Injury prevention

Why it is important?

• Every year, nearly 1 million children die from injuries. Tens of millions more require hospital care for non-fatal injuries. Many are left with permanent disabilities or brain damage.
• Injuries affect children of all ages. Girls and boys under 5 years of age are at particular risk. More boys than girls die from injuries.
• The most common injuries are traffic injuries, non-fatal drowning (sometimes referred to as near drowning), burns, falls and poisoning.
• Traffic injuries and drowning are the leading causes of injury-related death.
• The most common place for young children to be injured is in or around their homes.
• Almost all injuries can be prevented.
• Families, communities and governments have an obligation to ensure children's right to live in a safe environment and be protected from injury.

What every family and community has a right to know ?

1. Many serious injuries can be prevented if parents and other caregivers supervise children carefully and keep their environment safe.
2. Young children are at risk on or near roads. They should not play on or near the road and should always have someone older with them when they are near or crossing a road. They should wear a helmet when on a bicycle or motorcycle and should be securely strapped into an age-appropriate child restraint when being transported in a vehicle.
3. Children can drown in less than two minutes and in a very small amount of water, even in a bathtub. They should never be left alone in or near water.
4. Burns can be prevented by keeping children away from fires, cooking stoves, hot liquids and foods, and exposed electric wires.
5. Falls are a major cause of injury for young children. Stairs, balconies, roofs, windows, and play and sleeping areas should be made secure, using barriers with vertical bars to protect children from falling.
6. Medicines, poisons, insecticides, bleach, acids and liquid fertilizers and fuels, such as paraffin (kerosene), should be stored carefully out of children's sight and reach. Dangerous substances should be stored in clearly marked containers and never in drinking bottles. Child-resistant closures, where available, should be used on the containers of poisonous products.
7. Knives, scissors, sharp or pointed objects and broken glass can cause serious injuries. These objects should be kept out of children's reach. Plastic bags, which can cause suffocation, should be kept away from young children.
8. Young children like to put things in their mouths. To prevent choking, small objects, such as coins, nuts and buttons, should be kept out of their reach. Children's foods should be cut into small pieces that can be easily chewed and swallowed.

Supporting information

Key Messages - Many serious injuries can be prevented if parents and other caregivers supervise children carefully and keep their environment safe.

• Young children, especially as they begin to move around on their own – and particularly between 12 months and 4 years old – are at high risk of injuries in and near the home. Almost all these injuries can be prevented. Prevention requires supervising children carefully and keeping them away from dangers, such as cooking fires, water sources, places where they can fall, roads, and items that can poison, choke or hurt them.

Key Messages - Young children are at risk on or near the roads. They should not play on or near the road and should always have someone older with them when they are near or crossing a road.

Children may be hurt when they are crossing or walking along roads, or if they play near roads. Young children do not think before they run onto the road.

Families need to:

• Watch children carefully
• Fence the house and close the gate to prevent young children from running onto the road
• Teach young children never to cross or walk along a road unless accompanied by an adult or older child
• Prevent children from playing near the road
• Teach children not to run after balls, moving toys or kites that go on or near the road
• Instruct children to walk on the side of the road, facing traffic
• If there is a sidewalk, teach children to use it rather than walk on the road.

When crossing the road, young children should be taught to:

• Stop at the side of the road
• Look both ways
• Listen for cars or other vehicles before crossing
• Hold the hand of another person
• Walk, not run
• In urban areas, use pedestrian crossings
• Avoid crossing the road at a curve or between parked cars
• Avoid crossing roads with high-speed traffic.

Children are also at high risk of serious injury if they travel in the front seat of a car, unsupervised on the bed of a truck or agricultural machinery, or on a motorcycle.

In a car, children should use an age-appropriate child restraint or a booster seat until they are 150 centimetres tall or 10 years old, when they are big enough to use an adult seat belt.

While travelling with parents or other caregivers on a motorbike, all passengers, including children, should wear a helmet that is securely strapped under the chin so it cannot come off in case of an accident.

Bicycle accidents are a frequent cause of injury and death among children. All children should learn road safety and wear a bicycle helmet when riding a bike.

Key Messages - Children can drown in less than two minutes and in a very small amount of water, even in a bathtub. They should never be left alone in or near water.

Drowning may cause brain injury or death. To prevent children from drowning, parents and other caregivers should always closely supervise children who are near or in the water.'

Where there is water, it is important to:

• Cover wells and water tanks so children cannot open them
• Turn tubs and buckets upside down when not in use, and always supervise children taking a bath
• Teach children to stay away from ditches and drains
• For families who live near bodies of water, install a fence around the house and close the gates to prevent young children from going in the water
• Fence ponds and pools with vertical rails spaced close together to prevent children from getting through them to the water
• For families who live directly on the water, put vertical bars on terraces, windows and doors to prevent young children from falling in the water
• Teach children how to swim when they are young
• Have young children and children who cannot swim wear an approved flotation device (life jacket) when playing in the water or on a boat
• Always supervise children who are swimming
• Teach children never to swim in fast-flowing streams and never to swim alone
• in flood-prone areas, carefully watch children when the water begins to rise; make sure that all family members, including children old enough to understand, are well informed of safe places to go to if they need to leave the home quickly.

Key Messages - Burns can be prevented by keeping children away from fires, cooking stoves, hot liquids and foods, and exposed electric wires.

Burning and scalding are among the most common causes of serious injury among young children. Burns often cause permanent scarring, and some are fatal. The great majority of these are preventable.

One of the most common types of burns is from direct contact with fires or flames or touching hot surfaces. To prevent this kind of burn:

• Keep young children away from cooking fires, matches, paraffin lamps, candles and flammable liquids such as paraffin and kerosene
• Put stoves on a flat, raised surface out of the reach of children
• If an open cooking fire is used, make it on a raised mound of clay, not directly on the ground. A barrier of mud, bamboo or other material or a playpen can also be used to keep young children out of reach of the cooking place.
• Do not leave small children alone near fires or to tend fires or cook
• Keep children away from heaters, hot irons and other hot appliances
• Never leave a child alone in a room with a candle or fire burning.

Another major cause of burns is scalding from hot liquids or foods. To prevent scalds:

• Turn the handles of all cooking pots away from the reach of children
• Keep hot foods and liquids in a safe place and out of children's reach
• Do not let children turn on the hot water tap in a bath or shower by themselves
• Keep the temperature of water heaters below a medium setting to prevent scalding if children turn on the hot water
• Teach children not to play rough around people with hot drinks or in the kitchen when meals are being prepared
• Never hold a child when having hot liquids or foods.

Children can get a serious shock or burn if they come in contact with electricity. To prevent shocks and burns:

• Teach children never to put their fingers or other objects into electric sockets
• Cover power sockets to prevent access
• Keep electric wires out of children's reach
• Cover bare electric wires, which are particularly dangerous, using insulating tape.

Key Messages - Falls are a major cause of injury for young children. Stairs, balconies, roofs, windows, and play and sleeping areas should be made secure, using barriers with vertical bars to protect children from falling.

Children often fall as they learn to walk, run and jump. Many of these falls cause small scrapes and bruises. Sometimes falls can cause broken bones, head injuries or other serious injuries, even death.

Infants left unattended may fall from beds, cots or hammocks. Young children may fall down stairs or from windows or balconies.

Children like to climb. They can be seriously injured if they fall from a high place or try to climb up on top of heavy furniture that might fall on them.

In addition to supervision, some steps to prevent children from serious falls include:

• Discourage and prevent children from climbing onto unsafe places
• Do not allow children to play on stairs and balconies, and, if they do, watch them closely
• Use railings of appropriate width and height with vertical bars on stairs, windows or balconies
• Keep the home clean, well lit and free of sharp objects and rough edges
• Properly secure babies in high chairs
• Do not leave infants unattended on beds, cots, hammocks or in walkers or other baby equipment
• Keep furniture such as beds, chairs and cribs away from windows
• Do not put toys or other items on high shelves that may attract small children, and fasten heavy furniture such as cabinets or shelves to the wall.

Key Messages - Medicines, poisons, insecticides, bleach, acids and liquid fertilizers and fuels, such as paraffin (kerosene), should be stored carefully out of children's sight and reach.

Poisoning is a serious danger to small children. Bleach, insect and rat poison, paraffin (kerosene) and household detergents can kill or permanently injure a child.

Many poisons can kill, cause brain damage, blind or permanently injure if they:

• Are swallowed
• Are inhaled
• Get onto the skin
• Get into the eyes.

The key to preventing poisoning is to keep harmful substances out of children's reach.

• Poisons should never be put in soft drink or beer bottles, jars or cups, as children may drink them by mistake. All medicines, chemicals and poisons should be stored in their original containers, tightly sealed and out of children's reach.
• Detergents, bleaches, chemicals and medicines should never be left where children can reach them. They should be tightly sealed and labelled. They should also be locked in a cupboard or trunk or put on a high shelf where children cannot see or reach them.
• Medicines meant for adults can kill or injure small children. Medicine should only be given to a child if it is prescribed for that child. It should never be given to a child if it is prescribed for an adult or some other child. A child should never take medication on his or her own. The parent or other caregiver should give the medication to the child each time it is needed. Medication should be stored out of reach and sight of children.
• Child-resistant closures, where available, should be used on containers storing poisonous substances.

Key Messages - Knives, scissors, sharp or pointed objects and broken glass can cause serious injuries. These objects should be kept out of children's reach. Plastic bags, which can cause suffocation, should be kept away from young children.

Broken glass can cause serious cuts, loss of blood and infected wounds. Sharp metal objects, machinery and rusty cans can cause wounds that can become badly infected.

Families can reduce the risk of children's injuries from glass and sharp objects if they:

• Keep glass bottles out of reach of young children and keep the house and play area free of broken glass and refuse
• Place knives, razors and scissors in drawers or locked cabinets well out of reach of young children
• Safely dispose of household refuse, including broken bottles and old cans.

Other injuries around the home can be prevented by teaching children about the dangers of throwing stones or other sharp objects and of playing with knives or scissors.

Plastic bags should be kept away from young children to prevent suffocation.

Key Messages - Young children like to put things in their mouths. To prevent choking, small objects, such as coins, nuts and buttons, should be kept out of their reach. Children's foods should be cut into small pieces that can be easily chewed and swallowed.

One way young children explore their environment is by putting things in their mouths which might cause them to choke. Also, young children have difficulty chewing and swallowing some foods such as hard sweets that can cause them to choke.

Parents or other caregivers should:

• Keep play and sleeping areas free of small objects such as buttons, beads, balloons, pen caps, coins, seeds and nuts
• Check new toys carefully before children play with them to make sure they have no loose or sharp pieces that could break and be swallowed by or hurt the child
• Never give young children foods they can choke on such as groundnuts (peanuts), hard sweets or food with small bones or seeds
• Always supervise young children during meals, and cut or tear children's food into small pieces that can be easily chewed or swallowed.

Coughing, gagging and high-pitched, noisy breathing or the inability to make any sound at all indicate breathing difficulty and possible choking. Parents and other caregivers should suspect a child is choking when he or she suddenly has trouble breathing, even if no one has seen the child put something into the mouth.

Source: UNICEF