Pediatric window-cord strangulations in the United States, 1981-1995

Objective.-To document the prevalence of pediatric asphyxial death from window-covering cords in the United States and identify associated risk factors. Design.-Retrospective analysis of existing death certificate and incident files compiled by the US Consumer Product Safety Commission. Setting.-United States, 1981 through 1995. Patients.-Children aged 1 month to 8 years suffering unintentional traumatic asphyxiation from a window-covering cord. Results.-A total of 183 fatal window-cord strangulations were reported for the years 1981 through 1995, representing a mortality rate of 0.14 (95% confidence interval [CI], 0.10-0.18) per 100 000 persons (less than or equal to 3 years old) per year in the United States, Ninety-three percent of victims were 3 years of age or younger. Pull cords on venetian-type horizontal window coverings accounted for 86% of documented injuries. Infant victims were more likely to become entangled while put down for a nap and toddlers were more likely to be suspended by the cord after falling or jumping from a height (P=.002), Window coverings remained anchored and did not undrape when substantial weight was suspended in the draw-cord loop. Conclusions.-Window-covering cords represent a substantial strangulation hazard compared with other potentially harmful household products that were modified based on voluntary standards to mitigate the risk of injury. Product design modifications and parental education will be necessary to avert this type of fatal home injury.