Acute traumatic injuries in rural populations

In the United States, injuries are the leading cause of death among individuals aged 1 to 45 years and the fourth leading cause of death overall. Rural populations exhibit disproportionately high injury mortality rates. Deaths resulting from motor vehicle crashes, traumatic occupational injuries, drowning, residential fires, and suicide all increase with increasing rurality. We describe differences in rates and patterns of injury among rural and urban populations and discuss factors that contribute to these differences.     

Childhood injury deaths: national analysis and geographic variations.

Twenty-three causes of injury mortality in children ages 0-14 in the United States were analyzed by age, race, sex, and state of residence for the years 1980-85. Motor vehicles caused 37 per cent of all injury-related deaths and were the leading cause of injury mortality in every group except children younger than one year, for whom homicide was the leading cause. Male death rates were at least four times female rates for suicide, unintentional firearm injury, and injuries related to farm machinery or motorcycles. The drowning rate among Whites was almost twice that of Blacks for ages 1-4, but in the 10-14 year age group the drowning rate for Blacks was over three times that of Whites. In general, the highest injury death rates were in the mountain states and the south. Between 1980 and 1985, the suicide rate in the 10-14 year age group more than doubled.     

Trends in injury mortality among young people in the European Union: a report from the EURORISC working group.

PURPOSE: To examine the trends in injury mortality among young people aged 15-24 years residing in the 15 current member states of the European Union between 1984 and 1993. METHODS: As part of a European Commission-funded project entitled European Review of Injury Surveillance and Control (EURORISC), mortality data for all externally caused physical injuries (International Classification of Disease Codes E800-999) were obtained from the World Health Organization. Data were analyzed to generate age-specific injury mortality rates and proportional differences in rates over the study period. Linear regression was used to represent the linear component of the mortality profile. RESULTS: Almost a quarter of a million young people died as a result of sustaining an externally caused physical injury (either unintentional or intentional) in the study countries between 1984 and 1993. Injury accounted for two-thirds of all deaths in this age group. Over three-quarters (76%) of deaths were due to unintentional injury, a further 17% to self-inflicted injuries, and the remaining 7% to homicide and other violent causes. Motor vehicle traffic fatalities accounted for 84% of unintentional injury deaths. Although a decline in injury mortality was observed throughout Europe, rates of mortality owing to both unintentional injuries and suicide varied widely among study countries at both the beginning and end of the study period. CONCLUSIONS: Whereas injury mortality rates in young people in most European countries are lower than in other parts of the world (including the United States), injuries represent a major public health problem in the European Union. The death toll from motor vehicle traffic crashes is a particular cause for concern.     

Unintentional injuries in the home in the United States Part I: mortality

BACKGROUND: Unintentional injuries are a leading cause of death in the United States. It is unclear, however, what proportion of these injuries occur in the home. The purpose of this paper is to quantify and describe fatal unintentional injuries that take place in the home environment. METHODS: Data from the National Vital Statistics System (NVSS) were used to calculate average annual rates for unintentional home injury deaths, with 95% confidence intervals from 1992 to 1999 for the United States overall, and by mechanism of injury, gender, and age group. RESULTS: From 1992 to 1999, an average of 18,048 unintentional home injury deaths occurred annually in the United States (6.83 deaths per 100,000). Home injury deaths varied by age and gender, with males having higher rates of home injury death than females (8.78 vs 4.97 per 100,000), and older adults (>/=70 years) having higher rates than all other age groups. Falls (2.25 per 100,000), poisoning (1.83 per 100,000), and fire/burn injuries (1.29 per 100,000) were the leading causes of home injury death. Rates of fall death were highest for older adults, poisoning deaths were highest among middle-aged adults, and fire/burn death rates were highest among children. Inhalation/suffocation and drowning deaths were important injury issues for young children. CONCLUSIONS: Unintentional injury in the home is a significant problem. Specific home injury issues include falls among older adults, poisonings among middle-aged adults, fire/burn injuries among older adults and children, and inhalation/suffocation and drowning among young children. In addition, recommendations are presented for improvements to the NVSS.     

Comparative study about methods of suicide between Japan and the United States

BACKGROUND: Suicide is one of the most important public health issues in both Japan and the United States. This study is to clarify the differences in methods of suicide between the two countries, among various races within the United States, and between genders and age-groups. METHODS: Vital statistics mortality data and the estimated population in 1999 in Japan and in the United States were used. Age-adjusted mortality rates were calculated using the age-specific total population of Japan and the United States as a standard population. In addition, the proportionate distribution of suicide methods was calculated. RESULTS: Age-adjusted mortality rates from suicide in Japan were about 2 times higher for males and 3 times higher for females compared with the United States. The most common method among both genders in Japan was hanging, followed by jumping from a high place. In the United States, it was firearms among both genders, followed by hanging among males and drugs among females. For Asians in the United States, hanging was the method of choice for about half among both genders; hanging was the most common method for the age group of 40 years or more among males and for all age groups among females. Firearms were the method of choice for the 20-39 age group among males. CONCLUSIONS: Although the overall suicide rates among Asians in the United States were lower than Japan, the methods were similar to those in Japan.     

2010—2012年河南省洛阳市新安县居民伤害死亡状况分析

目的分析2010—2012年河南省新安县居民伤害死亡状况,为制定伤害防控策略和措施提供科学依据。方法选择2010—2012年河南省新安县全人群死因监测数据中常住居民的伤害死亡个案为研究对象,使用国家推荐的死因监测数据清洗与分析工具和Excel 2003进行统计分析。结果新安县居民伤害死亡居全死因的第4位,死亡率62.53/10万,标化死亡率59.30/10万,占全死因的9.54%。伤害前5位死因依次为机动车辆交通事故、意外跌落、自杀、意外中毒、淹死,占伤害死亡的84.02%。婴儿主要死因为机械性窒息;幼儿主要死因为淹死;青少年第1位为机动车辆交通事故,占40.00%,第2位为淹死,占30.00%;青年人第1位为机动车辆交通事故,占52.94%,第2位为自杀,占9.66%;中年人第1位为机动车辆交通事故,占53.21%,第2位为意外跌落,占14.44%;老年人第1位为机动车辆交通事故,占46.67%,第2位为自杀,占16.92%,第3位为意外跌落,占14.87%。结论伤害严重威胁新安县居民的生命健康,特别是机动车辆交通事故,应根据不同人群的特点,采取有效防控措施,降低伤害的发生和死亡,提高居民的生活质量。     

宁波市2006-2007年居民伤害死因分析

目的：探讨宁波市居民伤害的死亡特征、分布规律和对居民健康的影响,为预防和控制提供科学依据。方法：收集宁波市2006--2007年居民伤害死因监测资料进行统计分析。结果：宁波市居民伤害位居全死因的第4位,但在潜在寿命损失年排位中跃居第2位。标化死亡率为47．83／10万,男女性别比为1．48：1。伤害前5位的死因分别是机动车交通事故、意外跌落、其他意外事故和有害效应、淹死和自杀,共占总死因的85．75％。结论：伤害是宁波市一个严重的公共卫生问题,应予以重视和控制。     

辉县市农村人群伤害死亡的流行病学分析

目的 分析辉县市农村人群伤害死亡的死因特点，评价该人群伤害死亡的危害程度。方法 计算伤害死亡率、YPLL、YPLL率、WYPLL和WYPLL率等指标，对辉县市农村人群伤害死因进行分析。结果 1997～2001年辉县市农村人群的平均伤害标化死亡率为70．27／10万，男性高于女性；占总死因构成的9．65％，死因顺位居第四位；伤害死亡的标化YPLL率为21．60％，占全部YPLL的30．41％；标化WYPLL率为17．20‰，占全部WYPLL的34．56％，YPLL和WYPLL占总死亡的比重分别比全国水平高23．62％和30．42％，死因顺位高居第一。死亡率、YPLL率和WYPLL率均以交通事故、自杀、淹死、意外跌落居前四位。结论 伤害不仅成为严重危害辉县市农村人群生命健康的主要问题，而且也是造成当地劳动力人群YPLL和WYPLL的主要原因。     

Swimming pool drownings among US residents aged 5-24 years: understanding racial/ethnic disparities

OBJECTIVE: We examined circumstances surrounding swimming pool drownings among US residents aged 5 to 24 years to understand why Black males and other racial/ethnic groups have high drowning rates. METHODS: We obtained data about drowning deaths in the United States (1995-1998) from death certificates, medical examiner reports, and newspaper clippings collected by the US Consumer Product Safety Commission. RESULTS: During the study period, 678 US residents aged 5 to 24 years drowned in pools. Seventy-five percent were male, 47% were Black, 33% were White, and 12% were Hispanic. Drowning rates were highest among Black males, and this increased risk persisted after we controlled for income. The majority of Black victims (51%) drowned in public pools, the majority of White victims (55%) drowned in residential pools, and the majority of Hispanic victims (35%) drowned in neighborhood pools (e.g., an apartment complex pool). Foreign-born males also had an increased risk for drowning compared with American-born males. CONCLUSIONS: Targeted interventions are needed to reduce the incidence of swimming pool drownings across racial/ethnic groups, particularly adult supervision at public pools.     

宁波市1987～2001年城区老年人伤害死亡分析

目的：探讨城市老年人伤害所致死亡原因，对预防和控制老年人伤害事件的发生、发展及降低死亡率具有重要意义，并可为有关部门制定相应干预措施提供依据。方法：采用国际疾病分类UCD—9对宁波市城区1987—2001年60岁及以上老年人的伤害死亡资料进行了分析。结果：老年人的伤害标化死亡率为173．35/10万，伤害在老年人所有病伤死因顺位中居第4位。男性老年人的伤害标化死亡率明显高于女性，老年人伤害所致死亡的前5位死因顺位分别是：意外跌落、机动车交通事故、自杀、其他事故有害效应和淹死。机动车交通事故为男性老年人第1位死因，男性是女性的2．35倍，而意外跌落为女性老年人第1位死因，意外跌落主要发生在75岁以上高龄(尤其女性)老年人中。结论：伤害已成为严重威胁老年人健康与生命质量的危险因素，应采取一系列社会综合干预措施加以预防和控制。     

1978 - 2017年上海市金山区老年人伤害死因分析

目的 分析1978 - 2017年上海市金山区≥60岁老年人伤害死亡特征和变化趋势,为制订有效的老年人伤害干预措施提供科学依据。方法 收集1978 - 2017年金山区≥60岁老年人伤害死亡信息进行描述性流行病学分析。结果 1978 - 2017年金山区老年人标化伤害死亡率为116.25/10万,随年龄增长呈上升趋势。意外跌落、交通事故、自杀、淹死和其他事故是老年人伤害主要死因,占老年人伤害总死亡的95.38%。不同性别、不同年龄段老年人伤害死因分布特点不同。结论 伤害已成为威胁金山区老年人健康的重要原因,根据不同老年人伤害发生特征采取针对性的社区伤害预防和干预措施极为必要。     

Recent trends in violent deaths among young adults in the United States.

Those Americans who feel that theirs has become an increasingly violent society have support for that belief in recent mortality statistics. Since 1960, death rates in the United States among young adults from motor vehicle accidents, homicide, and suicide have increased dramatically. As of 1973, homicide and suicide rates have shown no indication of leveling off. Death rates from nonviolent causes among young adults, however, are declining, particularly among nonwhite females.     

Homicide, suicide, motor vehicle crash, and fall mortality: United States'' experience in comparative perspective.

US mortality data on motor vehicle crashes, falls, suicide, and homicide for 1980 are compared with corresponding data for France, Japan, West Germany, and the United Kingdom. Unadjusted and age-specific death rates are presented, together with age-adjusted rates of years of life lost (YLL). A large male excess in rates is typical outside the fall category. Motor vehicle crashes are the predominant cause of YLL, and the United States manifests the highest YLL rates for each sex. US fall death rates at the older ages are exceeded by those of France and West Germany. The elderly generally manifest the greatest risk of suicide; American females exhibit a unique rate decline after ages 45-54 years, however. Beyond early adulthood, US suicide rates are lower than those of France, Japan, and West Germany. US homicide rates dwarf those of the comparison countries with 16- to 29-fold differentials separating prime-risk American males aged 25-34 years from their foreign counterparts.     

1990—2010年上海市金山区居民伤害死亡原因及其所致寿命损失分析

目的了解1990—2010年上海市金山区居民伤害致死原因及其所造成的寿命损失,为制定伤害防治策略和措施提供参考依据。方法利用Microsoft Excel 2003对1990—2010年居民病伤死亡原因年报表中伤害死因资料进行汇总整理,计算各类伤害死因别死亡率、年龄组死亡率、潜在寿命损失(PYL)和潜在寿命损失率(PYLLR)等指标。结果 1990—2010年,金山区居民伤害死亡率为51.28/10万,占总死亡的7.58%,位居全死因顺位的第4位。金山区居民前4位死因是交通事故、意外跌落、自杀和溺水,死因别死亡率在6.19/10万～22.25/10万之间。男性和女性前4位伤害死因与全人群相同,死因别死亡率分别在7.28/10万～31.13/10万和5.11/10万～13.48/10万之间。0～14岁组前4位伤害死因为溺水、交通事故、意外跌落和自杀,15～44岁和45～64岁组前4位伤害死因均为交通事故、自杀、意外跌落和溺水,65岁及以上组前4位伤害死因分别为意外跌落、交通事故、溺水和自杀。按寿命损失率排序,前4位伤害死因为交通事故、自杀、溺水和意外跌落,潜在寿命损失率在1.16‰～7.26‰之间。结论伤害已成为严重威胁金山区居民身体健康和生命安全的重大公共卫生问题。宜按具体工作目标来确定各类伤害危害的严重程度和防治的优先顺序,以期用较少的投入获得较大的伤害防治效果。     

宁夏地区居民伤害的流行病学趋势研究

目的：研究宁夏居民伤害死亡的流行学特征和死亡率的长期时间趋势。方法：采用宁夏疾病监测系统中20世纪90年代的人口学资料和死亡资料,死亡率的时间趋势分析采用线性回归统计模型。结果：10年间宁夏居民伤害死亡率上升了28.22%,其余死因顺位上升至第3位;1999年导致伤害死亡的前4位死因是交通事故、自杀、溺水和中毒;死亡率时间趋势不尽相同,总伤害死亡率、交通事故死亡率、自杀死亡率呈上升趋势,溺水死亡率呈下降趋势,预测至2005年,自杀将成为宁夏居民伤害死因第1顺位。结论：伤害是影响宁夏居民健康和生命的主要危险因素,且存在长期时间趋势。应重点对交通事故、自杀、溺水和意外中毒实施有效的研究、预防和控制。     

广东省1991～2000年伤害死亡趋势及原因分析

目的 探讨广东省伤害死亡的原因和趋势，为采取干预措施提供基础数据，方法 通过疾病监测系统收集资料，用描述性流行病学方法阐述伤害死亡趋势和原因。结果 广东省10年伤害的平均死亡率为32.00/10万，占总死亡的7.24%，在死因顺位中排第5位。但按潜在寿命损伤年（YPLL）排第1位；伤害死亡率农村高于城市，男性高于女性，伤害是青壮年死亡的主要原因，10年伤害的死亡率呈逐年上升趋势，交通事故，淹死，自杀，坠落和中毒是伤害死亡的前5位原因，不同年龄组人群伤害死亡的原因顺位是不同的，结论 伤害是广东省居民的主要死因之一。且呈上升趋势，必须把伤害纳入疾病预防控制规划，采取有效的干预措施。     

Drowning--United States, 2005-2009

Drowning is a leading cause of unintentional injury death worldwide, and the highest rates are among children. Overall, drowning death rates in the United States have declined in the last decade; however, drowning is the leading cause of injury death among children aged 1-4 years. In 2001, approximately 3,300 persons died from unintentional drowning in recreational water settings, and an estimated 5,600 were treated in emergency departments (EDs). To update information on the incidence and characteristics of fatal and nonfatal unintentional drowning in the United States, CDC analyzed death certificate data from the National Vital Statistics System and injury data from the National Electronic Injury Surveillance System--All Injury Program (NEISS-AIP) for 2005-2009. The results indicated that each year an average of 3,880 persons were victims of fatal drowning and an estimated 5,789 persons were treated in U.S. hospital EDs for nonfatal drowning. Death rates and nonfatal injury rates were highest among children aged ≤4 years; these children most commonly drowned in swimming pools. The drowning death rate among males (2.07 per 100,000 population) was approximately four times that for females (0.54). To prevent drowning, all parents and children should learn survival swimming skills. In addition, 1) environmental protections (e.g., isolation pool fences and lifeguards) should be in place; 2) alcohol use should be avoided while swimming, boating, water skiing, or supervising children; 3) lifejackets should be used by all boaters and weaker swimmers; and 4) all caregivers and supervisors should have training in cardiopulmonary resuscitation.     

2008-2012年合肥市居民伤害死因分析

目的了解2008-2012年合肥市居民伤害致死的主要原因及其所造成的寿命损失,为制定伤害防治策略和措施提供参考依据。方法利用Excel和SPSS对2008-2012年死因监测数据进行统计、分析。结果2008-2012年合肥市居民因伤害死亡率38．07／10万,伤害死亡的前5位死因分别是交通事故、意外跌落、自杀、溺水和意外中毒,0～14岁组溺水为第1位死因,15—44、45—59和≥60岁组的第1位死因均为交通事故,其他死因顺位各年龄组略有不同。以潜在寿命损失率（PYLLR）排序,前5位死因分别为交通事故、溺水、意外跌落、自杀和意外中毒。结论伤害已成为严重威胁合肥市居民身体健康和生命安全的重大公共卫生问题。可针对不同人群开展重点防治工作,以较少的投入获得较大的伤害防治效果。     

Urban-Rural Disparities in Injury Mortality in China, 2006

Context: Urban-rural disparity is an important issue for injury control in China. Details of the urban-rural disparities in fatal injuries have not been analyzed.
Purpose: To target key injury causes that most contribute to the urban-rural disparity, we decomposed total urban-rural differences in 2006 injury mortality by gender, age, and cause.
Methods: Mortality data came from the Chinese Vital Registration data, covering a sample of about 10% of the total population. The chi-square test was used to test the significance of urban-rural disparities.
Findings: For all ages combined, the injury death rate for males was 60.1/100,000 in rural areas compared with 40.9 in urban areas; for females, the respective rates were 31.5 and 23.6/100,000. The greatest disparity was at age <1 year for both sexes, where the rate from unintentional suffocation in rural areas was more than twice the urban rate. The higher mortality from drowning among males of all ages and among females ages 1-24 and 35+ contributed substantially to the age-specific urban-rural disparities. For both sexes, transportation incidents and suicide were the most important contributors to higher rates among rural residents ages 15+.
Conclusions: Unintentional suffocation, drowning, transportation incidents, and suicide not only are the major causes of injury death, but also play a key role in explaining the urban-rural disparities in fatal injuries. Further research is needed to identify factors leading to higher rural death rates and to explore economical and feasible interventions for reducing injuries and narrowing the urban-rural gap in injury mortality.     

1976-2006年大丰市居民伤害死亡趋势分析

目的了解大丰市1976—2006年居民因伤害引起的死亡现状,分析居民伤害死亡的趋势和特征,为制定伤害预防控制策略和措施提供科学依据。方法收集大丰市1976—2006年死因登记资料,用Joinpoint回归分析主要伤害死亡趋势,用Poisson回归分析性别、年龄和时间的伤害死亡率比。结果1976—2006年大丰市居民累计因伤害死亡13905人,年均死亡率为61.40/10万,其中男性死亡率为70.18/10万,女性为51.85/10万,男性高于女性（P〈0.05）。年均死亡率1976—1980年为67.96/10万,标化率为82.58/10万;2006年下降到42.37/10万,标化率为38.99/10万。引起伤害死亡的原因中位居前3位的分别是自杀、溺水和交通事故。0～14岁儿童青少年伤害死亡中溺水死亡率最高,为41.76/10万;15岁以上人群中伤害死亡以自杀和交通事故为主。31a间总的伤害死亡有下降趋势,其中自杀死亡波动较大,但仍有下降趋势;溺水死亡下降显著,死亡率从1976—1980年的27.74/10万下降到2006年的7.95/10万;交通事故死亡上升迅速,死亡率从1976—1980年的1.68/10万上升到2006年的19.34/10万。结论31a来大丰市居民伤害死亡率虽有下降趋势,但低年龄组人群伤害死亡所占构成比上升,交通事故死亡上升迅速,伤害仍然是危害居民生命健康的主要原因之一。