台灣地區腳踏車傷害之危險因子調查

Survey of Risk Factors for Cycling Injuries in Taiwan

蔡欣達(Shin-Da Tsai)

指導教授 ： 邱文達

臺北醫學大學/公共衛生暨營養學院/傷害防治學研究所/碩士(2005年)

摘要

前言：在已開發和開發中國家腳踏車是一種重要的運輸工具，大人和孩子也常把騎腳踏車當成上學或娛樂活動的工具，也因此騎腳踏車相關的傷害越來越多，但是在台灣相關的研究卻不多。其中頭部傷害也是腳踏車常見的傷害，在國外有許多研究證實腳踏車安全帽，在事故發生時，具有其保護效果。以潛在生命損失來說，它的潛在生命損失更大。因此，為了預防腳踏車的頭部傷害，腳踏車安全帽立法的施行是刻不容緩。材料與方法： 本資料分析創傷登錄2001年7月1日至 2002年6月30日間所登錄的資料。本研究共分兩部分，第一部份為創傷登錄的基本資料中因騎腳踏車而導致外傷的病人。第二部分為電話訪視補充相關資料。統計分析以單變項分析做次數分配及百分比來描述資料，再以卡方檢定探討各變項間分佈有無差異。多變項分析方面先以單變項邏輯式回歸作分析，其P值小於0.2的因子，再納入多變項邏輯式回歸分析。結果：創傷登錄中腳踏車造成的傷害共1,132位。受傷時間以早上7-8點及下午5-6點為主；依年齡層來看，腳踏車傷害者的傷害部位、機轉發現0-9歲主要是從腳踏車上跌落為主；10-14歲主要是和靜止物體碰撞為主；而15歲以上主要是和移動物體碰撞為主； 0-9歲主要以頭部傷害及四肢傷害為主；10-14歲及15歲以上則以四肢為主。324位頭部傷害中男性會有嚴重頭部外傷的的勝算比為4.86，信賴區間為2.89-5.68；10?19歲會有嚴重頭部外傷的勝算比為3.85，信賴區間為1.68-4.55；沒有戴安全帽會有嚴重頭部外傷的勝算比為4.64，信賴區間為1.38-5.68；無裝設反光物品會有嚴重頭部外傷的勝算比為2.64，信賴區間為1.38-4.58；背負物品會有嚴重頭部外傷的勝算比為5.26，信賴區間為4.23-8.98；朝路面外會有嚴重頭部外傷的勝算比為3.89，信賴區間為2.11-4.68；速度過快會有嚴重頭部外傷的勝算比為2.45，信賴區間為1.65-2.88；煞車線壞掉會有嚴重頭部外傷的勝算比為2.13，信賴區間為1.25-2.69。討論：結果顯示男性有較高的危險性，這點與我們研究結果中不論嚴重頭部外傷及嚴重傷害均以男性顯著為高相吻合。學齡兒童腳踏車傷害一直是個未被重視的問題，此問題在尤其嚴重，與機車事故好發的年齡層（20-29歲）相比，年齡有較低的趨勢本研究中腳踏車事故引起的嚴重頭部外傷，發生年齡層在5-9歲及10-14歲分別較其他年齡層顯著為高。頭部傷害的問題可由戴安全帽來預防，但是大部分的人也都忽略了安全帽以外的防護器具，如護膝等。此外背負重物及腳踏車車體安全的檢查(剎車線是否壞掉)，都是預防腳踏車傷害不可忽略的因子。

關鍵字

腳踏車 ； 安全帽 ； 嚴重頭部外傷

並列摘要

Introduction: Cycling is a worldwide activity. In both developed and developing countries it serves as an important means of transportation as well as an enjoyable recreational activity for adults and children. Injuries related to cycling are comparatively common, especially head injuries, which account for one third of visits to emergency departments and three quarters of deaths. Head injuries also carry a substantial risk of long term disability. Thus, preventing head injuries from cycling is relatively important. In order to decrease Years of Potential Life Lost(YPLL) significantly and to protect teenagers from severe head injury, the bicycle helmet law should be enforced immediately. Methods: In this particular study, we utilized case control study for analyzing the result of GCS to discriminate the severity of head injury. Hospital trauma registry was used to investigate the traumatic patients from six hospitals in Taiwan since February 2nd to November 30th, 2001. Telephone interviews were conducted to confirm whether or not the injury was caused by bicycle accident, and to complete the insufficient information. Frequency and Pearson Chi-Square was used to test for univariables, and multiple logistic regression was used to examine the association between severity and related confounders in multivariables. Result: There were a total of 1,132 bicycle induced injuries in the traumatic registry. Injury mainly occurs during 7-8 o'clock in the morning and 5-6 o'clock in the afternoon. According to age distribution, by observing the injury position, the 0-9 years old were injured mainly from falling off the bicycle; 10-14 years old were mainly injured by colliding with static objects.; and those over 15 years old were mainly injured by colliding with moving objects; and the injury position of 0-9 years old are mainly head and limbs; while for people 10-14 and over 15 are mainly limbs. Among the 324 head injured man, the rate of having severe head injury is 4.86 , while the confidence interval is 2.89-5.68; the rate of 10- 19 years old having severe head injury is 3.85 , the confidence interval is 1.68-4.55; the rate of not wearing helmet and cause severe head injury is 4.64 , the confidence interval is 1.38-5.68; the rate of not having reflecting equipments and cause severe head injury is 2.64 ,the confidence interval is 1.38-4.58; the rate of carrying objects and cause severe head injury is 5.26 , the confidence interval is 4.23-8.98; the rate of biking towards the outer road side and have severe head injury is 3.89 , the confidence interval is 2.11-4.68; the rate of speeding and cause severe head injury is 2.45 , the confidence interval is 1.65-2.88 ; the rate of having malfunction break and cause severe head injury is 2.13 , the confidence interval is 1.25-2.69 . Discussion: The Result shows that men have higher risks of getting severe head injury then woman. Bicycle injury among school-age children has been and continuous to be a severe issue that requires special attention. In comparison the age group that suffer from motorcycle accident injuries, the study shows that the age of those who suffered from severe head trauma induced by bicycle riding was lower. The accidents that occurred in age groups of 5-9 and 10-14 were higher then the other age groups. Although head injury can be prevented by wearing a helmet, most people tend to neglect other protective items such as knee pads. In addition, caring heavy objects and performing safety check on the bicycle itself are other factors that can not be neglected.

並列關鍵字

cycling ； helmet ； severe head injury

參考文獻

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