12 yaş altı çocuklarda ev kazalarına bağlı ölümler: Yaralanma türleri ve aile özellikleri

Öz

AMAÇ: Kaza sonucu ölümler alınabilecek önlemlerle azaltılabilir/önlenebilir ölümler olduğundan adli tıbbın ve koruyucu hekimliğin önemli konuları arasında yer almaktadır. Özellikle yeni hareket kabiliyeti kazanmış bebekler ve oyun çocukları güvenli olması gereken evlerinde kazaya maruz kalmaktadır. Literatürde en sık karşılaşılan ev kazaları düşme, haşlanma, yanma ve zehirlenmelerdir. Bu çalışmanın amacı ailelerin sosyodemografik özelliklerinin, ebeveynin eğitim durumunun ve aile yapısının çocuk ev kazaları sıklığı ve türleri üzerindeki etkisinin araştırılmasıdır. YÖNTEM: Çalışma prospektif olarak tasarlanmış olup Adli Tıp Kurumu İstanbul Morg İhtisas Dairesine otopsi yapılmak üzere gönderilen 12 yaş altı çocuklar çalışmaya dahil edilmiştir. Olay yeri ve otopsi bulguları ile birlikte aile bireylerinden aile yapısı, eğitim durumu ile ilgili alınan bilgilerle çalışma grubu oluşturulmuştur. BULGULAR: Bir yıllık zaman dilimi içerisinde ev ortamında meydana gelmiş kaza sonucu ölen 31’i erkek, 22’si kız olmak üzere 53 çocuk olgu otopsi yapılmak üzere gönderilmiştir. Ortalama yaş 4,32± 2,95 olarak bulunmuştur. Olaylar çocuğun kendi eylemi ÇKE ve çocuktan bağımsız ÇB olmak üzere iki ana grup altında değerlendirilmiştir. ÇKE sonucu meydana gelen kazalarda annenin yaş ortalaması 28,82±5,68, babanın yaş ortalaması ise 33,26±5,65’tir. ÇKE sonucu oluşan kaza grubunda düşme en sık görülen kaza türü olmuştur n=20, %37,7 tüm gruplarda, ÇKE grubunda %58,8 . Yüksekten düşmeler ilkbahar ve yaz mevsiminde daha sık görülmüştür. Çocuğun cinsiyeti ile olay türü arasında istatistiksel anlamlı bir ilişki bulunmazken ailenin düşük eğitim düzeyi ile olay türü arasında anlamlı bir ilişki bulunmuştur. Düşük eğitim düzeyli ailelerde yüksekten düşmeler diğer gruplara göre fazla sayıda bulunmuştur. annesi çalışan çocukların yaş ortalaması anlamlı düzeyde yüksek bulunmuştur ancak annenin çalışma durumu ile olay türü arasında anlamlı bir ilişki bulunamamıştır. SONUÇ: Sıcak havalarda evlerdeki açık balkon kapıları ve pencereler çocuklar için önemli bir risk faktörüdür. Küçük çocuk yaşı yüksekten düşmeler için bir risk faktörü olarak bulunmuştur. Erken çocukluk döneminde dengesiz motor aktiviteleri ve motor gelişim seviyesinin yetersizliği bunun sebebi olarak düşünülmüştür. Çalışmanın sonucu olarak çocukların korunması ve evlerde kazalara karşı alınabilecek tedbirler konusunda ailelerin eğitilmesinin ev ortamında çocukların geçireceği kazaları azaltmada en önemli faktör olduğu düşünülmüştür. Kaza sonucu çocuk ölümlerinin engellenmesinde ilk basamak ailelerin ev ortamındaki tehlikelerin farkında olmasının sağlanmasıdır.

Anahtar Kelimeler

• Ev kazaları
• çocuk
• aile yapısı
• ailelerin eğitim düzeyi

Deaths due to household injuries among children under 12 years of age: Injury type and family characteristics

Öz

INTRODUCTION: Accidental deaths are important subjects of Forensic Medicine and Preventive Medicine that are preventable / reducible causes of death with taking necessary measures. Especially babies, newly acquiring moving abilities and toddlers have accidents in their houses where they are supposed to be safe. In the literature most encountered injury types of household accidents are due to falls from height, scalds, burns and intoxications. Aim of this study is to determine effects of socio-demographic characteristics of families, parental education degrees and family structure on frequencies and types of childhood domestic accidents.METHODS: Study designed as a prostective study. Case group include the pediatric autopsy cases, under 12 years old, of Istanbul Morgue Department of Council of Forensic Medicine. With death scene and autopsy findings; family structure and educational status information that taken from the relatives were evaluated.RESULTS: Incident types evaluated in two main groups: Own action of child OAC and Independent from child’s action IfCA . In OAC group mean age of mothers were 28.82 ± 5.68 years range 15 to 43 , fathers mean age was found 33.26 ± 5.65 years range 22 to 44 . In one year period 53 child death cases including 31 boys and 22 girls with a mean age of 4.32 ± 2.95 were referred to determine the cause of death after a household accident. Falls from height n=20, 37.7% in all groups and 58.8% in OAC group was the most common accident type in OAC group. Falls from heights were common in spring and summer seasons. There was no significant relationship between sex of child and accident type. But there was a statistically significant relationship between low parental education degree and accident type. In the low educated parent group falls from heights were more frequent than other groups. Ages of children were found significantly higher in the group whose mothers were employed and there was no relationship between mother employment and accident type.CONCLUSION: These findings showed us that opened windows or balcony doors in warm weather were important risk factors for childhood accidental injuries. Low child age was found as a risk factor for falls from heights. In early childhood motor immaturity with imbalanced motor activities, were thought to be the most important factor on this finding. As a conclusion educating families about childcare and about measures should be taken to avoid accidents, was thought to be the most important factor on decreasing childhood accidental injuries. First step of preventing accidental childhood injuries is increasing the awareness of parents about dangers in the household environment.

Anahtar Kelimeler

• Household accidental death
• child
• family structure
• education status of parents

Kaynakça

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