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Risk and protective factors for falls on stairs in young children: multicentre case-control study
D Kendrick1, K Zou1, J Ablewhite1
1Division of Primary Care, School of Medicine, Nottingham, UK.
Insights
Stair gates, carpeted stairs, and mid-stair landings significantly reduce fall injuries in young children. Keeping stairs in good repair also lowers risks, highlighting key safety factors for prevention.
Area of Science:
- Pediatric injury prevention
- Home safety research
- Public health
Background:
- Stair falls are a common cause of injury in children under five.
- Identifying modifiable risk and protective factors is crucial for effective prevention strategies.
Purpose of the Study:
- To investigate risk and protective factors associated with stair falls in children under five years old.
- To inform targeted interventions for reducing pediatric stair fall injuries.
Main Methods:
- A multicenter case-control study was conducted involving children with medically attended stair fall injuries (cases) and matched controls.
- Data were collected from hospitals, minor injury units, and general practices across four UK study centers.
- A total of 610 cases and 2658 controls participated in the study.
Main Results:
- Lack of stair gates (adjusted odds ratio [AOR] 2.50) and open stair gates (AOR 3.09) were significant risk factors.
- Uncarpeted stairs (AOR 1.52), absence of mid-stair landings (AOR 1.34), and stairs in disrepair (AOR 1.71) also increased injury risk.
- Parental perception of stairs as unsafe further correlated with increased fall risk.
Conclusions:
- Structural factors like stair landings and good repair, alongside family factors such as closed stair gates and carpeted stairs, are associated with reduced stair fall risk.
- Implementing these findings in housing policy and child health promotion could significantly decrease stair fall injuries in young children.
- Targeting environmental and behavioral factors offers a promising approach to pediatric injury prevention.
Aim:
To investigate risk and protective factors for stair falls in children aged <5 years.
Methods:
Multicentre case-control study at hospitals, minor injury units and general practices in and around four UK study centres. Cases were children with medically attended stair fall injuries. Controls were matched on age, sex, calendar time and study centre. A total of 610 cases and 2658 controls participated.
Results:
Cases' most common injuries were bangs on the head (66%), cuts/grazes not requiring stitches (14%) and fractures (12%). Parents of cases were significantly more likely not to have stair gates (adjusted OR (AOR) 2.50, 95% CI 1.90 to 3.29; population attributable fraction (PAF) 21%) or to leave stair gates open (AOR 3.09, 95% CI 2.39 to 4.00; PAF 24%) both compared with having closed stair gates. They were more likely not to have carpeted stairs (AOR 1.52, 95% CI 1.09 to 2.10; PAF 5%) and not to have a landing part-way up their stairs (AOR 1.34, 95% CI 1.08 to 1.65; PAF 18%). They were more likely to consider their stairs unsafe to use (AOR 1.46, 95% CI 1.07 to 1.99; PAF 5%) or to be in need of repair (AOR 1.71, 95% CI 1.16 to 2.50; PAF 5%).
Conclusion:
Structural factors including having landings part-way up the stairs and keeping stairs in good repair were associated with reduced stair fall injury risk. Family factors including having stair gates, not leaving gates open and having stair carpets were associated with reduced injury risk. If these associations are causal, addressing these factors in housing policy and routine child health promotion could reduce stair fall injuries.
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