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In Developed countries, as advances in medicine and surgical techniques have reduced the threat from fatal birth injury, malnutrition and infections, so health promotion and accident prevention have been given greater resources. Physical danger has always taken its toll on human society; archaeological remains often show old injuries, such as fractures and other signs of violent injury or death. There arc great differences in the safety and accident rates between different countries. This discussion is based on experience in the United Kingdom.

An overview

While accidents account for approximately 2% of all deaths, between the ages of one and 35 they are the single greatest cause of death. Above 35 they are steadily overtaken by illnesses related to advanced age such as heart disease, cancer and strokes.

While most accidents occur at home, since this is where we spend the greatest part of our time, the majority of accidental deaths occur not surprisingly on the road. Domestic accidents,
particularly falls, can be fatal, however, as can accidents that take place in the workplace or sports field. The consumption of alcohol plays a part in at least 30% of all accidents.

What are accidents?

In this context an accident can be defined as an unforeseeable event leading to injury. In practice, and with the benefit of hindsight, many accidents are predictable although not necessarily preventable. It is an important goal of public health to try to reduce the incidence of accidents, while realizing that some accidents arc, by their very nature, unavoidable. The risk and nature of accidents vary greatly at different ages.

The lure of the familiar

The more often we perform a familiar task the more likely we are to take risks, for example when going up a ladder to clean windows or remembering not to tread on a loose floorboard. It is better to do something about a hazard now than to be saying in hospital,’ I always knew I ought to do something about those slippery stairs.’

Safety and children

The aim is to encourage exploration in a safe environment. The onus is on carers to anticipate hazards, especially those that adults take for granted, such as being careful with pointed objects. Checklists can be tedious – just about anything can be a hazard if misused – and common sense should guide you.

The home

Secure objects which children might pull on to themselves; fit guards to the top and bottom of stairs; remove trailing electrical flexes, sharp objects and poisonous substances such as bleach, medicines and garden chemicals. Fit socket guards; lock doors leading to hazardous areas such as the garage. Do not leave children unattended near fires, hot pans or other hot objects.

Always test the temperature of baths, food and drinks meant for children. Keep only safe domestic pets and avoid leaving children alone in a room with a dog, no matter how well behaved it normally is. Secure the area around garden ponds or swimming pools and never allow young children to go near them without close adult supervision.


Fit safety seats in your car and use them, making sure they are the right size for the child and in good condition; always strap children in the car and do not let them hang out of an open window. Children love bikes but make sure they get into the habit of wearing safety helmets and reflective clothing, even during daylight hours. Teach road safety from the earliest age, while remembering that no child under the age of 10 is safe alone on a road.

Other risks

Satisfy yourself about the safety of playgrounds and the degree of supervision on trips and special outings. Unless you are going to cocoon your child in an unrealistic world, however, accidents in childhood are unavoidable, but you can make sure that accidents are as minor as possible.

Safety from the age of 13 to 35

The aim is to enjoy life without endangering someone else’s. Adolescence is a period of flexing all the muscles and trying everything. So, not surprisingly, this is the period where accidental deaths peak, mainly through road traffic accidents.

Road safety

Nearly half of all male deaths in this age group are through road traffic accidents. The means to reduce risk are simple: wearing seat belts whether you are a driver or a passenger, driving at a safe speed, not drinking and driving. Pedestrian safety is equally important; many accidents occur to inebriated pedestrians.

Sports and workplace safety

Although far less important numerically, workplace accidents and sporting injuries account for significant numbers of deaths and disabilities each year. Young people may feel they jeopardize a macho image if they use safety equipment, but office and factory personnel and sports instructors should keep emphasizing the safe way of doing things.

Signalling Aggression

  • Standing very close to someone
  • Making eye contact
  • Physical contact

Signalling Non-Aggression

  • Speaking in a low, calm voice
  • Averting your gaze
  • Keeping your arms by your sides


Violent assaults make a small but important contribution to injuries in teenage years and early adulthood. Most societies find youth aggression a difficult problem, with no simple answers. It is tied to socio-economic disadvantage, unemployment, alcohol and drugs, but, at root, young people are aggressive and large groups are aggressive towards each other. Those wishing to avoid confrontation must keep away from troublespots and learn to recognize anger in themselves so they can alter their body language and walk away from tense or hostile situations.

Safety from the age of 36 to 64

The aim for this age group should be to benefit from wisdom and experience! Road traffic accidents are still the major hazard, less so workplace, home and sports injuries. Alcohol still continues to play an important role.

Safety beyond the age of 65

The aim for older people is to maintain independence despite deteriorating senses and balance. Accidents become increasingly prevalent the older you get, although as a percentage of death and disability they appear less important. Falls alone account for 60% of all deaths due to accidents in women above the age of 75, and 40% in men. Road traffic accidents account for 10-20% of deaths through accidents, most of which relate to elderly pedestrians rather than elderly drivers.


Make sure your glasses and hearing aid, if worn, are as efficient as possible because you will be relying on your eyes and ears for your safety.

The home

Look at the potential hazards in the home. The simplest things are the most important to fix. Secure loose rugs, lit handrails on stairs and tidy up trailing flexes. Do not lift things beyond your capability. Try not to have open flames or candles, which could start a fire. Have bright lighting, especially in dangerous areas like the stairs.

Many elderly people feel giddy on standing up or turning their head; allow for this by taking your time moving around. Consider getting a personal alarm, especially if you have fallen before, and let neighbours have a key for an emergency.


Wear well-fitting shoes with non-slip heels. Think twice about going out in the ice or snow – just a minor fall can fracture your wrist or thigh. Take advantage of handrails and support from a friend or partner and if the time has come for a walking stick do not let pride stop you from using one.

Crossing the road is a potential hazard for the elderly: you should choose your spot with care at a proper marked crossing and cross with the lights. Do not assume that being elderly suspends the laws of motion, so give traffic time to stop.

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