A3.1. Death statistics

The number of domestic accidents is underestimated by not only health professionals, but also product designers and certainly consumers.

More than 21,000 people die per year due to accidents in their everyday lives³.

From simple burns or cuts, to fatal falls, Santé publique France (Public Health France) estimated that 11–12 million people each year are the victims of an accident at home. Among them, five million go to the emergency room and 500,000 are hospitalized (Durand 2017).

It has been determined that cancer and cardiovascular diseases can be the cause of trauma and accidents⁴; however, we ignore the fact that accidents of everyday life can also occur, which can potentially cause years of damage to people’s lives, since they often occur in children and young people. The media coverage of fatal accidents often refers to a traffic accident, whereas accidents in people’s everyday lives kill three times more people than those on the road⁵.

It is unacceptable that people should die or suffer severe consequences from accidents that could be completely avoidable. There is no exact information on the circumstances of these accidents.

The term “accident” implies a resigned acceptance: the accident is deemed “inevitable” precisely because “it was an accident”, and even deaths can be accepted as terrible luck.

A3.2. The cost of these accidents

In France, for example, the cost of these domestic accidents has been studied very little. The public authorities concern themselves with fatalities on the road, but not with everyday accidents in the home.

A3.3. Problems due to products

It would be appropriate to improve the design of certain products or facilities, rather than to dictate recommendations for protection or prevention. “Instruction manuals” are perceived as limiting the freedom or the pleasure of certain activities, including sports.

The European network, Rapex, identifies products that constitute a serious risk (mainly toys and electrical products), providing detailed information on the product and its dangers. It is managed in France at the national level by the DGCCRF (Direction générale de la concurrence, de la consommation et de la répression des frauds, Directorate-General for Competition, Consumer Affairs and Fraud Control).

It is important to be wary of slippery floors, rugs, electrical cords, poor lighting, objects or furniture that are poorly arranged or move too easily, beds, armchairs, toilets that are too high or too low, unstable stools and ladders, and also pets, especially if they are the same color as the carpet!

Some sidewalks are unstable, especially those with unsuitable surfaces or those that are narrow, difficult to cross or under construction or repair. It is also necessary to avoid clothes that are too long or too tight.

Obviously, we cannot remove all of the risks, with the exception of those directly related to poor product design or arrangement, but we can make them more acceptable. Safety does not require overprotection or carelessness. Just because riding a bike comes with risks, it does not mean that children should be prohibited from using it and deprived of it. The negligence of the elementary usage criteria comes with consequences.

The actual functionality of a product, whether it is a self-contained object such as a tricycle or a bathtub that forms part of a bathroom, it must include, from the outset, a number of basic ergonomic principles relating to the convenience of use, safety and comfort.

A3.4. Aches

Minor issues, such as scratches, aches and bruises, are only rarely recorded and analyzed, even though the occurrence of mild accidents may be able to shed light on the origins of accidents according to the choice of products or equipment.

A3.5. Disabilities

Few “global” studies analyze the consequences of the severe accidents that lead to a significant number of disabilities. The less severe accidents are, the less well known they are, due to the fact that they do not give rise to any recourse to medical care, including emergency services, and only result in self-medication.

A3.6. Children

Accidents in everyday life are one of the leading causes of child deaths. In France, children account for more than 11 million “victims”⁶, including five million who are injured and have to go to hospital emergency rooms. This results in several hundreds of thousands of hospitalizations, with essentially debilitating consequences.

More than 300 children under the age of 15 die⁷ each year from accidents occurring in everyday life. 20% of deaths in children between one and four years old are due to household accidents, while 50% of these accidents affect children 0–15 years old. Accidents in everyday life are the leading cause of death in this age group. Drowning and asphyxiation are the leading causes of death in the 0–14 age group⁸. Incomplete physiological development makes children more vulnerable. Their small size, sensory immaturity (especially in terms of sight), low muscle strength and imperfect motor coordination expose children to risks in an environment designed for adults, which only rarely takes into account their specific needs.

Children’s psycho-motor development is accompanied by curiosity, and their desire for discovery, sources of danger and the acquisition of the market increase their risk of exposure to accidents.

Suffocation or asphyxiation (3,543 deaths)⁹ is the leading cause of death in children under five years of age. The majority of asphyxiation cases occur in children under six years of age.

A3.7. Dangerous substances

Many household products, cosmetics and gardening products contain substances that are dangerous if they are swallowed or inhaled, or if they come into contact with the skin, eyes or mouth.

Plants¹⁰ may contain active ingredients that trigger allergies or digestive, cardiovascular or neurological disorders. Young children, often with high levels of curiosity, are the most affected, suffering from: sleep disorders, skin irritation, hypersensitivity to light, cramps, vomiting or diarrhea, which can be fatal. Dangerous products and drugs must be kept out of reach from children, with packaging that cannot be opened by children below the appropriate age.

A3.8. Dangerous products

Accidents related to whipped cream nozzles can have serious consequences (loss of an eye, broken teeth, fractures to the face or chest, etc.).

Many fires are caused by various household electrical appliances, and explosions or fires notably occur as a result of issues with lithium-ion batteries. These can include smartphones, single-wheel vehicles, hoverboards or electric skateboards.

A3.9. The elderly

Fatalities from accidents occurring during everyday life are very high among the elderly, meaning here people over 65 years of age. Falls are the most common injuries due to the fact that vision and balance problems, isolation and an unsuitable living environment all generate a risk of falls among the elderly.

People over the age of 85 suffer from falls the most often due to accidents in everyday life.

A3.10. Road accidents

Each year, there are currently about 1.3 million deaths on the road around the world, and 50 million people who are injured. Road accidents are also the primary cause of death among young people from 15 to 29 years old¹¹.

Most of the victims are pedestrians and people on two-wheeled vehicles, due to the mixed nature of traffic and the frailty of these commuters relative to larger and faster vehicles.

The risk of bodily injury while on foot or on a bike is almost two times higher than the risk in a car. It is more than eight times higher on a moped or¹² motorcycle! In France, this statistic went from 18,000 deaths in 1972, to 9,300 in 1989 and then 3,500 in 2016¹³ for road accidents, as a result of improved vehicle design, increased maintenance control and improvements to road conditions. Although highways are quite safe, with a low rate of accidents per kilometers traveled, the risk of fatality, especially due to excess weight or sleepiness, is significant.

The use of seatbelts, airbags and other devices has helped to reduce fatalities in accidents. Helmets for motorcycles and bicycles have significantly reduced the risk of death and serious injury. However, devices for protection against falls, such as helmets, can encourage risk-taking. Although they are often difficult to install, safety devices for children dramatically reduce the mortality rate of infants and young children on roads. Sadly, in Spain and Australia, the implementation of the requirement for cyclists to wear a helmet in cities seems to have hampered the development of this sport, because some view helmets as uncomfortable.

It is often recalled, and rightly so, that the use of phones and especially text messages slows reaction times when responding to ambient conditions. “Hands-free” devices (something of a misnomer) have the same serious drawbacks as handheld devices.

A3.11. Falls

Falling remains the most common cause of fatalities: 9,600 deaths occur per year in this manner, or 26 per day on average. Falls are the main cause of fatal household accidents¹⁴ and the fatality rate for falls increases with age.

For example, over the age of 65, one in five people say they have experienced a fall in the past year¹⁵.

External risk factors for falls account for approximately half of cases. In most cases, it involves a staircase or a bed. It can also include improperly marked thresholds, slippery flooring, incorrect placement of carpets, poor lighting, unnecessary clutter or a lack of support points. Greater safety around the house is necessary, but this may raise concerns from senior citizens if it is presented as being for the sole purpose of securing their homes. The risk of falls for children up to six years of age includes: falling from high chairs, from couches, from changing tables, down stairs, from an open window or a balcony, etc. In addition, the part of the body that is most often affected by these falls is the head.

Therefore, children should be protected with devices such as protective barriers; this encourages independence while at the same time providing oversight.

A3.12. Accidents during household activities

A3.13. Fires in homes

We do not know the exact number and the circumstances of household fires that claim victims’ lives¹⁸. The number of fires in homes, of all different origins, is roughly estimated to be around 250,000 per year, with approximately 800 deaths per year, and many serious injuries that leave their victims disabled¹⁹.

The severity of the consequences of fires in homes could be greatly diminished if victims were alerted as soon as the fires began, and if they knew how to react to the fires. The presence of so-called “mandatory” systems for monitoring smoke must not lead us to forget to be vigilant.

Wood burners and fireplaces in individual homes are often the cause of fires. A great number of fires are caused by the absence of firewalls in front of fireplaces, the unsafe lighting of fireplaces with flammable liquids, or the failure to sweep chimney flues.

Cigarettes in rooms, unattended candles, clothes on electric heaters and halogen lighting near curtains are all risk factors. The field of fire safety has not escaped the actions of lobbying groups.

A3.14. Drowning

Drowning is the leading cause of death in children between the ages of one and 14 years.

Children can drown in the water in their bathtubs, in a container (e.g. if they stick their head in it), in a pool, in water from a water supply, etc. Babies can drown in a few centimeters of water if they have their faces completely underwater. They can quickly lose consciousness if left alone in the bathroom for a few moments.

Buckets of water placed on the floor, in the bathroom or elsewhere, and other utility containers used for domestic purposes are also causes of drowning among children when they begin to move on their own. These containers must allow the child to move or bend the item during a fall.

Drowning while at home can involve: water points, wells, cisterns, water recovery systems, wash houses, small ornamental pools, duck ponds, drinking troughs, septic tanks and pits of liquid manure; these all present potentially serious and permanent dangers for children who find these areas attractive.

If children accidentally fall into water, they are incapable of escaping from the problem alone, since they are unable to call for help. The drowning is then made worse, because the adults who then look for the children are not expecting to find them where they are.

A3.15. Sports

Sports activities, after recreational games, rank as the second-leading cause of accidents in everyday life. These cause one out of three accidents in people between 15 and 24 years old²¹.

Accidents from playing soccer alone represent 25% of sports accidents, while winter sports accidents account for 10%.

A3.16. Home improvement work and gardening

Accidents from lawnmowers are serious. They involve the user, a child or even another person nearby. Lawnmower accidents involve shocks, falls, cuts, burns, etc. due to the technical characteristics of the product, and to errors in the user’s understanding of its assembly and use.

A3.17. Toys and walkers

Walkers are high-risk toys. Often, parents are impatient to see their baby take their first steps and moving around alone. To learn to walk, walkers may seem like an ideal solution but their use can be controversial. Some specialists have sounded the alarm on the poor development of the market.

Babies give the impression of walking on their tip-toes, of moving without effort. They do not explore the coordination of their arms and their legs. Finding themselves in what is effectively an upright position, they cannot find their own balance. In addition, the fun that they get from gaining greater speed multiplies the risk of electric shock and falls. These devices must be viewed as dangerous. Walkers have been prohibited in Canada since 2004. More than 80% of accidents in walkers involve stairs, where the child falls down them, with the majority of cases resulting in head trauma or brain damage. The position of children in the walker means that the injuries often occur on their faces²⁴.

Falls on staircases: children placed in walkers can quickly reach the edge of a staircase and fall. It is a common type of accident if no protective barrier is placed on the landing at the top of the stairs; the child may suffer serious or even fatal head injuries.

Wobbly walkers: walkers are likely to wobble on uneven surfaces, doorways or carpet edges, causing children to fall with a possible impact on their heads and a risk of head trauma.

Walkers are responsible for a very large number of falls, serious burns and scalding²⁵. Walker accidents are one of the leading causes of young children being taken to emergency rooms.

This can happen because of stairs, a slope, a rough surface, an obstacle on the ground, a wheel of the walker becoming stuck in a piece of furniture (chair, table leg, etc.) or a turn that is navigated with too much speed. Objects could fall on the child, who is effectively at a greater height than usual and has access to new things: tablecloths, objects sticking out over the edges of tables, etc. If the child catches onto or pulls on these objects, there is a significant risk that the objects will fall on them. Once again, there is a risk of bumps to the head or burns. These accidents happen very often when parents are present and monitoring their children, but the speed of the walker changes the situation compared to the usual speed of the child, and the parents cannot anticipate these changes as quickly. Thus, these accidents happen in spite of parents’ vigilance.

In terms of the risk of the onset of a psycho-motor disorder, the walker is a tool of artificial recovery, which means that the children cannot control how they stand, nor control how they support their feet on the ground, nor maintain their balance. The child must therefore compensate for this as best they can, and use strategies that could be very harmful later on in life. Children feel that they cannot move around in this position, and then become very watchful, trying to regain control of the situation. This hyper-vigilance is a source of muscular and emotional tension, which can have a negative impact on their psycho-motor development.

The children cannot build their motor skills or experience for themselves the transitions of postures: moving from a sitting position to a four-legged position, and from there to standing up. As a result, they cannot build support at the level of their entire body, and therefore manage their imbalances by grabbing hold of something with their hands, for example, or falling backward.

With walkers, children are likely to come to a standing position in a way that is disconnected from the rest of their motor skills, and will not be able to return to the ground by themselves or get back up when they fall. They may then develop a significant fear of imbalance and falling.

The knowledge of the body is developed in children through how they perceive their support on the ground and the sensations experienced in their daily movement, and this all occurs before they know that one part of their body is called a “hand” and another is called a “foot”. By touching them, looking at them and feeling them move, they incorporate them into their “body schema”, and they know that they are of part of themselves, that the little hand that they are seeing is their own, but not the large hand nearby, which is the hand of their daddy. In the walker, they are stuck in a harness and cannot explore their body in any way; they cannot even see it. The experiments and equipment are very poor and cannot be integrated into a “body schema”. With a walker, they can barely see the outcomes of their movements and have the illusion that this rapid movement is their own and not that of the trotter. Later, outside of the walker, they cannot find that speed of action, and may not even move, instead making random movements with their bodies. They may then have to endure a number of difficulties in that their movement itself is slower and needs to be repeated, consolidated and experienced in various forms before returning to a speed that is comparable to that of the trotter. This is very damaging to their development, since the progressive buildup of their motor skills, in finding their own pace, favors many things including self-confidence and the desire to learn by themselves.

The use of a walker also has an impact on the child’s exploration of space; the child moves themselves in a given direction, but the walker moves itself in its own way: little Louie cannot make a u-turn, stop and bend down to pick something up, move forward on a rounded path, zig zag, go diagonally up to the corner of the room, get under a table, climb on a pillow, etc.

Therefore, they cannot explore all of the spatial components of their environment, when it is precisely this kind of exploration that allows them to form all their notions of spatial relations: up, down, over, under, small, large, in front of, behind, etc.

In addition, in the walker, they always have a tray in front of and around them, and this creates an additional distance between themselves and nearby objects. With the walker, they become used to always having this distance and begin to incorporate it as something that cannot be changed. Once out of their walkers, they become startled because they do not anticipate the need to slow down, move around or put their hands forward to cushion themselves, and then they bump into things again, and again, and again.

Motor damage to joints and muscles results from the use of a walker when the child moves forward by pushing on their tiptoes, as this can lead to deformities in the foot and leg and articulation of the hip joint, as well as tendon problems in the calves: in the latter case, the children will still, almost exclusively, walk on their tiptoes when they are bigger.

The use of walkers is not recommended, and in addition, is not shown any interest. As stated before, walkers are also prohibited in Canada, and several other countries are following suit.

A3.18. Quad bikes

Almost a hundred accidents involving quad bikes have resulted in hospitalization and visits to emergency rooms. The accidents are mainly due to off-road driving, collisions with other vehicles, the driver being thrown off and possibly crushed, or the vehicle flipping over, and this can be on racetracks as well as on roads or uneven terrain.

Accidents, as a general rule, occur on private property; riders do not always wear helmets. In the United States, where the development of all-terrain vehicles is a much older phenomenon, the statistics are overwhelming. For the year 1998 alone, 73,900 road accidents were recorded, of which 27,400 involved children and adolescents under 16 years old. Pedestrians have also been involved in these accidents²⁶.

Most users are not very familiar with their quad bikes. There are only a few quad bikes that are in use, but far too many accidents, and only some are declared. A quad bike is not as stable as it might look, despite having four wheels. Quad bikes are in fashion, but they are a dangerous trend. There is currently no need to have a special permit to ride a quad bike; however, driving them is a unique skill. It is critical that riders receive training.

A3.19. Waves

Researchers are beginning to analyze the effects of waves generated by cell phones. Currently, there is still not enough being done to control the risks. However, children and teenagers are more vulnerable to the radiation from cell phones. Their brains are smaller and their nervous systems are still developing. The effects of these waves on children occur more quickly and with more serious consequences than they do for adults. In addition, attention must be paid to devices that are intended to monitor what is happening in homes with small children: these devices emit waves whose effects reach over a meter. Keep them away from babies’ heads! Of course, it is strongly recommended to keep all phones away from pregnant women, in order for the fetuses not to be exposed. People with cardiac implants should not allow their cell phones to come within 20 cm of them! It is not recommended for them to carry a mobile phone. It is always better to keep phones more than one meter away from the body, particularly the heart, hips or genitals. Proximity to the brain also comes with risks. Mobile phones should be used in speakerphone mode or with headsets as much as possible, if possible connected with wires that themselves do not emit waves. The device should be placed more than 50 cm away from users’ heads at night if it is charging or on standby.