One of the study's authors said it's important for parents to supervise little kids when they're on the stairs and discourage them from using stairs for games. But he added that changes in how staircases are designed might be needed in order to make a significant dent in injury rates.

“It is the exception to the rule that a home won't have a young child living in it or visiting" at some point, said Dr. Gary Smith, head of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio.

“We should build environments where we know children will live or visit so that they're safe for children," he told Reuters Health.

That includes built-in gates at the top and bottom of stairs, as well as handrails that are easy to grip firmly, Smith said.

He and his colleagues used a collection of data from about 100 hospitals that reported descriptions of everyone who visited their emergency departments from 1999 through 2008, homing in on kids under five.

Based on the locations of hospitals and the people they treated, Smith and his colleagues used the sample to estimate how many young kids had a stair-related injury nationwide during that period.

They calculated that over the ten years, about 47 out of every 10,000 young kids -- or 93,000 altogether -- got injured on the stairs every year, such as from tripping, being dropped by a parent or riding a tricycle down the stairs.

Those injuries were most commonly bruises, sprains or cuts, often around the head or neck. About one in ten of the injured kids broke a bone in the accident, and less than three percent of all children had to be hospitalized.

Dr. Young-Jin Sue, an emergency doctor at The Children's Hospital at Montefiore in New York, said that was consistent with her own experience in the emergency department.

“Fortunately the vast majority of stair injuries are very mild," she said. “They're soft tissue injuries -- bumps and bruises. I can't remember the last time we had to hospitalize a child" who was injured on the stairs.

From the beginning to the end of the study period, the number of stair-related injuries that happened each year dropped by about 12 percent.

Researchers agreed that's probably at least in part the result of parents learning the dangers of baby walkers, as well as new standards for the production of safer ones. Those toys allow kids to move around on their own before they can walk -- “a recipe for disaster at the top of the stairs," said Sue, who wasn't involved in the new study. Newer versions are designed to lock if one wheel goes off the top step.

ONE EVERY SIX MINUTES

Despite the decline, the most recent data show that a child is admitted to the ER every six minutes with an injury suffered on the stairs, Smith's team reported Monday in the journal Pediatrics.

That's “the sobering statistic, and the one that was a surprise to me," the researcher said.

Sue pointed to the importance of keeping the stairs free of clutter, and making sure little kids are always supervised.

“I think the message for parents over and over and over again is: they're growing human beings, and you think you've got them figured out, but then they're always one step ahead of you," she told Reuters Health.

Still, even the perfect parent can't be watching a kid at every second, Smith said.

He said that stairs should be built from the beginning with kids' safety in mind: with gates at the top and bottom that adults can remove if no little children will be coming by, with thin railings that can be gripped firmly by small hands and with top stairs that aren't so easy to trip on -- all more “layers of protection" against injury.

SOURCE: bit.ly/jsoh2P Pediatrics, online March 12, 2012.

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