Topic Editor: Frederick Rivara, MD, University of Washington, USA
Falls
The most common countermeasure to reduce fall injuries is the use of window locks or barriers for homes with floors above the ground level. Other effective strategies include the provision of stair gates, handrails, and the use of energy absorbing material under playground equipment. In terms of supervision-related strategies, parents should never leave a baby on a changing table without supervision and they are also encouraged to monitor children’s climbing behaviours.
Road Traffic Injury
For motor vehicle occupant injuries, the most important countermeasure is the use of seat restraints. From birth until they weigh about 10 kilograms, children should be restrained in rear-facing child seats. Children should be in forward-facing seats from then until about 4 years of age. Then, booster seats must be used until the adult seat belt fits children properly (around 145 cm of height). Seats should be adjusted correctly and seat belt properly worn on each riding occasion. Finally, parents are encouraged to provide supervision until children are cognitively able to safely cross the street (around 10 years of age).
Drowning
Passive strategies recommended to prevent drowning include: 1) installing a 4-sided fence surrounding the swimming pool; 2) placing a cover on a well; and 3) emptying water from large containers when not used. Although less effective than passive strategies, behavioural interventions should also be considered such as: 1) teaching a child how to swim (it reduces the risk of drowning by 40 to 88% for children between 1 and 4); 2) training lifeguards on beaches and at public swimming pools in CPR (cardiopulmonary resuscitation; and 3) wearing life vests when boating or in open water.
Burns
Prevention strategies to reduce burns include home safety education as well as the regular maintenance of smoke alarm installation. Parents should also ensure that matches, lighters, and hot liquids are kept out of young children’s reach. Furthermore, it is recommended that the temperature of hot tap water be reduced to prevent tap water scalds.
Poisoning
The most effective strategy to reduce poisoning is to prevent the child from getting to poisons and toxins in the home. Parents should throw out unused prescription medications and always use child resistant caps on medication bottles. Poisons such as kerosene and pesticides should not be kept in the home, always kept in their original containers equipped with child resistant caps. Finally, parental supervision should always be favoured to sibling supervision considering the latter tends to increase the risk of injury in young children.
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