4.2: Unintentional Injuries

Unintentional injuries are often referred to as “accidents,” meaning something that was not intended. These include falls, drowning, motor vehicle crashes, fires, and poisoning.

Falls

For adults over 65 years, falls are the leading cause of death due to injury. In 2019 older adult falls caused 34,000 deaths, 3 million visits to the emergency room, and over 800,000 hospitalizations attributing to over $50 billion in medical costs annually. It is estimated that more than one out of four older people fall each year with one out of five falls causing serious injury. Traumatic brain injuries (TBI) and hip fractures are the most common serious injuries. The injuries associated with falls impact a persons quality of life making it hard for a person to get around, do everyday activities, or live on their own. Many people who fall, even if they’re not injured, become afraid of falling. This fear may impact their quality of life by causing a person to cut down on their everyday activities. When a person is less active, they become weaker and this increases their chances of falling.

Fall risk and prevention tips include:

• Lower body weakness, difficulties with walking and balance, or foot pain or poor footwear
  • Do exercises that make your legs stronger and improve your balance. Tai Chi is a good example of this kind of exercise.
  • Ask your doctor or healthcare provider to evaluate your risk for falling and talk with them about specific things you can do.
• Vitamin D deficiency (that is, not enough vitamin D in your system)
  • Ask your doctor or healthcare provider about taking vitamin D supplements.
• Use of medicines, such as tranquilizers, sedatives, or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet.
  • Ask your doctor or pharmacist to review your medicines to see if any might make you dizzy or sleepy. This should include prescription medicines and over-the counter medicines.
• Vision problems
  • Have your eyes checked by an eye doctor at least once a year, and be sure to update your eyeglasses if needed.
  • If you have bifocal or progressive lenses, you may want to get a pair of glasses with only your distance prescription for outdoor activities, such as walking. Sometimes these types of lenses can make things seem closer or farther away than they really are.
• Home hazards or dangers such as broken or uneven steps, and throw rugs or clutter that can be tripped over.
  • Get rid of things you could trip over.
  • Add grab bars inside and outside your tub or shower and next to the toilet.
  • Put railings on both sides of stairs.
  • Make sure your home has lots of light by adding more or brighter light bulbs.
  • Keep items you use often in cabinets you can reach easily without using a step stool.
  • Use non-slip mats in the bathtub and on shower floors.

Drowning

Drowning is the process of experiencing respiratory impairment from submersion or immersion in liquid. Drowning can happen in seconds and is often silent. It can happen to anyone, any time there is access to water. Not all drownings are fatal, drowning injuries can cause brain damage and other serious outcomes, including long-term disability. Drowning kills nearly 4,000 people each year in the United States and is the leading cause of injury death for children 1 to 4 years of age. For every child who dies from drowning, another eight receive emergency department care for non-fatal drowning. Not all drownings are fatal, drowning injuries can cause brain damage and other serious outcomes, including long-term disability.

Drowning risk and prevention tips include:

• Not being able to swim
  • Adults and children should participate in formal swim lessons.
• Missing or ineffective fences around water
  • A four-sided isolation fence which separates the pool area from the house and yard reduces a child’s risk of drowning by 83% compared to three-sided property-line fencing (which encloses the entire yard, but does not separate the pool from the house).
• Lack of close supervision
  • Drowning can happen quickly and quietly anywhere there is water, especially to unsupervised children. It happens in lakes and oceans, pools, bathtubs, and even buckets of water. Drowning can occur when lifeguards are present.
  • Use the buddy system! Always swim with another person.
• Location
  • The highest risk locations for drowning vary by age. Among infants under 1 year old, two thirds of all drownings occur in bathtubs. Most drownings happen in home swimming pools among children ages 1-4. More than half of fatal and nonfatal drownings among people 15 years and older occur in natural waters like lakes, rivers, or oceans.
  • It is important to know the risks or natural water, such as ocean rip currents.
• Not wearing life jackets
  • Life jackets can prevent drowning during water activities, especially boating and swimming. The U.S. Coast Guard reported 613 boating-related deaths in 2019, 79% of these deaths were drowning related, and of those who died from drowning 86% were not wearing life jackets.
• Drinking alcohol or using drugs
  • Among adolescents and adults, alcohol use is involved in:
    • up to 70% of deaths associated with water recreation,
    • nearly 1 in 4 emergency department visits for drowning, and
    • about 1 in 5 reported boating deaths.

Motor Vehicle Crashes

In 2021, more than 43,000 people died in motor vehicle crashes in the United States, that is more than 117 people killed in crashes every day. There were over 2.1 million emergency department visits for injuries from motor vehicle crashes in 2020. Deaths from crashes in 2021 resulted in over $430 billion in total costs—including medical costs and cost estimates for lost quality of life and lives lost. Motor vehicle injuries are often associated with distracted, impaired, or inexperienced drivers.

Distracted Drivers

• Distracted driving is doing another activity that takes the driver’s attention away from driving that can increase the chance of a motor vehicle crash. There are three main types of distracted driving: visual (taking your eyes off the road), manual (taking your hands off the wheel), and cognitive (taking your mind off driving).
• In 2021, 3,100 people were killed and about 424,000 were injured in crashes involving a distracted driver. Not all persons killed by distracted drivers were in cars, about 1 in 5 were walking, riding their bikes, or otherwise outside a vehicle.
• Prevention: Do not multitask while driving. Whether it’s adjusting your mirrors, selecting music, eating, making a phone call, or reading a text or email―do it before or after your trip, not during.

📌 At 55 mph, sending or receiving a text is like driving the length of a football field with your eyes closed.

Child Passenger Safety

• Motor vehicle injuries are a leading cause of death among children in the United States. But many of these deaths can be prevented. Always buckling children in age- and size-appropriate car seats, booster seats, and seat belts reduces serious and fatal injuries by up to 80%.

Seatbelts

• Although most drivers follow these safety measures on every trip, there are still millions who don’t. In fact, it is estimated that 2,549 lives (of people 5 years and older) could have been saved in 2017 alone if all motor vehicle occupants were restrained on every trip.

Teen Drivers

• In 2019, almost 2,400 teens in the United States aged 13–19 were killed and about 258,000 were treated in emergency departments for injuries suffered in motor vehicle crashes. That means that every day, about seven teens died due to motor vehicle crashes, and hundreds more were injured. In addition, motor vehicle crash deaths among teens 15–19 years of age resulted in about $4.8 billion in medical and work loss costs for crashes that occurred in 2018.
• Teens who are at especially high risk for motor vehicle crashes are: Males, teens driving with teen or young adult passengers, and newly licensed teens.
• Risk factors include: Inexperience, nighttime and weekend driving, not using a seat belt, distracted driving, speeding, alcohol/drug use

Older drivers

• In 2019, about 8,000 older adults (aged 65+) were killed in traffic crashes, and more than 250,000 were treated in emergency departments for crash injuries. This means that each day, more than 20 older adults are killed and almost 700 are injured in crashes. Drivers aged 70+ have higher crash death rates per mile driven than middle-aged drivers (aged 35-54). Higher crash death rates among this age group are primarily due to increased vulnerability to injury in a crash. Across all age groups, males have substantially higher death rates than females.
• Age-related declines in vision and cognitive functioning (ability to reason and remember), as well as physical changes, might affect some older adults’ driving abilities.

Impaired driving

• Every day, 29 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver, this is one death every 50 minutes. The annual cost of alcohol-related crashes totals more than $44 billion.
• Drugs other than alcohol (legal and illegal) are involved in about 16% of motor vehicle crashes. In 2018, 12.6 million people reported driving under the influence of marijuana or other illicit drugs.
• Drugs other than alcohol (legal and illegal) are involved in about 16% of motor vehicle crashes.

Pedestrian Safety

• More than 7,000 pedestrians were killed on our nation’s roads in crashes involving a motor vehicle in 2020. That’s about one death every 75 minutes.
• Alcohol, speeding, and location are major risk factors for pedestrian deaths caused by motor vehicles.
• Adults aged 65 years and older accounted for 20% of all pedestrian deaths in 2020, yet were only about 17% of the U.S. population.
• Pedestrian injuries can be reduced by: increasing your visibility, using cross walks, using designated sidewalks/paths, avoiding distractions while walking like headphones, and avoid walking when impaired.

Motorcycle Safety

• More than 5,500 motorcyclists died on our nation’s roads in 2020, and more than 180,000 were treated in emergency departments for crash injuries.
• Motorcycle helmets are important to save lives. In 2017, helmets saved an estimated 1,872 lives and an additional 749 more lives could have been saved if all motorcyclists had worn helmets. Motorcycle helmets are 37 percent (for riders) and 41 percent (for passengers) effective in preventing deaths. Helmets reduce the risk of head injury by 69%.

Bicycle Safety

• Bicycle trips make up only 1% of all trips in the United States. However, bicyclists account for over 2% of people who die in a crash involving a motor vehicle on our nation’s roads. Nearly 1,000 bicyclists die and over 130,000 are injured in crashes that occur on roads in the United States every year.
• Adults ages 55-69 have the highest bicycle death rates and adolescents, teens, and young adults have the highest rates of bicycle-related injuries treated in emergency departments (EDs).
• Male bicyclists have death rates 6 times higher and injury rates 5 times higher than females.

Fires

Fire is fast, in less than 30 seconds a small flame can turn into a major fire. In 2019, there were 1,291,500 fires which caused 3,704 deaths, 16,600 injuries, and accounts for $14.8 billion.

Home fire safety:

• Smoke alarms
  • Put smoke alarms on every level of your home and inside/outside of all sleeping areas.
  • Test them often to make sure they work and replace them after 10 years.
• In the kitchen
  • Do not leave the room when cooking, if you leave the kitchen turn off the burners.
  • Move flammable objects away from the cooking area.
  • Turn pot handles toward the back of the stove to avoid unintentionally knocking them.
• Home heating
  • Move flammable objects away from fireplaces, wood stoves, space heaters, or radiators.
  • Never use an extension cord with a space heater.
  • Ensure space heaters have an auto turn off if tipped over.
  • Have your chimney inspected.
• Smoking in the house
  • If you smoke in your home you have an increased risk of home fires.
  • Never smoke in bed or when drowsy
  • Ensure all cigarettes are completely put out- use water to ensure!
• Young children and older adults
  • Keep children away for anything that gets hot.
  • Keep matches and lighters out of reach of children.
  • Teach children how to escape the home if you cannot help them in the event of a home fire.
  • Older adults may need assistance to escape a home fire.

Poisoning

Poisoning is one of the top three causes of fatal unintentional injuries. In response to public health concerns regarding poisoning, in 1980 the National Capital Poison Center (NCPC) was founded, which is an independent, not-for-profit 501(c)(3) organization. There are 2 ways to get help from Poison Control: online at webPOISONCONTROL® or by phone at 1-800-222-1222.

As the primary organization providing help with poisoning, the NCPC data provides a picture of the commonality of injuries associated with poisoning. In 2020, the 55 U.S. poison control centers provided telephone guidance for over 2.1 million human poison exposures, which included:

• 6.4 poison exposures/1000 population,
• 37.9 poison exposures in children younger than 6 years/1000 children,
• 1 poison exposure reported to U.S. poison control centers every 15 seconds.
• In 2020, adults comprised almost half of all exposures (47%), followed by children younger than 6 (39%), then teens (8%).

Common types of poisoning include food poisoning, poisonous plants, and carbon monoxide poisoning.

Food poisoning symptoms can be anywhere from mild to very serious and may include: Upset stomach, stomach, cramps, nausea, vomiting, diarrhea, and fever. Some foods are more associated with foodborne illnesses and food poisoning than others, such as raw animal foods. While certain foods are more likely to make you sick, any food can get contaminated in the field, during processing, or during other stages in the food production chain, including through cross-contamination with raw meat in kitchens.

Many native and exotic plants are poisonous to humans when ingested or if there is skin contact with plant chemicals. However, the most common problems with poisonous plants arise from contact with the sap oil of several native plants that cause an allergic skin reaction—poison ivy, poison oak, and poison sumac.

Everyone is at risk for Carbon monoxide (CO) poisoning. CO, an odorless, colorless gas, that can cause sudden illness and death. CO is found in fumes produced any time you burn fuel in cars or trucks, small engines, stoves, lanterns, grills, fireplaces, gas ranges, or furnaces. CO can build up indoors and poison people and animals who breathe it. The most common symptoms of CO poisoning are headache, dizziness, weakness, upset stomach, vomiting, chest pain, and confusion. CO symptoms are often described as “flu-like.” If you breathe in a lot of CO it can make you pass out or kill you. People who are sleeping or drunk can die from CO poisoning before they have symptoms. It is important to use Carbon Monoxide detectors to know if CO is present.