The Barcelona injury surveillance system

Abstract Issue/problem Injuries are a leading cause of death and disability worldwide, often marked by social inequalities. Barcelona, a dense and mobile city, previously had fragmented monitoring. The Barcelona Injury Surveillance System (BISS) was developed to integrate multiple data sources and support prevention and equity-oriented action. It combines data from emergency departments (EDs), hospitalizations, and mortality records, and includes a road traffic injury (RTI) subsystem with police data. This abstract describes the system and demonstrates its use with 2021 data, focusing on injury mechanisms, affected groups, and inequalities. Description of the problem BISS includes three subsets: nonfatal injuries in EDs, hospitalizations, and deaths. The BISS-RTI subsystem includes health and police data to describe injuries by transport mode. Sixty indicators were developed using international classifications. In 2021, data was analyzed by sex, age, mechanism, and severity. Crude and age-adjusted rates per 100,000 residents were calculated. Results In 2021, EDs treated 38,138 men and 35,949 women for external injuries. Of these, 69.9% of men and 78.6% of women were residents, with rates of 3,381.5 and 3,265.8 per 100,000. Hospitalizations included 4,458 men and 4,841 women; resident rates were 368.9 and 456.2 per 100,000. Among residents, 336 men and 303 women died from injuries (42.6 and 35.0 per 100,000). Young men (15-44) had higher rates of traffic and violence-related injuries. Fractures dominated hospitalizations, especially in women. BISS identified gaps in external cause coding in EDs. Lessons BISS shows that integrating routine health and police data enables robust, equity-focused surveillance. Standard indicators support local policy and action. Priorities include improving ED data quality and tailoring prevention by age and sex. The BISS model is transferable to other cities, supporting global efforts in injury prevention and health equity. Key messages • Integrating routinely collected health and police data enables and enhances effective, equity-focused urban injury surveillance and prevention. • The BISS model is transferable and could support targeted, data-driven public health action in other cities and countries.