Masud Sarwat, Hyder Adnan A, Rahim Khan Uzma, Ullah Khan Nadeem, Raheem Ahmed, Petrucka Pammla
Department of Emergency Medicine, Aga Khan University Hospital Karachi, Pakistan.
Milken Institute of Public Health, George Washington University, Washington, DC, United States.
Inquiry. 2025 Jan-Dec;62:469580251343779. doi: 10.1177/00469580251343779. Epub 2025 Jun 13.
There is a lack of recent data on the incidence of unintentional injuries and occupational injuries from Pakistan, among youth 15 to 24 years of age. This survey was conducted among vocational school youth in Peshawar, Pakistan (2021-22). Parental consent and assent were obtained for students <18 years of age. After obtaining consent, students were given a hard copy of the self-administered, World Health Organization community survey guide for injuries and violence questionnaire in a classroom session. Incidence Rate Ratios (IRR) were reported for unintentional and occupational injuries There were 547 youth of which [356 (54%)] were males. Majority [535 (97%)] of the students had received formal education before vocational training, while fathers had higher formal education [437(80%)], compared to mothers [326 (60%)]. The median family income of these vocational students was 30 000 Pakistani rupee (PKR) per month. Vocational youth mostly lived in crowded family settings with 239 participants (44%) living with ≥8 family members in the household. In terms of risk behaviors, there was minimal use of tobacco [532 (97.3%)] and minimal alcohol [9 (2%)]. Non-use of helmets was found in [273 (50%)], which was similar to seat belt non-use in [307 (56%)] of participants. Eight percent of students carried a gun for personal protection. Males had 3.24 times higher rates of road traffic injuries, 1.28 times higher rates of occupational injuries, and 1.63 times higher rates of unintentional injuries overall compared to their female counterparts. The 15 to 19 age group had significantly lower incidence of burns and falls compared to the 20 to 24 age group. Factors that increased the risk of unintentional injuries UI were tobacco use adjusted IRR = 1.25 (95% CI: 1.05-2.69, = .049), not using a seat belt adjusted IRR = 1.3 (95% CI: 1.14-1.69, < .001), lack of formal education prior to vocational training in the youth, adjusted IRR of 4.6 (95% CI: 1.12-18.91, = .034), lack of father's education adjusted IRR = 4.71 (95% CI: 2.12-10.49, < .001), lower family income (≤35 000 PKR) adjusted IRR = 2.04 ( 95% CI: 1.04-4.02, = .039), larger household size (≥8 members), with an adjusted IRR of 3.59 (95% CI: 3.11-5.07, < .001). In contrast, age ≤19 years showed a higher unadjusted risk (IRR = 2.05, 95% CI: 1-4.2, = .049), but this association was not significant after adjustment (adjusted IRR = 1.61, 95% CI: 0.8-3.27, = .184). Marital status and mother's education were not significantly associated with UI This study on vocational youth in Pakistan highlights the critical need for targeted interventions. We recommend prioritizing stricter enforcement of traffic laws, implementing public awareness campaigns specifically for vocational youth, and providing subsidized safety equipment, such as helmets. Furthermore, integrating comprehensive road safety and health education into vocational training curricula is crucial. By addressing these critical areas, significant reduction in injury rates and improved safety and well-being of this vulnerable population may be realized.
目前缺乏有关巴基斯坦15至24岁青年意外伤害和职业伤害发生率的最新数据。这项调查于2021 - 2022年在巴基斯坦白沙瓦的职业学校青年中进行。对于18岁以下的学生,已获得家长同意和学生本人同意。获得同意后,在课堂上向学生发放了一份世界卫生组织社区伤害与暴力调查问卷的纸质版,由学生自行填写。报告了意外伤害和职业伤害的发病率比(IRR)。共有547名青年,其中[356名(54%)]为男性。大多数[535名(97%)]学生在接受职业培训之前接受过正规教育,而父亲接受正规教育的比例更高[437名(80%)],相比之下母亲的比例为[326名(60%)]。这些职业学生的家庭月收入中位数为30000巴基斯坦卢比(PKR)。职业青年大多生活在拥挤的家庭环境中,239名参与者(44%)与家中≥8名家庭成员一起生活。在风险行为方面,烟草使用率极低[532名(97.3%)],酒精使用率也极低[9名(2%)]。发现[273名(50%)]参与者不使用头盔,这与[307名(56%)]参与者不使用安全带的情况相似。8%的学生携带枪支用于自我保护。总体而言,男性道路交通伤害发生率比女性高3.24倍,职业伤害发生率高1.28倍,意外伤害发生率高1.63倍。15至19岁年龄组的烧伤和跌倒发生率明显低于20至24岁年龄组。增加意外伤害(UI)风险的因素包括:吸烟,调整后的IRR = 1.25(95%置信区间:1.05 - 2.69,P = 0.049);不使用安全带,调整后的IRR = 1.3(95%置信区间:1.14 - 1.69,P < 0.001);青年在职业培训前缺乏正规教育,调整后的IRR为4.6(95%置信区间:1.12 - 18.91,P = 0.034);父亲缺乏教育,调整后的IRR = 4.71(95%置信区间:2.12 - 10.49,P < 0.001);家庭收入较低(≤35000 PKR),调整后的IRR = 2.04(95%置信区间:1.04 - 4.02,P = 0.039);家庭规模较大(≥8名成员),调整后的IRR为3.59(95%置信区间:3.11 - 5.07),P < 0.001)。相比之下,年龄≤19岁显示出较高的未调整风险(IRR = 2.05,95%置信区间:1 - 4.2,P = 0.049),但调整后这种关联不显著(调整后的IRR = 1.61,95%置信区间:0.8 - 3.27,P = 0.184)。婚姻状况和母亲的教育程度与意外伤害无显著关联。这项针对巴基斯坦职业青年的研究突出了针对性干预措施的迫切需求。我们建议优先加强交通法规的执行力度,专门为职业青年开展公众意识宣传活动,并提供补贴的安全设备,如头盔。此外,将全面的道路安全和健康教育纳入职业培训课程至关重要。通过解决这些关键领域的问题,可能会显著降低伤害发生率,改善这一弱势群体的安全和福祉。