Combining measures of risk exposure with injury incidence estimates to estimate nursery product injury rates

Abstract

Introduction: Nursery product hazards have been a frequent topic in the published literature. However, because information on the exposure to nursery product risks has not been generally available, there has been little evaluation of exposure-adjusted injury rates. Methods: A national survey of durable nursery product use, by nursery product type, was conducted in 2013. Two measures of risk exposure were developed for each nursery product type: the number used frequently (i.e., used every day or a few times a week) and the total number in use by households, regardless of usage frequency. These data were combined with national estimates of nursery product injuries treated in U.S. hospital emergency departments to determine exposure-adjusted injury rates. Results: For the 13 nursery products examined, there were an estimated 79.9 million in use; 81.6% were reportedly used frequently. When combined with injury estimates, there were an average of 104.1 injuries per 100,000 frequently used nursery products and 85.0 injuries per 100,000 in use. The exposure-adjusted injury rate rankings for the 13 products, from highest to lowest, varied substantially from rankings based on injury incidence alone. Although the injury rate rankings for the two risk exposure measures were not identical, they were highly correlated. Conclusions: The use of exposure-adjusted injury rates provides an enhanced understanding of product-related injury patterns, and can play an important role in program development and evaluation. Estimates of frequently used products may be preferable to products in use as a measure of risk exposure, because such estimates may better reflect intensity of use; both, however, represent valid alternatives that can result in improved program and policy analysis. Practical Applications: Exposure-adjusted injury rates can provide for a more comprehensive evaluation of injury patterns than incidence estimates alone. Analysts should, when possible, take risk exposure into account when evaluating safety programs and policy options.