Safety from Falls

Where, When and How

• More than 80 percent of fall-related injuries to children 4 years and under occur in the home. For children ages 5 to 14 years, nearly half of fall-related injuries occur in the home; 23 percent occur at school.
• Window falls occur more frequently in large urban areas, low-income neighborhoods, and in overcrowded housing.
• Children living in apartment buildings have the highest number of window fall incidents – five times more than children living in other residences.
• The majority of falls occur at noon and early evening, the most common playtime for children.
• Infants are at risk from falls associated with furniture, stairs and baby walkers.
• Windows and playground equipment are major risk factors for toddlers and older children.
• In 2004, nearly 3,900 children (less than age 4 years) were treated in hospital emergency rooms for baby walker-related injuries.

Who

• Males are more than twice as likely as females to die from fall-related injuries.
• Window fall victims are more likely to be male children, under age 5 years and playing unsupervised at the time of the fall.
• Low-income children are more likely to be injured from falls due to improper supervision and unsafe environments, including aging or deteriorating housing.
• Black and Hispanic children are at greater risk of falls from heights due to their increased likelihood of living in urban, multiple-story, low-income housing.

Proven Interventions

• Window screens are not enough. Window guards should be installed on upper floors, making sure they’re designed to open quickly from the inside in case of fire.
• Protective surfacing under and around playground equipment can prevent falls or reduce the severity of fall-related injuries.
• The use of safety gates at the tops and bottoms of stairs reduces a young child’s chances of falling.
• In New York City, an education and window guard distribution program combined with window guard legislation resulted in a 35 percent reduction in window fall-related fatalities after two years.

Costs

• The largest portion of injury costs for children ages 14 years and under is attributed to falls.
• Falls are responsible for approximately one-quarter of all childhood unintentional injury-related costs.

Laws and Regulations

• In June 2000, the American Society for Testing and Materials (ASTM) established voluntary safety standards for window guards, which ensure that those guards designed for single-family homes or the lower floors of apartment buildings have simple emergency-release mechanisms for use in the event of a fire.
• Playground equipment guidelines have been developed by the U.S. Consumer Product Safety Commission (CPSC) and ASTM. Fifteen states have passed legislation or regulations to address playground safety.
• All baby walkers must meet ASTM voluntary and mandatory standards, which require that baby walkers either be too wide to fit through a standard doorway or have features, such as a gripping mechanism, to stop the walker at the edge of a step.