Knife-related injuries treated in United States emergency departments, 1990-2008

Knives cause more disabling injuries than any other type of hand tool.

This study investigates knife-related injuries requiring Emergency Department (ED) treatment among children and adults in the United States (US) from 1990 through 2008.

A retrospective analysis of data from the National Electronic Injury Surveillance System of the Consumer Product Safety Commission was conducted.

An estimated 8,250,914 (95% confidence interval [CI] 7,149,074-9,352,755) knife-related injuries were treated in US EDs from 1990 to 2008, averaging 434,259 (95% CI 427,198-441,322) injuries annually, or 1190 per day. The injury rate was 1.56 injuries per 1000 US resident population per year. Fingers/thumbs (66%; 5,447,467 of 8,249,410) were injured most often, and lacerations (94%; 7,793,487 of 8,249,553) were the most common type of injury. Pocket/utility knives were associated with injury most often (47%; 1,169,960 of 2,481,994), followed by cooking/kitchen knives (36%; 900,812 of 2,481,994). Children were more likely than adults to be injured while playing with a knife or during horseplay (p < 0.01; odds ratio 9.57; 95% CI 8.10-11.30). One percent of patients were admitted to the hospital, and altercation-related stabbings to the trunk accounted for 52% of these admissions.

Knives represent an important source of morbidity and mortality to people of all ages. Manufacturers should develop safer knife designs that incorporate features, such as improved opening and closing mechanisms on pocket knives, to prevent these injuries. Other potential safety efforts include targeted educational interventions and changes in voluntary product safety standards and public policy.