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Most children feel safe and secure in their own home, yet unfortunately at home is where many injuries and deaths occur. These injuries and deaths are primarily caused by: fire and burns, poisoning, drowning, suffocation, and falls. Unintentional injury remains the leading cause of death among children ages 14 and younger in the United States. According to information compiled by the National Safe Kids Campaign, more than 6,040 children ages 14 and younger died from unintentional injury in 1997. Among children of this age, it is estimated that 40 percent of deaths and 50 percent of nonfatal unintentional injuries occur in and around the home. The good news is that approximately 90 percent of unintentional injuries can be prevented.

Fire and Burn Safety
Facts about home safety and accidents include:

• Thousands of children suffer burn-related injuries each year.
• In 1998, The National Safe Kids Campaign reported an estimated 88,000 children ages 14 and younger were treated in emergency rooms for burn-related injuries.
• In young children, scald-burn injury (hot liquid or steam) is the most common type of burn-related injury.
• Flame burns are more common among older children.
• Hot tap water is responsible for approximately one-fourth of all scald burns among children.
• The National Safe Kids Campaign also reported that more than 75 percent of all scald-burn injuries among children two and younger could be prevented through behavioral and environmental modifications.
• Smoke alarms save lives. The chance of dying in a residential fire is reduced 50 percent when a smoke alarm is present.
• Most fatal home fires occur at night. Smoke and poisonous gases can numb your senses in a short period of time.

• Keep hot-water thermostats below 120 degrees Fahrenheit (a child exposed to hot tap water at 140 degrees Fahrenheit will suffer a third-degree burn).
• Install antiscald devices on faucets and spouts.
• Never carry a child and hot items at the same time.
• Use back burners when cooking and turn pot handles toward the rear of the stove (See kitchen safety tips.)
• Do not drink hot liquids such as coffee, tea, or soup around small children.
• Cover unused electrical outlets.
• Don't use tablecloths if you have a toddler. They can pull on it and cause hot food items to fall on them.
• Do not run extension cords under carpeting.
• If an appliance is not in use, unplug it.
• Install smoke alarms on every level of your home and in every sleeping area.
• Test your alarms once a month. When testing, make sure you can hear the alarm from each bedroom with the door shut, and with music or other loud noise in the room.
• Replace the batteries at least yearly.
• Smoke alarms should be replaced every 10 years.
• Place a fire extinguisher on each level of your home and know how to use it (PASS method: Pull pin, Aim at base of fire, Squeeze handle, and Sweep from side to side).
• Develop and practice two fire escape plans.
• Keep bedroom doors closed while sleeping (use a monitor to listen for your child).
• Store flammable materials (paint, thinner, kerosene) outside in a shed.
• Keep all lighters and matches in a locked drawer or metal box.
• Post all emergency numbers close to each phone in your home! As soon as feasible, teach your children the 911 system.
• For additional information on fire and burn safety, contact the National Fire Protection Association (NFPA).

Poison Prevention
All of the following facts were compiled from information by National Safe Kids Campaign:

• In 1998, more than 1.1 million unintentional poisonings among children younger than five years of age were reported to U.S. poison control centers.
• More than 90 percent of all poison exposures occur in the home.
• Among children ages five and younger, 60 percent of poisoning cases are caused by non-pharmaceutical products (cosmetics, cleaning supplies, plants, and alcohol).
• Of the oral prescription drugs ingested by children ages four and younger, 23 percent belong to someone who does not live with the child; 17 percent belong to a grandparent or great-grandparent.
• All oral prescription drugs must be dispensed in child-resistant packaging unless non child-resistant packaging is specifically requested.
• It is estimated that 890,000 children ages one to five have blood-lead levels high enough to affect intelligence, growth, and development.
• Children ages one to two are at the greatest risk for lead poisoning. Lead-based paint is a major source of lead poisoning for children. Other sources include: decorated china, fine crystal, water pipes, and old comic books.
• Approximately two-thirds of the homes built prior to 1940, and one-half of the homes built from 1940 to 1960 contain heavily-leaded paint.
• In 1998, more than 2,300 cases of carbon-monoxide poisoning were reported to U.S. poison control centers.
• The majority of carbon monoxide exposures occur in the winter months and the common source is unvented supplemental heaters.

• Keep drugs, poisons, and household products locked away.
• Store harmful products away from food .
• Lock medicines in a medicine cabinet. Make sure medicines and other harmful products are ompletely unreachable to children.
• Avoid taking medicine in front of children—they love to imitate.
• Do not store chemicals in attractive bottles or containers.
• Have a bottle of syrup of Ipecac in the house (do not administer syrup of Ipecac unless instructed by your healthcare provider or poison control center).
• Post the telephone number of your poison control center by every phone.
• Know which houseplants are poisonous (e.g., Azalea) and nonpoisonous (e.g., Impatiens) If you are not sure, contact your regional poison control center.
• If your home was built prior to 1978, check paint for lead.
• Cover the paint with a sealant or hire a professional company to remove the paint (contact your state and local health departments' lead poisoning prevention programs and housing authorities for information about testing laboratories and contractors who can safely remove lead-based paint).
• Children should be screened for lead poisoning (lead poisoning is 10 micrograms of lead per deciliter).
• Test your water supply for lead content.
• Check your crystal and china. If lead is present, do not use it for serving. You can contact your state and local health departments lead poisoning prevention programs for information on how to check for lead.
• Throw away or properly store old comics.
• Use a carbon monoxide detector in your home.
• Have your chimney professionally cleaned yearly.
• Have your furnace professionally inspected yearly.
• Do not warm up your car in a closed or poorly ventilated garage.

Drowning
It's not just in pools that children drown. Some drowning facts illustrate this point.

• Drowning is the leading cause of unintentional injury-related death among children ages one to four.
• The majority of drownings and near-drownings occur in residential swimming pools.
• Children can drown in as little as one inch of water. They are, therefore, at risk of drowning in wading pools, bathtubs, buckets, toilets, and hot tubs.
• Child drownings and near-drownings occur in a matter of seconds. Within two minutes, a child will lose consciousness. Irreversible brain damage occurs after four to six minutes.
• In 1997, nearly 1,000 children younger than 14 drowned.

• Never leave a child unattended in the water or pool area for any reason.
• Do not rely on swimming lessons or "floaties" (e.g., water wings, inner-tubes) to protect your children in the water.
• Install four-sided isolation fencing, at least five feet high, equipped with self-closing and self-latching gates, that completely surrounds the swimming pool. It is estimated that this could prevent 50 to 90 percent of childhood residential swimming pool drownings and near-drownings.
• Use a pool alarm, which sounds when someone falls into the water of an unattended pool.
• Attend a CPR class. Make sure your babysitter knows CPR. Contact your local fire department, hospital, or Red Cross for the nearest class.
• Do not overestimate your child's ability to swim.

Room-by-Room Childproofing
Safety tips for every room in the house help prevent accidents and injuries.
Kitchen and dining room

• Install a stove guard to prevent children from turning on the knobs.
• Unplug appliances when not in use.
• Keep all sharp utensils in a childproofed drawer or cabinet.
• Place microwave oven out of the reach of children.
• Keep wastebaskets covered or out of the reach of children.
• Protect your children from sharp or jagged edges of your dining room table.
• Check your china closet for stability; bolt unstable furniture to the wall to prevent it from falling.
• Secure booster chairs firmly to prevent children from slipping.

• Install window guards and sliding glass door locks. Windows and doors should not be opened more than four inches.
• Install a fireplace hearth protector or screen, or block off the fireplace.
• Use a VCR lock to prevent children from putting objects or fingers into the VCR.
• Remove tables with glass inserts.
• Keep window-blind cords out of reach of children. Wind up the cords or tie them near the top of the blind. A new safety device, distributed by Hunter Douglas (see resources), prevents strangulation with the use of a new plastic tassel. It comes apart with pressure, thereby releasing the hold. The Window Covering Safety Council (see resources) offers a free repair kit for drapery cords or vertical blinds that require a loop to operate.
• Remove small objects from lower shelves—they present a choking hazard.
• If you have a bar, lock away all alcohol.

• Only use furniture that meets the Juvenile Products Manufacturers Association's (JPMA) certification requirements. Only furniture with a JPMA seal meets the certification.
• Do not buy or borrow an older crib. It could be missing parts.
• Crib slats should be spaced no more than 2 3/8 inches apart.
• The crib mattress should fit snugly—less than a two-finger width between mattress and crib side.
• No crib hardware should be missing and all connections (knobs, screws, etc.) should be tight.
• Crib corner posts should be no higher than 1/16 inch to prevent entanglement of clothing.
• Always keep the side-rail up when the child is in the crib.
• Remove mobiles from the crib when the baby can pull up on his hands and knees (approximately five months of age).
• Replace a crib with a bed when the child is 35 inches tall or can climb and/or fall over the sides of the crib.
• Do not place furniture under windows—children love to climb.
• Do not place a baby on a waterbed to sleep. The baby can roll on its stomach and suffocate.
• Use a bed rail to prevent the child from falling out of bed.
• Remove the plastic bag from dry cleaned clothes or tie a knot at the bottom.
• Use a toy chest that has a safety latch- it will lock open and not fall on the child's head.
• Place a night light in the child's room and make sure all toys are put away at the end of the day. This will help prevent tripping on toys.
• To prevent strangulation, never hang pacifiers or other items around a child's neck.
• Buy flame-resistant clothing for your child.
• For a more detailed checklist, consult the Consumer Product Safety Commission (see resources).

• Keep hot water heater set below 120 degrees Fahrenheit, and install antiscald devices.
• Use a nonslip mat or tub stickers to prevent falls.
• Install a spout cover to protect from burns.
• Test the water before putting your child in. Run the cold water first.
• Keep the toilet lid down and install a lock to prevent the child from playing in the toilet.
• Use cabinet locks to prevent children from getting into the medicine cabinet and sink cabinet.
• Make sure the bathroom door does not lock.
• Never leave your child unattended in the bath!

• Use only garage door openers with automatic stopping devices.
• Remove the doors from any old refrigerators you may have in your home. Children can enter the refrigerator and suffocate.
• Keep hazardous chemicals out of reach of children.

• Purchase toys recommended for the age of your child. Follow the manufacturer's recommendation. The Child Safety Protection Act requires choking hazard warning labels on packages that contain small balls, balloons, marbles. Certain toys and games with small parts that are intended for use by children ages three to six, must also be labeled.
• Inspect old and new toys for potential hazards. Discard damaged toys.
• Toy chests should have safety supports to prevent the lid from falling on the child's head.
• Do not store toys on top of furniture or on shelves in a closet. Children may fall while climbing to reach these toys.
• Consider purchasing a small parts tester, which can measure toy parts to determine if they present a choking hazard for children younger than three.
• Use Mylar balloons instead of latex. The leading cause of toy-related deaths is choking, mostly on latex balloons.
• Check the U.S. Consumer Product Safety Commission Web site (see resources) regularly for information on recent toy recalls.

• Fit a safety gate to the top and bottom of the stairs. Do not use accordion-style gates—children can get caught in this type of gate.
• Keep stairs clear of clutter. Do not leave anything lying on or near the stairs.
• Banister rails should be no more than four inches apart. Larger openings enable children to place their head between the rails.
• Install a plastic rail guard or rail net.
• Make sure hand-rails and banisters are secure.
• Do not let children use rolling walkers. They are the number-one reason for falls down the stairs, and they also make children tall enough to pull things down onto their heads.
• Stair carpets should be fitted well so they do not slip.
• Keep stairs and hallways well lit.

Conclusion
Home can, in fact, be a safe place for children, providing that certain precautions are taken. This article is meant to raise your awareness about some of the hazards present in your home and begin to offer solutions. For more detailed information please consult the resource list.

Resource List

U.S. Consumer Product Safety Commission: www.cpsc.gov
National Fire Protection Association: www.nfpa.org
National Safe Kids Campaign: www.safekids.org
National Safety Council: www.nsc.org
Centers for Disease Control and Injury Prevention: www.cdc.gov
The Window Covering Safety Council: www.windowcoverings.org
Hunter Douglas: www.hunterdouglas.com
Kids Safe: www.kidssafe.com
National Parent Information Network: www.npin.org
Go Ape Over Safety: www.safetyape.com
The Ouchy Child Safety Sticker and Home Safety Program:www.bedford.net/earthling/ouchy.htm
Be a Safe Kid Inc.: www.beesafekid.com