International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, Maryland 21205, United States of America.
Department of Public Health, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Accid Anal Prev. 2019 Apr;125:79-84. doi: 10.1016/j.aap.2019.01.028. Epub 2019 Feb 5.
To investigate the extent and patterns of regional disparities of road traffic injury rates involving elementary and junior high school children while commuting among Japan's 47 prefectures.
We conducted a cross-sectional ecological study using the national police data for 2004-2013 on the number of children who were killed or seriously injured (KSI) in traffic collisions stratified by prefecture, grade, mode of transport, and purpose of trip (commuting or non-commuting). We calculated stratified KSI rates by dividing the number of KSI cases by the corresponding number of children and presented these rates for the 47 prefectures. Also, for pedestrian elementary school children and cyclist junior high school children, we regressed the KSI rates while commuting by prefecture on the non-commuting KSI rates and the proportion of people who live in the urban, densely inhabited districts.
There were 6463 KSI cases while commuting. The ratios of the highest KSI rate to the lowest KSI rate among prefectures were 12, 30, and 58 for pedestrian elementary school children and pedestrian and cyclist junior high school children, respectively. The non-commuting KSI rates and the proportion of those living in densely inhabited districts were positively and inversely associated with the commuting KSI rates, respectively. The analysis of the residuals of the regression models did not identify prefectures with significantly higher or lower KSI rates while commuting than others.
There were large inter-prefecture disparities in the KSI rates while commuting, and the disparity was especially large among cyclist junior high school children.
调查日本 47 个都道府县在中小学生上下学期间道路交通伤害率的地区差异程度和模式。
我们采用 2004-2013 年全国警察数据进行了一项横断面生态研究，研究对象按都道府县、年级、交通方式和出行目的（上下学或非上下学）分层的儿童因交通事故死亡或重伤（KSI）人数。我们通过将 KSI 病例数除以相应的儿童人数来计算分层 KSI 率，并为 47 个都道府县呈现这些率。此外，对于步行上学的小学生和骑自行车上学的初中生，我们按都道府县回归上下学的 KSI 率与非上下学的 KSI 率和居住在城市、人口稠密地区的人口比例的关系。
有 6463 例 KSI 病例发生在上下学期间。都道府县之间 KSI 率的最高值与最低值之比分别为步行上学的小学生 12 倍、30 倍和 58 倍，步行和骑自行车上学的初中生也是如此。非上下学的 KSI 率和居住在人口稠密地区的比例与上下学的 KSI 率呈正相关和负相关。对回归模型残差的分析未发现上下学 KSI 率明显高于或低于其他都道府县的都道府县。
上下学期间 KSI 率在都道府县之间存在较大差异，骑自行车上学的初中生之间的差异尤其大。
