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Risk and protective factors for falls on stairs in young children: multicentre case–control study
  1. D Kendrick1,
  2. K Zou1,
  3. J Ablewhite1,
  4. M Watson2,
  5. C Coupland1,
  6. B Kay3,
  7. A Hawkins4,
  8. R Reading5
  1. 1Division of Primary Care, School of Medicine, Nottingham, UK
  2. 2School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK
  3. 3Emergency Department, Bristol Children's Hospital, Bristol, UK
  4. 4Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Research Unit Level 2, Newcastle upon Tyne, UK
  5. 5Jenny Lind Paediatric Department, Norfolk and Norwich University Hospital, Norfolk Community Health and Care NHS Trust, Norwich, UK
  1. Correspondence to Professor Denise Kendrick, Division of Primary Care, School of Medicine, Floor 13 Tower Building, University Park, Nottingham NG7 2RD, UK; denise.kendrick{at}nottingham.ac.uk

Abstract

Aim To investigate risk and protective factors for stair falls in children aged <5 years.

Methods Multicentre case–control study at hospitals, minor injury units and general practices in and around four UK study centres. Cases were children with medically attended stair fall injuries. Controls were matched on age, sex, calendar time and study centre. A total of 610 cases and 2658 controls participated.

Results Cases’ most common injuries were bangs on the head (66%), cuts/grazes not requiring stitches (14%) and fractures (12%). Parents of cases were significantly more likely not to have stair gates (adjusted OR (AOR) 2.50, 95% CI 1.90 to 3.29; population attributable fraction (PAF) 21%) or to leave stair gates open (AOR 3.09, 95% CI 2.39 to 4.00; PAF 24%) both compared with having closed stair gates. They were more likely not to have carpeted stairs (AOR 1.52, 95% CI 1.09 to 2.10; PAF 5%) and not to have a landing part-way up their stairs (AOR 1.34, 95% CI 1.08 to 1.65; PAF 18%). They were more likely to consider their stairs unsafe to use (AOR 1.46, 95% CI 1.07 to 1.99; PAF 5%) or to be in need of repair (AOR 1.71, 95% CI 1.16 to 2.50; PAF 5%).

Conclusion Structural factors including having landings part-way up the stairs and keeping stairs in good repair were associated with reduced stair fall injury risk. Family factors including having stair gates, not leaving gates open and having stair carpets were associated with reduced injury risk. If these associations are causal, addressing these factors in housing policy and routine child health promotion could reduce stair fall injuries.

  • falls
  • stairs
  • risk factors
  • case-control

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