Furniture and television tip-over injuries to children treated in United States emergency departments

Abstract

Background Furniture and television tip-over injuries are an important source of injury to children, especially those younger than 6 years old. A current epidemiologic evaluation of tip-over injuries is needed, especially considering changes in the voluntary safety standard for clothing storage units (CSUs) and the shift in the consumer market from cathode ray tube to flat-screen televisions (TVs), and a decline in household TV ownership during recent years. The objective of this study is to update our understanding of the epidemiologic characteristics and trends of furniture (especially CSU) and TV tip-over injuries treated in United States emergency departments among children < 18 years old. Methods This study retrospectively analyzed data from the National Electronic Injury Surveillance System from 1990 to 2019. Trends in population-based rates were evaluated with regression techniques. All numbers of cases are expressed as national estimates. Results An estimated 560,203 children < 18 years old were treated in United States emergency departments for furniture or TV tip-over injuries during the 30-year study period, averaging 18,673 children annually. CSUs were involved in 17.2% (n = 96,321) of tip-overs, and TVs accounted for 41.1% (n = 230,325), which included 16,904 tip-overs (3.0%) that involved both a CSU and TV. The rate of furniture and TV tip-over injuries among children < 18 years old increased by 53.8% (p < 0.0001) from 1990 to 2010, and then decreased by 56.8% (p < 0.0001) from 2010 to 2019. Almost half (47.0%) of injuries occurred to the head/neck; 3.4% of children were admitted to the hospital. Children < 6 years old accounted for 69.9% of furniture and TV tip-over injuries overall; they accounted for 82.5% of CSU-related and 74.7% of TV-related tip-over injuries. Conclusions Despite the decline in tip-over injuries since 2010, more should be done to prevent these injuries, especially among children < 6 years old, because the number of injuries remains high, outcomes can be life-threatening, and effective prevention strategies are known. Safety education, warning labels, and promotion and use of tip restraint devices, while important, are not a substitute for strengthening and enforcing the stability requirements for CSUs and TVs.

Toppling television injuries in children and adolescents: a systematic review and meta-analysis

“…In this study, most skull fractures were localised to the occipital bones 1. This injury pattern may relate to a combination of characteristics in young children including short stature with a large head to body ratio, a thin skull and inadequate reflexive ability to avoid falling objects and cognitive abilities to predict danger 2 5 11. In addition, 25% of young children with head injures from toppling TVs have significant neurological sequalae and functional limitations at discharge from hospital 11 18.…”

“…Given the elevation and weight of TVs in relation to young children, injuries from toppling TVs can be severe and potentially fatal, with head and neck injuries commonly being described 2 17. Death from head trauma associated with toppling TVs fluctuates between 2% and 12% 5.…”

“…Children spend a substantial amount of time in front of a TV and this provides ample opportunity for accidents 19. Toppling TV injuries decreased in the USA in the last decade by 57% from approximately 27 000 injuries in 2010 to roughly 12 000 in 2019 2. Despite this downward trend the number of injuries, particularly in children under 6 years of age, remains high (10 per 100 000 children) 2.…”

“…Toppling TV injuries decreased in the USA in the last decade by 57% from approximately 27 000 injuries in 2010 to roughly 12 000 in 2019 2. Despite this downward trend the number of injuries, particularly in children under 6 years of age, remains high (10 per 100 000 children) 2. Factors which may have contributed to this downward trend included a decline in the number of household TVs and their replacement by portable devices, and increased awareness about product instability 2 23.…”

“…Trauma causes a substantial number of paediatric injuries and deaths and over one-third of those injuries occur in the home 1. Product instability or ‘toppling furniture’ including televisions (TVs) is a significant source of injury 2. Toppling accidents involve situations in which heavy pieces of furniture fall on individuals, mostly after some sort of interaction with the product while it is in its normal position of use 3.…”