A STUDY OF NONFATAL ACCIDENTS IN CHILDREN UNDER SUPERVISION IN CHILD HEALTH STATIONS OF NEW YORK CITY DEPARTMENT OF HEALTH (1952-1959)

Accidents are the leading cause of death and disability in young children. Data are presented on 5,000 nonfatal accidents in which 4,791 children under supervision in New York City child health stations were involved. Based on a health examination by the physician, a physician-parent conference, and/or nurse-parent conference, it is our impression that these children are not in the main dissimilar in growth and development and intelligence from the group not involved in accidents. Age and sex are important factors in the occurrence of nonfatal accidents. The highest frequency was at ages 12 to 17 months. A statistically significant preponderance in male children was also noted. No conclusions are drawn as to color; the high incidence in the nonwhite and Puerto Rican population is not a racial characteristic, but a reflection of overcrowding and substandard housing. Of all accidents 56.6% were of a serious nature. The frequency of home accidents is very high in the first 2 years of life. Type of accident varies with age. Falls and burns were the two leading causes of accidents. The head was frequently involved in falls and the upper extremity in burns. The relationship of congenital malformations and behavior disorders to accidents could not be determined in this study. The majority of the reported accidents were judged preventable. Accordingly, education is assumed to be crucial in accident prevention, with the physician playing a dominant role. However, it is to be emphasized that accident prevention requires a team approach from all facets of the community. Further systematic and intensive research is needed about many phases of accidental occurrences and particularly about the human facets, including the cultural and social as pects. While much still remains unknown, a great body of knowledge has already been accumulated, and much more could be accomplished now if current existing knowledge were much more widely applied. It is strongly recommended that accident prevention become part of the physician's daily practice, and that it be included as an integral part of well-child supervision. Any program of accident prevention must be predicated on two essentials: 1) Get the facts; 2) Act quickly on the facts obtained.