By Linda Carroll

(Reuters Health) – The majority of the more than four million traumatic brain injuries in kids treated in U.S. emergency rooms involved consumer products, a new study suggests.

Brain injuries in younger children were tied to products such as beds and flooring, while injuries in older kids were tied to sports, such as football, basketball and bicycling, researchers reported in Brain Injury.

“A child’s age is important when looking at the incidence and causes of these injuries,” said the study’s lead author, Bina Ali, a research scientist at the Pacific Institute for Research and Evaluation in Beltsville, Maryland. “In this study we found that home furnishings and fixtures, primarily beds, were highest among infants and children up to 4 years old. Among children aged 5 to 19 traumatic brain injuries from sports and recreation were highest. The findings indicate priority areas for traumatic brain injury prevention.”

Using the National Electronic Injury Surveillance System–All Injury Program, the researchers identified 4,091,376 nonfatal pediatric TBIs seen in emergency rooms between 2010 and 2013. Stratified by age, there were 380,842 TBIs in infants under a year, 1,085,680 in children ages 1 to 4, 682,826 in kids ages 5 to 9, 834,565 in 10- to 14-year-olds, and 1,107,463 in those ages 15 to 19.

Most youngsters with TBIs (92%) were treated in the emergency room and then released.

Overall, 28.8% of the TBIs were related to sports and recreation, 17.2% to home furnishings and 17.1% to home structures and construction materials. Toys were linked with 2.4% of brain injuries, while personal use items, home electronics and hobbies and other product groups accounted for another 6.6% of TBIs.

Most injuries in infants (71.3%) and children ages 1 to 4 (60.6%) were related to home furnishings and fixtures, home structures and construction materials.

To protect these younger kids Ali recommends “removing tripping hazards, such as area rugs, improving lighting, avoiding hard surface playgrounds, using home safety devices, such as stair gates and stairway handrails.”

By the time children reached ages 5 to 9, sports and recreation were accounting for 31.8% of brain injuries. That percentage rose to 53.9% in children ages 10 to 14 and dropped to 38.3% among youngsters ages 15 to 19.

The biggest single source of TBIs in 10- to 19-year-olds was American football, followed by basketball.

There are a number of strategies to keep brains safe in sports-playing kids in these age groups, said Dr. Chris Giza, a professor of pediatrics and neurosurgery at the University of California, Los Angeles, and UCLA’s Mattel Children’s Hospital.

“Use protective devices,” Giza said. “Make sure helmets fit properly and are actually worn. Head injuries prevented by helmets are often skull fractures and other severe injuries. Those are the ones with the more debilitating long-term consequences.”

Giza also suggested that parents of kids playing organized sports get to know the coach and other staff. “You wouldn’t sign your child up for piano lessons without vetting the teacher,” he said. “Many parents don’t know the coach or the athletic trainer or whether there is medical supervision.”

“You also want to know whether the officials enforce the rules,” Giza said. “Does the coach have any training in injury prevention? What is the mentality of the team? Is it win at all costs or is there an emphasis on having fun and making sure there is good sportsmanship?”

Overall, Giza was pleased to see some “hard numbers” on TBIs in kids, although he suspects the numbers would be even higher if the researchers had included doctors’ visits.

Parents may be surprised to find that toys, playgrounds and monkey bars accounted for such a small percentage of injuries. But that may be because “kids don’t have as much unstructured time these days,” Giza said. “You rarely see kids playing in the park or climbing trees.”

SOURCE: Brain Injury, online July 29, 2019.