Annual risk of death resulting from short falls among young children: Less than 1 in 1 million. David L Chadwick, Gina Bertocci, Edward Castillo, Lori Frasier, Elisabeth Guenther, Karen Hansen, Bruce Herman, Henry Krous. Pediatrics 2008;121:1213-1224. (from San Diego CA, Louisville KY, and Salt Lake City UT)
Review from Winter 2009 issue
The objective of this research was to develop an estimate of the risk of death resulting from short falls of less than 1.5 meters in vertical height, affecting infants and young children between birth and the fifth birthday. The study sought to review critically the pediatric fall literature and three relevant public injury databases in an effort to approximate the incidence of child deaths resulting from short falls in the population of young children.
For purposes of this review, a short fall was defined as a fall of less than 1.5 meters (less than 4.7 feet) in vertical height, not involving horizontal velocity beyond what a young child can achieve alone. Fall height was best defined as the difference in the positions of the child’s center of gravity at the start and end of the fall. The authors concede that consistent definitions were not found in the literature review, so the articles they reviewed did not necessarily conform to this definition. The definition of a fatal case they used was one in which the injury was the proximate cause of death.
The study set was derived from several sources:
In their discussion, the authors reiterate the difficulty involved in determining the likelihood of death resulting from a short fall in a young child. That difficulty derives from the impossibility in determining the accuracy of the history of the incident. However, the authors opine that the “best solution to this problem is the ongoing collection of data on hospitalized and fatal injuries from large numbers of injury events affecting infants and young children in large states.”
The authors conclude that the best estimate for risk of death from short falls in an infant or a young child is less than one in a million young children per year. No evidence can be found in the rich literature on children’s fall-related injuries or in other public databases to support a higher incidence.
Reviewed by Robert M. Reece, M.D.
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