the George Institute for International Health, University of Sydney, PO Box M201, Missenden Road, New South Wales 2050, Australia.
Pediatrics. 2010 Feb;125(2):304-12. doi: 10.1542/peds.2009-1171. Epub 2010 Jan 11.
Because public health resources for injury prevention are limited, methods for comparing competing strategies are needed. We aimed to estimate potential injury reductions for 4 population-level interventions that target restraint practices for child car passengers aged 0 to 12 years.
Population-attributable risk fraction (PARF) is a population-level estimate of excess risk from exposure to a risk factor. PARFs were calculated for each intervention scenario by using published age-specific mortality/injury relative-risk estimates; restraint practices among injured child car passengers from police-collected data; and observational data for correctness of restraint use in New South Wales, Australia. PARF reductions were estimated for population uptakes of 25%, 50%, and 75%.
Assuming a 50% population uptake, (1) promoting age-appropriate restraint use could prevent additional fatalities (5.1%, infants; 3.4%, 1- to 6-year-olds) and nonfatal injuries (3.2%, infants; 16.2%, 1- to 6-year-olds) compared with promoting any restraint use; (2) further encouraging correct age-appropriate restraint use could also prevent additional fatalities (9.1%, infants; 14.3%, 1- to 6-year-olds) and nonfatal injuries (9.2%, infants; 10.7%, 1- to 6-year-olds); and (3) for children aged 7 to 12 years, promoting correct use of restraints could prevent an additional 3.4% fatalities and 3.1% nonfatal injuries compared with promoting any restraint use.
Interventions that target child passenger-restraint practices offer population-level benefits in terms of reduction in fatalities and injuries. These tangible benefits call for action internationally, not only to promote restraint use but correct age-appropriate restraint use for child car passengers.
由于公共卫生资源有限，因此需要有比较竞争策略的方法。我们旨在估计针对 0 至 12 岁儿童汽车乘客约束实践的 4 项人群干预措施的潜在伤害减少量。
人群归因风险分数（PARF）是人群中因暴露于危险因素而导致的超额风险的估计值。通过使用已发表的年龄特异性死亡率/伤害相对风险估计值、警察收集的受伤儿童汽车乘客的约束实践数据以及澳大利亚新南威尔士州的约束使用正确性观察数据，为每个干预方案计算了 PARF。估计了人群吸收率为 25％、50％和 75％的 PARF 减少量。
假设人群吸收率为 50％，（1）与促进任何约束使用相比，促进适合年龄的约束使用可以预防更多的死亡（5.1％，婴儿；3.4％，1 至 6 岁儿童）和非致命性伤害（3.2％，婴儿；16.2％，1 至 6 岁儿童）；（2）进一步鼓励正确适合年龄的约束使用也可以预防更多的死亡（9.1％，婴儿；14.3％，1 至 6 岁儿童）和非致命性伤害（9.2％，婴儿；10.7％，1 至 6 岁儿童）；（3）对于 7 至 12 岁的儿童，与促进任何约束使用相比，促进正确使用约束装置可预防额外的 3.4％死亡和 3.1％非致命性伤害。
针对儿童乘客约束实践的干预措施在减少死亡和伤害方面具有人群效益。这些切实的收益呼吁国际采取行动，不仅要促进约束使用，还要为儿童汽车乘客提供正确适合年龄的约束使用。
