Finland leads 31 European countries in tackling child injuries with Greece last

BMJ 2012; 344 doi: (Published 12 June 2012) Cite this as: BMJ 2012;344:e4008
  1. Zosia Kmietowicz
  1. 1London

National governments need to do more to prevent children injuring themselves and dying in the home from drowning, falls, burns and scalds, poisoning, and choking or strangulation, according to an assessment of child safety policies in 31 countries across Europe.

The Netherlands leads Europe with the lowest rate of deaths from injury among children and adolescents in 2010 or the most recent year available (4.99 deaths from injury per 100 000 children aged 0 to 19), followed by Sweden (5.02), the UK (6.01), and Germany (6.16).1

The worst performing country is Lithuania (23.91 deaths per 100 000), followed by Bulgaria (17.37), Romania (17.20) and Latvia (16.06). The report covers 27 EU member states plus Croatia, Iceland, Israel, and Norway.

“A child dies every hour of every day in the EU as a result of an injury,” said Joanne Vincenten, director of the European Child Safety Alliance, which has produced the report. “Consistent use of proven prevention strategies across the EU could save most of these lives. It would also save billions of Euros spent each year on treating injuries and would allow children and adolescents to grow up to be healthy and active contributors to future economic growth in Europe.”

The alliance has compiled child safety report cards for 31 countries in Europe that scores them on adopting, implementing, and enforcing over 100 strategies and policies proved to prevent unintentional injury. These show that, overall, countries have worked harder to implement policies related to transport than those related to preventing injuries in the home.

To date no country has adopted all the recommended safety measures and scores range widely—from 45 points out of a possible 60 for Finland to 14.5 points for Greece. Close behind Finland were Iceland (44.5), the Netherlands (43.5), Czech Republic (43.5), and Poland (43.5). With 37.5 points Scotland was ranked 16th, England 17th (36 points), and Wales 24th (31 points).

England’s scorecard, for example, says that it could do more to prevent falls by enforcing national standards for playground equipment, banning baby walkers, and reducing choking hazards by redesigning or banning latex balloons and blind cords.

This is the third round of report card assessments to be conducted by the alliance, with 18 countries participating in 2007, 26 in 2009, and now 31 in 2012. There has been a substantial improvement in scores with some of the greatest improvements in countries with the greatest investments to prevent injuries in the last five years, such as the Czech Republic, Finland, Hungary, Scotland, and Spain. The report says a decrease in Greece’s score since 2009 probably reflects the economic crisis there.

The report says that:

  • Only 13 countries (42%) have a law requiring use of a bicycle helmet while cycling and just eight fully implement and enforce it.

  • No country has a law requiring children to use a rear facing child passenger restraint to age 4, although this is normal practice in Sweden where child passenger deaths in this age group have been reduced to almost zero.

  • Only seven countries (23%) have a law requiring barrier fencing for private pools, but in only one (France) is the law fully implemented.

  • Only 15 countries (48%) have a law requiring child resistant packaging of medications.

  • Only 16 countries (52%) have a law to prevent children from falling out of windows (for example, window guards), but half the laws only apply to new buildings or renovations.

MEP Malcolm Harbour, chairman of the Internal Market and Consumer Protection Committee, said that current efforts to evaluate progress are hampered because the impact of few policies are currently monitored.

He added, “Monitoring needs to be incorporated before a policy is put in place to ensure that the necessary data for measuring impact are available. This will require the cooperation and commitment of many sectors, but it is a critical gap right now and without it we cannot demonstrate which child safety policies are having the most effect.”


Cite this as: BMJ 2012;344:e4008