Ample opportunity to increase the use of protective devices and limit the presence of fall hazards in many U.S. homes

Only a third of homes with a child age 6 or younger and windows on upper stories reported having window guards or locks to keep children from falling out, a new national survey finds.

In a third of the surveyed homes with stairs, at least one set of stairs had no handrail or banister, according to the survey, which suggests that private homes and apartments could use more protective devices like stair railings, window locks and grab bars in the bathroom to prevent dangerous falls.

Falls are the second most common cause of death from unintentional injury, after motor vehicle crashes, according to Carol W. Runyan, M.P.H., Ph.D., of the University of North Carolina Injury Prevention Research Center and colleagues. Their findings appear in the American Journal of Preventive Medicine.

"Clearly, there is ample opportunity to increase the use of protective devices and limit the presence of fall hazards in many U.S. homes," Runyan says.

Runyan and colleagues surveyed 1,003 households nationwide about anti-fall devices in their homes as part of a larger survey on home safety and injuries. Overall, about 7 percent of the households said that someone in or around their home had fallen and required medical attention within the last year.

Falls were almost as common in homes with protective anti-fall devices as those without the devices, but this may have been because falls were more prevalent in homes with younger children and adults age 70 or older. Homes with these vulnerable individuals appeared to be more likely to be aware of their fall risks, installing more bathroom grab bars, anti-skid bath mats and child safety gates than other homes, the researchers say.

Only a quarter of the households reported using grab bars or handrails in bathrooms, while 64 percent said they used bath mats or anti-skid strips in the tub. Households with older adults tended to use more of these devices. Rental households had fewer grab bars or handrails in the bathroom than privately owned homes.

In homes with stairs and small children under age 2, 65 percent reported using safety gates on stairs. This percentage shrunk, however, as the children got older. In homes with children age 6 and under, only 53 percent used safety gates.

Runyan and colleagues suggest that new building codes that require railings for all stairs and window bars in high-rise apartments would help eliminate some home fall hazards.

Runyan also says adding gates, handrails and grab bars to an existing home "can be relatively low-cost and readily implemented. However, it does require that homeowners take an active interest in installing these devices. Rebates and educational campaigns are potential tools for encouraging this behavior change."

The study was supported by the Home Safety Council and the National Center for Injury Prevention and Control.