Document 44xbVEJ8qQV71R7Gxq9qbYpze

list Current Topics in HOME -ii&l SAFETY .. 23 . L ~ . 28 . 29 . 30 . 31 . 32 . 33 . 34 ERS wore h 5. 0 0 0 11. ILL. VHP : As preseated ia the Home Safety Sessloas of the . 1950 Ncrfioaal Safety Congress Accidents: Childhood's Greatest Health Hazard............. 3 Introductory Remarks ............. 3 The Pediatric Approach to Accident Control (A Symposium) .......................................................... 4 Accident Control Through Pediatric Practice....................................... 4 Accident Control Through Pediatric Research....................................... 7 12 16 21 21 22 22 25 27 31 The Pediatrician and Child Accident Prevention... 35 Volume 13 Transactions 1950 National Safety Congress NATIONAL SAFETY COUNCIL 425 No. Michigan 4venae Chicago II, III. ,* . v* if ` **. *- *- \*. te . .*** * 1J1I1 ' *:' } ' :fe---iit-'S'i - ;> vr l?:ki-f>cV: }#W .-;^v ;-:-4&W' ^LABJTjFFsT^ ^TlaSIfPS | EXHIBIT I r EXHIBIT a WI |i Oflftift. 12. In safety, as in all other human activities, die question is repeatedly asked, "What's new?" Many answers to that question are given every year by those who participate in the various sessions of the National Safety Congress. Many new methods, devices, and ideas which later became generally accepted first were presented at a Congress session. Because of this fact; safety directors throughout the nation have always found the Transactions of the Congress a valuable tool in their accident prevention programs. Publication of the Transactions in small volumes--one for each Section or Division--permits wide distribution of pertinent portions of the Congress material to man agement and supervisory personnel at small cost The 34 volumes of the 1950 Congress Transactions are listed on the last page. Distribution of these volumes to key personnel is suggested as a valuable aid in the safety program. In preparing these Transactions the proceedings of the Congress have been condensed and edited for reference purposes. Complete original manuscripts, with any charts or illustrations which were used, are available in National Safety Council files. Views expressed at the Congress or in this record are those of the Congress participants, and not necessarily those of the National Safety Council. THE HOME SAFETY COHFEIEHCE This volume is a record of the sessions hdd at the 1950 National Safety Congress by the Home Safety Conference. The conduct of these Congress sessions each year is only one of the many cooperative activities which the Conference carries on for the benefit of accident prevention work in the home. The activities of the Conference are under the direction of the officers of the Conference listed at the dose of this volume. i Intro Dfi tional opera comp one v for t! one. die b acridi to th injur the < they art l were proW very Th sight him from for s An < slight but i smalt a pro magn As goes fives took fiou ' Metr Natit repre wfaid probl pbysi form: Dr. < acadc acrid Ml the c orgar Home Safety ' 3 Accidents: Childhood's Greatest Health Hazard. ; Introductory Remarks by Presiding Officers : Edward .B. ;Shaw, UD, San Francisco, President, American Academy of Pediatrics; and Ned H. Dearborn, Ph.D.;: President, National Safety. Council, Chicago DR. SHAW: I want to assure the Na- yon might not--at the extent to which com- tional Safety Goundl of the Academy's co- petition prevailed a decade ago, among or- operation in what yon are trying to ac- ganizations who were striving for the public complish, and state that our interests are as welfare, indodtng die Conned. The feeling one with years. The concern of pediatricians seems to. hhve been that there must be some for the problem of accidents is a very great particular prerogative which one could claim one. About a third of the dnldrai who for his own-, organization. Sometimes it die between die ages of 1 and 15 die from was very obvious that this was just the accidents, and all of you will bear witness selfish interest of some person who happened to the fact that many, many children are to . be m a position of importance in the injured accidentally. Children don't die of organization. However, it was contrary to the effects of' disease to nearly the exteqf the. bade belief that I hold regarding the they used to. Many of our infant plagues ultimate achievements we all strive for-- are no laager as great a menace as they which is that in the field of public health were in years past So proportionately, the we all need to have cooperation, problem of childhood accidents becomes a I've been interested ini the viewpoints of very modi greater one.- differed thinkers and writers in die last There is the additional fact which is lost few weeks, peirticnlariy as this meeting sight of, that the veiy size of a child makes approached. Many reasons for cooperation him very' much more vulnerable to injury are presented--psychological, political, philo- from an accident Ail injmy which is minor sophfcal and scientific. The world's knowl- for an adnlt may be serions for a child, edge is not restricted to the use of any one An adnlt who takes a harmless pill in a group at alL There is room for competition, slight overdose may not suffer great harm, but in this field it rirould not be for die but when , tins effect is magnified by the amount of credit; glory, or prestige which smallness-of achildwe're confronted with an organization or individual can derive a problem of much greater importance and from ms efforts, hut rather to see who can magnitude. do the most good.. And I am coavinced that As an academy, our interest in safety through cooperative efforts, group planning goes hade several years, us do our coopera- and die execution of programs agreed upoa tive activities in the field. In 1948, we under- by the group, the greatest results will accrue, took a special educational effort; in coopera- We lave competition as a consequence of tion with die. U. S.Children's Bureau, die some of ottr natural impulses; of course. We Metropolitan Life Insurance Ox, and- the see that in our young people particularly. National Safety GounriL Dr. Albert Kaiser The schools have their athletic teams; and represented the academy in tins, activity, there are other areas in our educational which helped to bring die child accident . institutions where our young people compete problem to die fore in the minds of many, witheach other in terms of different skills physicians. At the present time there is in- and abilities. In the field of business we in formation, undmv.the able;chairmanriiip of. this, country have accepted competition as Dr. George Wheatley, a committee of the a basic .principle of our economic order, academy dealing with child safety from And. yet; among those competing organiza- aeddents. . tidhs there are many areas where they can MR. DEARBORN: I look forward to cooperate to a mutual end, an end which the closestkind of cooperation between our is of. common benefit. to the competing or- organizatioDS in .tins particular area where ganizations. And that benefit is determined, our interests; are common. I have been I dunk; by whether or not the enmmnn end preaching the doctrine of cooperation in the is good for- people as a whole, area. of hninan welfare^ particulariy as it We have, in onr own organization a pat- applied to our work; ever* since I assumed tern which was put into effect three years die duties of this office eight years ago: ago; what we call "conferences" in the tfif- Some of you might be surprised--some of ferent . fields of accident prevention. These 4 Home Safety conferences are comprised of representatives of the leading national organizations, public and private agencies in traffic and trans portation, local organizations for the promo tion of safety (home, farm, school, college) public information services, and industrial companies. Those organizations had these questions to ask themselves and to answer: What is the nature and the magnitude of the problem we face in our particular field, what should be done to solve it, and who should do what? They have to decide among themselves where the responsibility for this or that shall reside After this Conference organization was established, each group was advised that the Coimdl staff would no longer determine the program which the staff would carry out, but that each conference would deride the activities of its own staff people We hoped that our staff would be com petent to come before the different con ferences with good ideas, but it was the the responsibility of the conference mem bers to determine whether an idea was meritorious or not, and also whether it should be carried out by our staff or some other organization, or divided up among two or three. I assure you that this was one of the most revolutionary things our con ference members had ever heard of, and I doubt very much' that many of them be lieved it at first As time went on, though, I am sure more and more of the repm sentatives comprising the conferences have taken them seriously. I hope and I believe that in my time we wilt see representatives of other organiza tions coming to these conference meetings-- in fact, it is already beginning--with their own ideas to put before the group for its judgment as to worthiness and to be dis cussed for ways and means to effectuate them. When that time comes we'll hart real cooperation. I have hoped for a long time that sre might have a similar relationship with the various agencies in the field of public health. We need in this work of ours the help of the medical and allied groups of this country. I know there are areas of common interest Last January in Los Angeles I observed one of your number in action--Dr. Dietrich, personifying the kind of inter relationship I had been looking for, in his yrork for the prevention of accidents as well as in the treatment of victims, talking about safety as a matter directly concerned with his professional work. Eminent groups like the American Medical Association, the American Public Health Association, the National Health Council are already cooperating, and I wish to pay tribute to our own Dr. Armstrong our Vice-president for Home Safety, for his leadership in bringing about these better relations. This meeting is another big step forward, and I rejoice in it, as I think you people do. I thank you for joining bands with us in the prevention of accidents so these young people can grow into fine, strong, healthy men and women, so that our country may have the benefit of their pro ductive powers, no matter in which area of human endeavor they happen to fall. It's a great responsiblity that is yours and mine, and I think we should take pride and fed a great sense of satisfaction in working to gether in this field. The Pediatric Approach to Accident Control (A Symposium) Accident Control Through Pediatric Practice By HARRY F. DIETRICH, MJD. Associate Professor of Clinical Pediatrics, University of Southern California Medical School; Staff Member, Children's Hospital, Los Angeles, Calif. The efforts of practicing pediatricians to control childhood accidents must align them selves in four channels. First; the pediatrician must interest him self in, and enlighten himself on the prob lem. He must be keenly and shamefully aware of the monstrous toll in death and crippling that is caused by childhood acci dents. He must recognize that in every childhood year but the first, accidents are the number one killer of children. He must blush freely when he learns that in the first two months of the Korean War, while "do or die" Communist divisions with all the lethal weapons of combat were killing 600 of our desperately fighting servicemen, wt at b 2.00( must nitm & doct acrii pedi four is c injo com theii and able H pm urns com fon and don betv cabl B chflf don veai is a If i or i prof A rem five only com edu< is ; play of j pan R one obvi con veai the vulr ertt It by mat end pom exp men Accident Control Through Pediatric Practice at home, in peace and complacency, killed 2,000 of our own children. We physicians most awaken ourselves to the grisly mag nitude of this problem. Secondly, we must work effectively at the doctor-patient level to protect children from accidental - death and crippling. If we as pediatricians explain to parents that no foundation, no matter how wise or wealthy, is ever going to provide them with one easy injection to prevent accidents. If we can convince them that only they can immunize their children against accidental tragedy, and if we then aid them by providing stat able advice; then we can solve this problem. How can the physician advise on accident prevention? In adults, accident prevention most be engrafted like manners or military courtesy. In children, safe conduct is a form of behavior, and as such can be shaped Medical I and developed. A theory of accident prevenHealth I don winch embraces reciprocal relationships Council I between protection and education is applito pay I cable ig; our I Briefly interpreted, accident prevention in for his I childhood begins with 100 per cent protecbetter I tion. The non-ambulatory infant under one tig step I year of age, who is not adroit at dodging, ink you | is completely at the mercy of its custodians. If it is burned, drowned, poisoned, crushed, or mangled it is because it has been denied protection by those responsible for its care. Accident prevention in this age group is remarkably uncomplicated. At the age of five or six the child should need protection only from previously unexperienced or in comprehensible dangers. Admonitions and education he will still need, but protection is largely unfeasible because school and play remove him from the physical sphere of parental influence. Education will accom pany him, but protection remains at home. Returning now to the intervening years, one to five; their vital importance becomes obvious. In this short span of time die completely protected, wholly dependent one year old infant most he transformed into the safely independent school child whose vulnerability to accident has not been in creased by too much protection. It is apparent that this period is marked by bravely decreasing protection and dra matically increasing education. Towards the end of the first year an educational com ponent must be introduced, and then rapidly expanded to meet the astounding require ments of the six vear old. In general, our protective and educational practices most be tuned to the developmental level of the child. We know that the newly ambulant youngster is embarking on an orgy of exploration. He will taste, touch, test, and tag at every article within his ever growing reach. Anticipation of this be havior should indicate where protection is needed, and into which of our educational traps we can lure him. At around two years of age mimicry of older children and adults, negativism, and marked increased speech comprehension will complicate his singleness of purpose. With new sophistication he will test people and animals as well as objects. This and other anticipated behavior can readily be used in the application of the theory of accident prevention. Absolute protection must be maintained against lethal and crippling hazards, but the run-about child must begin to amass a back log of experience, and gam some practical concepts of pain, heat, gravity, non-edibility, etc. Split lips, technicolor braises, chipped teeth, bloody scalps, and even ample frac tures we must expect Properly handled by physicians and parents minor injuries are of tremendous and lasting educational value. This value must not be corrupted by morphmiring emotional poultices. Nor should the issue he benmddled with moral impli cations about "good children don't. .or saccharine parental pleas of "I wish yon wouldn't. . Pain is a warning that sur vival is threatened, and because the human body wants above all else to survive, lessons learned hr pain are not soon forgotten. I have suggested that the theory of acci dent prevention is a practical one; that is, usable. The tools necessary for its ap plication are few and readily available. They are forethought, time, and discipline. Fore thought requires that; within wide limits, a child's developmental progress and interests should be anticipated. Here the pediatrician has both a responsibility and an opportunity. At each major developmental level he can dispel parental tension by predicting and dissipating unfounded worries; he can at the same time arm parents with anticipatory advice which will enable them to avoid major dangers, and capitalize on the edu cational value of minor ones. Time might seem to be the tool in scarcity. Nothing could be further from W i: * ; - 'v`'ft 6 Home Safety fact. Even the time spent in feeding a young infant is .totally and pitifully wasted if that child is killed by accident. During early infancy we must physically bring food to the baby's moiuth; at any later age acci dent prevention is the only truly vital childparent activity we parents have. Can we not find time for this? Fortunately we can find time easily. Parents need only borrow a fraction of the time they spend on fruit less and unfounded worries to activate ef fective accident prevention programs in their homes. Here is another role for the pediatrician. He must not by his demeanor, his words, or his charges magnify minor ailments and situations. He must actively, and at the cost of his own rime, dispel old wives' tales, and correct pediatric fables that are written in the almost indelible inks of past genera tions of doctors. He must in short give his patients the perspective, composure, and confidence that will encourage them to spend their rime in the pursuit of safety for their children. Forethought and time. The third and indispensible tool of any juvenile accident pre vention program is discipline. Discipline is as necessary to a child's happiness as it is to his Ufe. Due to a misinterpretation of modern psychologic and psychoanalytic thinking, too many children have been deprived of the physical and ctock tional security that rests on mild, consistent and logical discipline. Here again the ad visory role of the pediatrician is both im portant and apparent. I cannot refrain from pointing out that accident prevention is not an isolated facet of child care. When pursued with imagina tion it contributes tremendous increments to all the components of a child's sense of security. The knowledge that his parents* love and affection will not permit him to do any truly injurious act, more effectively convinces the child of that love than any other parental display. His need for dis cipline is fruitfully satisfied. The knowledge that he gains from his parents' educational efforts daily augments his self-confidence. There is in fact no other single phase of child-parent relationship which so literally and largely enhances a child's sense of security. Having tended to his own and his pa tients' education, the pediatrician must next turn his efforts to the entire medical profes sion. In as much as medicine is dedicated to the creation and preservation of physical and mental health, no specialty can validly disclaim its responsibility in the problem of accident prevention in children. And hap pily, none will try to, but we, as pediatri cians, must seek their attention and show them the problem. So far we have had the pediatrician: 1. enlightening himself Z instructing his patients 3. enlisting his colleagues If he discharges these obligations effec tively he will be doing a good, but not a complete, job. There remains the need to organize and continuously reactivate com munity child accident prevention program?. The enlistment of the interest of already organized groups, that they may devote some; or more, of their efforts to home and child accident prevention will lend real power to any community program. In the evolution of the National Safety Council it was only natural that emphasis and major effort has been directed toward accident prevention in occupational, traffic and public situations. In each area, such efforts embrace education and protection (protection in engineering and equipment). I would like to suggest that there has been a terrifically wasteful and not fully effective reduplication of effort in the field of educa tion by each individual industry and com pany. Consider for a moment the entire accident problem. The problem of accident prevention in the nation presents a virtually endless list of variables that have somehow distracted our attention from the logical solution of the problem. We have somehow overlooked the opportunity to simplify the problem by using the two common denominators in every accident--the human being, and his domicile. Every accident victim, whether he has been injured in a mine, an aeroplane, on a tri cycle or in a bath tub usually spends 8 to 24 hours a day in a place of residence. The desire for, and principles of, safe behavior can best be taught in the home. Once ac quired at home, the basic practices of safe conduct will accompany the individual to school, on the street, under ground, in the air, and in all the places where men go to "make a living." In this endless variety of situations, when dealing with individuals cal proftsed d to f *. ^sical an validly jroblem of And haps pediatriand show atritian: ions effecbut not a te need to vate coraprogram;. of already ay devote to home I lend real L tal Safety : emphasis ed toward lal, traffic, area, such protection luipment). e has been y effective of tcaanv jnathe entire don in the ss list of racted our on of the looked the n by using in every s domicile, te has been on a tritends 8 to ence. The e behavior Once ac es of safe ividual to nd, in the aen go to variety of individuals Accident Control Through Pediatric Research who have been home sensitized to safe conduct, it is only necessary to point out, or protect against unusual or subtle hazards. Making the home the nidus of our acci dent prevention efforts has one very im portant psychologic advantage. Many indi viduals, too smugly certain of their own infallibility to heed warnings for their own protection, will attend diligently to advice aimed at protecting their spouses, relatives, or children. If the adults in the home are encouraged to teach their children safe con duct; the adults will unconsciously assimilate those attitudes. One cannot teach without teaming thereby. ' The pediatrician's role in accident preven tion in childhood is a multi-faced one. 1. He must gain an enlightened awareness of the problem. 2. He must attempt to immunize his patients against serious accidents by pro viding parents with the theory of accident prevention, and sufficient advice and en couragement to apply it 3. He must alert the entire medical pro fession to the gravity and needs of the problem. 4. He must enlist the aid of all available organizations in a continuous community and national child accident prevention cam paign. Under this latter, directive I have respectfully suggested to the National Safety Council that intensive effort to pre vent home and child accidents would exert beneficial secondary pressures in all fields of accident prevention. If we as pediatricians do this job wisely and well, it will, aside from saving lives and limbs, constitute a tremendous public service. If we don't accept this responsi bility, remember that accidents may be the toilers and parents may be the accomplices, but we the medical profession will be the accomplices before the fact. - Accident Control Through Pediatric Research By RUSTIN McINTOSH, M. D. Professor of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, N. Y. Any pediatrician has a vital interest in the prevention of accidents in infancy and childhood. He is well aware of the serious ness of tiie problem and has himself seen far more of the baneful results of accidents, many of them dearly preventable, than he likes to recall. But research in this field, in what you might call its clinical rather than its technical aspects, is for practical pur poses virtually in its early infancy. The need for imaginative thinking and for the formulation of definite plans and programs in the prevention of childhood accidents is only too obvious. . A little reflection brings out the fact that the nature and scope of the problem has not jet been dearly defined. When we allude to the seriousness of acddents at the early age levels, we are apt to point up the re mark with a reference to the statement that for a number of years past, accidents as understood in the,,Interntional List of Causes of Death have been the leading cause of death in successive age categories from one year of age up to the late teens and beyond, a statistic only too familiar to public health officers and actuaries, as well as to pediatricians. At the same time, we must recall that we are confronted by one of these iceberg situa tions: There is:a lot more to the problem than that part which shows above the sur face, and the hidden part can be in some respects just as serious. I need only call to your minds the estimate, based on a limited study, that for every death from a home accident, some 150 additional disabling acci dents occur. And I might point out too in this connection that the circumstances which build up to a fatal accident may differ from those that result in virtually negligible con sequences by as little as, literally, a hair's breadth. It is quite obvious, then, that while we cannot Ignore the challenge of the fatal acddents, which point up only too grimly the urgency of the need for a preventive program, in the actual formulations of a i,, rtf H s ! 1 iiii . . V. ,. r;Tu "% I c-ru-vl * '<v * ' *K j > V-i ii -ill 8 Home Safety program we cannot afford to confine our attention to lethal or even to permanently disabling accidents, but must address our selves to the whole problem of the avoid ance of situations out of which accidents emerge. What we need to know, it seems to me, is the total accident experience of a community over a representative period of time, with adequate records of all accidents suffered--probably suffered is too strong a word, and I should say all accidents of all types experienced--so that a basis might be available for valid comparison of one prophy lactic or therapeutic policy or program with another. No statistician would ask for less than this. But don't misunderstand me in the mean ing which I am willing to attach to that word community. I'm not talking about a metropolitan community like Chicago, much less New York. Some have even advocated that a fully detailed and documented study be set up to cover the whole United States. If all die world were paper and all the sea were ink we probably couldn't keep ade quate records of so vast and diffuse a problem; and besides, even the Federal Gov ernment couldn't afford to undertake the job. In formulating a research program we shall have to exercise some common sense and pick communities of a size we can deal with. We shall also want to apply considerable thought and critical discrimi nation in the selection of the types of com munity in which we can test the various hypotheses we plan to submit to judgment, the various questions we expect to ask of the data assembled. Industry has set the pattern in electing to study a limited community like drill press operators, or workers in an asbestos mine, or a factory, or some finite segment of industry like oil well drilling. In exploring the problem of accident control in childhood we must set different limits to our survey pattern. The community we select for study can be a family, or a number of families or households; or a school, or even a play ground; or it can be a village, or a town, or a doctor's practice; or several doctors' practices. But in laying down the postulate that we must have adequate data in regard to the take-off point before we can hope to measure progress, I am expressing neither the counsel of perfection nor the counsel of despair. It is necessary merely to insist that we select for close study a community ap propriate to the hypotheses we wish to test; and this can be made an entirely practical matter. Dr. John Gordon, of the Harvard School of Public Health, enters a plea for study ing the accident problem in much the same manner as projects have been set up in the epidemiology of communicable infections, leading to better understanding of their na ture and, in some notable instances, to great reduction in their incidence and practical importance. His comparison gets off to a good start: Deaths from accidents are re portable, and accidents which, lead to hos pitalization likewise become reported in a sense, and in a manner which makes further study of the individual case possible. But what of the accident that is patched up at home and never gets entered in a ledger? It is agreed that this type of episode cannot be ignored in any comprehensive approach to the problem. He suggests using public health nurses as scouts. Will it work? Per haps, but only if their number is large enough in proportion to the community un der study. In any event, it seems dear to me that before any such approach can yield fruitful information, not only must the com munity to be examined be appropriately cir cumscribed in the light of the available re sources for the project, but also the various component factors of any accident must be separately evaluated with a view to extract ing the pertinent information about each. In any accident we have a threefold inter play of (1) the person afflicted, (2) the agent by which injury was done, and (3) the setting in which the accident occurred I propose to make a few comments on each of these factors as they seem to me to have a bearing on the childhood accident problem. First, the person injured or, in epidemio logical terms, the host Much has been written about the accident-prone individual, especially in industry and in the field of automotive injuries. There is little question that the accident-prone adult exists and gets himself and others into a pile of trouble. On the other hand, I have seen a good deal of evidence of loose thinking when the effort has been made to apply this same concent to children. Is there such a creature as an accidentprone child? I don't deny the possibility. but ab die tbai dos star ous or t too: acd hoo sub is a the moi lots mea hav peri into V eno non inst indi stee to sun con do* nirif tun in t for V stm rest is t. revt sud trib of i con said one any era! wh< to ; we indi torj met the moi inter2) the id (3) mrred. n each me to xident idemhility. Accident Control Through Pediatric Research bat I would point out that the labeling of a boy or girl as accident-prone merely on the basis of his having experienced more than his fair share of accidents, without closer study of the environmental circum stances in die individual case, comes danger ously dose to oversimplification. Parental or other supervision comes into the picture too; it has to. Moreover, if we grant that aeddent-proneness does appear as a child hood trait, when does it emerge? I would submit the hyothesis that every young infant is aeddent-prone in the sense that we apply the term to adults, and what may be needed more than a study of the children who have lots of aeddents is a closer inquiry into the means which growing infants and children have at their disposal for learning by ex perience in such a way as to avoid getting into significant trouble. We need to correlate aeddent experi ence with the developmental sequences of normal growth. It is well established, for instance; that the curve of frequency of individual injuries as related to age mounts steeply from the moment an infant learns to walk unsupported, and there exist pre sumably additional inflections of the curve corresponding to the age of pulling objects down from a high level, the age of begin ning climbing; of descending a staircase; of turning knobs and switches, and so on. Here, in the field of developmental neuromuscular physiology, we have a highly fruitful area for dose study of the host We hear it said, largely on the basis of study of small samples of questionable rep resentativeness; that the aeddent-prone child is typically in revolt against authority. Now revolt against authority is in some measure such a universal and, therefore; normal at tribute of a child's life that the mere noting of its presence in a child who has got hurt contributes little or no understanding. It is said also that the overprotected child is the one most prone to get hurt, and certainly any school physician will testify to the gen eralization that it's always the spoiled brat whose mother is a worry-wart who seems to get into the most troublesome fix. But we are now characterizing the child as an individual, or are we poaching on the terri tory of the third component, the environ ment, and begging thefluestion by broaching the subject of social adjustment? Much more study and observation of larger groups of children along the lines of developmental psychology and the emergence of person ality treats is called for. An important beginning in this direction has been made by Fuller in her study of a carefully circumscribed community, the oc cupants of a particular nursery school in Minnesota. She makes a number of highly provocative observations, such as that at the two-year-old level accidental injuries are about equally frequent in the two sexes, but that in the age progression from two through four there appears a significant sex difference, with boys getting hurt appre ciably more often than girls, while for the group 'as a whole the referrals for injury decline; in other words, young children ex hibit a capacity to learn to keep out of trouble. Frequency of injury shows no correlation with intelligence-as measured by. psycho metric test At the same time, it is evident that children who play together are more apt to get hurt than do those who play alone. Ike personalities of the young chil dren who had fewest injuries bore certain resemblances to each other. On the other hand, the individual who had the highest injuries scores, while they were picturesque characters in the sense that their teachers and others filed a relatively large number of comments on their behavior, showed few traits in common except for the one gen eral characteristic that they all had problems related to harmonizing with group living. Suggestive correlation was found between frequency of injury and a variety of more or less measurable attributes: exceptional physical strength; a daredevil attitude; emo tional reactions easily aroused; impulsive or unreflective behavior; a rude or insulting attitude toward others, especially toward adults; and, in girls, the tomboy trait Obvi ously, certain of these characteristics derive more from environmental influence than from innate qualities. Dr. Fuller projects further studies along these lines, which will be awaited with interest In connection with aeddent-proneness and its elusive application to childhood, it is per haps worth pointing out that physical dis ability, so common a factor in determining individual susceptibility to acadents among adults; seems to play no such role in child hood. Children who have a congenital defect .:rtt-IiVTt > ,'-VJV` . XT s $r&.> * T f* -V : Hffe ^tr 10 Home Safety have a way of learning their limitations research effort until we are confronted with throughout the whole process of acquisition actual, rather than potential, victims. of motor skills, and there is reason to be lieve that by virtue of not bong tempted to attempt too much they succeed effectively in protecting themselves from harm. Similarly, a child who acquires disability, as follow ing an attack of poliomyelitis, approaches the problem of rehabilitation with salutary caution. The differences between children and adults in this regard deserve consider ably closer study. The second factor in any accident situa tion, the agent by which injury was inflicted, has traditionally received, and will doubtless continue to receive, its share of attention-- perhaps even more than its share. I say "more than its share" not because I would deprecate its importance but because in ar riving at an understanding of the genesis of accidents in childhood it seems to me a mistake to focus undue attention on the bullet or the gun, rather than on the fellow who let the child get hold of the weapon in the first place. Moreover, the putative agent of injury has sometimes turned out to be a red her ring. Closer study of instances of so-called Many accidents in winch the agent is nec essarily in the foreground--for example, cases of poisoning by some chemical sub stance--occur so infrequently and in such scattered geographical distribution that it is not until a series has been assembled and published that we become aware of the uni versality of the risk. Examples that might be cited include injury to the esophagus from swallowing caustic soda, aspiration of kerosene, ingestion or inhalation of lead, and the formation of methemoglobin from eat ing crayons that contain poisonous aniline derivatives or from contamination of weD water with nitrates. Research is involved in the study of the mechanism of injury, but the actual prob lem of prevention is chiefly one of educa tion. When a child is killed by a dose of phosphorus-containing poison which was in tended for a rat, the real question is "What ignorant or thoughtless person left poison where a child could get hold of it?" And that brings me to the third factor, the situa tion in which the accident occurred. suffocation of infants by their bed clothes, The setting--the environment, in a broad or by the pillow or blanket in a carriage, sense--is in my judgment the most fruitful has established the fact that a not inconsid area of study in this whole problem of acci erable proportion of these sudden and ap dent prevention in childhood. It is also the parently unexplained deaths prove to be due most elusive. One can even question whether to quite other causes, usually to some over we have adequate resources to conduct a whelming infection. It is not to be doubted valid study. I am referring here not so that where the agent is a primary and un much to numbers of field workers with pad avoidable source of risk, we are confronted and penal, filling out questionnaires, al with an obligation to apply all posable tech though they will be needed too. I am con nological and organizational ingenuity to cerned more with technics of studying mo diminish the risk. tivation in young subjects, but I'll come back Proper toys for infants can be constructed to that later. that are free from sharp points or cutting So far as the physical characteristics of edges and that don't permit detachment of the setting are concerned, we know the part fragments which might be swallowed or played by defective home equipment in de aspirated. Fool-proof, or what might better termining injury from falls, and a rough be called meddle-proof, gas stoves and elec correlation between the frequency of fatal trical equipment can be designed. We can injuries and low family income has led some improve traffic regulations, organize su students of the question to accept the con pervision of street-crossings, we can legis clusion that an improvement in the standard late for adequate periodic inspection of au of living of the lower gionps should in tomobile brakes, and we can agitate for itself lead to a reduction in fatal accidents adequate playground space to keep the chil in childhood. The validity of the reasoning dren off our city streets. The tragedy is may be questioned. A moment's reflection that we so often wait for disaster to prod makes one realize that the matter is far us into action after harm has been done, more complicated, being Inevitably concerned sparing our ingenuity and withholding our with family size, sibling rivalry, parental or of < cep! que as tig! the res C asp inct gm tail pro neti stai the tiot sch are onl; sur me I acc age mis tha dre hea alo aut dre par to to cor tati me g Hal tail hin on cur chi chi ma ma by yot yoi Br dre it ed with g moe back Accident Control Through' Pediatric Research 11 or other supervision, alcoholism, and a host of other components. Although we may ac cept the negative correlation between fre quency of accidents' and standard of living as a first approximation, we must not lose sight of the fact that the larger aspects of the problem provide a fruitful field for research. Of much greater import are the social aspects of the accident situation. Injuries incurred at home, in school, on the play ground, even automobile injuries sus tained in city streets, can seldom be properly evaluated in terms of simple ki netics. I have spoken of the promising start made by Elizabeth Fuller in observing the frequency of physical injury with rela tion to the social adjustment of nursery school children. More studies of this kind are needed, and they should be applied not only at higher age levels but also to home surroundings as well as to school environ ment. It has been stated that four-fifths of all accidents to children under five, years of age are due to errors of omission or com mission by adults. Need one be surprised that Fabian and Bender, in a study of chil dren admitted to Bellevue Hospital with head injuries, found a high incidence of alcoholism in the parents? These same authors, and others as well, ascribe to chil dren a variety of motives underlying or pre paring the ground for an accident: the effort to frustrate an adult, to penalize a parent, to atone tor a sense of guilt more or less consciously appreciated. Are these interpre tations really valid, and have we adequate means of confirming or refuting them? A great deal of study is needed to bring re liable answers to these questions and to ob tain trustworthy information from the child himself without our bang obliged to impose on' him a judgment based largely on cir cumstantial evidence and doubtful inference. There is good reason to believe that many childhood accidents stem directly from a child's concern over his standing in the cli mate of opinion of his own crowd. How many accidents or near misses are preceded by the challenge to show your gust? "I dare you to jump from that branch," or "I dare you to beat that car across the street" Bravery rates high ^s a virtue among chil dren, and certainly 'their open discussion of it shows that in general they care more about courage than about faith, hope, or charity. And when it comes to education of par ents, teachers, and others in the means of accident-prevention which are now common knowledge, can we point with pride to our record? I gather that the attitudes of prac ticing pediatricians in this respect vary all the way from deep concern combined with intelligent practice, to complete intellectual paralysis based on fatalism. Those who are interested are working out their own tech nics of parent-teaching, but none of them claims by any means to have the final word. Is not this another highly important field for research in-educational policies? In a primitive society, where the technical equip ment of the home is so elementary that the risk of a child's injuring himself perma nently is virtually negligible, it may be all right to leave the educational process to the child's own search for adventure. Perhaps one can concave of an environment in which it is both safe and practicable to let the child learn the inherent danger of heat by momentarily moving too close to the fire, of moving vehicles by getting bumped by the wheelbarrow. But for us in this country those days have passed with the passing of the frontier. Today's child, even the child on a farm, is literally surrounded by lethal weapons. We need to plan his education in the matter of risks by a carefully thoughtout program of adult education, so designed in its sequences as to anticipate, rather than follow, disaster. At every' age, we would want to have our children live dangerously --within the limits of perfect safety. Have we worked out these technics so as to ac complish the desired results? I would sub mit that here again we have an important area for investigation. In summary, I would point out that we now have the beginnings of an understand ing of the problem with which we are faced. There is certainly no point in our trying to run away from it Mortality statistics prove only too convincingly that we cannot escape the obligation of attacking it with all the resources , at our disposal. The scat tered suggestions which I have offered for a research approach do not by any means cover the whole field, but I hope that some of these challenges will be taken up. We must put ourselves in a proper posture of defense and prepare ourselves to move forward to the attack. t- i.f:f-f TdiSl ' 1 V :.! Ilffi * i *r* UVT' a'.Y` ;ri 12 Home Safety .8` SB`fi, s.g .. 5 ai b-3 The Challenge of Child Accident Prevention By HEROLD C. HUNT, D.EcL General Superintendent of Schools, Chicago, 111 With all the scientific knowledge that is today being applied to practical situations to make life easier, simpler, more healthful, longer, it is all the more tragic to contem plate upon that killer that intrudes upon us by taking so great a toll among our young est age group. I speak, of course, of acci dents among children. We have heard that, with the tremendous strides made in the conquest of communi cable diseases, child accidents now stand as the leading cause of death and disabling injuries among children from one to four teen years of age; we have heard how the reduction in death from accidents has in the past quarter-century lagged far behind the reduction in death from communicable dis eases; we have heard how home accidents claim die lives today of more than 5,000 pre-school children annually, a figure which exceeds the one-time death toll from diph theria when that disease was considered, some twenty-five years ago, as the world's worst child killer; we have heard how phy sicians are likening accidents to diseases and are working scientifically at their prevention and elimination; we have heard too how important and vital it is that education, safety education, practices on all sides .to develop a safety consciousness on the part of all people to the extent that accidents will not, cannot occur. It is in this area of safety education that child accident prevention presents a very real challenge to the teacher and the school administrator. Effective accident control is best and most readily achieved through wide spread public education. This represents, of course, a long-range program, but one from which the effectiveness will, in part at least, be realized as the procedure is bring de veloped and the learning process taking place. Base, naturally, is the development of public interest in the problem, awareness to the need for concerted effort in mastering it; understanding of both individual respon sibility in carrying on the campaign and the need for constant viligance concerning his own and his neighbor's safety practices; active participation in adhering to estab lished safety standards; and careful thinking, planning and study of the area for the development of a complete safety conscious ness. We have said that safety education is a long-range program. And so it is. It may and should be directed to, and for, all age groups from the youngest school child all the way through the high school and college student up to and including the parents and other adult groups who, in turn, will assist the pre-school child in the area. The full realization of the safety teaching will not be felt, however, until the whole generation, exposed to and participating in the program throughout the entire school career, has de veloped to the point where its children are .reared in the safety consciousness so pains takingly developed throughout the life of the parent group. It has been pointed out on this program that most child accidents happen to the pre school youngsters and that the greatest num ber of these occur in and about the home. It would seem, therefore, that the most strategic area for concentrated attention to safety education would be among the par ent group. That is true for immediate re sults but in the process the long-range program must not be overlooked. In it lies the hope for permanent improvement of the record. Let us examine for a moment the areas which can be stressed in the program of safety education for parents. First there is the subject of accidents in the home. Par ents must be educated to see that their homes are free from conditions which might prove unsafe; they must be educated, too. to give adequate safety instructions to their young pre-school children. Parents must be taught to make certain that home equipment is safe and that the places where their chil dren stay and work and play are safe. In the kitchen, for example, if older children want to help their parents, as they always do in this imitative age; they should be taught to use pot holders to avoid burns when taking anything hot from the stove; they should be taught that hands must be dry before touching electric plugs and that all nffl-oo -d. s>r<* s s9.a a a l thinkfor the iscious- m is a It may all age lild all college its and 1 assist he full rill not nation, rogratn las deen are painslife of rogram ie pre* num- botne. t most don to ie parate ref-r it . of the : areas am of here is t. Part their . might d, too. o their tost be ipment ir chillfe. In hildren ays do taught when ^ they be dry bat all The Challenge of Child Accident Prevention 13 electric equipment should be unplugged when not in use. They should be taught that nothing which can catch fire should be placed or hung near the flame of the stove. And the parent also makes certain that in secticides, disinfectants, poisons, fuel oils, c^ning fluids and the like are kept safely out of reach of young hands and mouths. In die safe hone the bathroom is carefully kept clear of loose razor blades and safety pins, buttons and other small objects that may cause trouble are beyond a child's reach. Medicines are in a high latched cabinet The parents make it a habit to mark and read labels carefully before using die con tents of any bottle or package. . In other parts of the bouse, small objects are out of the way so there is no danger of their being the cause of tripping or fall ing, guards on windows and stairs assure that youngsters will not fall through or down. Small rugs are fastened down, no objects are left on the stairs, hallways are well lighted. Within a safe house, safety practices be come second nature for young children. And in such a home we may be certain that the parents are ever on the alert to check any physical defect which might appear in the young child that could prove hazardous to his safety. Eyes and ears are checked to see that they present no difficulty and motor coordination is developed consistently. If this appears difficult every effort is made to de termine the cause and to correct it. Outside the house comparable safety pre cautions are taken. The yard is safe be cause no nails or broken glass or broken pieces of wood are about The clothes line is strung above even adult heads. Garden tools are put in appropriately safe places with pointed ends covered or protected. Leaves and papers are burned only in per forated, metal containers, an an adult always supervises the job. The cellar door is kept dosed, as are the garage doors except when it is planned to start up the car. Youngsters are taught to stay in the yard or on the sidewalk. In the company of their parents they early learn, however, to cross streets only at intersections, and only when traffic has been stopped by the light, or, where there is no light, only after a careful checking in both directions to see that no vehides are approaching. In recreational activities, too, safety char acterizes every phase. Appropriate super vision is.provided when necessary, and safety rules are understood and enforced. At the beach, the importance of remaining in shal low water is taught, as is the need to remain out of the water for at least an hour after eating Boating is permitted only with adult supervision. Proper protective equipment is provided for all sport and team games. Playing areas are free from holes, stones and other hazards. Education of parents for child accident prevention pays dividends when these and other safety practices become a part of the parent's consciousness and are in turn trans mitted to the children. The areas and the items listed seem obvi ous and die cautioning hackneyed. Their very simplicity, however, is the reason for repeated emphasis, for despite the efforts thus far, those simple ommissions or faults cause the greatest amount of tragedy and heartaches. In educating parents to educate their pre school chilren toward safe living, the teach ing may become especially effective when it is remembered that youngsters of this age are in the most imitative stage of their existence and that they will therefore read ily follow the pattern set by the parents. Safety practices of parents thus become the safety habits of the children. And these early developed habits will become the ones to lead the youngsters safely through life. When the child reaches school age the challenge of child accident prevention be comes greater and closer to home for the educator. Now the work can be accom plished cm a -first-hand basis with no inter mediary step to be blamed in case of failure! Tie responsibility is defined, it must be undertaken--and successfully so. Among children of school age (5 to 14), accidents take the lives of about 6,000 a year in this country. This figttre reflects some slight reduction during the past few decades, but there most be a much greater reduction, bordering on practical elhnination, if we are to feel that the job of safety education is bring carried on effectively. All of you are doubtless familiar with the various types of these fatal accidents--motor vehicle acci dents which account for a third of the total, those motor vehicle accidents occurring while youngsters are crossing streets or highways X :: M-t- 4-".> 14 Home Safety or are playing in the road; drownings which are responsible for a fourth of die acci dental deaths, drownings which come about not only as a result of swimming, wading and boating activities, but in addition drown ings because of falls from rafts or bridges, from banks or ledges, and drownings be cause of thin ice. Over ten per cent of the fatalities in this school age group are caused by burns, conflagrations and explosions, and nearly seven per cent are die result of fireanus accidents. Strangulation and railroad accidents account for still other deaths. From this listing it is obvious that much more must be done in die area of safety education. Most accidents are unnecessary. They must be prevented. Parents can, of course; do much to avoid accidents for their school age children, just as they can for their pre-school daughters and sons. Physicians bio can play an im portant role in sensitizing parents to the dangers and encouraging diem to take proper precautions both in training and in supervision. During the school years too, continued attention, to remedying or com pensating for physical defects of children will do much to raise the accident prevention score. Within the school itself, however, much can be done. Today, starting in die kinder garten and continuing throughout the high school, effective programs of safety educa tion are being included as a part of the cur- riculum. Safety at home, at school, on the playground, en route to school, are stressed in regular courses of study. Safe practices are pointed out, and praised and encouraged; carelessness and unsafe conditions are like wise explained but condemned and discour aged. The school environment is made safe and what is done toward this end is care fully interpreted with the thought that the same practice may well be followed outside of the school. Training in the "safest route to school" is carried on and in this activity the cooperation of parents is actively en listed. School safety patrols are: organized and the members develop a safety conscious ness for themselves and for their classmates and friends. School safety councils are elected and at their meeting the representa tives consider problems of safety and the elimination of hazards. Everywhere at all levels, throughout the school, safety becomes a key word, permeat ing the curriculum, the activities, the pro gram and the very life of the school, until the concept is firmly implanted in the minds and actions of every pupiL A new emphasis which is daily being in creasingly placed in school systems through out the country lies in the area of traffic safety education. Although an integral pan of the over-all safety program, this phase of safety education requires additional at tention not only because it represents the area in which the child mortality rate is the highest but also because. In Its modern appeal to young people; heightened interest, understanding and determination are more readily developed. Encompassing the whole field of motor vehicle and traffic dangers, traffic safety education aims at the develop ment of safe practices in activities all the way from simple crossing-of streets to the complicated problems of the correct han dling' of motor vehicles under all circum stances and conditions. Concentrated and meaningful attention to this vital phase throughout the school years will serve both to guide girls and boys safely through their school years and to make of them young men and women who will re spect the rights of others in traffic and motor vehicle situations. Behind-the-wheel driver education, the culmination of the ex tensive and continuing traffic safety educa tion program, is greatly facilitated by the foundation of correct thinking, habits, and practices which are developed in each school pupil through the traffic safety education program. The efforts of the school, however, sup plemented by the assistance of parents and the young people themselves, are not suffi cient to conquer the child accident problem unless the entire community is organized for action in this direction. The work of individuals and of groups--even large groups such as the school system--is still effective if there is no over-all organization to inte grate the procedure and make certain that specialized activity is not wasted because of lade of attention to a related area. The ef fectiveness of any effort to reduce the num ber of fatal and near-fatal child accidents will depend, in the final analysis, upon the interest of the community and the steps which the community as a whole takes to study the problem and activate the controls necessary for its elimination. The Challenge oj Child Accident Prevention 15 Perhaps the most effective way to initiate a community-wide child safety program is for some recognized community agency, to assume leadership in sponsoring the activity. The civic representation already present within the agency assures at the outset a spread of influence and interest Participa tion of other influential agencies such as the police department, the fire department, the park department, the health department, the board of education and many others, large and small, public and private, can readily be secured when the movement is inaugu rated by a well known, established group. By the ample procedure of calling an or ganization meeting, the original sponsor will be provided with representation from the various agencies and the movement will be under way. An early activity might well be to make an inventory of local organizations to make certain that each one capable of assisting in the program is represented. A survey of accident conditions, next undertaken, will indicate the areas most in need of immediate attention as well as all of the circumstances, some tittle suspected in many cases, which contribute to the problem. A careful analy sis of all of the physical conditions affect ing child safety, including the homes, the schools, the playgrounds and other recrea tional areas, as well as actual traffic condi tions, witi undoubtedly point the direction of activity. Enlistment of the support of pubbtirity and interpretative agencies and of press and radio outlets will assist in the de velopment of awareness and in the promo tion of enthusiasm for participating and as sisting in the program. With interest and awareness established and the organization developed to cany out the determined program, all efforts will be concentrated in a single direction and results will be almost immediately noticeable. From then on the problem is to carry on the ac tivity with continuing zeal until the con stant hammering on the theme results in a deep-seated safety consciousness for the en tire community. With this complete safety consciousness the accident problem is solved. The challenge of child accident prevention is, therefore, one of developing interest, awareness, and action on a community-wide bass, and of organizing and integrating the respective individual efforts to contribute to the over-all program. With concentrated attention on all tides the rate of reduction in child accidents will soon be keeping pace with the reductions in child mortality from communicable diseases which has resulted from scientific research. Organization for child accident prevention will yield, surely, these gratifying results and whether we are safety experts, medical men, educators, or just plain citizens we must work together for this goaL The challenge is for us to see to it that our children survive to fulfill the rich and worthwhile lives we covet for them. 16 Home Safety Let's Dis-Harm Our Homes (A Panel Discussion) Presiding: Tyler S. Rogers, Chairman, Home Safety Conference; Assistant to Executive Vice-President, Owens-Coming Fiberglas Corp., Toledo, Ohio. Participants: Leonard G. Haeger, Ass't Director, Div. of Housing Research, Housing & Home Finance Agency, Washington, D. C Stewart J. Owen, Jr., Chief Safety Engineer, U. S. Dept, of Commerce, Washington, D. G Frederick S. Kent, Chief, Special Proj ects Section, Bureau of State Services, U. S. Public Health Service, Washing ton, D. C Edith Ramsay, Home Equipment Editor, The American Home Magazine, New York. MR. ROGERS: The main idea in each of our three home safety meetings of this Congress is a particular "target area." in order to concentrate our thinking and in formation. and to develop the outlines of a program that will really save lives. We must shoot at clearly defined objectives, or "pin-point" our campaigns. Local, state, and national efforts tie in so closely--each job influencing the others and the total result-- that better integration is called for. All of these discussions will, we hope, be aimed right at our big target---the develop ment of specific and concrete program sug gestions that will actually reduce home ac cidents. In other words, we want our speakers to tell us how we can put the in formation they give us into community pro grams which will result in safer homes. A minimum of "back-patting" seems Called for. We should realize that however well we may have done in the past there is still much to be accomplished. The three specific target areas for the Home Safety Conference national program are: first, the home; second, the community; and third the state and nation. It is sig nificant that each home session of the Con gress this year will be devoted to one of these target areas. Our panel this morning will deal with the first target, the house itself, how to eliminate or diminish physical hazards in the home environment, including the building as well as its fixtures and ap pliances. We will try, with audience help, to develop definite campaign recommenda tions and responsibilities in this phase oi home safety. LEONARD G. HAEGER: Housing con struction this year is topping well over a million units--an All-American record. Yet one thing is wrong with this happy picture: we are building accidents into our new homes faster than ever before. In American homes in 1930, we can expect a total oi about 3,000,000 disabling injuries and 30,000 fatalities. This appalling casualty toll is unnecessary. Counting all accidents to people of all ages, it is much safer to work in a factory, or ride airplanes or trains, than to stay at home! The safety record in industry as a whole is twice as good as it is in our dwellings, and in certain outstanding indus tries is nine times better. But the compara tively low rate of industrial accidents cer tainly shows what can be done when a carefully-planned prevention program is put into action. The Housing Act of 1949 created a broad program of housing research for the Hous ing and Home Finance Agency. The pro gram is aimed at the National Housing Objectives as defined by the Congress. In its simplest form, these objectives are to help the housing industry, through research, in building better homes for Americans at lower costs. Inplidt in this is the patterning of homes to enhance American family life And certainly home safety is an important factor in our family life As housing has improved in so many ways in recent years, how is it that we continue to build accidents into our homes? In my opinion, a major factor in home accidents is the steady reduction of space whidi is an inevitable consequence of inflation. As costs have gone up, dwelling size has gone down. This creeping space reduction has followed in inverse proportion the rising costs during the past 15 pears. The resultant congestion boosts the accident potential in our modem kitchens, and throughout the 4 xecubrt ce help, unendahase of ng conover a rd. Yet picture: ir new nerican otal of I 30.000 Let's Dis-Harm Our Homes 17 vertical and horizontal circulation patterns in our homes. We are not doing enough of the right planning to prevent falls, for ex ample, by safeguarding stairs, etc. and to increase safety at many other critical points inside the home and to prevent our yards and gardens from becoming virtual boobytraps. Before probing ways oat of this dilemma, let me sketch briefly our work in the Hous ing and Home Finance Agency. As you know*, it is the Federal government's parent agency in the housing field. Its constituent agencies are the Federal Housing Adminis tration, a mortgage insurance business; the Public Housing Administration, concerned with the administration of subsidized lowrent housing programs; and the Home Loan Bank Board, a bank in the housing mort gage field which operates in a manner roughly parallel to the function of the Fed eral Reserve Board in the money field. The Division of Housing Research is a part of the Office of the Administrator, which also includes the Division of Shim Clearance, the National Housing Council, and other activities. In research, our acti vities cover both socio-economic as well as technological housing subjects. Our Division has no laboratories of its own but carries on its work through staff research and facilities of universities or non-profit founda tions. as well as the laboratories of other federal agencies. Of oar 59 present re search projects, at least 36 have significance in connection with home safety. Nine are related to health. Two safety projects concern fire preven tion. including the development of better, safer chimneys, and investigation of flame spread in houses. Two studies are aimed at developing sound home planning criteria. It is our hope to help establish sound planning standards which will cut down the accident risks to house inhabitants, as well as reduce the home finance risks of mort gage bankers. The remainder of the 36 projects are concerned with strength of the structure, obviously related to safety. Meanwhile, our constituent agencies have taken the lead in several areas of home safety.. Over the years the Federal Housing Administration, as an example, has assisted the gas industry in determining standards for gas heating units.* As a result, the label of the American Gas Association on a furnace today means that it is not only an efficient heating device but also a fire safe product The Public Housing Administra tion meanwhile has been working in a field of safety unique to large bousing projects. Through their efforts, positive steps have been taken to reduce the hazard inherent in the use of gas as a fuel, especially in large heating systems where accumulation of gas may cause major explosions. These examples indicate the efforts of our agency in the field of home safety-. Our services as a government agency are avail able, of course, for the guidance of home owners and the construction industry. At this time we offer more than 40 publications dealing with the construction, repair and maintenance of houses. In the end it seems to me that the whole business of promoting safety in the home is educational All segments of the housing industry, as well as home owners and ten ants, must pool their energies to overcome the present accident hazards in houses. I should like to suggest, then, that the Na tional Safety Council sponsor the creation in each community of a guidance clinic con cerned solely with "bnilt-m" home safety. The responsible local officials, namely the building commissioner, the health officer and the local fire marshal are the natural nucleus for such a clinic. Add to these local citizens representing the varied interests of the com munity, mix well and you have the basis, I believe, for reducing home accidents tre mendously. STEWART J, OWEN, JR.: Many of the accident hazards found in residences are of the type which can best be eliminated when the dwelling is designed and before construction is completed. It is difficult and costly to remove dangerous conditions after the house is completed and you have lived in it for a time. In localities with statutory requirements governing-the safe construction of dwellings and installation of equipment, it is mandatory' that they be complied with. Where there are no such regulations, it is strongly recommended that the standards issued by the National Bureau of Standards, the American Standards Association, the National Fire Protection Association and other recognized authorities be followed. When a person is about to build a home it is best to secure first the sendees of an architect to draw the plans and speerfica- mw ^.'-51 r.l J . .! .1 i 18 Home Safety tions ::i accordance with established stand ards' then to employ an experienced and reli:' le contractor to put up the house in stri' i accordance with these plans and spe cifications. In many communities it is required that house plans and specifications be approved by local building authorities before con struction is started. A wise provision some times embodied in the building contract is that the contractor must furnish the owner with a certificate signed by the proper au thorities that the dwelling is constructed and equipped in accordance with all applicable codes or standards. Such a provision not only saves the owner the expense of correct ing building code violations discovered after the house is finished and occupied, but it may also be of value to him when he applies for fire or other insurance on his property. The prevention of accidents in the home requires that the following be considered carefully before and during construction: 1. Use of fire-resistant materials in both exterior and interior. 2. Safe chimneys and fireplaces, and fire stops properly located in walls and floors. 3. Safe installation of heating and cooking equipment like boilers, furnaces, ranges, etc 4. Protection against vermin and termites. 5. Code-approved electric wiring. 6. Protection against lightning. 7. Adequate drainage of water from rain and melting ice. 8. Safe planning and construction of drive ways and walkways. 9. Adequate fire fighting apparatus. 10. Safe enclosures for ponds. Local libraries can usually furnish names and addresses of firms and associations who supply publications and standards applying to these subjects. Unfortunately, ordinances for the elimina tion of fire and other physical hazards in dwellings are not uniform in different local ities. However, the National Bureau of Standards, the American Standards As sociation, the National Fire Protection As sociation, associations of architects and builders, and other authorities are cooperat ing to improve this situation. It is worthy to note that the National Bureau of Stand ards iias a division composed of technically trained men engaged in laboratory* tests of building materials and other special research. Their findings are used toward development of uniform building codes for the design and construction of safe and efficient homes for our people. After a dwelling has been completed it is essential, of course, that it be kept in a safe condition. Both old and new houses, though carefully built, need occasional re pairs. Like other kinds of property, houses will deteriorate, become unsafe, and decline in value if they are not properly cared tor. Alertness to signs of wear can often elimi nate the need for major repairs, which us ually begin with minor defects. A faulty electrical fixture can cause a dis astrous fire; a sticking window can result in glass breakage and injury; bad plumbing can cause ceiling plaster to fall; a leak in the roof may produce rot in framing mem bers of the house. For such reasons, pe riodic inspections should be made and any unsafe conditions corrected without delay. The repair work involved, especially it major, should be undertaken only by some one trained and skilled (and licensed in some cases). These regular inspections should take in all parts of the house, its equipment, fix tures, etc. If the foundation walls are of concrete, they should be examined for cracks; if they are of unit masonry*, the joints should be examined for loose or fallen mortar. Wooden sills on top of the founda tion walls should be checked for deteriora tion and for cracks between wall and sills that are not calked to keep out moisture and cold air. Girders and beams which sup port the floor joists should be examined for settlement, sagging and, if the material is of wood, for shrinkage. Treads and stringers of stairs need to be examined' for splits and secure fastening. Steps should have at least one solid handrail, be well lighted and never used as a catch-all or storage place. Check for signs of break-down in basement posts, sills, joists, and other woodwork from termites, etc Look also for evidence of dry-rot, especially in sills and at ends of joists adjoining masonry. Because there are many types of heating systems, inspections necessarily vary in de tails. Automatically controlled equipment such as oil burners, gas furnaces, mechanical era mai iac ties ma: ant me I fire be Boi era pip the No chi the me teri are brii anc fra loo bro doc par thr we anc rio I cor bre she cot the pip ful COE are 1 wa cot of of wit foi ma fre suj net cep nically :sts -' sc IJWli.il design homes :ted it t in a louses, al re houses fecline d for. elimi:h us- a disresult tubing ak in mems. pe el any delay, ly if somesome ke in . fixre of for undariora! sills isture . supd for ial is ngers splits ve at 1 and place, ment from e of is of ating i de ment nical Let's Dis-Harm Our Homes 19 coal stokers, and water heaters should be maintained in accordance with the manu facturer's instructions. In some communi ties, public service companies offer limited maintenance, but in any case, adjustments and repairs should be made only by trained mechanics. If the grates are warped or broken, or if firebox walls are cracked, new parts should be obtained and repairs made promptly. Boilers should be examined for possible cracks or leaks, a check made of the heating pipes to see if they need re-covering, and of the smoke pipe where it enters the chimney. Notice whether woodwork adjoining the chimney requires fireproof covering to lessen the fire hazard. After the basement structure and equip ment have been inspected, the house ex terior should be gone over. If the walls are of masonry*, there may be cracks, broken bricks or blocks, especially above the door and window openings. If the house is of frame construction, siding boards may be loose or rotted. Examine the windows for broken panes and loose putty; the outside doors for defects in the wood or metal paneling, glass or hardware: Sills and thresholds should be inspected for extent of wear and soundness of fastenings, and steps and porches for structural defects, dete riorated materials, and insecure fastenings. If the roof is of slate, tile, wood or composition shingles, see if any pieces are broken, missing or loose. Sheet metal roofs should be examined for holes, open joints, corrosion, rusting and defective fastenings; the flashing around the chimney and vent pipes, and in the roof valleys, checked care fully for rust or displacement Notice the condition of the gutters and water pipes to determine whether they need replacing or repair, the chimneys to make sure they are in good condition. Inside the house, examine doors, stair ways, walls, floors, etc, for any defect which could cause an accident. Note the condition of all plumbing fixtures and pipes, as well as of electrical fixtures. Inspect all exposed wiring to make sure it is the right type for the purpose and fully insulated. As a matter of expediency, the householder will frequently employ an extension cord to supply an area not movided with a perma nent outlet While that practice may be ac ceptable temporarily it should not be con tinued longer than necessary. Permanent wall outlets should be installed as soon as practicable, with help and advice from the local utility company. Check-lists to guide these periodic inspec tions will be found in National Bureau of Standards Grcular 463, "Safety for the Household," and Circular 489, "Care and Repair of the House." Those two publica tions contain much information of value to the prevention of home accidents. Suitable check-lists may also be obtained from the National Safety Council, Chicago, I1L; the American Red Cross, Washington, D. C; the National Fire Protection Association, Boston, Mass.; or from the local agent of your fire insurance company. In any community the whole-hearted team-work of all residents will accomplish much to decrease home accidents. In many localities, women's clubs have formed safety committees to look into local conditions and take steps to diminish the toll from home fires and accidents. Parent-teacher associa tions can perform a similar service. The or ganization of a safety council in any com munity will do much to promote home safety if a good program is adopted and every citizen does his or her part. Full information on the organization of an effective local safety council may be ob tained from the National Safety Council. The American National Red Cross also fur nishes data helpful in the development of a community safety program. - The subject of safe homes also can be stressed by school teachers. More and more schools are giving instruction in accident prevention, and where this has been done the results are apparent in statistics on home accidents particularly. I assure you that we of the United States Department of Commerce want to do all we can to reduce the number and severity of accidents in American homes by making them the safe places they should and can be. FRED S. KENT (Summary of Mr. Kent's Remarks) : In a study of 1,000 families out side Boston who had been re-housed in gov ernment sponsored modem dwellings, cover ing a period of two years before the move and some time afterwards, it was brought out that the type of accidents changed. For example, in the old houses, stairs were a major factor in accidents, as were steam radiators and old stoves. Rotten and loose boards also accounted for quite a few in- it >y>VM: S - ` . ... .. \ :: 1. pB * r.* 5- ij~ L'j.' __ ' III 20 Home Safety juries there. In the- new houses, explosion from incinerator dust was a significant type. Mr. Kent cited the case of a friend's family who moved into a new $25,000 home. Three days later, the 31-year old wife was killed in a home accident She opened a hall door, thinking it was to the kitchen, and fell down the cellar steps. There were three major accident hazards in that costly house: 1. No landing at top of basement steps. 2. No hand rail on them. 3. No automatic light switch controlled by the door. He pointed out that with the normal span of life increasing, every' effort should be made to design and build accident hazards out of houses, for the sake of disabled and elderly people especially. He stated that home accident prevention is an important adjunct for public health programs. EDITH RAMSAY: One of the Mg fac tors in home accidents is laziness. The usu ally disastrous result of that is clutter and disorder, things left around in the way to be put aside "sometime" instead of having a place for everything and keeping it there; using a rickety chair to stand on instead of a safe step-stool or ladder. Without organi zation and good management in housework, accidents are hard to avoid. There has been a lot of talk about the modem woman being able to "take" things. But if daily' routine is not planned so that energy and time for running a home are not used efficiently, even the best woman may turn into an old-fash ioned nag--and that is no longer smart! From laziness and failure to plan comes that great foe of home safety--fatigue. It was proven many years ago that long work ing hours for men in industry did not pay. Now, women are awakening to the same realization for themselves. We know now that a complete analysis of our time is a real investment; to counteract die effect of emergencies when we most, for example, spend long hours awake with a ride child and still get up to do a wash. Instead of an exception it is now a rule to arrange systematically the things you are going to use for a job before you begin it, whether it be cooking, dishwashing, cleaning, sewing, or any other work. This business of homemaking has been blessed in recent years with many things to help make the "woman's work is never done" statement far less true. Ten years ago, the automatic washing machine was well on its way, and now we have many reliable ones to choose from, though all are expensive compared to the roll-wringer type. The tumbler-type clothes dryer has done even more for fatigue-saving and safety than the automatic washer. No more carry ing thosetwo tons of dryclothes (four tons of damp dry) per year! The average fam ily of four has two tons of laundry a year to be carried up the cellar stairs and out into the yard, with fatigue and accidents as a result When the automatic washer is turned on the laundry is quickly and easily done, lifted to the automatic dryer dose by, and is caught up with safely from day to day, as our heroine, the modem housewife, goes about her other jobs. And with many fab rics today which don't need it she has much less ironing to do or can rit down for that job with an adjustable board or an electric mangle, in a chair with a comfortable back rest and with music from the radio to work by. What about food preservation in the home of today? It used to be that this could be done only by canning, but the last decade has brought freezers into two and one-half million homes. No more scares from botulinous poisoning; no more hazard ous pressure canning; no more standing over hot and dangerous open kettles in a hot and stuffy kitchen. Yes, why boil when you can freeze? And haw a better and safer product too! Then there are automatic dishwashers. Unsanitary cloths and mops, tea towels and their incumbent germs are out of the picture, for the electric dishwasher uses such hot water and strong detergents that cleaning and salutation are done quickly and effectively, with the incidence of family colds bring thus cut down and mother again a well and gay companion instead of a drudge: The water is kept at a safe temper ature; for the water heater can be regu lated easily to the requirements for sanita tion and safety. Other modem improvements in home equipment which males housework easier, pleasanter and safer for women are rinks of proper height; easily-wrung sponge mops; gas ranges with automatic ignition for both S. *>a S* B SB K* f tn <S '3 3 ,g, g 5 gRfe>'tS` S ;g -g S '3 J ^ ,, ,g . B 'S 8 t ^ ( S ' E I ' never yr many ill are type. done safety carrvr tons : fami year id -out nts as ed on lifted nd is ay, as goes r fabmuch r that lectric : back lio to > the t this e last > and scares tzardnd' in when and shers. owels f the uses > that y and amily again of a nperreguutita- hotne aster, sinks mops, both Our Second Target--The Community 21 oven and top f burners, electric* waxers to remove the excess wax which! often causes falls and to make floor waxing easier, in-, stinctive safety releases for washer wring ers, automatic waste disposal units, etc. - Each member of this audience should go out and sell ten un-safety-minded people on the prevention of home accidents, and each one of those should sell ten more on the simple methods for reducing the ap palling. annual, national toll from these preventable casualties. Perhaps we need a National Safety Award like the Good Housekeeping Seal, presented each year at the National Safety Congress; or awards for the safest mother, father, or child during the year. Industry may be brought into the picture for the financial assistance needed, as well as associations like the American Home Laundry Manufacturers' Association, the Home Division of the Edison Electric Company, and the American Gas Association. It is good business for the insurance com panies to prevent fires, and they have done a terrific job in fire safety education. The automobile industry knows that investments in traffic safety education are money well spent, and that area of accident prevention gets a big play at this Congress. Advertising is at a new low ebb, according to. one of bur largest retailers; for it em phasizes price, price--not quality. Buyers in retail., establishments need to get away from those profit and loss sheets and once again learn their products to help their advertising departments sell safety and qual ity. The Advertising Council needs more teeth in its accident prevention program through retail stores. It' is the duty of the National Safety Council to inspire home equipment manu facturers to make and promote the use of safe equipment in our homes. To accom plish this there is a great need for a facility like Underwriters' Laboratories to test and approve for safety all household items not already provided with such serv ice. I wonder how many manufacturers have been approached about supporting safety standards for all home fixtures and equipment Such protection for the women of this country is certainly something to think about, and quickly, too, before we lose many more lives in home accidents. Homemaking is the most wonderful oc cupation in the world, but this great women's industry is the most unorganized of alL With more and better tools to help us be better, safer managers at home, let's carry this torch of safety into every home in this country. If the industrial front can mobilize for it, so can we! Our Second Target---The Community Preliminary Remarks (Summary) By MRS. GEORGE WELLES, JR. Vice-Chairman, Home Safety Conference, National Safety Council Mrs. Welles reviewed the three target areas under cousideratioa at these home safety meetings--the home, the community, and the state and nation--and stated that the community would be the target for this session. She explained that toe new system of annual Home Safety Merit Awards, established by the Home Safety Conference this yeaj, is to nationally recog nize exceptional public service in the- prevention of home accidents by local organi zations, to encourage more widespread and intensive activities in home safety education, to improve the reporting of home accidents, and to rid future-program planning through the exchange of ideas and information be tween local and national groups. The eleven Merit Awards give this first year were for all-round community programs, and the four Honorable- Mention Certificates for a par ticular outstanding project 22 Home Safety Presentation oi Home Safety Awards for 1950 By NED H. DEARBORN President, National Safety Council The following were cited for exceptional public service in the prevention of home accidents during the year 1949-1950 and presented with Award for Merit certifi cates: Automobile Gub Safety Council, Winona, Minn. Greater Dayton Safety Council. Dayton, Ohio. Kalamazoo Gtv-County Health Dept, Kalamazoo, Mich. Kansas Gtv Safetv Council, Kansas Citv, Mo. Greater Los Angeles Chapter, NSC, Los Angeles, Calif. Middletown Safety Council, Middletown, Ohio. Greater Minneapolis Safety Council, Min neapolis, Minn. Rochester Safety Council, Rochester, N. Y. St Joseph Safety Council, St Joseph, Mo. Utah Safety Council, Salt Lake Gty, Utah. Women's Institute of Duluth, Duluth, Minn. The following were cited for meritorious activity in home safety education during the year 1949-1950 with Certificates of Honor able Mention: Atlanta Qjapter, American Red Cross, Atlanta, Ga. Girl Scouts of Chicago, Chicago, III. Oklahoma Agricultural Extension Service, Stillwater, Okla. Sedgwick County Chapter, American Red Cross, Wichita, Kans. We Point With Pride (Description of Five Award-Winning Programs) WALTER D. LADD, Manager, St. Joseph Safety Council, St Joseph, Mo.: I have been impressed throughout some fifteen years of effort to reduce home ac cidents through education, with the ineffec tiveness of our methods. The emphasis on traffic safety' has caused the equally im portant field of home acddent prevention to be neglected. We know all about home accidents, or at least enough to instruct peo ple in what the dangers are and what to do to avoid them, but so often I have left a meeting feeling that it had been largely time wasted. And the results in my town and in' others seem to confirm this belief. So in St Joseph, Missouri, we have de vised a new vehicle for home safety edu cation, and we call it the home safety party'. It is a simple method in all respects but one. We ask any woman in our town and county* to invite a group of her friends or her neighbors, or members of a small dub, to her home for a safety' party. Then we said a competent home safety engineer to conduct the party*. It is just another way of giving a home safety program, but it has the party* flavor. We give an attendance prize, and we give the hostess a prize, and we give chances on two merchandise prizes, value $20 and $10, which are drawn for when 300 women have attended the parties. The hostess serves light refreshments, coffee or a soft drink and cookies. We pay her 10 cents a person for the refreshments. Our speaker gives his talk, using a num ber of gadgets to illustrate his points and making demonstrations so far as possible. He also makes a safety inspection of the home, not a snooping expedition, but an inspection that he works in with his talk, pointing out any hazards observed and also praising good features of the physical lay out. The home safety party plan has two fea tures that are not found at the usual home ester, iluth, nous g the snor- TOSS, vice. Red ome ivor. give > on $10, rave rves rink rson umand ible. the an alk, also lay- :eatme We Point With Pride 23 safety meeting in a place of assembly. First, it has an intimate atmosphere. You have to get people to take home safety personally, to visualize home accidents with relation to their own homes. The guests are together in a living room in a home, and they are given plenty of opportunity to take part in the program through discussion and partici pation in demonstration. The speaker is able to get closer to his audience. Second, the meeting is in a home, the place where home accidents occur. The audience is shown the things the speaker is talking about They see stairways with out handrails and without lights. They see a polished floor on which a throw rug slides underfoot and, they see that rug anchored with a sheet of rubber so it will not slip. They can try it for themselves. They see and hear a home fire alarm in action. They learn what it costs. They examine a home fire extinguisher and see it work, see how easy it is. They see the top of a stairway with a door opening dangerously down the first step instead of having a landing beyond the door. They are shown, and can handle, a broken porcelain faucet handle with its sharp edges that can cut the tendons in a hand. For once, they get dose to the com mon home hazards, so they can visualize like conditions in their own homes and go home and compare them. They likewise see the good things and can compare or con trast them with conditions at their homes. Finally, the home safety party plan is applicable anywhere, in a big dty, a medium sized town, or in a rural area. We have held parties in farm homes and in city homes and apartments. I said earlier that this is a simple method of home safety education, with one excep tion. That exception is the hard work it takes to "sell" the plan wdl enough to the housewives to get good coverage. A group of people must really work to set up enough parties to reach a large number of home makers. But, given good speakers, who know their subject and can answer questions and discuss their subject fully and intelli gently, and given a good working group who will keep the plan going, it b an in teresting and successful approach to the problem of effective home safety education. MRS. MURRAY Y. CALLISTER, Vice-President, Women's Division, Greater Dayton Safety Council, Dayton, Ohio: Our Women's Division is composed of safety chairmen from local organizations like paro chial and public school P.T.A.'s, women's dubs, etc, and anyone else interested in safety education. These organizations stress special aspects of home safety simultane ously. Monthly, from September through May, 28,000 NSC Safety Bulletins are dis tributed to homes through all schools in Dayton and Montgomery Counties on all four grade levels, and home safety instruc tion b given in school classes. We have a committee which gets in formation from local hospitals each month of the number and type of home aeddents, both non-fatal and fatal, and this evidence shows the number is decreasing. Each meeting b followed by a sodal hour, which has proved to be an excellent means for an informal and more effective discussion of safety problems. During Fire Prevention Week, we dis tributed 50,000 leaflets, and the interest shown was very encouraging. Our `activities are planned wdl in advance, and have sea sonal appropriateness as wdl as variety in subject matter. We strive constantly to in crease our membership and arouse interest in safety education. Of particular signifi cance the past year, we think, was effective emphasb on the elimination of outdoor, hazards to children. MR. A. PAUL FRIEDERICH, Chair man, Home Safety Committee, Rochester Safety Coundl, Rochester, N. Y.: Our organization promotes home safety continu ally. In the past year we sponsored a baby-sitter training course through the schools and Red .Cross, a dean-up week, distribution of over 42,000 pieces of safety education literature (induding 10,000 to elderly people through social agencies), a permanent "talking house" exhibit, depart ment store advertising of safe household artides with safety messages; collaborated with doctors, and public health officials in the passage of a safer housing law; ar ranged a study of human factors in aed dents, home safety' instruction for visiting nurses, and constant promotion through radio, newspapers, films, and meetings. We have a block leader organization pro^ viding for a visit to every home in each block by the leader four times a year, to ' discuss home safety, health, eta, with the families and distribute safety* literature. ~>-*i . ' M. 24 Home Safety MRS. GEORGE P. PARKER, VicePresident, Utah Safety Council, Salt Lake City, Utah: One of the outstanding results of home safety work in Utah is the broad cooperation which has been won to the cause. We have been able to channel our program through the facilities of many participating groups and agencies. The per sonnel of our Council's Home Division, which meets regularly during the year, has been chosen from those organizations most interested in home welfare, and consists of representatives from the Parent-Teacher Association, Utah Federated Women's Clubs. Public Health Nurses Association, Girl Scouts, Red Cross, Labor Auxiliaries; Latter-Day-Saints, Catholic, Jewish and Protestant churches. It also includes a doc tor and an architect. Each member brings his group's particular safety problems and methods of approach. Utah newspapers are always willing to publish home safety releases sent to them, and give several thousand inches of news paper lineage each year. Radio stations have also been very fine in giving broad casting time, on special occasions as well as regularly throughout the year. The new est vehicle for public dissemination of news and entertainment--television--has been very gracious in this respect; too. Through these .media, many thousands of people in Utah are being reached with home safety educa tion continually. Our Home Safety Bulletin, with about 3,000 copies, is published quarterly, contain ing timely suggestions for seasonal activities of member women's clubs, church groups, and local safety councils. Safe toys, for example, were stressed in the Winter Bul letin. Through these channels it is distri buted to all sections of the state. Several special events are held each year, one of which is a Home Safety Week, pro claimed by the Governor during March or April--spring hosecleaning time. Through this observance we can make an extra-effec tive effort in highlighting and pin-pointing a certain phase of home safety through all regular promotion services and special meet ings in churches, schools and on public oc casions, using films, demonstrations, etc. Films selected for showing during Home Safety Week this past year were: "Home, Safe Home," "It's Your Home--Plan It Safely," and "Miracle in Paradise Valiev." Retail stores cooperate by giving space in windows and show rooms for displays. An other project was the production and dis tribution of a pamphlet alerting mothers to dangers surrounding small children. All hospitals cooperated so that each mother received one of these pamphlets when she left the maternity ward. A home safety check list was distributed through schools all over the state, and the State Federation of Women's Clubs has set aside at least one program each year for safety education. Through public health departments and visiting nurses, much more safety information and material has been gotten into Utah homes. The Council worked with Johnson & Johnson in their "Emer gencies don't wait" campaign to get first-aid supplies kept in all homes. On our agenda now is a project for gathering statistics on non-fatal home ac cidents, to be publicized on radio public service programs. We also propose to work for a National Home Safety Week, believ ing that such a period for unified, concen trated action would help point up each year the ever-present necessity for constant vigi lance against accidents in American homes. MRS. GEORGE WELLES, JR-, repre senting the Women's Institute of Duluth, Minn.: In cooperation with the St Louis County Safety Council, our organization developed standards and training classes for baby' sitters, promoted fire safety through distribution of a letter to 16,000 families of school children, and actively supported the safety council in organizing home safety programs in smaller outlying communities. tinting gb m. ic oc.tc. Home Home, an It illev.*' ice in AnI "disJthers - AH (other a she buted d the is set r for lealth more been srked imer>t-aid for ; acublic work diev- kx vigixnes. :preJuth, -ouis ition t for High 3 of the ifety ides. Now You Listen to Usl (A Panel Discussion) Discussion Leaders: Mss. Eugene F. Sims, Program Director, Girl Scouts of Chicago; Mary M. Weeks, Health and Safety Advisor, Girl Scouts of the United States, New York. Participants: Scouts Flora Slutzker, Carol Ross, Barbara Wiloams, Dartha Cloud man, and Sally Rothschild. MRS. SIMS: As we all know, over 90,000 people die needlessly in accidents each year in America. During 1949, 1,403 of these deaths were in the dty of Chicago. Accidents cost America, over seven billion dollars annually, including fire losses, medi cal expenses, production and wage losses, property damage, training of new workers, and so forth. America has the worst acci dent situation of any civilized country, and we pay a terrific price, not only in dollars and cents, but also in suffering and anguish. Of all accidents in this country, those in homes kill and injure more people than any other type. In Chicago last year there were 447 deaths and about 68,000 disabling in juries from home accidents. In our program, health and safety are not topics to be just "talked about" but are ways of "doing" that bring enrichment of life. Effective safety education is vitally impor tant in all our work. Adult leaders, guided by our manual "Safety Wise," encourage Girl Scouts to recognize dangerous situa tions, to maintain a sane attitude about correcting them, and to meet unavoidable _hazards intelligently and courageously. These results are best achieved by learning just what to do under actual conditions of everyday life. Chicago Girl Scout troops at all three program levels carry on many health and safety projects during the year. Brownie Scouts, age 7-10, are primarily interested in their own homes and families. Most of their service is rendered to their homes and the occupants. The Intermediate Scouts, age 10-14, participate in a badge program which embraces eleven fields of interest, Health and Safety bong one of the most popular. Senior Girl Scouts, age 14-18, do a great deal in the Health and Safety field through their activities in Child Care, Hos pital Aide and Nutrition Aide training. By means of the question and answer period which follows we will point- out how the Girl Scout Health and Safety Pro gram fits into Home Accident Prevention. Questions and Answers Question: Sally, could you tell us some of the ways that Brownie Scouts help to make their homes safer? Answer: Brownie troops emphasize mak ing homes safe from accidents. One troop decided that each girl would keep a weekly record of the things she did to keep her home safe. This was a three-month project and a committee of troop members drew up a chart to be kept at the meeting place. The chart had each girl's name on it with a space for each week. As the girls brought in their weekly lists of activities they were checked off on the chart. At the end of the three months, the Brownies who had remembered to turn in their lists each week and who had made contributions to the health and safety of their homes were awarded certificates. The Scout who bad removed the most hazards was crowned Home Safety Queen. The certificates meant nothing in them selves. It was the learning experience the girls had while earning them. One of the things the girls learned was how and when to roll the fire department, the police de partment, and the family physician. They did skits to show what to do and that you won't do the right thing in an emergency unless you know ahead of time what you're going to do if a certain thing happens. They talked at meetings about children stay ing away from things like sewing machines and hunting equipment. Question: Flora, How does the Inter mediate Girl Scout badge program fit into this picture? Answer: As the girls grow older and they can do a greater variety of things. They become Intermediate Scouts and take part in a badge program covering eleven fields. Health and Safety is one of these, and it is very popular with the Girl Scouts of 26 Home Sajety Chicago, as evidenced by the fact that last year it ranked third in the number of badges earned-- 1,306 (out of 5,400 na tionally) -- only Homemaklng; Arts and Crafts having more. Many of the badges earned were for Child Care, First Aid, and Home Health and Safety. Eleven badges require work in Home Safety, and thirty-six others have one or more requirements dealing with health and safety. For the First Aid Badge, the Scouts take a Red Cross course; in earning a Childcare Badge they learn what to do in case of accidents. Intermediate Scouts make over old toys and give them to hospital patients at Christmas, making sure the toys and other articles are safe. Question: Has any of your troops carried on special Home Safety projects during the past year? Answer: Yes, one troop discovered through informal discussions that there was a great need in the neighborhood for a safety education program. A committee of girls was appointed to work out a plan of action, and derided to do a home safety program and take a first aid course. A questionnaire for distribution to house wives in the neighborhood was compiled, de signed to discover the most common home accident hazards. The troop members worked in twos, and each pair took one block of a street. They put on their best Girl Scout manners to go with their urnforms, and went from door to door pre-scnting the questionnaire to die lady of the house, explaining its purpose and the reason for their interest They went carefully over each question with her, and got her answers. Then they made a report to the troop, from which the group worked out a plan to pre sent to the school principal -whereby they could get all students to help in clearing up some of die unsafe conditions in their homes. Young people are usually enthusiastic about group projects, and the' idea of doing something that would really show results was well accepted. The schedule set up for four successive Saturdays was: (1) Clean attics and dispose of waste materials; (2) Clean back porches and back yards; (3) Clean basements; and (4) Clean garages and remove any flammable materials. In homes where there were no children, the Girl Scout troop volunteered to help with the work. The girls made posters and put them around the neighborhood in stores and also of all of the school bulletin boards. As in all projects of this kind, there were hitches, but the results as a whole were excellent. Not only were the people in the neighborhood alerted to home accident haz ards, but also the project opened up new avenues of activity for the Girl Scout troop. The school faculty was pleased and arranged a special assembly at which the troop was honored for originating the idea. Skits, de picting some of the project activities, were enacted by the students and safety songs were song. This project was in keeping with the Girl Scout program, and the troop was very pleased with the results. Another troop project was a skit during Fire Prevention Week which was good enough for presenta tion at the school. One troop visited their Fire. Station for instruction in the preven tion of and protection against fire. Question: Barbara, what kinds of activi ties do Senior Scouts carry on in Health and Safety? Answer: Senior Girl Scouts do a great deal in Health and Safety' through the Childcare Aide program, and many of them become hospital aides and nutrition aides. In all of this work they* leant basic health and safety facts through study' and practice. A great deal of valuable basic material is found in National Girl Scout publications, like "Safety Wise," "The Girl Scout Leader Magazine," "The American Girl Magazine." and the handbooks for different ages. Question: Dartha, what can youth or ganizations do in cooperation with city gov ernment to help protect young people from accidents? Answer: Chicago youth organizations, like the Girl Scouts of Chicago, can work with the Park District to make playgrounds safer by putting game courts away* from gates, by having safety patrols at the en trances and exits, and by marking paths between play centers. They can look for dangerous places, like deep holes, ditches, dumps, etc, where small children especially might get hurt They can put danger signs cm these spots, and request the owners to make them safe, getting the Health De partment to require it if they refuse the request lie Girl is very troop vention resenta;d their preven- activiHeahh An Analysis of the Home Accident Problem 27 Youth organizations can work with the Board of Education on projects such as making swimming instruction a required class for all school pupils; having courses in home economics, domestic science, manual arts, etc, include lessons in how to make homes safe from accidents and some training in first aid. They can work with the police department to reduce the number of accidents to boys and girls riding bicycles, with the fire de partment to provide home inspections to point out fire hazards around houses; and they can get the superintendent of schools to distribute a home safety check list to every home through the school children. Question: What do you teen agers think the parents' responsibility is in removing home hazards? How can children help their parents in this job? Answer: It is definitely the parents' re sponsibility to remove home hazards like defective electrical wiring. However, older children also have a responsibility to point out hazards around the house. For instance, is furniture so arranged that someone might fall over it in the dark or when in a hurry? Is the floor so highly waxed that scatter rugs will slip? Do toys and other objects clutter the stairs, doorways, or the room? Are sharp knives dropped into the dish water with other cutlery? And is there no first aid kit in the home? Question: Have any of you girls bad ex perience in baby sitting? Answer: Yes, most of the Girl Scouts on the panel have done baby sitting, but we do it as individuals, not as members of a Girl Scout troop, because the Girl Scout Or ganization, as such, does not supply baby sitters. We usually have an easy time with the babies--it's their parents who need to be educated. We have found the National Safety Council baby sitter form to be very helpful. Parents often forget to tell the sitter where they will be. Also, dangerous things are found stored next to food, easily reached by* small children or mixed with the food by mistake.- Question: Why is Home Safety a pro gram that never stops? Answer: Home Safety is a program which never stops because a safe home re quires knowledge, alertness, common sense, constant thoughtfulness for yourself and others. In Girl Scouting the Health and Safety program cannot be pointed to as a special program because it is the underlying consideration in all Girl Scout fields of in terest. Safety cannot succeed without the support of the women, and Girl Scouts of today who are the homemakers of to morrow. An Analysis of the Home Accident Problem By A. L. CHAPMAN. M.D. Medical Director and Chief, Div. of Chronic Disease, Federal Security Agency, Public Health Service, Washington, D. C. Presented by ELTON S. OSBORNE, JR, M.D. Ass't Chief, Division of Chronic Disease, Public Health Service, Washington, D. C. There are several important reasons why the public has remained aloof to the home accident problem. One of the most im portant reasons is that the problem has not been clarified sufficiently for the public, so that a successful solution to it can be en visioned. Inherent in many of the solutions that have been proposed up until now has been the mirage that habit patterns can be changed by infornjational efforts alone. Unfortunately, most' people instinctively know that this is, to say the least, imprac tical. Therefore they have shown little en thusiasm for home accident prevention. If. ever we are to enlist the wholehearted support of the public in a continued cam paign to reduce the number of home ac cidents we will have to .develop a preventive program that is practical, above all else. Such a program must not consist of a reaffirmation of general principles. It must m a nnf:i r.j * Vi? iri .41 ?r* mf -.I t'i4"4 ;: : .; > v*& ?. . , * i i fe- 28 Home Safety deal 'with the home accident problem in terms of people and money and times and places. There are certain hasic principles that will have to be recognized when such a program is outlined. 1. A program is practical only if it works. 2. No program can work if its success de pends upon community ingredients which are non-existent Some of the ingredients needed to construct a sound community home accident program are: Interested personnel. Financial support Community organization. Public education and motivation. Official recognition, participation and support 3. No sporadic publicity program, no mat ter how eye appealing it may be, will ever solve the long range accident prevention problem. 4. The home accident prevention program must be directed to those age groups and to those types of accidents that constitute the bulk of the home accident problem. There are no funds, time; or personnel to be wasted on unimportant aspects of the prob lem. It is not sufficient to concentrate our attention on "falls" as a category- We must be more specific than that. We must con centrate on more specific categories, such as "falls among people over 65" or "bums among children under 5." 5. Our educational efforts must be more sophisticated. It has been shown that throw away, one shot, so-called educational cam paigns produce no lasting motivation. Moti vation results from a continuing series of impacts. We must actually achieve a perma nent training status for the'public, or at least for certain key members of the public. 6. Programs must be adaptable to com munities that may vary widely in size of population, financial status, and home acci dent pattern. 7. Home accident prevention programs must be of such a nature that they attract widespread community participation. In this way the participants themselves become safe ty conscious and excel as "home safely sales men." A beginning may be made along these lines by breaking down the 1949 total of 31,000 home accident deaths into categorical groups which are fairly discrete. These deaths may be considered under eight head ings which include the bulk of the 31,000 home accident deaths. 1. The first of these is falls among people over 65 years of age. 15,700 home accident deaths occur each year from falls but of these deaths only 5 per cent occur among people under the age of 45 and 85 per cent occur among people over the age of 65. 2. The second large group of home acci dents consists of burns among children under 5 years of-age. Of the 4,700 annual deaths due to burns, 52 per cent of them occur among two age groups, children under 5 (22 per cent), and adults over 65 (30 per cent). 3. The third group, of course, is bums among people over the age of 65. 4. Although death certificates show that mechanical suffocation in infants occurs often enough to make it the fourth group, the Children's Bureau, along with many pediatridans and medical examiners, is now realizing that many diagnoses of mechanical suffocation have been incorrect. Studies of a series of infant deaths reportedly caused by suffocation indicate that in a vast majority of instances the infants were victims of massive; overwhelming bacterial infection. Further studies now in progress appear to confirm these initial findings. 5. Poisoning among children under 5 con stitutes the fifth group. There are 1,400 annual deaths due to poisoning other than by gas. These deaths fall into two main groups, poisoning in chil dren under 5, and barbiturate poisoning in adults. 6. Therefore, the sixth group is poison ing due to barbiturates. 7. Utility gas poisoning among persons over 45 makes up the seventh group. Two-thirds of the 1,200 deaths due to gas poisoning occur in the age group over 45, and most of them involve utility gas. &. Deaths from firearms among children under 14 years of age is the heading for the eighth and last group. 1,200 annual deaths are caused by fire arms. Almost one-third of these deaths occur among children under 15 years of age. ategorical e. ""'esc gK adhe 31,000 <ng peopk xur each iths only mder the >r among me icd-en under to burns, two age mt). and is burns low that occurs !t group, h many , is now chanica) aches of ' caused najoriti tans of ifecdoa ipcr t ' 5 con- due to deaths in chiltting in Poison- Persons iildren lor the r firedeaths 'f age. An Analysts oj the Home Accident Problem 29 For each of these groups a reasonably concrete preventive program can be worked out There are, however, four techniques which are applicable to most types of home accidents. These techniques deserve a fairly detailed discussion. 1. Analysis and pictorialisation--If we ever are to be able to portray the extent of the home accident problem in any community, it still be necessary to obtain some idea of the size and characteristics of the local home accident problem. We will have to investi gate all reports of accidental deaths. Public health nurses, sanitarians, or properly in structed volunteers, may be used to do the field epidemiology that will be needed. Having obtained the best possible analysis of the local home accident problem, the facts that have been found may be drama tized for the public by the use of good audio-visual materials. 2. Selection and education of the "index" person--This technique is a new one. It represents a new concept in home accident prevention. It is the antithesis of the cur rent theory that habit patterns may be changed by transient or superficial educa tional programs. It is based on the assump tion that children and oldsters are not going to change their habit patterns overnight and that someone else must accept the re sponsibility for their safety. This has been the weak point in our approach to home safety in the past. We have assumed falsely that, by educational methods alone, each in dividual could be made to accept a personal responsibility for his or her own safety. Experience has indicated that such an as sumption is not warranted. Since the ma jority of home accidents occur to children and oldsters, our attempts to persuade them to take care of themselves have been very largely, if not totally, wasted. We must find in each home situation the person best suited by age, by sense of re sponsibility, by intelligence, and by con science, to accept the responsibility for re ceiving the training that will enable him or her to protect children and oldsters in their care from fatal home accidents. Whoever it is that is selected will have to understand the gravity of the responsi bility which is being assumed; trill have to be trilling to attend group conferences or home safety dimes, tind will have to accept some type of home safety supervirion. It is not contrary to human nature to expect the index person to show more con cern for the youngster or oldster in his or her charge than most of ns show for our own safety. 3. Inspection of premises and eradication of danger spots--Now that sanitarians are finding some of their work in the field of infectious disease control lessened by suc cesses in the control of these diseases, some of their time may be made available to make periodic home visits for the purpose of checking on the presence of home aeddent hazards. Certainly a poorly lighted cellar stairway is as dangerous to life as an over flowing garbage tail, or a poorly screened privy, and should he of at least equal inter est to the public health worker. Even pub lic health nurses, as busy as they often are, perform less valuable tasks than checking off a home safety inspection form with some one in the household. Volunteer workers could find no better outlet for their pent up sense of community usefulness than In visit ing homes, under the guidance of the local health department; or safety council, for the purpose of assisting home owners and ten ants to remove home aeddent hazards. 4. Detection and correction of physical impairments--Many falls and burns and other home disasters are attributable to physical infirmities and disabilities. The cor rection of an qye defect may be all that is needed to make the home safe for grandma or grandpa. A proper diet aimed at over coming a nutritional anemia in an oldster may re-awaken reflexes, the failure of which might result in a fall downstairs. Physio therapy can be employed economically at home, under the guidance of a physician, to improve circulation in aging limbs and bring bade some of their waning elastidty. Many other causes of accidents such as dizzy and fainting spells, petit mal attacks, or paraly ses; may be bettered by medical treatment Physical infirmities per se, many of them amenable to correction, are important con tributing factors In many heme aeddents. In addition to the application of these four principal techniques for preventing home aeddents, there are other techniques that are limited to individual segments of the problem. For example; an effective method of pre vention for those suffocation and strangula tion deaths that still occur would be to p M ; :-v] V ifm *y,m 30 Home Safety utilize some of the time that the mother spends in the maternity ward after her baby is born, to educate her concerning safe methods oi infant care and the importance of reporting mild illnesses at once. Never again during the child's life will there be such a splendid opportunity to interest the mother in the welfare of her infant The poisonings in the age group under five are, for the most part, preventable by the use of a little common sense. It is sur prising that most parents underestimate or do not appreciate the monkey-like quali ties of children who can, with little diffi culty. climb on top of bathroom wash bowls to reach easily opened medicine chests. The only logical solution to this problem is to lock the cabinet or to equip it with a fastener that fastens from the top. As for the roach pastes and rat poisons: the insect repellents and chloride of lime cans; the varnish re movers and the ammonia bottles; the turpen tine and the other deadly concoctions that so often are placed temptingly within the baby's reach, there is notliing to l>e done but to place them safely on a high shelf, behind a cabinet door that fastens securely. In the case of barbiturate poisoning there are several very practical things that can be done. Barbiturates should not be kept in the house in quantities sufficient to cause death. Overdosage with barbiturates has offered an all too easy way out for persons who arc only temporarily suicide minded. The wisest and safest thing to do is to pass and enforce legislation designed to pre vent the sale of barbiturates except by prescription. There are loopholes in the enforcement of such laws, wherever they exist, but their net effect has been to reduce the abuse of these drugs and thereby decrease the danger of accidents and'suicides. The accidental poisoning of children with barbiturates can be prevented by the same measures that are designed to prevent poi soning with other noxious substances. Such substances must be kept safely out of reach. The index person should see to that Unlit}* gas poisoning is another cause of accidental death which can be reduced dras tically by the application of a reasonable amount of supervision. Utility gas poison ing kills more people than do firearms. You have to have a license in most states to use a gun, and a license is required to operate a motor vehicle. Even pest exterminators are licensed. Yet anyone, 'no mutter what his mental status is, or what his emotional sta bility is not, can purchase a gas stove and operate it Systems for instructing purchasers in the proper and safe use of gas appliances are not the rule. There is no periodic check up to see that appliances are properly installed; and there is no way oi knowing whether they are being used in a safe manner. Gas stoves and gas itself have been improved to the point where theoretically at least, normal people should not be able to harm themselves. Unfor tunately completely "normal'' people are at a premium. Therefore it might be helpful if utility companies, which have been in the forefront of the home safety movement, could find some way of instructing users of gas stoves and appliances in safety tech niques, and could make more frequent and thorough inspections of home gas installa tions. Firearms are a special menace to young sters in a home. There is only one sate place for guns in a home, particularly the empty ones (which too often are not empty), and that is under lock and key. A gun that a cliild can not reach can not blow his brains out To temporize with this problem by suggesting that the gun be unloaded, that the breech be broken, or that the gun be disassembled, is to invite disaster. By breaking down the home accident problem into its more important parts, we can more easily develop reasonably spe cific methods for dealing with each pan. These methods and techniques, because of their simplicity, are more likely to be under stood and carried out by the laity, than are more vague and - general directives that cover all of the various types of fatal home accidents that mar or might occur. Right now several countries are rebuild ing their civil defense organizations block by block because dvil defense cannot be coped with centrally. An effective home aeddent program, like a dvil defense pro gram, cannot be handled centrally. We will have to build the preventive home aeddent program, person by person, block by block, community by community, until the people who are destined to be the victims of home accidents save themselves by joining hands to save others. The facts .are very dear. We are not in vesting enough man hours of labor, of Governor Dewey's Team--The New York Story 31 instruction, nor in organizational activities to -warrant a reduction in hone accident deaths. Until we increase our investment, Johnny and Mary, dad and grandpa, will continue to burn themselves to death, as phyxiate themselves, poison themselves, break their necks, and in sundry other ways do themselves in. Home accidents can be pre vented, but it will take organized com munity effort to do it. 4-r n younge sate dy the mpty). m that w his robletn i, that tm be Governor Dewey's Team--The New York Story By DANIEL P. WEBSTER Safety Coordinator, Division of Safety, State of New York, Albany, N. Y. The prevention of home accidents is one oi the most challenging problems being faced today. A state safety program, to do maximum good for the most people; needs the interest and active support of every person having a logical part to play in it It is a moot question as to the responsi bility which a state government morally and legally should assume in combatting this "menace on the home front" If the Con stitution of the State of New York is typical, there is little definite implication of the part government should play in re ducing this national, state; community, and family tolL Article XVII, Section 3, of the New York State Constitution, enacted No vember 8, 1938, states, "The protection and promotion of the health of the inhabitants of the state shall be made by the state and by such of its subdivisions, and in such manner, and by such means as the legis lature shall from time to time determine." It is fortunate that leaders of both fed eral and state governments have seen the need for broadly interpreting statutes which pertain to the health and welfare of their citizens. In 'these days of turbulent world affairs and a possible national emergency, the tune to strike at home accidents is all the more pressing. New York may be typical of those states which have gradually recognized the need for concerted action against home accidents. It is unfortunate that the departments which have initiated action have often had to enter "by the back door." As more and more governmental agencies have become conscious of` thdr responsibility in borne safety, frequently due to the relationship with their own basic function, the need for coordination of activities has become more urgent In New York State, for example. The Workmen's Compensation Board has re cently become officially concerned with the home accident situation in connection with our new State Disability Benefits law, effec tive July 1, 1950, granting compensation to employees for non-occupational injuries as well as work injuries. For about the last ten years the State Health Department's Division of Medical Services, headed by Dr. I. Jay Brigfttman, has been conducting re search into the underlying causes of home accidents, and working to promote com munity safety organizations and their home safety programs. Public health representa tives in tbe field, once aware of a com munity's need and desire for an action pro gram, have consulted with community' leaders and outlined the steps to be taken in the activation of a safety council. The University of the State of New York, which indudes the Board of Regents and the State Education Department, has long induded home safety material in its Health Teaching Syllabi for dementary, and sec ondary schools. At the same time; the New York State University, comprising 33 state colleges and universities, through its exten sion service, has been active in the promo tion of home safety through farm and home bureaus, 4-H dubs, granges, and other groups. It was not until 1946 that legisla tion was enacted creating an independent Division of Safety in the Executive Depart ment under the directorship of Thomas W. Ryan. This division has been specifically charged with the coordination of efforts in home safety by; public arid private groups throughout the state: . Recently the New York State Employee Safety Program was launched. The Divirion of. Safety feds, that employee groups are I h-i'x M-. <1 1.! u. If V i!fei J: * II t -ui l- :.' P 32 Home Safety some of the best channels for general home safety education. For this reason it has been included as a vital part of the four phases of this operation: 1. Reduction of job accidents involving both temporary and permanent state em ployees. 2. Prevention of accidents to inmates of public institutions and to the public while on state property. 3. Drastic reduction of non-occupational accidents among state employees, which ac counts for as much as two-thirds of the time lost by them from accidents. Home accidents are the primary' objective in this phase of the program. 4. Education through state employees to reduce the number and severity of accidents among their families. Again, home safety is the number one objective in this phase The occupational safety part of this pro gram is bring handled through selected safety' directors. Initial steps included the designa tion and training of a safety administrator for each of the state's nineteen departments, and the appointment of over 200 safety' supervisors for the major divisions, institu tions, and department branches. Instruction, made possible through regional conferences, was first devoted to accurate accident in vestigation and reporting. As the program developed, it has rather closely paralleled successful industrial safety' programs. Ac tivities have included accident analyses,* safety inspections, preparation and dissemi nation of information; employee selection, placement and training with safety in mind; arousing of employee interest and program participation through meetings, talks, films, posters, bulletins, and safety contests. The public safety phases of the program are directly related to this work safety aspect Inmates and patients of institutions frequently require a unique approach, and it is rare that a uniform pattern can be followed. The procedure found most suc cessful is to put the patient on a quasi-em ployee basis. Many have work assignments of some sort, and safety committees have been formed of both employees and patients. Application of principles has been through engineering and enforcement as well as education and personal and recreational safety' have been indoctrinated with good effect. A large proportion of the New York State Employee Safety Program is bring devoted to off-the-job safety. Smaller departments, particularly those with comparatively ncmhazardous occupations such as clerical, are already carrying out that part of the cam paign. Special information bulletins on sea sonal and continuing hazards in the home and in recreational pursuits have been pre pared. Causes of lost time not due to work accidents or ordinary illnesses are bring determined .in order to point out specific program needs. Employee safety meetings include all of these phases. In summary, it seems that the initial broadside against the home safety problem by a state government should be through its own employees. The possibilities of this ap proach become more evident when the total number of people who will be reached there by is considered. In New York this is esti mated at over a half million, which includes 83,000 employees, and 330,000 in their families; pins 150,000 inmates of our hos pitals, correctional institutions, and similar establishments. At the same time the num ber of educational contacts with the public who at some time during the year are guests of the state is very large. The rather nebulous nature of the home accident problem has made it difficult for state governments to bring their resources to bear toward a solution. At the same time, governmental agencies have been charged with usurping and monopolizing the func tions of private groups. The State of. New York has always realized the need for grassroot activities in a democracy and as a re sult has confined its efforts in home safety largely to the encouragement of effort on the part of community organizations and groups. A state government's primary function it seems, ought to be toward preventing need less duplications and unnecessary omissions m a well-rounded statewide program. In addition, it most provide the basic informa tion and promotion necessary for increased participation by community groups. How, then, can state government best utilize its resources for home safety? 1. The state should dosriy examine its population to understand the effect of social and economic circumstances on the home accident experience of its citizens. Each passing year you are hearing more hoi levoted msnpublic r are best lore Governor Dewey's Team--The New York Story 33 and more about the underlying causes of major importance in this state, with one accidents, and the need for an understanding of every two accidental deaths resulting of the human factors which enter into them. from a home injury, although the national The socio-economic influences of our society ratio was one out of three. Almost 70 per are intimately interwoven into accident cent of the home accident deaths in New causation. In New York the complication York involved falls, which accounted for of a land of plenty, with the fast tempo of over a third of all accident fatalities. Other business and industrial life and war nerves, leading types of fatal home accidents which may contribute greatly to the number and struck the citizen, in the order of their num severity of home accidents. ber, were fire and explosions, gas poisoning, In order to determine program require and mechanical suffocation. ments it has been necessary to analyze ob Except in the case of falls, die accident jectively the environment of the human pattern in the various age groups has been bring who inhabits this area of approxi found to compare fairly closely with the mately' 50,000 square miles. In much the nationwide experience. Significant facts last same way that a physician must know the year were that three-fourths of accident patient if he is to diagnose the ailment, it deaths to New York children under five is essentia] that this `home accident patient" occurred in homes; that nearly half of the be thoroughly understood. Our patient may home accident fatalities in the 25-44 year be almost identical to yours, but even small group were from falls. differences have been found important in determining the right treatment Many apparently unrelated facts become significant For example, the extent of use and the types of labor-saving devices in the homes must be considered in a realistic approach. Kerosene is still used as a lighting fuel to some extent, and must be reckoned with as a potential hazard. The handling of that miniature atom bomb, the pressure cooker, may present a broader danger because of its commonplace use. 3. A state should conduct or sponsor basic research into the underlying causes of home accidents. The importance of research has been recognized in New York, but as it requires extensive and specialized services, progress has been limited. The findings of organizations like the National Safety Coun cil, and the Center for Safety Education of New York University have been most helpfuL Notable research is being con ducted in Rochester and Syracuse by our State Department of Health, and is serving 2. The state government should collect, as a pilot plan for more extensive investi summarize, and evaluate information per gations to be made in the future. The six taining to the frequency and severity of teen colleges in New York-that already are home accidents, distributing it to agencies offering safety courses for teachers will and groups for use in their programs. no doubt provide additional impetus to fac- In New York; as in other states, the .tual research and the extension of safety facilities of data-collecting services have education. been utilized to determine home accident 4. The state should maintain a current facts. According to figures from the Office inventory of all home safety activities, and of Vital Statistics, in 1948 the average aid in publicizing those that are particularly New Yorker took about the same risk of effective. Continuous exchange of ideas and bring killed in an accident as the average materials is fundamental to the program's U. S. citizen. success. In New. York this is a monstrous You may find it of interest to note that' task, and it has not yet been found possible New York Gty, with its high concentration to keep up-to-date on all the efforts of all of population and industry, had a lower rate groups. It is easy to miss important pro of home accident fatalities per 100,000 peo grams, because they are frequently disguised. ple than the remainder of the state. In 1949 The Department of Social Welfare, for almost 3,350 of the estimated 7,800,000 resi dents of New York Gty were aeddentaly lolled, while over 4,350 of the 6,900,000 other people in the s^ate died from accidents. example, works closely with the National Safety Council in home teaching of the blind. In this program, children and adults are taught safe practices in the routine Statistics for last year disclose that the processes of walking, housekeeping, etc. home accident problem continues to be of New York also relies heavily upon its Fed- ;s & li 34 Home. Safety eration of Community Safety Councils /or exchange of home safety information, or ganizing and guiding the local councils. 5. A state government should determine the resources of all agencies and groups within the state which can contribute to home safety, and enlist their cooperation in specific responsibilities toward the common goal. A comprehensive program to be effective must indude representation of busi ness and professional groups; official and voluntary social, educational, welfare, and youth agencies; manufacturers and protec tive organizations. Despite opinions to the contrary, the woman is the controlling figure or "boss' in the home. Our Division of Safety in Albany, in selling home accident prevention has recognized the potential ties of the nu merous state and local women's organiza tions. The New York State Women's Advisory Committee, representing some of our leading women's groups, has been most helpful in reaching homemakers with safety messages. This committee includes the Federation of Women's Clubs. Conference of Parents and Teachers, Medical Sodety Auxiliary# 4-H Clubs. Business and Professional Women's Clubs, Camp Fire Girls, Assodations of University Women, local Granges, Coundls of Jewish Women, the Federation of Home Bureaus, Girl Scouts. Home Economics Associations, Dairyman's League CoopCornell University Extension Service, Good Housekeeping Institute, and safety organi zations. 6. A state safety department should spon- sor and assist in the devdopment of a state and new community safety coundls. as well as other safety' organizations. It should also encourage the adoption of home safety as part of the regular programs of existing community groups. Several of our state departments, through field representa tives, have been active in -the formation of local safety coundls. The State Federation of Safety Coundls, by providing speakers. materials, and plans of organization, has hdped the number of local safety groups steadily increase. 7. It is the responsibility of a state safety department to promote meetings by and between the various officials and volunteer groups, for the purpose of stimulating and coordinating their activities in home and other fidds of safety. Out of these gather ings should be produced specific action pro grams in advance, with timely objectives and definite responsibilities. Periodic meet ings representing industry, labor, social and welfare organizations, and others have been found essentia] to a broad, effective cam paign. 8. A state safety -department should take full advantage of all public education chan nels in its home safety program. Safety is a difficult commodity to sell. The radio, press, and television have not been utilized to the extent possible and required for wide coverage. In New York, the Depart ment of Commerce has prepared and re leased scripts for network and newspaper use. During the past two years at least one radio spot announcement on home safety has been issued each month. Recently' this tempo has been increased to weekly. Civic and business organizations can influence newspapers and radio stations to support a safety campaign, and a state agency can assist them with prepared messages. Many' business firms manufacturing or selling household appliances and materials with safety features have found that mer chandising and home safety* tie in benefi cially for their sales and public welfare. The State of New York's campaign against home accidents is growing. Not all the activities of participating organizations can be mentioned here, but this part of our team's story' may indicate what we think can and should be done. Coordination is the keynote,-and it has been gratifying to see how well the pieces of the puzzle fit together in this much needed humanitarian program. .i: - 35 The Pediatrician and Child Accident Prevention te safety by and volunteer ting and me and gatherion pro>jectives c meetda! and ve been re cam paign ot all itions f our think s the > -see ether .Tam. By ESTHER B. CLARK, M.D. Department of Pediatrics, Palo Alto Clinic, Palo Alto, Calif. Should pediatricians concern themselves acddents are caused mainly by fate, or bad with child acddents? Are accidents impor luck, or circumstances beyond human control, tant causes of child death and disability? or that accidental deaths are unimportant? What is the chief aim of the medical pro Probably all of these factors are responsible, fession? Let us answer these questions in for the fact that tremendous progress has reverse order. The main concern of the been made in the last 10 years in mortality medical profession is the postponement of reduction due to disease (by general im death and cure or prevention of disability. provement in health standards, inoculations,' Acddents are the leading cause of child hood death--far outnumbering many of the important disease killers combined. About and the new antibiotics) in contrast to practically no reduction in the acddental death rate. 14,000 children under 15 years are killed an The medical profession in general, and nually and about 15,000,000 receive disabling pediatricians in particular, must concern injuries. On a numerical basis then, the themselves with this greatest of all killers pediatricians should be devoting a very large and disabler of children. The techniques to part of their energies to the problem of child be employed will be totally different from acddents. Are pediatricians concerning them the techniques employed to prevent diph selves with child acddents? Every pedia theria, small-pox, whooping cough, typhoid trician cares for many diildren injured in fever or any other preventable disease. How accidents, but few pediatricians concern shall we attack this problem? themselves with aeddent prevention. Certain types of acddents occur chiefly There exists among the laity and medical within the home, or the immediate profession alike, a strange attitude toward accidental deaths, quite different than the attitude toward disease causes of death. A "normal" weekend in the United States re home environment, namdy burns, falls, poi sonings, many of the firearm acddents and some of the automobile acddents. The re ported 1,400 deaths from suffocation may sults in the acddental death of about 450 persons. During the 1950 long 4th of July holiday about 800 persons were killed by accidents. Because of this, do we have our best stientists working to study the causes of accidents, that they may be prevented? Do we have a research foundation for the study and prevention of accidents? Do we have drives to raise funds for the care of aeddent victims, and to provide research that a means may be found to control this great killer? We do none of these things. All of these things are .done for the lead ing disease killers, why not for acddents? It is because the usual armamentarenm of the'sdentist is-not immediately applicable to a study of child aeddent prevention? Microscopes, test tubes, blood chemistry, guinea pigs, inoculations and the usual re search laboratory facilities do not seem to fit into a study of the causes and prevention of child aeddente* Are we so neglectful be challenged, as undoubtedly improved au topsy techniques would reveal medical causes for many if not most of these sudden deaths occurring chiefly in infants. Many of the drownings occur within the home -- from children bdng left alone in bath tubs, and many others;.are the result of inadequate supervision of small children about bodies of water. Many motor-vehide acddents are the result of children playing on the streets or in driveways and bdng hit by cars. About half the railroad acddents are caused by children playing on the railroad right-of-way. It is apparent then that in these cases in volving the younger children, adequate super vision and care in making the child's environ ment safe within.and without his home could have prevented most of these deaths. In the acddents involving older children adequate, early, and constant forceful instruction in ways of safety would, in many instances, have kept the child from having the aeddent. of child aeddent prevention because so many The parents, or those adults responsible people, mduding some doctors, believe that for the care of babies and young children. hMm sni : p ! .* i X * ; ** . p I 36 Home Safety must be taught what to do to prevent these accidents. Who is to do this instructing? We must make it fashionable to eradicate accidental death and disability, just as it is to have children immunized, given vitamins and checked by a doctor. It must become as disgraceful for a community to have a high accidental death rate as it is to have a high death rate from small-pox or typhoid fever. This improved attitude, which requires the acceptance of the fact that because accidents are caused they can be prevented and must be prevented, will need a great deal of public education. The role of the pediatrician should be a leading one. He is the one to give definite instruction to the mother on how to prevent fatal and disabling child accidents, and to do it so well and forcefully that Ins instruc tions will be accepted and acted upon. His directions are much more apt to fall on fertile and receptive soil if the ground has been prepared by good propaganda and the mood set for its reception. In the early days of the development of small-pox and diphtheria immunizations there was a great deal of opposition to the pro cedure, and a great deal of public health prop aganda was necessary before it became almost universally accepted, as it is now. Methods of child accident prevention do not meet with opposition, but with apathy, indifference, or the belief that nothing can be done. The all too prevalent apathetic acceptance- of fatal and disabling accidents as a built in feature of our society will require a vast amount of education and propaganda to eradicate. All possible agencies must participate in the setting up of an accident prevention propaganda and educational machine. The medical profession, the National Safety Council, life insurance companies, child wel fare groups, the Parent-Teachers Associa tion, health departments, service dubs, etc. must all take part in this great drive. The National Safety Council with its numerous and well organized subdivisions pertaining to all types of accident prevention and its fine contacts with the radio and press is in a most strategic position to so mold public opinion that the specific aeddent prevention directions to be suggested by the doctor or other agency will be accepted and fol lowed. Scientific research methods should be in voked to study the causes of accidents and also to study the various means of preven tion, and to determine which means will be most successful. For this purpose a Re search Foundation for the Study and Pre vention of Accidents should be organized and activated. It might well result in the saving of more lives and the prevention ot more disability than many of the large foundations now in existence dealing with single diseases. Certainly careful study of the conditions existing at the time of each accident will reveal its cause; hence the way of its pre vention will be indicated. For example: Small children may be kept from falling from moving cars by a safety device pre venting the opening of the car doors. Such a device should be standard equipment on all cars carrying children, and auto salesmen should urge their installation on cars pur chased by persons who have children. A warning bell which sounds whenever a car is backing would undoubtedly save many children from bring backed over. Vessels containing hot fluids must always be placed so a toddler cannot pull the contents onto himself. Syrup ant poisons must hot be placed so that their contents may be con sumed by small children. Thus by study the method of prevention for each type of accident may be revealed and appropriate action taken. Specifically the pediatrician's role in ac cident prevention is twofold, first, and most important, in his patient relationship, where he instructs parents specifically in methods of child aeddent prevention, and secondly in community activity. In Ins patient relationship the pediatrician is in a most favorable position to give mothers specific directions on how to pre vent child accidents. It is just as important that he give this advice as that he give advice on when an appendectomy should be done, or on when penicillin, aureomycin, or vitamins should be given; or on how to handle emotional and behaviour difficulties; and on a statistical basis it is probable that he will save more lives and prevent more disability in his role of accident preventer than in the other categories of his profession. He will be far more successful if his patient has been subjected to good accident prevention propaganda, and is in a mood to enthusiastically accept and act upon the ad vice given. The Pediatrician and Child Accident Prevention 37 The mother's function in preventing fatal and disabling child accidents is not ample or easy. It requires a great deal of super vision of the child himself, thought and care in keeping his environment safe, and careful and constant teaching to make him safely independent in his oven right as he grows toward maturity. The doctor's technique of giving advice may be verbal, or he may give the mother accident prevention literature prepared by himself, by other doctors, or by such or ganizations as the National Safety Council, life insurance companies, or other agencies, or he may do both of these things. His advice is apt to be especially successful if at the time of a house call he occasionally makes a safety inspection tour of the house and gives constructive advice on improving safety features. At the routine office calls he should also give timely advice. In his community activity the pediatri cian should activate and encourage various groups, dubs; and local safety coundls in the promotion of aeddent prevention propa ganda. He should be willing to speak on the subject, and supply data to others who may wish to give talks. By a well timed, energetic enthusiastic, co operative, and concerted effort by the pe diatricians, the National Safety Council, and other groups, the public may be aroused from its present apathetic acceptance of fatal and disabling accidents as an inevitable part of our civilization; and the role of accidents as the greatest killer and disabler of our children may be reduced to a place of insignificance. The result will be the sav ing of thousands of child fives, and the prevention of hundreds of thousands of disabling accidents. / Officers of the HOME SAFETY CONFERENCE NATIONAL SAFETY COUNCIL 1950-51 Motional Safety Council Vice-President for Homes--DR. DONALD B. ARMSTRONG, Second Vice-President for Health and Welfare, Metropolitan Life Insurance Co, New York, N. Y. Chairman--TYLER S. ROGERS, Assistant to the Executive Vice-President, OwensComing Fiberglas Corp, Toledo, Ohio. Vice-Chairman--MRS. GEORGE WELLES, JR, Duluth, Minn. Secretary--THOMAS FANSLER, Director, Home Safety Division, National Safety Council. Chicago, IIL Chairman of Committee on Community Resources and Services--MRS. GEORGE WELLES, JR. Chairman of Committee on Membership--W. GRAHAM COLE, Assistant Secretary. Safety, Metropolitan Life Insurance Co, New York, N, Y. Conference Representatives on Board of Directors, National Safety Council-- MISS KATHARINE FISHER, Director, Good Housekeeping Institute. New York, N. Y. DR. G. FOARD McGINNES, Vice-President for Health Services. American National Red Cross, Washington, D. C TYLER S. ROGERS. Other Volumes in this Series Users of this volume will find much value in its companion volumes. Here is the list: TITLE VOLUME No. General Sessions and Detailed Index to all Volumes......................................................... l Aeronautical Industries .......................................................... 2 Air Transport Industry................................................................................................................... 3 Automotive and Machine Shop Industries.................................................................................... 4 Cement and Quarry Industries....................................................................................................... j Chemical Industries .............................................................................................................. 6 Coal Mining Industry....................................................................................................................... 7 Construction Industry'....................................................................................................................... 8 Electrical Equipment Industry....................................................................................................... 9 Farm Safety...................................................................................................................................... JO Food Industry........................................ 11 Glass and Ceramics Industry........................................................................................................... 12 Home Safety.................................................. 13 Industrial Nursing............................................................................................................................. 14 Industrial Subject Sessions (Sponsored by ASSE).................................................................. 15 Maritime Industries (Marine Section).......................................................................................... 16 Meat Packing. Tanning and Leather Industries............................................................. 17 Metals Industry..............................:.................................................................................... '........... 18 Mining Industry................................................................................................................................. 19 Motor Transportation Industry (Commercial Vehicle Section)................. 20 Petroleum Industry............................................................................................................................. 21 Power Press and Forging Operations..............................................................................................22 Printing and Publishing Industry......................................................................................................23 Public Employment (Public Employees Safety Committee).......................................................24 Public Utilities Industries................................................................................................................... 25 Pulp and Paper Industry................................................................................................................... 26 Railroad Industry................................................. *........................................................................... 27 Rubber Industry'...................................................................................................................................28 School and College Safety................................................................................................................. 29 Textile Industry'...................................................................................................................................30 Traffic Safety.......................................................................................................................................31 Transit Industry...................................................................................................................................32 Wood Products Industries ........................................................ 33 Speaking With People (Early Morning Sessions).................................................................... 34 PRICES OF EXTRA COPIES OF INDIVIDUAL VOLUMES TO MEMBERS VOLUME SIZE lto9 copies Each 10 to99 copies Each 100 to 999 copies Each 1000 or more Each Less than 24 pages-- 24 to 48 pages-- 49 to 96 pages-- Over 96 pages-- $025 20 .40 .60 $020 25 25 25 $0.15 20 20 20 $0.15 20 20 20 Complete set of Transactions (34 volumes)--$6.00 NON-MEMBER prices are double member prices, except volumes 10, 13, 29 and 31. NATIONAL SAFETY COUNCIL 425 NORTH MICHIGAN AYE. CHICAGO 11. ILL. tuna is M4. 40 ^ 1100--251--WHP