White Coat, Black Art·DR. BRIAN'S BLOG

Brain injuries in kids linked to consumer products

Traumatic brain injuries are serious, especially in children. Many of those preventable injuries occur at home.

U.S. study unique in focusing on younger children and role consumer products like beds and flooring play

Ice hockey was the most common sport and recreational cause of brain injuries in young boys in Canada. (The Canadian Press)

A 2018 report by the U.S. Centers for Disease Control found that brain injuries — which are caused by a blow to the head — send just over a million children and adolescents per year to emergency departments. A study published Monday in the journal Brain Injury reveals some disturbing reasons for these potentially serious injuries.

Researchers led by Bina Ali from the U.S.-based Pacific Institute for Research and Evaluation reviewed injury surveillance data over a four-year period ending in 2013. They looked for specific causes of brain injuries in children and adolescents in five age groups from infancy to 19 years of age.

Overall, 72 per cent of brain injuries that did not result in death but did result in a visit to the emergency department were caused by consumer products that are regulated by the U.S. Consumer Product Safety Commission, the independent U.S. government agency that develops uniform standards while promoting the safety of consumer products. 

The study found that the type of consumer product depended on the age of the child. Infants under one year of age got traumatic brain injuries because they fell. According to the researchers, 25 per cent of all emergency visits for traumatic brain injuries in that age group were caused by a fall from the crib or bed. At 14 per cent, the second leading cause was uneven flooring that caused the infant to trip and fall.

Bunk beds were especially risky in children one to four years of age. But stairs and floors were equally hazardous in that age group. Between five and nine years of age, flooring was still the leading cause of brain injuries, and falling off a bicycle placed second.

Sports and falls common causes

The causes of brain injuries were different in older children. Among those 10 to 19 years of age, football was the leading cause of traumatic brain injury, followed by basketball. In the 10-14 year age group, soccer and falls were second while cycling was third.

In the 15-19 year cohort, soccer was second, followed by cycling in third.

Some people may be surprised that soccer is a significant risk factor for traumatic brain injury. I'm not, and that may have a lot to do with my personal experience breaking both bones in my forearm when I fell during a high school soccer game.

In the emergency department, we see a lot of older patients who hit their heads so hard from falling from a standing height they end up having brain bleeds. It's foolhardy to think infants and older children are immune to the effects of head injuries.

The researchers aimed their analysis at children with mild or moderate traumatic brain injury. Still, these injuries have consequences. They cause symptoms that include:

  • Headaches.
  • Dizziness.
  • Memory difficulties.
  • Sleep disruption.
  • Changes of mood.
Bunk beds were especially risky in children one to four years of age, researchers found. (Rogelio V. Solis/Associated Press)

Brain injuries are tracked in Canada, too. The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is an injury and poisoning surveillance system that collects and analyzes data on injuries to people who are seen at the emergency rooms of 11 pediatric hospitals and eight general hospitals in Canada.

From 2011 to 2017, CHIRPP has found that in boys five to nine years of age, the most common sport and recreational cause of brain injuries were:

  • Ice hockey.
  • Physical education classes.
  • Sledding and tobogganing.

In girls the same age, the top two causes were ice hockey and sledding and tobogganing. Ringette was the most common sports and recreational activity causing brain injuries in girls 10 to 19 years of age, with horseback riding being another common cause.

The U.S. study is unique in focusing on younger children and in examining the role regulated consumer products play in brain injuries in children.

4 tips for parents

The CDC estimates that 70 to 90 per cent of kids who are taken to the emergency department have mild brain injuries. These children stand the best chance of making a full recovery with no long-term adverse effects. Just two per cent of kids have severe traumatic brain injuries that leave patients who survive with a lifelong disability. 

The study's authors recommend that parents remove tripping hazards on floors and on stairs. They recommend installing stair gates and guard rails. They also say parents should avoid taking their children to playgrounds with hard surfaces.

The authors also recommend that parents consider equipping their kids with helmets. Children who play football already wear them, but it may be new to some kids who play soccer. I think it will take a big culture shift for kids who play basketball to start wearing helmets.

The study is a warning shot at the U.S. Consumer Product Safety Commission to take a greater interest in reducing the risk from bunk beds, flooring and other products. Some parents might see the concerns raised by the researchers as trying to keep kids from being kids.

If they could see how devastating head injuries can be, they might change their minds.

About the Author

Dr. Brian Goldman is a veteran ER physician and an award-winning medical reporter. As host of CBC Radio’s White Coat, Black Art, he uses his proven knack for making sense of medical bafflegab to show listeners what really goes on at hospitals and clinics. He is the author of The Night Shift and The Power of Kindness: Why Empathy is Essential in Everyday Life.

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