FALLS - EPIDEMIOLOGY AND STRATEGIES FOR PREVENTION

Injury secondary to falls is a largely preventable public health probl em. The records of 356 patients admitted following a fall to a level I trauma center over a 32-month period were reviewed to determine the e pidemiology and to define possible prevention strategies. Palls consti tuted 9% of total trauma admissions during this time period and had a mortality of 11% (38 of 356). Two hundred ninety-seven falls were acci dental, 36 were due to violent criminal behavior, 16 were from suicide attempts, and 7 were from house fires. Sixty-one children under the a ge of 13 fell; only one died. Falls out of windows accounted for 36% o f these falls with over three-quarters of children falling from three stories or less. Elderly patients (age more than 64 years) accounted f or only 44 (14%) of falls but over 50% of the deaths. This mortality r ate occurred despite the fact that the majority of these falls were fr om relatively low heights. There were 224 adult falls (ages 18 to 64 y ears); 36% were occupation-related, and most were by construction work ers, roofers, or painters. The remaining adult fall victims had a high rate of unemployment and alcohol and drug use. This study identified several groups where risk factors for falling permit targeted preventi on strategies. A large percentage of children who fell were preschool males who fell from windows and this may be related to the lack of win dow guard legislation in our area. Educational and community service p rograms should be aimed at the elderly, since most of the falls occurr ed at home during activities of daily living and resulted in significa nt mortality. Nonoccupational falls by adults correlated with poor soc ioeconomic factors such as unemployment and substance abuse which will be difficult to modify.