unintentional injuries

During 2006, 299 children aged under 15 in the UK died as the result of injury or poisoning. (England and Wales – 246; Scotland – 26; Northern Ireland – 27). Every year, over 2 million children are taken to a hospital after accidents. Around half of these accidents occur at home. One child in five attends an accident and emergency department every year – out of a class of 30 children, an average of six will have to go to hospital annually.

The good news is that the number of accidental deaths has been declining steadily. In England and Wales in 1979, almost 1,100 children were killed in accidents, compared with 246 in 2006.

Accidents to children are common as they develop and explore. The type of accidents children have relates very closely to their age and stage of physical development. Children are not small adults. Understanding the links between the developmental abilities of a child and the risks that these changes bring is essential to preventing accidents.

Accidents to children also happen because they are naturally inquisitive and learn by exploring. Like most beginners they can be clumsy when first learning to do things. Young children do not have the experience or understanding to keep themselves safe, or protect themselves from the world around them. Children should not be prevented from learning and developing naturally, but they need to grow up in a safe environment protected from unnecessary harm.

It is also important for children, as they get older to learn how to deal with everyday risk, for instance climbing the stairs, crossing the road, using knives or scissors or boiling a kettle. Bumps and bruises are part of growing up and learning, but no one has to have an accident that results in serious injury.

the types of accidents that children suffer

Very young babies are incapable of being independently mobile so are at risk as a result of the actions or inactions of adults or their older siblings. They may be dropped, have hot drinks poured over them, be caught in a house fire, or be injured when carried unrestrained in a car. Injuries due to pets (rarely leading to death), are common in this age group, as the baby may be seen as a threat to an otherwise docile family pet dog.

As they start to roll and wriggle, they may be scalded if they grab at cups when sitting on someone’s lap or pull on kettle leads or pull on tablecloths hanging down in arms reach. Falls if left unattended on raised surfaces, such as low cupboards, tables or chairs when having a nappy changed can lead to head injuries and broken bones. Choking becomes a risk if fed food they cannot cope with, such as lumps of meat, large pieces of sausage, and even potato crisps. If left unattended in the bath, even for a minute when their carer fetches a towel or answers the phone, they can drown, in as little as 2 inches of water.

With greater mobility comes additional risks. Crawling and walking allows toddlers to find objects that were out of reach and can lead to choking or poisoning – babies and toddlers learn about taste and texture by putting things in their mouths. The first attempts to climb stairs can result in falls. The kitchen is a hazardous place – hot pans, kettles and oven doors produce real risks of severe injuries that can require prolonged treatment. Pulling electric cables, and whatever is attached, will often lead to accidents.

As their mobility increases, toddlers may play with bath taps and severely burn themselves, or they may climb into a dangerously hot bath to recover a dropped toy – they still have little sense of danger, or the consequence of their actions.

As age increases so does the range of where they play. The garden often allows access to:

garden chemicals
the road if the gate is not secure
or an unguarded pond – sometimes next door.

When children start school, they face risks as pedestrians and eventually cyclists. They need safe access to stimulating and safe play areas, not necessarily formal playgrounds. School children have to be given independence as it is a part of growing up.

Visiting relatives can be another source of preventable accidents. Relatives and friends may not be aware of the dangers posed by leaving handbags containing dangerous medicines within grasp of eager adventurous hands, and kitchen cupboards may hide a wide range of potentially lethal powders and preparations, which if eaten may cause serious damage. Pets can be unpredictable in the presence of young children, and should be kept behind a closed door until properly supervised and used to the visiting children.

prevention is better than cure

Education, engineering and passing laws can all be used to reduce the numbers and severity of accidents. However these approaches are most effective when used together rather than individually. For example, the seat belt law was only introduced after a major public education campaign. This meant that by the time people had to ‘belt up’ they were already aware of the safety reasons for doing so.

Research has shown that there are many interventions that can reduce death and injury, or lead to improve behaviour to make accidents less likely. Programmes known to be effective are:

In the home