Pediatric Tree House-Related Injuries Treated in Emergency Departments in the United States: 1990-2006

The objective was to describe the epidemiology of tree house-related injuries in the United States among children and adolescents. The authors conducted a retrospective analysis using data from the National Electronic Injury Surveillance System for patients <= 19 years who were treated in an emergency department (ED) for a tree house-related injury from 1990 through 2006. An estimated 47,351 patients <= 19 years of age were treated in EDs for tree house-related injuries over the 17-year study period. Fractures were the most common diagnosis (36.6%), and the upper extremities were the most commonly injured body part (38.8%). The odds of sustaining a head injury were increased for children aged < 5 years. Falls were the most common injury mechanism (78.6%) and increased the odds of sustaining a fracture. Falls or jumps from a height >= 10 feet occurred in 29.3% of cases for which height of the fall/jump was recorded. Boys had significantly higher odds of falling or jumping from a height of >= 10 ft than girls, and children 10 to 19 years old also had significantly higher odds of falling or jumping from a height of >= 10 feet, compared to those 9 years old and younger. The odds of hospitalization were tripled if the patient fell or jumped from >= 10 feet and nearly tripled if the patient sustained a fracture. This study examined tree house-related injuries on a national level. Tree house safety deserves special attention because of the potential for serious injury or death due to falls from great heights, as well as the absence of national or regional safety standards. The authors provide safety and prevention recommendations based on the successful standards developed for playground equipment.