Drawstrings Pose Strangulation Risk

January 10, 1997

Drawstrings a threat

Articles of clothing with drawstrings, such as hooded sweatshirts and coats, or jackets with drawstrings about the waist, may lead to serious injury and accidental death. After studying 47 investigations of drawstring entrapments occurring between 1985 and 1994, in which eight children were killed, researchers at the Johns Hopkins School of Public Health Center for Injury Research and Policy outlined two distinct hazard patterns: strangulation caused when drawstrings are snagged by playground equipment and dragging when drawstrings are caught in vehicles. Their results, published in the January 15 issue of the Archives of Pediatrics and Adolescent Medicine, are accompanied by recommendations for reducing the drawstring hazard by eliminating or modifying drawstrings.

"Eliminating drawstrings is an effective way to prevent these accidents. Children would be safer with 'no strings attached'," said lead author, Dorothy Drago, MA, MPH, who conducted the study while a graduate student at the Hopkins School of Public Health.

Alternatives to eliminating drawstrings may be shortening drawstrings, sewing them into channels, making drawstrings "break away," or removing toggles and knots at the ends. These measures, however, need scientific testing before their benefits are established.

Of 47 incidents involving children ages two - 14 years of age, 31 involved drawstrings snagged on playground slides. Entanglement in school bus doors accounted for 12. "A typical playground accident occurred when a young child wearing a jacket with untied drawstrings around the neck was playing on a slide and the drawstring snagged near the top of the slide, between the platform or handrail and the start of the slide. As the child slid down, the snagged drawstring tightened and strangled the child," said principal investigator, Susan Baker, MPH, professor, Health Policy and Management.

Better playground supervision is not the answer, researchers said. "Placing the burden on supervision is not as effective as an intervention to change the product, " added Drago. "Supervision fails."

Leaving a school bus proved equally dangerous when, unnoticed by the driver or wearer, a jacket waist drawstring became entangled in the bus handrail, the doors closed and the driver drove off. Over the last several years, four children have been killed when they were dragged and run over by their school buses.

The U.S. Consumer Product Safety Commission (CPSC) has periodically addressed clothing entrapment and has issued safety recommendations on sliding board construction. The National Highway Transportation and Safety Administration (NHTSA) issued a 1993 voluntary recall to modify school bus door apparatus. The potential for drawstring injury persists because the NHTSA has no authority to enforce the recall or modifications.

Great Britain banned drawstrings on children's clothing in 1976.


This research was supported in part by U.S. Public Health Service Grant # R49

Johns Hopkins University Bloomberg School of Public Health

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.