By Clementine Wallace
New York - A combination of public education and re-design of infant walkers has resulted in a 76 percent decrease in emergency room visits for walker-related accidents between 1990 and 2001 in the United States, according to researchers from the Children's Hospital in Columbus, Ohio.
The drop occurred mostly between 1994 and 2001, the investigators report, with the introduction of stationary activity centres as an alternative to walkers for infants, and with improvements to walkers such as adding integral braking systems or making them too large to go through doors.
"These interventions have led to a public health success... Such dramatic declines in such a short period of time are rare in the area of consumer related-injuries," Dr Gary Smith, director of the hospital's Centre for Injury, Research and Policy, told Reuters Health.
In their article in the medical journal Pediatrics, Smith and colleague Brenda Shields note that the use of baby walkers, which give infants mobility beyond their natural capabilities, has been associated with numerous types of injuries - mostly fractures resulting from falling down stairs.
"We used to tell parents to get rid of walkers, because even the best parent in the world can't watch their child 100 percent of the time," said Smith.
"But year after year, despite education, despite warning labels, we still saw 20 000 to 25 000 children treated in the emergency department for walker-related injuries - this was the wrong approach."
Looking through the National Electronic Injury Surveillance System data for 1990 to 2001, Smith and Shields found 197 200 reported cases of baby walker-related injuries among children younger than 15 months treated in US emergency departments.
The data show that the number of injuries started decreasing after the introduction of stationary activity centres, and dropped dramatically after the 1997 revised American Society for Testing and Materials voluntary infant walker standard.
In 2001, only 5 100 injuries were recorded, compared with 20 900 in 1990.
Head trauma occurred in 91 percent of cases, and skull fractures were the most common type of fractures observed, the authors report. Falling down stairs was the mechanism of injury in 74 percent of cases.
"We should try to learn from this approach - there are many examples where this type of prevention strategy would work and we are simply not doing it," said Smith, who cited, for example, the dangers related to shopping carts and lawn mowers.
SOURCE: Pediatrics, March 2006.