Escalator-related injuries among children

Approximately 2,000 children are treated in United States hospital emergency rooms annually for escalator-related injuries.

According to a study published in the August issue of Pediatrics and conducted by researchers at the Center for Injury Research and Policy (CIRP) in the Columbus Children's Research Institute at Columbus Children's Hospital, an estimated 26,000 U.S. children 19 years of age and younger were treated in a hospital emergency department for an escalator-related injury in 1990-2002.

"This study is the first to describe the epidemiology of escalator-related injuries among children using a national sample," said CIRP Director Gary Smith, MD, DrPH, senior author of the study and a faculty member of The Ohio State University College of Medicine. "Escalator designs that reduce the gap between the steps and sidewall or shield against access to the gap may decrease entrapment risk. This redesign approach provides automatic, or 'passive,' protection that is most likely to prevent entrapment injuries in all age groups."

Data from the National Electronic Injury Surveillance System (NEISS) of the U.S. Consumer Product Safety Commission were used to estimate national numbers and rates of escalator-related injuries. The analysis included all patients in the NEISS database who were 0 to 19 years of age and were seen in an emergency department for an escalator-related injury during the 13-year period, 1990-2002.

Children younger than five years had the largest number of injuries (12, 000), and the highest annual escalator-related injury rate, with entrapment accounting for nearly 37 percent of injuries. Six percent (723) of injuries to these children involved a stroller, with most occurring when a child fell out of the stroller while on the escalator. The hand was the most common injury site (40.6%) among these young children, with hand injuries frequently occurring as a result of entrapment.

"Young children should be supervised properly and should not be transported in a stroller while riding on an escalator," said Jennifer McGeehan, MPH, lead author of the study and member of the CIRP staff. "If an escalator is used, then parents should remove their child from the stroller and carry him or her while on the escalator, making sure that they have one hand free to hold the escalator railing for balance. Additional research is needed to determine the relationship among passenger behavior, escalator design and escalator-related injuries."

The most common mechanism of injury for all age groups was a fall, which accounted for more than half of the injuries. Entrapment accounted for 29 percent of injuries, and the leg was the most frequent (28%) site of injury for all age groups combined.