Pediatric window-cord strangulations in the United States, 1981-1995
R. Rauchschwalbe and N. C. Mann
Office of Compliance, US Consumer Product Safety Commission, Washington, DC, USA.
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
100000 persons (< or =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.
