Preventing Window Falls
Imagine a lovely Saturday afternoon. Winter has officially left, and you open the windows of your home to let in the fresh spring air. You are playing with two of your three kids and the third, your 4-year old boy, has gone upstairs to get a toy. The next thing you hear is a thud. Your heart stops as you call out for your son. No answer.
You go to investigate, and as you walk into the room, you notice the screen is missing from the side window. Rushing to the window, you see your son motionless on the ground below.
Stories like this happen to people all over the country. If you paid attention to the news over the past year alone, you may have noticed headlines like this: “Baby Falls 22-Feet From Window In Hyannis.” Or “Child dies after falling from a sixth story window” (in Providence, R.I.).
International news stories also indicate this problem is not unique to the United States: “Hotel owners fined after child falls from window” (Aberdeenshire, Scotland); “Girl, 2, falls to her death from flat window” (Hong Kong, China).
One of the most famous stories of a window fall is that of Conor, the son of singer Eric Clapton. He fell from an open window in a skyscraper apartment 53 stories to his death in 1991. These stories include children who were closely supervised and those who were not; those falling from first floor windows and those falling from greater heights; unwitnessed falls, falls witnessed by parents, falls while under the care of a babysitter ; falls from homes, falls from apartments, and falls from hotels. In short, these reports illustrate that any child can fall from any window in any building at any time, in the presence of anybody. All it takes is a second.
A 2011 study in Pediatrics, the official journal of the American Academy of Pediatrics, reports that between 1990 and 2008, on average, more than 5,000 children fell from windows each year. Although the average age of those who fell was about 5 years old, many of these children were younger. Most of the injuries occurred in the warmer months from May through August. Almost 70 percent of falls were from windows on the second story or higher.
Children older than 5 are also injured in window falls. Many of these events in older children were because of the children climbing on or jumping from the windows. In the last year at Boston Children’s Hospital, 12 children were admitted with fall-related injuries; seven were less than 5 years old.
The severity of the injury that results from these falls depends on many things. Obviously, more serious injuries can occur in children falling from greater heights, but the surface on which the child lands (grass or sand versus concrete or wood) also plays an important role in injury severity. Many children walk away from window falls with minor bumps and scrapes. However, according to the Pediatrics study, one out of every four children required hospitalization after falling out of a window, and two of every 1,000 hospitalized children died from their injuries. This does not include those children that die at the scene of the fall.
Almost 50 percent of injuries occurred to the head or face, especially in children 4 years old or younger. This is because in younger children, most of the weight is in the head, so the head is most likely to hit the ground first. Therefore, even if children survive, they can have traumatic brain injuries that can affect their development and ability to function independently later in life. Another study in Pediatrics published the same year revealed that one in five patients who fell from windows had long-term effects from their injuries.
Changing the Tide
Efforts have been made by many groups to educate the public about window falls. The National Safety Council formed a Window Safety Task Force in 1997, made of members of architectural, construction, and building supply organizations, to address issues regarding window safety; they have designated the first week in April (April 5-11 of this year) as National Window Safety Week to raise community awareness.
State and local governments are increasingly aware of this issue and have begun to put forth efforts to ensure window safety measures, especially in apartment buildings and in the construction of new homes.
New York City passed a law in 1976 requiring landlords to put window guards on apartment building windows if a child younger than 10 lived there, which cut the number of falls by half in just two years according to a report published in the American Journal of Public Health about a program called “Kids Can’t Fly.” Boston instituted a similar injury prevention program by the same name in 1993 that provided landlords and homeowners with discounts for purchasing and instructions for installing window guards. Though this campaign did not mandate installation of window guards, there was an 83% decrease in hospitalizations due to window fall-related injuries.
A common concern with placement of window guards is that people will be trapped if there is a fire. However, after the initiation of regulations for window safety in New York City, there was no increase in deaths related to fires in homes. Other cities and states have similar prevention programs; however only Minnesota has a state law designed to prevent window falls. “Laela’s Law” was inspired by a case of toddler injured after falling from a fourth story window in an apartment building; she survived, but another child who fell from the same apartment building later that year did not.
What Can Parents and Caregivers Do?
As the weather begins to warm up, now is the time to make sure all windows in your home are properly fitted with window guards or window locks. According to the Kids Can’t Fly program from the Boston Public Health Commission, window guards should be installed on any window greater than 12 feet from the ground as measured from the outside. (Some windows may be first floor on the inside but because of elevated entrances are actually farther from the ground). Remember, screens are not made to keep kids in, but to keep bugs out. The average window screen can easily be pushed out by a child leaning against or running into it, whereas window guards are made to withstand up to 150 pounds of direct pressure. Permanent window guards are not recommended; instead, for windows associated with a fire escape, guards should be installed that can easily be removed by an adult in the case of a fire.
Other window safety tips:
* Make sure all unopened windows are locked.
* Open windows from the top down (instead of from the bottom up) if possible.
* Install window guards on any window that opens greater than four inches.
* Make sure there is no furniture (or anything a child can climb on) near a window.
Keep these tips in mind when visiting family or friends, or when taking your kids to school or daycare. A fall can happen anywhere, even in a hotel when you are on vacation. If you live in an apartment building where window guards are not in place, speak with your landlord about having them installed. Take a tour of your home to identify potential problem areas. Then take proper steps to give yourself peace of mind.
For more information, see the Window Falls Prevention page on the Boston Public Health Commission website: bphc.org/whatwedo/childrens-health/injury-prevention/safe-at-home/Pages/Window-Falls-Prevention.aspx, which includes a video demonstrating how to install window guards (available in English and Spanish).
Chinwendu Onwubiko, M.D., Ph.D.; Boston Children’s Hospital Injury Prevention Program, 617-355-7332