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ARTICLES: Kimberly E. Stone, Emmanuella M. Eastman, Andrea C. Gielen, Barbara Squires, Glenda Hicks, Dana Kaplin, and Janet R. Serwint Home Safety in Inner Cities: Prevalence and Feasibility of Home Safety-Product Use in Inner-City Housing Pediatrics 2007; 120: e346-e353 [Abstract] [Full text] [PDF]

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Seven Statements Inconsistent With References, Other Literature, or Web Pages

Richard K.P. Sun   (21 June 2009)

Seven Statements Inconsistent With References, Other Literature, or Web Pages 21 June 2009
Richard K.P. Sun, Physician Sacramento, California Send letter to journal: Re: Seven Statements Inconsistent With References, Other Literature, or Web Pages RichardKPSunMD{at}comcast.net Richard K.P. Sun	Although this paper contains valuable information, at least seven statements in it are inconsistent with the references cited, with other (uncited) articles in the biomedical literature, or with Web pages: - "In 1993-1999, data from the National Hospital Ambulatory Medical Care Survey reported >50% of unintentional injury emergency visits for children <20 years of age were because of residential injuries" (page e347): Based on the Figure in the 2005 study cited for this sentence[1], this sentence should have read "...<20 years of age (when the location of injury was known) were because of...." The reason is that the ">50%" figure appears to be derived from the sentence "The home was the single most common location of injury, accounting for 39% of injury-related ED visits and 51% of all unintentional injury visits with known locations"[1]. - "Many residential injuries can be prevented using recommended home safety products such as smoke alarms, stair gates, and cabinet locks" (page e347): The 1985 article[2] cited for this sentence did not concern stair gates and cabinet locks, and provided no direct evidence of the effectiveness of smoke alarms in preventing injuries (although the article did review previous literature on the topic). In contrast, a 2005 randomized controlled trial showed that provision of free smoke alarms, stair gates, and cabinet locks "did not reduce injuries that necessitated medical attendance"[3]. Furthermore, a 2007 systematic review of literature up to 2006 found a "lack of evidence" that home safety education, with or without the provision of safety equipment such as smoke alarms, stair gates, and cabinet locks, actually prevents residential injuries[4]. The sentence should have read "Home safety products such as smoke alarms and stair gates are recommended for the prevention of residential injuries in children," which is consistent with a 1994 policy of the American Academy of Pediatrics[5]. - "Previous research has demonstrated that general housing and neighborhood conditions at... [the] census tract level... [have] been associated with parent safety practices and child injury risk" (page e347): The 1996 article "Does home visiting prevent childhood injury?" (reference 13) cited for this statement does not contain the words "census" or "tract"; I believe that the authors intended to cite the 1994 article "Low-income neighborhoods..." (reference 6) instead. - "We hypothesized that... self-report is higher than observed home safety practices" (page e347): Comparison of self-reported practices and observed practices was not a major focus of the 2001 paper "Randomized trial of enhanced anticipatory guidance for injury prevention" (reference 7) cited for this statement. I believe that the 2003 paper "Validity of self reported home safety practices" (reference 8), which concerned the same study subjects as reference 7, should have been cited alongside it. - "To use a stair gate correctly, the width of the opening at the top of the stairs must be 28 inches to accommodate a wall-anchored stair gate" (page e349): The wall-mounted KidCo Safeway® Model G20 gate, which has been available since at least 2003[6] and is still widely available as of 2009[7], can fit an opening as narrow as 24.75 inches. If this gate had been considered, the "Width too narrow for recommended gate" and "Homes unable to accommodate recommended stair gates" numbers and percentages in Table 3 on page e350 would have been lower. - "The staircase must have a flat surface on both sides to which the gate can be anchored" (page e349): Since at least 2003, KidCo has manufactured a Safety Gate Installation Kit Model K10 for the installation of child safety gates "to wood banisters... or wrought iron"[6], and this is still widely available as of 2009[8]. If this installation kit had been considered, the "Banister design" and "Homes unable to accommodate recommended stair gates" numbers and percentages in Table 3 on page e350 would have been lower. - "One study in Philadelphia, Pennsylvania, found that 21% of homes had staircases with broken or loose railings (page e351): Based on Table 4 in the 1993 article[9] cited, this sentence should have read "...had interior staircases with missing [not 'broken'] or loose railings." In the 1993 article, "interior" stairs excluded stairs located outside a house or in a basement. REFERENCES 1. Phelan KJ, Khoury J, Kalkwarf H, Lanphear B. Residential injuries in U.S. children and adolescents. Public Health Rep 2005;120:63-70. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1497684. Accessed June 20, 2009 2. Gorman RL, Charney E, Holtzman NA, Roberts KB. A successful city- wide smoke detector giveaway program. Pediatrics 1985;75:14-18. Available at: http://pediatrics.aappublications.org/cgi/reprint/75/1/14. Accessed June 20, 2009 3. Watson M, Kendrick D, Coupland C, Woods A, Futers D, Robinson J. Providing child safety equipment to prevent injuries: randomised controlled trial. BMJ 2005;330:178. Available at: http://www.bmj.com/cgi/content/full/330/7484/178. Accessed June 20, 2009 4. Kendrick D, Coupland C, Mulvaney C, Simpson J, Smith S, Sutton A, Watson M. Home safety education and provision of safety equipment for injury prevention. Cochrane Database Syst Rev 2007;(1):CD005014. Available at: http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005014/frame.html. Accessed June 20, 2009 5. American Academy of Pediatrics, Committee on Injury and Poison Prevention. Office-based counseling for injury prevention. Pediatrics 1994;94:566–567. Available at: http://aappolicy.aappublications.org/cgi/reprint/pediatrics;94/4/566. Accessed June 20, 2009 6. KidCo. Child & pet safety gates [Web page archived on April 7, 2003]. Available at: http://web.archive.org/web/20030407085438/http://www.kidco.com/gates.cfm. Accessed June 20, 2009 7. KidCo. Safeway® Model G20. Available at: http://www.kidco.com/main.taf?erube_fh=kidco&kidco.submit.gateDetails=1&kidco.modelNumber=G20&kidco.bc=gc. Accessed June 20, 2009 8. KidCo. Safety Gate Installation Kit Model K10. Available at: http://www.kidco.com/main.taf?erube_fh=kidco&kidco.submit.gateDetails=1&kidco.modelNumber=K10&kidco.bc=gc. Accessed June 20, 2009 9. Schwarz DF, Grisso JA, Miles C, Holmes JH, Sutton RL. An injury prevention program in an urban African-American community. Am J Public Health 1993;83:675-680. Available at: http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1694716. Accessed June 20, 2009 Conflict of Interest: None declared