Causes of Mortality and Risk Factors for Injury Mortality among Children in the Agricultural Health Study.
Causes of Mortality and Risk Factors for Injury Mortality among Children in the Agricultural Health Study.
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DOI：
10.1300/j096v11n03_06
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发表时间：
2007-06-05
影响因子：
2.4
通讯作者：
Sandler, Dale P
中科院分区：
文献类型：
--
作者：
Flower, Kori B;Hoppin, Jane A;Sandler, Dale P
由于与危险机械和材料共用居住环境，农场儿童面临着独特的健康风险。农场儿童死亡的原因没有得到全面的描述。目的：在农业健康研究（AHS）队列中，我们研究了1975年至1998年间爱荷华州和北卡罗来纳州21360名儿童的死亡原因。方法：我们将母亲在自填问卷中提供的儿童识别信息与州死亡登记处（1975-1998）相匹配。1993-1997年由家长通过入组问卷提供农场和家庭特征数据。使用各州死亡率数据计算标准化死亡率（SMRs）以产生预期死亡率。我们使用逻辑回归来检查与伤害死亡率相关的父母、儿童和农场特征。结果：爱荷华州0-19岁儿童中有162例死亡（SMR=0.69； 95%可信区间(CI)=0.60, 0.81），北卡罗来纳州有26例死亡（SMR=0.42; 95%CI=0.28, 0.61）。这一缺陷主要是由于出生后第一年的死亡。尽管总体非故意伤害造成的死亡没有增加，但在爱荷华州发现了农业机械死亡率过高的现象（SMR=9.25; 95% CI=5.12, 16.70）。在病例对照比较中，母亲出生时年龄小于25岁（OR=2.17; 95%CI=1.05, 4.49）和家庭中有2个以上孩子（OR=2.79; 95%CI=1.47, 5.30）与儿童伤害死亡率增加相关。对于14岁以下儿童，参与农活与农业机械相关死亡风险增加相关（OR=3.92; 95% CI=1.04, 14.78）。结论：与儿童伤害死亡率相关的父母和儿童特征可用于有针对性的农场安全干预。
Farm children face unique health risks due to sharing their residential environment with hazardous machinery and materials. Causes of mortality among farm children have not been comprehensively described. OBJECTIVE: In the Agricultural Health Study (AHS) cohort, we examined causes of mortality among 21,360 children in Iowa and North Carolina between 1975 and 1998. METHODS: We matched identifying information for children provided by mothers on self-administered questionnaires to state death registries (1975-1998). Data on farm and family characteristics were provided by parents via enrollment questionnaires (1993-1997). Standardized mortality ratios (SMRs) were calculated, using state mortality data to generate expected deaths. We used logistic regression to examine parent, child and farm characteristics associated with injury mortality. RESULTS: There were 162 deaths in Iowa (SMR=0.69; 95% confidence interval (CI)=0.60, 0.81) and 26 deaths in North Carolina (SMR=0.42; 95%CI=0.28, 0.61) in children aged 0-19 years. This deficit was largely due to deaths in the first year of life. Although deaths from overall unintentional injury were not increased, excess agricultural machinery mortality was observed in Iowa (SMR=9.25; 95% CI=5.12, 16.70). In case-control comparisons, maternal age less than 25 years at child's birth (OR=2.17; 95%CI=1.05, 4.49) and having more than 2 children in the family (OR=2.79; 95%CI=1.47, 5.30) were associated with increased child injury mortality. For children under 14 years, participation in farm work was associated with increased risk of agricultural machine-related mortality (OR=3.92; 95% CI=1.04, 14.78). CONCLUSIONS: Parent and child characteristics associated with child injury mortality could be used to target farm safety interventions.