Clothing drawstring entrapment in playground slides and school buses - Contributing factors and potential interventions

Objectives: To identify factors associated with the entrapment of children by clothing drawstrings and to explore intervention strategies that could be implemented through a voluntary standard to reduce or eliminate injuries. Design: Fifty-eight cases reported to the US Consumer Product Safety Commission between January 1, 1985, and June 30, 1995, that involved the entrapment of children's clothing drawstrings in other products were reviewed. A computerized database was created for information about the victim, clothing, object in which the drawstring caught, and injury circumstances. Factors were analyzed by their contribution to preevent, event, and postevent phases, using a modified Haddon matrix. Results: Two primary and distinct hazard patterns were identified: (1) strangulation by hanging associated with the snagging of a hood or neck drawstring in a gap between segments of playground slides and (2) vehicular dragging associated with the snagging of a waist or bottom drawstring in a school bus handrail or door. Conclusions: Potential intervention strategies targeting clothing drawstrings include (1) remove drawstrings; (2) shorten drawstrings, sew them to the channel, and remove toggles and knots; and (3) design breakaway drawstrings. Based on available data, the only feasible intervention is removal of drawstrings. Improved supervision and increased awareness are in themselves infeasible interventions, but they can be interim or supplemental measures.