Table 3.

Prevention Successes and Opportunities for Unintentional Home Injury in Children and Older Adults.

Injury	Prevention Successes and Opportunities
SUIDS	After AAP promoted supine sleep position, sudden infant death rates declined by 53% and rates of supine sleeping increased from 13% to 72%. Caregivers need to be educated that infants should sleep alone, on their backs, in a clutter-free crib with a firm mattress, and in a smoke-free environment.37,38
Falls in children	The CPSC instituted a voluntary baby walker standard in 1994, which has been credited with an 88% reduction in baby walker–associated falls between 1994 and 2008.47 Caregivers need be educated to never use baby walkers with wheels.
	In 1976 the New York City board of health passed a law requiring property owners of multiple-story buildings to provide window guards for all dwellings with children younger than 10 years of age, resulting in a 96% reduction in hospital admissions for falls from windows.48 In the absence of such legislation, caregivers need to be educated about the use of window guards.
Poisoning in children	Studies show clear declines in poisonings after passage of the Poison Prevention Packaging Act in 1970.50,51 Improperly secured safety caps or products that are not required to be packaged in a child-resistant container continue to cause poisoning, making caregiver education necessary as well.45
Drowning in children	Drowning prevention strategies include basic swimming skills, life jacket use, 4-sided pool fencing with self-latching gates, close supervision, no alcohol use when swimming, and bystander cardiopulmonary resuscitation (CPR) skills.55-58
Falls in older adults	CDC Compendium of Effective Interventions lists 41 interventions that were successful at reducing falls among community-dwelling older adults.66
	STEADI (Stopping Elderly Accidents, Deaths, and Injuries) initiative67: STEADI comprises clinical decision support tools and educational materials for health care providers (eg, medical doctors, nurses, physical therapists, medical assistants).
Poisoning in older adults	Prescription medication overdose is being addressed with prescribing guidelines, prescription drug monitoring programs, pharmacy benefits management, addiction treatment, engineering changes, naloxone education and distribution, and community interventions95
Fire and scald burns in older adults	Voluntary standard by the CPSC mandated that new water heaters be sold with thermostats preset to 120°F after a similar measure in Washington state showed a significant reduction in scald burns.80 A recent study found that the majority of the homes with preset water heaters still had tap water at temperatures above 120°F,81 making public education and new engineering solutions necessary.
	The CPSC revised the standard for cigarette lighters, so that they were inoperable by children younger than 5 years old and is credited with preventing an estimated 3300 fires, 100 deaths, 660 injuries, and $52.5 million in property loss in 1998.63
	As of 2011, “fire safe” cigarettes are the only types allowed to be sold in the United States; one published evaluation demonstrated a 28% reduction in house fires.86
	Smoke alarms reduce the risk of death in a house fire by 50%, but most homes are not properly protected82
	Compared with homes with smoke alarms only, homes with residential sprinklers have 100% fewer civilian fatalities, 57% fewer civilian injuries, and 32% less direct property loss.83 Sprinklers for new homes are now included in the International Residential Code, although multiple states are excluding this requirement locally.

Abbreviations: AAP, American Academy of Pediatrics; CDC, Centers for Disease Control and Prevention; CPSC, Consumer Product Safety Commission; SUIDs, sudden unexplained infant deaths.