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.     

医生的常识和责任—让儿童使用自行车头盔

美国每年有1300人死于骑自行车的意外伤害,而这些死亡者中近半数为14岁以下的儿童。有调查人员建议,若骑车者带上头盔,那么这类与骑自行车有关的头部损伤事件将会明显地减少。使用保护性头盔可减少其他运动中的严重脑创伤,如足球和曲棍球运动。最近,自行车头盔已进行了象足球、曲棍球运动头盔类似的定标和运动试验。在美国,儿童死于自行车事故的人数已超过意外中毒、摔伤、烧伤和其他严重医学疾病的死亡致。由此看来医生对患者进行有     

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…     

台湾地区各式摩托车头盔对头部外伤颈椎伤害效应的多中心研究

目的评估被摩托车碰撞后头部外伤(HI)患者中,各类头盔对颈椎损伤(CSI)的影响,并研究其作用机制。方法从台湾地区头部外伤登录数据库中获得2000—2009年摩托车事故患者5 225例资料。根据头部外伤后有无伴随颈椎损伤,将患者被分为病例组和对照组。比较两组头盔的使用和类型,并用多因素logistic回归分析获得颈椎损伤的OR值。结果本研究结果,由摩托事故引起颈椎损伤的发生率为3.3%(173/5 225)。其中有戴头盔者OR=0.31(0.19～0.49)、半罩式头盔防护者OR=0.35(0.21～0.56)全罩式头盔防护者OR值仅0.19(0.10～0.36);与未戴头盔者相比,颈椎损伤发生率均明显下降。结论戴全罩式和半罩式的头盔防护,均明显降低了摩托车撞车后头部外伤患者的颈椎损伤风险。这种效应与头盔具有光滑的表面和坚硬的填充材料有关。     

广东省部分医院运输事故伤害住院病例原因分析

目的分析2010年广东省部分地区运输事故伤害住院患者状况,为制定防制策略提供依据。方法在广东省伤害城市监测点深圳市、珠海市各选3家二级以上共6家医院,农村点南雄市、新兴县、连平县各选取1家市(县)人民医院,收集2010年1月1日至2010年12月31日所有伤害住院病历首页,对其中运输事故伤害住院病例分析。结果广东省9家综合医院因运输事故伤害住院病例5427例,占伤害住院病例的28.3%,男女性别比为2.24∶1(3752/1675),运输事故伤害高发于冬季(33.5%),43.7%的伤害病例为流动人口,以骑摩托车人员在运输事故中损伤最多(36.3%),头部损伤2227例(41.1%),住院天数中位数为10 d,住院费用中位数为5468.97元。结论广东省运输事故伤害不容忽视,流动人口的交通运输安全已成为严重的公共卫生问题。     

自行车交通事故伤亡的现状及其预防对策

自行车事故伤害是发病和死亡的一个重要原因。事故及伤害的发生是人－车－道－环境等多种因素作用的结果，其中骑车的行为因素占有主导地位。有机动车涉及的损伤占严重伤、多发伤和头部伤的大部分，而且后果较为严重，国内以青壮年人为主要受害；从美国、澳大利亚等发达国家来看，少年儿童是发病和死亡的高危险人群；受害男性明显多于女性。通过制定的执行自行车交通安全法规；改善交通环境；开展安全教育；推广使用头盔，发挥     

腾冲县2007-2013年居民伤害死亡原因分析

[目的]了解腾冲县居民伤害死亡发生特点、变化及其对居民健康的影响程度,为进一步开展伤害的预防和卫生规划提供依据。[方法]腾冲县2007-2013年居民死因监测数据,用中国疾病预防控制中心死因监测数据清洗与分析工具(2010)、Excel 2003和SPSS17.0软件进行数据统计、分析。[结果]2007-2013年,腾冲县伤害死亡2795例,伤害粗死亡率61.67/10万,标化死亡率64.83/10万,占总死亡的13.02%,居全死因顺位的第3位。7年监测数据显示伤害死亡率总体呈上升趋势,其中道路交通事故死亡率上升最明显。前5位伤害死因依次为:道路交通事故、自杀、意外跌落、砸死、其他意外事故和有害效应,占伤害死亡的76.71%。男性年平均死亡率86.72/10万,标化率90.80/10万;女性年平均死亡率35.02/10万,标化率37.08/10万,男性伤害死亡率高于女性,是女性的2.48倍,道路交通事故和自杀是导致腾冲县男性和女性伤害死亡的主要原因。不同年龄组伤害导致的主要死亡原因不同,0~岁主要是意外的机械性窒息,1~14岁以淹死为主,15~44岁组以道路交通事故为主,45~64岁以道路交通事故为主,65岁及以上年龄组以意外跌落为主。[结论]伤害已成为腾冲县居民死亡的主要原因之一,应根据其变化特点开展针对性的综合防治措施。     

2007年庄河市居民病伤死亡资料分析

[目的]了解居民疾病与伤害死亡情况,给政府和相关部门制订疾病预防控制对策提供信息。[方法]对庄河市2007年居民疾病与伤害死亡资料进行分析。[结果]2007年庄河市居民死亡率为6．07‰,其中男性为6．77‰,女性为5．36‰居民死亡的前5位原因依次是循环系统疾病、恶性肿瘤、损伤和中毒、呼吸系统疾病、内分泌和代谢性疾病。[结论]庄河市属恶性肿瘤高发地区,慢性非传染性疾病与损伤和中毒是居民的主要死因。     

1998—2007年福建省城乡居民伤害死亡及其YPLL分析

[目的]了解福建省城乡居民10年来伤害死亡的变化趋势、特点和寿命损失情况。[方法]分析福建省1998—2007年死因统计年报资料,用伤害死亡率、死因别死亡率、构成比和潜在寿命损失年描述伤害的死亡水平。[结果]1998—2007年福建省城乡居民伤害平均死亡率分别为29.67/10万和59.78/10万,均居死亡顺位第5位,总体呈下降趋势。农村死亡率是城市的2.0倍,男性死亡率高于女性。城乡居民的前3位伤害死因均为运输事故、自杀和意外跌落。城市的运输事故死亡率呈下降趋势,而农村则上升明显。城市伤害YPLL为85 453人年,占全死因YPLL的21.0%;农村居民相应为415 278人年、31.7%。[结论]伤害是我省居民的主要死因之一,对寿命损失的影响较其它疾病严重,应积极采取有效的干预措施。     

125例道路交通事故死亡案例分析

[目的]分析山东省某县道路交通事故死亡案件的特点。[方法]将125例道路交通事故死亡的案例资料,按性别、年龄、救治情况、损伤部位、直接死因、事故发生时间及地点进行统计分析。[结果]男性死者多于女性死者;死者的年龄多见于21～60岁;死者的损伤部位以头面部和胸部最常见,且致死率也最高,直接死因主要为重度颅脑损伤(99例,79.20%)。案发以秋冬季较多,时间以0时、6时、15～17时、19～21时最多;案发地点以主干公路为主。[结论]有关部门应进一步完善交通安全设施,加快城乡道路建设步伐,让行人、自行车、机动车分道而行,以减少交通事故的发生,降低交通事故的死亡率。     

Injuries to bicyclists in Wuhan, People's Republic of China.

OBJECTIVES: This study examined the morbidity and mortality from bicycling injuries in Wuhan, China. METHODS: Police department data for the year 1993 complemented by data from emergency room interviews were analyzed. RESULTS: The death rate from bicycling injuries was estimated as 2.2 per 100000 population, more than seven times the rate for the United States. At least 79% of the fatalities and 17% of the emergency room cases sustained head injuries, the majority (71%) of which resulted from contact of the head with the concrete or asphalt road. None of the patients was wearing a helmet at the time of injury, and helmet use among the general bicyclist population was nonexistent. CONCLUSIONS: Bicycle-related head injury is an important public health issue in China. The effectiveness of safety helmets in developing countries needs to be evaluated.     

Bicycle injuries: road trauma is not the only concern

Data on bicycle injury presentations at a public hospital emergency department for 1991–95 inclusive were analysed to determine the nature and extent of bicycle injuries in the community. There were 599 bicycle injury presentations during the study period, representing more than 2.0% of all injury-related presentations to the emergency department. The main outcome measures were severity and type of injury. Distribution by gender, age, helmet use (1991 and 1992 only), location and mechanism was examined. Rider-only injuries (falls or collisions with stationary objects) accounted for 79.3% of all presentations with only 5.2% due to collisions on a public road or footpath with other moving traffic. Of all injuries where a location was determined, 61.6% occurred in off-road locations. There was little difference in the overall proportions of hospital admissions from injuries on-road (12.4%) and off-road (9.0%). Cyclists injured in on-road collisions with traffic had a higher proportion of hospital admissions (40.0%) than those injured on-road by other mechanisms (7.6%). Children under 10 years of age who had been riding without a helmet suffered a much higher proportion of injuries to the head (53.2% of all injuries) than older cyclists riding without a helmet (19.4%). The majority (83.1%) of head injuries in children under 10 years of age occurred off-road and helmet use was lowest in this group (28.6%). Given previous evidence that helmet use can prevent head injuries, strategies to increase helmet use among cyclists, particularly young children, while riding both on and off-road, should be given a high priority. Rider-only injuries are also an important public health issue.     

Changes in motorcycle-related head injury deaths, hospitalizations, and hospital charges following repeal of Pennsylvania's mandatory motorcycle helmet law

To evaluate the 2003 repeal of Pennsylvania's motorcycle helmet law, we assessed changes in helmet use and compared motorcycle-related head injuries with non-head injuries from 2001-2002 to 2004-2005. Helmet use among riders in crashes decreased from 82% to 58%. Head injury deaths increased 66%; nonhead injury deaths increased 25%. Motorcycle-related head injury hospitalizations increased 78% compared with 28% for nonhead injury hospitalizations. Helmet law repeals jeopardize motorcycle riders. Until repeals are reversed, states need voluntary strategies to increase helmet use.     

Age gradient in the cost-effectiveness of bicycle helmets

OBJECTIVES: This study analyzed the reduction in risk of head injuries associated with use of bicycle helmets among persons ages 3 to 70 and the cost-effectiveness of helmet use based on this estimated risk reduction. METHODS: To derive our cost-effectiveness estimates, we combined injury incidence data gathered through a detailed and comprehensive injury registration system in Norway, acute medical treatment cost information for the Norwegian health service, and information reported in the scientific literature regarding the health protective effects of helmet use. The analysis included all cases of head injuries reported through the registration system from 1990 through 1996. We performed an age-stratified analysis to determine the incidence of bicycle-related head injuries, the 5-year reduction in absolute risk of injury, the number needed to treat, and the cost-effectiveness of helmet use. To test the robustness of the findings to parameter assumptions, we performed sensitivity analysis. RESULTS: The risk of head injury was highest among children aged 5 to 16. The greatest reduction in absolute risk of head injury, 1.0 to 1.4% over 5 years estimated helmet lifetime, occurred among children who started using a helmet between the ages of 3 and 13. Estimates indicate that it would cost approximately U.S. $2,200 in bicycle helmet expenses to prevent any one upper head injury in children ages 3-13. In contrast, it would cost U.S. $10,000-25,000 to avoid a single injury among adults. CONCLUSIONS: Bicycle safety helmets appear to be several times more cost-effective for children than adults, primarily because of the higher risk of head injury among children. Programs aiming to increase helmet use should consider the differences in injury risk and cost-effectiveness among different age groups and target their efforts accordingly.     

2004—2008年浙江省15岁以上摩托车驾驶员道路交通伤害监测结果分析

目的分析浙江省摩托车驾驶员道路交通伤害情况,为今后开展相关干预提供依据。方法利用浙江省医院伤害监测数据进行分析。结果 2004—2008年共监测15岁以上摩托车驾驶员道路交通伤害病例7053例,男女性别比为3.58∶1;25～44岁年龄组占59.59%。伤害严重程度以中度为主,占43.46%。安全头盔配置率和使用率分别为40.61%和33.43%,伤害病例中,自报饮酒率为4.08%。伤害性质以软组织伤为主(71.93%),伤害部位以头部为主(41.25%)。结论摩托车驾驶员道路交通伤害的发生有其特性与规律,应针对安全头盔使用和酒后驾驶开展干预。     

2006 - 2015年间西藏自治区伤害监测报告病例分析

目的 分析2006 - 2015年间西藏自治区伤害监测点报告病例分布情况,为西藏自治区开展伤害干预工作提供依据。方法 依据《全国伤害监测工作手册》的相关标准和定义,对2006 - 2015年3所哨点医院的监测数据进行描述分析。结果 伤害以男性（70.18%）,年龄20～45岁者（66.5%）为主,商业、服务业者（17.3%）以及小学学历者（39.1%）是伤害的常见人群。伤害发生原因主要为跌倒/坠落（29.7%）、机动车车祸（27.5%）、钝器伤（16.9%）,在2007 - 2015年间,伤害发生原因顺位没有发生变化;地点主要为公路/街道（33.9%）、公共居住场所（17.4%）及家中（15.1％）,在每年的伤害发生地点中,公路与街道始终位居首位;伤害发生时活动主要为家务（36.9%）、休闲活动（20.2%）、学习（19.8％）;伤害性质主要为挫伤/擦伤（43.3%）、锐器/咬伤/开放伤（22.7%）及骨折（15.7％）,10年间,伤害性质的顺位基本不发生变化;部位主要是头部（30.3%),始终居于首位;伤害意图每年都以非故意(77.8%)为主;严重程度每年都以轻度(71.3%)为主。结论 男性青壮年是干预的重点人群,公路/街道是干预的重要地点,跌倒/坠落是干预的重要原因,头部是重要干预部位,需积极采取高危人群-高危地点-高危原因-高危部位四位一体综合防控干预措施。     

Head injury resulting from scooter accidents in Rome: differences before and after implementing a universal helmet law

OBJECTIVES: To estimate the incidence rates and related determinants of head injuries before and after the implementation of a new universal helmet law in Italy. METHODS: The investigation took place in the Emergency Room of the Accident and Emergency Department, Teaching Hospital 'Umberto I', Rome, in 1999 (before the new law), and 2000 (two periods after the new law). Personal data, injury circumstances, helmet use, others involved in injury and health data, were collected. Incidence rates by time period were calculated and differences between groups were analysed. Logistic regression models were conducted to assess the association between head trauma and potential determinants. RESULTS: The incidence rate of all injury among scooter riders rose from 64.36/10,000 person-years before the new law (1999) to 98.05/10,000 person years afterwards. The incidence rate of head trauma among scooter riders showed an opposite trend, i.e. a decrease from 26.65/10,000 person-years (1999) to 8.88/10,000 person-years in the second post-legislation period. Helmet use among injured scooter riders rose from 5% before the new law to 90% afterwards. Helmet use is a protective factor for being a patient with head trauma, in all the periods considered (OR 0.24-0.44). After implementation of the new law, age (18+) showed a protective effect as well (OR 0.42-0.44). CONCLUSION: Helmet use has a protective effect on head trauma among scooter riders. One year after implementing a universal law, helmet use has increased substantially and a sharp reduction in head trauma among persons older than 18 years could be observed.     

A decrease in both mild and severe bicycle-related head injuries in helmet wearing ages--trend analyses in Sweden

Several international studies point at the efficacy of bicycle helmets in reducing head injuries. In Sweden, observational studies show that from 1988 to 1996 helmet use increased in all categories of cyclists. The objectives of this study were to analyse the trends of bicycle-related head injuries based on their main diagnosis and external cause of injury by different age groups. Our study area was the whole population of Sweden from 1987 to 1996. Outcome evaluation was based on data from the Swedish National Hospital Discharge Register concerning all bicycle-related injuries from 1987 to 1996, which presented 49 758 reported in-patient care. The trends in incidence rates (IRs) were studied with regression analyses. The results show that children under 15 years had the highest IRs. For these children, the IR decreased by 46%. The head injuries in children decreased both in collisions with motor vehicles and in other accidents. Similarly, the IR of concussion and skull fracture decreased. For non-head injuries, there were no significant changes for children. On the other hand, the incidence of both head and other injuries for adults aged 16-50 years increased. Ages above that showed no significant changes. Our conclusions are that the decrease in IR for bicycle-related head injuries refers to children in ages for whom bicycle helmet use during the period increased. This could not be explained by any general decrease in bicycle-related accidents or by any changes in the distribution of injuries after collision with motor vehicles. The increasing helmet use among younger schoolchildren probably contributed to the decrease in head injuries.     

广西摩托车驾乘人员佩戴头盔的研究

目的　调查了解摩托车驾乘人员佩戴头盔的情况 ,为预防和控制摩托车伤害提出正确佩戴合格头盔的对策。方法　在广西贵港地区 18个观察点 ,通过路边观察和问卷调查的方法估计摩托车驾乘人员的头盔佩戴率、合格头盔佩戴率和合格头盔正确佩戴率。结果　在 4 76 8位接受调查的摩托车驾乘人员中有 2 6 79位佩戴头盔 ,佩戴率为 5 6 .2 %。在头盔佩戴者中 ,只有 32 .7%的人佩戴合格头盔。只有 16 .4 %的摩托车驾乘人员正确佩戴合格头盔。结论　尽管我国的交通法规强制要求摩托车驾乘人员佩戴头盔 ,但实际头盔佩戴率、合格头盔佩戴率和合格头盔正确佩戴率都很低 ,为了有效预防和控制摩托车伤害的发生 ,急需开展正确佩戴合格头盔的综合干预项目。     

Unspecified injuries on death certificates: a source of bias in injury research.

Protective gear (for example, helmets and bulletproof vests) shields certain body regions from damaging energy. Failure to specify on death certificates the body region and nature of fatal injuries compromises the utility of mortality data for epidemiologic or prevention research. Of fatally injured California motorcyclists, 41% had no specific injuries listed on their death certificates in 1988. To examine the implications of this problem, the authors abstracted 186 coroner's or medical examiner's reports from four California counties with over 60% nonspecific injuries and one county with few such injuries. These data were merged with computerized death certificate files and with the Fatal Accident Reporting System. Among the 99 cases with nonspecific injury codes, 68% had head injuries, 63% had chest injuries, 58% had abdominal injuries, and 58% had extremity injuries. Reporting sensitivity in the four problem counties varied from 36% for head injury to less than 5% for abdominal, spinal, and extremity injury. The association between head injury and failure to wear a helmet was statistically significant using the coroner's diagnoses (p = 0.02), but not using death certificate diagnoses (p = 0.17). The value of mortality data to injury researchers would be enhanced by better reporting of the nature of injury on death certificates.