The financial costs of children falling are high, with 2005 costs at $439 million for hospitalizations and $643 million for visits to the emergency department.
The study, published in JAMA Pediatrics, examined the potential risks and protective factors for children aged up to 4 years involved in falls from furniture who required medical attention, delivered through emergency departments (EDs), hospital admissions or minor injury units.
In the US, over 1 million children aged 0-4 years attend EDs every year due to falls - around half of all injury-related ED attendances for this age group. The majority of these falls involve furniture in the home, such as baby walkers, beds, chairs, changing tables and high chairs, the researchers write.
The financial costs of these largely preventable incidents are high; in 2005, it was estimated that the costs of falling children in US were $439 million for hospitalizations and $643 million for ED visits.
According to the researchers, interventions could lead to increased safety gate and baby walker use. These measures may potentially reduce falls in the home, although until now there has been little evidence available about the extent to which prevention practices reduce falls or fall-related injuries.
More falls for children not taught rules about climbing
The study examined 672 children, aged 0-4 years, who had been involved in falls from furniture at home and received medical attention. These children were compared with 2,648 control children of the same age who had not had medically attended falls when the other children had.
In the majority of cases (86%), children received single injuries from their falls. These included bangs on the head (59%), cuts or grazes that did not require stitches (19%) and fractures (14%).
In most instances (60%), treatment was not required after examination. Otherwise, children were treated in the ED (29%), treated and given follow-up appointments (7%), or admitted to the hospital (4%).
Further data for the children was ascertained through the use of parent-completed questionnaires specific to the age of the child. Such data included exposures, potential confounding variables, the health of the child and their quality of life.
The researchers found that parents of children who fell were less likely to use safety gates or teach their children rules about climbing on objects in the kitchen than the parents of the control participants.
Children aged up to 1 year who fell were more likely to have been left on, had their diapers changed on, and placed in car or bouncing seats on raised surfaces. Children aged 3 and older who fell were most likely to have climbed or played on furniture in the home.
Advice on fall prevention could help
The authors state that their study is the largest published case-control study to date to explore modifiable factors for falls from furniture in the home.
A number of limitations to the study are acknowledged by the researchers. They note that participation rates for the study were low, and this factor, coupled with the self-reporting of exposures, could mean that the findings are not truly representative.
By assessing a large number of exposures, the study tested for multiple significances. The authors write that this means observed associations may appear significant by chance alone. Finally, they note that families with gardens and garden furniture - included as sites for falling within the study - may be more advantaged and thus have children with a lower risk of falling.
The authors conclude that larger studies are now required to assess the association of specific forms of furniture - such as baby walkers and playpens - with falls.
"If our estimated associations are causal," they write, "some falls from furniture may be prevented by incorporating fall-prevention advice into child health surveillance programs, personal child health records, home safety assessments and other child health contracts."
Recently, Medical News Today covered the World Health Organization's (WHO) first global report on drowning, in which it was revealed that every hour, more than 40 people worldwide die from drowning, with young children most at risk.