Brooks D R, Davis L K, Gallagher S S
Occupational Health Surveillance Program, Bureau of Health Statistics, Research and Evaluation, Massachusetts Department of Public Health, Boston 02111.
Am J Ind Med. 1993 Sep;24(3):313-24. doi: 10.1002/ajim.4700240308.
Millions of children in the United States work and, despite federal and state laws, face safety hazards. Previous studies have documented large numbers of injuries suffered on the job by working children. This study describes work-related injuries to children 14-17 years old in 14 Massachusetts communities (representing 5% of the state population) based on data from emergency departments and hospital admissions collected as part of a large population-based surveillance study of injuries to children and adolescents from 1979 to 1982. An estimated 1,176 work-related injuries occurred during the three-year period, accounting for 7-13% of all injury-related emergency department visits in this age group; the proportion among 17-year-olds was 14-26%. Cuts and lacerations were the most frequent type of injury, cutting/piercing was the most common cause, and cutting instruments were the most frequently identified products. Seventeen children were hospitalized for work-related injuries during the course of the study. The estimated annual rate of occupational injury rose from 3.7/1,000 children for 14- to 15-year-olds to 44.7/1000 for 17-year-olds; these rates count all resident children, regardless of their employment status, in the denominator. Rates based on actual hours worked are much higher, and strongly suggest that working minors should be considered a high-risk group for occupational injury. This study adds to the mounting evidence that work-related injuries to children are a significant public health problem and contribute significantly to the overall incidence of injuries among children 14-17 years old. The study also demonstrates the potential of emergency department data as a valuable source of information about work-related injuries to children. Active surveillance systems combining data from emergency departments, workers' compensation, and other potential sources should be established to fully document the nature and extent of the problem. Efforts to prevent these injuries will require the combined attention of employers, parents, medical providers, educators and regulators, as well as working children themselves.
在美国，数以百万计的儿童在工作，尽管有联邦和州法律，但他们仍面临安全隐患。此前的研究记录了大量童工在工作中遭受的伤害。本研究基于1979年至1982年一项针对儿童和青少年伤害的大型人群监测研究收集的急诊室和医院入院数据，描述了马萨诸塞州14个社区（占该州人口的5%）中14至17岁儿童与工作相关的伤害情况。在这三年期间，估计发生了1176起与工作相关的伤害，占该年龄组所有与伤害相关的急诊室就诊病例的7%至13%；17岁儿童中的比例为14%至26%。割伤和撕裂伤是最常见的伤害类型，切割/穿刺是最常见的原因，切割工具是最常涉及的产品。在研究过程中，有17名儿童因与工作相关的伤害住院。估计职业伤害年发生率从14至15岁儿童的每1000人中有3.7例升至17岁儿童的每1000人中有44.7例；这些发生率在分母中计入了所有常住儿童，无论其就业状况如何。基于实际工作小时数的发生率要高得多，这强烈表明，应将工作的未成年人视为职业伤害的高危群体。这项研究进一步证明，儿童与工作相关的伤害是一个重大的公共卫生问题，对14至17岁儿童的总体伤害发生率有重大影响。该研究还表明，急诊室数据有可能成为有关儿童与工作相关伤害的宝贵信息来源。应建立积极的监测系统，整合急诊室、工伤赔偿和其他潜在来源的数据，以全面记录该问题的性质和程度。预防这些伤害需要雇主、家长、医疗服务提供者、教育工作者和监管机构以及工作的儿童自身共同关注。
