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Renae Rauchschwalbe, MS; N. Clay Mann, PhD

JAMA. 1997;277(21):1696-1698.

Abstract
Objective.
—To document the prevalence of pediatric asphyxial death from window-covering cords in the United States and identify associated risk factors.

Design.
—Retrospective analysis of existing death certificate and incident files compiled by the US Consumer Product Safety Commission.

Setting.
—United States, 1981 through 1995.

Patients.
—Children aged 1 month to 8 years suffering unintentional traumatic asphyxiation from a window-covering cord.

Results.
—A total of 183 fatal window-cord strangulations were reported for the years 1981 through 1995, representing a mortality rate of 0.14 (95% confidence interval [CI], 0.10-0.18) per 100 000 persons (3 years old) per year in the United States. Ninety-three percent of victims were 3 years of age or younger. Pull cords on venetian-type horizontal window coverings accounted for 86% of documented injuries. Infant victims were more likely to become entangled while put down for a nap and toddlers were more likely to be suspended by the cord after falling or jumping from a height (P=.002). Window coverings remained anchored and did not undrape when substantial weight was suspended in the draw-cord loop.

Conclusions.
—Window-covering cords represent a substantial strangulation hazard compared with other potentially harmful household products that were modified based on voluntary standards to mitigate the risk of injury. Product design modifications and parental education will be necessary to avert this type of fatal home injury.

Author Affiliations
From the Office of Compliance, US Consumer Product Safety Commission, Washington, DC (Ms Rauchschwalbe), and the Department of Emergency Medicine, Oregon Health Sciences University, Portland (Dr Mann).

Footnotes
Presented as a poster exhibit at the annual meeting of the Society for Academic Emergency Medicine, Denver, Colo, May 1996.

The contribution made to this article by Ms Rauchschwalbe, a senior compliance officer for the US Consumer Product Safety Commission, was performed in her official capacity. However, it is not intended nor should it be inferred that the opinions expressed herein represent the official position of the US Consumer Product Safety Commission.

Reprints: N. Clay Mann, PhD, Department of Emergency Medicine, UHN-52, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR 97201-3098.

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