Trends in Child and Adolescent Injury Mortality in Taiwan, 1986-2006

台灣地區1986-2006年兒童及青少年事故傷害死亡趨勢

10.6288/TJPH2010-29-01-03

簡戊鑑(Wu-Chien Chien)；白璐(Lu Pai)；朱基銘(Chi-Ming Chu)；高森永(Senyeong Kao)；蔡行瀚(Shin-Han Tsai)

趨勢 ； 兒童青少年 ； 事故傷害 ； 死亡率 ； Trends ； Children ； Injury ； Mortality

台灣公共衛生雜誌

29卷1期（2010 / 02 / 01）

22 - 32

英文

目標：描述台灣地區1986-2006年0-19歲兒童及青少年事故傷害死亡率的長期趨勢。方法：利用衛生署生命統計資料進行分析。以國際疾病傷害死因分類標準第九版，將事故傷害類型區分為非蓄意性及蓄意性，並以簡單線性迴歸對各類傷害死亡率進行趨勢檢定。結果：自1986-2006年，0-19兒童及青少年非蓄意性傷害死亡率下降63%（由35.3/10萬人，至13.2/10萬人），自殺死亡率下降近五成（由1.9/10萬人，至1.0/10萬人）。0-19歲兒童及青少年整體他殺死亡率雖然下降，但5歲以下幼童他殺死亡率卻上升；而且，除了5歲以下他殺外，其他各年齡層死亡率均呈下降趨勢。15-19歲青少年事故傷害（佔全部傷害死亡的52%）死亡率是各年齡層中最高者。交通事故是最常見的傷害類型（佔全部傷害死亡的50%），其次是溺水(17%)、梗塞窒息(7%)、燒燙傷(4%)、跌倒墜落(4%)及中毒(2%)。一歲以下嬰兒事故傷害死亡者中，有68%是梗塞窒息所致。結論：自1989年後，非蓄意傷害死亡率及自殺死亡率均呈下降趨勢，但幼童他殺死亡率呈上升趨勢。往後應加強家庭暴力防制法規的執行、強化溺水防範措施及納入「兒童及少年安全實施方案」；另外，亦應對15-19歲青少年的交通傷害與自殺、0-19歲兒童及青少年的溺水、5歲以下幼童的他殺及1歲以下嬰兒的梗塞窒息等傷害，擬定有效的防制計畫。

Objectives: To describe national trends in injury mortality rates for Taiwanese children aged 0-19 from 1986 to 2006. Methods: Data were obtained from the official Vital Statistics System of the Department of Health, Executive Yuan. Injuries were classified by intent and mechanism using ICD-9 criteria. Mortality rates were age-adjusted for each year's standard population. Simple linear regression was used to determine the trends. Results: From 1986 to 2006, the mortality rate per 100,000 for unintentional injuries at ages 0-19 declined by 63% (from 35.3 to 13.2) and the suicide rate declined by almost half (from 1.9 to 1.0). The homicide rate for ages 0-19 combined declined but the homicide rate for children under age 5 increased. Except for homicide in young children, all age groups showed decreasing trends. The 15-19 age group had the highest total death rate due to injury and accounted for 52% of all injury deaths. Motor vehicle injuries (MVI) were the most common cause of death (accounting for 50% of all injury deaths), followed by drowning (17%), suffocation (7%), fire and flames (4%), falls (4%) and poisoning (2%). Suffocation caused 68% of injury deaths in infants. Conclusions: After 1989, the mortality rates for unintentional injuries and suicide declined, but the homicide rate for young children increased. Laws to prevent violence in the home must be enforced, and drowning prevention programs implemented and incorporated into the Children and Adolescent Safety Implementation Program. Preventive efforts should also target MVI and suicide in the15-19 age group, drowning at all ages, and suffocation and homicide for infants and children under 5 years of age.

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