title: Risk and protective factors for falls on stairs in young children: multicentre case-control study.
abstract: OBJECTIVE
  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%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Primary Care, School of Medicine, Nottingham, UK.
authors.forename: D
authors.initials: D
authors.lastname: Kendrick
authors.affiliation: Division of Primary Care, School of Medicine, Nottingham, UK.
authors.forename: K
authors.initials: K
authors.lastname: Zou
authors.affiliation: Division of Primary Care, School of Medicine, Nottingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Ablewhite
authors.affiliation: School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
authors.forename: M
authors.initials: M
authors.lastname: Watson
authors.affiliation: Division of Primary Care, School of Medicine, Nottingham, UK.
authors.forename: C
authors.initials: C
authors.lastname: Coupland
authors.affiliation: Emergency Department, Bristol Children's Hospital, Bristol, UK.
authors.forename: B
authors.initials: B
authors.lastname: Kay
authors.affiliation: Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Research Unit Level 2, Newcastle upon Tyne, UK.
authors.forename: A
authors.initials: A
authors.lastname: Hawkins
authors.affiliation: Jenny Lind Paediatric Department, Norfolk and Norwich University Hospital, Norfolk Community Health and Care NHS Trust, Norwich, UK.
authors.forename: R
authors.initials: R
authors.lastname: Reading
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000061:Accidents, Home / Q000517:prevention & control*; D016022:Case-Control Studies; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005191:Family Characteristics; D006794:Household Articles / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011482:Protective Devices; D065840:Protective Factors; D012307:Risk Factors; D000072799:Stair Climbing / Q000502:physiology; D006113:United Kingdom
keywords: case-control; falls; risk factors; stairs