Garrard J, Leland N, Smith D K
Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis 55455.
Am J Dis Child. 1988 Jun;142(6):643-50. doi: 10.1001/archpedi.1988.02150060077037.
The purpose of this study was to examine the epidemiology of human bites to children in a day-care center over a one-year period. This was a cohort study based on the injury log maintained on a daily basis by staff of the day-care center, as required by state II-censure law. A total of 224 children was enrolled in the center during the study period: 29 infants (ages 0 to 16 months), 62 toddlers (16.1 to 30 months), and 133 preschoolers (30.1 to 72 months). One hundred four children were bitten one or more times by other children in the center, with a total of 347 bites. The bite rates (defined as number of bites per 100 child days of enrollment in the center) varied significantly by age group but not by gender for initial or first-time bites, with toddlers having the highest rate and preschoolers the lowest (infants, 0.7129; toddlers, 1.3672; preschoolers, 0.4193). Total bite rates (which took into account multiple bites per child over the 12-month study period) varied significantly by age group, with toddlers having the highest rate per 100 days of enrollment and preschoolers the lowest (infants, 2.1931; toddlers, 3.1300; preschoolers, 0.5611). Males and females differed significantly in total bite rates per 100 enrollment days within the toddler age group (males, 3.6683; females, 2.3096) but not within the other two age groups. None of the demographic characteristics available in this study distinguished between children who were bitten compared with those who were not bitten with the exception of number of days of enrollment. The circumstances surrounding the biting events were examined with respect to the activity of the child when bitten, the victim's location when bitten, body part bitten, and treatment by staff. The results of this study raise policy questions about treatment protocols for human bites of children in group child-care settings, the routine recording of biting events, and the ethics and practice of reporting such events to parents.
本研究的目的是调查日托中心一年内儿童被人咬伤的流行病学情况。这是一项队列研究，基于日托中心工作人员按照州二级审查法律要求每日记录的伤害日志开展。研究期间，该中心共有224名儿童入托：29名婴儿（0至16个月）、62名幼儿（16.1至30个月）和133名学龄前儿童（30.1至72个月）。104名儿童在中心被其他儿童咬了一次或多次，总共发生了347次咬伤。初始或首次咬伤的发生率（定义为每100名儿童入托天数的咬伤次数）在不同年龄组之间差异显著，但在性别上无差异，幼儿的发生率最高，学龄前儿童最低（婴儿，0.7129；幼儿，1.3672；学龄前儿童，0.4193）。总咬伤发生率（考虑了12个月研究期间每名儿童的多次咬伤情况）在不同年龄组之间差异显著，幼儿每100天入托天数的发生率最高，学龄前儿童最低（婴儿，2.1931；幼儿，3.1300；学龄前儿童，0.5611）。在幼儿年龄组中，每100天入托天数的总咬伤发生率在男性和女性之间存在显著差异（男性，3.6683；女性，2.3096），但在其他两个年龄组中无差异。除入托天数外，本研究中可用的人口统计学特征均无法区分被咬儿童和未被咬儿童。针对咬伤事件的相关情况，研究了儿童被咬时的活动、被咬时受害者的位置、被咬身体部位以及工作人员的处理情况。本研究结果引发了关于集体儿童保育环境中儿童被人咬伤的治疗方案、咬伤事件的常规记录以及向家长报告此类事件的伦理和做法等政策问题。
