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The Editors of Effect Measure are senior public health scientists and practitioners. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts "Revere" to recognize the public service of a professional forerunner better known for other things.

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« The dangers of weed | Main | That Superbowl ad (not the anti-abortion one; the other one) »

Your home is your (dangerous) castle

Category: Injury
Posted on: February 8, 2010 6:02 AM, by revere

Most people feel safe at home, but statistically it's not the safest place to be, at least in terms of being injured (here injury includes not only trauma but poisoning, but if we restrict it to trauma probably little is changed). Here's one of CDC's "Quickstat" looks at the percentage distribution of injuries by place of occurrence, as reported in a cluster sample of the US population (the National Health Interview Survey). The years covered are 2004 to 2007:

m904qsf.jpg

Source: Morbidity and Mortality Weekly Report (MMWR)

Here's how the NHIS defined these places: home includes both inside and outside the home; recreation area includes recreation or sports facility, recreation area, lake, river, or pool; street includes highway, sidewalk, or parking lot; commercial area includes industrial, construction, farm, trade, or service area; school includes school, child care center, or preschool; other includes hospital or residential institution, other public building, or other place not specified.

There is a lot of injury occurring in our communities every year, most of it minor, but adding up to big numbers: in excess of 30 million a year. The events reported here by this sample of the US population was a bit more serious. Subjects were asked to report injuries in the previous 5 weeks that required medical attendance, so these weren't just little scrapes and bruises. Still, if you think about it, it's not too surprising most the most likely place for them to occur is in the home, where here it's not just inside the house or apartment but includes the back porch, outside stairs, driveway, garage, etc. These places are full of slippery walks, throw rugs, stuff left on the stairs to trip on, a kitchen full of sharp instruments or a garage or basement full of dangerous tools and people spend a lot of time there doing a tremendously broad range of activities, many of which have the potential for causing injury to people spanning a huge age range.

Many of the things that can hurt you at work can also hurt you in the home. Most people work hard at home and do the same things that cause injury in the workplace, like lifting things or using something that can hurt them. You can burn yourself in the kitchen, slash yourself opening a clamshell package, trip over a toy left on the landing or hurt yourself doing any of a number of physically demanding task, like making a bed. Then there's child care. I currently have a nasty back problem I brought it on myself by tossing my grandchild in the air. What thrilled him was the danger. I wouldn't be allowed to do that at a day care center.

As an aside, tossing toddlers in the air seems to be a male impulse. Mrs. R. says she's never seen a woman do this and I admit I have an irresistible impulse whenever the little guy toddles in the front door. I have no idea why. And since my back really hurts, I'm usually sorry. But I've hurt my back exactly the same way in his last three visits. Not very smart of me.

But we often aren't smart on our own territory. We feel more secure. We also spend a lot time there. And we are more likely to get hurt there than anywhere else.

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Comments

1

To add to the comment do it yourselfers do not have any safety standards applied to them. For example no fall protection is likley used. In addition although the manuals with new devices probably contain safety info they are not read.
How many practice proper lifting technique at home, (as noted in the post he did not got a back ache).

Posted by: Lyle | February 8, 2010 8:21 AM

2

There is some confounding here by the amount of time spent at home vs. other places. I wonder what the comparative risks would be properly adjusted for how much time we spend there.

Posted by: Alex | February 8, 2010 10:41 AM

3

Alex: Only if you consider a proper measure of risk incidence-time. Exactly what the measure should be is a choice. For example, for travel, it might be per miles traveled or per time traveling. That could possible alter the relations of car and plane travel (not sure if it does, but it certainly makes them closer if you take incidence-time rather than incidence-miles).

Posted by: revere | February 8, 2010 11:15 AM

4

I know, for myself, that I do middling-dangerous things at home that I'd be committing a criminal offence by doing in a work environment: cooking under the influence, climbing furniture to work at height (or standing on the windowsill to reach the gutters), handling caustic chemicals without PPE. Of course I face greater risk of injury! Then compare the potential risks of working in an office or service environment versus using power tools even with proper precautions.

Posted by: stripey_cat | February 8, 2010 12:39 PM

5

I remember finding out that most auto accidents occurred within five miles of home
so I moved
Also what should be taken into account is the influence of narcotics and/or alcohol. I dare say I have been at least slightly more intoxicated while working at home than at my job (at least slightly).

Posted by: Dan | February 8, 2010 2:21 PM

6

Dan: You sound like you re channelling Steve Reich. But yes, inebriation is certainly a factor in the home setting.

Posted by: revere | February 8, 2010 2:55 PM

7

To pile on Alex's comment (and your penultimate sentencest): the typical person might spend an hour or so a day on "the street" but 12+ hours "at home" - per unit of time "home" is safer. How about waking hours? Well probably at least 4 of those hours at home are awake time so "home" is still at least as safe as "the street" even then. "School" OTOH is very safe - well if one limits to awake time maybe not!

Posted by: Don S | February 8, 2010 3:30 PM

8

Seems a reasonable possibility the higher number of home injuries for women results from women's doing more of the work of the home, but since outside/yard work's included, this gets more interesting. I wonder how home offices affect these figures. Re the dangers of house--especially kitchen--work, I remember reading (somewhere!) that deaths from cooking fire accidents were very high among women on the U.S. frontier.

Posted by: Paula | February 9, 2010 2:34 AM

9

I agree with Alex - as well, though, the times that we spend at home are perhaps also dangerous times. We are more prone to injuring ourselves when we are tired, and we are generally at home at that point. Looking at accident rates at workplaces shows that accidents are more common at certain times of the day - it could be that a similar temporal effect is at work (as well as the obvious problem of engaging in dangerous activities like handling blades, saws, power tools, etc).

Really, it should probably be broken down not by location, but by activity. At home and not cooking/showering/using power tools is probably as safe as being at school; and cooking or using power tools on the job is probably nearly as dangerous (when the same precautions are taken, though safety measures are likely more strictly followed at work) as in the home setting.

Posted by: Epinephrine | February 9, 2010 8:02 PM

10

Is there any indication if these injuries are known to be accidental? Sadly, assault isn't uncommon in many homes.

Posted by: Cath the Canberra Cook | February 9, 2010 10:02 PM

11

In Australia there is a big statistic on serious injuries from ageing men falling off ladders. Past a certain age, your balance deteriorates but you may not realize it. Or you might, but pride won't let you admit it. "I've always cleaned the dead leaves out of my own gutters and I'm sure as hell not going to..." You get the picture. I would be surprised if America is much different.

Posted by: Sandgroper | February 10, 2010 5:38 AM

12

Really, it should probably be broken down not by location, but by activity. At home and not cooking/showering/using power tools is probably as safe as being at school; and cooking or using power tools on the job is probably nearly as dangerous (when the same precautions are taken, though safety measures are likely more strictly followed at work) as in the home setting.

Posted by: Tatil | February 10, 2010 4:14 PM

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