World report on child prevention Fatal childfallinjuryratesper100000population n n n Mortality Scale oftheproblem worldwide. efforts safety child of focus vital a becomes fall-related of (particularly as a result of head injuries) demand that the prevention of risk significant the and costs, health-care falls, non-fatal burden on health care facilities around the world. The frequency of injury death for children. Non-fatal falls also represent a significant body,child’s unintentional of cause largest fourth the them making a of resilience the beyond go falls some But bruises. and cuts few a than more much sustaining without lives their in times many fall children most and consequence little of are environment. Fortunately,falls most physical the explore learning and – jump run, develops climb, child walk, a to way the of part normal a is

13th leadingcauseofdisability-adjustedlifeyears lost. the are falls non-fatal years, 15 under children Among 5–9 year oldsand15-19year olds. adults, falls rank as the 12th leading cause of death among among are fall-related of majority the Although from fallsworldwide–over 46000were children. died ages all of people 000 424 estimated an 2004, In il ...... 1.9 0.3 2.3 0.3 0.6 0.2 2.4 0.4 0.1 1.1 Girls os1803103005134035052.5 0.5 3.5 4.0 1.3 fact 0.5 3.0 1.0 0.3 1.8 Boys sheet fiaAmericas Africa MCHCLI MCHCLI I MCHCLMIC HIC LMIC HIC LMIC HIC LMIC LMIC HIC LMIC falls Children and atAi Europe East Asia South- a bysex,countryincomelevelandWHOregion,2004 n n n eierna Western Pacific Mediterranean

while 8%were theresult offallsonthesamelevel. height, a from occur children among falls fatal of 66% per 100000orless. 0.3 of rates fall fatal have countries high-income Most the highest ratesoffatalfalls. have Pacific Western and Mediterranean Eastern the of countries low-income the and Asia South-East Eastern W h a t i s a f a l l ? ? l l a f a s i t a h W level (WHO). on thegroundorfloorotherlower person comingtorestinadvertently A fallisaneventwhichresultsina a 2004 update. Source: WHO(2008),GlobalBurdenofDisease: countries. LMIC =Low-incomeandmiddle-income HIC =High-incomecountries;

age. These datarefertothoseunder20yearsof Morbidity Risk factors

n Data indicate that falls comprise a leading, if not the n In every region of the world more boys die from falls than most frequent, type of injury resulting in hospitalization girls. emergency room attendance or restricting activity in most n Infants less than one year of age in low-income and high-income countries. middle-income countries are at the greatest risk. n An injury survey in China reported that for every n There is a strong relationship between social class and child death resulting from a fall, there were 4 cases of childhood falls, both between regions and within permanent disability, 13 cases requiring hospitalization countries. Risks identified include greater exposure to for 10 or more days, 24 cases requiring hospitalization overcrowding, hazardous environments, sole parenthood, for 1–9 days, and 690 cases who sought care or missed unemployment, young maternal age, low maternal at least one day of work or school. education, caregiver stress and mental health problems, and inequities in access to health care. n Injury pyramid for fall-related injuries among children 0–17 years, Consumer products such as prams, baby walkers, high Jiangxi province, China chairs, changing-tables and cots which do not conform to standards present risks in high-income countries and are increasingly considered to be a problem for children in low-income and middle-income as their availability grows. Death n Children in the labour force are at substantial risk of falls (1) because the work demands more than their developmental Permanent disability skills, strength, stamina and size allow. (4) n Other risk factors for falling include: animal riding, Hospitalization (10+ days) inappropriate heights and surfacing in playgrounds, and (13) inadequate supervision of younger children. Hospitalization (1–9 days) (24) Missed work or school or sought treatment (690)

Falls are the most common type of childhood injury n Falls are the leading cause of , with “ a significant risk of long-term sequelae especially among presenting at emergency departments, accounting for young children. between 20–25% of such visits.” n Falls are costly. An estimate from Canada suggests that if proven fall prevention strategies were implemented they would result in a 20% reduction in the incidence of falls and net savings of more than 126 million Canadian dollars (US$ 120 million) annually.

Interventions

Effective approaches to reducing falls — What does not work?

3 Identifying, replacing or modifying unsafe 3 Establishing and enforcing legislation requiring 7 There is insufficient evidence to promote the use of products. For example removing or redesigning the installation of window guards by landlords in stand-alone educational campaigns, implementing nursery furniture such as cribs, changing mats, buildings with more than one storey. housing and building codes and covering wells and baby walkers and bunk beds. 3 Developing and implementing multifaceted ditches as fall prevention strategies. 3 Developing and enforcing standards for the community programmes that use multiple design and maintenance of safe playgrounds, educational strategies repeated in different including installation of rubber or bark forms and contexts as a means of fostering a ground surfacing of sufficient depth, and the culture of safety within communities. incorporation of safe heights for climbing fact sheet fact structures and equipment such as slides.

Source: This fact sheet is based on the World report on child injury prevention. To download a copy of the report please go to http://www.who.int/violence_injury_prevention/child/en/ Copies of this document are available from: Department of Violence and Injury Prevention and Disability, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland, Email: [email protected]