广州市7岁以下儿童意外伤害流行病学分布特征

【目的】了解广州市7岁以下儿童意外伤害分布特征,探讨伤害发生原因,为预防与控制意外伤害提供流行病学资料。【方法】通过广州市儿童意外伤害监测网络,调查7岁以下儿童意外伤害发生情况及相关因素。【结果】儿童意外伤害主要集中在1~5岁组,以3~4岁组所占比例居多,男童多于女童,差异有统计学意义(P0.01)。儿童意外伤害的首位原因为跌伤,其他依次为烧烫伤、道路交通伤、动物伤。溺水和道路交通伤是致残致死的首要原因。【结论】防止儿童溺水和道路交通伤发生,是伤害干预的首要任务。跌伤、烧烫伤是伤害控制的主要危险因素,动物伤是广州市伤害控制一个新的课题。控制儿童意外伤害需要社会各部门的参与和家庭配合,采取综合措施干预。     

儿童伤害的流行现状与预防控制

凡由于能量(机械能、热能、化学能等)的传递或干扰超过人体的耐受性造成组织损伤,或窒息导致缺氧,影响了正常活动,需要医治或看护,称之为伤害[1]。伤害按其意图可分为意外伤害和故意伤害,常见的意外伤害包括道路交通伤害、溺水、跌伤、中毒和烧烫伤;常见的儿童故意伤害包括儿童     

邯郸市高中生意外伤害的流行病学调查

目的：了解邯郸市高中生意外伤害率,伤害种类,原因及地点等,为有关部门制定意外伤害的防治措施提供依据。方法：采取多级抽样方法对高中生过去一学年的意外伤害进行了流行病学调查。结果：意外伤害率为9．46％,男生（13．72％）高于女生（5．93％）伤害人次率居前五位的是跌伤（4．41％）、碰伤（2．70％）、自行车伤（1．53％）、刀剪等锐器伤（1．20％）和烧烫伤（1．14％）,伤害原因主要是体育运动、骑自行车和劳动,结：意外伤害是可以预防的疾病,应通过各种方工加强高中生的安全教育,减少意外的伤害的发生。     

7岁以下儿童意外伤害相关因素488例分析

目的 分析7岁以下儿童意外伤害的特点及相关因素, 为有效预防提供理论依据。方法 回顾性分析从化市2012年1-12月发生的488例7岁以下儿童意外伤害病例。结果 儿童意外伤害的顺位为跌伤、动物伤害、烧烫伤、锐器伤、道路交通伤和异物伤, 意外伤害的性别及年龄分布差异有统计学意义(P＜0.01), 男童发生动物伤害的比例高于女童(P＜0.01), 而女童烧烫伤的比例高于男童(P＜0.05);3~7岁儿童道路交通伤发生的比例高于0~2岁儿童(P＜0.01), 而异物伤低于0~2岁儿童(P＜0.01)。在幼儿园由老师看护的儿童, 中重度意外伤害发生的比例较高。结论 儿童意外伤害动物伤害的发生率较高, 高年龄儿童易发生道路交通伤, 低年龄儿童易发生异物伤, 托幼园所是意外伤害预防的重点, 应根据儿童意外伤害发生的特点, 采取有针对性的干预措施。     

长途铁路旅客意外伤害发生现况及危险因素分析

目的 了解铁路旅客意外伤害的发生现况并探索其危险因素。方法 采用现况研究的方法调查铁路旅客意外伤害的发生情况,用病例对照研究探索其危险因素。结果 铁路旅客总的伤害发生率为1．2％,男女差异无显性,伤害类型以烫伤、碰伤和跌伤为主（占93．28％）。性格内向、饮食差、睡眠差、旅行中饮酒是旅客伤害发生的危险因素,而有伤害忧患意识和经常出差则是旅客伤害发生的保护因素。结论 铁路旅客是意外伤害的高危人群,必须重视这一巨大人群的伤害预防。     

驾驶员与道路交通伤害

探索道路交通伤害的危险因素，减少和控制危险因素是预防道路交通伤害的关键。在构成道路交通伤害的整个过程中，驾驶员是导致道路交通伤害的主导因素，主要包括驾驶员的酒精行为、疲劳驾驶、个性特征、使用手机、驾驶能力、安全带的使用、摩托车骑者的特征、生理特征、年龄、性别等危险因素。针对这些危险因素采取必要的措施，可减少道路交通伤害的发生。     

中国7省／市21所综合性医院急诊伤害发生状况的描述性分析

目的　调查中国7省/市2 1所综合性医院急诊伤害发生状况,为实施有效的干预措施和分类指导提供科学依据。方法　以登记调查方式对2 0 0 4年1～8月到综合性医院就诊的36 4 89例首诊伤害患者进行调查,调查内容为伤害患者职业、伤害发生的时间、地点、原因、意图、性质、严重程度等。采用专题小组会谈、个人访谈等定性调查方式对主要伤害发生原因及影响因素进行分析。结果　急诊伤害患者男性多于女性;15～34岁年龄组的伤害患者最多,平均年龄为30 7±15 8岁;伤害程度多为轻度;发生的意图以意外伤害为主;受伤部位以头颈部为主;伤害的前3位原因分别为机械伤、跌伤、道路交通伤害(下简称交通伤害) ,伤害在4～6月、周一和周五、下午14 :4 5有一定的集中趋势。结论　青壮年为伤害防治的重点人群,机械伤、跌伤、交通伤害为优先防治的伤害种类。对不同种类伤害的防治应进行分类指导     

江西省儿童道路交通伤流行病学分析

目的掌握江西省儿童道路交通伤流行病学特征。方法采用多阶段整群随机抽样方法。结果道路交通伤发生率在儿童各类伤害中排第三位。0～17岁儿童道路交通伤发生率为750.5/10万,各年龄组以10～14岁组发生率最高,男童发生率高于女童;上学放学时间是5～17岁儿童道路交通伤发生的高危时间段;城市儿童道路交通伤发生率高于农村儿童,不同的交通模式具有不同水平的危险性,骑自行车的危险水平最高,其次为徒步、摩托车。结论道路交通伤是引起儿童伤害的主要原因,建议针对儿童的年龄特征、城乡居住环境和不同交通模式等特点开展交通安全教育和干预措施。     

珠海市城区幼儿园儿童伤害现况及影响因素分析

【目的】 了解珠海市城区幼儿园儿童意外伤害现况,明确儿童意外伤害的影响因素,为开展伤害的预防工作提供依据。 【方法】 分层随机整群抽取12所幼儿园,对1 428名2~6岁儿童的父母进行回顾性调查,了解研究对象在2010年3月-2011年3月期间的意外伤害情况。 【结果】 珠海市城区幼儿园儿童的意外伤害发生率为53.2%。常见的伤害种类是跌伤(26.8%)、碰伤(16.1%)、咬伤和抓伤(13.0%)。伤害发生的危险因素为儿童左利手、母亲不良管教方式、儿童骑童车母亲未监管、儿童坐立不定、家庭月总收入、家里有玻璃家具;保护因素为家庭备有急救小药箱、母亲对伤害认识正确、母亲定期检查玩具。 【结论】 应针对儿童意外伤害发生的影响因素,采取综合安全防范措施。     

鄞州区2005-2006年急诊室外来人口伤害特征分析

目的了解鄞州区内急诊室外来人口伤害发生特征及分析其原因,为该人群伤害预防提供科学依据。方法分层抽取3家哨点医院,对急诊室伤害就诊病例情况进行统一登记,建立数据库后,对数据进行统计分析。结果共监测急诊室外来人口伤害病例6431例,男女比为3:1。意外伤害占79.4%(5106例),自伤占2.4%(152例),他人故意伤害占18.2%(1173例),所有伤害中死亡15人,死亡率为0.2%。伤害发生的主要原因依次为钝器伤、跌或坠落伤、刺或割伤、交通伤,分别占33.2%、23.4%、19.8%、15.5%。饮酒和工厂做工是伤害发生的重要危险因素。结论外来人口急诊室伤害发生严重,应加强健康宣教和针对重要危险因素实施干预措施。     

Pattern of Pedestrian Injuries in the City of Nairobi: Implications for Urban Safety Planning

Pedestrians are overrepresented in road traffic injuries and deaths in Nairobi, the capital city of Kenya, yet little research has been done to provide better understanding of the characteristics of pedestrian injuries. This paper presents the data obtained from road traffic injury admissions to Kenyatta National Hospital (KNH) over a 3-month period starting from 1 June to 31 August 2011. A total of 176 persons involved road traffic injuries in Nairobi were admitted to KNH during this period. Pedestrians comprised the highest (59.1 %) proportion of road traffic injury admissions, followed by motor vehicle passengers (24.4 %) and motor cyclists (9.7 %). Bicyclists and drivers accounted for 5.1 and 1.7 %, respectively. Cars (39.4 %) were the leading category of motorized four-wheeler vehicles that were involved in collisions with pedestrians, followed by matatus (35.5 %). Seventy percent of pedestrians were hit while crossing the road, 10.8 % while standing by the road, and 8.1 % while walking along the road. The highest proportion of pedestrian crashes occurred on Saturdays (25.5 %) and Sundays (16.7 %). Most of the pedestrian injuries (67.7 %) affected the limbs. The paper argues that safety of pedestrians should be a priority in road safety efforts in the city of Nairobi. Urban road safety planners should adopt existing cost-effective interventions to improve the safety of pedestrians such as area-wide traffic calming to limit the speeds of motor vehicles to 30 km/h, providing sidewalks for pedestrians, traffic calming in residential neighborhoods, people-and-not-car-oriented urban road designs, traffic education, and enforcement of traffic regulations.     

我国车祸的流行病学特征及影响因素分析

本研究的目的在于分析1951～1994年我国车祸的流行病学特征及其影响因素，为车祸的预防和控制提供依据。43年中我国车祸发生数增加了42倍，死亡人数增加了77倍。1984～1994年车祸年死亡率由2．43／10万人上升到5．56／10万人，平均年增长率为12．9％。广东、浙江、辽宁、四川和江苏是车祸最多的省份，5省的车祸发生数占全国总发生数45％，死亡人数占38％。1994年30个省市区的车祸死亡率以北京市为最低（3．41／10万人），浙江省最高（12．09／10万人），广东省的升幅最大。致死性车祸多发生于天气晴朗时的平直路段，以20～50岁的农民和职工居多，死者2／3为行人、骑自行车者和乘车者。各类事故的原因中驾驶员责任、无证开车、骑自行车人责任和行人过失等人的因素占90％。驾驶员肇事原因主要是违章行车、判断错误或疏忽大意。车辆增加、运输繁忙和道路不足、交通条件欠完善是导致车祸的主要因素。预防和控制车祸的根本措施在于改善交通环境和加强交通安全教育。     

A diary study of the risk perceptions of road users

Employing an in situ diary, 291 road users in Oxford (pedestrians, cyclists, motorcyclists, car drivers and bus drivers) recorded details of all journeys made during 1 week and noted any incidents and near-misses which occurred on these journeys. On average, pedestrians and cyclists reported 0.18 incidents per mile travelled (one incident every 5.59 miles) and motorcyclists, car drivers and bus drivers reported 0.02 incidents per mile travelled (one incident every 41.67 miles). Analysis revealed mutual conflict between cyclists and buses, and irritation on behalf of pedestrians towards cyclists on pavements. Only 35% of incidents involving cyclists occurred at junctions and the paper discusses likely reasons for the discrepancy between this and the usual two-thirds figure quoted in official accident records. While the rate of incident perception reflected the vulnerability of pedestrians and cyclists, the amount of distress experienced did not, as bus drivers rated more of their incidents as distressing than did any other group. When incident reporting was compared to accident figures, the data suggest that car drivers were paying more attention to near-misses with the less vulnerable road users (i.e. those who could harm them) than they were to near-misses with more vulnerable road users (i.e. those whom they could harm).     

2005年湖北省中重度伤害住院患者伤害状况

目的了解湖北省中重度伤害住院患者的发生水平和分布特征,为制定全省伤害防制规划及全面开展伤害预防与控制工作提供科学依据。方法在全省随机抽取10个市、县,兼顾地理位置和农村、城市等经济类别。每个市、县随机选取一、二、三级医院各1家作为调查医院。凡2005年1月1日-12月31日期间因伤害住院者均为调查对象,填写统一的调查表。结果共报告病例9393例,男、女性别比为2．33：1。伤害的构成以18～44岁年龄段最高（50．38％）;职业分布中,以农牧渔水利业生产人员比例最高,其次为家务人员、生产运输操作人员和在校学生。伤害发生前3位依次为交通事故伤害（40．37％）、跌落坠落（26．82％）、中毒（7．70％）,导致骨折（40．26％）、挫伤与擦伤（19．58％）、脑震荡与脑戳裂伤（14．64％）;损伤部位以头部、下肢、上肢损伤为主,主要以非故意伤害（意外事故）为主,但女性自我伤害的比例高于男性。伤害导致住院时间短至1d,长至747d;平均每例伤害患者的住院费用为3914．16元,高达77．53％的患者是自费医疗。89．41％的患者经住院治疗后痊愈或好转出院,有1．32％的患者需转院治疗,1．09％的患者因伤害而导致死亡。结论2005年湖北省中重度伤害住院患者男性多于女性;年龄以中青年为主;伤害类型以交通事故为主。     

The effect of legal drinking age on fatal injuries of adolescents and young adults.

This study examined the effect of legal drinking age (LDA) on fatal injuries in persons aged 15 to 24 years in the United States between 1979 and 1984. Effects on pre-LDA teens, adolescents targeted by LDA, initiation at LDA, and post-LDA drinking experience were assessed. A higher LDA was also associated with reduced death rates for motor vehicle drivers, pedestrians, unintentional injuries excluding motor vehicle injuries, and suicide. An initiation effect on homicides was identified. Reductions in injury deaths related to drinking experience were not found. In general, a higher LDA reduced deaths among adolescents and young adults for various categories of violent death.     

2006-2014年我国门急诊儿童非故意和故意伤害病例分析

目的 了解我国儿童非故意与故意伤害的主要流行特征。方法 对2006-2014年全国伤害监测系统收集的0～17岁儿童伤害病例的主要特征进行分析。结果 2006-2014年在哨点医院门诊和急诊收集的儿童伤害病例中的故意伤害病例所占比例呈现降低趋势。2014年收集病例中,男性非故意伤害和暴力/攻击病例多于女性,不同性别自残/自杀病例所占比例接近。非故意伤害前三位发生原因是跌倒/坠落、道路交通伤害和钝器伤,自残/自杀病例前三位发生原因是中毒、刀/锐器伤和跌倒/坠落,暴力/攻击病例前三位发生原因是钝器伤、刀/锐器伤和动物伤。非故意伤害和自残/自杀病例首位发生地点是家中,暴力/攻击病例首位发生地点是学校与公共场所。自残/自杀病例中、重度病例比例高于非故意伤害和暴力/攻击病例。不同性别、年龄儿童伤害发生原因、发生地点、严重程度和结局均有差别。结论 儿童非故意伤害和故意伤害防控需根据其流行特征采取有针对性的策略和措施。     

2006-2010年宁波市居民交通运输伤害死亡特征分析

目的：分析宁波市2006-2010年交通运输伤害死亡特征,为伤害干预工作提供依据。方法：死亡数据来源于2006-2010年宁波市死因监测系统,研究对象为户籍居民。通过计算死亡率、死亡构成比等指标进行数据分析。结果：2006-2010年宁波市居民交通运输伤害死亡率平均为18.59/10万,男性高于女性,男性死亡率随年度变化呈现下降趋势。不同交通运输方式发生的伤害死亡,以道路上为主（占伤害死亡的97.83%）,其次为水上（占2.11%）。以行人、骑摩托车者和骑脚踏车者死亡居多。死亡发生月份集中在10-12月。结论：道路伤害是交通运输伤害的主要类型,需针对发生特点采取措施。     

Alcohol and fatal injuries: temporal patterns

Although alcohol use has been established as a risk factor for injuries associated with motor vehicle crashes, the role of alcohol for other unintentional and intentional injuries is less defined. A review of 102,401 deaths investigated by North Carolina medical examiners in the period 1973-1983 characterized the temporal patterns of ethyl alcohol in unintentional injury fatalities, suicides, homicides, and persons who died of natural or unknown causes. Victims of homicides (85.9%) and suicides (77.7%) were tested for alcohol more frequently than were fatalities resulting from unintentional injury (67.5%) or natural causes (61.6%). Alcohol was present in 62.8% of homicide victims, 48.6% of unintentional injury fatalities, 35.3% of suicides, and 14.4% of deaths from natural causes. The percentage of alcohol-associated deaths for each manner of death showed little yearly or seasonal variation. Alcohol was most frequently detected in persons fatally injured on the weekend and from 6 PM to 6 AM. This study highlights the magnitude of alcohol's role in intentional and unintentional injuries, especially for persons injured at night and on weekends.     

Global childhood unintentional injury surveillance in four cities in developing countries: a pilot study

Objective

To determine the frequency and nature of childhood injuries and to explore the risk factors for such injuries in low-income countries by using emergency department (ED) surveillance data.

Methods

This pilot study represents the initial phase of a multi-country global childhood unintentional injury surveillance (GCUIS) project and was based on a sequential sample of children < 11 years of age of either gender who presented to selected EDs in Bangladesh, Colombia, Egypt and Pakistan over a 3–4 month period, which varied for each site, in 2007.

Findings

Of 1559 injured children across all sites, 1010 (65%) were male; 941 (60%) were aged ≥ 5 years, 32 (2%) were < 1 year old. Injuries were especially frequent (34%) during the morning hours. They occurred in and around the home in 56% of the cases, outside while children played in 63% and during trips in 11%. Of all the injuries observed, 913 (56%) involved falls; 350 (22%), road traffic injuries; 210 (13%), burns; 66 (4%), poisoning; and 20 (1%), near drowning or drowning. Falls occurred most often from stairs or ladders; road traffic injuries most often involved pedestrians; the majority of burns were from hot liquids; poisonings typically involved medicines, and most drowning occurred in the home. The mean injury severity score was highest for near drowning or drowning (11), followed closely by road traffic injuries (10). There were 6 deaths, of which 2 resulted from drowning, 2 from falls and 2 from road traffic injuries.

Conclusion

Hospitals in low-income countries bear a substantial burden of childhood injuries, and systematic surveillance is required to identify the epidemiological distribution of such injuries and understand their risk factors. Methodological standardization for surveillance across countries makes it possible to draw international comparisons and identify common issues.     

浙江省道路交通伤害病例对照研究

目的探讨道路交通伤害危险因素,为进一步开展道路交通伤害预防控制提供科学依据。方法采用1∶2配对病例对照研究方法,通过面访形式收集病例组和对照组驾驶员的一般情况、交通工具状况、驾驶相关行为、睡眠状况、吸烟、饮酒、药物使用、道路状况等因素。结果 2008-2009年间共调查246例病例组和492例对照组驾驶员,在控制年龄、性别、驾驶机动车类型等因素下,驾车频率高(OR=3.08)、有吸烟史(OR=1.94)、行驶车道错误(OR=2.36)、驾车时身体状况差(OR=1.87)、睡眠不足(OR=4.63)、定期车辆检修(OR=0.33)、佩戴安全带/安全头盔(OR=0.30)等因素在病例组和对照组间差异有统计学意义。结论道路交通伤害与驾驶员行为、车辆和环境等因素有关,应针对人、车、路三方面采取相应干预措施,降低道路交通伤害的发生。