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July 24, 1948

Note: The Regulations entered into force, January 1, 1950 and with respect to the Philippines, on the same date.

Reference: This Regulations is also published in 66 UNTS, p. 25.

The World Health Assembly,

Recognizing the importance of ensuring as far as possible the uniformity and comparability of statistics of diseases and causes of death,

Having regard to Articles 2 (s), 21 (b), 22 and 64 of the Constitution of the World Health Organization,

Adopts this twenty-fourth day of July one thousand nine hundred and forty-eight the following Regulations, which may be cited as the Nomenclature Regulations 1948.

ARTICLE 1

Members of the World Health Organization for whom these Regulations shall come into force under Article 20 of the present Regulations (hereinafter referred to as Members) shall compile and publish annually for each calendar year statistics of causes of death, in accordance with Articles 2-8, 12, 17-19 of the Regulations and in accordance with the classification, nomenclature and numbering as set out in the Lists given in the Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, annexed to the present Regulations. The Lists hereinafter mentioned are the Lists set forth in the Annex.

ARTICLE 2

Each Member shall code mortality statistics in accordance with the International Statistical Classification of Diseases, Injuries, and Causes of Death with or without four-digit subcategories, and using for the purpose the Tabular List of Inclusions and Alphabetical Index.

ARTICLE 3

Each Member shall publish statistics of causes of death in respect of:

(a) its territory as a whole;

(b) principal towns;

(c) national aggregates of urban areas (districts);

(d) national aggregate of rural areas (districts)

Each Member shall append to the statistics referred to under (c) and (d) the definition of "urban" and "rural" areas applied therein.

For the purpose of this Article and of Articles 6 and 16, "territory" designates the metropolitan (home) territory of the Member, and not dependent territories, whether protectorates, colonies, other outlying possessions or territories under trusteeship.

ARTICLE 4

Statistics of causes of death in respect of the territory of a Member, taken as a whole, shall be published in accordance with:

(a) the List of three-digit categories of the Classification (Detailed List) with or without four-digit subcategories; or, if this is not possible, in accordance with:

(b) the Intermediate List of 150 Causes.

ARTICLE 5

Statistics and causes of death in respect of principal towns, national aggregates of urban areas (districts), national aggregate of rural areas (districts) shall be published in accordance with:

(a) the Intermediate List of 150 Causes; or, if this is not possible, in accordance with:

(b) the Abbreviated List of 50 Causes.

If they are given in greater detail, without reaching the extent of the Detailed List, they shall be so arranged that, by suitable grouping, they can be reduced to the Intermediate List of 150 Causes or to the Abbreviated List of 50 Causes.

ARTICLE 6

Statistics of causes of death shall be published according to the following sex and age groupings:

(a) for: the whole territory of the Member

(i) by sex and

(ii) for the ages:

under one year

single years to 4 years inclusive

five-year groups from 5 to 84 years

85 years and over;

(b) for: each town of 1,000,000 population and over, otherwise the largest town with population of at least 100,000;

national aggregate of urban areas of 100,000 population and over;

national aggregate of urban areas of less than 100,000 population;

national aggregate of rural areas

(i) by sex and

(ii) for the ages:

under one year
1-4 years
5-14 years
15-24 years
25-44 years
45-64 years
65-74 years
75 years and over.

If the age grouping is given in greater detail it shall be so arranged as to allow condensation into the age groups under (b) (ii).

ARTICLE 7

It statistics for administrative subdivisions are published by the age grouping given under (b) (ii) of Article 6 shall be used.

ARTICLE 8

If special statistics of infant mortality are published by age, the following age grouping shall be used; by single days for the first week of life (under one day, 1, 2, 3, 4, 5, 6 days) 7-13 days 14-20 days 21-27 days 28 days to 2 months by single month of life from 2 months to one year (2, 3, 4, ... 11 months).

ARTICLE 9

Each Member shall adopt a form of medical certificate of the cause of death that provides for the statement of:

I. the disease or condition directly leading to death, together with such antecedent morbid conditions as may exist, so that the underlying cause of death will be clearly indicated, and

II. such other significant conditions contributing to the death but not related to the disease or condition causing death.

The form of medical certificate of cause of death to be used shall conform as far as possible to the model given in the Annex.

ARTICLE 10

As far as possible, medical certification of the cause of death shall be the responsibility of the attending physician.

ARTICLE 11

As far as possible, the administrative procedure for the completion, transmission and statistical treatment of the medical certificate of cause of death shall ensure protection of the confidential nature of the medical information contained therein.

ARTICLE 12

Each Member shall adopt the underlying cause as the main cause for tabulation of mortality statistics. The selection of the underlying cause from the information stated on the medical certificate of cause of death shall follow the rules given in the Annex.

ARTICLE 13

Each Member, when preparing statistics of morbidity, shall code the causes of illness in accordance with the International Statistical Classification of Diseases, Injuries, and Causes of Death with or without four-digit subcategories, using for the purpose the Tabular List of Inclusions and Alphabetical Index.

ARTICLE 14

Each Member, when publishing statistics of morbidity, shall do so in accordance with:

(a) the Detailed List, or

(b) the Intermediate List of 150 Causes, or

(c) the Special List of 50 Causes adapted to the use of social security organizations,

depending upon the purpose of such statistics.

If they are published in another form the categories selected shall be so arranged that by suitable grouping they can be reduced to (a) the Detailed List, or (b) the Intermediate List, or (c) the Special List.

ARTICLE 15

Statistics of morbidity shall, in so far as possible, be compiled and published in accordance with the sex and age groupings specified in articles 6, 7 and 8 for mortality statistics.

ARTICLE 16

Each Member undertakes to recommend that morbidity statistics published or compiled by autonomous official or non-official institutions and agencies within its territory conform as far as possible with the provisions of articles 13-17.

ARTICLE 17

Each Member, in compiling and publishing mortality and morbidity statistics, shall have regard to such technical recommendations as may be made on these subjects by the World Health Assembly under article 23 of the Constitution.

ARTICLE 18

Each Member shall, under article 64 of the Constitution, provide the Director-General of the Organization with a copy of the statistics published in accordance with the present Regulations.

ARTICLE 19

The present Regulations shall come into force on the 1st of January 1950.

ARTICLE 20

The present Regulations shall apply to each Member, except such Member as may, under article 22 of the Constitution, notify the Director-General of the Organization, within a period of 12 months from the date of adoption of these Regulations by the Assembly, of rejection or of reservations.

ARTICLE 21

Each Member may withdraw its rejections or the whole or any part of its reservations at any time by notifying the Director-General of the Organization.

ARTICLE 22

Each Member to which the present Regulations apply shall bring them to the notice of the Governments of the territories for whose international relations it is responsible, and may at any time notify the Director-General of the Organization that the Regulations shall extend to any or all of such territories with or without reservations. Each Member may withdraw the whole or any part of such reservations at any time by notifying the Director-General.

ARTICLE 23

The Director-General of the Organization shall notify all Members of the Organization of any rejections, reservations or withdrawals made under articles 20, 21, and 22 of the present Regulations.

ARTICLE 24

The present Regulations and the Annex thereto may be amended by the World Health Assembly by regulations adopted under articles 21 and 22 of the Constitution. In faith whereof we have appended our signatures this twenty-fourth of July 1948.

Parties to the Agreement: