Unintentional injuries pose significant challenges to public health, impacting individuals and communities. They also create significant economic costs for society as a whole. Common preventable fatal unintentional injuries among adults of working age include, among others, falls, poisonings, traffic accidents and drowning.

To examine the incidence trends of the changes in fatal unintentional injuries among working-age (25–64) adults in Finland, with alcohol and/or drug intoxication as a contributing cause of death.

We used open data from the Causes of Death register hosted by Statistics Finland. Injury deaths between 1998 and 2022 were included in the analysis. The Mann-Kendall non-parametric trend test was used for incidence rates, assessing whether a monotonic trend was present.

The most common fatal unintentional injuries in working-age adults in Finland were due to poisonings, falls and traffic accidents. The results showed a significant downward trend in the number of all fatal unintentional injuries, with the exception of poisonings among the youngest age group, 25–34 years, in both males and females. The incidence of fatal unintentional injuries among men decreased by 53 % during the study period, and by 46 % among women. Men were more frequently involved in fatal unintentional injuries than women.

Fatal unintentional injuries among the working-age population have decreased in Finland due to national collaborative efforts in recent decades. However, preventive measures are still needed, especially to prevent unintentional injuries caused by substance abuse.