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画像 国連、ユニセフ、WHOは合同レポートで、毎年80万人以上の子どもが、火傷、自動車事故、落下、溺水、中毒、その他の事故で亡くなっていると警告している。さらに数百万人が障害で生活困難な状況にあるという。ほとんどはアフリカや南東アジアの開発途上国で起きており、簡単な予防手段で死者は半減できる。
 World Report on Child Injury Prevention 2008 による原因の上位5つは、交通事故、溺水、火傷、墜落、中毒である。
 交通事故で年に26万人の子どもが死亡し、約1000万人がケガを負い、10-19才では最も多い死因である。溺水で毎年約175,000人が死亡、火災に伴う火傷で約96,000人、転落で約47,000人、中毒で45,000人以上が亡くなる。
 9才以降は不慮の事故が最大の死因で、95%が途上国で起きている。
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Page last updated at 17:36 GMT, Wednesday, 10 December 2008
UN raises child accidents alarm
http://news.bbc.co.uk/2/hi/in_depth/7776127.stm

画像A baby is buckled into a car seat
Often, simple precautionary measures can prevent accidents

More than 800,000 children die each year from burns, car crashes, falls, drowning, poisoning and other accidents, according to a UN report.

Millions more suffer injuries that leave them disabled for life, said the joint report by two UN agencies, Unicef and the World Health Organization.
Most accidents happen in developing countries, with the problem most severe in Africa and South-East Asia.
Simple prevention measures could halve the number of deaths, the report said.
Crashes, drowning, falls
The top five causes of injury and death are road crashes, drowning, burns, falls and poisoning, according to the World Report on Child Injury Prevention 2008.

Top five causes of injury death
Road crashes: 260,000 children a year
Drowning: 175,000 children a year
Burns: 96,000 children a year
Falls: 47,000 children a year
Poisoning: 45,000 children each year

Road crashes kill 260,000 children a year, injure about 10 million and are the leading cause of death among 10-19 year olds.
About 175,000 children die through drowning every year.
Fire-related burns kill nearly 96,000 children a year, while nearly 47,000 children fall to their deaths every year and more than 45,000 die from unintended poisoning.
"Unintentional injuries are the leading cause of childhood death after the age of nine years and 95% of these child injuries occur in developing countries," said Ann Veneman, Unicef executive director.
"More must be done to prevent such harm to children."
Urgent action is needed, the organisations said.
"The price of failure is high," Margaret Chan, director general of the WHO, added.
"On current estimates, unintentional injuries claim the lives of around 830,000 children worldwide every year."
Regional differences
Africa has the highest rate for unintentional injury deaths.
Its rate is 10 times higher than that in higher-income countries in Europe, which have the lowest rates of child injury.
But accident-related deaths still account for 40% of all child deaths in developed countries.
Better emergency medical care and rehabilitation services would help, the report said, as would the redesign of toys and playground equipment.
Using seatbelts and helmets, fencing in pools and water, and using child-safe medicine bottles could reduce the rate of accidents, it added.

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Report Sounds Alarm on Child Accidents
http://www.nytimes.com/2008/12/10/health/10injury.html
By DONALD G. McNEIL Jr.
Published: December 9, 2008
画像

Around the globe, accidents kill 830,000 children ― the equivalent of all the children in Chicago ― every year, according to a report issued Tuesday by the World Health Organization and Unicef.

The report, the first to collect all known data on child injuries worldwide, makes broad estimates because many poor countries gather few health statistics, and many children are hurt or killed without ever seeing a doctor. But it relies on the kind of household surveys that have led to more accurate estimates for many health problems, including AIDS deaths.

The major types of fatal injuries are the same worldwide: drowning, burns, traffic accidents, falls and poisoning. But trends vary widely across countries.

Over all, although 95 percent of all injuries to children occur in poor and middle-income countries, injuries account for 40 percent of all child deaths in rich ones.

That is because wealthy countries have better childhood health care, but many fail to do enough about childhood accidents, said Dr. Étienne Krug, director of injuries and violence prevention at the World Health Organization, who oversaw the report.

“This is a huge public health problem, and it’s been ignored for a long time,” Dr. Krug said in a telephone interview. “It’s a combination of ignorance about how big it is, and because of fatalism, of thinking, ‘Oh, it’s an accident, we can’t do anything about it.’ ”

In poor countries, newborns are much more likely to die of birth complications or diseases like pneumonia or measles. But as soon as toddlers learn to walk, accidents rise into the top 10 causes of death; drowning soon edges out meningitis and whooping cough. Wooden covers on wells and narrow-mouthed buckets for drinking water that toddlers cannot tumble into would save thousands of lives, the report said.

Also, about 5,000 children die each year from drinking the kerosene their parents use for cooking; childproof caps would save most of them.

But by the teenage years, road injuries become major killers in poor countries as in rich ones. In the 15 to 19 age group, for example, the leading causes of death are, in order: traffic accidents, suicide, homicide, pneumonia, drowning, tuberculosis, fire, AIDS, leukemia, meningitis, childbirth, falls, poison, abortion and epilepsy.

Only about 2 percent of all child deaths are from war injuries, the report said.

In wealthy countries, indigenous peoples like American Indians, Australian aborigines and New Zealand Maoris have injury rates more than double the country’s average.

In the United States, accidents kill 12,175 children a year ― more than all diseases combined, according to a report from the Centers for Disease Control based on hospital records, which was released in conjunction with the W.H.O. and Unicef report.

Car crashes were the leading cause, except for infants under 1 year of age, who more often died of suffocation, and those age 1 to 4, who more often drowned.

The three changes that would save the most lives of American children, said Ileana Arias, the Centers for Disease Control’s chief of injury prevention, would be for more states to pass “graduated driver’s license” laws, which forbid teenagers to drive at night or with teenage passengers, to enforce seat-belt laws on teenagers and to make all children younger than 8 ride in booster seats.

Domestic fatal injury rates were highest for American Indians, lowest for Asians and about equal for blacks and whites in the United States. Twice as many boys as girls died accidentally.

When the global data are divided by sex, boys die more often than girls in all accidents, except burns. That anomaly occurs, Dr. Krug said, because most burns happen in the kitchen and because girls in Asia are more likely to wear long garments of flammable material. Also, he said, it is impossible to be sure, but some of the burn deaths reported may not have been accidental, but attacks by suitors or families settling scores.

The report emphasizes the growing death toll from road accidents as globalization enriches poorer nations. In many poor countries, the streets are choked with a mix of large trucks, small motorcycles and bicycles and sometimes animal carts, often barely visible to truck drivers because of dust and a lack of daytime running lights. Helmets are not universally used, and it is common to see only a male driver on a moped wearing one while a wife and child sit sidesaddle on the back, bareheaded. Accidents involving overloaded buses, minivans and even dump trucks used to transport people often lead to multiple deaths in a single collision.

Even among rich countries, there are differences. Children killed in road accidents, for example, are most likely to be car passengers in the United States, Australia and Turkey; pedestrians in Britain, Switzerland and South Korea; and bicyclists in the Netherlands.

Some countries were singled out in the report for having done especially well.

Sweden, for example, has cut its death rate for children and teenagers by almost 80 percent since 1969. It did so by diverting traffic away from residential areas and schools, controlling speeders, teaching swimming, fencing pools, requiring helmets and seat belts, improving product safety, having nurses inspect homes and teaching safety at school. The report credited one pediatrician, Dr. Ragnar Berfenstam, with championing the cause.

Canada was praised for having its hospitals gather detailed data on each accident so causes could be addressed. Auditors were able to assess the impact of new bicycle-helmet laws, safer playground equipment and new rules allowing younger hockey players to body check each other. The reports have allowed investigators to assess all-terrain vehicles, trampolines, diving boards and hot-water plumbing.

Canada is the only country to ban baby walkers. It found that children were disproportionately hurt or killed in them.

The report was officially released in Hanoi to recognize Vietnam for making progress, despite its poverty. A year ago, Vietnam passed a mandatory helmet law, sending use over 90 percent. Rumors quickly spread that the helmets caused neck injuries in children and their use dropped. The country countered with a public education campaign and plans to fine drivers whose children were unprotected.

New York City was praised for its “Children Can’t Fly” campaign of the 1970s, which mandated window guards. Deaths from window falls declined by 50 percent in the Bronx at the time.

The report found that dog bites are a more serious problem than had been realized. In China alone, dog ownership, illegal 20 years ago, is now common, as are bite injuries. Children are more likely to be bitten in the head or neck.

In wealthy countries, dog bites are rarely fatal, but where rabies is endemic, including China, India and Africa, it causes about 55,000 deaths a year.

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Preventable injuries kill 2000 children every day
http://www.who.int/mediacentre/news/releases/2008/pr46/en/index.html

10 December 2008 | Geneva/Hanoi/New York -- More than 2000 children die every day as a result of unintentional or accidental injuries. Every year tens of millions more worldwide are taken to hospitals with injuries that often leave them with lifelong disabilities, according to a new report by WHO and UNICEF.

The World report on child injury prevention provides the first comprehensive global assessment of unintentional childhood injuries and prescribes measures to prevent them. It concludes that if proven prevention measures were adopted everywhere at least 1000 children’s lives could be saved every day.

“Child injuries are an important public health and development issue. In addition to the 830 000 deaths every year, millions of children suffer non-fatal injuries that often require long-term hospitalization and rehabilitation," said WHO Director-General Dr Margaret Chan. "The costs of such treatment can throw an entire family into poverty. Children in poorer families and communities are at increased risk of injury because they are less likely to benefit from prevention programmes and high quality health services."

“This report is the result of a collaboration of more than 180 experts from all regions of the world,” said UNICEF Executive Director Ann M. Veneman. “It shows that unintentional injuries are the leading cause of childhood death after the age of nine years and that 95% of these child injuries occur in developing countries. More must be done to prevent such harm to children.”

Africa has the highest rate overall for unintentional injury deaths. The report finds the rate is 10 times higher in Africa than in high-income countries in Europe and the Western Pacific such as Australia, the Netherlands, New Zealand, Sweden and the United Kingdom, which have the lowest rates of child injury.

However, the report finds that although many high-income countries have been able to reduce their child injury deaths by up to 50% over the past 30 years, the issue remains a problem for them, with unintentional injuries accounting for 40% of all child deaths in such countries.

The report finds that the top five causes of injury deaths are:

* Road crashes: They kill 260 000 children a year and injure about 10 million. They are the leading cause of death among 10-19 year olds and a leading cause of child disability.
* Drowning: It kills more than 175 000 children a year. Every year, up to 3 million children survive a drowning incident. Due to brain damage in some survivors, non-fatal drowning has the highest average lifetime health and economic impact of any injury type.
* Burns: Fire-related burns kill nearly 96 000 children a year and the death rate is 11 times higher in low- and middle-income countries than in high-income countries.
* Falls: Nearly 47 000 children fall to their deaths every year, but hundreds of thousands more sustain less serious injuries from a fall.
* Poisoning: More than 45 000 children die each year from unintended poisoning.

“Improvements can be made in all countries,” said Dr Etienne Krug, Director of WHO’s Department of Violence and Injury Prevention and Disability. “When a child is left disfigured by a burn, paralysed by a fall, brain damaged by a near drowning or emotionally traumatized by any such serious incident, the effects can reverberate through the child's life. Each such tragedy is unnecessary. We have enough evidence about what works. A known set of prevention programmes should be implemented in all countries.”

The report outlines the impact that proven prevention measures can have. These measures include:

* laws on child-appropriate seatbelts and helmets;
* hot tap water temperature regulations;
* child-resistant closures on medicine bottles, lighters and household product containers; separate traffic lanes for motorcycles or bicycles;
* draining unnecessary water from baths and buckets;
* redesigning nursery furniture, toys and playground equipment;
* strengthening emergency medical care and rehabilitation services.

It also identifies approaches that either should be avoided or are not backed by sufficient evidence to recommend them. For example, it concludes

* that blister packaging for tablets may not be child resistant;
* that airbags in the front seat of a car could be harmful to children under 13 years;
* that butter, sugar, oil and other traditional remedies should not be used on burns;
* that public education campaigns on their own don't reduce rates of drowning.

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