From the Journals

Decline of infant walker–related injuries continues



Infant walker–related injuries have decreased by more than 90% since 1990, but most of that drop occurred before the federal mandatory safety standard went into effect in 2010, according to an analysis of a federal injury database.

In 1990, there were 20,650 walker-related injuries among children younger than 15 months, and by 2003 that number was down to 3,201 – a significant decline of 85%. In 2014, the last year for which data were available, there were 1,995 such injuries, which translates to a nonsignificant decrease of 38% from 2003 to 2014, Ariel Sims, MS, and her associates at the Center for Injury Research and Policy at Nationwide Children’s Hospital, Columbus, Ohio, wrote in Pediatrics.

Infant walker-related injuries in children <15 months old

During the study period from 1990 to 2014, a total of 230,676 children aged less than 15 months received treatment in emergency departments after walker-related injuries, with the majority (74%) caused by falls down stairs. That percentage did go down over time, though, with falls down stairs representing more than 80% of all such injuries during 1990-1996, 66% during 1997-2009, and 41% during 2010-2014, Ms. Sims and her associates reported based on data from the National Electronic Injury Surveillance System.

As for the 2010 federal safety standard, the annual average injury total went from 2,801 for the previous 4 years (2006-2009) to 2,165 for the 4 years after (2010-2014) – a decline of 23% (P = .019), they noted.

The federal standard may have contributed to the overall decline, Ms. Sims and her associates suggested, but the “reduction is most likely attributable to … an increase in public awareness of infant walker–related injury risks when advocacy groups petitioned the [Consumer Product Safety Commission] in 1992 to ban infant walker sales in the United States, the increasing use of stationary activity centers as an alternative to infant walkers, and improvements in the voluntary infant walker safety standard.”

In a September 2001 policy statement, the American Academy of Pediatrics recommended a ban on the manufacture and sale of mobile infant walkers (Pediatrics. 2001 Sep. doi: 10.1542/peds.108.3.790). This policy has been reaffirmed every 5 years in accordance with AAP policy.

Ms. Sims received a research stipend from the Research Institute at Nationwide Children’s Hospital and was funded by the Centers for Disease Control and Prevention and the Child Injury Prevention Alliance. The other investigators said that they have no relevant financial disclosures.

SOURCE: Sims A et al. Pediatrics. 2018 Sep 17. doi: 10.1542/peds.2017-4332.

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