CLOTHING DRAWSTRING ENTRAPMENT IN PLAYGROUND SLIDES AND SCHOOL BUSES - CONTRIBUTING FACTORS AND POTENTIAL INTERVENTIONS

Objectives: To identify factors associated with the entrapment of chil dren by clothing drawstrings and to explore intervention strategies th at could be implemented through a voluntary standard to reduce or elim inate injuries. Design: Fifty-eight cases reported to the US Consumer Product Safety Commission between January 1, 1985, and June 30, 1995, that involved the entrapment of children's clothing drawstrings in oth er products were reviewed. A computerized database was created for inf ormation about the victim, clothing, object in which the drawstring ca ught, and injury circumstances. Factors were analyzed by their contrib ution to preevent, event, and postevent phases, using a modified Haddo n matrix. Results: Two primary and distinct hazard patterns were ident ified: (1) strangulation by hanging associated with the snagging of a hood or neck drawstring in a gap between segments of playground slides and (2) vehicular dragging associated with the snagging of a waist or bottom drawstring in a school bus handrail or door. Conclusions: Pote ntial intervention strategies targeting clothing drawstrings include ( 1) remove drawstrings; (2) shorten drawstrings, sew them to the channe l, and remove toggles and knots; and (3) design breakaway drawstrings. Based on available data, the only feasible intervention is removal of drawstrings. Improved supervision and increased awareness are in them selves infeasible interventions, but they can be interim or supplement al measures.