上海市自行车伤害流行特征研究

目的 了解大城市自行车伤害的流行特征,分析不同人口社会学特征与自行车伤害的关系.方法 采用分层多阶段按规模大小成比例概率( probability proportion to size,PPS)系统整群随机抽样的方法,抽取上海市常住居民46 049人进行人户调查；同时采集58家医院自行车伤害信息及全市居民病伤死亡原因及其相关人口统计学资料.结果 1992-2007年,上海市人均可支配收入增加了685％,但自行车伤害死亡率反而增加了79.6％.总受伤率为259.502/10万,其中10 ～ 14岁组儿童受伤率在所有年龄组中居于首位.女性自行车伤害发生率和死亡率高于男性.受教育程度与自行车伤害率之间成反比,小学及以下文化程度死亡率为12.33/10万(51.72％),受伤率为501.57/10万(41.74％).居民收入与自行车伤害率之间成反比,位于中心城区的卢湾和静安死亡率最低,而其年人均可支配收入在全市为最高.在所有自行车伤亡者中,头部受伤致死比例达71.9％,且所有病例无一在受伤时戴头盔.结论 自行车伤害防治面临着一个巨大的挑战,建议尽快建立一个电动自行车强制戴头盔的地方法律,在新医改推出的家庭医生责任制系统中增加伤害防治服务包以降低自行车伤害发生率.

Study on pattern of bicycle-related injuries in Shanghai City

Objective To characterize epidemiologic features,and relationships of age and education level with bicycle-related injuries in the megalopolises of China.Methods Multi-stage stratified random cluster sampling was used;a total of 46 049 households conducted a questionnaire survey.Mortality data from all households were collected from the local vital registration system in 1992-2007.Information on cases of hospitalization and fatalities in 58 hospitals was analyzed.Local level economic accounting data,demographic data,and labour force data from Shanghai Municipal Statistics Bureau in 1992-2007 were used.Results In the past 16 years,bicycle-related mortality rate had an upward trend with the increase of income.The morbidity was 259.502/100 000 populations.The morbidity rate among 10-14 age groups was the highest among children.The female mortality rate was 2.32 times higher than the male mortality rate.Head injuries accounted for 71.9% of fatalities and 33.1% of the nonfatal cases.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.Conclusions Megalopolis must face enormous challenges in bicycle-related injury prevention.More efforts are needed,such as the enactment of mandatory helmet laws for operating an electric bicycle and a new responsibility system of family doctors with comprehensive injury prevention programs.