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Risk factors for unintentional injuries due to falls in children aged 0–6 years: a systematic review
  1. A Khambalia1,
  2. P Joshi2,
  3. M Brussoni2,
  4. P Raina3,
  5. B Morrongiello4,
  6. C Macarthur5
  1. 1Division of Paediatric Medicine and the Paediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada; University of Toronto, Ontario, Canada
  2. 2British Columbia Injury Research and Prevention Unit, Vancouver, British Columbia, Canada; University of British Columbia, Vancouver, British Columbia, Canada
  3. 3Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
  4. 4Child Development Research Unit, Department of Psychology, University of Guelph, Ontario, Canada
  5. 5Department of Paediatrics, Toronto, Ontario, Canada
  1. Correspondence to:
 C Macarthur
 Bloorview Kids Rehab, 150 Kilgour Road Toronto, ON, Canada M4G 1R8; cmacarthur{at}


Objective: To identify risk factors for unintentional injuries due to falls in children aged 0–6 years.

Design: A systematic review of the literature.

Methods: Electronic databases from 1966 to March 2005 were comprehensively searched to identify empirical research that evaluated risk factors for unintentional injuries due to falls in children aged 0–6 years and included a comparison group.

Results: 14 studies met the inclusion criteria. Studies varied by the type of fall injury that was considered (ie, bunk bed, stairway, playground or infant walker) and with respect to the quality of evidence. In general, major risk factors for the incidence or severity of injuries due to falls in children included age of the child, sex, height of the fall, type of surface, mechanism (dropped, stairway or using a walker), setting (day care v home care) and socioeconomic status.

Conclusion: Despite a high burden, few controlled studies have examined the risk and protective factors for injuries due to falls in children aged 0–6 years. The only study to examine falls from a population health perspective suggests that age, sex and poverty are independent risk factors for injuries due to falls in children.

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  • i Prevention and control

  • ii Epidemiology

  • Funding: This study was supported by a grant from the City of Toronto (9155-03-7366).

  • Competing interests: None.

  • The funding organization had no role in the study design and conduct; data collection, management, analysis and interpretation; manuscript preparation and approval.