Civilian casualties in Afghanistan hit a record high in 2016 with 11,418 civilians killed or injured, the United Nations said Monday.

“The killing and maiming of thousands of Afghan civilians is deeply harrowing and largely preventable,” Tadamichi Yamamoto, the U.N. secretary-general’s special representative for Afghanistan, said in a statement. “All parties to the conflict must take immediate concrete measures to protect the ordinary Afghan men, women and children whose lives are being shattered.”

Last year’s total tops the 11,035 civilian injuries and deaths in 2015, which itself was the highest civilian casualty toll since 2009, when the U.N. started tracking the number.

The 2016 casualties break down into 3,498 deaths and 7,920 injuries. The deaths themselves were a 2 percent drop from 2015, but the injuries jumped by 6 percent.

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And of the totals, children made up 923 of the dead and 2,589 of the injured, according to Monday’s report from the United Nations Assistance Mission in Afghanistan.

“Children have been killed, blinded, crippled — or inadvertently caused the death of their friends — while playing with unexploded ordnance that is negligently left behind by parties to the conflict,” Zeid Ra’ad Al Hussein, U.N. high commissioner for human rights, said in the report. “The consequences of each act of violence ripple through families and entire communities that are left broken, unable to sustain themselves and largely failing to obtain any semblance of justice or reparation."

Most of the total casualties were again caused by civilians getting caught in the crossfire during ground engagements by pro-government forces and the Taliban or other anti-government forces.

Two-thirds of the casualties were caused by anti-government forces such as the Taliban, but a quarter were caused by pro-government forces.

Of the pro-government forces, international forces such as the United States accounted for 2 percent of the casualties.

Casualties from airstrikes carried out by Afghan and international forces continued to rise. Such airstrikes caused 250 deaths and 340 injuries, nearly double the number recorded in 2015 and the highest since 2009.

The report also documents an increase in attacks from the Islamic State in Iraq and Syria’s branch in Afghanistan, known as ISKP. The group caused 899 civilian casualties, up from 82 in 2015, according to the report.

“The increased capacity of Daesh/ISKP to strike beyond its perceived areas of influence and presence in eastern Afghanistan exacerbated the escalation in conflict and deteriorating security environment,” the report says. “The nature of attacks perpetrated by Daesh/ISKP is indicative of attempts to expand the conflict along sectarian lines, further compounding concerns for the protection of civilians.”