| Background China currently has the highest burden of fall-related injury-related diseases in the world,resulting in about twice the annual loss of disability life in the rest of the world.In recent years,with the attention to global climate change and the rise of medical meteorology,the impact of meteorological factors on fall-related injuries has also begun to attract attention,but there is still a lack of relevant research in China.Objectives The purpose of this study is to investigate the epidemiological characteristics of fall-related injury of the outpatient and emergency department in Ma'anshan city,focus on the relationship between fall-related injury and meteorological factors,carry out the fall-related injury prediction research.The purpose is to achieve injury warning and prevention guidelines,to provide scientific basis for reducing the incidence of injury.Methods Data on fall-related injury from 2007 to 2015 in three national injury sentinel hospitals in Anhui Province,China(People's Hospital of Ma'anshan,the Central Hospital of Ma'anshan,and Ma'anshan Shiqiye Hospital)were collected.Meteorological data of Ma'anshan city during the same period were collected.The injury information mainly includes: age,gender,household registration,education level,occupation,time/place of injury occurrence and so on.The negative binomial regression model was used to quantitatively evaluate the relationship between meteorological factors and unintentional fall-related injury,and the predictive effect of the model was testedResults A total of 30,614 unintentional fall-related injuries were captured over the study period in Ma'anshan.There were 18,799 males reported the unintentional fall-related injuries compared to 11,815 females,with the male/female ratio was 1.59:1.There were24,774 cases <60 years old and 5,840 cases ? 60 years old,most of which were under 60 years old.The education level of the cases of unintentional fall-related injuries reported by surveillance was dominated by junior high school students and below(75.97%),and the occupations were dominated by school students(19.39%),production and transportation equipment operators(15.27%),and retirees(14.06%)In addition,the number of cases in the total population and each subgroups showed an overall rising trend during the study period.Unintentional fall-related injury distribution characteristics: June is the peak month,and the 24 h time point distribution shows a bimodal distribution,reaching the first and second peaks at 10:00 and 17:00 respectively.Injuries were common in the home(33.24%),highway/street(17.10%)and public housing(16.33%).Housework was the most common injury activity(45.22%),and the proportion was higher in women than in men(52.05% vs.40.93%).Contusions and abrasions(46.99%)were the most common injuries,followed by fractures(18.88%).Injury part of body were mainly the head(34.26%),lower limbs(29.89%),upper limbs(19.20%)and trunk(12.02%).The injury severity were mainly mild(67.81%)and moderate(30.17%),with discharged after outpatient and emergency treatment as the main outcome(79.32%).Comparative analysis showed that continuous high temperature(heat wave)and heavy rain are associated with increased unintentional fall-related injuries,but not with high temperature,cold wave.The negative binomial regression analysis found that snow depth,maximum temperature,average wind speed,sunshine duration and minimum relative humidity were related to the occurrence of unintentional fall-related injuries.Analysis of the total population found a 5.6% increase in unintentional fall-related injuries for every 1cm increase in snow depth.For every 1°C increase in maximum temperature,unintentional unintentional fall-related injuries increased by 1.6%.Mean wind speed(m/s),hours of sunshine(h),and minimum relative humidity(%)were negatively correlated with unintentional fall-related injuries(5.9%,3.1%,and 0.5%,respectively,for each unit increase of each indicator).A subgroup analysis found that the association was stronger for maximum temperature,mean wind speed,hours of sunshine and minimum relative humidity in men and in the <60 years age group.However,for snow depth,there was a stronger correlation for women and the ?60 years age group.As for the severity of the injury,the results varied among the subgroups.Evaluation of model prediction effect: the negative binomial regression model has a good prediction effect on the number of unintentional fall-related injuries.The prediction accuracy of the number of unintentional fall-related injuries in the total population was 71.50%,and the prediction accuracy was higher for the <60 year old,male,and moderate severe unintentional fall-related injuries(male vs.female: 70.63%vs.68.60%;<60 vs.? 60 years old: 69.92% vs.66.71%;Moderate/severe vs.mild:64.83% vs.60.51%).Conclusion From 2007 to 2015,the number of cases of unintentional fall-related injuries in Ma'anshan city,Anhui province was higher and on the rise.Meteorological factors associated with the occurrence of unintentional fall-related injuries include snow depth,maximum temperature,average wind speed,hours of sunshine,and minimum relative humidity.There were differences in the sensitivity of different age,sex and injury severity groups to meteorological factors.The subgroup analysis found that men and age groups < 60 were more susceptible to changes in maximum temperature,average wind speed,sunshine duration and minimum relative humidity,while women and age groups ?60 were more susceptible to changes in snow depth.Continued high temperatures(heat waves)and heavy rain are associated with increased unintentional fall-related injury.The results show that the model has a good prediction effect on the number of cases,which will help to provide a basis for the prediction and warning of unintentional fall-related injuries based on meteorological factors in the future.Therefore,attention should be paid to the formulation and implementation of prevention strategies in the future. |
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