How useful are home safety behaviours for predicting childhood injury? A cohort study.

Little work has examined the utility of home safety behaviours in predicting childhood injury. This study examines the relationship between safety behaviours and child injury using a cohort of 1717 families, with 2357 children aged 0-7 years. Safety behaviours, and sociodemographic and family characteristics were measured using a validated questionnaire, and medically attended injuries were ascertained from medical records. Hospital admission rates were lower amongst children from families with fitted and working smoke alarms [incidence rate ratio (IRR) 0.55, 95% confidence interval (CI) 0.31-0.96], who stored sharp objects safely (IRR 0.44, 95% CI 0.23-0.84) and who had fitted stair gates (IRR 0.57, 95% CI 0.31-1.03). Not having a stair gate and not storing sharp objects safely had high sensitivities and negative predictive values for predicting hospital admission. These findings are unlikely to be explained by reductions in the risk of injuries these items are designed to prevent. Families with a range of safety behaviours may also be 'safer' in other ways. Further exploration of factors that may explain lower injury rates in these families is required. Information on safety behaviours may be useful for targeting and monitoring injury prevention activity.