Unintentional Home Injuries Research Articles

Environmental change interventions to prevent unintentional home injuries among children in low- and middle-income countries: A systematic review and meta-analysis.

Unintentional home injury is an important cause of death and disability among children, especially those living in low- and middle-income countries (LMICs). This systematic review aimed to synthesize evidence about the effectiveness of environmental interventions to prevent unintentional child injury and/or reduce injury hazards in the home in LMICs. Seven electronic databases were searched for randomized controlled trials (RCTs) and controlled before and after (CBA) studies published up to 1 April 2018. Potentially eligible citations were screened by title and abstract and full texts of studies obtained. Synthesis was reported narratively, and where possible, meta-analysis was conducted. Four studies met the inclusion criteria: One CBA study reported changes in injury incidence, and three RCTs reported changes in frequency of home hazards. In one study, child resistant containers were found effective in reducing the incidence of paraffin ingestion by 47% during and by 50% postintervention. A meta-analysis of two trials found that home inspection, safety education and safety devices reduced postintervention mean scores for poisoning hazards [mean difference (MD) -0.77; 95% CI [-1.36, -0.19]] and burn-related unsafe practices (MD -0.37; 95% CI [-0.66, -0.09]) but not for falls or electrical and paraffin burn hazards. A single trial found that home inspection and safety education reduced the postintervention mean scores for fall hazards (MD -0.5; 95% CI [-0.66, -0.33]) but not for ingestion hazards. There is limited evidence that environmental change interventions reduce child injuries but evidence that they reduce some home hazards. More evidence is needed to determine if altering the physical home environment by removing potential hazards reduces injuries in LMICs.

وبائيات الإصابات المنزلية غير المتعمدة بين الأطفال منذ الولادة وحتى سن الرابعة عشر في محافظة أسيوط، مصر: دراسة مجتمعية مستعرضة

إن التغير في النمط الوبائي لوفيات الأطفال والتقدم الكبير فى مكافحة الأمراض المعدية وزيادة خطر الإصابات ليخلق رؤية جديدة لمعدل إصابات ووفيات الأطفال حول العالم لما تمثله من خطر جسيم حيث تتسبب الإصابات في قتل 5مليون شخص كل عام وأن معظم هذه الإصابات يقع داخل وحول نطاق المنزل حيث يقضى الأطفال في هذه المرحلة العمرية أكثر وقتهم بالمنزل. لذا ركزت في هذا البحث على هذه المرحلة العمرية في واحده من أكبر محافظات صعيد مصر وهي أسيوط. الهدف: دراسة حجم ونمط الإصابات المنزلية غير المقصودة في الأطفال الذين تتراوح أعمارهم بين 0 و 14 عامًا وتقييم المخاطر البيئية المرتبطة بالإصابات المنزلية. الأساليب: أجريت دراسة مجتمعية مستعرضة في عام 2018، على سكان الريف في محافظة أسيوط، مصر. تم اختيار العينة الإجمالية للأطفال من 500 أسرة عن طريق أخذ عينات عشوائية منهجية. تم جمع البيانات باستخدام استبيان محدد سلفا ومنظم من كل من الآباء والأمهات والأطفال. النتائج: من بين 1337 طفلاً، وجد أن معدل الإصابة في المنزل بلغ 43.8% في العام الماضي، وهو أعلى بكثير في الفئة العمرية من 1 إلى 3 سنوات (60%) تليها 5-10 سنوات (45.7%). كان إجمالي عدد الإصابات ومتوسط عدد الإصابات لدى الأولاد أعلى بكثير من البنات. كان أكثر أنواع الإصابات المنزلية شيوعًا هو السقوط (54.6%) يليه الإصابة بالحروق (16.1%) والإصابة بالأدوات الحادة (11.8%)، وتم تقييم الخطر البيئي باستخدام تعريفات قياسية وعملية ووجد نقاط كهربائية غير آمنة (97%)، السلالم غير الآمنة (100%)، طاولة طعام غير آمنة قصيرة (72%)، مطبخ غير آمن مع إمكانية الوصول إلى الأدوات الحادة (27.6%)، الوصول إلى النيران النشطة (23.6%)، والأثاث والأشياء غير الآمنة (22%). الاستنتاجات: إن إصابات الأطفال المنزلية غير المقصودة شائعة في صعيد مصر. كان إجمالي عدد الإصابات ومتوسط عدد الإصابات لدى الأولاد أعلى بكثير من البنات. كان السقوط أكثر أنواع الإصابات شيوعًا بين جميع الفئات العمرية. كشفت الدراسة عن وجود عبء كبير من أخطار إصابات الطفولة داخل منازلهم. التوصيات: يعد تنفيذ تدابير السلامة والوقاية من الإصابات التي قد تنطوي على تغييرات قانونية، وتطبيق استراتيجيات السلامة السلبية، وتثقيف الآباء والأمهات والأطفال في المدارس، والدعم المالي للأسر الفقيرة، استراتيجيات مهمة للوقاية من الإصابات المنزلية.

Assessment of home hazards for non-fatal childhood injuries in rural Nepal: a community survey

BackgroundUnintentional injuries in and around the home are important causes of preventable death and disability among young children globally. In Nepal, there is a lack of data regarding home injuries...

EFFECTIVENESS OF HEALTH EDUCATION AMONG MOTHERS TO REDUCE UNINTENTIONAL HOME INJURIES OF UNDER-FIVE YEAR OLD CHILDREN IN RURAL COMMUNITY

Background: Unintentional home injuries among under five year old children in rural community is a common issue which lead serious health problems and increase disability rate in children under five year of age. The aim of study was to assess the effectiveness of health education among mothers to reduce unintentional home injuries of under-five year old children in rural community. Methods: A study design was quasi experimental, one group pre and post test design was used and data was collected at Ali Raza Abad community, Raiwand Road Lahore. Convenient sampling technique was used. Sample size was 71 community mothers who have children under 5- year of age with age group 18 years to 45 years. Data was collected by administering knowledge and practice questionnaire before and after the health education programme. The post data was collected after four week intervention after pre data collection. Results: The current study shows that the overall mean score of pre-test is .4907 and overall mean score of post-test knowledge was .8422. The overall mean score of pretest was .4930 and overall mean score of post-test practice was .8003. These results show that health education is effective to enhance the knowledge and safety practice of mothers. Conclusion: Based on the findings of this study, it concluded that health education is so effective to bring significant change in knowledge and practice among mothers of under under-five year of old children.

Frequency of Unintentional Home Injuries in Children under Five Years and its Relation with Environmental Risk factors, Cairo, Egypt

Frequency of Unintentional Home Injuries in Children under Five Years and its Relation with Environmental Risk factors, Cairo, Egypt

Effectiveness of Health Education Among Mothers to Reduce Unintentional Home Injuries of Under- Five Year Old Children in Rural Community

Background: Unintentional home injuries are common in children. Unintentional home injuries are main causes of disability, morbidity and mortality in children, results show that every year 630,000 children died due to unintentional home injuries. Unintentional injuries occur in homes due to lack of awareness and due to improper knowledge, attitude and lifestyle of primary caregiver in homes. Aim of study: The aim of study was to assess the effectiveness of health education among mothers to reduce unintentional home injuries of under-five year old children in rural community. Method: A study design was quasi experimental, one group pre and post test design was used and data was collected at Ali Raza Abad community, Raiwand Road Lahore. Convenient sampling technique was used. Sample size was 71 community mothers who have children under 5- year of age with age group 18 to 45 years. Data was collected by administering knowledge and practice questionnaire before and after the health education programme. Results: The current study shows that the overall mean score of pretest is .4907 and overall mean score of post-test knowledge was .8422. The overall mean score of pretest was .4930 and overall mean score of post-test practice was .8003. These results show that health education is effective to enhance the knowledge and safety practice of mothers. Conclusion: Unintentional home injuries are commonly occur in children and unintentional home injury is also a global health issue in communities. Health education is very important to enhance the general knowledge and safety practice of mothers toward home injuries. On community level health education program is effective to improve the knowledge and safety practice of mother. Keywords: Effectiveness, Health Education, Mothers and Under Five – year old Children, Rural Community. DOI : 10.7176/JHMN/58-03

Preventing unintentional home injuries among children: exploring the perceptions of Iranian health professionals.

Health professionals are key stakeholders who potentially have important roles in preventing unintentional child home injuries. This study aimed to identify facilitators and barriers to the prevention of unintentional child home injuries perceived by health professionals. A generic qualitative study involving semi-structured interviews. The capital city of Iran. Data for this study were collected through 28 in-depth interviews with health professionals. Purposive sampling was conducted from three areas of Tehran based on their socio-economic development. Thematic data analysis yielded nine overarching themes: prioritising child home injury, knowledge, the nature of injury and injury prevention, child-related factors, parent-related factors, living environment, cultural issues, resources and management. Health professionals can potentially be supportive to meet families' needs. However, further support and resources will be required if they are to fully develop their potential in preventing injuries in the home. The lack of a national action plan was a significant constraint for health professionals.

Health promotion approach to reduce unintentional home injuries of young children in rural villages in the North Central Province of Sri Lanka

Background: South East Asian region reports a higher risk for deaths from injuries and in Sri Lanka 16% child mortality is due to injuries. Objectives: To describe the types and extent of unintentional home injuries among children below 5 years of age, to evaluate the knowledge, attitudes and current practices of primary caregivers on reducing unintentional home injuries in two villages and to assess the effectiveness of a health promotion approach in rural villages in the North Central Province of Sri Lanka. Method: A quasi experimental study was carried by selecting 2 rural villages. Baseline measures were gathered in experimental and control areas using a questionnaire, a history record index and a practice checklist. A health promotion intervention was administered in the experimental study area. The intervention was developed consulting the community and targeted identifying determinants of unintentional home injuries and improving knowledge, changing attitudes, obtaining family support and improving skills on identifying risks for home injuries. The health promotion intervention was delivered through lectures and activities. Post evaluation assessment was on change in practices which was the primary outcome, and the change in knowledge and attitudes were secondary outcomes. Results: Injury prevalence was 31% (CI 20.5- 43.1), burns (36.4%) being the most common. The difference between pre and post scores of mean practice was significantly higher (p=0.001) in the intervention group which showed knowledge improvement and a positive change in attitudes. Conclusions : Nearly one third of caregivers reported a home injury and the health promotion intervention was effective in improving injury prevention practices, knowledge and attitudes. Sri Lanka Journal of Child Health , 2018; 47(1): 33-39

Unintentional home injuries among children aged 1–9 years in slums of Burdwan Municipality, West Bengal: A cross-sectional study

Context: Unintentional home injuries result in morbidities among children. Aims: This study aimed to find out the prevalence and patterns of unintentional home injuries among children aged 1–9 years, in slums of Burdwan Municipality; to determine an association of various sociodemographic factors with such injuries; and to assess known risk factors for unintentional injuries. Settings and Design: This community-based cross-sectional study was conducted in three randomly selected slums of Burdwan Municipality, West Bengal. Materials and Methods: The study was conducted during July–November 2017 among 219 children aged 1–9 years residing in the study area. Data were collected at the household level by interviewing the respondents, record review, and observation. The occurrence of any unintentional home injury during the last 1 year was considered to estimate period prevalence. Results: Overall prevalence of unintentional home injury was 19.6%; with 20.8% and 18.6% among girls and boys, respectively. Mean episode of injuries was 0.37±0.9 in a year. Majority of injury episodes were cut by fall (73.2%), affected ankle and foot (44%), and occurred in the living room (84.1%) and while playing (98.8%). Overcrowding (82.2%), access to sharps in the kitchen (59.4%), and sharp objects within reach in living rooms (44.7%) were the prevalent known risk factors at the households. Conclusions: Unintentional home injuries among children are substantially high in the area with some of theprevalent risk factors. Intensive health education activities for mothers and awareness campaigns for preventive measures need to be implemented.Context: Unintentional home injuries result in morbidities among children. Aims: This study aimed to find out the prevalence and patterns of unintentional home injuries among children aged 1–9 years, in slums of Burdwan Municipality; to determine an association of various sociodemographic factors with such injuries; and to assess known risk factors for unintentional injuries.Settings and Design: This community-based cross-sectional study was conducted in three randomly selected slums of Burdwan Municipality, West Bengal. Materials and Methods: The study was conducted during July–November 2017 among 219 children aged 1–9 years residing in the study area. Data were collected at the household level by interviewing the respondents, record review, and observation. The occurrence of any unintentional home injury during the last 1 year was considered to estimate period prevalence. Results: Overall prevalence of unintentional home injury was 19.6%; with 20.8% and 18.6% among girls and boys, respectively. Mean episode of injuries was 0.37±0.9 in a year. Majority of injury episodes were cut by fall (73.2%), affected ankle and foot (44%), and occurred in the living room (84.1%) and while playing (98.8%). Overcrowding (82.2%), access to sharps in the kitchen (59.4%), and sharp objects within reach in living rooms (44.7%) were the prevalent known risk factors at the households. Conclusions: Unintentional home injuries among children are substantially high in the area with some of the prevalent risk factors. Intensive health education activities for mothers and awareness campaigns for preventive measures need to be implemented.

Parents’ voices: perceptions of barriers and facilitators to prevent unintentional home injuries among young children

Background: Young children face injury as a potentially life-threatening problem. Injury still has considerable financial, emotional and social effects on families and society as a whole. A variety of interventions are known to prevent child injuries. The literature, however, provides meagre information on what factors enable or inhibit the implementation of these interventions for controlling home injuries in Iran. Methods: Qualitative study was applied using eighteen semi-structured interviews with parents attending urban health centres in Tehran City. The recorded interviews were transcribed verbatim and the data were analysed using thematic analysis. Findings: Factors believed to influence the prevention of home injuries among urban children aged under 5 years are presented as five major themes. These were: the nature of injury and injury prevention, child-related factors, parent-related factors, living environment and society-related factors. Conclusions: The findings highlighted the need for greater support for parents. Half of the parents were struggling with barriers such as money and time. The study has implications for further research and practice to promote child safety at home.

Child injury prevention: a survey of local authorities and health boards

Aims: Unintentional home injuries are a significant global public health issue and are a major cause of mortality and morbidity. Within each country, injuries disproportionately affect children from low income families. Recent guidance issued in the UK recommends actions to be taken by local authorities to reduce injury rates and inequalities. This study aimed to describe and quantify child home injury prevention activities of local authorities (LAs) in England and health boards (HBs) in Wales.Methods: A questionnaire was sent to Directors of Public Health in all 153 upper-tier LAs in England and 7 HBs in Wales. The questionnaire covered the five broad areas recommended for injury prevention activities by NICE guidelines.Results: A response rate of 58% was achieved. NICE guidance (75%) and Public Health England guidance (57%) were most commonly used to support child injury prevention decision-making. Half (50%) of respondents had a child injury prevention alliance in their area. One fifth (19%) reported that their area had a written child injury prevention strategy. Fewer than half of responders provided training to practitioners about child unintentional injury prevention (43%), home safety assessments (43%) or an equipment scheme (43%). Of the 43% of areas with equipment schemes, most (59%) were small scale, supplying up to 200 families per year with equipment.Conclusions: Although some LAs/HBs show implementation of recent guidance on preventing home injuries in childhood, most do not. LAs/HBs are likely to need support to implement guidance in order that child injury rates and inequalities can be reduced.

Risk factors of Non-fatal Unintentional Home Injuries among Children under 5 Years Old; a Population-Based Study.

In addition to the annual mortality rate, unintentional home injury may result in temporary or permanent disability and requires medical attention and continuous care in millions of children. This study aimed to explore features and risk factors of these injuries. In this cross-sectional study, demographic variables and epidemiologic pattern of home injuries among children under 5 years of age were collected via a population-based survey in seven main cities of Khuzestan province, southwest Iran, during September 2011 to December 2012. Developing a risk stratification model, independent risk factors of unintentional home injury were determined and put to multivariate logistic regression analysis. 2693 children with the mean age of 27.36 ± 15.55 months (1 to 60) were evaluated (50.9% boy). 827 (30.7%) cases had a history of at least one home injury occurrence since birth to study time. The most common injury mechanisms were burning with 291 (38.4%) cases, falling with 214 (28.3%) and poisoning with 66 (8.7%) cases, respectively. The independent risk factors of unintentional home injury were age ≥ 24 month (p<0.001), residency in Ahvaz city (p<0.001), mother's illiteracy (p<0.014), ethnicity (p<0.001), private housing (p=0.01), birth weight (p<0.001), and being the first child (p=0. 01). Sensitivity, specificity, and area under the ROC curve of the model designed by multivariate analysis were 53.5%, 84.8%, and 0.75 (95% CI: 0.73- 0.77; P < 0.001, figure 1), respectively. According to the findings of this study, 30.7% of the studied children were injured at least once since birth. Burning, falling, poisoning, swallowing objects, choking, and biting were the main home injury mechanisms. Age ≥ 24 months, being the first child, living in a private house, being a resident of Ahvaz city, and having an illiterate mother were found to be risk factors of home injury.

Unintentional Home Injury Prevention in Preschool Children; a Study of Contributing Factors.

Different factors such as parents' knowledge and attitudes regarding preventive measures (PM) have a great role in reducing children unintentional home injuries. The present study aims to evaluate the contributing factors of unintentional home injury prevention in preschool victims presented to the emergency department. The subjects consisted of all the mothers of preschool children who were presented to the emergency department of Imam Hossein and Shohadaie-Hafte-Tir Hospitals, with unintentional home injuries, from March 2011 to February 2012. The participants were divided into two groups according to implementation of preventive measures status. The significant confounding factors of PM application was determined by chi-squared test and entered into the backward multivariate logistic regression model. 230 mothers with the mean age of 29.4 ± 5.2 years were evaluated. 225 (97.83%) of them were still married, 74 (32.17%) had high school education or higher, 122 (53.04%) were homemakers, and 31 (13.49%) worked outside the home for at least 8 hours daily. High level of knowledge (OR = 0.05; 95% CI: 0.002‒0.32; P = 0.002), appropriate attitude (OR = 0.12; 95% CI: 0.03‒0.51; P = 0.01), having at least three children (OR = 7.2; 95% CI: 1.1‒32.9; P = 0.04), daily absence of mother for at least 8 hours (OR = 9.2; 95% CI: 2.2‒35.46; P = 0.002), and a history of home injury during the previous 3 weeks (OR = 8.3; 95% CI: 2.1‒41.3; P = 0.001) were independent factors which influenced application of preventive measures. Increasing mothers' knowledge level and improving their attitudes were facilitating factors and mothers' absence from the house for more than 8 hours a day and having at least 3 children were obstacles to application of preventive measures. In addition, a history of same injury during the previous 3 weeks increased the risk of repeated event.

Primary Care Opportunities to Prevent Unintentional Home Injuries: A Focus on Children and Older Adults.

Unintentional injuries are a persistent public health problem in the United States. A new health care landscape has the potential to create a clinical environment that fosters greater involvement by health care providers in injury prevention. The aim of this article is to provide evidence supporting the need for engagement by primary care providers in unintentional home injury prevention along with examples of how this could be accomplished. We know a great deal about what population groups are at risk for certain types of injuries. We also know that many injuries can be prevented through policies, programs, and resources that ensure safe environments and promote safe behaviors. For example, the Centers for Disease Control and Prevention's STEADI (Stopping Elderly Accidents, Deaths, and Injuries) initiative comprises clinical decision support tools and educational materials for health care providers. Two effective interventions that have demonstrated a reduction in falls among children are the redesign of baby walkers (engineering) and the mandated use of window guards (enforcement). Primary care clinicians can play a key role in promoting their patient's safety. Taken collectively, a focused attention on preventing unintentional home injuries by primary care providers can contribute to the reduction of injuries and result in optimal health for all.

Unintentional home injuries across the life span: problems and solutions.

Home injuries cause more than 30,000 deaths and 12 million nonfatal injuries annually in the United States. They generate an estimated $222 billion in lifetime costs annually. Despite some data limitations in documenting home as the location of an injury, much progress has been made in identifying effective prevention strategies that reduce injury or mitigate risk behaviors. The current interest in public health in the role of housing in health offers unparalleled opportunities for injury prevention professionals concerned with home injuries. Sharing the science of injury prevention with the wide array of professionals-such as architects, home builders, home visitors, and fire and emergency medical services providers-who create home environments and interact with residents could be a useful approach. A collaborative national effort to reduce the burden of home injuries is needed.

Characteristics and predictors of home injury hazards among toddlers in Wenzhou, China: a community-based cross-sectional study.

BackgroundHome hazards are associated with toddlers receiving unintentional home injuries (UHI). These result in not only physical and psychological difficulties for children, but also economic losses and additional stress for their families. Few researchers pay attention to predictors of home hazards among toddlers in a systematic way. The purpose of this study is firstly to describe the characteristics of homes with hazards and secondly to explore the predicted relationship of children, parents and family factors to home hazards among toddlers aged 24–47 months in Wenzhou, China.MethodsA random cluster sampling was employed to select 366 parents having children aged 24 – 47 months from 13 kindergartens between March and April of 2012. Four instruments assessed home hazards, demographics, parent’s awareness of UHI, as well as family functioning.ResultsDescriptive statistics showed that the mean of home hazards was 12.29 (SD = 6.39). The nine kinds of home hazards that were identified in over 50% of households were: plastic bags (74.3%), coin buttons (69.1%), and toys with small components (66.7%) etc. Multivariate linear regression revealed that the predictors of home hazards were the child’s age, the child’s residential status and family functioning (b = .19, 2.02, - .07, p < .01, < .05 and < .01, respectively).ConclusionsThe results showed that a higher number of home hazards were significantly attributed to older toddlers, migrant toddlers and poorer family functioning. This result suggested that heath care providers should focus on the vulnerable family and help the parents assess home hazards. Further study is needed to find interventions on how to manage home hazards for toddlers in China.

The feasibility of using a parenting programme for the prevention of unintentional home injuries in the under-fives: a cluster randomised controlled trial

Unintentional injury is the leading cause of preventable death of children over the age of 1 year in the UK and a major cause of attendance at emergency departments. Children having one injury are at increased risk of further injuries. Parenting programmes can reduce injuries in preschool children if delivered in the home and on a one-to-one basis. It is not known if group-based programmes delivered outside the home are effective. To develop (1) a parenting programme to prevent recurrent unintentional home injuries in preschool children and (2) a tool for parents to report unintentional home injuries occurring to their preschool children. To assess the feasibility of delivering and evaluating the parenting programme through a cluster randomised controlled trial, specifically to (1) assess methods for the recruitment and retention of parents; (2) determine the training, equipment and facilities needed for the delivery of the programme; (3) establish appropriate primary and secondary outcome measures and methods for their collection; (4) determine how 'normal care' in a comparison arm should be defined; and (5) determine the resource utilisation and costing data that would need to be collected for the cost-effectiveness component of a future trial; and (6) produce estimates of effect sizes to inform sample size estimation for a main trial. Feasibility multicentre, cluster, randomised, unblinded trial. Eight children's centres in Bristol and Nottingham, UK. Ninety-six parents of preschool children who had sustained an unintentional injury requiring medical attention in the previous 12 months. The First-aid Advice and Safety Training (FAST) parent programme, comprising parenting support and skills combined with first aid and home safety advice. Parent-reported medically attended injuries in the index child and any preschool siblings sustained during a 6-month period of observation. An 8-week parenting programme was produced, designed with participant-friendly, incrementally progressive content. A slimline, month-to-a-view injury calendar, spiral bound and suitable for hanging on a wall, was designed for parents to record injuries occurring to their preschool children during the 6-month period of observed time. Fifty-one parents were recruited (40 meeting eligibility criteria plus 11 following 'open invite' to participate); 15 parents completed the FAST parent programme and 49 provided data at baseline and during follow-up. Completion of the programme was significantly greater for participants using the 'open invite' approach (85%) than for those recruited using the original eligibility criteria (31%). Prototype resource use checklists, unit costs and total costs were developed for phases 0, 1 and 2 of the study for use in a future trial. This feasibility study has developed an innovative injury prevention intervention and a tool to record parent-reported injuries in preschool children. It was not feasible to recruit parents of children who had sustained a recent injury, or to ask health visitor teams to identify potential participants and to deliver the programme. A trial should target all families attending children's centres in disadvantaged areas. The intervention could be delivered by a health professional supported by a member of the children's centre team in a community setting. Current Controlled Trials ISRCTN03605270. This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 18, No. 3. See the NIHR Journals Library website for further project information.

Delivery of a national home safety equipment scheme in England: a survey of local scheme leaders

Unintentional home injuries sustained by preschool children are a major cause of morbidity in the UK. Home safety equipment schemes may reduce home injury rates. In 2009, the Royal Society for the Prevention of Accidents was appointed as central coordinator of a two-year, £18m national home safety equipment scheme in England. This paper reports the findings from a national survey of all scheme leaders responsible for local scheme delivery. A questionnaire mailed to all local scheme leaders sought details of how the schemes were operated locally; barriers and facilitators to scheme implementation; evaluation of the local scheme and its sustainability. A response rate of 73% was achieved. Health visitors and family support workers played a key role in both the identification of eligible families and performing home safety checks. The majority of local scheme leaders (94.6%) reported that they thought their local scheme had been successful in including those families considered 'harder to engage'. Many scheme leaders (72.4%) reported that they had evaluated the provision of safety equipment in their scheme and over half (56.6%) stated that they would not be able to continue the scheme once funding ceased. Local schemes need support to effectively evaluate their scheme and to seek sustainability funding to ensure the future of the scheme. There remains a lack of evidence of whether the provision of home safety equipment reduces injuries in preschool children.

Home Unintentional Non-fatal Injury Among Children Under 5 Years of Age in a Rural Area, El Minia Governorate, Egypt

Injury is the leading cause of morbidity and mortality in children aged 1-14years, with home injuries a particular problem in the preschool-age group. The focus of this study was to determine the frequency, and the outcome of unintentional non-fatal injuries among children under 5years of age in the household, and to describe the related risk factors through a community-based survey. A cross-sectional community based study was conducted on a random sample of 1,255 rural Egyptian children under 5years of age. Data were collected by a questionnaire which included; socio-demographic data, history, type, and the outcome of unintentional home injuries in the previous year. Of 1,255 children, 55.9% were males and 44.1% were females, and their mean age was 28.6±11.8months. The frequency of unintentional non-fatal home-related injuries was 20.6%. Injury rates were the highest among children during the third year of life, those of less educated parents, those whom mothers are of young age, and those with low household socioeconomic standard. Homes of injured children were not significantly different from the homes of non-injured children. Burns were the most common injuries among all the study groups (38%) followed by falls (35.3%). 'Handicaps' were more strongly associated with falls and burns (6.6 and 4.1% respectively). Unintentional injuries are common among children under 5years of age in rural Egypt. Therefore, measures should be taken to prevent children from the most frequently recorded home injuries such as burns and falls.

Fatal Unintentional Injuries in the Home in the U.S., 2000–2008

From 1992 to 1999, an average of more than 18,000 unintentional home injury deaths occurred in the U.S. annually. The objective of this study was to provide current prevalence estimates of fatal unintentional injury in the home. Data from the 2000-2008 National Vital Statistics System were used in 2011 to calculate average annual rates for unintentional home injury deaths for the U.S. overall, and by mechanism of injury, gender, and age group. From 2000 to 2008, there was an annual average of 30,569 unintentional injury deaths occurring in the home environment in the U.S. (10.3 deaths per 100,000). Poisonings (4.5 per 100,000) and falls (3.5 per 100,000) were the leading causes of home injury deaths. Men/boys had higher rates of home injury death than women/girls (12.7 vs 8.2 per 100,000), and older adults (≥80 years) had higher rates than other age groups. Home injury deaths and rates increased significantly from 2000 to 2008. More than 30,000 people die annually in the U.S. from unintentional injuries at home, with the trend rising since the year 2000. The overall rise is due in large part to the dramatic increase in deaths due to poisonings, and to a lesser degree falls at home. Unintentional home injuries are both predictable and preventable. Through a multifaceted approach combining behavioral change, adequate supervision of children, installation and maintenance of safety devices, and adherence to building codes, safety regulations and legislation, home injuries can be reduced.