Flavin Michael P, Dostaler Suzanne M, Simpson Kelly, Brison Robert J, Pickett William
Department of Paediatrics, Queen's University, Doran 3, Kingston General Hospital, Kingston, Ontario, K7L 2V7, Canada.
BMC Public Health. 2006 Jul 18;6:187. doi: 10.1186/1471-2458-6-187.
In Canada, there are many formal public health programs under development that aim to prevent injuries in the early years (e.g. 0-6). There are paradoxically no population-based studies that have examined patterns of injury by developmental stage among these young children. This represents a gap in the Canadian biomedical literature. The current population-based analysis explores external causes and consequences of injuries experienced by young children who present to the emergency department for assessment and treatment. This provides objective evidence about prevention priorities to be considered in anticipatory counseling and public health planning.
Four complete years of data (1999-2002; n = 5876 cases) were reviewed from the Kingston sites of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), an ongoing injury surveillance initiative. Epidemiological analyses were used to characterize injury patterns within and across age groups (0-6 years) that corresponded to normative developmental stages.
The average annual rate of emergency department-attended childhood injury was 107 per 1000 (95% CI 91-123), with boys experiencing higher annual rates of injury than girls (122 vs. 91 per 1000; p < 0.05). External causes of injury changed substantially by developmental stage. This lead to the identification of four prevention priorities surrounding 1) the optimization of supervision; 2) limiting access to hazards; 3) protection from heights; and 4) anticipation of risks.
This population-based injury surveillance analysis provides a strong evidence-base to inform and enhance anticipatory counseling and other public health efforts aimed at the prevention of childhood injury during the early years.
在加拿大，有许多正在开展的正式公共卫生项目旨在预防儿童早期（如0至6岁）的伤害。矛盾的是，尚无基于人群的研究考察这些幼儿在不同发育阶段的伤害模式。这在加拿大生物医学文献中是一个空白。当前基于人群的分析探讨了到急诊科接受评估和治疗的幼儿所经历伤害的外部原因及后果。这为在预防性咨询和公共卫生规划中应考虑的预防重点提供了客观依据。
对加拿大医院伤害报告与预防项目（CHIRPP）金斯敦站点连续四年（1999 - 2002年；n = 5876例）的数据进行了回顾，该项目是一项持续进行的伤害监测倡议。采用流行病学分析来描述与正常发育阶段相对应的各年龄组（0至6岁）内及各年龄组间的伤害模式。
到急诊科就诊的儿童伤害年均发生率为每1000人中有107例（95%置信区间91 - 123），男孩的年伤害发生率高于女孩（每1000人中有122例对91例；p < 0.05）。伤害的外部原因随发育阶段有很大变化。这导致确定了四个预防重点，围绕1）优化监督；2）限制接触危险物；3）防止高处坠落；4）预见风险。
这种基于人群的伤害监测分析提供了有力的证据基础，为旨在预防儿童早期伤害的预防性咨询和其他公共卫生工作提供信息并予以加强。
