Fang Ya, Dai Long, Jaung Michael S, Chen Xiaoxuan, Yu Songlin, Xiang Huiyun
Department of Preventive Medicine, College of Medicine, Xiamen University, Xiamen, China.
Inj Prev. 2007 Oct;13(5):339-43. doi: 10.1136/ip.2007.016683.
Risk-factor research and prevention programs targeting drowning deaths in children have been well developed in industrialized countries, but little research has been undertaken in developing countries where the majority of drowning deaths occur. We conducted an epidemiological study to describe the sociodemographic characteristics, drowning circumstances, and medical service in drowning deaths of children in Xiamen city and suburbs, People's Republic of China.
Drowning deaths in 1-14-year-old children between 2001 and 2005 were identified using death certificates. Parents of each case were interviewed face to face about the sociodemographics of the family and child, the drowning event, and medical care received. Mortalities were calculated using census data for urban and rural areas, and Poisson regression was used to evaluate confounding effects and interactions of several major risk factors for drowning death.
Of 67 drowning deaths identified, 52 (77.6%) were males. A higher proportion of deaths were in children aged 5-9 years (40.3%) and 10-14 years (40.3%). The drowning mortality per 100 000 population was 5.84 in rural areas and 0.75 in urban areas. Drowning events occurred most commonly during the summer months (56.7% from June to August), during the hours of 13:00-17:59 (62.7%), and in natural or man-made bodies of water (eg, ponds, ditches, construction sites, and wells). None of the children were proficient swimmers, the majority of drowning events (88.1%) occurred in the absence of adult supervision, and 86.6% children died at the scene without any medical care. Results from muiltivariable Poisson regression analysis indicated that 10-14-year-old boys were at the highest risk of drowning deaths in this area.
Drowning deaths in children in Xiamen city and suburbs follow trends that are markedly different from patterns observed in other countries. Different prevention strategies may be required for preventing child drowning deaths in Xiamen and other developing regions.
针对儿童溺水死亡的风险因素研究及预防项目在工业化国家已得到充分发展,但在大多数溺水死亡事件发生的发展中国家,相关研究较少。我们开展了一项流行病学研究,以描述中华人民共和国厦门市及郊区儿童溺水死亡的社会人口学特征、溺水情况及医疗服务情况。
利用死亡证明确定2001年至2005年间1至14岁儿童的溺水死亡情况。对每个案例的父母进行面对面访谈,了解家庭和儿童的社会人口学信息、溺水事件及所接受的医疗救治情况。使用城乡人口普查数据计算死亡率,并采用泊松回归评估溺水死亡的几个主要风险因素的混杂效应和相互作用。
在确定的67例溺水死亡案例中,52例(77.6%)为男性。5至9岁儿童(40.3%)和10至14岁儿童(40.3%)的死亡比例较高。农村地区每10万人口的溺水死亡率为5.84,城市地区为0.75。溺水事件最常发生在夏季(6月至8月占56.7%)、13:00至17:59时段(62.7%),以及天然或人工水体(如池塘、沟渠、建筑工地和水井)。没有儿童精通游泳,大多数溺水事件(88.1%)发生在没有成人监管的情况下,86.6%的儿童在现场死亡,未接受任何医疗救治。多变量泊松回归分析结果表明,10至14岁男孩在该地区溺水死亡风险最高。
厦门市及郊区儿童溺水死亡情况呈现出与其他国家明显不同的趋势。在厦门及其他发展中地区预防儿童溺水死亡可能需要不同的预防策略。