Hashikawa Andrew N, Newton Manya F, Cunningham Rebecca M, Stevens Martha W
University of Michigan Medical School, USA
University of Michigan Medical School, USA.
J Child Health Care. 2015 Mar;19(1):93-105. doi: 10.1177/1367493513501020. Epub 2013 Oct 3.
The study systematically reviewed all types of unintentional injury and injury prevention research studies occurring within child care centers in the United States. A total of 2 reviewers searched 11 electronic databases to identify 53 articles meeting inclusion criteria. No studies used trauma registries or randomized control trials. Data were not pooled for further analysis because studies lacked standardized definitions for injury, rates, severity, exposure, and demographics. The following child care center injury rates were reported: (0.25-5.31 injuries per 100,000 child-hours); (11.3-18 injuries per 100 children per year); (6-49 injuries per 1000 child-years); (2.5-8.29 injuries per child-year); (2.6-3.3 injuries per child); (3.3-6.3 injuries per 100 observations); (635-835 medically attended injuries per year per 100,000 children and 271-364 child care center playground injuries per year per 100,000 children); and (3.8 injuries per child per 2000 exposure hours). Child care center injury rates were comparable to injury rates published for schools, playground, and summer camp. Most injuries were minor, while most severe injuries (fractures and concussions) were falls from playground structures. Future studies need to use standardized injury definitions and injury severity scales, focus efforts on preventing severe playground injuries in child care centers, and report child care parameters for inclusion in national injury databases.
该研究系统回顾了美国儿童保育中心内发生的各类意外伤害及伤害预防研究。共有2名评审人员检索了11个电子数据库，以确定53篇符合纳入标准的文章。没有研究使用创伤登记或随机对照试验。由于研究缺乏关于伤害、发生率、严重程度、暴露情况和人口统计学的标准化定义，因此未对数据进行汇总以作进一步分析。报告的儿童保育中心伤害发生率如下：（每100,000儿童小时0.25 - 5.31起伤害）；（每年每100名儿童11.3 - 18起伤害）；（每1000儿童年6 - 49起伤害）；（每儿童年2.5 - 8.29起伤害）；（每名儿童2.6 - 3.3起伤害）；（每100次观察3.3 - 6.3起伤害）；（每年每100,000名儿童635 - 835起需就医的伤害以及每年每100,000名儿童271 - 364起儿童保育中心操场伤害）；以及（每2000暴露小时每名儿童3.8起伤害）。儿童保育中心的伤害发生率与学校、操场和夏令营公布的伤害发生率相当。大多数伤害为轻伤，而大多数重伤（骨折和脑震荡）是从操场设施上跌落所致。未来的研究需要使用标准化的伤害定义和伤害严重程度量表，将工作重点放在预防儿童保育中心的严重操场伤害上，并报告儿童保育参数以便纳入国家伤害数据库。
