Pediatric Injuries Attributable to Falls From Windows in the United States in 1990–2008

Harris, Vaughn A.; Rochette, Lynne M.; Smith, Gary A.

doi:10.1542/peds.2010-2687

Cited by 55 publications

(55 citation statements)

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“…Amongst the successful local programs were the “Children Can’t Fly” and “Kids Can’t Fly” campaigns in New York City and Boston, respectively. Within the first 10 years of implementation, these public health campaigns resulted in up to a 96% reduction of window falls for children < 5-years-old (Harris et al, 2011). Nationally, the American Academy of Pediatrics (AAP) has been at the forefront of providing pediatric caregiver and community education as well as fall prevention strategies through Council on Injury, Violence, and Poison Prevention (COIVPP) policy statements about injuries associated with infant walkers, shopping carts, trampolines, and falls from heights (American Academy of Pediatrics, 2001a; American Academy of Pediatrics, 2006; American Academy of Pediatrics, 2012; American Academy of Pediatrics, 2001b).…”

Section: Introductionmentioning

confidence: 99%

“…Prior studies on pediatric falls have evaluated specific mechanisms of falls (windows, stairs, furniture) (Harris et al, 2011; Pressley & Barlow, 2005; Zielinski et al, 2012; Pomerantz et al, 2012; Kendrick et al, 2015; Kendrick et al, 2016) or specific injuries sustained (head injury) (Love et al, 2009; Ibrahim et al, 2012). Few population-based studies have examined overall risk factors and injury mechanisms for falls as a function of age (Khambalia et al, 2006; Pitone & Attia, 2006; Unni et al, 2012; Wang et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Pediatric falls ages 0–4: understanding demographics, mechanisms, and injury severities

et al. 2018

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BackgroundPediatric unintentional falls are the leading cause of injury-related emergency visits for children < 5 years old. The purpose of this study was to identify population characteristics, injury mechanisms, and injury severities and patterns among children < 5 years to better inform age-appropriate falls prevention strategies.MethodsThis retrospective database study used trauma registry data from the lead pediatric trauma system in Georgia. Data were analyzed for all patients < 5 years with an international classification of disease, 9th revision, clinical modification (ICD-9 CM) external cause of injury code (E-code) for unintentional falls between 1/1/2013 and 12/31/2015. Age (months) was compared across categories of demographic variables, injury mechanisms, and emergency department (ED) disposition using Kruskal-Wallis ANOVA and the Mann Whitney U test. The relationships between demographic variables, mechanism of injury (MOI), and Injury Severity Score (ISS) were evaluated using multinomial logistic regression.ResultsInclusion criteria were met by 1086 patients (median age = 28 months; 59.7% male; 53.8% White; 49.1% < 1 m fall height). Younger children, < 1-year-old, primarily fell from caregiver’s arms, bed, or furniture, while older children sustained more falls from furniture and playgrounds. Children who fell from playground equipment were older (median = 49 months, p < 0.01) than those who fell from the bed (median = 10 months), stairs (median = 18 months), or furniture (median = 19 months). Children < 1 year had the highest proportion of head injuries including skull fracture (63.1%) and intracranial hemorrhage (65.5%), 2-year-old children had the highest proportion of femur fractures (32.9%), and 4-year-old children had the highest proportion of humerus fractures (41.0%). Medicaid patients were younger (median = 24.5 months, p < 0.01) than private payer (median = 34 months). Black patients were younger (median = 20.5 months, p < 0.001) than White patients (median = 29 months). Results from multinomial logistic regression models suggest that as age increases, odds of a severe ISS (16–25) decreased (OR = 0.95, CI = 0.93–0.97).ConclusionsPediatric unintentional falls are a significant burden of injury for children < 5 years. Future work will use these risk and injury profiles to inform current safety recommendations and develop evidence-based interventions for parents/caregivers and pediatric providers.Electronic supplementary materialThe online version of this article (10.1186/s40621-018-0147-x) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pediatric falls ages 0–4: understanding demographics, mechanisms, and injury severities

et al. 2018

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“…Injuries from falls from a window especially occur in children aged 0–4 years old, with a peak at one year [18]. In our study we saw that number of children was correlated with absence of a window guard and no other demographic characteristics or PMT constructs.…”

Section: Discussionmentioning

confidence: 43%

First-Time Parents Are Not Well Enough Prepared for the Safety of Their Infant

et al. 2013

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BackgroundUnintentional falls and poisonings are major causes of death and disability among infants. Although guidelines are available to prevent these injuries, safety behaviours are not performed by parents, causing unnecessary risks. Little is known about safety behaviours of first-time parents and whether they behave according to these guidelines.Aims/Objectives/PurposeThe objective of this study was to compare safety behaviours of first-time parents with those of non-first-time parents and to determine correlates of unsafe behaviour of parents of infants. We used self-report questionnaires to assess safety behaviours in a cross-sectional study sample.MethodsA total of 1439 parents visiting a preventive youth healthcare centre in the Netherlands were invited to complete a questionnaire with regard to the prevention of falls and poisonings. Parents were categorized into first-time parents and non-first-time parents. Correlates of parents' child safety behaviours were determined using multiple logistic regression analyses.Results/OutcomeMost respondents were mothers (93.2%); 48.2% of families were first-time parents. The mean age of the infants was 7.2 months (SD 1.1; range 4–12), 51.8% were boys, and 34.5% of infants could crawl. First-time parents were more likely not to have a stair gate installed (OR 16.46; 95% CI 12.36–21.93); were more likely to store cleaning products unsafely (OR 4.55; 95% CI 3.59–5.76); and were more likely to store medicines unsafely (OR 2.90; 95% CI 2.31–3.63) than non-first-time parents. First-time parents were more likely to not have a window guard installed (OR 1.52; 95% CI 1.08–2.15) (all P<0.05).Discussion/ConclusionFirst-time parents are not well prepared for the safety of their infant, causing unnecessary risks. The various parents' safety behaviours were influenced by different variables, for example, age of the infant, crawling of the infant, mother's educational level, mother's ethnicity, self-efficacy, vulnerability, severity.

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“…Death is a rare outcome (<1%) of child window falls but severe injury is far more common 1. The amounts of severe injury and long-term disability prevented by the window guard rule are not quantifiable.…”

Section: Discussionmentioning

confidence: 99%

“…Window falls are of particular concern in urban areas with a high concentration of multistorey buildings because falls from three or more stories are more likely to result in severe injury or death 1. From 1965 to 1969, >200 children in New York City (NYC) died due to falls 2.…”

Section: Introductionmentioning

confidence: 99%

New York City’s window guard policy: four decades of success

et al. 2018

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This article describes each stage of policy development, starting with epidemiological studies defining the scope of the problem in the 1960s and pilot-testing of the window guard intervention. We describe the adoption, implementation and enforcement of the rule. In addition, we show how the rule was modified over time and document the rule's impact on window fall incidence in NYC. We describe litigation that challenged the rule's constitutionality and discuss the legal arguments used by opponents of the rule. Finally, we discuss criminal and tort liability as drivers of compliance and summarise lessons learnt.

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Pediatric Injuries Attributable to Falls From Windows in the United States in 1990–2008

Cited by 55 publications

References 20 publications

Pediatric falls ages 0–4: understanding demographics, mechanisms, and injury severities

Pediatric falls ages 0–4: understanding demographics, mechanisms, and injury severities

First-Time Parents Are Not Well Enough Prepared for the Safety of Their Infant

New York City’s window guard policy: four decades of success

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