Home safety measures and the risk of unintentional injury among young children: a multicentre case-control study

Abstract

Background: Young children may sustain injuries when exposed to certain hazards in the home. To better understand the relation between several childproofing strategies and the risk of injuries to children in the home, we undertook a multicentre case-control study in which we compared hazards in the homes of children with and without injuries. Methods:We conducted this case-control study using records from 5 pediatric hospital emergency departments for the 2-year period 1995-1996. The 351 case subjects were children aged 7 years and less who presented with injuries from falls, burns or scalds, ingestions or choking. The matched control subjects were children who presented during the same period with acute non-injury-related conditions. A home visitor, blinded to case-control status, assessed 19 injury hazards at the children's homes. Results:Hazards found in the homes included baby walkers (21% of homes with infants), no functioning smoke alarm (17% of homes) and no fire extinguisher (51% of homes). Cases did not differ from controls in the mean proportion of home hazards. After controlling for siblings, maternal education and employment, we found that cases differed from controls for 5 hazards: the presence of a baby walker (odds ratio [OR] 9.0, 95% confidence interval [CI] 1.1-71.0), the presence of choking hazards within a child's reach (OR 2.0, 95% CI 1.0-3.7), no child-resistant lids in bathroom (OR 1.6, 95% CI 1.0-2.5), no smoke alarm (OR 3.2, 95% CI 1.4-7.7) and no functioning smoke alarm (OR 1.7, 95% CI 1.0-2.8).Interpretation: Homes of children with injuries differed from those of children without injuries in the proportions of specific hazards for falls, choking, poisoning and burns, with a striking difference noted for the presence of a baby walker. In addition to counselling parents about specific hazards, clinicians should consider that the presence of some hazards may indicate an increased risk for home injuries beyond those directly related to the hazard found. Families with any home hazard may be candidates for interventions to childproof against other types of home hazards. CMAJ 2006;175(8):883-7 Published at www.cmaj.ca on Sept. 21, 2006. Abstract

Child injury: Does home matter?

“…Our finding of an inverse relationship between home risk and childhood injury diverges from previous research in this area (Hapgood et al, 2001;Kamal, 2013;Kendrick et al, 2005b;LeBlanc et al, 2006;Ramsay et al, 2003). A possible exception is one study by Pearce et al (2012) which examined whether indictors of the home environment (housing quality and safety equipment use) mediated the relationship between socio-economic circumstances and unintentional injuries.…”

“…This finding is consistent with the study by Pearce et al (2012) which found that home environment measures did not mediate the relationship between socio-demographic variables and home injury in young children. On the other hand, Kendrick et al (2005b) found that the relationship between specific home safety practices and injury related hospital admission rates was independent of socio-economic variables, while the study by (LeBlanc et al, 2006) found a relationship between the presence of specific hazards and home injury risk after controlling for siblings, maternal education and employment. Whilst these inconsistent results may reflect the different measures of home environment and injury risk used across the studies, further research on the relationship between these factors is critical to the development of more effective injury prevention programs.…”

“…Of particular interest has been whether home safety practices are a useful predictor of injury and whether there are differences in the home safety practices of injured and uninjured children. The findings of these studies have been mixed with some showing a link between specific types of home safety practices or hazards and childhood injury (Kamal, 2013;Kendrick, Watson, Mulvaney, & Burton, 2005b;LeBlanc et al, 2006;Ramsay et al, 2003) and others finding no significant association between safety practices and injury occurrence (Hapgood, Kendrick, & Marsh, 2001). One study by Pearce et al (2012) found few indicators of the child's household M A N U S C R I P T…”

Prevention of childhood poisoning in the home: overview of systematic reviews and a systematic review of primary studies

“…Interventions promoting safe storage of household and other products. Interventions promoting the safe storage of household and other products (defined as use of safety catches or locks on cupboards/drawers, use of CRCs, and storage out of reach of children), were reported in 24 primary studies included in 11 reviews (DiGuiseppi & Roberts, 2000;Elkan et al, 2000;Guyer et al, 2009;Kendrick, Barlow et al, 2007;Kendrick, Coupland et al, 2007;Lyons et al, 2006;Lyons et al, 2003;Pearson et al, 2009;Towner et al, 1996United States Preventive Services Task Force, 1996) and in a further 7 studies not included in any reviews (Bulzacchelli et al, 2009;Gielen et al, 2007;LeBlanc et al, 2006;Nansel et al, 2008;Phelan et al, 2011;Reich et al, 2011;Swart et al, 2008) (see Table 4). One meta-analysis (Kendrick, Coupland et al, 2007) found evidence that education, with or without the provision of safety equipment was effective in increasing safe storage of household products (OR 1.63, 95% CI 1.22À2.17).…”

Mothers' knowledge, attitudes, and performance toward household accidents at home in children 1-5 years old: An intervention study

“…[37] Kamal and LeBlanc et al noted the relationship between knowledge and education. [38][39][40] Demographic results of this study showed that majority of participants had more than diploma degree and only a small number of mothers had less than diploma degree. The results showed that both multimedia-based education (SMS and multimedia) increase knowledge of mothers with children aged one to five visiting health centers in Bushehr.…”