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Health and Environmental Issues for Children Under Six

Preventing Injuries

Child Passenger Safety

Facts:

  • Motor vehicle crashes remain the leading cause of unintentional injury related death among children fourteen and under.
  • Child safety seats and safety belts, when correctly installed and used, can prevent injury and save lives. Unrestrained children are more likely to be injured, to suffer more injuries and to die in motor vehicle crashes than children who are restrained.
  • Misuse of child safety seats is widespread, it is estimated that approximately 85 percent of children who are placed in child safety seats are improperly restrained.
  • The back seat is the safest place for children to ride.

Tips:

  • Use rear facing child seats for children from birth to one year of age (at least 20 pounds).
  • Use forward facing child seats for children over 20 pounds and at least one year old to about 40 pounds and about age four.
  • Use belt positioning booster seats for children from about 40 pounds to about 80 pounds and 4' 9''.
  • Use seat belts for older children large enough for the belt to fit correctly: at least 4' 9'' tall and about 80 pounds.

USEFUL INTERNET RESOURCES:

Bicycle Safety

Facts:

  • Children ages 4 and under are more likely to be injured in non-street locations around the home (driveway, garage, yard) than are children ages 5 to 14.
  • Head injury is the leading cause of death in bicycle crashes and is the most important determinant of permanent disability.

Tips:

  • Have children wear properly fitted bicycle helmets.
  • Check brakes, tires, and general condition of bicycles frequently.

Playground Safety

Facts:

  • More than 70 percent of playground equipment related injuries involves falls to the surface, and 9 percent involve falls onto equipment.
  • Falls account for 90 percent of the most severe playground equipment related injuries (mostly head injuries and fractures). Head injuries are involved in 75 percent of all fall-related deaths associated with playground equipment.
  • Nearly 40 percent of playground injuries occur during the months of May, June and September.
    Swings, climbing equipment and slides account for more than 94 percent of playground equipment related injuries.

Tips:

  • Make sure that protective surfacing extends at least 6 feet in all directions from the play equipment and have at least 12 inches of wood chips, mulch, and or pea gravel, or mats made of safety-tested rubber or rubber like materials.
  • Make sure play structures more than 30 inches high are spaced at least 9 feet apart.
  • Check for dangerous hardware, like open S-hooks or protruding bolt ends.
  • Make sure spaces that can trap children, such as openings on guardrails or between ladder rungs, measure less than 3.5 inches or more than 9 inches.
  • Check for sharp points or edges in equipment.
  • Look out for tripping hazards, like exposed concrete footings, tree stumps, and rocks.
  • Make sure elevated surfaces, like platforms and ramps, have guard rails to prevent falls.
  • Check playgrounds regularly to see that equipment and surfacing are in good condition.
  • Always supervise children on playgrounds to make sure that they are safe.

Water Safety

Facts:

  • More than half of drownings among infants (under age 1) occur in bathtubs. Drownings in this age group also occur in toilets and in buckets.
  • More than 85 percent of drownings among children ages 1-6 are pool related.
  • For every child who drowns, an additional four are hospitalized for near drowning; for every hospital admission, four children are treated in hospital emergency rooms.
  • Drownings and near drownings tend to occur on Saturdays and Sundays (40 percent) and between the months of May and August (66 percent).
  • Drowning fatality rates are higher in southern and western states than any other region. Rural areas have higher death rates than urban or suburban areas, in part due to decreased access to emergency medical care.
  • Male children have a drowning rate two to four times that of female children.

Tips:

  • Never leave a child unsupervised in or around water inside or outside the home.
  • Install four-sided isolation fencing at least 5 feet high, equipped with self-closing and self-latching gates around pool areas.
  • Have children wear personal floatation devices.

Toy Safety

Facts:

  • The leading cause of toy-related death is choking on latex balloons.
  • Riding toys, mostly tricycles, have also been involved in toy-related deaths.
  • The majority of riding toy-related injuries occurs when a child falls from a toy.
  • Of all toy-related injuries, 55 percent are to the head and face area, which include the head, face, eyes, mouth and ears.

Tips:

  • Always supervise children at play.
  • Use Mylar balloons instead of latex balloons.
  • Store all balloons out of reach of children: do not allow children to inflate them, and after use, deflate and discard balloons and balloon pieces.
  • Select toys appropriate to a child's age, interests and skill level; look for quality design and construction and follow age and safety recommendations on labels.
  • Ensure that toys are used in a safe environment.
  • Do not allow riding toys near stairs, areas of traffic or swimming pools.
  • Put toys away safely after playing. Ensure that toys intended for younger children are stored separately from those for older children.
  • Use a small parts tester to determine whether small toys may present a choking hazard to children under age 3.
  • Inspect old and new toys regularly for damage and potential hazards. Make necessary repairs immediately or discard damaged toys out of children's reach.

Useful Internet Sites

Preventing Suffocation

Facts:

  • Sixty percent of infant suffocation occurs in the sleeping environment. Infants can suffocate when their faces become wedged against or buried in a mattress, pillow, infant cushion or other soft bedding, or when someone in the same bed rolls over onto them.
  • Infants can suffocate when their mouths or noses are pressed against a plastic bag.
  • Children can suffocate when they become trapped in household appliances such as refrigerators or dryers, and toy chests.
  • Each year, cribs and playpens are involved in nearly 57 percent of all nursery product related deaths among children ages 5 and under.

Tips:

  • Place infants on their backs on a firm, flat crib mattress, in a crib that meets national safety standards.
  • Remove pillows, comforters, toys and other soft products from the crib.
  • Never hang anything on or above crib with string longer than 7 inches.

Preventing Strangulation

Facts:

  • Strangulation occurs among children when consumer products become wrapped around their necks. Common items include clothing, drawstrings, ribbons or other decorations, necklaces, pacifier strings and window blinds and drapery cords.
  • Children can strangle in openings that are large enough for heads but are too small for their bodies. Some examples are spaces in bunk beds, cribs, playground equipment, baby strollers, carriages and high chairs.

Tips:

  • Remove hood and neck drawstrings from all children's outerwear.
  • Never allow children to wear necklaces, purses, scarves or clothing with drawstrings while on playgrounds.
  • Never place a crib near a window.
  • Tie up all window blinds and drapery cords, or cut the ends and retrofit with safety tassels.
  • Fit blinds with cord stops.

Choking

Facts:

  • The majority of childhood choking injuries and deaths are associated with small round foods such as hotdogs, candies, nuts, grapes, carrots and popcorn or non-food items that are round or conforming objects, including coins, small balls and balloons.
  • Unlike other causes of choking deaths, balloon related deaths are as common among children ages three and older as among younger children.

Tips:

  • Always supervise young children while eating and playing.
  • Do not allow children under age 6 to eat round or hard foods, like peanuts and other nuts, grapes, raw carrots, popcorn, seeds or hard candy.
  • Keep small items such as coins, safety pins, jewelry and buttons out of children's reach.
  • Do not let children run or play while eating.
  • Learn first aid and CPR.

Burns

Facts:

  • Sources of burns:
    • Playing with matches or lighters;
    • Scalding from hot foods or liquids;
    • Tap water burns;
    • Fireworks;
    • Electrical cords; and
    • Cooking equipment.

Tips:

  • Never leave a child alone, especially in the bathroom or kitchen. If you must leave the room, take the child with you.
  • Set water heater thermostat to 120ºF or below. Consider installing water faucets and showerheads containing anti-scald technology.
  • Install smoke alarms in the home on every level and in every sleeping area. Test them once a month, replace batteries at least once a year (unless designed for longer usage) and replace alarms every 10 years.
  • Keep matches, gasoline, lighters and all other flammable materials locked away and out of children's reach.
  • Use back burners and turn pot handles to the back of the stove when cooking.
  • Keep appliance cords out of children's reach, especially if the appliances contain hot foods or liquids.
  • Cover unused electrical outlets with safety devices.
  • Keep hot foods and liquids away from table and counter edges.
  • Never carry or hold children and hot foods and/or liquids at the same time.
  • Never allow children to handle fireworks.
  • Plan and practice several fire escape routes from each room of the home, and identify an outside meeting place. Practicing an escape plan may help children who become frightened and confused to escape to safety in a fire.