World Report on Child Injury Prevention
By the World Health Organization
Global-health experts remain mindful of the terrible toll disease and war take on the world's children, but a lot less attention is paid to how many kids are claimed each year by accident and injury. Part of that is a numbers game: 10 million children ages 5 and under die annually of disease, while fewer than a million 829,000 die from accidents. Still, that's 2,270 children every day, all year, who won't get a chance to grow up. The World Health Organization (WHO) just released its first annual report on the problem, listing the five leading killers and the steps to be taken to combat them. (Download the report.)
Cars and other vehicles claim about 260,000 children annually, or 718 per day, making them the leading killers of kids 10 to 19. That doesn't include the 10 million each year who are injured but survive. In the developed world, most victims are passengers in vehicles; in the developing world, they're pedestrians or bicyclists. The WHO recommends seven commonsense measures to reduce the toll, including stronger minimum-drinking-age laws; establishing and enforcing seat-belt, child-restraint and helmet laws; and reducing speed limits around schools, residential neighborhoods and play areas.
Kids drown everywhere, but the most dangerous places are the most watery places, which means the western Pacific and parts of Southeast Asia. More than 175,000 kids and teens drown annually 480 per day with children under 5 at the greatest risk. Keeping kids close to home is no guarantee of safety, since in or around the house is where most drownings take place. In lower-income countries, the greatest danger is in open bodies of water or in water-collection systems. In richer countries, swimming pools and the ocean are the most dangerous. Using flotation devices, providing effective resuscitation, fencing swimming pools and removing or covering water hazards are all recommended.
The toll here is 96,000 children under 20 each year or 263 per day. Infants are at the greatest risk, and kids between 10 and 14 are at the lowest. The rate rises again for kids 15 to 19, perhaps because of greater access to fireworks, gasoline and cooking materials. Once again, poorer countries are hit harder, with a rate 11 times higher than that of higher-income countries. In wealthier parts of the world, it's smoke inhalation, not the flames themselves, that causes the most deaths. For reasons not entirely clear, burns are the only type of injury that strike more girls than boys. Smoke alarms, childproof lighters and the establishment of dedicated burn centers are among the WHO's prescriptions.
Everywhere in the world, this one is a killer and everywhere, boys are at the greatest risk. Hazardous environments, low maternal education, caregiver stress and unemployment are highly associated with fatal falls, which claim 47,000 kids and teens annually, or 129 each day. And for every fall that proves lethal, there are an astounding 690 other kids who are hurt seriously enough to miss school or work. Those nonfatal falls are the most common reasons for visits to hospitals and for long-term disability. Childhood and public-information programs, redesigns of nursery furniture and playground equipment, and laws requiring window guards can all help.
This one has a flicker of hope about it, since poison-control centers around the world field millions of calls per day and resolve most poisonings over the phone. Still, a lot of lives are lost 45,000 per year, or 123 per day. Medicines both prescription and over-the-counter, household products, pesticides and the paraffin burned in some stoves and lamps are the biggest killers. Not surprisingly, kids under 1 year old particularly those in low- and middle-income countries are at the greatest risk. It's no surprise either that the most effective fixes include simply getting the poisons out of the house or at least keeping them securely out of reach. Child-resistant packaging, the establishment of poison-control centers and the requirement that potential poisons be packaged in nonlethal quantities will help too.
Kids are accidents waiting to happen and too often you don't have to wait long. There's a reason human children have so long a period of dependency compared with other mammals, and it's that it takes them that long to learn to look out for themselves. Until then, it's up to adults to take charge. The WHO's report can help.
The Verdict: Read (more than once if necessary)