Langley J D, Chalmers D, Collins B
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
J Paediatr Child Health. 1990 Dec;26(6):323-8. doi: 10.1111/j.1440-1754.1990.tb02445.x.
Unintentional injuries at school have been identified as a significant public health problem. A major barrier to the development of injury prevention policy has been the absence of national data on the circumstances of injuries to students which occur at school. This study sought to determine the incidence, nature, and circumstances of injuries which resulted in death or hospitalization. Fatalities were identified from national mortality data for 1977-86 inclusive. Coroners' files were then examined to obtain details of the circumstances of injury. Hospitalization cases were identified from the national hospital discharge summary for 1986. Fifteen fatalities were identified. The circumstances of the deaths were diverse with the most frequent event being a fall (n = 4). A total of 1013 first admissions to hospital were identified, giving an overall incidence rate of 152/100,000 students/year. Injury rates declined with increasing age, and males had higher rates than females for all ages. Fractures of the upper and lower limbs and intracranial injury represented more than three-quarters of all injury. The two leading causes of injury, falls, and incidents involving striking against or being struck by a person or object, represented 89% of all incidents. The use of playground equipment and involvement in sporting activity were two of the more common aspects of many injury events. The results suggest that prevention policy should place emphasis on those in their first 2 years of schooling, falls from playground equipment, provision of protective equipment for sporting activities, sporting activities designed to minimize physical contact, establishment of standardized injury referral procedures, first-aid training, and a standardized injury reporting system.
学校中的意外伤害已被认定为一个重大的公共卫生问题。伤害预防政策制定的一个主要障碍是缺乏关于学生在学校发生伤害情况的全国性数据。本研究旨在确定导致死亡或住院的伤害的发生率、性质和情况。通过1977年至1986年(含)的全国死亡率数据确定了死亡案例。随后查阅验尸官档案以获取伤害情况的详细信息。从1986年的全国医院出院总结中确定了住院病例。共确定了15例死亡案例。死亡情况各不相同,最常见的事件是摔倒(n = 4)。共确定了1013例首次住院病例,总体发病率为每年152/10万学生。伤害发生率随年龄增长而下降,各年龄段男性的发生率均高于女性。上肢和下肢骨折以及颅内损伤占所有伤害的四分之三以上。伤害的两个主要原因,即摔倒以及涉及与人员或物体碰撞或被碰撞的事件,占所有事件的89%。使用操场设备和参与体育活动是许多伤害事件中较常见的两个方面。结果表明,预防政策应侧重于入学头两年的学生、从操场设备上摔倒、为体育活动提供防护设备、旨在尽量减少身体接触的体育活动、建立标准化的伤害转诊程序、急救培训以及标准化的伤害报告系统。