Window screens are designed to keep bugs out, not children in.

Adults know this. Inquisitive toddlers do not.

Each year, adults demonstrate that they do not always act on what they know when it comes to their children. The leading cause of preventable disability and death in children is falls through windows, and off decks and balconies -- and not just from highrise buildings.

Dramatic media reports of children falling from highrise windows and balconies leave those who live in houses, townhomes and lowrise suites with a false sense of security. Most child falls, even those that cause permanent disability, do not make the news.

"If you were to look at stats in the City of Toronto, 53 per cent of falls are second-floor window or door falls," said Dean Shaddock, Coordinator of the Community Medicine Program at Toronto Emergency Medical Service (EMS), a key member of Partners Promoting Window and Balcony Safety. "The falls and the incidents that make the press are the ones from a highrise building, but there are documented cases of children dying in an second-floor fall."

Open windows and doors anywhere are welcoming invitations to small children. At the cottage, in a house or in a highrise condominium, children are at risk of a serious fall unless they are standing on level ground. Experts remind us that even falls from first-floor windows and decks can cause death or serious injury because young children usually land on their head -- the heaviest part of their bodies, representing as much as 40 percent of their weight.

For decades, governments, medical experts and community safety groups have campaigned to reduce the annual fall-generated death and disability toll, but preventable child falls continue. Most occur during warm months when windows and doors are open, and at the time of day -- between noon and 7:00 pm, and particularly after 3:00 pm -- when adult attention is elsewhere.

"What's causing the problem is a lack of education that clearly identifies the risks and how we can avoid them," said Shaddock, explaining the significance of the EMS three-pronged consumer program, which emphasizes education, proper supervision and use of safety devices. "What we found in our experience of dealing with people is that we often safety-proof areas of our home that we see as dangerous, but not the walls of our home and balconies? Those we see as extended living space, not danger. We [at EMS] often tell people to see the room the way a child views it -- as new, as a new adventure. Children do not have the experience or the knowledge to understand that what they are exploring is also dangerous."

Media coverage of fluke survivals from dramatic falls creates the false impression that children are so resilient they can escape serious injury when they fall smaller distances. One Ontario child survived a seven-storey fall after landing on exceptionally wet grassy garden. But the ground is normally an unforgiving surface and even short falls in our interlocking-brick, patio-stoned world can cause lifelong damage.

Children are at risk because caring supervision can be intermittent and intervention may be too late. Parents, grandparents, babysitters and other adults are poor fall-prevention barriers since they are easily distracted and not able to concentrate on a child 100 per cent of the time. Older siblings or playmates enlisted to "watch" a toddler may have short attention spans themselves. Small children will not always listen to them and may even be egged on during play to take more risks.

Falls happen quickly. Supervision is the crucial factor, but round-the-clock protection also requires a continuously safe environment with built-in safety barriers and smart design. Safety devices and furniture layout are not a substitute for full supervision, but they can prevent access to a balcony or make it difficult for a toddler to reach and open a window or door in that split-second when accidents happen.

Put forward thinking toward a safe environment in action in your home or cottage using:

  • Window guards that restrict window openings to 10 centimeters and that are too strong for children to remove, yet release in case of fire.
  • Patio door guards that restrict access to decks and balconies.
  • Removal of furniture, bikes, recycling boxes and anything under windows or near balcony railings.
  • Locks on closed balcony doors and windows at all times.

The goal seems simple: Stop enabling children to fall from windows and balconies. The challenges of designing a preventable injury campaign underline the complexity in achieving this simple goal:

  • Consumers are bombarded with safety messages from all fronts, important information that they want to understand and retain. However, trying to integrate this multi-source, detailed home-safety information into day-to-day living can be overwhelming for the average family.
  • The "simple" installation of safety hardware for windows and doors is not "simple" for everyone since use of a screwdriver and basic tools is not taught in school. Hiring an installer is not always a feasible or an affordable alternative.
  • Legislated changes to building standards, bylaws and product specifications are being used in other countries, but how can these improvements be consistently enforced in private homes? Mandated changes are rarely retroactive.
  • New homes and condominiums are not automatically safer environments. Although window and door manufacturers offer products with built-in child safety features, do home and condominium buyers understand the value of insisting on what are often upgrades?
  • In existing homes, condominiums and apartment buildings, safety solutions must be simple and not require replacement of windows or doors.
  • Once a properly-designed, and consistently-functioning safety device is developed, ineffective knock-offs flood the marketplace. Without widely-promoted national standards, consumers may not know what the essential buying criteria are.

According to Dr. Philip Groff, Director of Research & Evaluation for Toronto-based SMARTRISK, a nonprofit resource intent on preventing injury through smart thinking: "The short answer to the question of how to prevent these falls is to educate builders about the need to follow or exceed existing codes in installing these guards, and to educate the public about the need to leave them in place, un-tampered with ... . The National Building Code of Canada, 1995, states that any window in a residence with sills 50 centimeters or less from the floor must be protected by a guard ... . Mississauga also has a stricter code, however, not all major cities in Canada have anything in their building codes about window safety that go above the regulations stipulated by the National Building Code."

The value of safety features is often overlooked by buyers and sellers of homes and cottages, especially when children will be visitors not residents. Shaddock and his EMS colleagues plan to expand their preventable injury program to include professionals and industries that can have an impact on consumers' real estate and home-related decisions, so that homes of all types and heights are equally safe environments for children. Real estate, financial and other home-oriented professionals, who already promote consumer education to ensure the communities they serve are safe places to live and work, may decide to team up with local EMS teams.

"Most people, given the information, will make the best decision," said Shaddock. "We constantly see people who say 'I never thought of that.'"

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