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Crib Bumpers Continue to Cause Infant Deaths: A Need for a New Preventive Approach
N J Scheers1, Dean W Woodard2, Bradley T Thach3
1BDS Data Analytics, Alexandria, VA (former CPSC project manager, Infant Suffocation Project).
Insights
Crib bumper deaths increased significantly, with bumpers alone causing suffocation. Data does not support the safety or effectiveness of crib bumper use.
Area of Science:
- Pediatric safety
- Consumer product safety
- Injury prevention
Background:
- Crib bumpers have been associated with infant suffocation deaths.
- Previous studies have not conclusively determined the role of clutter in bumper-related infant deaths.
Purpose of the Study:
- To analyze bumper-related infant deaths and injuries.
- To identify the causal mechanisms of bumper-related incidents.
- To assess the role of clutter in bumper-related infant deaths.
Main Methods:
- Analysis of US Consumer Product Safety Commission (CPSC) databases for deaths (1985-2012) and incidents (1990-2012).
- Classification of incidents by causal mechanism.
- Statistical analysis including trend tests and ANOVA to compare age differences in injury mechanisms.
Main Results:
- A significant increase in bumper-related deaths was observed in recent years.
- Crib bumpers alone, not clutter, were the primary cause of suffocation in 48 reported deaths.
- Injury mechanisms were linked to design, construction, and quality control issues, with significant age-related differences.
Conclusions:
- The data does not support the effectiveness or safety benefits of crib bumper use.
- Public health recommendations and industry standards for crib bumpers were not substantiated by the findings.
- Limitations include undercounting of deaths and reliance on voluntary incident reports.
Objectives:
To assess whether clutter (comforters, blankets, pillows, toys) caused bumper deaths and provide an analysis of bumper-related incidents/injuries and their causal mechanisms.
Study Design:
Bumper-related deaths (January 1, 1985, to October 31, 2012) and incidents/injuries (January 1, 1990, to October 31, 2012) were identified from the US Consumer Product Safety Commission (CPSC) databases and classified by mechanism. Statistical analyses include mean age, 95% CIs, χ(2) test for trend, and ANOVA with a paired-comparisons information-criterion post hoc test for age differences among injury mechanisms.
Results:
There were 3 times more bumper deaths reported in the last 7 years than the 3 previous time periods (χ(2)(3) = 13.5, P ≤ .01). This could be attributable to increased reporting by the states, diagnostic shift, or both, or possibly a true increase in deaths. Bumpers caused 48 suffocations, 67% by a bumper alone, not clutter, and 33% by wedgings between a bumper and another object. The number of CPSC-reported deaths was compared with those from the National Center for the Review and Prevention of Child Deaths, 2008-2011; the latter reported substantially more deaths than CPSC, increasing the total to 77 deaths. Injury mechanisms showed significant differences by age (F4,120 = 3.2, P < .001) and were caused by design, construction, and quality control problems. Eleven injuries were apparent life-threatening events.
Conclusion:
The effectiveness of public health recommendations, industry voluntary standard requirements, and the benefits of crib bumper use were not supported by the data. Study limitations include an undercount of CPSC-reported deaths, lack of denominator information, and voluntary incident reports.
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