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Objective:To examine incidence, demographic risk factors, and patterns of injury resulting from falls from buildings and structures in areas with and without a legislation based prevention programme.Design and setting:The Health Care Cost and Utilization Project (KID-HCUP) was used to produce national estimates of hospital admissions due to falls from buildings in the US. Areas of New York with and without window guard legislation were identified through the New York Statewide Planning and Research Cooperative System (SPARCS).Subjects:Children and adolescents aged 0–18 years.Interventions:Legislation based window fall prevention programme with enforcement.Main outcome measures:Hospitalization for injury as a result of falls from buildings and structures in areas with and without enforced mandatory window guard legislation.Results:New York City has a higher proportion of the population residing in multifamily dwellings with 10 or more units compared with the nation (53.8%v12.6%, p<0.0001), but the incidence of injury resulting from falls from buildings is nearly half that observed in the US. For young children, warm weather risks begin earlier and extend later than previously reported. Incidence in very young minority children is nearly twice that of whites. Nearly 90% of children aged 0–4 years fall at home, but the proportion decreases linearly with age.Conclusions:Window guards are associated with reduced injury resulting from falls from buildings and should be mandated in multifamily dwellings where small children reside. Prevention programmes for young children should be initiated in early spring and continued through fall.
Objective:To examine incidence, demographic risk factors, and patterns of injury resulting from falls from buildings and structures in areas with and without a legislation based prevention programme.Design and setting:The Health Care Cost and Utilization Project (KID-HCUP) was used to produce national estimates of hospital admissions due to falls from buildings in the US. Areas of New York with and without window guard legislation were identified through the New York Statewide Planning and Research Cooperative System (SPARCS).Subjects:Children and adolescents aged 0–18 years.Interventions:Legislation based window fall prevention programme with enforcement.Main outcome measures:Hospitalization for injury as a result of falls from buildings and structures in areas with and without enforced mandatory window guard legislation.Results:New York City has a higher proportion of the population residing in multifamily dwellings with 10 or more units compared with the nation (53.8%v12.6%, p<0.0001), but the incidence of injury resulting from falls from buildings is nearly half that observed in the US. For young children, warm weather risks begin earlier and extend later than previously reported. Incidence in very young minority children is nearly twice that of whites. Nearly 90% of children aged 0–4 years fall at home, but the proportion decreases linearly with age.Conclusions:Window guards are associated with reduced injury resulting from falls from buildings and should be mandated in multifamily dwellings where small children reside. Prevention programmes for young children should be initiated in early spring and continued through fall.
Unintentional injuries claim the lives of more children each year than any other cause of death. A substantial proportion of child hospitalizations and emergency department visits also are attributable to unintentional injuries. The conceptualization of unintentional injuries as a public health problem that is preventable has gained credibility over the past few decades, as effective solutions to reduce the burden of injuries--such as child safety seats, bicycle helmets, and smoke detectors--have been identified. Successful implementation of these strategies requires a clear understanding of the circumstances surrounding injuries and the risk and protective factors that influence the likelihood that a child will be injured. Although adequate data on these factors is available for some causes of injury, such as motor vehicle crashes, it is almost nonexistent for others, such as unintentional firearm injuries. Overall, unintentional injury rates are highest among adolescents ages 15 to 19, males, children from impoverished families, and minorities. Also, some injuries occur more often in rural areas. Although these demographic risk factors cannot be modified, environmental and behavioral risks, such as unsafe roads, alcohol intoxication, unfenced swimming pools, and the absence of a smoke detector in the home, can be modified successfully with appropriate strategies. Motor vehicle occupant, drowning, and pedestrian injuries were the most common unintentional injuries causing death among children ages 0 to 19 in 1996. Together, these mechanisms accounted for more than half of all unintentional injury deaths among children and adolescents, although rates varied considerably by age. Child injury death rates across most age categories and mechanisms of injury have declined during the past 20 years, yet the reasons for these declines are poorly understood. Additional research about risk and protective factors, and efforts to implement successful injury prevention strategies among populations at highest risk for injuries, are necessary to further reduce the toll on children's lives.
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