Published online August 1, 2005
PEDIATRICS Vol. 116 No. 2 August 2005, pp. 454-461 (doi:10.1542/10.1542/peds.2004-1415)
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Deaths From Residential Injuries in US Children and Adolescents, 1985–1997

Jyothi Nagaraja, MS*, John Menkedick, MS*, Kieran J. Phelan, MD{ddagger}, Peter Ashley, DrPH§, Xiaoling Zhang, MS* and Bruce P. Lanphear, MD, MPH{ddagger}

* Battelle Memorial Institute, Columbus, Ohio
{ddagger} Cincinnati Center for Children's Environmental Health, Departments of Pediatrics and Environmental Health, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
§ US Department of Housing and Urban Development, Office of Healthy Homes and Lead Hazard Control, Washington, DC

Objective. The majority of deaths from unintentional injuries in children occur in the home environment, but there has not been a comprehensive analysis of residential deaths in the United States since 1985. The objective of this study was to determine the incidence and trends of deaths from injuries that occurred in the residential setting.

Methods. Injury-related death rates of all deaths among US children and adolescents who were younger than 20 years from 1985 to 1997 were calculated using National Vital Statistics System Mortality Data from 1985 to 1997 by age group, gender, region, and race. Poisson regression or negative binomial regression was used to test for trends over time in mortality rates.

Results. From 1985 to 1997, an average of 2822 (55%) of 5103 annual unintentional deaths in US children with a known location of injury took place in the home environment. The annual number and incidence of fatal residential injuries decreased by >22%, from 2973 (4.2 per 100000) in 1985 to 2310 (3.0 per 100000) in 1997. The death rate as a result of residential injury was highest in children who were younger than 1 year (12.6 per 100000) and 1 to 4 years (7.9 per 100000) compared with older children, boys compared with girls (4.9 vs 2.8 per 100000), and black children compared with white children (7.0 vs 3.3 per 100000). The highest death rates were attributable to fires (1.5 per 100000), submersion or suffocation (1.3 per 100000), poisoning (0.2 per 100000), and falls (0.1 per 100000).

Conclusions. Despite a 22% decline since 1985, residential injuries remain a leading cause of death in US children and adolescents. Black children were 2 times more likely to die from residential injuries than white children.

Key Words: disparities • environmental health • epidemiology • injury • home safety

Abbreviations: NCHS, National Center for Health Statistics • ICD, International Classification of Diseases • E-code, external causes of injury code • ICD-9, International Classification of Diseases, Ninth Revision

Accepted Nov 23, 2004.


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