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103
Since 1947 a Government Interdepartmental Committee, including representatives
of the Home Office and the Ministries of Health, Education and Works, has been studying
the problem. The experience of the Interdepartmental Committee has confirmed
that education of the individual in the home is the best way of preventing accidents.
Posters, pamphlets and films play a part, but are not thought to be very effective on
their own. The Home Safety Department of the Royal Society for the Prevention of
Accidents have produced some very useful posters and pamphlets which are in use in
the Council's maternity and child welfare centres.
The housing and valuation department of the Council is very conscious of the
importance of trying to eliminate accidents by means of good design. Balustrades on
staircases are of various designs and are constructed in several types of materials, but
very particular attention is paid in the design to eliminate footholds which might
encourage children to climb on them ; attention is paid to safety as well as to appearance
in the design of sun balconies, and protective rails are usually provided ; steps within
flats have been totally eliminated ; much attention has been given to the construction of
safe windows, which are designed so that they can be cleaned from the inside and with
the bottom pane of glass fixed so that it cannot be opened ; side-hung opening windows
have safety catches fitted to the casement stays to limit initial opening. Other measures
which have been taken include the siting of meters and fuses, so that they can be reached
without standing on chairs and yet be out of reach of small children.
The working party came to the conclusion that accidents in the home are caused
mainly through (a) the personal carelessness or negligence, physical frailty or infirmity
of some individual, not necessarily the victim; (b) the bad design or misuse of appliances
and equipment; (c) defects in the structure or maintenance of buildings, and (d)
overcrowding, particularly where children and old people are concerned. Having regard
to the unnecessary loss of life, the deformity and disablement not infrequently left in
survivors, the distress caused to the victims and their relatives, and the heavy cost,
particularly in personnel, of the ensuing medical and nursing treatment, accidents in the
home should be considered a major public health problem. It may be considered that
it is the responsibility of local authorities to try to make people more aware of the dangers
of accidents in their home and that the best way to do this is through the education,
by its own staff, of the individual in the home. As the health visitor already visits the
home and is accepted as a trusted friend and adviser, it is considered that she is the most
suitable person on whom to base the work, more particularly since over 75 per cent.
of all deaths caused through accidents in the home are among children under five years of
age and the elderly—those with whom her work is normally associated. Midwives,
district nurses, home helps and sanitary inspectors could also help in educating people
as they are in close contact with the homes. Other ways in which the local authority
can help are in the relief of overcrowding and the provision for the elderly, the blind,
etc., of homes in which the risks of fire and falls on stairs are minimised. The working
party took the view that it is desirable to establish practical means of measuring the
incidence of and morbidity from accidents in the home and the collection of information
additional to that already available (mainly from the Registrar-General) is, therefore,
necessary. They regarded the need to secure information about non-fatal accidents as
particularly vital and suggested means of collecting such information.
The first suggestion of the working party was that the Council could most fruitfully
and quickly approach the subject of home accidents through its existing organisation
covering health education. It proposed that information of fatal and non-fatal accidents
in the home should be collected and analysed so as to provide indices of trends and
information of those accidents against which propaganda is especially needed. This
information could be obtained by analysis of accident reports in the health visitors'
records, by seeking the co-operation of the district nursing associations in the reporting
of home accidents, by extraction of detail of home accidents from the ambulance service
reports, by the inclusion by teachers of notes of accidents on their daily return of