摘要：Objectives. We investigated the risk of nonfatal injury in US children with disabilities. Disability was defined as a long-term reduction in the ability to conduct social role activities, such as school or play, because of a chronic physical or mental condition. Methods. Among 57 909 children aged 5–17 years who participated in the 2000–2002 National Health Interview Survey, we identified 312 children with vision/hearing disabilities, 711 with mental retardation, 603 with attention-deficit/hyperactivity disorder (ADD/HD), and 403 with chronic asthma. We compared nonfatal injuries in the past 3 months between children with disabling conditions and those without using injury rates and logistic regression analyses. Results. Compared with children without a disability, a higher percentage of children with disabilities reported nonfatal injuries (4.2% for vision disability, 3.2% for mental retardation, 4.5% for attention-deficit/hyperactivity disorder, and 5.7% for asthma vs 2.5% for healthy children). After we controlled for confounding effects of sociodemographic variables, children with disabilities, with the exception of mental retardation, had a statistically significantly higher injury risk than those without disabling conditions. Conclusions. Children with a disabling condition from vision/hearing disability, ADD/HD, or chronic asthma had a significantly higher risk for nonfatal injuries compared with children without a disabling condition. These data underscore the need to promote injury control and prevention programs targeting children with disabilities. Disability ranks as a major public health problem affecting an estimated 54 million people, or nearly 20% of the population, in the United States. 1 – 5 Studies have estimated that among school-age children, 5 – 17 5.5% have school-related disabilities and an additional 2.0% have limitations in nonschool activities. 6 National data indicate that from 1990 to 1994, disability rates increased by 33% among girls and 40% among boys aged younger than 18 years. 7 Many factors have caused these dramatic increases, including biomedical advances enabling more children to survive and more disabled children to live longer, epidemics of chronic conditions as a result of changes in children’s lifestyles (e.g., overweight and asthma), more early detection of chronic diseases, and improved awareness of disabilities. 4 Disabled persons are believed to face a higher injury risk than their healthy counterparts because of their deficiencies in gait/motor control, impairments in mental processing, and the potential side effects of medications used to treat their condition(s). 8 – 14 In recent years, injury risk and injury prevention among disabled children has received attention from the public health community. Attention-deficit/hyperactivity disorder (ADD/HD) has been associated with an elevated risk of general injury, burn injury, traumatic brain injury, and automobile injury events. 12 , 14 – 19 Children with mental or developmental disabilities were also found to be significantly more likely to experience a nonfatal injury than their peers without disabilities. 8 , 10 , 11 , 20 Furthermore, 1 study found that injuries suffered by disabled children tended to be more severe compared with injuries among children with no disability. 9 Although injury risk among children with disabilities has been investigated by these studies, the problem of nonfatal injury risk and injury prevention in this vulnerable population has not been researched to the extent that the magnitude of the problem requires. Legood et al. investigated visual impairment and injury risk and concluded that sound epidemiological study of injury risk among individuals with visual impairment has never been done. 21 Sherrard et al. also recognized in a recent literature review that not enough injury studies have included people with an intellectual disability. 22 Using nationally representative data from the 2000–2002 National Health Interview Survey (NHIS), we sought to provide a current profile of nonfatal injuries among children with disabling conditions.
