New research suggests that parents of children who fell at home were more likely not to use safety gates and not to have taught their children rules about climbing on things in the kitchen.

Falls send more than 1 million children in the United States and more than 200,000 children in the United Kingdom to emergency departments (EDs) each year. Costs for falls were estimated at $439 million for hospitalized children and $643 million for ED visits in 2005. Most of the falls involve beds, chairs, baby walkers, bouncers, changing tables and high chairs, according to the study background.

Researchers from the University of Nottingham in England aimed to quantify the associations between modifiable risk factors and falls from furniture by young children.

For the study, researchers collected data from 672 children, up to 4 years old, with falls from furniture who ended up in the ED, admitted to the hospital or treated in another setting. The study also included 2,648 control participants of the same age without a medically attended fall on the date of another child's injury.

They found that in most of the cases, the children (86 percent) sustained single injuries; the most common were bangs on the head (59 percent), cuts and grazes not requiring stitches (19 percent) and fractures (14 percent). Most cases (60 percent) were seen and examined but did not require treatment; 29 percent were treated in the ED, 7 percent were treated and discharged with follow-up appointments, and 4 percent were admitted to the hospital.

Parents of children who fell were more likely than the parents of control participants to not use safety gates and not have taught their children rules about climbing on objects in the kitchen. Children (up to 1 year of age) who fell were more likely to have been left on raised surfaces, had their diapers changed on raised surfaces and been put in car/bouncing seats on raised surfaces. Children 3 years and older who fell were more likely to have played or climbed on furniture.

"If our estimated associations are causal, some falls from furniture may be prevented by incorporating fall-prevention advice into child health surveillance programs, personal child health records, home safety assessments and other child health contacts. Larger studies are required to assess association between use of bunk beds, baby walkers, playpens, stationary activity centers and falls," the study concludes.

The findings are detailed in JAMA Pediatrics.