贵港市农村1～14岁儿童意外中毒危险因素的病例对照研究

A case control study on the risk factors of poisoning among 1～14 years old children in countryside of Guigang city

目的:探讨农村地区儿童发生意外中毒的危险因素,为儿童意外中毒的预防和干预提供科学依据。方法:采用1∶1匹配的病例对照研究方法,对广西贵港市237例因意外中毒而住院或急诊的1～14岁农村儿童和居住于同一地区、性别、年龄匹配的237例对照儿童进行问卷调查。采用单因素和多因素条件Logistic回归模型分析危险因素。结果:单因素条件Logistic回归分析发现父母非第一监护人、母亲低学历、常外出玩耍、经常吃零食、经常吮手、随意放置鼠药或农药、监护频率高、学校有健康教育课程、知晓中毒预防知识、教育儿童卫生饮食10个因素与发生意外中毒有关。多因素条件Logistic回归分析发现母亲低学历(OR=2.134,P=0.003)、父母非第一监护人(OR=3.219,P=0.000)、常外出玩耍(OR=2.172,P=0.000)、经常吮手(OR=2.367,P=0.001)、随意放置鼠药或农药(OR=2.184,P=0.007)5个因素是危险因素;监护频率高(OR=0.570,P=0.007)、学校有健康教育课程(OR=0.327,P=0.011)、知晓中毒预防知识(OR=0.247,P=0.000)3个因素是保护因素。结论:农村地区儿童意外中毒的发生与健康教育、家庭因素、儿童监护、儿童自身危险行为、毒物管理等因素有关。应针对儿童中毒的危险因素制定综合的预防干预措施。

Objective：To investigate the risk factors of poisoning in age 1～14 years old children and to provide scientific evidence for the prevention and control. Methods：1∶1 case-control study was conducted.In the case group,237 rural children who hospitalized or visited the out-patient clinic due to poisoning in Guigang city were included.The children who were dwell on the same village,having same gender and close ages were recruited as matched controls.There were 237 controls in total.Both cases and controls receive questionnaire investigation.The relationship between risk factors and poisoning were analyzed by conditional univariate and multivariate logistic regression. Results：Through conditional univariate analysis,10 factors was identified with unintentional poisoning as follows： parents not as children＇s main guardian,low education background of mother,to play outside regularly,to have snacks commonly,to suck fingers regularly,place raticide or pesticide carelessly,high frequency of guardianship,to have educational courses in school,having knowledge towards poisoning prevention,to educate children not to contact poison,to educate children to have cleaning food and water.Through multivariate logistic regression analysis,we found that 5 risk factors were responsible for the incidence of poisoning as follows： low education background of mother（OR=2.134,P=0.003）,parents not as children＇s main guardian（OR=3.219,P=0.000）,to play outside regularly（OR=2.172,P=0.000）,to suck fingers regularly（OR=2.367,P=0.001）,and place raticide or pesticide carelessly（OR=2.184,P=0.007）.We also distinguished 3 protective factors as follows： high frequency of guardianship（OR=0.570,P=0.007）,to have educational courses in school（OR=0.327,P=0.011）,and having knowledge towards poisoning prevention（OR=0.247,P=0.000）. Conclusion：The occurrence of childhood poisoning accidence in rural area are caused by multiple factors,mainly including health education,family factors,guardianship of children,children＇s risk behaviors,management of bane.We should carry out comprehensive measures to modify the influencing factors of poisoning according to its risk fators.