1991-2005年中国人群伤害死亡状况与变化趋势

目的 分析1991-2005年中国人群伤害死亡状况和变化趋势,为伤害干预工作的开展提供依据.方法 2004-2005年数据来自于全国第3次死因回顾抽样调查,覆盖我国内地31个省(自治区、直辖市)的160个疾病监测点,共调查142 660482人年.通过计算粗死亡率、潜在寿命损失年(YPLL)、潜在工作寿命损失年(WYPLL)和标化死亡率来描述伤害死亡状况,计算标化死亡率时以2000年人口普查数据作为标准人口,将每5岁作为1个年龄组进行标化;1991-2000年数据来自于全国疾病监测系统,由145个监测点组成,覆盖1000多万人口,计算不同年代伤害死因构成比,分析伤害死亡的变化趋势.结果 2004-2005年调查地区共计有伤害死亡个案87 753例,其中男性59 664例,女性28 089例;城市23 308例,农村64 445例.伤害粗死亡率为61.51/10万,占全死亡的10.10%,标化死亡率为58.45/10万,是中国人群的第4位死因;伤害的YPLL为1579.61人年/10万,伤害的WYPLL为1721.41人年/10万,占总死亡WYPLL的32.34%.男性和女性伤害粗死亡率分别为81.76/10万和40.31/10万,标化死亡率分别为79.96/10万和36.25/10万,男性死亡率约为女性的2倍.城市和农村伤害粗死亡率分别为48.66/10万和68.01/10万,标化死亡率分别为44.08/10万和66.25/10万,农村伤害死亡率约为城市的1.4倍.15～44岁人群伤害死亡率为48.94/10万(35 497/72 531 671),约占总死亡的40%,是该年龄段人群第1位的死因.2004-2005年调查地区的前5位伤害死因依次为交通事故、自杀、跌倒、溺水、中毒,死亡个案分别为29 669、18 678、10 901、7752、4857例,粗死亡率分别是20.80/10万、13.09/10万、7.64/10万、5.43/10万、3.40/10万;交通事故死亡的构成比从1991年的15.00%(1551/10 338)上升到2005年的33.79%(14 792/43 774),呈现逐年增加的趋势,自杀死亡的构成比从1991年的26.66%(2756/10 338)下降到2005年的20.46%(8955/43 774),跌倒死亡的构成比从1991年的5.15%(532/10 338)上升到2005年的12.87%(5630/43 774).结论 伤害死亡是导致中国人群早死的首要疾病,交通事故是第1位的伤害死因,与20世纪90年代相比,中国人群伤害死因谱已经发生了转变.

Status and trend of injury deaths among Chinese population, 1991-2005

Objective To analyze the status and trend of injury deaths in Chinese people, and provide basic evidence for injury interventions. Methods Data came from 2004-2005 the 3rd national retrospective sampling survey of death cause and covered 31 province-level regions and 160 surveillance spots in the interior of China,Total 142 660 482 person years were investigated. To describe the status of injury deaths, the crude death rate, years of potential life lost (YPLL), working years of potential life lost (WYPLL) and the standardized death rate were calculated. The population used for standardization was from census in 2000 and each five-year was counted as an age group; To analyze the trend of injury deaths, the constitution of the death causes were calculated based on the data of 1991 - 2000 national disease surveillance system which covered more than 10 000 000 population and 145 surveillence spots. Results The total number of residents in survey districts died of injury between 2004 and 2005 was 87 753 (male 59 664, female 28 089, urban 23 308, rural 64 445) ; the crude death rate of injury in China 2004 - 2005 was 61.51/100 000 and accounting for 10. 10% of all deaths; the standardized death rate was 58.45/ 100 000, ranking the fourth among the main cause of death for Chinese people. The YPLL of injury was 1579.61 person years per 100 000 and the WYPLL was 1721.41 person years per 100 000. The crude death rate of injury was 81.76/100 000 in male and 40.31/100 000 in female; the standardized death rates were 79.96/100 000 and 36.25/100 000, respectively. Injury mortality in male was two times higher than that in female. The crude death rates of injury were 48.66/100 000 in urban area and 68.01/100 000 in rural area; the standardized death rate were 44.08/100 000 and 66.25/100 000, respectively; the mortality in rural area was 1.4 times higher than that in urban area. The mortality for the aged 15 -44 was 48.94/100 000 (35 497/72 531 671)and accounting for 40% of all deaths, injury was the first cause of death for the aged 15-44. During 2004-2005, the top five causes of death related to injury were traffic accidents, suicide, falls, drowning and poisoning; the cases were 29 669, 18 678, 10 901,7752, 4857 respectively in survey districts; the crude death rate were 20.80/100 000,13.09/100 000,7.64/100 000,5.43/100 000,3.40/ 100 000 respectively. From 1991 to 2005, the proportion of all injury deaths due to traffic accident increased from 15.00% (1551/10 338) to 33.79% (14 792/43 774) which showed a rising trend, the proportion of all injury deaths due to suicide decreased from 26.66% (2756/10 338) to 20.46% (8599/43 774) and the proportion of all injury deaths due to fall increased from 5.15% (532/10 338) to 12.87% (5630/43 774). Conclusion Injury is the primary cause of death resulting in the premature death among Chinese people, traffic accident is the first cause of injury death. Since 1990s, the pattern of injury mortality of Chinese people has changed.