Home accidents in childhood.

This paper first appeared in the New Englandjournal of Medicine (1959; 260: 1322-31) and is reprinted by permission. Copyright (1959) Massachusetts Medical Society. The following and many similar headines startle parent and physicians daily: 'Girl dead, boy blinded by antifreeze'; 'Three small children perish in home fire'; and 'Boy, two, dies in two-story fall'. To the physician, who today can usually successfully treat his child patients for such serious illnesses as meningitis, erythroblastosis fetalis and dehydration, it is particularly frustrating to be faced with the death or serious injury of one of these children from an accident; yet except for the first year of life accidents are the single greatest cause of death during childhood' (table 1). In 1956 accidents caused over 10 000 deaths in children from 1 to 14 years of age in the United States more than the combined total of the next four causes' (fig 1), and the importance of accidents as a cause of death rises throughout childhood until during adolescence over 50% of all deaths are due to accidents2 (fig 2). Even these striking statistics fail to emphasize the full importance of accidents in childhood, however, for it is estimated that 150 to 200 children are non-fatally injured for each accidental death, and of these, one in 40 is left permanently crippled. Lest one be led to believe that this importance of accidents in childhood mortality and morbidity is due to a recent increase in accident rates, it is pertinent to point out that the death rates from accidents actually declined 42% from 1928 to 1957.' This decline is primarily due to improvement in the care of the victim and not the result of a decrease in the rate of accidental injury. During the same period, however, mortality from most other causes in childhood declined even more dramatically, leaving accidents as the most common serious health problem of childhood today.