Palmera-Suárez Rocío, López-Cuadrado Teresa, Fernández-Cuenca Rafael, Alcalde-Cabero Enrique, Galán Iñaki
Department of Epidemiological Analysis and Health Status, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain.
Department of Epidemiological Analysis and Health Status, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid/IdiPAZ (Instituto de Investigación del Hospital Universitario La Paz/La Paz University Teaching Hospital Research Institute), Calle del Arzobispo Morcillo 4, PC 28029, Madrid, Spain.
Injury. 2018 Mar;49(3):549-555. doi: 10.1016/j.injury.2018.02.006. Epub 2018 Feb 7.
Although traffic injuries (TIs) are an important cause of disability the related factors are little known. We aimed to estimate the differences in risk of TI-related disability according to individual characteristics that might generate health inequalities.
Cross-sectional study using a representative Spanish population sample drawn from the European Health Interview Survey 2009/2010. We calculated traffic crashes in the preceding year which resulted in injuries. Disability was measured using the Global Activity Limitation Indicator and four indicators of limitations (sensory, physical functional, self-care and domestic activities). Principal socio-demographic and behavioural/lifestyle variables were studied. We used multivariate logistic regression to estimate the risk (ORs) of TI-related disability in the sample as whole and disability-related factors in persons who had experienced TIs.
Persons with TIs had a higher risk of global disability (OR = 1.61; 95%CI:1.17-2.20), physical functional limitations (OR = 1.96; 95%CI:1.33-2.89) and self-care limitations (OR = 1.73; 95%CI:0.98-3.05). Among persons with TIs, GALI-related risk was higher in women (OR = 3.06, p = 0.002) and persons aged over 30 years (OR = 6.81, p < 0.001; OR = 5.96, p = 0.011; OR = 4.54, p = 0.047). Lower risk was observed among persons with a higher educational level (OR = 0.22, p = 0.003). The risk of disability among persons with TIs who consumed illegal drugs was OR = 3.9 (p = 0.023).
Traffic injuries in the preceding year are associated with higher risk of disability, which is unevenly distributed. Individual (women and persons over 30 years), socio-economic (lower educational level) and behavioural (illegal drug use) factors are involved. Actions aimed at changing the unequal risk among vulnerable subgroups and providing health, social and protective services should be implemented.
尽管交通伤是导致残疾的一个重要原因，但相关因素却鲜为人知。我们旨在根据可能造成健康不平等的个体特征，评估与交通伤相关残疾风险的差异。
采用横断面研究，样本来自2009/2010年欧洲健康访谈调查中的具有代表性的西班牙人群。我们计算了上一年导致受伤的交通事故。使用全球活动受限指标和四个受限指标（感官、身体功能、自我护理和家务活动）来衡量残疾情况。研究了主要的社会人口统计学和行为/生活方式变量。我们使用多因素逻辑回归来估计整个样本中与交通伤相关残疾的风险（比值比）以及经历过交通伤的人群中与残疾相关的因素。
经历过交通伤的人群出现整体残疾（比值比=1.61；95%置信区间：1.17 - 2.20）、身体功能受限（比值比=1.96；95%置信区间：1.33 - 2.89）和自我护理受限（比值比=1.73；95%置信区间：0.98 - 3.05）的风险更高。在经历过交通伤的人群中，与全球活动受限指标相关的风险在女性中更高（比值比=3.06，p = 0.002）以及在30岁以上人群中更高（比值比=6.81，p < 0.001；比值比=5.96，p = 0.011；比值比=4.54，p = 0.047）。在教育水平较高的人群中观察到较低的风险（比值比=0.22，p = 0.003）。使用非法药物的交通伤患者出现残疾的风险为比值比=3.9（p = 0.023）。
上一年的交通伤与更高的残疾风险相关，且这种风险分布不均。涉及个体因素（女性和30岁以上人群）、社会经济因素（较低教育水平）和行为因素（使用非法药物）。应采取行动改变弱势群体中不平等的风险，并提供健康、社会和保护服务。
