Published online March 1, 2006
PEDIATRICS Vol. 117 No. 3 March 2006, pp. e452-e459 (doi:10.1542/peds.2005-1916)

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Success in the Prevention of Infant Walker–Related Injuries: An Analysis of National Data, 1990–2001

Brenda J. Shields, MS^a and Gary A. Smith, MD, DrPH^a,b

^a Center for Injury Research and Policy, Columbus Children's Research Institute, Children's Hospital, Columbus, Ohio
^b Department of Pediatrics, Ohio State University College of Medicine and Public Health, Columbus, Ohio

OBJECTIVE. Here we describe the epidemiologic characteristics and secular trends of infant walker–related injuries among children who are younger than 15 months in the United States.

METHODS. A retrospective analysis was conducted of data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission, 1990–2001. Sample weights that were provided by the National Electronic Injury Surveillance System were used in all analyses to adjust for the inverse probability of case selection and make national projections regarding infant walker–related injuries.

RESULTS. An estimated 197200 infant walker–related injuries occurred among children who were younger than 15 months and treated in US emergency departments from 1990 through 2001. Five percent of these children required admission to the hospital. The number of infant walker–related injuries remained relatively constant from 1990 through 1994, averaging 23000 cases per year. After the introduction in 1994 of stationary activity centers as an alternative to mobile infant walkers and the implementation of the revised American Society for Testing and Materials F977 voluntary infant walker standard in 1997, there was a marked decrease in the number of infant walker–related injuries. Overall, there was a 76% decrease in the number of injuries from 1990 to 2001 from 20900 injuries in 1990 to 5100 in 2001. Soft tissue injuries and lacerations represented 63% of the injuries. Trauma to the head region occurred in 91% of cases. Skull fractures were the most common (62%) type of fracture. Falls down stairs was the mechanism of injury in 74% of cases.

CONCLUSIONS. The adoption of passive injury-prevention strategies, such as use of stationary activity centers as alternatives to mobile infant walkers and redesign of infant walkers to prevent falls down stairs, were associated with a marked decrease in the number of infant walker–related injuries.

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Key Words: children • infant walker • injuries • injury prevention

Abbreviations: ED—emergency department • ASTM—American Society for Testing and Materials • CPSC—Consumer Product Safety Commission • NEISS—National Electronic Injury Surveillance System • OR—odds ratio • CI—confidence interval

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Accepted Aug 29, 2005.

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