Underlying and multiple cause mortality in a cohort of workers exposed to aromatic amines

Background The National Institute for Occupational Safety and Health (NIOSH) has previously conducted studies of bladder cancer incidence and mortality at a synthetic dye plant that manufactured beta-naphthylamine from 1940 through 1979. This report extends the period of mortality follow-up 13 years and analyzes both underlying and nonunderlying causes of death. Methods The vital status of each cohort member, as of December 31, 1992, was determined by using the National Death Index and information from the Internal Revenue Service and the U.S. Postal Service. The NIOSH life table analysis system (LTAS) was used to generate person-years-at-risk and the expected numbers of death for 92 categories of death, using several referent rates (U.S. underlying, Georgia underlying, U.S. multiple cause). Results There were three bladder cancer deaths listed as underlying cause, yielding a standardized mortality ratio (SMR) based on U.S. rates of 2.4 (95% confidence interval (CI) = 0.5, 7.0) and a total of eight bladder cancers listed anywhere on the death certificates (SMR based on multiple cause referent rates = 5.6; 95% CI = 2.4, 11.1). Mortality from esophageal cancer, which had been significantly elevated in the previous study, was no longer significantly elevated (SMR = 2.0; 95% CI = 0.8,4.1). Mortality from all causes was significantly higher than expected (SMR = 1.5; 95% CI = 1.3, 1.6). Conclusions The elevated bladder cancer risk in this cohort was detected by the multiple cause, but not the underlying cause, analysis. Elevated mortality from other causes of death, especially among short-term workers, may be related to regional and lifestyle factors. Am. J. Ind. Med. 34:506–511, 1998. © 1998 Wiley-Liss, Inc.     

Maternal smoking during pregnancy among Aboriginal women in New South Wales is linked to social gradient

Objective: Social gradients in Aboriginal health are seldom explored. This study describes social gradients and trends in smoking during pregnancy among Aboriginal mothers in NSW. Methods: This was a secondary analysis of the NSW Midwives Data Collection (MDC) 1994–2007, covering all births in NSW. Analyses examined associations between socio‐demographic characteristics and smoking during pregnancy. Results: Data from 1,214,206 pregnant women showed that 17.4% smoked during pregnancy. The rate of smoking during pregnancy among all NSW women declined from 22.3% in 1994 to 12.8% in 2007; the rate among Aboriginal women remained high, declining from 61.4% in 1994 to 50.2% in 2007. Smoking was substantially higher among Aboriginal mothers compared to non‐Aboriginal mothers. Socio‐economic analyses showed that the smoking rate among low SES Aboriginal mothers was approximately two and a half times that of high SES Aboriginal women, a similar gradient to non‐Aboriginal women. Conclusions: Indicators of socio‐economic position are a consistent, independent correlate of smoking during pregnancy for Aboriginal and non‐Aboriginal women. Implications: There is a need for a social inequalities approach to smoking during pregnancy, specifically targeting more disadvantaged Aboriginal mothers and all teenage mothers for smoking prevention. Strategies to access more disadvantaged mothers should not be missed through broadly focused Aboriginal tobacco control strategies.     

Increasing cancer mortality among opioid-dependent persons in Australia: a new public health challenge for a disadvantaged population

Objective: To examine cancer mortality in a population‐based cohort of opioid‐dependent persons. Methods: New South Wales opioid substitution therapy (OST) program registrants from 1985 to 2005 (n=43,789) were probabilistically linked to the National Death Index. Crude and standardised mortality rates and standardised mortality ratios (SMRs) were calculated. Results: The crude cancer mortality rate increased from 4 to 65 deaths per 100,000 person‐years (p trend <0.001). Overall, OST registrants were 1.7 times more likely to die of cancer than the general population (SMR 95% CI 1.4–1.9). Site‐specific SMRs were significantly elevated for lung cancer (3.6, 95% CI 2.8–4.6), liver cancer (6.9, 95% CI 4.3–10.5), and anogenital cancers (2.8, 95% CI 1.3–5.3), and significantly reduced for breast cancer (0.4, 95% CI 0.1–0.9). Conclusions: Cancer is an increasingly important cause of death among OST registrants as they live longer with their dependency. The site‐specific excess deaths suggest the role of tobacco, alcohol, and infection with hepatitis C and human papillomavirus. Implications: The OST setting may be a useful setting for the delivery of programs aimed at detection of precursor lesions, reducing exposure to established carcinogens, and treatment for those with HCV infection. Such targeted steps are likely to reduce the future cancer burden in this population.     

苏州市2008-2013年围产儿死亡率变化趋势及影响因素分析

目的分析苏州市围产儿死亡率变化及相关因素,探索降低围产儿死亡率的综合措施。方法对2008-2013年苏州市围产儿死亡资料进行统计分析。结果 6年中苏州市围产儿平均死亡率为7.11‰,并呈逐年下降趋势;多胎妊娠的发生率逐年上升;产妇年龄〈20岁及〉34岁组的围产儿死亡率较高;多胎妊娠的围产儿死亡率高于单胎妊娠;围产儿死亡原因依次为胎儿先天异常、原因不明、脐带因素、母体因素、早产低体重。结论要降低围产儿死亡率,应加大宣传力度,全面做好婚前、孕前、孕期、产时、产后宣教,提供各阶段的服务;加强人员培训,及早发现异常,尽早处理;加强对助孕机构的监管,减少多胎妊娠的发生;做好围产儿死亡评审工作,提高医务人员综合救治水平。     

北京市1992—2009年55岁人群全死因影响因素分析

目的分析北京市≥55岁人群全死因影响因素,为疾病的预防控制提供参考依据。方法采用生存分析方法对首都医科大学宣武医院1992—2009年收集的2 010名北京市≥55岁人群老龄化多维纵向研究数据进行分析。结果1992年基线的2 010名北京市≥55岁人群至2009年随访结束时共存活356人,失访700人,死亡954例;前3位死因依次为心血管疾病225例（23.58%）、脑血管疾病214例（22.43%）和肿瘤119例（12.47%）,占全部死因的58.49%;全死因COX分析结果表明,年龄≥61岁、文盲、饮酒、工具性日常生活活动能力异常、身体健康自评差、糖尿病和高血压人群的死亡风险较高,而女性、居住在城市和精神状态正常人群的死亡风险较低。结论年龄、性别、文化程度、居住地、饮酒、日常生活能力、身体健康自评情况、糖尿病、高血压和精神状态是北京市≥55岁人群全死因的影响因素。     

Risks and causes of mortality among low-birthweight infants in childhood and adolescence

The purpose of the study was to estimate the risks of mortality among infants with low birthweight (LBW, <2500 g) during their childhood and adolescence using a prospective cohort design. A total of 341 249 livebirths were registered in the 1985 Taiwan Birth Registry. We identified the 11 701 LBW singletons and randomly selected the same number of normal-birthweight (NBW) singletons. Study subjects of both LBW and NBW groups were linked, through the individual's unique personal identification number, to the Taiwan Death Registry to identify those who died between 1985 and 2003. Using the life-table method, we calculated the age-specific and cumulative survival rate for both LBW and NBW groups. We used Cox's proportional hazard model with adjustment for potential confounders to estimate the age-specific hazard ratio (HR) of mortality. Age-specific causes of mortality were presented for both groups. The result showed that the cumulative survival rate over an 18-year period for the LBW and NBW subjects was estimated at 95.83% and 99.37%, respectively. Significantly increased adjusted HR of mortality associated with LBW was limited to ages <1 year (boys: 8.99; girls: 8.29) and 1-4 years (boys: 2.19; girls: 2.25). Conditions originating in the perinatal period and congenital anomalies were the most prevalent cause of death among LBW and NBW, respectively. Between ages 1 and 18 years, injury and poisoning became the top ranked causes of death irrespective of birthweight and gender. Although there were small numbers of congenital anomalies, they were still a leading cause of death for LBW subjects, but not for NBW subjects, at ages 5-18 years. The LBW subjects were also likely to suffer from respiratory causes at 5-18 years. This study suggested, therefore, that LBW infants tended to have significantly elevated mortality rates under the age of 5 years, and were vulnerable to more non-injury deaths in their childhood and adolescence.     

Liver cancer and hepatitis B and C in New South Wales, 1990-2002: a linkage study

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) incidence has increased in Australia in the past 20-30 years. We conducted a community-based linkage study to examine the characteristics of hepatocellular carcinoma with particular reference to hepatitis B and C infections. METHODS: Hepatocellular carcinoma cases (n=2,072) notified to the New South Wales (NSW) Central Cancer Registry from 1990 to 2002 were probabilistically linked to HBV and HCV diagnoses notified to NSW Health. Sex, age, year of diagnosis, region of birth, method of diagnosis and spread at diagnosis and survival were compared by linkage group. RESULTS: Hepatocellular carcinoma incidence increased from 1.4/100,000 in 1990 to 2.8/100,000 in 2002. Incidence varied by region of birth (p<0.001), with people born in Vietnam having the highest relative rate compared with those born in Australia (RR=11.7, 95% CI 9.8-13.8). Of the hepatocellular carcinoma records, 15.6%, 12.9% and 0.8% were linked to hepatitis B, hepatitis C and hepatitis B/C co-infection respectively and 70.7% were unlinked. Median age at diagnosis of HCV-related hepatocellular carcinoma varied markedly at 51, 68 and 71 years for Australian, European, and Asian-born groups, respectively (p<0.0001). CONCLUSION: Contrasting age distribution of HCV-related HCC by country/region of birth is consistent with divergent patterns of HCV transmission. IMPLICATIONS: These data highlight the increase in HCC in NSW and the divergent populations whose needs in terms of treatment, care and prevention will need to be met.     

The extent and distribution of inequalities in childhood mortality by cause of death according to parental socioeconomic positions: A birth cohort study in South Korea

It has been shown that childhood mortality is affected by parental socioeconomic positions; in this article, we investigate the extent and distribution of inequalities across major causes of childhood death. We built a retrospective birth cohort using individually linked national birth and death records in South Korea. 1,329,540 children were followed up to exact age eight from 1995 to 1996 and total observed person-years were 10,594,168.18. Causes of death were identified from death records while parental education, occupation and birth characteristics were identified from birth records. Survival analysis was performed according to parental socioeconomic positions. Cox proportional hazard analysis was done according to parental education and occupation with adjustment of birth characteristics such as sex, parental age, gestational age, birth weight, multiple birth, the number of total births, and previous death of children. Cumulative incidence of mortality by age was obtained through a competing-risk method in each cause according to maternal education. From these results, distribution of inequalities across major causes of death was calculated.     

金昌队列人群随访十年主要慢性病死亡率与早死概率变化趋势

目的  分析金昌队列人群2011-2020年四种主要慢性病的死亡率、早死概率及变化趋势,锁定影响人群健康的核心病种,为人群慢性病防治提供基础数据。方法  以金昌队列为平台,纳入基线全部人群48 001人,连续10年追踪随访其结局,应用简略寿命表法与joinpoint回归法计算死因构成比、粗死亡率、标化死亡率、早死概率及年度变化百分比(annual percent change, APC)等指标。结果  2011-2020年金昌队列人群4类主要慢性病平均死亡构成比为80.26%,4类主要慢性病粗死亡率呈上升趋势(APC=6.48%),心脑血管疾病粗死亡率呈上升趋势(APC=10.02%),其他三类疾病粗死亡率与标化死亡率均无变化趋势。除女性心脑血管疾病早死概率呈上升趋势外(APC=12.92%),其他主要慢性病早死概率均无变化趋势。男性主要慢性病死亡率及早死概率高于女性。主要慢性病不同病种平均死亡率前3位为肺癌、脑卒中、冠心病。结论  4类主要慢性病是导致金昌队列人群死亡的主要疾病,肺癌、脑卒中为核心病种。男性为慢性病防治的重点人群,同时还应重点关注女性心脑血管疾病的防治,降低慢性病早死概率。     

Age and cause‐of‐death contributions to area socioeconomic,sex and remoteness differences in life expectancy in New South Wales, 2010–2012

Objectives: To determine age group‐ and cause‐of‐death‐specific contributions to area socioeconomic status (SES), sex and remoteness life expectancy inequalities. Methods: Mortality and estimated residential population data from New South Wales, Australia, over 2010–2012 was used to calculate life expectancy. Inequalities by sociodemographic groups were partitioned into age group‐ and cause‐of‐death‐specific contributions. Results: The largest contributions to SES differentials in life expectancy were observed at 60–84 years of age; for cancer, cardiovascular, endocrine and respiratory causes of death; and additionally external causes of death for males. Sex inequalities ranged from 3.6 to 5.2 years, with common causes of death such as cardiovascular disease and cancer in late adulthood (60+ years) accounting for the bulk of the differences. Smaller differences in life expectancy were observed by remoteness, with the largest contributions observed in ages 85 years and above, and for cardiovascular, mental, cancer and external causes of death. Conclusions: Common causes of death in late adulthood accounted for the bulk of life expectancy inequalities. Implications for public health: Development of policy and interventions aimed at addressing social determinants, such as proposed by the WHO's Global Plan of Action, are needed to help reduce sociodemographic inequalities in lifespan.     

Childhood sexual abuse and adult binge drinking among Kanak women in New Caledonia

The long-term consequences of violence against women are poorly documented within the context of political domination, economic inequalities and rapid social change of indigenous communities. Using data from the first population study on violence against women and their consequences on health in New Caledonia, South Pacific, this article investigates the association between childhood sexual abuse and binge drinking among 441 adult Kanak women. Face-to-face standardised interviews were conducted in 2002–2003, among women aged 18–54 years drawn from the electoral rolls. Childhood sexual abuse before 15 years of age was reported by 11.6% of respondents. Nearly all the perpetrators (96%) were known to the victims (63% being a close relative). The rate of frequent binge drinking amongst the women within the last 12 months was 34%. After controlling for social and demographic factors, an independent association was found between childhood sexual abuse and current binge drinking. This study is the first to analyse the contribution of childhood sexual abuse to the likelihood of later heavy alcohol use in an indigenous population in the South Pacific. The findings call for improving and giving priority to care for children who are victims of violence to prevent long-term health consequences and to develop prevention programs aimed at alcohol-related behaviour in women, while taking into account simultaneous individual and collective factors.     

绍兴市2006-2009年流动孕产妇死亡原因分析及对策

目的：分析2006-2009年绍兴市11例流动孕产妇死亡原因,寻找孕期保健薄弱环节,提出针对性措施。方法：对孕产妇死亡报告卡内容进行统计及分析。结果：死亡原因以在家分娩由非法接生而引起的产后出血及子宫破裂为主。结论：大力宣传孕产期保健,出台对流动孕产妇住院补助等政策,加快公共卫生服务均等化进程,多部门联动,加强流动孕产妇管理,取缔非法接生。     

The size of educational differences in mortality from specific causes of death in men and women

This study examines the association between education and mortality from specific causes of death based on mortality records for 1996 and 1997, and 1996 population census data from the Region of Madrid (Spain). Poisson regression models were used to estimate the percentage increase in mortality associated with 1 year less education. The percentage increases in mortality from stomach cancer, lung, bladder and liver cancers, for aids, chronic obstructive pulmonary disease, pneumonia and influenza, and chronic liver disease and cirrhosis were higher in men than in women, whereas the percentage increases in mortality from colon cancer, diabetes mellitus, ischemic heart disease and nephritis, nephrosis and nephrotic syndrome were higher in women. The results found for some causes of death – lung cancer, ischemic heart disease, diabetes mellitus and chronic obstructive pulmonary disease – reflect the variations by educational level in the prevalence of lifestyle-related risk factors in men and women. Various hypotheses have been suggested for other causes of death, but it is not known why the magnitude of the association between education and mortality from some causes of death differs between men and women. Future studies of this subject may provide some clues as to the underlying mechanisms of this association.     

2007—2009年十堰市城区居民伤害死亡分析

目的了解十堰市城区居民伤害死亡水平及伤害死因的分布,为有针对性地开展伤害预防、干预提供科学依据。方法利用2007—2009年十堰市城区疾病监测点死因监测系统数据和公安、民政部门提供的人口资料,根据疾病和有关健康问题的国际统计分类ICD-10编码手册进行根本死因分类,对十堰市城区居民伤害死亡进行分析。结果 2007—2009年十堰市城区居民因伤害死亡680人,占死亡总数的11.87%,居全死因第三位,年平均死亡率为59.91/10万;其中男性伤害死亡462人,年平均死亡率为77.77/10万;女性死亡218人,年平均死亡率为40.30/10万,男性死亡率高于女性,差异有统计学意义（P〈0.01）。前10位伤害死亡原因分别是机动车以外的运输事故、意外跌落、机动车辆交通事故、自杀、其他意外事故和有害效应、意外中毒、淹死、意外的机械性窒息、被杀、触电。伤害的减寿年数为16189人·年,减寿率为14.26‰。结论伤害是危害该市居民的重要死亡原因,在全死因减寿顺位中居第一位,应有针对性地开展伤害预防、干预工作。     

2004-2005年中国居民子宫颈癌死亡情况及30年变化趋势

目的 分析我国2004-2005年子宫颈癌死亡率的地区和人群分布特征及其30年的变化趋势.方法 人口资料与子宫颈癌死亡资料均来自2004-2005年全国第3次死因回顾抽样调查,样本由经多阶段分层整群抽样的我国内地31个省、自治区、直辖市的158个县(市)样本单位构成.其中,城市61个,农村97个;东部地区52个,中部地区49个,西部地区57个.两年合计总人年数为142 660 482,其中,男性72 970 241人年,女性69 690 241人年.计算子宫颈癌的粗死亡率和年龄别死亡率等指标.采用2000年人口普查的数据,将每5岁作为1个年龄组进行标化,计算中国人口标化死亡率(简称中标率),并与1973-1975、1990-1992年我国女性子官颈癌的死亡情况进行比较分析.结果 2004-2005年全国第3次死因调查样本地区子宫颈癌粗死亡率2.86/10万(1995/69 690 241),占肿瘤死因的2.86%(1995/69 667),在女性人口恶性肿瘤死因顺位中居第9位.农村和城市子宫颈癌粗死亡率分别为2.88/10万(1326/46 091 419)和2.83/10万(669/23 598 822),中标率分别为2.01/10万和1.67/10万.1973-1975、1990-1992年子宫颈癌死亡分别占肿瘤死因的17.91%、4.86%,中标率分别为11.10/10万和3.25/10万.2004-2005年样本地区子宫颈癌粗死亡率随年龄的增加而增加,从加岁开始增加较明显,到85岁达到峰值,为20.83/10万(82/393 624).35-44岁组子宫颈癌死亡率比90年代同年龄组的死亡率高.2004-2005年我国中部、西部和东部地区子宫颈癌粗死亡率分别为3.41/10万(827/24 225 738)、3.25/10万(636/19 563 647)和2.05/10万(532/25 900 856),中西部地区中标率约为东部地区的2倍(中部2.35/10万,西部2.38/10万,东部1.19/10万).结论 2004-2005年我国农村女性子宫颈癌死亡率略高于城市,中、西部明显高于东部地区.与1973-1975、1990-1992年相比,子宫颈癌的危害呈年轻化的趋势;子宫颈癌死亡率及在女性肿瘤死因中的构成比继续下降.     

西安市2000～2008年孕产妇死亡趋势与原因探析

目的 探讨孕产妇死亡的变化趋势、影响因素、根本原因及其风险因素,以改善应对措施,确保母婴安全.方法 对西安市2000～2008年常住人口和流动人口中死亡的孕产妇资料,使用Excel数据库进行资料录入,利用SPSS 13.0软件包进行统计学分析.结果 西安市常住人口中孕产妇死亡率有逐年下降的趋势,平均为36.06/10万,2008年在2000年的基础上显著下降了57.28%(χ2=5.205,P=0.030<0.05);流动人口中的孕产妇死亡率平均为213.45/10万,流动人口中的孕产妇死亡率显著高于常住人口中的孕产妇死亡率(χ2=60.814,P=0.000<0.05);孕产妇死亡的前5位死因依次是产后出血、羊水栓塞、妊娠期高血压疾病、妊娠合并症、胎盘早剥;孕产妇产后出血的死亡率有逐年下降的趋势;死亡孕产妇中高危年龄占到17.24%,88.28%居住在农村地区;孕期仅有37.24%产前检查达到5次;死亡孕产妇的孕期系统保健管理率(χ2=410.648,P=0.000<0.05 )与住院分娩率(χ2=56.485,P=0.000<0.05)显著低于全市;孕产妇死亡率与孕期系统保健管理率(r =-0.719,P<0.05)、住院分娩率(r=-0.799,P<0.01)呈显著负相关;评审结果显示死亡孕产妇中有85.90%是可以避免或创造条件可以避免的死亡.结论 西安市常住人口中孕产妇死亡率已经达到<西安市妇女发展纲要(2001～2010年)>目标,但85.9%是可以避免的死亡.应不断提高孕产妇的早孕检查率、系统保健管理率、住院分娩率,加强高危孕产妇的监管,将可避免的孕产妇死亡降到最低水平.     

Competing risk analysis of mortality from invasive cutaneous melanoma in New South Wales: a population‐based study, 1988–2007

Objective: Accurate estimates of risk of death from melanoma, based on the most recent information, are desirable, especially if secular improvements in survival have occurred. This study aims to investigate prognostic factors and temporal changes in mortality from primary invasive cutaneous melanoma (CM) and to predict cumulative probabilities of death from CM. Methods: Cases of CM from the NSW Central Cancer Registry (NSWCCR) diagnosed in 1988–2007 were analysed. We used Fine and Gray competing risks models to investigate prognostic factors associated with CM mortality, along with period effects of year of diagnosis. Adjusted cumulative probabilities of CM death were then estimated. Results: Of 52,330 CM cases, 5291 (10%) died from CM and 8290 (16%) from other causes. Patients with tumours thicker than 4 mm had 9.5 times the risk of death from CM compared to those with tumours 1 mm or less (subhazard ratio [SHR] 9.52; 95%CI:8.42–10.77). Risk of melanoma death was 31% lower in 2003–2007 compared to 1988–1992 (SHR 0.69; 95%CI: 0.63–0.76). Other risk factors for CM mortality included older age and male gender. Assuming the estimated period effect for a diagnosis in 2003–2007 applies now, the predicted probability of CM death within 10 years of diagnosis of a tumour 4+ mm thick is 26% in males and 19% in females. Conclusion: This study highlights the importance of awareness and early detection and shows a significant improvement in survival from CM since 1988.     

启东市居民主要恶性肿瘤死亡情况与减寿分析

目的:了解启东市居民19年来(1986年~2004年)主要恶性肿瘤的死亡情况并进行减寿分析,通过比较不同年代的不同恶性肿瘤对居民寿命的危害程度,为恶性肿瘤的防治提供重要线索。方法:采用减寿分析方法中的最大期望值法。结果:(1)19年间启东居民恶性肿瘤前5位死因顺位依次为肝癌、肺癌、胃癌、结肠直肠癌、食管癌,这期间启东居民的肝癌呈持续高死亡率,肺癌的死亡率也呈逐渐升高趋势,胃癌、结肠、直肠癌死亡率有所下降。(2)减寿年数(PYLL)前5位由高至低依次为肝癌、肺癌、胃癌、白血病、结肠直肠癌;而白血病、肝癌、结肠、直肠癌、乳腺癌等对平均减寿年数(AYLL)影响较大。(3)35岁前恶性肿瘤死亡率最高的是肝癌和白血病,35~65岁死亡率最高的为肝癌和肺癌,65岁以上死亡率高的为肺癌和胃癌。结论:肝癌、肺癌、胃癌、白血病、结肠、直肠癌是引起寿命损失最主要的恶性肿瘤,乳腺癌对女性寿命损失较大。肝癌防治依然是启东慢病控制的重要任务;肺癌死亡率的升高是值得关注的问题。     

1998—2017年天津市滨海新区塘沽地区儿童青少年死亡原因与减寿分析

目的 了解天津市滨海新区塘沽地区5～19岁儿童青少年的主要死亡原因,为政府等相关部门制定干预措施及政策提供可靠依据。方法 按照国际疾病分类法(ICD-9 和ICD-10)统一编码。用粗死亡率、标化死亡率、死因构成比、潜在减寿年数(PYLL)、潜在减寿率(PYLLR)、标化减寿年数(SPYLL)和标化减寿率(SPYLLR)等健康测量指标对天津市滨海新区塘沽地区20年间的死亡报表进行分析。采用Excel 2017、SPSS 20.0 软件进行统计分析,死亡率的比较采用χ2检验。结果 天津市滨海新区塘沽儿童青少年死亡率为39.02/10万,标化死亡率为5.63/10 万,男性死亡率为27.6/10 万,女性死亡率为18.4/10万,男性高于女性,差异有统计学意义(χ2 =2.87,P<0.05)。损伤中毒(17.33/10万)和肿瘤(9.13/10 万)是危害儿童青少年最主要的死因,占全死因死亡的67.8%。儿童青少年全死因PYLL 为15175.5人年,SPYLL 为8497.37 人年,潜在减寿率 为11.8‰,标化潜在减寿率 为29.5‰。结论 损伤中毒、肿瘤是天津市滨海新区塘沽地区5～19 岁儿童青少年的主要死因,要采取行之有效的干预措施减少死亡,降低疾病负担和寿命损失,促进儿童青少年的身心健康。