If you want to make your home hazard-free, start with stairways and other places where people can fall. Falls are far and away the most common cause of accidental death and serious injury, in the home, and they are a particular problem for the elderly.

About a third of the 28,400 accidental deaths that occurred in U.S. homes in 1997 resulted from falls, according to National Safety Council figures that are the latest available. Each year 200,000 people older than 65 wind up in the hospital with a broken hip suffered in a fall.

If you want to reduce the risks, stairways are a good place to start. They should have sturdy handrails at the appropriate height--a minimum of 32 inches above the stair treads, with 36 inches a better choice--and stairs should be evenly spaced and of a consistent height, Baker says. They should also be well lighted and be free of toys and other things someone could trip over.

Loose rugs are another big problem because they are easy to trip over. Use a non-slip mat under rugs.

Airborne hazards

Some household hazards can't be seen because they're in the air. Carbon monoxide accumulates when gas, oil, wood or charcoal doesn't burn completely. Breathed in small amounts, it can make someone feel tired or even cause chest pain. In larger amounts, it can cause headaches, dizziness, flu-like symptoms and death. Install a carbon monoxide alarm to warn of dangerous levels of the gas.

Childhood Accidents

A house is an exciting place for infants and small children, who love to explore but aren't aware of the potential dangers. Protecting your child from household dangers is your job - and it's a job that will always be evolving to keep up with your child's growing mobility and curiosity. Even before your baby comes home from the hospital, you will need to think carefully about his safety at home. And as he grows older, your job becomes more difficult, as he touches, tastes, and climbs his way through the world.

Life can't be risk-free, but most household accidents can be prevented by utilizing a household safety checklist. This will help you identify and eliminate potential hazards in your home.

Animal Bites

Pets and children seem like a natural combination - until one oversteps the other's boundaries. Take note of the following to promote household harmony:

• Never leave infants or toddlers alone with a family pet.
• Don't keep undomesticated animals (ferrets, for example, like to bite) as house pets.
• When choosing a family pet, look for one with a calm disposition. For example, some dog breeds tolerate children better than others; research breeds to find one that is appropriate for your family. There are even Web sites now that help you match family characteristics with the best breed of dog.
• Children under 4 years should be supervised when playing with a dog or cat.
• Teach children never to tease an animal, pull its tail or ears, or bother it while it is eating or sleeping. Children should always stay away from pets with their young.
• Children should be taught never to take a toy or bone away from a dog.

• Teach children never to pet or try to play with an animal that they don't know.

Burns

Burns, especially hot water burns (scalds), are some of the most common childhood accidents. Babies and children may be more susceptible to burns than adults are: they're curious, they're small, and they have sensitive skin that needs extra protection. Use these burn-prevention tips when your children are in different parts of the house, the car, and the great outdoors:

Bathroom

• Set the thermostat on your hot water heater to 120 degrees F or lower. A child can be scalded in 30 seconds if the temperature is only 5 degrees higher. If you are unable to control the water temperature (for example, you live in an apartment), install an antiscald device. This will slow water from tub spouts to a trickle if it reaches a certain temperature.

Kitchen/Dining Room

• When cooking, always turn pot handles toward the back of the stove. Don't hold a baby or small child while cooking.
• If you have to walk with hot liquid in the kitchen (like a pot of soup or cup of coffee), make sure you know where your child is, so you don't trip over him.
• Never drink hot beverages or soup with a child sitting on your lap.
• Avoid using tablecloths or large place mats. A small child can pull on them and overturn a hot drink or plate of food.
• Block access to the stove as much as possible.
• Never warm baby bottles full of milk in the microwave oven. The liquid may heat unevenly, resulting in pockets of milk that can scald your baby's mouth.
• Fireplaces and wood stoves must be screened. Radiators and electric baseboard heaters may need to be screened as well.

Outdoors/In the Car

• Use playground equipment with caution. If it is very hot outside, use the equipment only in the morning, when it has had a chance to cool down during the night. 
• Children can get burns from hot vinyl and metal, so remove your child's safety seat or stroller from the hot sun when not in use. If you must leave it in the sun, cover it with a blanket or towel.
• Before leaving your parked car on a hot day, hide the seatbelts' metal latch plates in the seats to prevent the sun from hitting them directly.

Choking

Putting things in their mouths is one of the ways that babies and small children explore the world. Anything that fits can be a danger. Choking is usually caused by food, toys, and other small objects that can easily lodge in a child's small airway. Pay special attention to the following to prevent your child from choking:

Food

• Don't give a child under age 4 any hard, smooth foods that can partially or completely block the windpipe. These include nuts of any type, sunflower seeds, watermelon with seeds, grapes, cherries with pits, raw carrots, raw peas, raw celery, popcorn, and hard candy.
• Some soft foods can also cause choking because they are the right shape for blocking a child's windpipe. These foods, including hot dogs, sausages, grapes, and caramels, can be served if they are chopped into small pieces. Spoonfuls of peanut butter and chewing gum should also be regarded as potential choking hazards.
• When babies begin eating solids, beware of foods like raw apples and pears, which may be difficult to chew without teeth (or with just a few teeth).
• Encourage children to sit when eating and to chew thoroughly. Teach them to chew and swallow their food before talking or laughing.
• Never let children run, play sports, or ride in the car with gum, candy, or lollipops in their mouths.
• Be especially vigilant during adult parties, when nuts and other foods might be easily accessible to small hands. Clean up early and carefully, and check the floor for dropped foods that can cause choking.

Toys

• Always follow all manufacturers' age recommendations when buying toys. Some toys have small parts that can cause choking, so heed all warnings on a toy's packaging.

• Never buy vending-machine toys for small children; these toys do not have to meet safety regulations and often contain small parts.

• Check toys frequently for loose or broken parts - for example, a stuffed animal's loose eye or a broken plastic hinge.

• Warn older children not to leave loose game parts or toys with small pieces in easy reach of younger siblings.

Balloons and Other Small Objects

• Never give balloons to a child younger than age eight. A child who is blowing up or chewing on a balloon can choke by inhaling it. Inflated balloons pose a risk because they can pop without warning and be inhaled.

• Safely dispose of button-cell batteries.

• Encourage children not to put pencils, crayons, or erasers in their mouths when coloring or drawing.

• Don't reward small children with coins.

Cuts

It's normal for children to get scrapes and cuts on the playground, but they must be protected from sharp and dangerous items around and outside the house. Take note of the following to prevent injuries from occurring in the kitchen, bathroom, and garage:

Kitchen and Bathroom

• Keep knives, forks, scissors, and other sharp tools in a drawer with a safety latch.

• Keep glass objects, such as drinking glasses or bowls, in a high cabinet far from reach.

• Store appliances with sharp blades (like blenders or food processors) far from reach or in a locked cabinet.

• Make sure your child is a safe distance away when you load and unload the dishwasher.

• If possible, keep the kitchen garbage can behind a cabinet door with a safety latch.

• If you use a razor to shave, keep it in a locked cabinet in the bathroom. Be sure extra blades are stored in a safe place, along with nail scissors and other sharp tools.

Garage

• Store all tools, including those used for gardening, automotive, and lawn care, in a locked container.

• If you recycle glass and metal in your home, keep the recycling containers far from reach.

Drowning

Infants and small children can drown in only a few inches of water. Protect them from danger by providing constant supervision whenever they are near water:

Bathtub/Bathroom

• Never leave a baby unattended in the bath. If you must answer the telephone or door, don't rely on an older sibling to watch the baby; wrap your baby in a towel and bring him with you.

• Stand guard over a bathtub that is filling with water.

• Don't use a bathtub seat with suction cups. The seat can overturn and flip a baby headfirst into the water.

• Install a toilet-lid locking device.

• Never leave a small child unattended near a bucket filled with any amount of water or other liquid.

Pool Area

• If you have a pool in your backyard, install fencing at least 4 feet high on all sides of the pool. Install a self-closing gate with a lock that is out of a child's reach.

• Don't leave children unattended by a pool, wading pool, or hot tub - even for a moment.

• Flotation devices like water wings and inflatable rings can give a false sense of security in the pool. Never use these as a substitute for constant adult supervision.

• Dump out all water from a wading pool when you are finished using it.

• Remove any ladders from an above-ground pool.

Electric Shock

Many household outlets and cords are right at a toddler's eye level. Protect your child from electric shock by following these safety rules:

• Cover all unused outlets with safety caps.

• Unplug all kitchen appliances when not in use, and keep cords far from reach.

• Unplug all bathroom appliances (hair dryers, curling irons, electric razors) when not in use.

• Position television and stereo equipment against walls, so small hands don't have access to the back surfaces or cords.

• To prevent injury from chewing on cords from lamps or other electrical equipment, bind excess cord with a twist-tie. You can also purchase a holder or spool specially designed to hide extra cord.

• Make sure all wires in the house are properly insulated.

• Check electronic toys frequently for signs of wear and tear; any object that sparks, feels hot, or smells unusual must be repaired or discarded immediately.

• Seasonal lighting, such as Christmas tree lights, can pose an especially inviting hazard. Make sure all wires are properly insulated, bind excess cord, and unplug all lights when they are not in use.

Falls

Babies and infants can be wiggly and roll around easily; toddlers and small children can climb their way into trouble. Protect your children from falls by paying special attention to windows, cribs and beds, different areas of the house, and outdoor playgrounds.

Walkers

• Babies in walkers can fall over objects, can roll into hot stoves, pools, and heaters; most dangerously, they can roll down stairs where a baby is at risk of head injury at the bottom.

• Walkers may give a baby the momentum needed to break through a gate (sometimes with stairs on the other side), something that results in head injuries to thousands of babies each year. The American Academy of Pediatrics (AAP) discourages their use.

Windows

• Install safety bars on upper-story windows. These bars must be childproof but easy for adults to open in case of fire.

• If you don't have safety bars on your windows, close and lock windows when children are present. For ventilation, open windows from the top, and provide adult supervision.

• Keep furniture away from windows to prevent children from climbing onto sills.

• Don't rely on window screens to keep children from falling out of windows.

Cribs/Beds

• Keep side rails up on cribs.

• Never leave a baby unattended on a changing table or bed. When choosing a changing table, opt for one with 2-inch guardrails.

• Always secure safety belts on changing tables, strollers, carriages, and high chairs. Be sure to strap a small child securely into the seat of a supermarket shopping cart.

• Do not put a child under age 6 on the top bunk of a bunk bed. Attach guardrails to the side of the top bunk.

Around the House

• Attach protective padding or other specially designed covers to corners of coffee tables, furniture, and countertops with sharp edges.

• Install hardware-mounted safety gates at the top and bottom of every stairway (pressure-mounted gates are not as secure). Avoid accordion gates, which can trap a child's head.

• Clean up any spills around the home immediately.

• Keep stairways clear.

• Make sure there are no loose rugs on the floor. Put specially designed pads under rugs to hold them securely to the floor's surface.

• Apply nonskid strips to the bottoms of bathtubs.

Outdoors

• Be sure outdoor playground equipment is safe, with no loose parts or rust.

• Playground surfaces should be soft to absorb the shock of falls. Good surface materials include sand and wood chips; avoid playgrounds with concrete and packed dirt.

• Never allow a child to play on a trampoline, even with adult supervision.

Injury From Firearms

In 1998, accidental shootings took the lives of 121 children aged 14 and under in the United States, and sent another 1,500 to the emergency room with unintentional firearm-related injuries. The best way to prevent injury and death from firearms is to avoid keeping guns in your home and avoid exposing your children to households where guns are kept. If you do own a firearm, or the parents of your children's playmates do, protect your children by ensuring that these rules are followed in your own home and in any home your children visit:

• Store guns in a securely locked case, out of children's reach. All firearms should be stored unloaded and in the uncocked position.

• Store ammunition in a separate place, in a securely locked container out of children's reach.

• Always use trigger locks or other childproof devices. Make revolvers childproof by attaching a padlock so that the cylinder cannot be locked into place.

• Always practice gun safety, and be sure to emphasize to children that guns are not toys and should never be played with.

• Take a firearm safety course to learn the safe and correct way to use your firearm.

Poisoning

Accidental poisoning can occur when a child ingests medications, cleaning products, alcohol, cosmetics, or other toxins. Many well-meaning adults fail to recognize how toxic certain substances can be and leave them in accessible places. Protect your child from the dangers of poisoning by following these rules:

Medications

• Store all medications - prescription and nonprescription - in a locked cabinet, far from children's reach.

• Never leave vitamin bottles, aspirin bottles, or other medications on the kitchen table, countertops, bedside tables, or dresser tops. Small children may decide to emulate adults and help themselves.

• Never tell a child that medicine is "candy."

• Take special precautions when you have houseguests. Be sure their medications are far from reach, preferably locked in one of their bags.

• Don't keep aspirin or other medicines in a pocketbook; children may find them when searching for gum or a toy.

• Child-resistant packaging does not mean childproof packaging. Don't rely on packaging to protect your children.

• Always keep pills and liquids in their original containers.

• Never administer medication to a child in the dark: you may give the wrong dosage or even the wrong medication.

• After taking or administering medication, be sure to reattach the the safety cap, and store the medication away safely.

Cleaning Products

• Store household cleaning products and aerosol sprays in a high cabinet far from reach. Don't keep any cleaning supplies under the sink, including dishwasher detergent and dishwashing liquids.

• Never put cleaning products in old soda bottles or containers that were once used for food.

• When you are cleaning or using household chemicals, never leave the bottles unattended if there is a small child present.

• Never put roach powders or rat poison on the floors of your home.

• Keep hazardous automotive and gardening products in a securely locked area in your garage.

Alcohol

• Don't leave alcoholic drinks where children can reach them. Take special care during parties - guests may not be conscious of where they've left their drinks. Clean up promptly after the party.

• Keep bottles of alcohol in a locked cabinet far from children's reach.

• Keep mouthwash out of the reach of children. Many mouthwashes contain substantial amounts of alcohol.

Lead Paint

• If you have an older home, have the paint tested for lead.

• Do not use cribs, bassinets, highchairs, painted toys, or toy chests made before 1978; these may have a finish that contains dangerously high levels of lead.

Other Items

• Never leave cosmetics and toiletries within easy reach of children. Be especially cautious with perfume, hair dye, hair spray, nail and shoe polish, and nail polish remover.

• Learn all the names of the plants in your house, and remove any that could be toxic.

• Discard used button-cell batteries safely, and store any unused ones far from children's reach (alkaline substances are poisonous).

Strangulation

Babies and children have been strangled by strings on clothing, cords, and infant furniture and accessories. Prevent strangulation by avoiding these sources and modifying certain items in your home:

Drawstrings, Ribbons, and Cords

• Don't buy garments with drawstrings, which can catch on objects and strangle a child. Cut all drawstrings out of hoods, jackets, and waistbands in your child's wardrobe. Cut strings off mittens.

• Clip strings or ribbons off hanging mobiles and other crib toys.

• Strings on crib bumpers should be no longer than 6 inches.

• Always tie up window blind cords so they are out of your child's reach. Cut the cords so there is no loop at the bottom, then secure them with clothespins or specially designed cord clips.

• Don't let long telephone cords dangle to the floor.

• Resist the temptation to put necklaces or headbands on your baby.

• Never tie a pacifier around your baby's neck.

• Don't tether a pacifier to your baby's clothing with a ribbon or piece of string.

• Don't hang diaper bags or purses on cribs - a baby can become entangled in the straps or strings.

Infant Furniture and Accessories

• Crib slats should be no more than 2 3/8 inches apart; anything wider can trap a child's head.

• Avoid cribs with cut-outs in the headboard or foot board.

• Never leave a child alone in a stroller; a child can slide down and trap his head.

• Don't use old accordion-style gates. These can trap a child's head.

Suffocation

Because babies are not yet able to raise their heads, they need special protection from suffocation. But small children are also at risk, primarily due to plastic bags of all sizes. Protect your children from the dangers of suffocation by following these rules:

• Never place an infant face down on soft bedding, such as a waterbed, quilt, sheepskin rug, or mattress cover. The same holds true for any type of soft pillow, such as a beanbag or bead-filled pillow. Avoid large stuffed animals.

• Be sure that a crib mattress fits snugly in the crib. This keeps a baby from slipping in between the mattress and the crib sides.

• Never put an infant down on a mattress covered with plastic or a plastic bag.

• Promptly dispose of plastic shopping bags and plastic dry-cleaning bags. Tie several knots in each bag before throwing it out.

• Keep plastic garbage bags and large sandwich-style plastic bags out of children's reach.

• When cleaning up after a birthday party or holiday, pay special attention to all plastic bags from toy packaging. Collect them and throw them out immediately.

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