Risk and Protective Factors for Falls From Furniture in Young Children: Multicenter Case-Control Study.
Kendrick D y cols. JAMA pediatr. 2014 Dec 1. doi: 10.1001/jamapediatrics.2014.2374. [Epub ahead of print]
Falls from furniture are common in young children but there is little evidence on protective factors for these falls.
To estimate associations for risk and protective factors for falls from furniture in children aged 0 to 4 years.
Design, Setting, and Participants:
case-control study at hospitals, minor injury units, and general
practices in and around 4 UK study centers. Recruitment commenced June
14, 2010, and ended April 27, 2012. Participants included 672 children
with falls from furniture and 2648 control participants matched on age,
sex, calendar time, and study center. Thirty-five percent of cases and
33% of control individuals agreed to participate. The mean age was 1.74
years for cases and 1.91 years for control participants. Fifty-four
percent of cases and 56% of control participants were male. Exposures
included safety practices, safety equipment use, and home hazards.
Main Outcomes and Measures:
from furniture occurring at the child's home resulting in attendance at
an emergency department, minor injury unit, or hospital admission.
with parents of control participants, parents of cases were
significantly more likely not to use safety gates in the home (adjusted
odds ratio [AOR], 1.65; 95% CI, 1.29-2.12) and not to have taught their
children rules about climbing on kitchen objects (AOR, 1.58; 95% CI,
1.16-2.15). Cases aged 0 to 12 months were significantly more likely to
have been left on raised surfaces (AOR, 5.62; 95% CI, 3.62-8.72), had
their diapers changed on raised surfaces (AOR, 1.89; 95% CI, 1.24-2.88),
and been put in car/bouncing seats on raised surfaces (AOR, 2.05; 95%
CI, 1.29-3.27). Cases 3 years and older were significantly more likely
to have played or climbed on furniture (AOR, 9.25; 95% CI, 1.22-70.07).
Cases were significantly less likely to have played or climbed on garden
furniture (AOR, 0.74; 95% CI, 0.56-0.97).
Conclusions and Relevance:
estimated associations are causal, some falls from furniture may be
prevented by incorporating advice into child health contacts, personal
child health records, and home safety assessments about use of safety
gates; not leaving children, changing diapers, or putting children in
car/bouncing seats on raised surfaces; allowing children to play or
climb on furniture; and teaching children safety rules about climbing on