LeBlanc John C, Pless I Barry, King W James, Bawden Harry, Bernard-Bonnin Anne-Claude, Klassen Terry, Tenenbein Milton
IWK Health Centre and the Department of Pediatrics, Dalhousie University, Halifax, NS.
CMAJ. 2006 Oct 10;175(8):883-7. doi: 10.1503/cmaj.050592. Epub 2006 Sep 22.
Young children may sustain injuries when exposed to certain hazards in the home. To better understand the relation between several childproofing strategies and the risk of injuries to children in the home, we undertook a multicentre case-control study in which we compared hazards in the homes of children with and without injuries.
We conducted this case-control study using records from 5 pediatric hospital emergency departments for the 2-year period 1995-1996. The 351 case subjects were children aged 7 years and less who presented with injuries from falls, burns or scalds, ingestions or choking. The matched control subjects were children who presented during the same period with acute non-injury-related conditions. A home visitor, blinded to case-control status, assessed 19 injury hazards at the children's homes.
Hazards found in the homes included baby walkers (21% of homes with infants), no functioning smoke alarm (17% of homes) and no fire extinguisher (51% of homes). Cases did not differ from controls in the mean proportion of home hazards. After controlling for siblings, maternal education and employment, we found that cases differed from controls for 5 hazards: the presence of a baby walker (odds ratio [OR] 9.0, 95% confidence interval [CI] 1.1-71.0), the presence of choking hazards within a child's reach (OR 2.0, 95% CI 1.0-3.7), no child-resistant lids in bathroom (OR 1.6, 95% CI 1.0-2.5), no smoke alarm (OR 3.2, 95% CI 1.4-7.7) and no functioning smoke alarm (OR 1.7, 95% CI 1.0-2.8).
Homes of children with injuries differed from those of children without injuries in the proportions of specific hazards for falls, choking, poisoning and burns, with a striking difference noted for the presence of a baby walker. In addition to counselling parents about specific hazards, clinicians should consider that the presence of some hazards may indicate an increased risk for home injuries beyond those directly related to the hazard found. Families with any home hazard may be candidates for interventions to childproof against other types of home hazards.
幼儿在家中接触某些危险因素时可能会受伤。为了更好地理解几种儿童安全防护策略与儿童在家中受伤风险之间的关系，我们开展了一项多中心病例对照研究，比较了受伤儿童和未受伤儿童家中的危险因素。
我们利用1995年至1996年这两年间5家儿科医院急诊科的记录进行了这项病例对照研究。351例病例为7岁及以下因跌倒、烧伤或烫伤、摄入或窒息而受伤的儿童。匹配的对照为同期出现急性非损伤相关病症的儿童。一名对病例对照状态不知情的家访人员对儿童家中的19种伤害危险因素进行了评估。
在家中发现的危险因素包括婴儿学步车（有婴儿的家庭中占21%）、无正常工作的烟雾报警器（家庭中占17%）和无灭火器（家庭中占51%）。病例组和对照组在家中危险因素的平均比例上没有差异。在对兄弟姐妹数量、母亲教育程度和就业情况进行控制后，我们发现病例组和对照组在5种危险因素方面存在差异：有婴儿学步车（比值比[OR]9.0，95%置信区间[CI]1.1 - 71.0）、儿童伸手可及范围内存在窒息危险（OR 2.0，95% CI 1.0 - 3.7）、浴室没有防儿童开启的盖子（OR 1.6，95% CI 1.0 - 2.5）、没有烟雾报警器（OR 3.2，95% CI 1.4 - 7.7）以及无正常工作的烟雾报警器（OR 1.7，95% CI 1.0 - 2.8）。
受伤儿童家中与未受伤儿童家中在跌倒、窒息、中毒和烧伤的特定危险因素比例上存在差异，婴儿学步车的存在差异显著。除了就特定危险因素向家长提供咨询外，临床医生应考虑到某些危险因素的存在可能表明家庭受伤风险增加，超出了与所发现危险因素直接相关的风险。有任何家庭危险因素的家庭可能是针对其他类型家庭危险因素进行儿童安全防护干预的对象。
