Deaths and injuries due to home accidents continue to be a significant problem, which has received only sporadic attention in the research literature. The circumstances of a variety of home accident types are only vaguely known but it appears that yet unsolved social problems such as low income and alcohol are involved. Although home accident data collection problems are significant, there have been some home safety success stories and methodological advances in recent years. Even so, research needs to be done at the local level on countermeasure adoption and effectiveness among high-risk target groups. The need for a home safety constituency with influence equal to that found in traffic and occupational safety is a necessary element if this objective is to be achieved.
Home accidents account for more than one fifth of the accidental deaths and approximately one third of the disabling injuries occurring in the United States each year. In 1977, they took the lives of 23,200 persons and caused an estimated 3.5 million disabling injuries [National Safety Council, 1979]. Although motor vehicle accidents (accounting for 49,500 fatalities in 1977) continue to he the leading cause of accidental death, home accidents have traditionally been the principal cause of injuries.
DATA COLLECTION
Home fatality figures are based on the compilation of death certificates by the Division of Vital Statistics (DVS). Accidental deaths are classified separately from those due to intentional episodes such as crime and self-inflicted violence, though this dichotomy is suspect. As Baker [1972, p. 8] points out, "Even for fatalities, the distinction between intentional and unintentional injury often is not clearcut; questionable homicides and suicides are often classified as "accidents" on the death certificate."
General information about the victim, location, and circumstances of accident mortality is published by DVS but multiple cross tabulations are infrequent. As a result, even a most elementary array, such as number of deaths by type of home accident and age of victim can only be estimated. Further unreliability results from the fact that the classification of place and detailed circumstances of accidental deaths are frequently unspecified.
As shown in Table 1, with exception of the fire/burn category, the percent of "unspecified" information is quite substantial. In the case of home falls for example, the "unspecified" category for detailed cause is very large with unspecified incidents being one third more frequent for female than male fall victims.
Unlike fatalities, home injuries are not compiled on a national basis so that totals must be approximated. The National Safety Council's disabling injury estimates are developed from special studies such as those conducted by the U.S. Public Health Services, state health departments and insurance companies. A disabling injury is one that results in death or some degree of permanent impairment, or one that renders that injured person unable to function normally for a full day beyond the day of injury.
Use of a broader definition yields a much larger home injury figure. For example, the National Health Survey (NHS) conducted by the Public Health Service, estimates that for the period 1975 through 1977, an annual average of 27.1 million persons were injured in the home. This figure, based on interviews of 42,000 of the 74 million households in the U.S., includes disabling as well as nondisabling injuries and those due to nonaccidental violence (e.g. crime and suicide).