交通事故伤害4752宗的流行病学分析

目的　探讨交通事故意外伤害的高危人群,高危车种和高发时间,以揭示车祸发生的危险因素。方法　用流行病学原理对番禺市１９９７年发生的４ ７５２宗交通事故（车祸）伤害进行回顾分析。结果　全年共发生交通事故４ ７５２ 宗,造成２６８ 人死亡,３ ２０２ 人受伤,死亡率为２０．９４／１０ 万。高发年龄是２０～４９ 岁的青壮年,男性车祸死亡率（２９．４５／１０ 万）是女性死亡率（１２．４６／１０ 万）的２．３６ 倍;骑自行车者和行人特别是老年人是车祸的高危人群,共死亡１２４ 人,占总死亡人数的４７．４６％ ;摩托车是造成交通事故的高危车种,全年摩托车发生车祸１０１ 宗,死亡１０５ 人,占总死亡宗数的４０．４０％ ,车辆死亡率为５．８４／万辆。而交通事故的高发时间是夜间（１７:００～２４:００）,共发生车祸１ ７０９宗,死亡１１６ 人,占总死亡人数４３．２８％ 。结论　预防和控制车祸的对策是加强群众性的交通安全教育,改善道路安全设施和限制摩托车上牌     

海宁市道路交通事故原因与疾病负担评价

目的探讨道路交通伤亡事故（简称车祸）原因与疾病负担。方法应用2001年全市车祸现场勘察信息及其相关资料，对车祸的成因、流行特征、人体损伤部位、经济损失情况等进行综合分析研究，并计算平均潜在寿命损失年（YPLL）、潜在工作寿命损失年（WYPLL）和潜在价值寿命损失年（VYPLL）在全死因中的位次。结果2001年海宁市人口车祸发生率188．59／10万、人口死亡率22．48／10万；万车事故发生率151．73、万车死亡率18．10。事故原因分析显示：人的因素占93．1％、其中驾驶员因素占89．4％，主要表现在：不按规定让行、措施不当、疏忽大意、纵向间距不够、违章行驶等；直接经济损失3127万元，平均每宗交通事故2．59万元，车祸导致的人均YPLL、WYPLL、VYPLL位居各类主要死因之首。结论提高驾驶员的综合素质，是预防车祸发生的关键。     

交通事故伤害4752宗的流行病学分析

目的探讨交通事故意外伤害的高危人群,高危车种和高发时间,以揭示车祸发生的危险因素.方法用流行病学原理对番禺市1997年发生的4 752宗交通事故(车祸)伤害进行回顾分析.结果全年共发生交通事故4 752宗,造成268人死亡,3 202人受伤,死亡率为20.94/10万.高发年龄是20～49岁的青壮年,男性车祸死亡率(29.45/10万)是女性死亡率(12.46/10万)的2.36倍;骑自行车者和行人特别是老年人是车祸的高危人群,共死亡124人,占总死亡人数的47.46%;摩托车是造成交通事故的高危车种,全年摩托车发生车祸101宗,死亡105人,占总死亡宗数的40.40%,车辆死亡率为5.84/万辆.而交通事故的高发时间是夜间(17:00～24:00),共发生车祸1 709宗,死亡116人,占总死亡人数43.28%.结论预防和控制车祸的对策是加强群众性的交通安全教育,改善道路安全设施和限制摩托车上牌.     

2004-2005年广东省居民意外交通伤害死亡状况和疾病负担研究

目的了解2004—2005年广东省居民意外交通伤害死亡状况及其疾病负担情况。方法以广东省2004-2005年居民死亡原因登记系统数据和交通伤害抽样调查资料为基础，采用多级整群抽样方法，根据地区经济发展状况，在广东省抽取12个调查点，用描述性流行病学方法分析其居民交通伤害死亡情况，通过计算潜在寿命损失年（YPLL），评价交通伤害死亡的疾病负担。结果2004-2005年广东省居民意外交通伤害死亡3237例，交通伤害死亡率为21．3／10万，标化死亡率为20．1／10万，占伤害死亡的41．9％（3237／7721），占总死亡的3．2％（3237／99919）。交通伤害标化死亡率农村（21．9／10万）高于城市（16．3／10万），男性（29．2／10万）高于女性（11．0／10万）（均P〈0．01）；交通伤害死亡主要集中在15～59岁年龄段，占全部交通伤害死亡的71．3％（2308／3237）。交通伤害死亡的主要人群是行人、骑摩托车者、骑自行车者，分别占交通伤害死亡的41．9％、20．1％、3．2％。12、1、2月的交通伤害死亡人数较多，分别为292、317和281例，占全年交通伤害死亡的9．0％、9．8％、8．7％；另一个高峰是夏季的6、7、8月，死亡人数分别为266、293和284例．占全年交通伤害死亡的8．2％、9．0％和8．8％。2004-2005年广东省因交通伤害死亡造成的YPLL为10．2万人年，YPLLR为674．2／10万，交通伤害死亡YPLL占伤害死亡YPLL的44．3％；其中农村和城市分别为7．7万人年和2．5万人年；男性和女性分别为7．4万人年和2．7万人年；15—29岁年龄组损失最高（3．8万人年），占该年龄组伤害YPLL的55．9％；30—44岁年龄组次之（3．4万人年），占该年龄组伤害死亡YPLL的49．3％。结论交通伤害死亡是广东省居民伤害死亡的主要原因，不仅危害青壮年人群健康和生命，还给个人、家庭和社会带来沉重的负担，政府应尽快采取有效的措施进行干预。     

萧山区居民车祸死亡原因分析

目的分析萧山区车祸死亡流行病学特征,为预防和控制道路交通事故提供依据。方法利用萧山区死因监测系统2002—2007年资料,采用ICD—10编码进行伤害死因分类统计,计算车祸死亡率、死因构成等。结果萧山区车祸死亡率为26．28／10万,居伤害夕E因的首位,男性高于女性,车祸死亡率随着年龄的增加上升。9种车祸死亡类型中,位居首位的是人-车碰撞造成行人死亡,46．4％为60岁以上老年人。骑（乘）摩托车车祸死亡主要集中在20～59岁之间,占总摩托车死亡的91．8％,主要危害男性,占87．1％。结论车祸已成为威胁萧山区健康的重要公共卫生问题,社会各部门应积极采取相应措施,加强道路交通法规的宣传和教育工作,减少交通事故的发生和死亡。     

2010年诸城市居民车祸死亡情况分析

[目的]了解诸城市居民车祸死亡特征,为预防和控制道路交通事故提供决策依据。[方法]对2010年诸城市居民车祸死亡情况进行分析。[结果]2010年诸城市居民车祸死亡率为32.52/10万。车祸死亡率,男性为47.13/10万,女性为17.73/10万;0~19岁为6.96/10万,20~29岁为38.78/10万,30~39岁为42.32/10万,40~49岁为45.11/10万,50~59岁为35.52/10万,60~69岁为46.31/10万,≥70岁为30.07/10万。车祸死亡的354人中,骑摩托车的占30.79%,行走的占25.99%,骑电动车的占11.58%,驾驶其他机动车的占8.76%,乘坐机动车的占9.89%,骑自行车的占10.45%,坐电动车的占0.85%,不明占1.41%,坐自行车的占0.28%;第一季度死亡的占28.25%,第二季度死亡的占20.90%,第三季度死亡的占20.90%,第四季度死亡的占29.94%;城区死亡的占27.40%,农村死亡的占72.60%。[结论]诸城市车祸死亡率较高。青壮年、男性、摩托车驾驶员是车祸的主要受害者。     

急诊道路交通事故伤的监测与政府干预措施的制定

目的 探讨道路交通事故伤发生时的详细情况，便于政府部门及时制定干预措施。方法 对广州某所医院的311例急诊交通事故伤患进行流行病学问卷调查。结果 伤中，摩托车驾驶员及搭乘占44．2％，行人占33．4％，骑自行车占15．8％和汽车中人员占8．3％。60．7％的伤由摩托车车祸造成。伤中，43．8％的行人和29．5％的骑自行车未在人行过道横过马路时被机动车撞伤，且多发生在人行横道、天桥或过街隧道较少，而路面较宽的路段。91．4％的伤在伤后1小时内到达医院就诊。结论 动态监测急诊交通事故伤发生时的详细情况，有助于在社区范围内及时发现伤害的常见原因和地点，以便政府有关部门采取预防措施，如大举兴建隧道天桥方便市民过横道，减少伤害的继续发生。     

奉化市疾病监测点人群意外伤害的流行病学分析

目的：探讨农村人群意外伤害的流行病学特点，为制订防制意外伤害的措施提供依据。方法：根据11年的监测数据，描述伤害的死亡率、构成比例和流行趋势，分析主要伤害在不同年龄、性别的分布特点，以及伤害的潜在减寿年数（YPLL）。结果：伤害死亡率为64．69／10万，居人群全死因第4位。交通事故死亡率高达23．29／10万，男性死亡率为女性的2．25倍；在15－59岁年龄段，有50．5％的男性和32．0％的女性死于车祸，平均每年以4．6％的比率从1990年的18．42／10万上升到2000年的28．96／10万。自杀死亡率为17．48／10万，女性高于男性，自杀主要以15岁以上人群为主（98．7％），且死亡率随年龄增长而增加。淹死是0－14岁儿童和60岁以上老年人的主要死因，其死亡人数占总淹死人数的48．1％和23．6％，其中50．9％为1－4岁儿童。结论：车祸、自杀和淹死是伤害的三大主要死因。伤害的潜在寿命损失居监测人群全死因构成首位，已成为危害人群的主要死因之一。     

1986~1990年上海市道路交通意外伤害调查

1986~1990年上海市道路交通平均每年外伤率为44.62/10万;死亡率5.48/10万。66.56%的死亡事故发生于每天的7~16时。郊县的事故率及死亡率均高于市区(P<0.01)。机动车驾驶员在死亡事故中为主要肇事者占39.20%,骑自行车者占36.81%,行人与乘车者占19.01%。外地来沪机动车在机动车死亡事故中占32.27%。     

中国道路交通伤害长期趋势及其影响因素分析

目的总结与分析中国道路交通伤害的长期趋势及其影响因素,为道路交通安全管理提供决策依据。方法以万车死亡率、10万人口死亡率、里程死亡率、机动化程度和死亡系数等指标综合评价,采用聚类分析、等级相关方法分析道路交通伤害的影响因素。结果2000年以前道路交通伤害的伤亡人数以每10年翻一番的速度上升,2000年以来每年车祸死亡人数在10万上下。万车死亡率从1970年代中期开始下降,10万人口死亡率、里程死亡率和死亡系数等道路交通伤害指标从2002年以后开始出现下降迹象。中国道路交通伤害比较严重的地区为西藏、宁夏、新疆、青海等西部地区和浙江、广东沿海地区。道路交通伤害死亡人员中男性多于女性,男女性别比为3:1。死者主要分布在21-50岁年龄组;65岁以上的死亡人数呈逐年上升趋势。行人、乘客、骑自行车者和摩托车驾驶者是道路使用者中的弱势人群。机动车驾驶者是道路交通伤害的主要肇事者,其中半数以上为职业驾驶员,驾驶员超速行驶是发生道路交通伤害的最主要原因。等级相关分析显示,10万人口死亡率与机动车辆数(X1)、公路货运量(X2)、公路客运量(X3)、等级公路(X4)呈正相关关系(相关系数: r1=0.986、r2=0 986、r3=0.987、r4=0.985,P=0.001)。结论中国道路交通伤害10万人口死亡率经过半个世纪的持续上升,在2003年开始出现下降的趋势。     

柳州市2004～2009年城市道路交通伤害的流行病学研究

目的 探讨柳州城市道路交通伤害的流行病学规律,为预防和控制伤害的发生及其危害提供依据.方法 应用广西公安厅交警总队提供的数据和2004～2009年柳州市统计年鉴描述柳州市道路交通伤害的发生率、死亡率、伤人率和直接经济损失及其变化趋势,并描述道路交通伤害的车辆类型、地区和道路分布情况等相关特征.结果 2004～2009年柳州城市道路交通伤害在总体上发生率、死亡率和伤人率呈下降趋势,但2009年4项数据有回升趋势,直接经济损失为69.9万元,是2008年的1.90倍,受伤人数为252人,是2008年的2.50倍,2项数据升高较快;2004～2009年间柳州市道路交通伤害的主要成因是与道路交通伤害相关的人员因素,所占比例为61.80％～91.03％,其中机动车驾驶员的违章行为是主要原因,包括纵向间距不够和酒后驾驶等;发生交通伤害的主要车种为汽车和摩托车,两者所占比例每年都超过90％以上;交通伤害主要发生在城市主干道上,占76％左右.结论 柳州市道路交通伤害发生率得到了有效控制,适当控制汽车保有量的快速增长对于减少道路交通伤害作用明显;柳州城市道路交通伤害的预防和控制应以控制汽车驾驶员和摩托车驾驶员的违章行为为重点,同时增加警力,加强城市主干道的监督检查.     

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.     

Cross-national comparison of injury mortality: Los Angeles County, California and Mexico City, Mexico

BACKGROUND: Cross-national comparisons of injury mortality can suggest possible causal explanations for injuries across different countries and cultures. This study identifies differences in injury mortality between Los Angeles (LA) County, California and Mexico City DF, Mexico. METHODS: Using LA County and Mexico City death certificate data for 1994 and 1995, injury deaths were classified according to the International Classification of Diseases Ninth Revision-Clinical Modification external cause of injury codes. Crude, gender-, and age-adjusted annual fatality rates were calculated and comparisons were made between the two regions. RESULTS: Overall and age-adjusted injury death rates were higher for Mexico City than for LA County. Injury death rates were found to be higher for young adults in LA County and for elderly residents of Mexico City. Death rates for motor vehicle crashes, falls, and undetermined causes were higher in Mexico City, and relatively high rates of poisoning, homicide, and suicide were found for LA County. Motor vehicle crash and fall death rates in Mexico City increased beginning at about age 55, while homicide death rates were dramatically higher among young adults in LA County. The largest proportion of motor vehicle crash deaths was to motor vehicle occupants in LA County and to pedestrians in Mexico City. CONCLUSIONS: These findings illustrate the importance of primary injury prevention in countries having underdeveloped trauma care systems and should aid in setting priorities for future work. The high frequency of pedestrian fatalities in Mexico City may be related to migration of rural populations, differing vehicle characteristics and traffic patterns, and lack of safety knowledge. Mexico City's higher rate of fall-related deaths may be due to concurrent morbidity from chronic conditions, high-risk environments, and delay in seeking medical treatment.     

25家综合性医院急诊伤害调查

目的 探讨急诊科伤害的流行特征。方法 有条件地选择全国25家综合性医院急诊科作为调查点,在2001年7月至2002年6月进行伤害现况调查,对急性损伤仅做抽样调查。结果全国25家医院抽样调查伤害病例共25 019例,占急诊总就诊量的17.46％。81.67％为意外伤害;男女性别比为2:1;15～34岁占50.63％;前3位伤害种类依次为意外的机械性损伤、运输事故、跌倒;前三位伤害的职业依次为工人、农民和学生;病死率为5.12‰,青壮年死亡人数占总死亡数的79.69％。首位死因是交通事故,占46.88％。进一步分析了机械性等损伤和11 151例中毒的特点。结论 建立以医院急诊科为基础的伤害监测,有其必要性、迫切性和可行性。     

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.     

Deaths from external causes of injury among construction workers in North Carolina, 1988-1994

Records from the Office of the North Carolina Chief Medical Examiner were used to describe 3955 deaths, both on and off the job, between 1988 and 1994 from external causes of injury (E-codes) among individuals whose usual occupation was in the construction trades. For the calculation of rates, population sizes were estimated using 1980 and 1990 census data. Deaths from injuries occurred at an average rate of 226 per 100,000 population; 213 per 100,000 for non-work-related fatalities and 13 per 100,000 for work-related fatalities. Overall, deaths were most often from guns or motor vehicle accidents. Work-related deaths were most often caused by motor vehicles (21%); falls (20%), most commonly from roofs or scaffolds; and machinery (15%), electrocutions (14%), and falling objects (10%). Three major causes of work-related motor vehicle accidents were identified including injuries to pedestrians in highway work zones and in backovers on construction sites, and injuries to drivers caused by shifting loads while transporting construction materials. The circumstances surrounding deaths involving scaffolding document the need for training and safety procedures for erecting, moving, and disassembling scaffolds, but also for safe work practices on scaffolds. Training and safety procedures to avoid electrocutions must involve workers who are not in the electrical trades, as these deaths often occurred among individuals who were not electricians or linemen. Significant differences were observed in the proportion of victims having elevated blood-alcohol levels depending on whether the injury was work-related; 57 percent of victims were impaired at the time of fatal non-work-related injuries compared to 5 percent of work-related injuries. Interventions to treat and prevent alcohol abuse among construction workers could have a significant public health impact in the prevention of premature death from injury, particularly outside the workplace.     

Traumatic occupational fatalities in South Carolina, 1989-90.

Death certificates for South Carolina for 1989 and 1990 were examined to identify deaths resulting from injury incurred in the workplace. There were 277 deaths in that category in the 2-year period, an average yearly rate for traumatic occupational fatalities of 8.84 per 100,000 workers. The groups of industries with the highest fatality rates were transportation-communication-utilities, construction, and agriculture-fishing-forestry. The leading causes of death were injuries from motor vehicle crash, homicide, and falls. The traumatic occupational fatality rate for men was about 13 times greater than that for women; however, a much higher proportion of women died from homicide on the job. The findings in general reflect trends reported in other studies. The death rates for workers in South Carolina for 1989-90, however, were higher than national averages for 1980-88. National data for 1989-90 were not available for comparison. The data suggest that more effective injury prevention efforts need to be applied to such causes of on-the-job injury as motor vehicle crash, homicide, and falls. Those three categories accounted for more than 56 percent of all traumatic occupational fatalities in South Carolina in 1989 and 1990. Motor vehicle crash prevention efforts particularly are needed in the transportation-communication-utilities industries. The findings show that particular efforts need to be directed to the retail trade category for prevention of homicide and to the construction industry for prevention of falls.     

Injury fatalities among young children

Injuries and violence are the primary causes of death among young children in the United States. In particular, in 1982-84 motor vehicle injuries, fires, drowning, and homicide were the leading external causes of death at ages 1-4 years and 5-9 years, accounting for nearly 80 percent of all deaths from external causes. The purpose of this article is to analyze race and sex differentials in injury fatalities among young children. Race and sex differentials in injury mortality were measured in terms of relative risks, that is, race (black to white) and sex (male to female) mortality ratios. Race ratios for external causes ranged from 1.7 to 1.9 for children 1-4 and 5-9, while sex ratios were somewhat lower, 1.4 to 1.8. Although race and sex ratios were relatively small for passenger-related motor vehicle fatalities (0.8 to 1.2) the ratios for pedestrian-related injuries were considerably greater (1.5 to 2.0). Race ratios for deaths caused by fires and homicide were particularly large (3.4 to 4.3). Mortality differences were also measured in terms of excess mortality. For each age-race group more than 65 percent of the overall excess deaths among males were due to external causes of death. Pedestrian-related motor vehicle injuries and drownings accounted for the largest proportion of excess deaths among males. At ages 1-4, 53 percent of the overall excess deaths among blacks were due to external causes. Deaths caused by fires and homicide accounted for more than two-fifths of the excess in this age group.(ABSTRACT TRUNCATED AT 250 WORDS)     

National road casualties and economic development

OBJECTIVE: This paper explores why traffic fatalities increase with GDP per capita in lower income countries and decrease with GDP per capita in wealthy countries.METHODS: Data from 41 countries for the period 1992-1996 were obtained on road transport crashes, injuries, and fatalities as well as numbers of vehicles, kilometers of roadway, oil consumption, population, and GDP. Fixed effects regression was used to control for unobservable heterogeneity among countries.RESULTS: A 10% increase in GDP in a lower income country (GDP/Capita <1600) is expected to raise the number of crashes by 7.9%, the number of traffic injuries by 4.7%, and the number of deaths by 3.1% through a mechanism that is independent of population size, vehicle counts, oil use, and roadway availability. Increases in GDP in richer countries appear to reduce the number of traffic deaths, but do not reduce the number of crashes or injuries, all else equal. Greater petrol use and alcohol use are related to more traffic fatalities in rich countries, all else equal.CONCLUSION: In lower income countries a rise in traffic-related crashes, injuries, and deaths accompanies economic growth. At a threshold of around 1,500 dollars-8,000 dollars per capita economic growth no longer leads to additional traffic deaths, although crashes and traffic injuries continue to increase with growth. The negative association between GDP and traffic deaths in rich countries may be mediated by lower injury severity and post-injury ambulance transport and medical care.