Home safety interventions most commonly provided as one-to-one, face-to-face education, especially with the provision of safety equipment, are effective in increasing a range of safety practices. There is some evidence that such interventions may reduce injury rates, particularly where interventions are provided at home. Conflicting findings regarding interventions providing safety equipment on safety practices and injury outcomes are likely to be explained by two large studies; one clinic-based study provided equipment but did not reduce injury rates and one school-based study did not provide equipment but did demonstrate a significant reduction in injury rates. There was no consistent evidence that home safety education, with or without the provision of safety equipment, was less effective in those participants at greater risk of injury. Further studies are still required to confirm these findings with respect to injury rates.
ObjectiveChildhood burns and scalds are a significant public health problem. This systematic review and meta-analysis evaluates whether home safety education and the provision of safety equipment increases burn and scald prevention practices and reduces thermal injuries.MethodA range of bibliographic databases were searched until April 2009. Search methods also included other electronic sources; hand searching of conference abstracts, IPJ and reference lists. We included randomised controlled trials (RCTs), non-RCTs, and controlled before and after studies (CBA), involving children and young people aged 0–19 years, and their families.ResultsPreliminary results indicate that 49 studies met the inclusion criteria (29 RCTs, 6 non-RCTs, 13 CBAs and 1 CBA or non RCT). 27 studies were included in at least one meta-analysis. Families receiving home safety education +/– safety equipment were significantly more likely to have a functional smoke alarm (OR 1.83, 95% CI 1.22 to 2.73) and to have safe hot-tap water temperatures (OR 1.51, 95% CI 1.11 to 2.07). There was some evidence that interventions increased the prevalence of fireguards (OR 1.39, 95% CI 1.00 to 1.94). The prevalence of fire extinguishers was increased only by interventions providing these (OR 4.67, 95% CI 1.78 to 12.25).ConclusionsHome safety education and the provision of safety equipment are effective in improving the prevalence of functioning smoke alarms and safe hot tap water temperatures. They may be effective in increasing the prevalence of fireguards and fire extinguishers. Further work is required to explore the effect of improving safety practices on thermal injury occurrence.
Background
Injuries are the leading cause of childhood death in industrialised countries with steep social gradients in morbidity and mortality. Most injuries in pre-school children occur at home, however there is little meta-analytic evidence that home safety interventions (HSI) reduce injury rates, improve safety practices or impact on injury inequalities.
Aims/Objectives/Purpose
To investigate effectiveness of HSI in increasing home safety practices and reducing child injury rates and whether the effect varied by social group.
Methods
Bibliographic databases, relevant websites, conference proceedings, bibliographies of relevant studies, and previously published reviews were searched.
Results/Outcome
54 studies were included in at least one meta-analysis. HSI were effective in promoting safe hot tap water temperatures (OR 1.41, 95% CI 1.07 to 1.86), functional smoke alarms (OR 1.81, 95% CI 1.30 to 2.52), fire escape plans (OR 2.01, 95% CI 1,45 to 2.77), storing medicines (OR 1.53, 95% CI 1.27 to 1.84) and cleaning products (OR 1.55, 95% CI 1.22 to 1.96) out of reach, having syrup of ipecac (OR 3.34, 95% CI 1.50 to 7.44) and poison control centre numbers accessible (OR 3.30, 95% CI 1.70 to 6.39) and fitted stair gates (OR 1.61, 95% CI 1.19 to 2.17). HSI may reduce injury rates especially when delivered at home (IRR 0.75, 95% CI 0.62 to 0.91). There was no consistent evidence that HSI were less effective in those at greater risk of injury.
Significance/Contribution to the Field
HSI are effective in increasing a range of safety practices and may reduce injury rates without widening existing inequalities.
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