To the Editor: Thompson's report highlighting the danger of baby walkers and the applicability of the proposed Australian mandatory standard is welcome.1 However, we have some concerns with the statement that the injury data used in the analysis are "largely representative of such events in the major proportion of metropolitan Australia". The only data sources used were the South Australian Department of Human Services Injury Surveillance System and the original Victorian Injury Surveillance System. Equivalent data from Queensland, although readily available, were not used.

An analysis of 177 baby-walker injuries recorded in the Queensland Injury Surveillance Information System (ISIS) for the period 1989–1994 shows that only 9% of injuries were not stability related, and that 73% were associated with steps and stairs. Among the cases admitted to hospital, only one was not related to stability or falls down steps or stairs. Examination of more recent Queensland injury surveillance data, although not directly comparable, reveals a similar pattern.

These results, which appear to contradict the findings of Thompson, are not altogether surprising considering the differences in architectural styles between Queensland, with its high-set houses with verandahs and wooden steps, which present quite a different injury-prevention challenge to the style of housing more common in Adelaide and Melbourne. The introduction of a baby-walker standard to address the problem of stability and falls down steps and stairs would thus appear worthwhile in this setting. However, we accept that, in other parts of Australia, baby-walker-related injuries may be less amenable to prevention through this intervention. It is also of concern that the new standard is being promoted by the Commonwealth as able to prevent stair-related baby-walker injuries. In reality, this is not the case: a recent study by the US Consumer Product Safety Commission found that 15% of stair-related injuries involved the new-style walkers.2

Furthermore, introduction of the standard, and its ensuing publicity, may result in an increase in use of baby walkers, along with a perception that they are now safe. This has the potential to increase baby-walker injuries. It is our belief that, in this particular case, it may be better to keep publicity very low key.

Finally, use of baby walkers has also been associated with a delay in normal physical development.3

For all these reasons we would continue to advocate that the use of baby walkers be actively discouraged.