If you're a parent, grandparent or guardian, this study is a reminder to be ever vigilant of a young child, particularly around stairs. Records indicate that one child is treated every six minutes at the ER for stair related injuries.

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Injury Rates from Stairs Tumble but Kids Still at Risk

By Todd Neale, Senior Staff Writer, MedPage TodayPublished: March 12, 2012
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco.

Although stair-related injuries among young children have become less frequent, they are still a common source of injury in the U.S., researchers found.

Over a recent 10-year period, a child younger than 5 was treated in an emergency department for a stair-related injury every six minutes, on average, according to Gary Smith, MD, DrPH, of the Research Institute at Nationwide Children's Hospital in Columbus, Ohio, and colleagues.

In 2008, which were the most recent year data, an estimated 89,619 young children were treated for such an injury, the researchers reported online ahead of the March issue of Pediatrics.

"Increased prevention efforts are needed, including parental education and improved stairway design, to decrease stair-related injuries among young children," they wrote.

Until the mid-1990s, most stair-related injuries in young children involved baby walkers. That changed as walkers were increasingly cast aside for stationary activity centers, and the American Society for Testing and Materials released a new voluntary infant walker standard in 1997.

To provide a look at the patterns of stair-related injuries after the change, Smith and colleagues retrospectively examined data from the National Electronic Injury Surveillance System of the U.S. Consumer Product Safety Commission for 1999 through 2008.

During that 10-year period, an estimated 931,886 children younger than 5 were treated in an emergency department for a stair-related injury.

The total number of injuries dropped by 11.6% during the study period (P=0.011). The annual rate declined also -- from 53 to 42.4 per 10,000 population (P<0.001) -- even after excluding the baby walker cases.
Some of the other findings:

• The largest percentage of injuries occurred in 1-year-old kids (32.4%).
• Injuries were more common in boys at all ages than in girls (56.9% versus 43.1%).
• About one-third of the injuries were soft tissue injuries (34.6%) and most occurred to the head and neck (76.3%).
• The vast majority of the injuries were not serious, and only 2.7% required hospitalization. That rate was highest in children less than 1 (5.2%).

One-quarter of the infant injuries occurred when the caregiver was carrying the child. Babies hurt in this way were about three times more likely to be hospitalized as those injured in other ways (RR 3.10, 95% CI 2.41 to 3.99).

"Caretakers should minimize stair use while carrying children by placing the child in a safe place instead of bringing the child with them if possible," the authors wrote. "Child caretakers can also reduce injuries by keeping the stairs well maintained and free of objects that could result in tripping."

To continue the overall trend of declining stair-related injuries, Smith and colleagues suggested improving the design and construction of stairs, discouraging children from playing on or carrying objects down the stairs, not using baby walkers, and using, but not relying on, safety gates.

The study was limited, they said, by the inclusion of cases treated in the emergency department only, the lack of information on possible cases of abuse, and the difficulty in determining the mechanism of the fall for a large number of cases.

The study was supported by the National Center for Injury Prevention and Control at the CDC, which provided a student research stipend for one of the study authors while she worked on the study.
The authors reported that they had no conflicts of interest.

Primary source: Pediatrics
Source reference:
Zielinski A, et al "Stair-related injuries to young children treated in U.S. emergency departments, 1999-2008" Pediatrics 2012; DOI:10.1542/peds.2011-2314.