PW 2586 Safety in tow: pediatric traumatic brain injuries associated with stroller use

An infant stroller is a wheeled vehicle to assist caregivers with transporting a young child. In Canada, carriages and stroller are regulated under the Consumer Product Safety Act, which outlines product specifications intended to ensure safety and security. This study seeks to identify and describe the detailed mechanisms of cases of pediatric traumatic brain injuries (TBI) related to strollers that were captured within the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) database. Records entered into the eCHIRPP system with injury data between January 1, 2007 and July 17, 2017 were extracted for ages 0 to 4 years old. Traumatic brain injuries were identified based on nature of injury and body part codes. Stroller related injuries were identified using existing variable codes and text mining techniques, and location, mechanism, and admission to hospital were assessed. Descriptive statistics and text mining (PERL regular expressions) were conducted using SAS Enterprise Guide version 5.1. The frequency of stroller related TBI have decreased over the past decade (p<0.001). A total of 1033 cases of stroller related head injury were identified (502 stroller related TBI cases/100,000 eCHIRPP records), with the majority occurring among children 1 year old and below (74.2%). Falls, tip-overs and runaways were the three leading mechanisms of injury. Other mechanisms included stroller issues related to the wheel of breaks, or with the child or guardian’s actions contributing to an injury. A safety mechanism (seatbelt) was confirmed to have been in use in 16.0% of TBI cases, and 3.8% of stroller TBI cases were admitted to hospital. Stroller related TBIs appear to be decreasing among eCHIRPP centres. Our findings support opportunities for injury prevention: through engineering changes to stroller standards, education about supervision and appropriate use of the stroller, and enforcement of safety regulations. While stroller related TBIs appear to be decreasing, there are opportunities for injury prevention. Findings from this and other studies should help to inform safety standards associated with stroller design and public awareness regarding appropriate stroller use.