Frequency of cases prompt KKHospital to launch own study
ONE amputated toe, two fractured feet, three cut tendons, six deep cuts and four abrasions – all mishaps from simple escalator rides.
And all of them involving children between two and nine years old in rubber clogs.
The young ones were on escalators at shopping centres or train stations with an adult care-giver when their feet got caught between the side panel of the escalatorand the moving steps.
Nine were so badly injured, they had to be admitted for emergency surgery.
The incidents were becoming so frequent, doctors from KK Women’s and Children’s Hospital (KKH) decided to study them.
This is what they found: Of the 17 children who were taken to the hospital over two years from September 2006, more than three-quarters – 13 children – had been wearing rubber clogs. (See graphics at right.)
Ten boys andseven girls were involved in the study.
The report, the first on escalator-related foot injuries involving rubber clogs, was published in the July-August issue of the Journal of Pediatric Orthopaedics.
Dr Kevin Lim, a consultant at the hospital’s department of orthopaedic surgery and the study’s principal author, told The New Paper: “The broad toe box design (of rubber clogs) gives the appearance of an oversized footwear and a false perception of the distance between the foot and its surroundings.
“Children may think they are standing in the middle of the escalator, but they may be closer to the side (panel) than they think.”
Unlike adults, children also need to stand nearer to the side to hold the escalator handle, making them more susceptible to injury, he noted.
The material of rubber clogs does not help.
Dr Lim said: “The softness of the material also makes (the clogs) extremely pliable.
“As such, a rubber clog can be readily crushed by moving escalator steps once it is caught in the metallic side panel.”
It’s almost like an accident waiting to happen.
Dr Lim added: “All the children need to do is to turn around for a split second to talk to their parents and their clogs may get caught in the escalator and get rolled in.”
For eight children, their feet were trapped for just a split second. But in one case, the child’s foot was wedged in for 10 minutes.
Just last week, The New Paper reported that a four-year-old boy was injured while travelling down an escalator at 313@Somerset.
His injury was so severe, he had to have his big toe amputated.
Such injuries in children can range from mild abrasions to those that are so severe, they had to have their toe amputated.
Those who sustained severe injuries were hospitalised for two to three nights each.
In one case, the doctors had to amputate the left big toe of a five-year-old girl whose left foot was caught.
Her rubber clog was so badly mangled it was ripped into several parts.
Another patient, a four-year-old boy, suffered a deep gash on his big and second toes of his left, as well as a fracture and dislocation in one of the joints.
Doctors had to drill a wire into his foot to stabilise his fracture-dislocation. It was removed four weeks after the operation.
Dr Lim said that in cases where the children’s feet have been crushed by moving escalator steps, it would be difficult to re-attach their toes.
Explaining, he said: “The nerves and blood vessels would usually be completely crushed.
“Parents would ask us to try to re-attach the toes, but it would be impossible because the damage done is too
The study also found that none of the children had been playing on the escalator. In fact, all had been standing in a fairly central position on the step and had been supervised by adults.
Escalator accidents do not cause just physical stress. The psychological trauma can also be significant too, prompting the study, DrLim added.
“Previously, we could count the number of such cases on one hand. But after 2006, we were getting these cases one after another. That was why we felt that it was important to bring this to people’s attention.”
The numbers point to an escalating problem.
Last year, three patients were treated for severe escalator-related foot injuries at KKH. There have already been three such patients this year.
The Singapore Civil Defence Force said they have responded to five cases of children whose limbs were trapped in escalators this year.
The number of such accidents have been rising steadily over the past five years. In 2005, there were four cases. In 2006, six cases. The number went up to seven in 2007, but dipped to three in 2008.
Last year, the number of cases spiked – to a total of nine. But there are already five escalator mishaps for the first seven months of this year.
Noting that it was a “significant problem in other parts of the world”, as well, Dr Lim pointed out that safety groups in the US and Japan had issued warnings about rubber clogs posing as safety hazards to escalator riders.
According to theUSConsumer Product Safety Commission, of 77 escalator accidents reported since Jan 2006, 75 involved soft-sided, flexible rubber clogs.
Half of the accidents resulted in injury.
Dr Lim said: “It’s a big price to pay for a preventable injury.”
1. Adults should supervise children on escalators. Children should not ride alone.
2. When an adult shares a step with a child, ensure that the child is not too close to the side.
3. Always face forward and hold the handrail firmly.
4. Be mindful of clothing with strings or straps.
5. Avoid the edges or side of steps where
footwear can be trapped. Stand in the middle of the step.
6. Do not allow children to turn around, sit or play on escalator steps.
7. Note where the escalator emergency stop button is.