Objective To evaluate the effectiveness of the requirements of the voluntary safety standard for drawstrings on children's upper outerwear garments in preventing child deaths resulting from drawstring entanglement.
Design An interrupted time series design. Annual estimates of drawstring-related child deaths were developed for the study period of January 1985 to December 2009. A Poisson regression model for rate data was used to evaluate the effectiveness of the drawstring requirements during the postintervention period.
Setting United States.
Subjects Children aged 14 years and younger.
Intervention The application of the drawstring requirements of the voluntary standard that were adopted in 1997.
Main Outcome Measure The estimated percentage reduction in the drawstring-related child mortality rate associated with the application of the drawstring requirements.
Results The drawstring requirements of the voluntary standard were associated with a 90.9% (95% CI, 83.8%-96.1%) reduction in the drawstring-related mortality rate. This suggests the prevention of about 50 child deaths from 1997, when the voluntary standard was adopted, through the end of our study period in 2009.
Conclusions The requirements of the voluntary safety standard for drawstrings have been highly effective in preventing deaths resulting from the entanglement of drawstrings in children's upper outerwear garments.