Infant mechanical suffocation deaths in the United States, 1980-1997

Purpose. To document specific patterns and products associated with mechani cal suffocation among infants younger than 13 months of age for the period 1980 to 1997. Methodology. A total 2178 case summaries from the US Consumer Product Safet y Commission's Death Certificate File were reviewed. A computerized databas e was created for information about the infants, products, and patterns of suffocation. The relationships among products, patterns, rind age groups we re analyzed by chi(2). Thirty-eight investigations conducted on a subset of cases involving cribs were reviewed for details on crib age, structural in tegrity, and compliance with the federal crib regulation. Mortality rates w ere calculated based on the US population younger than 1 year old. Results. The most frequent causes of suffocation were 1) wedging between a bed or mattress and a wall and 2) oronasal obstruction by plastic bag. Patt erns of suffocation were significantly related to age group, but not to sex . Pattern-specific mortality rates comparing three time frames for the the 16-year period from 1980 to 1995 showed continued increases for overlain an d oronasal obstruction; an increase followed by a plateau for wedging, a de crease for hanging, and no substantial change for entrapment with suspensio n. Conclusions. Suffocation hazards presented by beds, bedding, pillows, and p lastic bags continue to be underrecognized by parents and caregivers. Bed-s haring and use of adult beds for infants should be discouraged. Only comply ing cribs should be used and maintained property to ensure structural integ rity. Suffocation deaths involving plastics should be investigated to deter mine the specific material characteristics and use patterns to design more effective interventions than selective labeling.