Table 1
Source publication
To describe the epidemiology of pediatric injuries associated with furniture tip-overs in the United States.
Data from the National Electronic Injury Surveillance System were analyzed for patients < or =17 years treated in emergency departments for a furniture tip-over-related injury from 1990 through 2007.
An estimated 264 200 furniture tip-over-r...
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Citations
... In this study, it was found that 90.4% of the injuries occurred in the home environment. Hence, overturning furniture and household equipment is among the most common causes of injury (Gottesman et al., 2009). ...
Aim of study: Furniture used indoors; threatens the life safety of users by being knocked over for many reasons such as design, production, user errors, earthquakes, etc. This study was carried out to determine the effects of the variables related to the foots used in the furniture and the horizontal forces on the overturning of furniture. Area of study: This study was carried out in Safranbolu Şefik Yılmaz Dizdar Vocational School Interior Design Department test laboratory. Material and methods: For the experiments, a leg model, which is widely used in the market, was determined and a multi-purpose cabinet was prepared. Loads were applied to this cabinet with the mechanism established within the scope of TS 9215 and TS EN 14073-2 standards. The effects of the obtained results on overturning were evaluated by analysis of variance and Duncan multiple comparison test. Main results: It has been observed that the variables such as the position, diameter, height of the foot used in the furniture and the height of the force causing the overturning are effective at various rates in the safe use of the furniture. It has been calculated that the effect of force application heights on overturning is 50.82% at most and foot positions 12.4% at most. Highlights: The results obtained can be used to increase indoors safety by making it more difficult for overturning of the furniture.
... TVs are also frequently involved in tip-over injuries, with an average of > 6200 children < 5 years old treated annually in US EDs with these injuries from 1990 to 2011 (De Roo et al., 2013). Traumatic brain injury has been commonly reported among nonfatal and fatal pediatric tip-overs (Suchy, 2021;Murray et al., 2009;Gottesman et al., 2009;De Roo et al., 2013;Yahya et al., 2005;Rutkoski et al., 2011;Lichenstein et al., 2015;Sikron et al., 2006;Bernard et al., 1998). ...
... In addition, although the estimate was potentially unstable, children < 6 years old represented about 99% of deaths. These findings are consistent with those from previous reports (Suchy, 2021;Murray et al., 2009;Gottesman et al., 2009;De Roo et al., 2013). ...
... The overall rate of concussion/ CHI, which is among the most serious injury diagnoses in this study based on admission rates, has decreased since 2010, but remains high in the younger age group. These findings are consistent with those reported previously (Suchy, 2021;Murray et al., 2009;Gottesman et al., 2009;De Roo et al., 2013). ...
Background:
Furniture and television tip-over injuries are an important source of injury to children, especially those younger than 6 years old. A current epidemiologic evaluation of tip-over injuries is needed, especially considering changes in the voluntary safety standard for clothing storage units (CSUs) and the shift in the consumer market from cathode ray tube to flat-screen televisions (TVs), and a decline in household TV ownership during recent years. The objective of this study is to update our understanding of the epidemiologic characteristics and trends of furniture (especially CSU) and TV tip-over injuries treated in United States emergency departments among children < 18 years old.
Methods:
This study retrospectively analyzed data from the National Electronic Injury Surveillance System from 1990 to 2019. Trends in population-based rates were evaluated with regression techniques. All numbers of cases are expressed as national estimates.
Results:
An estimated 560,203 children < 18 years old were treated in United States emergency departments for furniture or TV tip-over injuries during the 30-year study period, averaging 18,673 children annually. CSUs were involved in 17.2% (n = 96,321) of tip-overs, and TVs accounted for 41.1% (n = 230,325), which included 16,904 tip-overs (3.0%) that involved both a CSU and TV. The rate of furniture and TV tip-over injuries among children < 18 years old increased by 53.8% (p < 0.0001) from 1990 to 2010, and then decreased by 56.8% (p < 0.0001) from 2010 to 2019. Almost half (47.0%) of injuries occurred to the head/neck; 3.4% of children were admitted to the hospital. Children < 6 years old accounted for 69.9% of furniture and TV tip-over injuries overall; they accounted for 82.5% of CSU-related and 74.7% of TV-related tip-over injuries.
Conclusions:
Despite the decline in tip-over injuries since 2010, more should be done to prevent these injuries, especially among children < 6 years old, because the number of injuries remains high, outcomes can be life-threatening, and effective prevention strategies are known. Safety education, warning labels, and promotion and use of tip restraint devices, while important, are not a substitute for strengthening and enforcing the stability requirements for CSUs and TVs.
... The mean Glasgow Coma Scale (GCS) score at admission was 13.9±1.1 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). According to computerized tomography (CT) findings, 12 patients (13.9%) had intracranial hemorrhage and 19 patients (22%) had skull fractures. ...
Aim:
To identify, report, and raise awareness of the risk factors for television (TV) tip-over.
Material and methods:
In total, 86 children who were brought to the emergency service and hospitalized at the neurosurgery clinic because of TV tip-over-related head trauma between August 2011 and August 2016 were included in the study.
Results:
The 86 patients consisted of 47 males and 39 females. The mean age was 38.8 ± 19.5 (9â€"102) months. Low education level of the mother was a risk factor for this type of accident (p=0.009). In all the patients, injuries were caused by the tip-over of a cathode ray tube (CRT) TV. In 66 patients (77%), only the TV tipped over onto the child, whereas in 20 cases (23%), the TV tipped over with the TV stand. The TVs were not fixed to the stand or the wall in any of the homes. According to computerized tomography findings, 12 patients (13.9%) had intracranial hemorrhage and 19 patients (22%) had skull fractures. Five patients underwent neurosurgical intervention. Eighty-four patients (97.6%) were discharged with a GCS level of 15. One patient was discharged with a GCS level of 9/15 with a tracheostomy and nasogastric tube. One patient died.
Conclusion:
TV tip-over causes physical injury that may result in serious neurological damage and even death. It is becoming more common and may be prevented by taking simple precautions.
... These have included a retrospective case series covering a 10-year period, which described 183 patients with injuries from television tip-overs, 3 and additional studies, which used the National Electronic Injury Surveillance System (NEISS), a surveillance system maintained by the US CPSC that monitors approximately 100 emergency departments (EDs). 5,9,11,12 These studies document incidence trends, although they provide limited clinical data. Of note, the rate of injuries related to television tip-overs increased 95% between 1990 and 2011. ...
... More recent studies using the CPSC NEISS similarly showed that head injury occurs in approximately half of children struck by falling televisions. 8,9,12 The NEISS data are limited by the retrospective nature of data collection and clinical detail, such as the lack of GCS scores and the lack of detail in reporting serious outcomes such as death. ...
Objective:
The objective of the study was to describe the epidemiology, cranial computed tomography (CT) findings, and clinical outcomes of children with blunt head trauma after television tip-over injuries.
Methods:
We performed a secondary analysis of children younger than 18 years prospectively evaluated for blunt head trauma at 25 emergency departments (EDs) in the Pediatric Emergency Care Applied Research Network from June 2004 to September 2006. Children injured from falling televisions were included. Patients were excluded if injuries occurred more than 24 hours before ED evaluation or if neuroimaging was obtained before evaluation. Data collected included age, race, sex, cranial CT findings, and clinical outcomes. Clinically important traumatic brain injuries (ciTBIs) were defined as death from TBI, neurosurgery, intubation for more than 24 hours for the TBI, or hospital admission of 2 nights or more for the head injury, in association with TBI on CT.
Results:
A total of 43,904 children were enrolled into the primary study and 218 (0.5%; 95% confidence interval [CI], 0.4% to 0.6%) were struck by falling televisions. The median (interquartile range) age of the 218 patients was 3.1 (1.9-4.9) years. Seventy-five (34%) of the 218 underwent CT scanning. Ten (13.3%; 95% CI, 6.6% to 23.2%) of the 75 patients with an ED CT had traumatic findings on cranial CT scan. Six patients met the criteria for ciTBI. Three of these patients died. All 6 patients with ciTBIs were younger than 5 years.
Conclusions:
Television tip-overs may cause ciTBIs in children, including death, and the most severe injuries occur in children 5 years or younger. These injuries may be preventable by simple preventive measures such as anchoring television sets with straps.
... Murray et al. used only population-based estimates in their review of the National Electronic Injury Surveillance System, which surveys approximately 100 US hospitals. 35 These investi- 12,21 Data from multiple studies regarding the characteristics of the events that led to TV-toppling injuries are summarized in Table 2. Most (84%) of the injuries occur at home and more than three-fourths are unwitnessed by caregivers. The TVs are most commonly large (median size 27 inches) and elevated off the ground 1-5 feet. ...
... Toddlers were reported to have higher rates of climbing injuries than older children (> 4 years old), who were more likely to collide with the TV stand. 21,35,46 The wide variety of cranial pathologies caused by toppling TVs is summarized in Table 3. Superficial injuries included contusions, ear/nose/throat bleeds, abrasions, lacerations, ecchymosis, and other nonintracranial injuries. Neurological deficits included any temporary or permanent cranial nerve palsies as well as cognitive and memory deficits. ...
Injuries to children caused by falling televisions have become more frequent during the last decade. These injuries can be severe and even fatal and are likely to become even more common in the future as TVs increase in size and become more affordable.
To formulate guidelines for the prevention of these injuries, the authors systematically reviewed the literature on injuries related to toppling televisions. The authors searched MEDLINE, PubMed, Embase, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, and Google Scholar according to the Cochrane guidelines for all studies involving children 0–18 years of age who were injured by toppled TVs. Factors contributing to injury were categorized using Haddon’s Matrix, and the public health approach was used as a framework for developing strategies to prevent these injuries.
The vast majority (84%) of the injuries occurred in homes and more than three-fourths were unwitnessed by adult caregivers. The TVs were most commonly large and elevated off the ground. Dressers and other furniture not designed to support TVs were commonly involved in the TV-toppling incident. The case fatality rate varies widely, but almost all deaths reported (96%) were due to brain injuries. Toddlers between the ages of 1 and 3 years most frequently suffer injuries to the head and neck, and they are most likely to suffer severe injuries. Many of these injuries require brain imaging and neurosurgical intervention. Prevention of these injuries will require changes in TV design and legislation as well as increases in public education and awareness. Television-toppling injuries can be easily prevented; however, the rates of injury do not reflect a sufficient level of awareness, nor do they reflect an acceptable effort from an injury prevention perspective.
... Studies investigating the causes of the injuries by fallen television show an increase in the number of the cases about this concern in recent years; also they claim that this increase is a result of the increase in the use of plasma or LCD televisions; and also because of insufficient prevention of families 8,[11][12][13] . Relatives of the patients was learned that they use most of the plasma television in our study. ...
... 9 TVs are not covered by this voluntary standard, and even though they are implicated in approximately half of furniture-related tip-over injuries, no similar requirement applies to them. 36 Extending this type of requirement to TVs as part of the Underwriters Laboratories standard that addresses TV stability would be an important step in decreasing the number of injuries resulting from falling TVs. 8 Unanchored TVs in the home are unsafe. Cars are not sold without safety belts, and similarly, TVs should not be sold without the necessary safety anchors. ...
Objective:
To investigate the epidemiology of television (TV)-related injuries to children in the United States.
Methods:
Using data from the National Electronic Injury Surveillance System, children aged <18 years treated in United States hospital emergency departments for an injury associated with a TV from 1990 through 2011 were investigated.
Results:
An estimated 380,885 patients aged <18 years were treated in emergency departments for a TV-related injury during the 22-year study period, which equals an annual average of 17,313 children. The median age of patients was 3 years; children <5 years represented 64.3% of patients, and boys comprised 60.8%. The average annual injury rate was 2.43 (95% confidence interval [CI]: 2.07-2.80) injuries per 10,000 children aged <18 years, with a range of 2.15 (95% CI: 1.64-2.66) to 2.90 (95% CI: 2.31-3.49). Although the overall injury rate was steady, the number and rate of injuries associated with falling TVs increased significantly by 125.5% and 95.3%, respectively, during the study period. In addition, there was a significant 344.1% increase in the number of injuries associated with a TV falling from a dresser/bureau/chest of drawers/armoire during 1995-2011.
Conclusions:
The rate of pediatric injuries caused by falling TVs is increasing, which underscores the need for increased prevention efforts. Prevention strategies include public education, provision of TV anchoring devices at the point of sale of TVs, TV anchoring device distribution programs, strengthening of standards for TV stability, and redesign of TVs to improve stability.
... In order to improve healthcare outcomes, the furniture design and placement of furniture in HCFs should 'Reduce surface contamination linked to health care-associated infections' (e.g. by providing surfaces which are easy to clean) (Malone and Dellinger 2011); 'Reduce patient falls and associated injuries' (e.g. by offering adjustable chair seat height and chair with armrests) Intelligent Buildings International (Malone and Dellinger 2011); 'Decrease medication errors' (e.g. by providing adequate lighting and configurable furniture) (Malone and Dellinger 2011); 'Improve communication and social support for patients and family members' (e.g. by configuring furniture into small flexible groupings (Somner and Ross 1958;Melin and Gotestam 1981;Ulrich 1991Ulrich , 2000aUlrich , 2000cUlrich , 2000b and supporting variations in width, size and age (Sigrest 2003;CDC 2008;Gottesman et al. 2009;FGI 2010;Malone and Dellinger 2011)); 'Decrease patient, family member and staff stress and fatigue' (e.g. by testing furniture for safe and comfortable use); 'Improve staff effectiveness, efficiency, and communication' (e.g. by offering furniture that is easily adjustable to the ergonomic needs of individual workers and providing sound-absorbing materials); and 'Improve environmental safety' (by ensuring that materials do not contain harmful chemicals) (Malone and Dellinger 2011). In addition to this 'furniture design checklist' suggested by the Malone and Dellinger from the Center for Health Design (Malone and Dellinger 2011), the OSHA 2010 standard (OSHA 2010) as well as the BIFMA e3-2008 standard (BIFMA International 2008) for manufacturing should also be taken into account. ...
As a result of growing evidence regarding the effects of environmental characteristics on the health and wellbeing of people in healthcare facilities (HCFs), more emphasis is being placed on, and more attention being paid to, the consequences of design choices in HCFs. Therefore, we have critically reviewed the implications of key indoor physical design parameters, in relation to their potential impact on human health and wellbeing. In addition, we discussed these findings within the context of the relevant guidelines and standards for the design of HCFs. A total of 810 abstracts that met the inclusion criteria were identified through a PubMed search, and these covered journal articles, guidelines, books, reports and monographs in the studied area. Out of these, 230 full publications were selected for this review. According to the literature, the most beneficial design elements were: single-bed patient rooms, safe and easily cleaned surface materials, sound-absorbing ceiling tiles, adequate and sufficient ventilation, thermal comfort, natural daylight, control over temperature and lighting, views, exposure and access to nature, and appropriate equipment, tools and furniture. The effects of some design elements, such as lighting (e.g. artificial lighting levels) and layout (e.g. decentralized versus centralized nurses’ stations), on staff and patients vary, and ‘the best design practice’ for each HCF should always be formulated in co-operation with different user groups and a multi-professional design team. The relevant guidelines and standards should also be considered in future design, construction and renovations, in order to produce more favourable physical indoor environments in HCFs.
... TVs may be placed on furniture that was not designed to hold such weight, such as dressers and shelving units. [11] As a result, TVs are even more prone to tipping and falling when pulled or knocked by a child, and can bring their supporting furniture down as well. In our study, a variety of supportive structures were involved in the accidents, but dressers were the most common. ...
We reviewed retrospectively TV-related injuries to determine the risk factors, type of injuries, and operative intervention(s) required in children injured by falling TVs.
This was a retrospective descriptive study conducted on 42 pediatric patients who were admitted to Istanbul University, Istanbul Medical Faculty, Emergency Surgery Department. Case notes included all demographic and injury details, TV and TV-related furniture type, mechanism of injury, Pediatric Trauma Score (PTS), Pediatric Glasgow Coma Scale (PGCS), length of hospital stay, need for intensive care unit assessments, and management plans.
More than 65% of the children were aged 1 to 3 years. The injury rate was higher for boys (66.7%) than girls (33.3%). Of the 42 patients identified, 17 (40.5%) sustained only head injuries, with almost half of these having a definite traumatic brain injury; 6 (14.3%) had only thoracic injury, and 4 (9.5%) had only limb injury. The PGCS ranged from 3 to 15, with a mean of 7. The PTS ranged from -6 to 12, with a mean of 9. Five children (11.9%), all aged 2 years or younger, died in the hospital as a result of the TV-related injury, all sustaining head and thorax injuries, which are reflected in a significantly lower PTS and lower PGCS on admission compared with older children. TV falls on to children often occur because of unstable supports, with dressers and shelves being the most common. The most common mechanism of injury (71.4%) among all age groups was fall/tipping of furniture. Pulling the furniture onto oneself (19%) was the second most frequent mechanism of injury.
Injuries related to TV falls can lead to significant morbidity and mortality in children. As they are preventable injuries, restricted activity and improved supervision of children around the TV can potentially lead to fewer incidences.
... Falling TVs have created a potential risk for significant injury to children in households. However, despite the danger, only a few studies have been reported in the literature regarding this source of risk [1, 3–11]. Furthermore, several home safety guidelines for parents do not include how to prevent TV-related injuries [12, 13]. ...
... Most accidents take place in the home environment, especially in toddlers and pre-schoolers as they spend most of their time there [1, 2, 11]. This study showed that children aged 12 to 36 months of both genders had the highest overall injury rate resulting from TV-related injuries. ...
... Sikron et al. reported that nearly three-quarters of the children (73.3%) sustained head/neck injuries, with almost half of these having a definite traumatic brain injury [3]. Our results and the other relevant studies supported this evidence [5, 11]. There may be two reasons; either the TV falls onto the child’s head, or the child hits his head on the ground during the fall. ...
To quantify injuries in children that result from toppled televisions.
Children presenting directly to emergency department due to injuries caused by falling televisions were identified from our digital patient database, and a retrospective chart review of 71 children was performed. Descriptive statistics were applied.
71(1.8%) out of 3856 admissions due to injuries sustained at home were TV-related injuries. There were 50 (70.4%) boys and 21(29.6%) girls. Mean age was 39.79 ± 20.14 SD months. Almost three quarters of the children (49/71) sustained various head and facial injuries. There was traumatic brain injury in 14 patients, extremity injuries in 30 patients, thoracic injuries in 13 patients and abdominal injuries in ten patients. 16 patients were hospitalized. 14 of them required follow-up in intensive care unit. Two patients (one with epidural hematoma and one with subdural hematoma) underwent surgical intervention. Four patients with subarachnoid bleeding died. The mean length of hospital stay was 71.25 hours (range, 48-168) in hospitalised patients. The overall mortality rate was 5.6%.
Falling TVs may cause significant morbidity and mortality in children particularly those younger than 3 years old. Head and facial injuries are the most common body region involved and traumatic brain injury is the major cause of death. [This corrects the article on p. 305 in vol. 3, PMID: 21373297.].
