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Non-intentional asphyxiation deaths due to upper airway interference in children 0 to 14 years
1Public Health Branch, Department of Health and Community Services, Melbourne, Victoria, Australia.
Insights
Rope swings and other rope materials pose significant risks for child asphyxiation deaths. Prevention strategies must address product safety standards, labeling, and education for caregivers and children.
Area of Science:
- Pediatric Safety
- Public Health
- Accident Prevention
Background:
- Non-intentional asphyxiation deaths due to upper airway interference are a significant concern in children.
- Identifying avoidable contributing factors is crucial for developing effective prevention strategies.
Purpose of the Study:
- To identify avoidable, contributing factors associated with non-intentional asphyxiation deaths in children aged 0 to 14 years.
- To analyze the causes and circumstances of upper airway interference deaths in children.
Main Methods:
- A historical population-based incidence study was conducted.
- Data on postneonatal and childhood asphyxiation deaths (1985-1994) were compiled from the Victorian paediatric mortality surveillance system and State Coroner's Office.
- Case definition included children under 15 years who died from upper airway interference (e.g., facial occlusion, entrapment, strangulation, foreign body).
Main Results:
- 42 deaths were identified: 19% foreign body, 12% facial occlusion, 38% ropes/rope swings, and 31% entrapment (often in cots/beds).
- The average annual asphyxiation death rate for children 0-14 years was 4.7/million.
- Infants under 1 year had the highest rate (20.1/million), while 10-14 year olds had a rate of 2.0/million.
Conclusions:
- Rope swings and rope materials are particularly dangerous, leading to fatal outcomes, especially in older children.
- Environmental factors, including food and bedding, are critical for infant safety.
- Prevention requires mandatory product standards, clear labeling, and comprehensive education for children, caregivers, and healthcare professionals.
Objective:
This study was undertaken to identify avoidable, contributing factors associated with non-intentional asphyxiation deaths due to upper airway interference in children 0 to 14 years.
Design:
Historical population based incidence study.
Methods:
All postneonatal and childhood deaths by asphyxiation from 1985 to 1994, using appropriate ICD-9-CM codes, were compiled from the Victorian government legislated paediatric mortality surveillance system. Recent cases were identified from the State Coroner's Office. Case definition included children under 15 years who died from upper airway interference such as facial occlusion, head and neck entrapment, rope or cord strangulation, or foreign body.
Results:
Of the identified 42 deaths, eight (19%) were caused by a foreign body in the airway, five (12%) were due to facial occlusion, 16 (38%) were due to ropes and similar material (seven were homemade rope swings), and 13 (31%) were caused by entrapment (seven were in cots or beds). The average annual rate for asphyxiation deaths by all causes for children 0 to 14 years was 4.7 million. Infants under 1 year had a rate of 20.1/million, while the rate for 10 to 14 year olds dropped to 2.0/million.
Conclusion:
Rope swings and rope material are inherently dangerous and frequently prove fatal, especially for older children. For infants, environmental factors are important; in particular food and bedding. Prevention strategies need to be developed that include obligatory standards for the design and manufacture of products for children, appropriate labelling and warnings, and education for children, their carers, and health care professionals.