Safety: What Should I Worry About?

As we discussed last week, safety is a big issue, and some recommendations are summarily ignored. Why do we care so much about safety? Why do we push the bike helmets and childproofing homes and whatnot? Why do we have so many products aimed at safety? After all, 'when I was growing up, our parents didn't care about any of that stuff.'

Well, unintentional injury is the most common cause of death in children (aged 1-14). More than cancer, heart disease and every other disease children get, combined. The only reason it isn't so for the under 1 crowd is because we have a lot of babies born with various congenital conditions that lead to an early death.

Of course, those stats include all unintentional injuries, which covers a lot of things. What, specifically, causes death in children? Well, the CDC puts together that information for us too. The causes that are in the top 10 for all age groups through age 14 are:

1. Unintentional Suffocation (1117 deaths in 2012, differentiated from homicidal suffocation and undetermined suffocation)
2. Homicide (730 in 2012)
3. Drowning (725 in 2012)
4. Motor Vehicle Accidents (437 in 2012)
5. Burn (277 in 2012)

Others high on the list are those related to firearms (317 in 2012, but none in <1 year), pedestrian accidents (104) and environmental causes (89). All of these are something that we're concerned about. Many of these can be prevented by simply educating parents about what to look for. For instance, unintentional suffocation is the most common cause of unintentional injury death in children less than 1 year of age. So, we as pediatricians recommend that the beds not be lined with bumper pads, remove large fluffy pillows from the couches, etc, and careful supervision of these children. The number of children dying from suffocation drops dramatically after age 1. I'll cover safe sleep and SIDS in another blog post. For homicides, there isn't much we can tell the parents. Living in a bad neighborhood, violence at schools--these are things that are often beyond the parent's control. We deal with these as best we can. Drowning is most common in the 1-4 age group, and while pools are a concern, most children actually die in bathtubs, dog bowls, etc. It only takes 3 inches of water to drown--enough to cover the nose and mouth. So, watching the child, especially in the bathtub, is key for preventing these injuries. Motor vehicle accidents are very common, so we focus on making sure the kids are strapped in appropriately. This is likely a whole blog post in and of itself, but the gist is that children under age 2 need to be in a rear-facing seat, and should be in a car seat until they meet the weight recommendations for that seat. Then they should be in a booster seat until they can comfortably wear a seat belt (at about 4 ft 9 inches tall).

Burns are most commonly caused by hot water, and so we make the recommendation to keep water heaters set at 120 degrees F. Not because this is a safe temperature, but because it takes about 5 minutes at this temperature before a serious burn injury develops. Baths should be slightly warmer than body temperature, about 100 degrees F.

There are plenty more safety issues that can be discussed, from medications and poisonings to firearms to falls, but I feel this post is already long enough, so we'll save those for another time.

In the meantime, if you have any questions or comments, feel free to post in the comments below or use the 'contact me' form available as a tab at the top of the page.