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Article(id=1320442629872009641, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320442616123081022, articleNumber=null, orderNo=null, doi=10.11847/zgggws1146514, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1732636800000, receivedDateStr=2024-11-27, revisedDate=1754928000000, revisedDateStr=2025-08-12, acceptedDate=1756310400000, acceptedDateStr=2025-08-28, onlineDate=1792747655598, onlineDateStr=2026-10-23, pubDate=1767974400000, pubDateStr=2026-01-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792747655598, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792747655598, creator=13701087609, updateTime=1792747655598, updator=13701087609, issue=Issue{id=1320442616123081022, tenantId=1146029695717560320, journalId=1319373219989389464, year='2026', volume='42', issue='1', pageStart='1', pageEnd='128', issueExtLink='null', onlineDate='null', pubDate='1767974400000', pubDateStr='2026-01-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792747652321, creator='13701087609', updateTime=1792748136930, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320444648791851086, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320442616123081022, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320444648791851087, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320442616123081022, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=76, endPage=82, ext={EN=ArticleExt(id=1320442630056559018, articleId=1320442629872009641, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Epidemiological characteristics of fatal drowning and related factors in children and adolescents aged 0–17 years in Chongqing, 2022, columnId=1320427686514770171, journalTitle=Chinese Journal of Public Health, columnName=Survey and Report, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the epidemiological characteristics and related influencing factors of fatal drowning in children and adolescents aged 0–17 years in Chongqing, thus providing evidence for the prevention and control of fatal drowning in this population.

Methods

The Child Drowning Death Questionnaire designed by the Chronic Disease Center of Chinese Center for Disease Control and Prevention was adopted to collect case information of fatal drowning in children and adolescents aged 0–17 years in Chongqing, 2022 by medical history/death record review, telephone interviews, household surveys, and home visits. The investigation comprised three essential components: basic information, drowning death accident information, and drowning death accident investigation process information.

Results

In 2022, the drowning mortality of children and adolescents aged 0–17 years in Chongqing was 3.36/100 000 (standardized mortality of 3.42/100 000). The drowning mortality was higher in boys (4.64/100 000) than in girls (1.93/100 000) and higher in rural areas (4.19/100 000) than in urban areas (1.09/100 000). It was the highest among adolescents aged 15–17 years (5.66/100 000). There were differences in the places of fatal drowning among children of different ages (χ2 = 59.918, P < 0.001), with those over 10 years old mostly occurring in natural water bodies, and those under 10 years old primarily happening in public water storage areas. There was no significant difference (P > 0.05) in injury intention of fatal drowning among children of different sexes (χ2 = 3.866) and ages (χ2 = 7.021). Most (90.82%) of fatal drowning in children was unintentional, of which 4.26% were skilled swimmers; 0.53% took preventive measures; and 2.70% were effectively cared for (with an adult caregiver, uninterrupted care for nothing else and at arm′s length). On-site first aid mainly consisted of passers-by and adult caregivers, mainly cardiopulmonary resuscitation (CPR). However, the cases with time interval from drowning to CPR being ≤ 5 min only accounted for 6.76%.

Conclusions

The drowning mortality is high among children and adolescents in Chongqing, and special attention should be paid to the prevention of drowning in boys and rural areas. Attention be focused on the investigation and management of dangerous waters in rural areas, the swimming skill and water safety education for children and adolescents, the nursing awareness and nursing skill training of adult caregivers, the application of intelligent monitoring system in key waters, and the popularization of first aid technology.

, authors=Rongkun WU1, Jiashi TANG2, Yong ZHANG1, Xianbin DING3, Xianxian YANG3, authorsList=Rongkun WU, Jiashi TANG, Yong ZHANG, Xianbin DING, Xianxian YANG, authorCompany=null, correspAuthors=Xianxian YANG, authorNote=null, correspAuthorsNote=
YANG Xianxian, E-mail:
, copyrightStatement=Copyright © 2026 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1320442630408880555, articleId=1320442629872009641, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=2022年重庆市0～17岁儿童溺水死亡流行病学特征及相关因素：一项回顾性调查, columnId=1320427686770622717, journalTitle=中国公共卫生, columnName=调查报告与分析, runingTitle=null, highlight=null, articleAbstract=
目的

了解重庆市0～17岁儿童致死性溺水流行病学特征及相关影响因素，为开展儿童致死性溺水防控工作提供依据。

方法

采用中国疾病预防控制中心慢病中心制定的“儿童溺水死亡调查表”，通过病史/死亡调查记录查询、电话调查、入户调查、走访等方式收集2022年重庆市因溺水死亡的0～17岁儿童青少年个案信息。调查内容包括儿童青少年溺水死亡基本信息、溺水死亡事故信息、溺水死亡事故调查过程信息3个部分。

结果

2022年重庆市0～17岁儿童青少年溺水死亡率为3.36/10万（标化死亡率为3.42/10万）。溺水死亡率男童（4.64/10万）高于女童（1.93/10 万），农村（4.19/10万）高于城市（1.09/10万），15～17岁青少年溺水死亡率最高（5.66/10万）。儿童溺水致死场所随年龄而异（χ2=59.918，P<0.001），10岁以上多发生在开放性自然水域，而10岁以下多发生在公共蓄水设施。不同性别、年龄儿童致死性溺水的伤害意图差异无统计学意义（χ2=3.866、7.021，P>0.05）。90.82%儿童致死性溺水为非故意溺水，其中4.26%会熟练游泳，0.53%采取了防护措施，2.70%有有效看护（有成年看护人、看护不间断未做其他事情且看护距离在一臂之内），现场急救以路人和成年看护人为主，主要措施是心肺复苏，但发生溺水到获得心肺复苏的时间间隔≤5 min仅占6.76%。

结论

重庆市儿童青少年溺水死亡率高，应持续加强男童、农村地区的防溺水工作。应重点加强农村危险水域排查与管理、儿童青少年游泳技能和水上安全教育、成年看护人看护意识提升和看护技巧培训、重点水域智能监控系统应用以及急救技术普及等工作。

, authors=吴荣昆1, 唐佳诗2, 张雍1, 丁贤彬3, 杨弦弦3, *, *, authorsList=吴荣昆, 唐佳诗, 张雍, 丁贤彬, 杨弦弦, authorCompany=null, correspAuthors=杨弦弦, authorNote=

吴荣昆（1992—），医师，硕士，研究方向：少儿卫生与妇幼保健

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杨弦弦，E-mail：
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吴荣昆（1992—），医师，硕士，研究方向：少儿卫生与妇幼保健

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Drowning mortality among children and adolescents with different sexes, ages, and geographical areas in Chongqing, 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
人口特征　分类构成比/%死亡率/（1/10万）标化死亡率/（1/10万）
性别　男童72.954.644.72
　女童27.051.931.91
年龄组/岁　 0～<518.362.612.55
　 5～<1016.421.951.95
　10～<1534.303.883.88
　15～1730.925.665.66
地区　城市8.701.090.96
　农村91.304.193.59
合计100.003.363.42
), ArticleFig(id=1320442634682876377, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320442629872009641, language=CN, label=表1, caption=

2022年重庆市不同性别、年龄和地区的儿童青少年溺水死亡情况

, figureFileSmall=null, figureFileBig=null, tableContent=
人口特征　分类构成比/%死亡率/（1/10万）标化死亡率/（1/10万）
性别　男童72.954.644.72
　女童27.051.931.91
年龄组/岁　 0～<518.362.612.55
　 5～<1016.421.951.95
　10～<1534.303.883.88
　15～1730.925.665.66
地区　城市8.701.090.96
　农村91.304.193.59
合计100.003.363.42
), ArticleFig(id=1320442634745790938, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320442629872009641, language=EN, label=Tab.2, caption=

Intent classification of fatal drowning incidents among children and adolescents in Chongqing, 2022 (%)

, figureFileSmall=null, figureFileBig=null, tableContent=
伤害意图性别 a年龄组/岁 a合计
男童女童0～<55～<1010～<1515～17
非故意溺水92.7285.7194.7494.1287.3290.6390.82
自己故意溺水2.658.930.000.005.637.814.35
他人故意溺水0.000.000.000.000.000.000.00
意图不确定溺水4.635.365.265.887.051.664.83
), ArticleFig(id=1320442634821288411, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320442629872009641, language=CN, label=表2, caption=

2022年重庆市儿童青少年致死性溺水伤害意图分类（构成比/%）

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伤害意图性别 a年龄组/岁 a合计
男童女童0～<55～<1010～<1515～17
非故意溺水92.7285.7194.7494.1287.3290.6390.82
自己故意溺水2.658.930.000.005.637.814.35
他人故意溺水0.000.000.000.000.000.000.00
意图不确定溺水4.635.365.265.887.051.664.83
), ArticleFig(id=1320442634909368796, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320442629872009641, language=EN, label=Tab.3, caption=

Distribution of fatal drowning incidents among children and adolescents aged in Chongqing, 2022 (%)

, figureFileSmall=null, figureFileBig=null, tableContent=
水体类型性别 a年龄组/岁 a合计
男童女童0～<55～<1010～<1515～17
开放性自然水域50.3346.437.8932.3567.6062.5049.27
公共蓄水设施42.3846.4365.8064.7128.1735.9443.48
家用蓄水容器2.655.3615.790.000.001.563.38
公共商业娱乐活动水域2.651.785.262.942.820.002.42
其他1.990.005.260.001.410.001.45
), ArticleFig(id=1320442635001643485, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320442629872009641, language=CN, label=表3, caption=

2022年重庆市儿童青少年致死性溺水场所分布（构成比/%）

, figureFileSmall=null, figureFileBig=null, tableContent=
水体类型性别 a年龄组/岁 a合计
男童女童0～<55～<1010～<1515～17
开放性自然水域50.3346.437.8932.3567.6062.5049.27
公共蓄水设施42.3846.4365.8064.7128.1735.9443.48
家用蓄水容器2.655.3615.790.000.001.563.38
公共商业娱乐活动水域2.651.785.262.942.820.002.42
其他1.990.005.260.001.410.001.45
), ArticleFig(id=1320442635089723870, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320442629872009641, language=EN, label=Tab.4, caption=

Distribution of factors associated with unintentional drowning among children and adolescents in Chongqing, 2022 (%)

, figureFileSmall=null, figureFileBig=null, tableContent=
相关因素性别 a年龄组/岁a合计
男童女童0～<55～<1010～<1515～17
儿童游泳能力
　会熟练游泳5.002.080.000.004.838.624.26
　会游泳、不熟练23.574.172.783.1316.1339.6618.62
　不会游泳55.7287.5088.8990.6253.2344.8363.83
　不详15.716.258.336.2525.816.8913.29
防护措施
　儿童有防护措施0.710.000.000.000.001.720.53
　溺水发生地有防护措施37.1427.0927.7837.5035.4836.2134.58
　两者皆有0.710.000.000.000.001.720.53
　两者皆无53.5864.5861.1159.3853.2355.1856.38
　不详7.868.3311.113.1211.295.177.98
看护措施
看护人类型 b
　成年人20.0018.7544.4418.7511.2913.7919.68
　未成年人23.5727.095.5631.2537.1018.9724.47
　无看护人50.0045.8347.2246.8740.3260.3448.94
　不详6.438.332.783.1311.296.906.91
看护行为
　看护同时做其他事情32.1440.0037.5066.6614.2925.0026.00
　看护中断14.2930.0018.750.0028.5712.5012.00
　两者皆有14.2910.0025.0016.670.000.0030.00
　两者皆无7.140.000.000.0028.570.006.00
　不详32.1420.0018.7516.6728.5762.5026.00
看护距离
　一臂之内3.570.000.000.000.0012.502.70
　视线范围内35.7133.3312.5033.3385.7137.5035.14
　视线范围外53.5744.4568.7550.0014.2950.0051.35
　不详7.1522.2218.7516.670.000.0010.81
急救措施
现场第一急救人员类型
　成年看护人29.3125.0031.2547.0622.7315.7928.38
　未成年人12.070.006.255.889.0915.799.46
　路人27.5950.0025.0017.6545.4536.8432.43
　救生员10.340.006.255.889.0910.538.11
　医务人员18.9718.7518.7523.5313.6421.0518.92
　其他1.726.2512.500.000.000.002.70
现场急救措施
　心肺复苏51.7262.5056.2564.7250.0047.3754.05
　控水12.076.2518.755.884.5515.7910.81
　人工呼吸/其他6.906.2518.755.880.005.266.76
　无22.4112.500.0011.7636.3626.3220.27
　不详6.9012.506.2511.769.095.268.11
发生溺水到获得心肺复苏的时间间隔/min
　未获得20.6825.006.2511.7645.4415.7921.62
　≤56.906.2512.5011.764.550.006.76
　6～106.906.250.0011.7613.640.006.76
　11～2525.8625.0043.7511.764.5547.3725.68
　>2527.5918.7525.0047.0713.6421.0525.68
　不详12.0718.7512.505.8918.1815.7913.50
), ArticleFig(id=1320442635194581471, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320442629872009641, language=CN, label=表4, caption=

2022年重庆市儿童青少年非故意致死性溺水相关因素分布（构成比/%）

, figureFileSmall=null, figureFileBig=null, tableContent=
相关因素性别 a年龄组/岁a合计
男童女童0～<55～<1010～<1515～17
儿童游泳能力
　会熟练游泳5.002.080.000.004.838.624.26
　会游泳、不熟练23.574.172.783.1316.1339.6618.62
　不会游泳55.7287.5088.8990.6253.2344.8363.83
　不详15.716.258.336.2525.816.8913.29
防护措施
　儿童有防护措施0.710.000.000.000.001.720.53
　溺水发生地有防护措施37.1427.0927.7837.5035.4836.2134.58
　两者皆有0.710.000.000.000.001.720.53
　两者皆无53.5864.5861.1159.3853.2355.1856.38
　不详7.868.3311.113.1211.295.177.98
看护措施
看护人类型 b
　成年人20.0018.7544.4418.7511.2913.7919.68
　未成年人23.5727.095.5631.2537.1018.9724.47
　无看护人50.0045.8347.2246.8740.3260.3448.94
　不详6.438.332.783.1311.296.906.91
看护行为
　看护同时做其他事情32.1440.0037.5066.6614.2925.0026.00
　看护中断14.2930.0018.750.0028.5712.5012.00
　两者皆有14.2910.0025.0016.670.000.0030.00
　两者皆无7.140.000.000.0028.570.006.00
　不详32.1420.0018.7516.6728.5762.5026.00
看护距离
　一臂之内3.570.000.000.000.0012.502.70
　视线范围内35.7133.3312.5033.3385.7137.5035.14
　视线范围外53.5744.4568.7550.0014.2950.0051.35
　不详7.1522.2218.7516.670.000.0010.81
急救措施
现场第一急救人员类型
　成年看护人29.3125.0031.2547.0622.7315.7928.38
　未成年人12.070.006.255.889.0915.799.46
　路人27.5950.0025.0017.6545.4536.8432.43
　救生员10.340.006.255.889.0910.538.11
　医务人员18.9718.7518.7523.5313.6421.0518.92
　其他1.726.2512.500.000.000.002.70
现场急救措施
　心肺复苏51.7262.5056.2564.7250.0047.3754.05
　控水12.076.2518.755.884.5515.7910.81
　人工呼吸/其他6.906.2518.755.880.005.266.76
　无22.4112.500.0011.7636.3626.3220.27
　不详6.9012.506.2511.769.095.268.11
发生溺水到获得心肺复苏的时间间隔/min
　未获得20.6825.006.2511.7645.4415.7921.62
　≤56.906.2512.5011.764.550.006.76
　6～106.906.250.0011.7613.640.006.76
　11～2525.8625.0043.7511.764.5547.3725.68
　>2527.5918.7525.0047.0713.6421.0525.68
　不详12.0718.7512.505.8918.1815.7913.50
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2022年重庆市0～17岁儿童溺水死亡流行病学特征及相关因素：一项回顾性调查
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吴荣昆 1 , 唐佳诗 2 , 张雍 1 , 丁贤彬 3 , 杨弦弦 3, *, *
中国公共卫生 | 调查报告与分析 2026,42(1): 76-82
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中国公共卫生 |调查报告与分析 2026 , 42 (1) : 76 -82
2022年重庆市0～17岁儿童溺水死亡流行病学特征及相关因素：一项回顾性调查
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吴荣昆1, 唐佳诗2, 张雍1, 丁贤彬3, 杨弦弦3, *, *
作者信息
  • 1重庆市渝中区疾病预防控制中心慢病科，重庆 400010
  • 2西南医科大学公共卫生学院，泸州 646099
  • 3重庆市疾病预防控制中心慢病所，重庆 400042
通讯作者:
杨弦弦，E-mail：
作者简介:

吴荣昆（1992—），医师，硕士，研究方向：少儿卫生与妇幼保健

Epidemiological characteristics of fatal drowning and related factors in children and adolescents aged 0–17 years in Chongqing, 2022
Rongkun WU1, Jiashi TANG2, Yong ZHANG1, Xianbin DING3, Xianxian YANG3
Affiliations
  • 1Department of Chronic Diseases, Yuzhong District Center for Disease Control and Prevention, Chongqing 400010, China
  • 2School of Public Health, Southwest Medical University, Luzhou 646099, China
  • 3Chronic Disease Institute of Chongqing Center for Disease Control and Prevention, Chongqing 400042, China
    • Corresponding Author:
    YANG Xianxian, E-mail:
出版时间: 2026-01-10 doi: 10.11847/zgggws1146514
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摘要
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目的

了解重庆市0～17岁儿童致死性溺水流行病学特征及相关影响因素，为开展儿童致死性溺水防控工作提供依据。

方法

采用中国疾病预防控制中心慢病中心制定的“儿童溺水死亡调查表”，通过病史/死亡调查记录查询、电话调查、入户调查、走访等方式收集2022年重庆市因溺水死亡的0～17岁儿童青少年个案信息。调查内容包括儿童青少年溺水死亡基本信息、溺水死亡事故信息、溺水死亡事故调查过程信息3个部分。

结果

2022年重庆市0～17岁儿童青少年溺水死亡率为3.36/10万（标化死亡率为3.42/10万）。溺水死亡率男童（4.64/10万）高于女童（1.93/10 万），农村（4.19/10万）高于城市（1.09/10万），15～17岁青少年溺水死亡率最高（5.66/10万）。儿童溺水致死场所随年龄而异（χ2=59.918，P<0.001），10岁以上多发生在开放性自然水域，而10岁以下多发生在公共蓄水设施。不同性别、年龄儿童致死性溺水的伤害意图差异无统计学意义（χ2=3.866、7.021，P>0.05）。90.82%儿童致死性溺水为非故意溺水，其中4.26%会熟练游泳，0.53%采取了防护措施，2.70%有有效看护（有成年看护人、看护不间断未做其他事情且看护距离在一臂之内），现场急救以路人和成年看护人为主，主要措施是心肺复苏，但发生溺水到获得心肺复苏的时间间隔≤5 min仅占6.76%。

结论

重庆市儿童青少年溺水死亡率高，应持续加强男童、农村地区的防溺水工作。应重点加强农村危险水域排查与管理、儿童青少年游泳技能和水上安全教育、成年看护人看护意识提升和看护技巧培训、重点水域智能监控系统应用以及急救技术普及等工作。

儿童青少年  /  致死性溺水  /  死亡率  /  流行病学特征  /  重庆市
Objective

To investigate the epidemiological characteristics and related influencing factors of fatal drowning in children and adolescents aged 0–17 years in Chongqing, thus providing evidence for the prevention and control of fatal drowning in this population.

Methods

The Child Drowning Death Questionnaire designed by the Chronic Disease Center of Chinese Center for Disease Control and Prevention was adopted to collect case information of fatal drowning in children and adolescents aged 0–17 years in Chongqing, 2022 by medical history/death record review, telephone interviews, household surveys, and home visits. The investigation comprised three essential components: basic information, drowning death accident information, and drowning death accident investigation process information.

Results

In 2022, the drowning mortality of children and adolescents aged 0–17 years in Chongqing was 3.36/100 000 (standardized mortality of 3.42/100 000). The drowning mortality was higher in boys (4.64/100 000) than in girls (1.93/100 000) and higher in rural areas (4.19/100 000) than in urban areas (1.09/100 000). It was the highest among adolescents aged 15–17 years (5.66/100 000). There were differences in the places of fatal drowning among children of different ages (χ2 = 59.918, P < 0.001), with those over 10 years old mostly occurring in natural water bodies, and those under 10 years old primarily happening in public water storage areas. There was no significant difference (P > 0.05) in injury intention of fatal drowning among children of different sexes (χ2 = 3.866) and ages (χ2 = 7.021). Most (90.82%) of fatal drowning in children was unintentional, of which 4.26% were skilled swimmers; 0.53% took preventive measures; and 2.70% were effectively cared for (with an adult caregiver, uninterrupted care for nothing else and at arm′s length). On-site first aid mainly consisted of passers-by and adult caregivers, mainly cardiopulmonary resuscitation (CPR). However, the cases with time interval from drowning to CPR being ≤ 5 min only accounted for 6.76%.

Conclusions

The drowning mortality is high among children and adolescents in Chongqing, and special attention should be paid to the prevention of drowning in boys and rural areas. Attention be focused on the investigation and management of dangerous waters in rural areas, the swimming skill and water safety education for children and adolescents, the nursing awareness and nursing skill training of adult caregivers, the application of intelligent monitoring system in key waters, and the popularization of first aid technology.

children and adolescents  /  fatal drowning  /  mortality  /  epidemiological characteristics  /  Chongqing city
吴荣昆, 唐佳诗, 张雍, 丁贤彬, 杨弦弦. 2022年重庆市0～17岁儿童溺水死亡流行病学特征及相关因素：一项回顾性调查. 中国公共卫生, 2026 , 42 (1) : 76 -82 . DOI: 10.11847/zgggws1146514
Rongkun WU, Jiashi TANG, Yong ZHANG, Xianbin DING, Xianxian YANG. Epidemiological characteristics of fatal drowning and related factors in children and adolescents aged 0–17 years in Chongqing, 2022[J]. Chinese Journal of Public Health, 2026 , 42 (1) : 76 -82 . DOI: 10.11847/zgggws1146514
正文
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溺水是指人体淹没或浸泡于液体中，造成呼吸障碍的过程[1]。预防和减少儿童溺水是“健康中国2030”的重要内容。《中国儿童发展纲要（2021—2030年）》儿童与安全的主要目标是儿童伤害死亡率以2020年数据为基数下降20%[2]。中国疾病预防控制中心数据显示，近20年来，我国20岁以下儿童青少年溺水死亡率显著下降，由2013年的6.60/10万下降到2021年的3.28/10万，整体下降了50.30%[3]。2022年国家统计局数据显示，我国儿童青少年溺水死亡率已降至3.04/10万[4]。尽管如此，溺水依然是我国0～14岁儿童青少年死亡的首要原因、15～19岁人群的第二大死因[3]。重庆市地处长江上游，江河纵横，每平方千米水面积全国第一，素有江城之称，溺水防治工作形势非常严峻。1990—2013年中国及各省份人群疾病负担及变化情况，重庆市儿童青少年溺水死亡负担全国排名前六[5]。2012—2021年重庆市全人群死因监测数据显示，重庆市儿童青少年溺水死亡率由2012年的9.57/10万（标化率9.42/10万）下降到2021年的2.80/10万（标化率2.83/10万），年均下降13.15%（标化率年均下降13.06%），但溺水依然是重庆市18岁以下居民伤害死亡的第一死因[6–7]。全国和重庆市的数据表明，儿童青少年溺水死亡率均呈下降趋势[3–7]。然而，瑞典、澳大利亚、芬兰等高收入国家研究表明，官方统计的溺水漏报率可高达40%～50%，溺水的真实情况被严重低估[8–11]。全面了解儿童青少年溺水的死亡情况及其影响因素，有助于采取针对性的干预措施，评估干预措施效果。本研究依托2022年重庆市致死性儿童溺水专项调查，旨在全面了解重庆市儿童致死性溺水的流行病学特征及相关影响因素，为有针对性地实施干预措施提供依据。现报告如下。
1　对象与方法
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1.1　对象
2022年1月1日—12月31日，重庆市因溺水死亡[即“居民死亡医学证明（推断）书”根本死亡原因为溺水]的0～17岁儿童青少年，包括在辖区内死亡的户籍和非户籍人口。
1.2　调查方法
采用回顾性调查方法，以常规死因监测工作为基础，在发现儿童溺水死亡登记报告或基层工作人员主动发现儿童青少年溺亡个案后，区/县疾病预防控制工作人员采用中国疾病预防控制中心慢病中心制定的《儿童溺水死亡调查表》，30 d内通过病史/死亡调查记录查询、电话调查、入户调查、走访等方式追踪进行儿童溺水死亡事件个案调查。问卷调查对象包括溺亡儿童亲属和知情人，其中死者亲属应在调查前签署知情同意书，而知情人则无需签署。本研究已通过中国疾病预防控制中心慢性非传染性疾病预防控制中心伦理委员会审查（编码：202115）。
1.3　调查内容
包括儿童青少年溺水死亡基本信息、溺水死亡事故信息、溺水死亡事故调查信息3部分。
1.3.1　溺水死亡基本信息
来自常规死因监测工作填报的《居民死亡医学证明（推断）书》，包括居民死亡证编号、性别、年龄、个人身份、户籍地址、常住地址、死亡日期、死亡地点、发病至死亡大概间隔时间、溺水死亡ICD编码、死因诊断单位、死因诊断依据、死亡调查记录。
1.3.2　溺水死亡事故信息
来自儿童溺水死亡事件调查，包括溺水事件信息，即溺水发生地水体类型、溺水发生地与家庭/学校距离、溺水发生地点是否有防护措施、溺水发生地点是否有救生员或救生装备、溺水发生时活动、溺水发生时特殊天气/灾害情况；溺亡儿童及看护信息，即溺亡儿童是否流动/留守儿童、溺亡儿童游泳能力、溺亡儿童是否采取防护、溺亡儿童是否饮酒、溺水发生时现场陪同溺亡儿童的看护人、上述看护人的看护行为、上述看护人距离溺亡儿童的距离；溺水现场急救信息，即溺水现场第一急救人员、溺亡儿童第一时间获得的急救措施、溺亡儿童发生溺水到获得心肺复苏急救措施的时间间隔。
1.3.3　溺水死亡事故调查信息
儿童溺水死亡事件调查过程中的信息，包括儿童溺水死亡事件调查信息来源、儿童溺水死亡事件调查方式、儿童溺水死亡事件调查机构/调查人、儿童溺水死亡事件调查时长。
1.4　质量控制
按照国家要求和统一的质量控制方法，培训所有工作人员。为防止漏报、错报，工作人员定期与死因监测部门复核所有儿童死亡病例的死因和死因编码，并将基层工作人员主动发现的溺亡个案纳入调查。调查员选择对死者生前情况比较了解的亲属或知情人（死亡证、死亡证签发人员、非正常死亡的相关公安调查记录/人员、医疗机构救治记录/人员、社区/乡村知情人）进行调查。结合实地走访、查看监控视频、查阅相关记录、死者诊疗资料等多途径获取信息，从而提高调查信息的完整性和一致性。
1.5　溺水分类及疾病编码
根据国际疾病分类编码第10版（International Classification of Diseases, ICD-10）[12]，溺水分为故意性、非故意性和意图不确定3类，其中故意溺水包括用淹溺和沉没方式故意自害（X71）、用淹溺和沉没方式加害（X92），非故意性溺水包括意外淹溺和沉没（W65～W74）、自然灾害（X34～X39）和水上运输事故（V90～V92），意图不确定溺水（Y21）。
1.6　统计分析
调查数据采用Epi Data 3.1软件录入、SPSS 25.0软件进行统计分析。分析指标包括构成比、死亡率和标化死亡率。儿童青少年人口数据来自重庆市统计局提供的常住居民人口数。标化死亡率采用 2010年第6次人口普查标准人口计算。采用Pearson χ2检验或Fisher精确检验比较组间分布统计学差异。检验水准α=0.05（双侧）。
2　结　果
收起
2.1　总体情况（表1）
2022年重庆市0～17岁儿童致死性溺水监测项目共覆盖39个区（县），个案调查应答率100%。溺水死亡率3.36/10万，标化死亡率3.42/10万。其中，男童溺水死亡率（4.64/10万）高于女童（1.93/10万），差异有统计学意义（χ2=5.792，P=0.017）。91.30%的溺水事故发生在农村，农村溺水死亡率（4.19/10万）是城市（1.09/10万）的3.88倍，差异有统计学意义（χ2=5.887，P=0.015）。15～17岁青少年溺水死亡率最高（5.66/10万），5～<10岁最低（1.95/10万），差异有统计学意义（χ2=31.955，P<0.001）。
2.2　伤害意图（表2）
90.82%儿童致死性溺水为非故意溺水，其次是意图不确定溺水（4.83%）和自己故意溺水（4.35%），无他人故意溺水。男童（92.72%）非故意溺水比例略高于女童（85.71%），但差异无统计学意义（χ2=3.866，P=0.141）。不同年龄儿童致死性溺水的伤害意图比较差异无统计学意义（χ2=7.021，P=0.261）。
2.3　溺水发生地水体类型（表3）
49.27%的儿童致死性溺水发生在开放性自然水域，其次是公共蓄水设施（43.48%）、家用蓄水容器（3.38%）和公共商业娱乐活动水域（2.42%）。男、女童发生致死性溺水的场所比较差异无统计学意义（χ2=2.255，P=0.694）。不同年龄组发生溺水死亡的场所差异有统计学意义（χ2=59.918，P<0.001），其中≥10岁多发生在开放性自然水域，<10岁主要发生在公共蓄水设施。
2.4　儿童非故意致死性溺水相关因素（表4）
2.4.1　游泳能力
63.83%溺水儿童不会游泳，4.26%溺水儿童会熟练游泳。男童会游泳的比例高于女童，且差异有统计学意义（χ2=14.917，P=0.001）。不同年龄溺水儿童游泳能力比较差异有统计学意义（χ2=50.291，P<0.001），15～17岁会熟练游泳的占比最高，<10岁无会熟练游泳者。
2.4.2　防护措施
0.53%溺水儿童有防护措施，34.58%的溺水发生地有防护设施。不同性别、年龄间防护措施比较差异均无统计学意义（χ2=2.684、8.717，P>0.05）。
2.4.3　看护措施
19.68%的溺水现场有明确的成年看护人，其中26.00%的成年人看护同时做其他事情、12.00%的成年人看护有中断、30.00%的成年人看护同时做其他事情且看护有中断，51.35%的成年人看护在视线范围外，有成年人看护、看护时不做其他事情且不中断、看护距离在一臂内的有效看护占2.70%。男、女童间看护人类型（χ2=0.701）、看护行为（χ2=1.168）和看护距离（χ2=2.136）差异均无统计学意义（P>0.05）。不同年龄间看护人类型、看护距离的差异均有统计学意义（χ2=30.435、14.968，P<0.001），0～<5岁组有成年人看护占比最高（44.44%）、视线范围内的看护占比最少（12.50%），<15岁无一臂以内的看护。
2.4.4　急救措施
现场第一急救人员以路人（32.43%）和成年看护人（28.38%）为主，现场急救措施以心肺复苏（54.05%）为主。不同性别现场第一急救人员类型、急救措施比较差异均无统计学意义（P>0.05）。不同年龄间现场第一急救人员类型、急救措施比较差异均无统计学意义（P>0.05）。6.76%溺亡儿童发生溺水到获得心肺复苏的时间间隔≤5 min，该比例随着年龄的增加呈下降趋势（χ2=29.570，P=0.003）。
3　讨　论
收起
既往调查结果显示，近十年来，重庆市儿童青少年溺水死亡率整体呈下降趋势[6–7]，但2022年重庆市儿童青少年溺水死亡率（3.36/10万、标化死亡率3.42/10万），较2021年（2.80/10万、标化死亡率2.83/10万）略有升高[6]，可能与2022年新型冠状病毒感染疫情期间儿童青少年居家时间多、缺少学校和家长的有效看护[13–14]，加之重庆市当年夏季极端高温与局部暴雨交替出现的天气等有关[15–16]。本研究显示，重庆市儿童青少年溺水死亡率高于2022年浙江省（0.53/10万）和全国平均水平（3.04/10万）[4,17]，且高于美国（0.6/10万～3.1/10万）、澳大利亚（0.27/10万～1.04/10万）、瑞典（溺水发生率4.7/10万，致命性溺水占1/9.5）等国家[18–20]。表明重庆市溺水死亡率仍处于较高水平，与“健康2030”和《中国儿童发展纲要》的要求仍有差距，相关部门应引起重视。
本研究中，儿童致死性溺水易发生于男童和农村地区，与国内外研究一致[6–7,17–20]，可能与男童好动、活动范围广、缺乏安全意识、更易发生溺水高危行为（如野泳、饮酒、自杀等）有关。重庆市农村地区水系丰富，住宅和学校周边常交错散布开放性河道、池塘、水库等，增加了儿童青少年发生溺水的风险。既往也有报道农村地区对于危险水域的管理、家长和儿童青少年的安全教育、溺水预防相关的知信行以及医疗救助系统的可及性和及时性等均弱于城市地区[21–22]。本研究中，15～17岁儿童青少年的溺水死亡率高于0～14岁，与赵鸣等[17]研究结果一致，而与Li Z[3]和丁贤彬等[6]的结果有所不同。15～17岁易发生致死性溺水的原因可能是，一方面高年龄组儿童青少年更易高估自己游泳水平、轻视溺水风险，并发生野泳等溺水高危行为[23–25]；另一方面，高年龄组儿童青少年更易缺乏持续、有效的看护。在本次调查中，随着年龄的增长成年人看护逐渐减少，仅有2例15～17岁溺亡儿童溺水时有成年人看护，而仅有1例溺水是发生在一臂之内的看护距离中。既往研究显示，高中学生在校学习时间长，学校有很好的看护一直是其溺水死亡率较低的原因之一[26–27]。然而，2022年受新型冠状病毒感染疫情影响，各地中小学校停课，学生居家时间多，从而缺少了学校持续、有效的看护；在美国也有溺水死亡率受新型冠状病毒感染疫情影响的报道[14,28]。徐晶等[13]研究同样发现，新型冠状病毒感染疫情下医院收治的溺水相关意外伤害患儿中，青春期人数最多（占77.78%）。另外，与赵鸣等[17]结论相似，自己故意溺亡儿童均>10岁，且年龄越大占比越高；但本研究中年龄与伤害意图差异无统计学意义（χ2=7.021，P=0.261），两者关系有待进一步研究阐明。此外，溺水发生地防护不到位，儿童防护措施不足、游泳能力欠佳，家长近距离看护不持续，以及现场急救不及时，救护质量不高是导致儿童青少年非故意致死性溺水的主要原因，与国内外的研究结果一致[6–7,18–20]。值得注意的是，在非故意致死性溺水中，仅4.26%儿童会熟练游泳，而会游泳但不熟练的比例随年龄的增长而上升，提示应注重提高儿童游泳技能而非教儿童游泳。调查中，仅有0.53%的儿童采取了“自认为是”的防护措施（无防护作用的充气式游泳圈），提示儿童青少年不仅防护不足，而且还存在防护不当的可能。
本研究将故意溺水、非故意溺水中的自然灾害和水上运输事故，以及意图不确定的溺水死亡均纳入调查，更加全面地了解儿童青少年溺水死亡的真实情况。同时，调查者多途径获取信息，确保了溺水相关信息的完整性。本研究仍存在着局限性，首先存在回忆偏倚，尤其是无成年看护人时收集的信息还可能存在信息不全或不一致；另外，本研究缺乏对照，相关因素在溺水未死亡人群中的分布未知，需进一步的补充调查。综上所述，重庆市儿童青少年溺水死亡率较高，应持续加强男童、农村地区的儿童青少年防溺水工作。关注农村地区危险水域排查和管理、提高儿童青少年游泳技能、强化水上安全教育、提升成年看护人监护意识和看护技巧，推广重点水域智能监控系统以及普及现场急救技术是重庆市开展儿童青少年溺水防治工作应采取的主要措施。

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doi: 10.11847/zgggws1146514
  • 接收时间：2024-11-27
  • 首发时间：2026-10-23
  • 出版时间：2026-01-10
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  • 收稿日期：2024-11-27
  • 修回日期：2025-08-12
  • 录用日期：2025-08-28
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    1重庆市渝中区疾病预防控制中心慢病科，重庆 400010
    2西南医科大学公共卫生学院，泸州 646099
    3重庆市疾病预防控制中心慢病所，重庆 400042

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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