Incidence and risk factors of fall injuries among infants: a study in Greece.

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

A maternity hospital-based infant car-restraint loan scheme: public health and economic evaluation of an intervention for the reduction of road traffic injuries.

AIMS: The results of an infant car-restraint loan scheme and evaluate its cost-effectiveness are presented. METHODS: The intervention programme was initiated in 1996. Car-restraints, donated by manufacturers, were lent for a six-month period to eligible prospective parents for a modest fee. Specially trained health visitors performed in-person interviews with the participating parents. The data were collected and recorded on a pre-coded questionnaire. Cross-tabulations and multiple logistic regression were performed to analyse the data. Subsequent purchase of a next-stage car restraint, suitable for older children (up to four years of age) was considered as a proxy measure of the success of the programme. This information, along with the detailed operational and financial data collected during the implementation phase of the programme, was used to develop a model to assess the cost-effectiveness of a countrywide intervention. RESULTS: During a two-year period 188 families participated in a survey. On return of the infant car restraint, 92% of the participants reported proper use of the device and 82% had already purchased the second-stage car restraint. Parental age, gender, or educational status was not predictive of positive parental road safety practices for the newly born, whereas history of parental seat-belt use--as a proxy of personal road safety behaviour--was positively correlated with the likelihood of purchasing a second-stage car-restraint device. The cost-effectiveness ratio varies between 418.00 euro and 3,225.00 euro per life-year saved, depending on whether the modest administrative fee is considered. CONCLUSIONS: On the basis of plausible assumptions, a loan programme of infant car-restraints was shown to be particularly cost effective