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Structural housing elements associated with home injuries in children
  1. Wendy Shields,
  2. Eileen McDonald,
  3. Shannon Frattaroli,
  4. David Bishai,
  5. Xia Ma,
  6. Andrea Gielen
  1. Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  1. Correspondence to Wendy Shields, Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 527B, Baltimore, MD 21205, USA; wshields{at}


Objective To quantify unintentional injuries associated with housing elements among children less than 18 years old treated in US hospital emergency departments.

Methods The National Electronic Injury Surveillance System (NEISS) coding manual was reviewed, and all product codes that identified products permanently affixed to a home (housing elements) were identified. A query of the 2008 NEISS data for children under 18 determined the numbers of cases by severity code for each identified housing element. Housing elements were then tabulated by the number of cases for each severity code. The top 10 cases by severity code, (1) hospitalised or (2) treated in emergency departments, were included in a case review. Ten per cent of all cases or a minimum of 100 cases were randomly selected for review for each of the identified housing elements to assess if the case description could inform prevention efforts.

Results Twelve housing elements (bathtub, cabinet, carpet, ceiling/wall, counter, door, fence, floor, nail, porch, stairs and window) were identified as the leading causes of injuries resulting in hospitalisations or emergency department visits. A list of potential interventions was generated based on the review of the case histories. Suggested changes for NEISS coding are also offered to enhance future prevention research.

Conclusions NEISS is a valuable tool to identify home injury risks and inform design decisions for housing elements. Improved understanding of housing elements associated with injuries has the potential to enhance home inspection forms. However, interpretation of NEISS results is limited by lack of clarity about how the housing element was involved in the injury event.

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