上海市中小学生非致死性伤害流行病学研究
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摘要
【目的】了解上海市中小学生非致死性伤害发生状况和流行特征,为制定伤害预防干预策略提供依据。【方法】采用多阶段抽样的方法,在上海市随机抽取60所全日制学校的8 555名在读中小学生作为调查对象,问卷调查过去12个月内非致死性伤害发生情况和相关行为的危险因素。【结果】在过去12个月内上海市中小学生非致死性伤害发生率为9. 3%。其中,男生为10. 1%,女生为8. 5%,男女之间差异无统计学意义(χ~2=5. 80,P=0. 173);小学生为9. 4%,初中生为9. 4%,高中/中职校为8. 9%,不同学段之间差异无统计学意义(χ~2=0. 25,P=0. 911);城市中心地区为9. 7%,城郊结合地区为9. 7%,远郊地区为7. 3%,不同区域之间差异无统计学意义(χ~2=7. 05,P=0. 415)。跌倒/坠落为首位伤害发生原因,占59. 2%,其次为刀/锐器伤,占10. 2%,第三位为道路交通伤害,占8. 8%;伤害发生时活动主要为休闲活动(24. 8%),其次为体育活动(22. 1%),此外行走占21. 9%、驾乘交通工具占7. 6%;伤害发生时间以7、8、9、10月份较高;最主要的受伤地点是家中(33. 4%),其后依次为学校(24. 3%)、公路/街道(20. 1%),体育和运动场所(11. 0%);致伤意图非故意伤害为主(97. 7%),其次为故意(暴力、攻击)伤害(1. 1%);自残/自杀占0. 5%;因伤住院比例为1. 8%,因伤住院10天及以上占0. 3%,10天以下占1. 5%。【结论】上海市中小学生非致死伤害问题应引起重视,学校、家庭、社会应携手合作预防中小学生的伤害。
[Objective] To investigate the occurrence and epidemiological characteristics of non-fatal injuries among students in Shanghai,and to provide evidence for developing injury prevention strategies.[Methods] Using multi-stage sampling to select 8 555 students from 60 elementary,middle and high/vocational schools to participate in the questionnaire survey,the characteristics of non-fatal injuries and related risk factors were investigated during the past 12 months in Shanghai. [Results] Non-fatal injury incidence of Shanghai students was 9. 3% during the past 12 months,of which the incidence of male students was 10. 1%, and that of female students 8. 5%, and there was no significant difference in incidence between different genders( χ~2= 5. 80,P = 0. 173); the incidence of elementary school students was 9. 4%, middle school students 9. 4%, and high/vocational school students 8. 9%. There was no significant difference in incidence between different school stages( χ~2= 0. 25,P = 0. 911); the incidence of urban area was 9. 7%, suburban contiguous area 9. 7%, and exurb area 7. 3%. There was no significant difference in incidence between different regions( χ~2= 7. 05,P = 0. 415). Fall was the first leading cause of injuries,accounting for 59. 2%; followed by cut/pierce,accounting for 10. 2%; the third leading cause was road traffic injuries,accounting for 8. 8%. Jnjuries occurred with leisure and play( 24. 8%),sports( 22. 1%),walking( 21. 9%) and transports( 7. 6%). The time of injury occurrence was in July,August,September and October. The most important injury places were home( 33. 4%),followed by schools( 24. 3%),road/Street( 20. 1%),sports places( 11. 0%). And 97. 7% of injuries was unintentional injury,1. 1% intentional injury( violence,assault),0. 5% self-harm or suicide. The proportion of hospitalized injuries was 1. 8%,hospital stay for 10 days and above accounted for 0. 3%,and less than 10 days accounted for 1. 5%. [Conclusion]Schools,families and society should take injury problems with students seriously,and prevent students from injuries inside and outside school.
[Objective] To investigate the occurrence and epidemiological characteristics of non-fatal injuries among students in Shanghai,and to provide evidence for developing injury prevention strategies.[Methods] Using multi-stage sampling to select 8 555 students from 60 elementary,middle and high/vocational schools to participate in the questionnaire survey,the characteristics of non-fatal injuries and related risk factors were investigated during the past 12 months in Shanghai. [Results] Non-fatal injury incidence of Shanghai students was 9. 3% during the past 12 months,of which the incidence of male students was 10. 1%, and that of female students 8. 5%, and there was no significant difference in incidence between different genders( χ~2= 5. 80,P = 0. 173); the incidence of elementary school students was 9. 4%, middle school students 9. 4%, and high/vocational school students 8. 9%. There was no significant difference in incidence between different school stages( χ~2= 0. 25,P = 0. 911); the incidence of urban area was 9. 7%, suburban contiguous area 9. 7%, and exurb area 7. 3%. There was no significant difference in incidence between different regions( χ~2= 7. 05,P = 0. 415). Fall was the first leading cause of injuries,accounting for 59. 2%; followed by cut/pierce,accounting for 10. 2%; the third leading cause was road traffic injuries,accounting for 8. 8%. Jnjuries occurred with leisure and play( 24. 8%),sports( 22. 1%),walking( 21. 9%) and transports( 7. 6%). The time of injury occurrence was in July,August,September and October. The most important injury places were home( 33. 4%),followed by schools( 24. 3%),road/Street( 20. 1%),sports places( 11. 0%). And 97. 7% of injuries was unintentional injury,1. 1% intentional injury( violence,assault),0. 5% self-harm or suicide. The proportion of hospitalized injuries was 1. 8%,hospital stay for 10 days and above accounted for 0. 3%,and less than 10 days accounted for 1. 5%. [Conclusion]Schools,families and society should take injury problems with students seriously,and prevent students from injuries inside and outside school.
引文
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[19]曾光,耿玉田,荆瑞巍,等.北京市儿童青少年伤害流櫟毜行病学调查[J].中华流行病学杂志,2006,27(12):1024-1028.
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[21]谌丁艳,周丽,吴宇,等.深圳市中小学生伤害特征分析[J].中国学校卫生,2014,35(11):1737-1739.
[22]喻彦,黄丽妹,杨琛,等.上海市不同户籍小学生跌倒伤害流行特征分析[J].伤害医学(电子版),2016,5(2):27-32.
[23]MARTIN J,COOPER C D. Playground safety in south western Sydney[J]. J Paediatr Child Health,2005,41(11):587-591.
[24]李思杰,段蕾蕾.儿童跌落伤害预防研究进展[J].中国健康教育,2010,26(11):873-876.
[25]闫蓓,黄丽妹,彭娟娟,等.上海市儿童跌倒伤害干预项目效果评价[J].中华疾病控制杂志,2017,21(8):775-779.
[26]LIU B C,IVERS R,NORTON R,et al. Helmets for preventing injury in motorcycle riders[J]. Cochrane Database Syst Rev,2004(1):CD004333.
[27]THOMPSON D C,RIVARA F P,THOMPSON R. Helmets for preventing head and facial injuries in bicyclists[J]. Cochrane Database Syst Rev,2000(2):CD001855.
[28]彭宁宁,罗春燕,朱蔚,等.上海市青少年健康危险行为现状浅析[J].上海预防医学,2003,15(4):163-167.
[2]LINNAN M. Child mortality and injury in Asia:survey results and evidence[EB/OL].[2018-02-26] http://www. unicef-irc. org/publications/pdf/iwp_2007_06. pdf.
[3]A league table of child deaths by injury in rich countries. Innocenti report card No. 2[EB/OL].[2008-01-22]. http://www. unicef-icdc. org/publications/pdf/repcard2e. pdf.
[4]WHO.伤害与暴力社区调查指南[M].吴凡,译.北京:人民卫生出版社,2006:16.
[5]疾病控制基本数据集第6部分:伤害监测报告:WS375. 6—2012[S].北京:中国标准出版社,2012:1-12.
[6]ICECI Coordination and Maintenance Group. International classification of external causes of injury(ICECI)[R].AIHW,2004.
[7]KANN L. Youth risk behavior surveillance system(YRBSS)[EB/OL].[2008-01-22]. http://www. cdc. gov/healthyyouth/data/yrbs/index. htm? s_cid=hy-homepage-002.
[8]SALAM R A,ARSHAD A,DAS J K,et al. Interventions to prevent unintentional injuries among adolescents:a systematic review and meta-analysis[J]. J Adolesc Health,2016,59(4):76-87.
[9]胡国清,朱松林,王琦琦,等.中国五岁以下儿童非致死性伤害发生率及影响因素研究[J].中华流行病学杂志,2011,32(8):773-776.
[10]张译天,万幸,余小鸣,等. 2005—2015年中国青少年伤害发生率的Meta分析[J].中国儿童保健杂志,2016,24(10):1062-1064,1069.
[11]王声湧.伤害流行病学研究的内容与方法[J].预防医学文献信息,1998,4(3):299-300.
[12]王声湧.伤害流行病学[M].北京:人民卫生出版社,2003.
[13]马文军,许燕君,李剑森,等.广东省中小学生伤害流行特征[J].中国学校卫生,2006,27(1):47-49.
[14]周月芳,罗春燕,陆茜.上海市中小学生伤害流行病学特征分析[J].中国学校卫生,2010,31(11):1369-1372.
[15]符筠,段佳丽,律颖,等.北京市中小学校学生伤害流行特征分析[J].中国学校卫生,2014,35(11):1604-1606,1069.
[16]马双双,郝加虎,万宇辉,等.中国部分地区2012—2014年中学生意外伤害流行现状[J].中国学校卫生,2018,39(2):174-180.
[17]杨剑,刘晓玲,周亚敏,等.澳门地区中学生伤害现况及影响因素分析[J].中国公共卫生,2014,30(1):98-101.
[18]曾寒君,许韶君,万宇辉,等.中国六座城市中学生意外伤害流行现况及影响因素[J].中国学校卫生,2018,39(2):177-180.
[19]曾光,耿玉田,荆瑞巍,等.北京市儿童青少年伤害流櫟毜行病学调查[J].中华流行病学杂志,2006,27(12):1024-1028.
[20]余小鸣,王璐,徐海鹏,等.我国城市学龄儿童青少年伤害现状及特征[J].中国儿童保健杂志,2014,22(1):52-55.
[21]谌丁艳,周丽,吴宇,等.深圳市中小学生伤害特征分析[J].中国学校卫生,2014,35(11):1737-1739.
[22]喻彦,黄丽妹,杨琛,等.上海市不同户籍小学生跌倒伤害流行特征分析[J].伤害医学(电子版),2016,5(2):27-32.
[23]MARTIN J,COOPER C D. Playground safety in south western Sydney[J]. J Paediatr Child Health,2005,41(11):587-591.
[24]李思杰,段蕾蕾.儿童跌落伤害预防研究进展[J].中国健康教育,2010,26(11):873-876.
[25]闫蓓,黄丽妹,彭娟娟,等.上海市儿童跌倒伤害干预项目效果评价[J].中华疾病控制杂志,2017,21(8):775-779.
[26]LIU B C,IVERS R,NORTON R,et al. Helmets for preventing injury in motorcycle riders[J]. Cochrane Database Syst Rev,2004(1):CD004333.
[27]THOMPSON D C,RIVARA F P,THOMPSON R. Helmets for preventing head and facial injuries in bicyclists[J]. Cochrane Database Syst Rev,2000(2):CD001855.
[28]彭宁宁,罗春燕,朱蔚,等.上海市青少年健康危险行为现状浅析[J].上海预防医学,2003,15(4):163-167.