (14.7) 14 (14.3) 261 (13.4)

Day of the week

Week days 1,189 (73.0) 167 (74.1) 6 (67.0) 1,422 (72.9)

Weekend‡ 440 (27.0) 58 (25.9) 32 (33.0) 530 (27.1)

Place of fall

At work 817 (50.1) 99 (44.2) 50 (50.7) 965 (49.4)

Home 519 (31.9) 85 (37.6) 30 (31.0) 635 (32.5)

School 106 (6.5) 14 (6.1) 3 (2.8) 123 (6.3)

Recreational places 187 (11.5) 27 (12.2) 15 (15.5) 229 (11.8)

Status at the time of admission*

Conscious 1,510 (92.7) 215 (95.6) 87 (88.8) 1,812 (92.8)

Breathing 1,619 (99.4) 225 (100) 98 (100) 1,942 (99.5)

Bleeding 677 (41.5) 59 (26.2) 39 (39.8) 775 (39.7)

Glasgow coma score

Severe score 3–8 119 (7.3) 23 (10.2) 7 (7.2) 147 (7.5)

Moderate score 9–12 149 (9.1) 30 (13.3) 11 (11.2) 186 (9.5)

Mild score 13–15 1,361 (83.6) 172 (76.5) 80 (81.6) 1,619 (82.9)

Notes: § = significant P value = 0.005; ‡ = weekend is Friday and Saturday; *Multiple options: sum of percentage may not add to 100%. 



Abdulbari Bener, Yassir S. Abdul Rahman, Eltayib Y. Abdel Aleem and Muayad K. Khalid

Clinical and Basic Research | 247

collected regularly by the EMS staff using a standard 
questionnaire. The questionnaire included variables 
such as age, sex, time of injury, place of fall, the type 
of injury, the region of the body injured and the 
severity of injury. The data provided by this register 
are well suited for epidemiological purposes. 

Medical records of the victims were thoroughly 
reviewed in the event of any missing information. 
The patient information was extracted from 
the EMS registry and analysed. Head and neck 
injuries were defined according to the International 
Classification of Disease (ICD) ICD-10 criteria and 
external causes of injury recorded. Head injuries, 
neck injuries and a combination of both injuries 
together were mutually and exclusively reported. 
Fall-induced head and neck injuries were recorded 
by evaluating the primary and secondary diagnosis. 
Descriptive statistics were performed on the socio-
demographic characteristics, place of fall, status of 
the injury at the time of admission and diagnosis. 
According to ICD-10, injuries to the head were 
classified under categories S00–S09 and injuries to 
the neck were classified under S10–S19. The age-
specific incidence rate was calculated based on the 
population in that specific age group in that year.

The severity of head or neck injury was classified 
by Glasgow Coma Scale (GCS). This a tool for 
measuring degree of unconsciousness and is thus a 
useful tool for determining severity of head injury.13 
The GCS classifications are as follows: 1) Severe: 
score of 3–8; 2) Moderate: score of 9–12, and 3) 
Mild: score of 13–15. The GCS score of patients 
was taken when they were examined and, for the 
intubated patients, the score was taken prior to 
intubation. Informed consent by all participants was 
not required in this study, as it was a retrospective 
hospital based study. The study was approved by 
the Research Ethics Committee at Hamad General 
Hospital of Hamad Medical Corporation.

Data are expressed as mean and standard 
deviation (SD) unless otherwise stated. The Fisher 
exact and chi-square test for trend were used to 
compare frequencies between two or more than 
two categories. A P value of <0.05 was considered 
as the cut-off value for significance.  

Results
Table 1 shows the socio-demographic characteristics 
of patients with head and neck injuries resulting 

from falls during the period 2001–2006. A total 
of 1,952 patients were diagnosed with head and 
neck injuries from falls. The majority of them were 
non-Qataris (78.6%), males (86.6%) and in the age 
group 20–29 years (26.8%). Men outnumbered 
women by 6.5:1. A total of 27.1% of the head and 
neck injuries from falls occurred during weekends, 
while 72.9% occurred on week days. Nearly half of 
the head and neck injuries from falls occurred at 
work (49.4%), followed by falls at home (32.5%), 
then at recreational places (11.8%) and school 
(6.3%). According to the GCS score, 7.5% had severe 
and 9.5% had moderate injury. The majority of the 
patients had mild head (83.6%) and neck injury 
(76.5%). Neck injuries (10.2%) were more severe 
than head injuries (7.3%) among trauma patients. A 
significant difference was observed in the age group 
of fallers and the injuries occurred between week 
days and weekends (P = 0.005).

Table 2 shows the distribution of diagnosis of 
injuries and place of fall according to the age group 
of trauma patients. Most of the head and neck 
injuries were occupational injuries (49.5%) and 
32.5% of injuries happened at home. Older people 
above 60 years-old had more frequent injuries to 
the head and neck region from falls at home (70.9%), 
followed by children below 10 years (66.7%). Major 
fall related injuries included superficial injury of the 
head (29.4%), followed by an open wound on the 
head (23.4%), then blunt injury (19.5%). Superficial 
injury of head was more frequent among children 
below 10 years (33%). An open wound to the head 
was more common among patients above 60 years 
(32.8%).

Table 3 shows the incidence rate of head and 
neck injuries sustained from falls per 10,000 of the 
population according to age group and year during 
the period 2001–2006. There was a clear increase in 
the incidence of head and neck injuries: 2.1/10000 
in 2001 to 5.5/10000 in 2006. The elderly population 
above 60 years of age had the highest increase in  
incidence of head and neck injuries from falls (6.7 
to 18.6/10,000) across the study period. There was 
a significant difference found in the number of 
injuries in different age groups of fallers (P <0.001).

Figure 1 shows the incidence rate of head, 
neck injuries and both together per 10,000 of 
the population resulting from falls during the 
period 2001–2006. The number of neck injuries 
also increased to 4.9/10,000 population in 2006 



Trends and Characteristics of Head and Neck Injury from Falls 
A hospital based study, Qatar

248 | SQU Medical Journal, May 2011, Volume 11, Issue 2

compared to 1.8/10,000 population in 2001. 

Discussion
Falls are the commonest cause of head and neck 
injuries in children, adults and elderly people. 
Although fall-induced injuries among older adults 
are said to be a major public health concern in 
modern societies with ageing populations, reliable 
epidemiologic information on their trends and the 
pattern of injuries is limited. To our knowledge, this 
is the first study in Qatar examining and comparing 
fall related head and neck injuries in young, middle-

aged and older men and women. The focus was on 
the faller’s activity, the incidence of head and neck 
injuries, and the severity and type of injuries. Of all 
hospitalisations with head and neck injuries, 18.4% 
had head and neck injuries from falls, while 7.5% 
had a GCS score of <9 (severe), 9.5% a score of 
9–12 (moderate) and 82.9% a score of 13–15 (mild).  
Most of the patients with head and neck injuries 
were conscious (92.7%) at the time of admission 
after the fall. Head injuries accounted for the 
majority of the fall cases (83.5%), followed by neck 
injuries (11.5%). A similar result was observed in 
another study where 63.2% of the fall cases were 

Table 2: Place of fall and diagnosis by age group (N = 1,952)  

Variables Age group in years Total
n (%)

<10
n (%)

10–19
n (%)

20–29
n (%)

30–39
n (%)

40–49
n (%)

50–59
n (%)

60+
n (%)

Place of fall

At work 0 (0.0) 22 (11.5) 347 (66.3) 317 (72.0) 196 (73.7) 55 (42.3) 29 (21.6) 966 (49.5)

Home 178 (66.7) 49 (25.5) 81 (15.5) 91 (20.7) 67 (25.2) 73 (56.2) 95 (70.9) 634 (32.5)

Recreation 0 (0.0) 91 (47.4) 91 (17.4) 32 (7.3) 3 (1.1) 2 (1.5) 10 (7.5) 229 (11.7)

School 89 (33.3) 30 (15.6) 4 (0.8) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 123 (6.3)

Diagnosis

Superficial injury to 
head

 
88 (33.0)

 
48 (25.0)

 
150 (28.7)

 
131 (29.8)

 
76 (28.6)

 
38 (29.2)

 
42 (31.3)

 
573 (29.4)

Open wound on 
head

 
57 (21.3)

 
36 (18.8)

 
126 (24.1)

 
96 (21.8)

 
68 (25.6)

 
29 (22.3)

 
44 (32.8)

 
456 (23.4)

Blunt head injury 62 (23.2) 38 (19.8) 92 (17.6) 84 (19.1) 51 (19.2) 24 (18.5) 30 (22.4) 381 (19.5)

Superficial injury of 
neck

 
16 (6.0)

 
31 (16.1)

 
67 (12.8)

 
39 (8.9)

 
20 (7.5)

 
17 (13.1)

 
7 (5.2)

 
197 (10.1)

Soft tissue 
contusion

 
23 (8.6)

 
17 (8.9)

 
25 (4.8)

 
25 (5.7)

 
14 (5.3)

 
7 (5.4)

 
2 (1.5)

 
113 (5.8)

Traumatic 
amputation on head 
(ear & nose)

 
3 (1.1)

 
13 (6.8)

 
23 (4.4)

 
21 (4.8)

 
9 (3.4)

 
7 (5.4)

 
1 (0.7)

 
77 (3.9)

Dislocation, sprain, 
strain of joints of 
head

 
6 (2.2)

 
1 (0.5)

 
15 (2.9)

 
 

16 (3.6)
 

9 (3.4)
 

2 (1.5)
 

3 (2.2)
 

52 (2.7)

Fracture of skull & 
Facial bone

 
4 (1.5)

 
3 (1.6)

 
6 (1.1)

 
6 (1.4)

 
3 (1.1)

 
2 (1.5)

 
0 (0.0)

 
24 (1.2)

Multiple injuries of 
head

 
2 (0.7)

 
0 (0.0)

 
4 (0.8)

 
5 (1.1)

 
7 (2.6)

 
1 (0.8)

 
2 (1.5)

 
21 (1.1)

Open wound of neck 2 (0.7) 2 (1.0) 4 (0.8) 4 (0.9) 2 (0.8) 1 (0.8) 1 (0.7) 16 (0.8)

Burns & corrosions 3 (1.1) 1 (0.5) 3 (0.6) 4 (0.9) 3 (1.1) 0 (0.0) 1 (0.7) 15 (0.8)

Injury of nerves & 
spinal cord

 
0 (0.0)

 
0 (0.0)

 
4 (0.8)

 
6 (1.4)

 
3 (1.1)

 
2 (1.5)

 
0 (0.0)

 
15 (0.8)

Penetrating head 
injury

1 (0.4) 2 (1.0) 4 (0.8) 3 (0.7) 1 (0.4) 0(0.0) 1 (0.7) 12 (0.6)



Abdulbari Bener, Yassir S. Abdul Rahman, Eltayib Y. Abdel Aleem and Muayad K. Khalid

Clinical and Basic Research | 249

head injuries, followed by neck injuries (19.8%).14

Our findings revealed that both the head and 
neck injuries from falls were higher in young adults 
in the age group 20–29 years (25.7% and 31.6%) 
and 30–39 years (22.6% and 23.6%). A study by 
Hausdorff et al. documented that more than a 
third of older adults fall each year and 10–20% of 
falls cause serious injuries such as fractures or head 
trauma.15 This runs contrary to the study in Canada 
on fall-related emergency department visits, where 
the head and neck were injured most often (49%) 
among children below 20 years.16 In Ontario, 80% of 
head injury hospitalisations were reported among 
people aged 65 years and older, while only 17% were 
reported in the 15 to 34 years age group.17 Another 
study by Cheng et al. also reported that there was a 
trend for the elderly to have more frequent injuries 
to the head (53.2%) and neck (47.5%) region.18

The reason for the low proportion of falls among 

elderly people in Qatar is that the majority of the 
fall-induced head (78.9%) and neck injuries (76.9%) 
occurred in the non-Qatari population. These 
people leave Qatar once they reach their retirement 
age of 60 years. This is evident from the data as half 
of the head and neck injuries were occupational 
injuries (49.5%). Thus, falls are a common cause of 
occupational morbidity and mortality, resulting in 
significant losses of life, wages, as well as significant 
medical expenses. Falls are a risk factor for disability 
and frailty and exacerbate disablement among the 
adult non-Qatari population. Even in the United 
Arab Emirates, occupational injuries resulting from 
falls were frequent with 66.7% of hospitalisations.18 

Similar to Qatar, falls were the most frequent cause 
of head and neck injuries among non-nationals 
in the United Arab Emirates, whereas for injuries 
among nationals the main cause was road traffic 
crashes.18 Many studies indicate that falls continue 
to pose a serious problem to the elderly population, 
whereas it was a more serious issue for both the 
middle-aged working population and the elderly in 
Qatar.18,19

The incidence rate of fall induced head and 
neck injuries among the general population rose 
considerably in the study period: from 2.1 in 2001 
to 5.5 in 2006. Although the frequency of fall 
induced head and neck injuries was higher in young 
adults, the incidence rate in the elderly population 
above 60 years of age seemed to show an alarming 
rise with a rate that cannot be explained merely 
by demographic changes: from 2.8 in 2001 to 
19/10,000 in 2005 and 18.6/10,000 in 2006. The 
incidence rate in people above 60 years-old was four 
times higher than the incidence rate observed in 
younger people. A similar finding was observed in 

Table 3: Incidence rate of head and neck injuries 
resulting from falls per 10,000 population during the 
period 2001–2006 

Age 
group 

2001 2002 2003 2004 2005 2006 

<10 1.4 3.5 5.5 4.5 5.5 2.4 

10–19 2.4 3.4 2.7 3.4 4.1 4.0 

20–29 3.4 6.1 4.8 5.4 8.7 8.7 

30–39 1.7 2.4 4.0 4.4 6.2 5.4 

40–49 1.3 2.7 3.8 3.5 4.8 4.0

50–59 3.4 4.4 3.6 3.3 4.9 5.4

60+ 2.8 6.7 13.1 11.9 19.0 18.6

All 
Ages 

2.1 3.7 4.4 4.4 6.3 5.5

Note: P = <0.001 

Figure 1: Incidence rate of head injury, neck injury and both injuries per 10,000 of the population resulting from falls 
during the period 2001–2006.



Trends and Characteristics of Head and Neck Injury from Falls 
A hospital based study, Qatar

250 | SQU Medical Journal, May 2011, Volume 11, Issue 2

a study by Stevens and Soglow where the incidence 
rates for fall related head injuries increased with 
advancing age with a rate four to five times higher 
in people aged 85 years and older compare to those 
aged 65–74 years.20 Rubenstein et al. reported that 
beyond 50 years of age, there is a steady increase 
in the occurrence of falls and the magnitude of fall 
related complications.21 In Qatar, after the elderly 
population, young adults in the age group 20–29 
years were the most frequent victims of head and 
neck injuries from falls; 8.7/10000 in the years 2005 
and 2006.

The relationship between fall and injury varies 
by gender. In the study sample, 86.6% of the head 
and neck injuries were reported among men. Men 
outnumber women by 6.5:1. It was found that men 
sustain more fall injuries than women, perhaps due 
to the underlying causes or circumstances of their 
falls. This result differs to that of another study22 

where women had a higher risk of falling than men 
in general population studies, a trend not seen in the 
present study. Jenson et al. reported that the cause of 
the gender discrepancy may lie in divergent activity 
patterns between men and women over separate 
periods of the day and night or in differences in 
personal risk assessment between the genders.23  

In Qatar, expatriates (70% of the total population), 
especially the male labour force, are greater in 
number than nationals. A good proportion of the 
expatriate men are employed on construction sites 
where they are at high risk for occupational injuries. 
Elderly people are mostly nationals and they have a 
better life expectancy due to better health care and 
a higher standard of living.

In Qatar, superficial injuries of head have been 
observed overall with a frequency up to 29.4% 
in falls, followed by open wound on the head 
(23.4%). Superficial injury was more common 
among children below 10 years (33%) and in elderly 
population above 60 years (31.3%). However, an 
open wound to the head was more frequent among 
people above 60 years (32.8%). Nonetheless, blunt 
head injury was more frequent in children (23.2%) 
and the elderly population (22.4%) compared to 
other age groups. In another study by Turk and 
Tsoko, a higher frequency of blunt neck injuries 
were observed (33%) in falls from heights.24 Neck 
injuries were less common in falls in the studied 
population compared to head injuries. In Canada, 
74% of fall related hospital admissions are due 

to fractures and dislocations, with serious head 
injuries (20%).15 Elderly trauma patients differed 
from younger adult trauma patients in their injury 
patterns and the mode of presentation of significant 
injuries. 

The present study showed some differences 
and some similarities when compared to other 
studies related to fall injuries. The risk in our study 
increased with age and was higher among men, a 
similar finding to other studies. The findings of our 
study confirm the findings of previous studies25,26 

with regard to older age which is a well-recognised 
risk factor for falling in the general population. 
Additional efforts in Qatar are needed to reduce 
the occurrence of fall related occupational injuries. 
It is important to identify the risk factors related 
to fall induced head and neck injuries and develop 
comprehensive intervention programmes to 
reduce the risk for such falls. Falls have significant 
economic impact on the country, including costs 
to individuals and their families, to work places 
and the health system as well as to community and 
social services.

Conclusion
A relatively high rate of head and neck injuries from 
falls was demonstrated in this study. The incidence of 
head and neck injuries rose during the study period. 
Occupational fall injuries were most frequent in 
the general population, particularly among non-
nationals. Findings show that the age-specific 
incidence of fall-induced severe head injuries in 
the Qatar population above 60 years of age has 
increased steeply during the study period and also 
has not declined in more recent years. According to 
the GCS score, neck injuries were more severe than 
head injuries. The injuries represent an alarming 
epidemic and the predicted ageing of populations 
will soon exacerbate the burden on our health care 
systems.

c o n f l i c t o f i n t e r e s t
The authors reported no conflict of interest.

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