加拿大安大略省儿童和青少年的枪支伤害流行病学：一项基于人群的研究。

Firearm injury epidemiology in children and youth in Ontario, Canada: a population-based study.

机构信息

Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada

ICES, Toronto, Ontario, Canada.

出版信息

BMJ Open. 2021 Nov 18;11(11):e053859. doi: 10.1136/bmjopen-2021-053859.

DOI:10.1136/bmjopen-2021-053859

PMID:34794997

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8603258/

Abstract

BACKGROUND AND OBJECTIVE

Despite firearms contributing to significant morbidity and mortality globally, firearm injury epidemiology is seldom described outside of the USA. We examined firearm injuries among youth in Canada, including weapon type, and intent.

DESIGN

Population-based, pooled cross-sectional study using linked health administrative and demographic databases.

SETTING

Ontario, Canada.

PARTICIPANTS

All children and youth from birth to 24 years, residing in Ontario from 1 April 2003 to 31 March 2018.

EXPOSURE

Firearm injury intent and weapon type using the International Classification of Disease-10 CM codes with Canadian enhancements. Secondary exposures were sociodemographics including age, sex, rurality and income.

MAIN OUTCOMES

Any hospital or death record of a firearm injury with counts and rates of firearm injuries described overall and stratified by weapon type and injury intent. Multivariable Poisson regression stratified by injury intent was used to calculate rate ratios of firearm injuries by weapon type.

RESULTS

Of 5486 children and youth with a firearm injury (annual rate: 8.8/100 000 population), 90.7% survived. Most injuries occurred in males (90.1%, 15.5/100 000 population). 62.3% (3416) of injuries were unintentional (5.5/100 000 population) of which 1.9% were deaths, whereas 26.5% (1452) were assault related (2.3/100 00 population) of which 18.7% were deaths. Self-injury accounted for 3.7% (204) of cases of which 72.0% were deaths. Across all intents, adjusted regression models showed males were at an increased risk of injury. Non-powdered firearms accounted for half (48.6%, 3.9/100 000 population) of all injuries. Compared with handguns, non-powdered firearms had a higher risk of causing unintentional injuries (adjusted rate ratio (aRR) 14.75, 95% CI 12.01 to 18.12) but not assault (aRR 0.84, 95% CI 0.70 to 1.00).

CONCLUSIONS

Firearm injuries are a preventable public health problem among youth in Ontario, Canada. Unintentional injuries and those caused by non-powdered firearms were most common and assault and self-injury contributed to substantial firearm-related deaths and should be a focus of prevention efforts.

摘要

背景与目的

尽管枪支在全球范围内导致了大量的发病率和死亡率，但枪支伤害的流行病学情况在美国以外的地区很少被描述。我们检查了加拿大青少年的枪支伤害情况，包括武器类型和意图。

设计

使用链接的健康管理和人口统计数据库进行基于人群的、汇总的横断面研究。

地点

加拿大安大略省。

参与者

所有 0 至 24 岁的儿童和青少年，2003 年 4 月 1 日至 2018 年 3 月 31 日期间居住在安大略省。

暴露情况

使用国际疾病分类第 10 版 CM 代码和加拿大增强版，对枪支伤害意图和武器类型进行分类。次要暴露因素包括年龄、性别、农村和收入等社会人口统计学因素。

主要结果

任何因枪支受伤的住院或死亡记录，描述了总体以及按武器类型和伤害意图分层的枪支伤害发生率和率。按伤害意图分层的多变量泊松回归用于计算按武器类型划分的枪支伤害率比。

结果

在 5486 名患有枪支伤害的儿童和青少年中（年发生率：8.8/100000 人口），90.7%的人幸存。大多数伤害发生在男性（90.1%，15.5/100000 人口）。62.3%（3416 人）的伤害是无意的（5.5/100000 人口），其中 1.9%是死亡，而 26.5%（1452 人）是与攻击有关的（2.3/100000 人口），其中 18.7%是死亡。自我伤害占病例的 3.7%（204 人），其中 72.0%是死亡。在所有意图中，调整后的回归模型显示男性受伤风险增加。无烟火药占所有伤害的一半（48.6%，3.9/100000 人口）。与手枪相比，无烟火药导致意外伤害的风险更高（调整后的比率比（aRR）14.75，95%CI 12.01 至 18.12），但不导致攻击（aRR 0.84，95%CI 0.70 至 1.00）。