Child falls from windows continues to be a worldwide epidemic
Mark Meshulam is an expert witness for child falls from window and a window safety consultant.
As long as there is gravity and windows it is sadly inevitable that there will be falls from windows, resulting in injury or death. Unfortunately, most who suffer these window fall accidents are children, and most of these child falls from windows could have been prevented.
A number of studies have delved into the statistics regarding child falls from windows. This study, published in September 2011 in Pediatrics, the Official Journal of the American Academy of Pediatrics, took a new and unique tack. It is a study entitled, “Pediatric Injuries Attributable to Falls From Windows in the United States in 1990-2008” by Vaughn A. Harris, Lynne M. Rochette and Gary A. Smith.
The authors accessed a wealth of data provided by the National Electronic Injury Surveillance System (NEISS), a service of the CSPC, the Consumer Product Safety Commission. NEISS uses data from about 100 hospital emergency departments and extrapolates their results to represent activity at 6100 similar hospitals.
These data are publicly available. You can query the NEISS system for free. NEISS even publishes a coding manual that helps the user inputting search criteria for injuries associated with consumer products such as windows.
Broad range of data
The authors analyzed the output from their search not only by tabulating data for years 1990 through 2008, but also by searching and analyzing descriptive language filed in the accident reports when falls from windows occurred. From this analysis, they were able to evaluate not only the normally available data fields such as gender, age, treatment level and injury type, but they also teased out additional data, such as height of window fall, status of the window, presence of a screen, involvement of nearby furniture and even the landing surface. Child falls from windows generated a surprising amount of data.
Product codes used in study
These are the window fall related NEISS product codes studied: Windows (1894), storm windows (1826), window glass (1870), window sills (1870), window blinds (1828), shades or shutters (0638), window screens (1828), plastic window panels (1854), window barriers (1888), and window locks (0707).
Results of window fall study
During the 19 year study period, about 98,400 children were treated in US hospital emergency departments for injuries related to falls from windows.
Mortality rates for falls from windows
.2%, or 197 children, an average of over 10 children per year, died of their window fall injuries. The fatality statistic is unrealistically low because children who fall from windows and die immediately were not taken to emergency departments and therefore were not counted. The true number could be many times that which was reported. The US Consumer Product Safety Commission stated they knew of 120 child window fall related deaths to 1990-2000, which averages to about 11 per year.
Three quarters of those children injured in falls from windows were treated and released. One quarter of children who fell from windows became inpatients.
Worst ages for falls from windows
Injuries increase with the temperature. Incidence of window fall injuries spiked for ages 2-5, then tapered to a lower level through age 17. Age two has especially high injury rates, giving new meaning to the phrase the “terrible twos”.
Gender and falls from windows
Boys represented 58% of the injured by falls from windows. Thirty eight percent of these injured kids displayed risky behavior such as climbing out of or jumping from a window.
Window height and injury seriousness
31% of the children fell from a one-story window. 63% fell from a window on the second story. The remaining 6% fell from windows three-stories or higher. Understandably, this last group had a higher percentage of fractures or death as a result of the fall.
Insect screens and falls from windows
83% of the windows had a window screen in place before the fall. The authors state that “Parents and other child caregivers should be counseled not to depend on window screens to prevent children from falling out of windows. To prevent these falls, window guards or window locks that prevent the window from opening greater than 4 inches should be used.”
Window type and falls from windows
Adjacent furniture and falls from windows
4% of window falls involved adjacent furniture that raised the child closer to the window. This number is also low due to low availability of data. Only 5% of the cases had information on this topic. However if you extrapolate the numbers, you could justify a percentage as high as 80% where child falls from windows involved adjacent furniture or other items they could step upon.
Landing surface and window fall injuries
There was only information regarding the landing surface in 24% of the child window fall occurrences. Of these, 40% landed on hard surfaces such as concrete or asphalt, 43% landed on firm surfaces such as dirt, and 16% landed on soft surfaces such as bushes. Those who landed on hard surfaces were more likely to sustain head injuries. The authors state, “In a window fall, the 2 factors that determine the amount of energy transferred to a child’s body on impact with the landing surface are the height of the fall and the energy-absorbing capacity of the surface. Therefore, window fall prevention efforts also should consider the properties of the surfaces below windows.”
Public awareness of falls from windows
The rates of child falls from windows were much higher before 1996. There may have been a positive effect of public awareness and local programs such as “Kids Can’t Fly”, which promoted the use of window guards to prevent child falls from windows.
Window limit stops are critical
The authors conclude: “Prevention measures for young children should aim to prevent window falls by reducing the child’s opportunity to exit the window, through the use of devices such as window guards or window locks and through placement of furniture away from windows, to decrease access to windows by young children.”
European study of child falls from windows
The 2006 article “The silent epidemic of falls from buildings: analysis of risk factors”, by Lena Mayer, Martin Meuli, Ulrich Lips and Bernhard Frey studied seven years of emergency department activity at the University Children’s Hospital Zurich. Their results, which include falls from windows and balconies, will have a familiar ring:
Fifteen children (49%) climbed on a piece of furniture before falling from the window. In almost 20% of the accidents dangerous balcony or house constructions led to the fall. In seven accidents (23%) there was a chair, a bed, or bedside table, a sofa or a ledge in front of the window allowing the children to move up.
They also found that child window falls correlated more strongly with “an immigrant family setting” and low socio-professional category of the parents.
The American Academy of Pediatrics has issued a policy statement entitled “Falls From Heights: Windows, Roofs, and Balconies”
The policy points out children older than one year old can not pass through a 4-in opening. As a result of this, most regional code agencies have adopted the 4-in spacing standard.
“In 1976, the New York City Board of Health, noting that child falls from windows accounted for 12% of deaths from unintentional injury of children younger than 15 years, passed a law requiring the owners of multiple-story dwellings to provide window guards in apartments where children 10 years and younger reside. The pilot program resulted in a 35% reduction in deaths attributable to child falls from windows and a 50% reduction in child fall incidents; no child fell from a window equipped with a window guard.”
“The mandatory program resulted in a reduction of up to 96% in admissions to local hospitals for the treatment of window-fall-related injuries. Follow-up through 1993 revealed a continuing downward trend. Recent data on the New York City experience showed no increase in the number of deaths attributable to residential fires (in fact, there was a decrease) after the introduction of window guards as required by city ordinance.”
Guidance from U.S. Consumer Product Safety Commission
To help prevent window fall injuries and tragedies, CPSC recommends the following safety tips:
- Safeguard your children by using window guards or window limit stops.
- Install window guards to prevent children against falls from windows. (For windows on the 6th floor and below, install window guards that adults and older children can open easily in case of fire.)
- Install window stops so that windows open no more than 4 inches.
- Never depend on screens to keep children safe from falls from windows.
- Whenever possible, open windows from the top, not the bottom.
- Keep furniture away from windows, to discourage children from climbing near windows.
- Some jurisdictions require landlords to install guards. Check your local regulations.
Recent News at the time this article was written
March 16, 2012, Infant injured in 20-foot fall, Richmond, IN
March 14, 2012, Abu Dhabi moves to end fatal child falls: No high-rise window to open more than 10cms, Abu Dhabu, UAE
March 14, 2012, Warm Weather Brings Danger to Pets, Chicago, IL
March 6, 2012, Parents anguish as son falls from first floor window of Gosport flat, Gosport, UK
February 4, 2012, Boy, 5, falls 10m onto concrete from window, Auburn, NSW, AU
February 2, 2012, Saved just weeks ago, 3-year-old plunges again… to her death, Abu Dhabi, UAE
February 2, 2012, Start with parents to stop tragic falls, Dubai, UAE
January 31, 2012, New rules to protect kids in high-rises, Perth, Western Australia, AU
January 17, 2012, Toddler falls from upstairs window, Campsie, New South Wales, AU
December 1, 2011, Another child dies in high-rise fall, Sharjah, UAE
September 30, 2011, Bronx teen dies after 60-foot fall from window, Bronx, NY
September 28, 2011, Safety probe into high-rise windows after eight child deaths, Dubai, UAE
September 28, 2011, Toddler Critical After Head-First Fall from Window, Orange County, CA
September 12, 2011, Child Falls from Window, Beaverton, OR
September 8, 2011, Parents urged to childproof windows after record number of falls in Calgary, Calgary, Alberta, Canada
August 3, 2011, 11-month-old St. Paul girl dies in fall from ninth-floor window, St. Paul, MN
July 18, 2011, 4-year-old Boy Dies After Third-Story Fall, Marina Del Rey, CA
July 11, 2011, At Least 8 Kids Fall From Windows, Authorities Urge Precautions, Portland, OR
April 13, 2009, Boy falls to death from same window as brother, Allendale Twp, MI
Consumer Products Safety Commission Standards for Window Guards, June 21, 2000
New York Department of Health and Mental Hygiene: Window Falls Prevention Program
Partners Promoting Window and Balcony Safety
Resources from AAMA (American Architectural Manufacturers Association)
“Keeping the Promise of Safety” Brochure
Window Safety Tips
Window Safety Checklist
Window Safety Activity and Coloring Book
“Fire Escape and Window Safety: A Balanced Approach”
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