1990-2019年浙江省道路交通伤害疾病负担变化趋势研究

Trend of disease burden caused by road traffic injury in Zhejiang, 1990−2019

  • 摘要:
    目的 分析1990—2019年浙江省道路交通伤害疾病负担及其变化趋势,为制定更适用于浙江省的道路交通伤害防控措施提供依据。
    方法 利用2019年全球疾病负担(GBD 2019)数据,采用死亡率、伤残调整寿命年(DALY)率、过早死亡损失寿命年(YLL)率和伤残损失寿命年(YLD)率等指标评估道路交通伤害疾病负担,并与全国、世界不同社会人口学指数(SDI)地区进行横向比较。 应用Joinpoint软件计算各指标的平均年度变化百分比(AAPC)。
    结果 1990—2019年浙江省道路交通伤害标化死亡率、标化DALY率和标化YLL率均呈下降趋势(AAPC=−2.02%、−1.74%、−2.66%,均P<0.001),但标化YLD率呈上升趋势(AAPC=1.24%,P<0.001)。 2019年浙江省道路交通伤害标化死亡率和标化DALY率分别为11.25/10万和681.13/10万,人行道路伤害居首位,男性标化死亡率(15.83/10万)、标化YLL率(632.49/10万)、标化YLD率(264.04/10万)、标化DALY率(896.53/10万)均高于女性(分别为6.70/10万、255.93/10万、197.83/10万和453.78/10万)。 与1990年相比,2019年0岁年龄组儿童伤害死亡率、YLL率、DALY率下降幅度最大(男性分别为79.60%、79.59%和79.51%,女性分别为78.35%、78.34%和78.27%),80岁及以上年龄组男性道路交通伤死亡率上升了25.32%,且2019年≥60岁男性、≥65岁女性的DALY率均超过1990年。 与不同地区的横向比较发现,浙江省道路交通伤害疾病负担处于相对较低水平(标化YLL率最低,标化死亡率和标化DALY率仅高于高SDI地区)。
    结论 浙江省道路交通伤害疾病负担总体呈下降趋势,横向比较处于较低水平,但也存在标化YLD率上升,高年龄组、男性疾病负担较重等问题。 应继续加强道路交通伤害的预防与控制,进一步降低浙江省道路交通伤害疾病负担。

     

    Abstract:
    Objective To analyze the disease burden caused by road traffic injury and its changing trend in Zhejiang province from 1990 to 2019 and provide evidence for the development of more appropriate prevention and control measures for road traffic injury in Zhejiang.
    Methods By using the data of Global Burden of Disease 2019 (GBD 2019), the burden of road traffic injury was evaluated by mortality, disability-adjusted life years (DALY) rate, years of life lost (YLL) due to premature mortality rate and years lived with disability (YLD) rate, and compared with the areas in China and the regions in the world with different socio-demographic index (SDI). Software Joinpoint was used to calculate the average annual percent change (AAPC) of each indicator.
    Results From 1990 to 2019, the age-standardized mortality, age-standardized DALY rate and age-standardized YLL rate of road traffic injury in Zhejiang showed a downward trend (AAPC = −2.02%, −1.74% and −2.66%, all P<0.001), but the age-standardized YLD rate showed an upward trend (APCC=1.24%, P<0.001). In 2019, the age-standardized mortality and age-standardized DALY rate of road traffic injury in Zhejiang were 11.25/100 000 and 681.13/100 000, respectively. The mortality rate of pedestrian road injury ranked first. The age-standardized mortality rate (15.83/100 000), age-standardized YLL rate (632.49/100 000), age-standardized YLD rate (264.04/100 000) and age-standardized DALY rate (896.53/100 000) in men were higher than those in women (6.70/100 000, 255.93/100 000, 197.86/100 000 and 453.78/100 000). Compared with 1990, the mortality, YLL and DALY rates in children aged 0 years decreased most obviously in 2019 (79.60%, 79.59% and 79.51% in boys, and 78.35%, 78.34% and 78.27% in girls), while the mortality rate of road traffic injury in men aged ≥80 years increased by 25.32%. In addition, the DALY rates of road traffic injury in men aged ≥60 years and in women aged ≥65 years were higher in 2019 than in 1990. The cross-regional comparison showed that the disease burden level of road traffic injury in Zhejiang was relatively low, the age-standardized YLL rate was lowest and only the age-standardized mortality and DALY rates were higher than those in high SDI areas.
    Conclusion The disease burden level of road traffic injury in Zhejiang showed decline trend, and the cross-regional comparison indicated a relatively low level. However, there were also problems such as the increased age-standardized YLD rate, and the higher level of disease burden in old age group and in men. It is still necessary to strengthen the prevention and control of road traffic injury to further reduce the related disease burden in Zhejiang.

     

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