Περίληψη:
We used a case-crossover design to evaluate short-term effects of
several exposures on the risk of childhood accident. One hundred
fifty-six hospitalized children with injuries responded to an
interviewer-administered questionnaire that included, among other
variables, information concerning transient exposures that had
terminated within 26 hours before the occurrence of the accident. We
considered the 2-hour interval preceding the accident as the likely
effect period and made within-individual comparisons between this period
and the remaining 2-hour intervals during which the child was awake. We
used conditional logistic regression analyses to evaluate the effect of
the transient exposures on the occurrence of childhood accidents. We
present univariate and multivariate analyses adjusting for possible
within-person confounding by exposure to more than one exposure
simultaneously and for clock time. The adjusted odds ratios (ORs) and
95% confidence intervals (CIs) were as follows: for strenuous physical
activity, OR = 24.2, 95% CI = 10.8-54.4; for intellectual exertion, OR
= 9.0, 95% CI = 1.9-25.8; for involvement in family quarrels, OR = 2.6,
95% CI = 0.4-16.9; for school examination, OR = 3.8, 95% CI = 1.5-9.4;
and for a pleasing event, OR = 3.4, 95% CI = 1.5-8.2. Other transient
exposures were not associated with increased accident risk. Comparison
of the overall frequency of reported transient events between the first
of the control intervals (3rd and 4th hours before the accident) and the
2-hour interval covering the 25th and 26th hours before the accident
suggested that information bias may have led to slight overreporting of
transient exposures during the period most proximal to the accident;
this bias, however, was too small to explain the marked risk elevations
associated with the indicated transient exposures. We conclude that
several transient exposures are important component causes in the
occurrence of childhood accidents.
Συγγραφείς:
Petridou, E
Mittleman, MA
Trohanis, D
Dessypris, N and
Karpathios, T
Trichopoulos, D