Even though window coverings have been recognized for decades as a safety hazard to children, injuries from blinds and shades still send many kids to the emergency room each year, a U.S. study suggests.

Almost 17,000 children under age 6 were treated for injuries from window blinds in U.S. emergency departments from 1990 to 2015, researchers report online December 11 in Pediatrics. That translates to an injury rate of almost 3 out of every 100,000 kids.

Most of the time, the injuries weren't serious. But there were 228 cases when young children caught their necks in cords and two-thirds of these injuries were fatal.

While the majority of children were treated and released, there was still about one child death each month - most from strangulation when a child became entangled by the neck in a window blind cord.

"The findings of this study confirm that children continue to die from strangulation on window blind cords," said senior author Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio. "This is unacceptable."


"We've known about this problem since the 1940s," Smith said by email. "We have had a voluntary safety standard in this country since the mid-1990s and we've had product recalls, and yet we continue to see these deaths."

The U.S. Consumer Product Safety Commission approved a petition to develop mandatory safety standards for window coverings in 2014, Smith said. Unlike current voluntary standards designed to reduce the risk of strangulation, the proposed mandatory standards would require all window coverings to be cordless or have cords that are inaccessible to children.

"Cordless technologies are available for most blinds and shades and add little cost to manufacturing," Smith said. "What we need now is for manufacturers to simply eliminate accessible cords in their products so that children can't gain access to them."

Almost two-thirds of the injuries children in the study sustained were head injuries, most often cuts, contusions and abrasions.

In almost half of the cases, the blinds struck kids, and cuts were the next most common mechanism of injury. Overall, about 12 percent of cases involved kids getting entangled in cords.

The majority of the cases occurred when parents were home with kids, but adults witnessed very few of the injuries. Often children were put to sleep, playing or watching television when injuries occurred.

When kids were alone, they often were unsupervised for less than 10 minutes before they got hurt.

One limitation of the study is that it only includes cases treated at hospitals and may underestimate the true injury rate associated with window coverings, the authors note. Researchers also lacked detailed information on the exact types of blinds involved in strangulation cases.

Even so, the findings suggest that voluntary safety standards aren't enough to prevent serious injuries, said Dr. Sean Bandzar, an emergency medicine researcher at New York Presbyterian Hospital who wasn't involved in the study.

This means parents need to be vigilant.

"The majority of injuries in this study occurred while children were under the care of parents with the children placed to sleep or playing," Bandzar said by email. "Better parental supervision should be encouraged."

Aiming baby monitors or cameras at blinds should help parents keep an eye on kids near windows at night or other times when they're not in the room, he suggested.

If replacing blinds with dangling cords isn't feasible or affordable, parents should focus their efforts on the rooms where kids spend the most time, like bedrooms or living rooms, Smith advised. Moving furniture away from windows so kids don't have an easy way to climb and reach blinds can also help.

Child safety kits designed to keep blinds out of reach don't always prevent kids from getting injured, he added.

"Some of the fixes can provide a false sense of security," Smith said. "The best way to keep your children safe is to replace all blinds that have cords with either cordless blinds, blinds with inaccessible cords or other types of cordless window coverings, such as interior window shutters."