Infographics: The highest accident risks lurk in the home

Life is dangerous, but have you ever considered where the greatest dangers lurk? Here’s a hint: It’s not in a plane or the bustle of the city; the chance of falling victim to a plane crash or a terrorist attack is minuscule. The risk is far greater there, where we feel safest. Behind our own front door.

More fatal accidents happen in the home than in traffic. (Picture: Peter Hübbe/DEKRA)

Safety is an important topic in modern life. We talk of safe cars, safe playgrounds and safe workplaces. Yet once we step through our own front doors, our internal alarm bells seem to shut down. Little do we know, our homes are filled wall-to-wall with danger. How else would one explain the fact more than twice as many fatal accidents occur in German homes – approximately 9,000 every year – than the 3,500 that take place on the road?

According to data provided by the German Federal Office of Statistics, most accidents happen in the home. Despite this, detailed information on domestic accidents in Germany is not readily available; if you go to the emergency room missing a fingertip, you’ll be treated, but details on where your injury took place are not recorded. For this reason, the German Federal Institute for Occupational Safety and Health (BAuA) compiles various statistics provided by insurers and the Federal Office of Statistics, as well as estimates by the Robert Koch Institute (RKI). According to data from the BAuA, around 2.8 million people are injured at home every year. Adding those that injure themselves doing recreational activities increases that number to an incredible 5.9 million victims. The number of traffic related injuries – approximately 370,000 – fades in comparison.

The risk of familiarity

How are such high numbers possible? Dr. Jörg Angenendt – a psychologist at Freiburg University Hospital – believes our subconscious is to blame, as this is what governs our interpretation of safety and risk. “At home, you are, as it were, at home.  You’re somewhere that you trust. You sense no danger or threat to your wellbeing when opting to clamber onto a chair rather than up a ladder.” Angenendt explains that it is our own overestimation of our control in certain situations that leads to such astonishing figures – figures that most people are entirely unaware of. “If something goes wrong at home, perhaps a couple of neighbors will hear about it. However, if a plane crashes, every major news outlet on the planet picks up on the story, thus causing mass panic,” according to Angenendt.

Although airplanes are, statistically speaking, an incredibly safe method of transport, an accident that kills 150 people in one fell swoop does tend to play on your conscience. “Domestic incidents are silent, unspectacular affairs. They aren’t discussed in the wider world, as there are no images,” explains the psychologist. “We don’t see footage of the elderly lady, lying in her stairwell – helpless and wracked with pain – waiting for the emergency services to arrive. It’s a private occurrence with little public visibility.” The relevance of household accidents is not just misjudged, but also largely ignored. Neither politicians nor consumer protection bodies are actively tackling the issue in Germany. The Benelux and Scandinavian nations have made considerable progress here, as has Switzerland, whose Accident Prevention Advice Center (BFU) performs stunning work.

Injury prevention in Switzerland

“We make people safe” is the slogan of the BFU, whose annual statistical report on non-occupational accidents reveals insights into general safety in Switzerland. It covers traffic, sporting, domestic and recreational accidents. “We cover the entire cycle of prevention,” announces BFU Director Brigitte Buhmann. Her organization carries out research whilst simultaneously educating teachers, police officers and safety professionals. It also provides advice to architects and construction experts and creates informational campaigns. The most recent campaign was dedicated to preventing falls (www.sichergehen.ch). To tackle more complex tasks, psychologists, lawyers, sociologists, economists and physiologists pool their knowledge and work together.

“We start by asking what’s happening, why is it happening, and how it can be prevented,” explains Buhmann. Goals are then set and measures defined. “If we research it today, we can already be implementing it by tomorrow.” Yet this is only possible with access to the relevant data. This data also shows whether existing measures are working and how effective accident prevention is from a socioeconomic perspective. The result: Every Swiss franc invested in prevention saves seven francs in post-accident treatment costs. “We want to influence both behaviors and general conditions,” says Buhmann, meaning infrastructure, products, standards and laws. Their independence from economic and political interests is important to her – thanks to this, the Advice Center can issue sales bans for dangerous products. The BFU has been in existence since 1938. The private foundation received its legal mandate in 1984. Cooperation with various federal agencies, institutions and organizations plays an important role. The Advice Center’s budget equates to approximately 25 million euros, the majority of which coming from a premium supplement levied by accidental injury insurers. In Switzerland, every gainfully employed person is insured by their employer. (www.bfu.ch)

Safe homes

“To effectively target their prevention, we need reliable statistics that tell us how many accidents actually take place,” says Dr. Susanne Woelk. Woelk is from Hamburg, and the managing director of the initiative Das Sichere Haus e. V. (The Safe House). This is a German trust that promotes recreational and home safety. Their goal is to decrease the high numbers of accidents by offering advice and assistance. Taking the figures cited by the Federal Office of Statistics as a basis, it is apparent that there has been an enormous increase in fatal accidents in private settings. In 2005, these accounted for 33.5 percent of all casualties. Ten years later, that figure had climbed to almost 40%. Of these victims, approximately three-quarters are aged 65 or above. Statisticians therefore attribute this increase to the aging of Germany’s demographic structure. In addition, it is fair to assume that many of the accidents covered by “other incidents” would have happened at home or during recreational activities, says Woelk.

The category “other incidents” covers casualties that cannot be assigned to any explicit category, such as those who have died of hypothermia. The large number of fatalities without defined manners of death is often to be attributed to the attending doctor failing to note the cause of death on the death certificate. The Federal Office of Statistics assumes, however, that a great many of these casualties were caused by domestic accidents.

The most common cause of an accident at home is falling. (Picture: DEKRA)

Representing more than 80% of fatal accidents, trips and falls hold the depressing record of biggest killer. Woelk asserts that more than three quarters of those casualties are aged 60 or above. It is also to be noted that the victim of every second accident is a child. That doesn’t make those falling between these age ranges immune, however. A frequent cause of fatal injury is standing on folding chairs rather than ladders to clean windows. Objects left on the stairs “just for a moment”, carelessly placed buckets and thick carpets are also common trip
risks. As if that weren’t enough, trips and falls are also a regular occurrence on level ground, however hard that may be to believe.

At home, it seems that nowhere is safe. Falls are also common in the bedroom; tripping over slippers in the dark claims more victims than one would expect. All too often, the consequences are not just limited to bruises, pulled muscles and broken bones. Woelk wishes that the state would take more of an interest in home safety. It would cost money, yet workplace and road safety both receive investment and extensive support. “Just think about the introduction of the seatbelt, which led to a massive drop in traffic deaths,” she offers as food for thought. However, Woelk recognizes that the protection of individuals’ privacy sets limits regarding the extent to which the state can interfere in home life. Despite these limitations, Germany was able to pass important legislation that made smoke detectors compulsory in residential properties. Fires continue to be the fourth most common cause of fatal injury for children.

Underestimated risks

“Domestic accidents can be split into two categories,” explains Professor Florian Gebhard, President of the German Association for Emergency Surgery. “There are those that happen due to carelessness, and those that are thanks to the improper usage of equipment.” The most common cause of injury for patients aged below 60 is underestimating risk, often coupled with the announcement “it’ll do!” A perennial classic is the burnt-out light bulb, quickly changed whilst standing on a swivel chair. “You fall and break something as a direct result of
underestimating the risk.”

Machinery seems to be the natural predator of the do-it-yourselfer. “We have observed an increase in people hiring professional equipment to carry out home builds and repairs – equipment which then proves to be too much for them. Often, this can be attributed to simply not having read the instruction manual. He recounts the tale of a patient that attempted to smooth down his parquet flooring with a planing machine. The patient quickly lost control of the machine, causing themselves serious injuries. Of course, the home includes the garden
too, and all those accidents due to the improper usage of lawnmowers and electric pruners along with it. Another interesting phenomenon is the increase in broken bones at the end of the fruit harvest, when daring and ill-advised attempts are made to pick the highest fruit.

Childish recklessness

So what should be done? In order to effectively promoting home safety, this question needs to be actively addressed. This is not something that can  be reasonably expected of children. They want and need to be able to act out their urge to move. This shouldn’t prevent adults from discussing dangers with them though, or from stopping them from repurposing the sofa as makeshift trampoline. According to investigations by the German Federal Institute for Occupational Safety and Health, every third accident involving a child involves a household appliance. Quality seals cover the safety of a product under its prescribed usage. It cannot prevent an unsupervised toddler from pulling the power cord of a kettle and scalding itself.

Though the children’s book “Struwwelpeter” is no longer quite up to date, some of the messages it holds are as true as they ever were: Left home alone, Pauline finds a box of matches and starts a fire, whilst eternal fidget Philipp ends up falling backwards off his chair. Modern parents can at least rely on smoke detectors and certified untippable highchairs for little ones. Child locks for securing both electrical outlets and cupboards with dangerous contents also make the home a little safer for children, whilst stair gates prevent them taking a tumble. Children are unable to judge danger, meaning that adults need to act with foresight and remain attentive. Distraction or stress on behalf of the parents is often a contributing factor to babies falling from changing tables.

The elderly are also at particularly high risk. The threat of injury at home is three times as high as that of a car accident. Despite this, many older citizens quite rightly wish to retain their independence. Recognizing and dealing with the fact that once easy tasks are becoming more difficult – and crucially, more dangerous – is something that needs to be taught. For example, good lighting is especially important for those with worsening eyesight. Rugs with thick edges, raised thresholds and slippery floor coverings are best avoided by senior citizens, whilst handrails are necessary for all steps. Whilst perhaps contrary to fashion, slippers with closed toes and a secured heel provide surer footing than their more open brethren. At the end of the day, it is people that define home safety; it starts with safe construction and equipping the house with approved appliances, toys and furniture, and ends with the resident’s danger awareness.

The infographics shows the distribution of domestic accident risks:

Picture: Niko Winkelmann