Abstract
Background
Unintentional injuries are the leading cause of death in children, and falls are the most common type of unintentional injury in the US. The incidence of falls from windows, a common cause of death in urban areas, has not been described outside major cities such as New York and Chicago, and rates in urban and suburban areas have not been compared.
Objective
To estimate the incidence and identify the population at risk for falls from windows among children in Hamilton County, Ohio.
Design
Retrospective case series identified using Cincinnati Children's Hospital Medical Center (CHMC) Trauma Registry.
Setting
Hamilton County, Ohio, which has urban and nonurban areas.
Participants
Children less than 15 years old residing in Hamilton County, Ohio, presenting to CHMC in Cincinnati, Ohio, after a fall from a window between January 1, 1991, and December 31, 1997.
Outcome Measure
Annual incidence by age, race, gender, and residence of those who fell from windows.
Results
Over the 7-year study period, 86 (6.3%) of 1,363 falls were from windows. The mortality rate for falls from windows was 4.7%, compared to 0.07% for all other falls presenting to CHMC (P<.0001). Children 0–4 years old had a higher rate of falls than children aged 5–14 (14.6/100,000 vs. 2.0/100,000) (P<.0001). Males were twice as likely to fall as females (P<.016), and black children were three times more likely to fall than non-black children (P<.002). The incidence of falls in the city of Cincinnati was four times that of the non-urban area (P<.0002).
Conclusions
Injuries from falls from windows are a public health problem in Hamilton County, Ohio, especially for young, urban children.
Key words: Childhood Injury, Injury Prevention, Urban Trauma, Window Falls
Full Text
The Full Text of this article is available as a PDF (405.3 KB).
References
- 1.Rivara FP, Grossman DC. Prevention of traumatic deaths to children in the United States: how far have we come and where do we need to go? Pediatrics. 1996;97:791–797. [PubMed] [Google Scholar]
- 2.Hazinski M, Fancescutti LH, Lapidus GD, Micik S, Rivara FP. Pediatric injury prevention. Ann Emerg Med. 1993;22:456–467. doi: 10.1016/S0196-0644(05)80478-0. [DOI] [PubMed] [Google Scholar]
- 3.Rivara FP, Grossman DC, Cummings P. Injury prevention: first of two parts. N Engl J Med. 1997;337:543–548. doi: 10.1056/NEJM199708213370807. [DOI] [PubMed] [Google Scholar]
- 4.Rivara FP, Grossman DC, Cummings P. Injury prevention: second of two parts. N Engl J Med. 1997;337:613–618. doi: 10.1056/NEJM199708283370907. [DOI] [PubMed] [Google Scholar]
- 5.Garrettson LK, Gallagher SS. Falls in children and youth. Pediatr Clin North Am. 1985;32:153–162. doi: 10.1016/s0031-3955(16)34763-0. [DOI] [PubMed] [Google Scholar]
- 6.Rivara FP, Alexander B, Johnston B, Soderberg R. Population-based study of fall injuries in children and adolescents resulting in hospitalization or death. Pediatrics. 1993;92:61–63. [PubMed] [Google Scholar]
- 7.Mortality Statistics. Atlanta, GA: CDC; 1993–1995. [Google Scholar]
- 8.Hamilton County General Health District Division of Community Health Information Services.Hamilton County Injury Surveillance Report. Hamilton County General Health District; 1994–1996.
- 9.Bergner L, Mayer S, Harris D. Falls from heights: a childhood epidemic in an urban area. Am J Public Health. 1971;61:90–96. doi: 10.2105/ajph.61.1.90. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Sieben RL, Leavitt JD, French JH. Falls as childhood accidents: an increasing urban risk. Pediatrics. 1971;47:886–892. [PubMed] [Google Scholar]
- 11.Spiegel CN, Lindaman FC. Children Can't Fly: a program to prevent childhood morbidity and mortality from window falls. Am J Public Health. 1977;67:1143–1146. doi: 10.2105/ajph.67.12.1143. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Smith MD, Burrington JD, Woolf AD. Injuries in children sustained in free falls: an analysis of 66 cases. J Trauma. 1975;15:987–991. doi: 10.1097/00005373-197511000-00008. [DOI] [PubMed] [Google Scholar]
- 13.Meller JL, Shermeta DW. falls in urban children: a problem revisited. Am J Dis Child. 1987;141:1271–1275. doi: 10.1001/archpedi.1987.04460120033027. [DOI] [PubMed] [Google Scholar]
- 14.Mosenthal AC, Livingston DH, Elcavage J, Merritt S, Stucker S. Falls: epidemiology and strategies for prevention. J Trauma. 1995;38:753–756. doi: 10.1097/00005373-199505000-00013. [DOI] [PubMed] [Google Scholar]
- 15.Lehman D, Schonfeld N. Falls from heights: a problem not just in the northeast. Pediatrics. 1993;92:121–124. [PubMed] [Google Scholar]
- 16.Barlow B, Niemirska M, Gandhi RP, Leblanc W. Ten years of experience with falls from a height in children. J Pediatr Surg. 1983;18:509–511. doi: 10.1016/s0022-3468(83)80210-3. [DOI] [PubMed] [Google Scholar]
- 17.Musemeche CA, Barthel M, Cosentino C, Reynolds M. Pediatric falls from heights. J Trauma. 1991;31:1347–1349. doi: 10.1097/00005373-199110000-00004. [DOI] [PubMed] [Google Scholar]
- 18.International Classification of Diseases, Ninth Revision, Clinical Modification. Washington, DC: US Department of Human Services; 1980. [Google Scholar]
- 19.Census of Population and Housing: 1990. Washington, DC: US Department of Commerce; 1993. [Google Scholar]