Falls -- whether down a stairwell, off a bike or out a window -- are, in fact, the leading cause of non-fatal injury to people of all ages in the United States. Each year, 3 million children under age 15 require emergency-department care for fall-related injuries, and 140 of those are fatal, according to statistics from the Centers for Disease Control and Prevention.
And this time of year is a particularly critical time for falls from heights and windows, simply because warm weather means more open windows.
"In the summer, you see the incidence of falls from heights going way up," explains Dr. Lloyd Van Winkle, an associate clinical professor of medicine at the University of Texas Health Science Center in San Antonio.
"Children don't perceive the lack of the solid quality of the screen," he says. "They see it and think it will bear their weight and lean against it, but they'll go right through it."
Most deaths among children who fall occur when the fall is from a height greater than two stories or if the child's head hits a hard surface, according to a new policy statement from the American Academy of Pediatrics.
Although a large number of falls take place in multiple-story, often deteriorating housing in urban areas, any window or balcony poses a risk to children.
"It's simply not enough to have a screen in a window," says Dr. Susan Tully, who helped develop the academy's statement. "Screens are not designed to keep children in but to keep bugs out, and they're by and large not strong enough to bear the weight of children falling against them."
It only takes a momentary push against a loose screen or a restless child slipping through balcony bars in a split second, Tully says. That's why supervision, while always helpful, isn't enough to prevent such falls, she says.
"People will have other things on their minds, and they won't realize how dangerous windows or balconies can be," Tully says.
The best way to prevent such falls, the academy says, is to have "window guards" on windows. They operate much like bars that keep burglars out, but the guards can be opened from the inside in case of fire. Adults and older kids can operate the devices, but young children cannot.
In pushing for more public awareness and legislation to require window guards, the doctors' group points to a window-guard law passed in New York City in 1976 that has virtually wiped out falls from high-rise buildings.
The law was passed after a pilot program that resulted in a 35 percent reduction of deaths attributable to falls from windows. The law then led to a reduction of up to 96 percent in admissions to local hospitals for the treatment of injuries from window falls.
To reduce the risk of falls, the academy recommends:
- Supervising small children at all times, particularly when windows are open.
- Installing locks on sliding windows to keep them from opening more than 4 inches.
- Opening double-hung windows from the top only.
- Avoiding fixed window guards, commonly used to prevent intrusion, because they could prevent escape in the case of fire.
- Installing operable window guards on all second- and higher-story windows, unless prohibited by local fire regulations.
- Discouraging or prohibiting children from playing on fire escapes, roofs and balconies, especially those that are not adequately fenced with vertical bars that have openings of less than 4 inches.
- Not placing furniture, on which children may climb, near windows or on balconies.
What To Do
To read the full statement on childhood falls from heights, go to the Web site of the American Academy of Pediatrics.