Trends in Unintentional Injury Mortality Among Children and Adolescents in Poland, 2010-2024: An Unfinished Lesson for Public Health in Changing Social Realities.

INTRODUCTION: Unintentional injuries are a major cause of death among children and adolescents in Europe. Poland has historically reported elevated mortality levels. This study assesses national trends in injury mortality among individuals aged 1-19 years from 2010 to 2024. METHODS: A national time-trend analysis was conducted using Statistics Poland death registry data. Mortality rates were calculated by age group, sex, residence, and cause of death. Trends were modelled using log-linear Poisson regression to estimate annual percent change (APC). Global Burden of Disease estimates provided international context. RESULTS: A total of 6,812 deaths from unintentional injuries occurred during 2010-2024. Overall mortality decreased from 8.5 to 4.9 per 100,000 (APC -4.8%; 95% CI -5.3 to -4.3). The highest average mortality rate during 2010-2024 was observed in the 15-19 age group (15.4; 95% CI 14.9-15.8). Rural areas showed the steepest improvement (APC -6.7%), with rates declining from 11.7 in 2010 to 4.7 in 2024. The fastest age-specific decline occurred among children aged 5-9 years (APC -6.7%). Transport-related injuries contributed approximately 71% of the total decline. Drowning mortality showed the most pronounced relative decrease (APC -10.0%), while poisoning mortality increased significantly (APC +6.3%). CONCLUSIONS: Mortality from unintentional injuries among children and adolescents in Poland has declined to levels comparable with the European Union; however, these improvements have been uneven across population groups. Further progress will require adapting prevention strategies to increasingly complex and evolving risk factors shaped by changing societal conditions.