Children and fall

World report on child injury prevention
Children and
falls
Falling is a normal part of the way a child develops – learning
to walk, climb, run, jump and explore the physical environment.
Fortunately, most falls are of little consequence and most children
fall many times in their lives without sustaining much more than a
few cuts and bruises. But some falls go beyond the resilience of a
child’s body, making them the fourth largest cause of unintentional What is a fall?
injury death for children. Non-fatal falls also represent a significant A fall is an event which results in a
burden on health care facilities around the world. The frequency of person coming to rest inadvertently
on the ground or floor or other lower
non-fatal falls, health-care costs, and the significant risk of death level (WHO).
(particularly as a result of head injuries) demand that the prevention
of fall-related injuries becomes a vital focus of child safety efforts
worldwide.
fact sheet
Scale of the problem

Mortality
n In 2004, an estimated 424 000 people of all ages died n South-East Asia and the low-income countries of the
from falls worldwide – over 46 000 were children. Eastern Mediterranean and Western Pacific have the
n Although the majority of fall-related deaths are among highest rates of fatal falls.
adults, falls rank as the 12th leading cause of death among n Most high-income countries have fatal fall rates of 0.3
5–9 year olds and 15-19 year olds. per 100 000 or less.
n Among children under 15 years, non-fatal falls are the n 66% of fatal falls among children occur from a height,
13th leading cause of disability-adjusted life years lost. while 8% were the result of falls on the same level.
Fatal child fall injury rates per 100 000 populationa by sex, country income level and WHO region, 2004
South- Eastern a These data refer to those under 20 years of

Africa Americas East Asia Europe Mediterranean Western Pacific age.
LMIC HIC LMIC LMIC HIC LMIC HIC LMIC HIC LMIC HIC = High-income countries;
LMIC = Low-income and middle-income
Boys 1.8 0.3 1.0 3.0 0.5 1.3 4.0 3.5 0.5 2.5 countries.
Source: WHO (2008), Global Burden of Disease:
Girls 1.1 0.1 0.4 2.4 0.2 0.6 0.3 2.3 0.3 1.9 2004 update.
Morbidity Risk factors
n Data indicate that falls comprise a leading, if not the n In every region of the world more boys die from falls than
most frequent, type of injury resulting in hospitalization girls.
emergency room attendance or restricting activity in most n Infants less than one year of age in low-income and
high-income countries. middle-income countries are at the greatest risk.
n An injury survey in China reported that for every n There is a strong relationship between social class and
child death resulting from a fall, there were 4 cases of childhood falls, both between regions and within
permanent disability, 13 cases requiring hospitalization countries. Risks identified include greater exposure to
for 10 or more days, 24 cases requiring hospitalization overcrowding, hazardous environments, sole parenthood,
for 1–9 days, and 690 cases who sought care or missed unemployment, young maternal age, low maternal
at least one day of work or school. education, caregiver stress and mental health problems,
and inequities in access to health care.
n Consumer products such as prams, baby walkers, high
Injury pyramid for fall-related injuries among children 0–17 years,
Jiangxi province, China chairs, changing-tables and cots which do not conform
to standards present risks in high-income countries and
are increasingly considered to be a problem for children
in low-income and middle-income as their availability
grows.
fact sheet
Death n Children in the labour force are at substantial risk of falls

(1) because the work demands more than their developmental
skills, strength, stamina and size allow.
Permanent disability
(4) n Other risk factors for falling include: animal riding,
Hospitalization (10+ days) inappropriate heights and surfacing in playgrounds, and
(13) inadequate supervision of younger children.
Hospitalization (1–9 days)
(24)
Missed work or school or sought treatment
(690)
n Falls are the leading cause of traumatic brain injury, with “Falls are the most common type of childhood injury
a significant risk of long-term sequelae especially among presenting at emergency departments, accounting for
young children. between 20–25% of such visits.”
n Falls are costly. An estimate from Canada suggests that
if proven fall prevention strategies were implemented
they would result in a 20% reduction in the incidence of
falls and net savings of more than 126 million Canadian
dollars (US$ 120 million) annually.
Interventions
Effective approaches to reducing falls — What does not work?
3 Identifying, replacing or modifying unsafe 3 Establishing and enforcing legislation requiring 7 There is insufficient evidence to promote the use of
products. For example removing or redesigning the installation of window guards by landlords in stand-alone educational campaigns, implementing
nursery furniture such as cribs, changing mats, buildings with more than one storey. housing and building codes and covering wells and
baby walkers and bunk beds. ditches as fall prevention strategies.
3 Developing and implementing multifaceted
3 Developing and enforcing standards for the community programmes that use multiple
design and maintenance of safe playgrounds, educational strategies repeated in different
including installation of rubber or bark forms and contexts as a means of fostering a
ground surfacing of sufficient depth, and the culture of safety within communities.
incorporation of safe heights for climbing
structures and equipment such as slides.
Source: This fact sheet is based on the World report on child injury prevention.
To download a copy of the report please go to http://www.who.int/violence_injury_prevention/child/en/
Copies of this document are available from: Department of Violence and Injury Prevention and Disability, World Health Organization, 20 Avenue Appia, 1211 Geneva 27,
Switzerland, Email: childinjury@who.int

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World report on child injury prevention

Scale of the problem

South- Eastern a These data refer to those under 20 years of

Death n Children in the labour force are at substantial risk of falls

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