Drowning prevention in children: the need for new strategies.
Drowning prevention in children: the need for new strategies.
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DOI：
10.1136/ip.1.4.216
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发表时间：
1995-12-01
期刊：
影响因子：
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通讯作者：
Smith, G S
中科院分区：
文献类型：
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作者：
Smith, G S
溺水现在是美国1-4岁儿童受伤死亡的唯一主要原因，超过了机动车乘员和行人死亡。Asher等人在本期关于水安全培训的文章代表了一个非常需要的预防溺水研究的新途径（见第228页）。尽管存在经证实的预防幼儿溺水的策略，但在美国，这一年龄组的溺水率已被证明是难治性的。[3]自1971年以来，这些比率变化不大，婴儿的比率实际上有所增加。这与10-19岁的溺水率形成了鲜明对比，溺水率每年下降5%以上。任何预防工作的核心是了解溺水发生的方式和原因。溺水情况因年龄而异，在某种程度上也因地理位置而异。1岁以下儿童最容易在浴缸中溺水。1岁以后，随着活动能力的增加，在家里的游泳池、热水浴缸和游泳池、水桶和其他地方溺水的发生率会增加。由于缺乏良好的国家数据（由于溺水E代码缺乏特异性），大多数区域研究发现，到2岁时，主要地点是家庭游泳池。[2]例如，在洛杉矶县，2-3岁的儿童（正在讨论的研究对象）中，89%的溺水发生在私人游泳池中。4该年龄组的其他场所是浴缸（4%），热水浴缸和游泳池（3%），其余的是其他场所。虽然家庭游泳池的重要性因州而异，但它是5岁以下溺水的主要地点，特别是在溺水率高的州，即西部各州，夏威夷和佛罗里达州，所有这些州都有很高的游泳池拥有率。因此，Asher等人的研究基于游泳池，代表了对幼儿溺水最有可能发生的情况和环境的现实模拟。虽然消极的预防方法，如四面游泳池围栏，是非常有效的，必须保持我们的初级预防战略，有许多障碍，阻止其实施。2随着时间的推移，幼儿溺水率没有显著下降3，这表明除了游泳池围栏外，还需要制定其他策略。然而，很少有研究已经做了其他方法来防止溺水。Asher等人提供了第一个全面的研究，证明教游泳和
Drowning is now the single leading cause of injury death in children 1-4 years of age in the US, surpassing both motor vehicle occupant and pedestrian deaths.'The article by Asher et al on water safety training in this issue represents a much needed new avenue of prevention research on drowning (see p 228). Despite the existence of proven strategies for preventing drownings in early childhood, 2 drowning rates in the US have proven refrac-tory in this age group. 3 Since 1971 these rates have changed little and have actually increased in infants. This is in contrast to drowning rates at ages 10-19, which have declined by more than 5% annually.Central to any prevention effort is an understanding of how and why drownings occur. Drowning circumstances vary widely by age and to some extent also bygeographic location. Under age 1 most drowningsoccur in bathtubs. After age 1, associated with increasing mobility, there is a transition to a higher incidence of drownings in home pools, hot tubs and whirlpools, buckets, and other sites. In the absence of good national data (due to lack of specificity in drowning E-codes), most regional studies find that by age 2 the leading site is home swimming pools. 2 For example in Los Angeles County among children ages 2-3 years (the target of the study under discussion) 89% of drowning occurred in private pools. 4 Other sites in this age groupwere bathtubs (4%), hot tubs and whirlpools (3%), with the remainder at other sites. Although the importance of the home pool obviously varies by state it is the leading site for drownings under aged 5, especially in those states with high drowning rates, that is western states, Hawaii, and Florida-all of which have high rates ofpool ownership. Thus the study by Asher et al, based as it is on swimming pools, represents a realistic simulation of the situation and environment where drownings to young children are most likely to occur. While passive prevention methods, such as four sided pool fencing, are very effective and must remain our primary prevention strategy there are many barriers that prevent their implementation. 2 The lack of any significant decline in drowning rates to young children over time3 indicates the need to develop other strategies in addition to pool fencing. However, little research has been done on other ap-proaches to drowning prevention. Asher et al have provided the first comprehensive study that demonstrates that teaching swimming and