上海市居民跌倒伤害的流行特征

[目的]观察不同收入、受教育程度及老龄化人群跌倒伤害的分布情况,以分析上海市城市居民跌倒伤害的流行特征。[方法]于2006年,调查采用分层多阶段概率比例整群抽样的方法,抽取上海市常住居民45 857人进行入户调查;同时采集164家医院跌倒伤害信息及2001—2011年全市居民病伤死亡原因及其相关人口统计学资料。采用logistic多因素回归分析,控制年龄、性别、教育程度及收入的混杂效应。[结果]1在2001—2011年的11年里,上海市人均年工资性收入增加了206.63%,但居民跌倒伤害死亡率从2001年的10.63/10万上升到2011年的14.76/10万。总受伤率为14.70‰。家庭月人均收入低于500元人民币的受伤率约为收入高于5 000元人民币的6.5倍。2小学及以下文化程度人群的跌倒伤害死亡率及受伤率最高,分别是57.85/10万（73.23%）和33.96‰（49.24%）,分别约为大学及以上文化程度者的22倍和5.5倍;3老龄化程度最大的卢湾区和静安区,其相应的死亡率也最高,分别为24.10/10万和19.59/10万。5岁以下年龄组死亡率在所有儿童中居于首位,15~64岁劳动力人口的死伤率随年龄增长而加大,其中50~54岁年龄组所占比重最高,受伤率增加幅度显著加快。女性死伤率高于男性。在所有跌倒伤亡者中,因头部受伤致死者近半。生活水准越低、受教育程度越低及老龄化程度越严重,发生跌倒伤害的风险越大,其相对危险性OR值分别为1.39、1.27和1.21。[结论]上海市居民跌倒伤害预防和控制面临着巨大的挑战,收入、受教育程度,年龄是跌倒伤害相关的主要危险因素。干预重点应放在低于小学文化程度、低收入、年龄5岁以下或50岁以上人群,建议在新医改中推出的家庭医生责任制系统中增加跌倒伤害防治服务包。     

上海市居民交通伤害流行特征及相关因素分析

目的 分析上海市交通伤害的流行特征，探讨受教育程度、经济收入及年龄等对交通伤害的影响。方法 采用分层多阶段概率比例整群抽样方法抽取2011年上海市常住居民61 786人进行入户调查；收集1992-2012年上海市生命统计年鉴居民损伤数据及其相关社会人口资料。结果 上海市交通伤害死亡率从1992年的10.73/10万下降到2012年的9.32/10万。总受伤率为101.16/万。家庭月人均收入<1 000元的受伤率约为≥5 000元的4.37倍。在受教育程度为小学及以下的人群中，交通伤害的受伤率和死亡率是146.88/万和27.05/10万，为大专以上文化程度者的6.41倍和2.42倍。5~9岁年龄组死亡率在所有儿童中居于首位，30~34岁和55~59岁劳动力人口的受伤率增加幅度最大。多因素分析表明经济条件越差、受教育程度越低和年龄越大交通伤害越容易发生。结论 干预重点人群应为低收入、低文化程度人群及老年人。亟需实施有针对性的防控措施，提供均等化的公共服务产品，并建立伤害大数据的共享应用平台。     

H地区骑自行车者伤害的动态研究

[目的 ]分析H地区自行车伤害的发生率和死亡率及其动态变化 ,为开展伤害预防提供依据。 [方法 ]采用1994年到 1998年公安部交通管理局及部分H地区公安局的道路交通事故统计数据 ,及H地区人口统计资料进行分析。[结果 ]自行车伤害在不同交通方式伤害中居首位 ,其伤害的死亡率最高值为 2 5 82 /10万 ,是美国的 8倍多。其中至少有 61 5 %的死亡者为头部损伤 ,其中大部分 (74 6% )由头部与水泥或柏油路面碰撞引起。所有的病人无一在受伤时佩带头盔 ,而且在所有骑自行车的人群中都没有使用头盔。 [结论 ]在H地区同自行车相关的头部损伤是一个严重的公共卫生问题 ,应尽快建立自行车事故伤的监测系统 ,通过采取立法手段在公众中强制推行佩带头盔同时进行自行车安全教育干预 ,改善道路环境等措施控制自行车事故伤害     

美国儿童骑自行车戴头盔情况调查

1991年美国因骑自行车受伤在医院急诊治疗有531000人次，其中15岁以下儿童占利％；特别是头部受伤，10岁以下儿童有一半为头部或面部受伤。最近经伤害调查，戴自行车头盔能减少头部受伤的严重程度，这一成果促使儿童使用头盔者增多一而根据各地区调查，于SO年代中期和后期，儿童使用头盔率仅为2％－5％。本文作者撰文目的籍以了解美国匕岁以下儿童饮用或不使用自行车头盔的原因以及相关因素提供有关部门参考。l调查方法对美国48州常住户用Mitofsky－Waksbefg随机方法采用电话进行调查。打通6076户，有4346户回答，回签率为71．5％；其中26…     

2008-2010年上海市大华地区恶性肿瘤死亡状况分析

目的 分析上海市大华地区居民恶性肿瘤死亡状况,为制定恶性肿瘤防治计划以及采取相应的防治对策和干预措施提供科学依据.方法 根据上海市宝山区大华地区死因监测系统的居民病伤死亡原因报告和大华派出所提供的人口资料,对大华地区2008-2010年恶性肿瘤的粗死亡率、标化死亡率、35～64岁截缩标化死亡率、累积死亡率、死因顺位、潜在减寿年数(potential years of life lost,PYLL)和减寿率等死亡特征进行分析.以2000年中国人口标准构成计算标化死亡率.结果 恶性肿瘤年均死亡率为174.04/10万(男204.71/10万,女142.88/10万),标化率为101.25/10万(男115.97/10万,女85.15/10万).全部恶性肿瘤死亡合计的中位死亡年龄72.00岁(男71.00岁,女74.00岁),男女恶性肿瘤死亡率性别比为1.43∶1.35～64岁截缩标化死亡率为93.54/10万(男114.31/10万,女74.09/10万),0～74岁累积死亡率为109.99/10万(男138.58/10万,女80.35/10万).死亡率较高的前5位恶性肿瘤依次为肺癌、肝癌、胃癌、肠癌和胰腺癌.恶性肿瘤总潜在减寿年数是4 459.09年,减寿率是20.98％(男性25.94％,女性15.86％),标化减寿率是16.14％(男性19.04％,女性13.07％).结论 肺癌和消化道肿瘤是严重危害当地居民身体健康的最主要的恶性肿瘤,是当前肿瘤防治工作的重点.     

珠海市居民交通伤害死亡状况及疾病负担研究

目的 探讨2011-2016年珠海市户籍居民交通伤害死亡原因及疾病负担情况,为制定交通伤害相关防控策略提供科学依据。方法 利用2011-2016年珠海市户籍居民交通伤害死因监测数据,计算死亡率、标化死亡率、年度变化百分比（APC）、潜在寿命损失年（PYLL）、PYLL率等指标。率的检验采用χ2检验。结果 2011 - 2016年珠海市户籍居民交通伤害死亡率为6.58/10万,其中男性10.48/10万,女性2.53/10万,男性明显高于女性（χ2 = 156.78,P＜0.01）;交通伤害死亡率及标化死亡率在6年间总体均下降,从7.97/10万（7.57/10万）下降至4.82/10万（4.13/10万）。交通伤害死亡人群以骑摩托车者、行人、骑自行车者为主,占交通伤害总死因的85.39%;交通伤害死亡年龄分布主要在20～59岁的青年和中年人群,占所有年龄死亡65.66%。2011 - 2016年珠海市户籍居民去除交通伤害后人均寿命增加0.21岁,总的潜在减寿年数（PYLL）为15 894.63人年,平均减寿年数（AYLL）为36.88人年;2011 - 2016年,珠海市户籍居民因交通伤害造成的PYLL和PYLLR总体呈下降趋势,PYLL下降39.03%,PYLLR下降43.81%。结论 交通伤害已成为珠海市户籍居民伤害的主要死因,2011 - 2016年珠海市交通伤害死亡水平和PYLLR均下降,男性交通伤害疾病负担远高于女性,应重点加强对青壮年男性的交通伤害干预。     

深化改革完善政策促进卫生服务公平与效率协同发展

江苏省南通市是一座正在蓬勃发展的沿海对外开放城市。市区现有人口75.45万人,面积350Km~2,2000年人均GDP为24 539元,人均可支配收入7 910元,恩格尔系数为33％,人口自然增长率1.68‰,婴儿死亡率6.88‰,孕产妇死亡率24.56/10万(“九五”期间平均值:婴儿残废率9.45‰,孕产妇死亡率4.8/10万),人均期望寿命75.5岁,男73.3岁,女78.6岁,市区每千人拥有病床数8.16张,每千人拥有医生4.61人,平均每床占建筑面积100m~2。2000年市区卫生事业费财政拨款7301.31万元,占财政支出的5.7％,人均卫生事业费96.83元。     

2012-2017年阆中市居民伤害死亡情况分析

目的 分析2012-2017年阆中市居民伤害死亡特征和分布规律,为制定综合防治决策提供科学依据。方法 对人口死亡信息登记管理系统中报告的阆中市2012-2017年伤害死亡数据进行描述性统计分析。结果 2012-2017年阆中市居民伤害平均粗死亡率为55.25/10万(标化率为49.27/10万),占全死因8.33%,居全死因顺序第4位,男性死亡率为69.72/10万(标化率为62.63/10万),女性死亡率为40.11/10万(标化率为41.75/10万);前5位主要死因为机动车辆交通事故、意外跌落、自杀、意外淹死、意外中毒,占伤害总死亡80.07%。因伤害造成减寿年数最多的是机动车辆交通事故,为2015年,平均减寿年数最多的是意外的机械性窒息,为57.44年。结论 伤害是危害阆中市居民健康的主要疾病之一,应根据主要伤害死亡的类型、不同年龄组死亡特点制定综合防治措施,降低伤害死亡率。     

松阳县赤寿社区居民慢性病患病状况调查

松阳县位于浙江省西南部,总面积1 406 km2.2007年全县户籍人口23.46万人,出生率1.213%,死亡率0.764%,自然增长率0.449%,6;城镇居民人均可支配收入13 784元,农村居民人均纯收入3 741元.为了解松阳县农村社区居民慢性病患病情况及影响因素,探索慢性病社区管理模式,为今后社区慢性病的综合防治提供科学依据,笔者于2008年6月选择赤寿社区作为综合防治试点乡,对35岁以上常住居民进行了慢性病基线调查.     

2008-2015年湖北省老年人伤害死亡流行现状及趋势

目的 为了解分析2008-2015年湖北省老年人伤害死亡流行病学状况及趋势,为老年人伤害预防防治工作提供依据.方法 收集湖北省所有死因监测点居民死因监测资料,对≥60岁老年人伤害死亡进行SPSS 20.0统计学方法分析.结果 2008-2015年湖北省老年人伤害平均死亡率为215.26/10万,标化率为252.22/10万.年龄越高,老年人伤害死亡率越低,其最高年龄组高达1 288.06/10万.自杀死因位居湖北省首位,死亡率为1 096.60/10万.农村老年人的意外伤害死亡率(289.97/10万)高于城市老年人(133.72/10万),男性意外伤害死亡率(234.75/10万)高于女性(196.33/10万).城乡老年人前3位伤害死因类别次位不同,但顺位与全人群相一致.结论 伤害已成为湖北省老年人健康和生命安全的主要威胁,在湖北省全人群死因构成谱位居第4位,预防防治老年人伤害的是湖北省重要战略和应对公共卫生领域变化的重要举措.     

A study on bicycle-related injuries and their costs in Shanghai, China

China is known as the Bicycle Kingdom, but the nature, extent, and costs of bicycle-related injuries remain largely unknown. The authors' findings showed that the bicycle-related mortality rate increased 99% from 1992 to 2004, and it increased with age, from 0.64 per 100,000 population in the 0-14 age group to 5.93 per 100,000 population in the 65 and older age group. Labor force groups represented the majority of fatalities (70.8%) and nonfatal injuries (81.5%). The male mortality rate was 2.4 times higher than the female mortality rate. Head injuries accounted for 71.9% of fatalities and 33.1% of the hospitalizations. People with lower levels of education had higher injury rates. The poorer districts located in the countryside had the highest mortality rates compared to those located in the central, wealthier regions. The total annual cost of bicycle-related injuries was 1.1 billion CHY (Chinese Yuan) (over $137 million U.S.). To reduce bicycle-related injuries, mandatory helmet legislations, environmental modifications, and representative monitoring systems in China are required.     

Identifying high-risk small business industries for occupational safety and health interventions

BACKGROUND: Approximately one-third (32%) of U.S. workers are employed in small business industries (those with 80% of workers in establishments with fewer than 100 employees), and approximately 53 million persons in private industry work in small business establishments. This study was performed to identify small business industries at high risk for occupational injuries, illnesses, and fatalities. METHODS: Small business industries were identified from among all three- and four-digit Standard Industrial Classification (SIC) codes and ranked using Bureau of Labor Statistics (BLS) data by rates and numbers of occupational injuries, illnesses, and fatalities. Both incidence rates and number of injury, illness, and fatality cases were evaluated. RESULTS: The 253 small business industries identified accounted for 1,568 work-related fatalities (34% of all private industry). Transportation incidents and violent acts were the leading causes of these fatalities. Detailed injury and illness data were available for 105 small business industries, that accounted for 1,476,400 work-related injuries, and 55,850 occupational illnesses. Many of the small business industries had morbidity and mortality rates exceeding the average rates for all private industry. The highest risk small business industries, based on a combined morbidity and mortality index, included logging, cut stone and stone products, truck terminals, and roofing, siding, and sheet metal work. CONCLUSIONS: Identification of high-risk small business industries indicates priorities for those interested in developing targeted prevention programs.     

Utilizing United States Coast Guard data to calculate incidence rates and identify risk factors for occupational fishing injuries in New Jersey

Commercial fishing has high rates of work-related injury and death and needs preventive strategies. Work-related fatal and nonfatal injury rates for New Jersey (NJ) commercial fishermen who suffered unintentional traumatic injuries from 2001 to 2007 are calculated using data from the United States Coast Guard (USCG) Marine Safety and Pollution Database and estimated denominator data. Fatalities were compared to those ascertained by the NJ Fatality Assessment Control and Evaluation (FACE) surveillance system. For the study years, 225 nonfatal injuries and 31 fatal injuries were reported. Among nonfatal injuries, the causes by frequency were fall onto surface, crushed between objects, struck by moving object, line handling/caught in lines, collision with fixed objects, fall into water, and other noncontact injuries. The distribution of fatal injuries differed, with the most frequent cause as crushed between objects. Falls into water and several noncontact injuries accounted for most of the other fatalities. The large majority (96%) of nonfatal injuries were contact injuries, whereas only 68% of fatalities were classified as contact. The overall incidence rate of nonfatal injuries was 1188 per 100,000 full-time equivalents (FTEs) per year. The rate varied considerably by year, from a low of 286 per 100,000 FTEs in 2001 and 2007 to 3806 per 100,000 FTEs in 2003. The overall occupational fatality rate over the period 2001-2007 was 164 per 100,000 FTEs per year. These results can aid in targeting the commercial fishing industry for injury prevention strategies and interventions, especially for falls, crushing injuries, and drownings.     

The Effect of an All-Ages Bicycle Helmet Law on Bicycle-Related Trauma

In 2003, Seattle implemented an all-ages bicycle helmet law; King County outside of Seattle had implemented a similar law since 1994. For the period 2000–2010, the effect of the helmet legislation on helmet use, helmet-preventable injuries, and bicycle-related fatalities was examined, comparing Seattle to the rest of King County. Data was retrieved from the Washington State Trauma Registry and the King County Medical Examiner. Results comparing the proportions of bicycle related head injuries before (2000–2002) and after (2004–2010) the law show no significant change in the proportion of bicyclists admitted to the hospital and treated for head injuries in either Seattle (37.9 vs 40.2 % p = 0.75) nor in the rest of King County (30.7 vs 31.4 %, p = 0.84) with the extension of the helmet law to Seattle in 2003. However, bicycle-related major head trauma as a proportion of all bicycle-related head trauma did decrease significantly in Seattle (83.9 vs 64.9 %, p = 0.04), while there was no significant change in King County (64.4 vs 57.6 %, p = 0.41). While the results do not show an overall decrease in head injuries, they do reveal a decrease in the severity of head injuries, as well as bicycle-related fatalities, suggesting that the helmet legislation was effective in reducing severe disability and death, contributing to injury prevention in Seattle and King County. The promotion of helmet use through an all ages helmet law is a vital preventative strategy for reducing major bicycle-related head trauma.     

Population-based study of emergency department admissions and deaths from injuries in Barcelona,Spain: Incidence,causes and severity

The aim of this study was to estimate the incidence of morbidity and mortality due to injuries in the population over the age of 14 years in Barcelona, Spain. Injury distribution according to sex, age, external cause, place of occurrence of the injury and severity was also obtained. A one-year survey was conducted in the emergency departments of the six main hospitals in Barcelona, based on a multistage sampling. Information was collected prospectively in emergency services by specially trained non-staff interviewers. Mortality data were drawn from death certificates. The incidence rate was 74.7 injury cases per 1,000 person-years over 14 years of age, higher in males than in females. Injury rates were highest in the youngest age-group and progressively lower until people over 75 years of age. Main external causes of injury were falls, being struck or caught by objects, and traffic-related injuries. The leading specific causes of injury mortality were traffic injuries, suicides and poisonings. While the overall admission incidence was 3.34 cases per 1,000 inhabitants, the proportion of hospitalized cases was 45.0 per 1,000 injury cases admitted to emergency rooms, higher for females, for traffic injuries and in the elderly population. Ninety-six percent of injury cases had an ISS value of 8 or less, mean ISS being highest for traffic injuries and falls. Injury morbidity and mortality amongst residents of Barcelona follow sex, age and cause of injury patterns which are, overall, comparable to those observed in other industrialized countries, suggesting that similar etiologic factors might be operating in those areas. The results should enable the orientation of injury prevention policies in the urban environment targeted on the young and the elderly population.     

Injury mortality in American Indian, Hispanic, and non-Hispanic white children in New Mexico, 1958-1982

Childhood fatalities from injuries are a serious public health problem in New Mexico, a state which ranks second in the nation in injury-related mortality rates. To determine the extent of injury mortality in children in this state, and to examine time trends and differences in mortality rates in New Mexico's American Indian, Hispanic, and non-Hispanic white children aged 0-14 years, we analyzed vital records collected from 1958 to 1982. American Indian children experienced the highest mortality rates from all external causes combined. Among all three major ethnic groups, children aged 0-4 years were at the highest risk for injury fatalities. Unintentional injuries accounted for 85% of all injury-related deaths. Motor vehicle crashes and drowning were the first and second leading causes of death in all three groups, while other important causes of death included fire, choking on food or other objects, poisoning, and homicide. Although the fatality rates on most types of injuries decreased over the 25-year period, childhood fatality rates for motor vehicle crashes and homicide increased in each ethnic group. Despite the overall decrease in injury mortality rates in New Mexican children, the rates are excessively high compared to other states, especially in American Indian children.     

Incidence rates of firearm injuries in Galveston, Texas, 1979-1981

Firearm injury mortality rates have been characterized in various settings, but little is known of the total magnitude of firearm injury, including morbidity. The authors determined population-based incidence rates of firearm injury among residents of Galveston, Texas, from 1979-1981 by using police, emergency department, hospital, emergency medical services, medical examiner, and vital records to identify 239 firearm injury cases. Vital records, medical examiner, and police records each identified more than 95% of the fatalities, but police records (sensitivity = 98%) were better than emergency department or hospital records (sensitivity = 82% and 28%, respectively) for identifying all nonfatal cases. The annual age-adjusted incidence rate of firearm injury was 128 per 100,000 persons. Black males, with the highest firearm injury rate (459 per 100,000 persons), were injured at 46 times the rate of white females (10 per 100,000 persons). The overall case fatality rate was 30%, including 25% of the assaults/homicides, 81% of the parasuicides/suicides, and 0% of the unintentional injuries. On the basis of the case fatality rates, an estimated 140,000 firearm injuries occur in the United States annually. The case fatality rate for penetrating head injuries was 80% versus 48% for chest injuries and 6% for all other parts of the body. The results are discussed with respect to policy recommendations for reducing firearm injuries.     

江西省O～17岁儿童交通伤害研究

目的 探讨江西省0～17岁儿童交通伤害发生情况、发生机制及其相应的疾病负担.方法 利用PPS抽样在江西省的住户中抽取约10万户进行入户调查,对样本户中的儿童进行交通伤害问卷调查.结果 江西省0～17岁儿童交通伤害死亡率为10.17/10万,病死率为1.36%;非致死性交通伤害发生率为7.40‰,其中男童发生率为8.29‰,女童为6.26‰;重度交通伤害发生率为1.79‰,其中城市儿童发生率为0.93‰,农村儿童为1.88‰,城乡重度伤害发生率之间差异有统计学意义.交通伤害发生时伤者主要是行人和骑自行车者,占总伤者的80.48%;平均每例交通伤害者的医疗费用为1369.57元,平均住院天数为3.63,平均休工(学)天数为8.79.结论 江西省农村地区的交通重度伤害发生率高于城市地区;男童的伤害发生率、死亡率均高于女童;交通伤害的疾病负担较重.