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Risk and protective factors for falls on one level in young children: multicentre case-control study
P Benford1, B Young1, C Coupland1
1Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK.
Insights
Childhood falls on one level are common, but this study found no specific safety behaviors, equipment, or home hazards significantly reduced risk in children aged 0-4. Current prevention strategies may need re-evaluation.
Area of Science:
- Pediatric Public Health
- Injury Prevention Science
- Epidemiology
Background:
- Childhood falls represent a significant global public health concern, particularly falls on one level.
- There is a notable lack of robust evidence regarding effective prevention strategies for these common injuries.
- Falls on one level lead to substantial morbidity and impose considerable costs on healthcare systems.
Purpose of the Study:
- To investigate the association between various safety behaviors, safety equipment usage, and home hazards with the risk of one-level falls in children aged 0-4 years.
- To estimate the odds ratios (ORs) for falls on one level in relation to specific preventive measures.
Main Methods:
- A multicenter case-control study was conducted across four UK study centers.
- Participants included 582 children under five with medically attended home fall injuries (cases) and 2460 matched controls.
- Data were collected on safety behaviors, equipment use, and home hazards to assess their correlation with fall risk.
Main Results:
- The most frequent injuries among cases were head injuries (52%), superficial cuts/grazes (29%), and lacerations requiring stitches (17%).
- Adjusted analyses revealed that children were less likely to fall if their households had furniture corner covers (adjusted OR [AOR] 0.72) or securely fixed rugs/carpets (AOR 0.76).
- No other significant associations were found between tested safety factors and the risk of falls on one level.
Conclusions:
- The study did not identify specific safety practices, equipment, or home hazards that significantly reduce the risk of one-level falls in young children.
- Current findings suggest that existing injury prevention practices for falls may not be sufficiently supported by this evidence.
- Further research may be needed to identify effective interventions for preventing childhood falls on one level.
Background:
Childhood falls are an important global public health problem, but there is lack of evidence about their prevention. Falls on one level result in considerable morbidity and they are costly to health services.
Objective:
To estimate ORs for falls on one level in children aged 0-4 years for a range of safety behaviours, safety equipment use and home hazards.
Design, Setting And Participants:
Multicentre case-control study at hospitals, minor injury units and general practices in and around four UK study centres. Participants included 582 children less than 5 years of age with a medically attended fall injury occurring at home and 2460 controls matched on age, sex, calendar time and study centre.
Main Outcome Measure:
Fall on one level.
Results:
Cases' most common injuries were bangs on the head (52%), cuts or grazes not needing stitches (29%) or cuts or grazes needing stitches (17%). Comparing cases to community controls in the adjusted analyses, significant findings were observed for only two exposures. Injured children were significantly less likely to live in a household without furniture corner covers (adjusted OR (AOR) 0.72, 95% CI 0.55 to 0.95), or without rugs and carpets firmly fixed to the floor (AOR 0.76, 95% CI 0.59 to 0.98).
Conclusions:
We did not find any safety practices, use of safety equipment or home hazards associated with a reduced risk of fall on one level. Our findings do not provide evidence to support changes to current injury prevention practice.
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