Home safety measures and the risk of unintentional injury among young children: a multicentre case–control study. John C. LeBlanc, I. Barry Pless, W. James King, Harry Bawden, Anne-Claude Bernard-Bonnin, Terry Klassen and Milton Tenenbein.CMAJ • October 10, 2006 • 175(8) | 883
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.