age 65 and older. About 7.5 million people require
medical attention for accidental injuries received
in falls, Falls account for nearly a third of medical
visits for accidental injury and are most frequent
among those under age 14 (2.3 million) and over
age 60 (1.8 million). Child walkers (wheeled
chairs prewalking children can push around with
their feet) and stairs account for the greatest num-
ber of falls among young children. Among older
adults, stairs, irregular surfaces, and items such as
throw rugs present the most common falling haz-
ards, particularly when lighting is poor as when
getting up at night to go to the bathroom. Medica-
tion side effects such as drowsiness and balance
disturbances often are contributing factors to falls
among older adults.
Choking Choking is a significant risk among
the very young, the very old, and those who have
temporary or long-term SWALLOWING DISORDERS.
Choking accounts for 4,200 deaths each year as
well as nearly 600,000 medical care visits. Two
thirds of choking episodes involve food. Balloons,
coins, and candy are also choking hazards for
children.
Fires Nearly 4,000 people lose their lives in
residential fires each year, most of whom die from
inhaling toxic gases and smoke (ASPHYXIATION)
rather than BURNS. Health-care providers treat
another 500,000 people a year for burns received
in residential fires, about half of which are serious
enough to result in lifelong disability.
Recreational activities Recreational activities
result in 5 million injuries that require medical
attention each year. Water activities are the most
lethal, accounting for 4,000 deaths annually, with
25 percent of them among children. Basketball,
football, and baseball collectively account for the
highest number of injuries resulting from partici-
pation in structured athletic activities, nearly 1
million per year. Bicycling accidents account for
about 500,000 injuries and 800 deaths annually.
Each year playground injuries send more than
200,000 children for medical care and over 2 mil-
lion adults require medical attention for injuries
related to overexertion.
FireworksThough fireworks are illegal in most
federal, state, and municipal jurisdictions, fire-
works account for more than 9,000 injuries that
require medical attention each year. Injuries tend
to concentrate in the weeks around the Fourth of
July and New Year’s Day celebrations. Children
are at greatest risk for injuries due to fireworks,
two thirds of which are burns. Cuts to the face,
fingers, and hands, as well as traumatic AMPUTA-
TIONof fingers and vision-threatening EYEinjuries,
occur most commonly.Health Consequences of Accidental Injuries
Though many people fully recover from the
injuries they receive, some experience residual
consequences that may include extended or life-
long disability. Among the most significant of such
consequences are- TRAUMATIC BRAIN INJURY(TBI)
- SPINAL CORD INJURY
- loss of limbs, fingers, and toes
- extensive scarring and disfigurement
- VISION IMPAIRMENT
Even short-term recovery, such as from frac-
tures, burns, and lacerations, disrupts regular
activities such as school and work.Preventive Measures
Many, if not most, accidental injuries are prevent-
able through measures that require little extra
effort. Often people are unaware of the risks of
their behaviors or believe their participation is not
enough to expose them to such risks; for example,
driving only a few blocks to the store without
wearing a seat belt or turning attention away from
a child in a swimming pool to answer the tele-
phone. Overall, however, 90 percent of unin-
tended injuries occur in or within two miles of
home.
Key preventive measures among children, for
whom accidental injuries carry high risk of serious
disability or death, include requiring use of appro-
priate safety gear and supervision when participat-
ing in recreational activities. Health experts
estimate that proper helmet use could prevent 80
percent of the 800 deaths and thousands of seri-
ous head injuries that result from bicycle acci-
dents, most of which do not involve collisions
with motor vehicles, among children and adults
alike. Properly worn helmets reduce the risk of6 Preventive Medicine