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Risk and protective factors for falls from furniture in young children: multicenter case-control study
Denise Kendrick1, Asiya Maula1, Richard Reading2
1Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, England.
Insights
Preventing furniture falls in young children involves using safety gates and teaching climbing rules. Avoid leaving infants on raised surfaces and supervise older children
Area of Science:
- Pediatric safety
- Injury prevention research
- Child health and development
Background:
- Falls from furniture are a significant cause of injury in young children.
- Limited evidence exists on protective factors mitigating these falls.
- Understanding risk and protective factors is crucial for effective prevention strategies.
Purpose of the Study:
- To identify and estimate the associations between risk and protective factors and falls from furniture in children aged 0 to 4 years.
- To provide evidence-based recommendations for preventing furniture-related fall injuries in pediatric populations.
- To inform public health initiatives and parental guidance on child safety.
Main Methods:
- A multicenter case-control study was conducted across four UK study centers.
- Data were collected from 672 children who experienced falls from furniture (cases) and 2648 matched control participants.
- Exposures assessed included home safety practices, safety equipment use, and identification of home hazards.
Main Results:
- Not using safety gates (adjusted odds ratio [AOR], 1.65) and not teaching climbing safety rules (AOR, 1.58) were associated with increased fall risk.
- Infants (0-12 months) left on raised surfaces (AOR, 5.62) or having diapers changed on them (AOR, 1.89) faced higher risks.
- Older children (3+ years) playing on furniture (AOR, 9.25) had significantly increased risk, while playing on garden furniture showed a protective association (AOR, 0.74).
Conclusions:
- Falls from furniture may be preventable through targeted interventions and education.
- Recommendations include promoting safety gate use, safe practices on raised surfaces, and teaching children about climbing.
- Integrating safety advice into child health contacts and home safety assessments is recommended.
Importance:
Falls from furniture are common in young children but there is little evidence on protective factors for these falls.
Objective:
To estimate associations for risk and protective factors for falls from furniture in children aged 0 to 4 years.
Design, Setting, And Participants:
Multicenter 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:
Falls from furniture occurring at the child's home resulting in attendance at an emergency department, minor injury unit, or hospital admission.
Results:
Compared 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:
If 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 objects.
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