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A Study in Greece

Xanthi Dedoukou, MD; Themis Spyridopoulos, MD; Simon Kedikoglou, MD; Delia Marina Alexe, MD; Nick Dessypris, MSc; Eleni Petridou, MD, MPH

Arch Pediatr Adolesc Med. 2004;158:1002-1006.

Objective  To assess the incidence of fall injuries among infants in Greece, overall and by type of nursery equipment.

Design  Review of data from a large injury database.

Setting  The Emergency Department Injury Surveillance System in Greece.

Patients  A total of 2672 injured infants.

Interventions  Specially trained health visitors performed in-person interviews with the children’s guardians, using a precoded questionnaire. The results of an independent survey of 777 mothers of noninjured children younger than 2 years attending the same emergency departments were used to allow quantification of the role of specific nursery equipment in the causation of infant fall injuries.

Main Outcome Measures  Annual rate of injury by falling in infants, overall and by cause.

Results  About 4400 infant fall injuries occur annually in Greece, corresponding to an annual incidence rate of 44 injuries per 1000 infants. The incidence of falls increases with increasing infant age. A high percentage of severe injuries was detected, most of them concussions (14.3%) and fractures (9.4%). Approximately 10% of infants with fall-related injuries required hospitalization. More than 36% of fall injuries involved nursery equipment. Infant walker use was associated with a higher incidence of falls (about 9 per 1000 infant-years), and these falls occasionally involved stairs and caused serious injuries. Infant bouncers, strollers, and changing tables were all associated with a similar incidence of falls (about 4 per 1000 infant-years).

Conclusions  Falls are a common cause of serious infant injuries, and nursery equipment is frequently involved in the injury-causing event.

Author Affiliations: From the Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece (Drs Dedoukou, Spyridopoulos, Kedikoglou, Alexe, and Petridou and Mr Dessypris); and Department of Epidemiology, Harvard School of Public Health, Boston, Mass (Dr Petridou).