UCL Institute for Environmental Design and Engineering, UCL, London, United Kingdom.
UCL Great Ormond Street Institute of Child Health, UCL, London, United Kingdom.
J Pediatr. 2024 Dec;275:114191. doi: 10.1016/j.jpeds.2024.114191. Epub 2024 Jul 14.
To assess associations between housing characteristics and risk of hospital admissions related to falls on/from stairs in children, to help inform prevention measures.
An existing dataset of birth records linked to hospital admissions up to age 5 for a cohort of 3 925 737 children born in England between 2008 and 2014, was linked to postcode-level housing data from Energy Performance Certificates. Association between housing construction age, tenure (eg, owner occupied), and built form and risk of stair fall-related hospital admissions was estimated using Poisson regression. We stratified by age (<1 and 1-4 years), and adjusted for geographic region, Index of Multiple Deprivation, and maternal age.
The incidence was higher in both age strata for children in neighborhoods with homes built before 1900 compared with homes built in 2003 or later (incidence rate ratio [IRR], 1.40; 95% CI, 1.10-1.77 [age <1 year], 1.20; 95% CI, 1.05-1.36 [age 1-4 years]). For those aged 1-4 years, the incidence was higher for those in neighborhoods with housing built between 1900 and 1929, compared with 2003 or later (IRR, 1.26; 95% CI, 1.13-1.41), or with predominantly social-rented homes compared with owner occupied (IRR, 1.21; 95% CI, 1.13-1.29). Neighborhoods with predominantly houses compared with flats had higher incidence (IRR, 1.24; 95% CI, 1.08-1.42 [<1 year] and IRR 1.16; 95% CI, 1.08-1.25 [1-4 years]).
Changes in building regulations may explain the lower fall incidence in newer homes compared with older homes. Fall prevention campaigns should consider targeting neighborhoods with older or social-rented housing. Future analyses would benefit from data linkage to individual homes, as opposed to local area level.
评估住房特征与儿童楼梯跌倒相关住院风险之间的关联，以帮助制定预防措施。
将 2008 年至 2014 年间在英格兰出生的 3925737 名儿童的出生记录与截至 5 岁的住院记录与邮政编码级别的能源性能证书住房数据进行链接，利用泊松回归估计住房建筑年代、保有权（例如自有住房）和建筑形式与楼梯跌倒相关住院风险之间的关系。我们按年龄（<1 岁和 1-4 岁）进行分层，并按地理区域、多重剥夺指数和产妇年龄进行调整。
在<1 岁和 1-4 岁两个年龄组中，居住在 1900 年以前建造的房屋所在社区的儿童，其跌倒相关住院的发生率均高于 2003 年以后建造的房屋（<1 岁时的发病率比，1.40；95%置信区间，1.10-1.77；1-4 岁时的发病率比，1.20；95%置信区间，1.05-1.36）。对于 1-4 岁的儿童，居住在 1900 年至 1929 年期间建造的房屋所在社区的儿童，其跌倒相关住院的发生率高于 2003 年以后建造的房屋（发病率比，1.26；95%置信区间，1.13-1.41），或居住在主要为社会出租房屋的社区，其发病率高于自有住房（发病率比，1.21；95%置信区间，1.13-1.29）。与公寓相比，主要为独立屋的社区发病率更高（<1 岁时的发病率比，1.24；95%置信区间，1.08-1.42；1-4 岁时的发病率比，1.16；95%置信区间，1.08-1.25）。
建筑法规的变化可能可以解释与较老房屋相比，新房屋跌倒发生率较低的原因。预防跌倒的宣传活动应考虑针对较老或社会出租房屋的社区。未来的分析将受益于与个人家庭而不是与当地社区水平的数据链接。
