Kids’ Falls from Windows Still a Problem, Research Finds

By Cory Hatch 22 August 2011

Emergency rooms treat approximately 5,100 children who’ve fall out of windows every year, and more education is needed to bring that number down, new research shows.

Researchers from Nationwide Children’s Hospital and Ohio State University used emergency room data from the National Electronic Injury Surveillance System to analyze the cases of 3,974 children who suffered injuries after falling out of windows between 1990 and 2008.

Using those data, researchers estimated that emergency rooms across the United States treated an estimated 98,415 children for injuries related from falling out of windows during the study period, equal to about 5,100 children a year, or 14 children a day.

«We’ve known that falls from windows are a problem for children, and we’ve known that for decades,» said study co-author Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio. «The best parent in the world can’t watch their children 100 percent of the time. Children want to check things out, and they don’t know that an open window is a danger that has very severe consequences.»

Injuries decreased in younger children

Injury rates for children younger than five decreased substantially during the first few years of the study, but leveled out starting in about 2000.

Even with that decrease, by 2008 these children still accounted for roughly two-thirds of emergency room visits related to falling out of windows in the study of all children ages 17 and under, Smith told MyHealthNewsDaily.

Younger children are «the most important group,» Smith said. «They’re the group we should focus our prevention efforts on.»

The researchers categorized injuries by the sex of the child and the part of the body that was injured.

The data showed that boys are more likely than girls to suffer window-related injuries. About a quarter of patients who went to the emergency room were hospitalized, and nearly 50 percent of children had injuries to their heads or faces.

Children have higher centers of gravity than adults, Smith said. «When children lean out… they topple forward and they land head first,» he said. «That’s why we see such a predominance of head injuries.»

While data describing the circumstances of these injuries were sparse, researchers think that many children were able to reach windows by standing on furniture. Also, screens were unlikely to help prevent falls, Smith said.

The National Electronic Injury Surveillance System is a database developed to monitor injuries associated with sports activities, recreational activities and consumer products from a sample of 100 hospitals with 24-hour emergency departments throughout the United States.

The data also didn’t reflect children who died before they reached the emergency room, children with injuries that didn’t require a visit to the emergency room and children whose parents sought a different type of medical care.

Still, the study has a lot of merit, said David Mooney, director of the Trauma Program at Children’s Hospital Boston.

Decades ago, big public information campaigns were initiated in cities across the United States, especially in New York City and Boston, Mooney said. As a result, injury rates resulting from falling out of windows dropped.

«I was kind of surprised that things haven’t changed since 2000,» Mooney said. «One of the problems with success is that it breeds complacency. This one has fallen off of a lot of people’s radar in the last few years.»

A problem we can preven

Both Smith and Mooney agreed that the study results call for a renewed public education campaign to prevent falls from windows.

Precautions such as window guards — devices that block kids from exiting open windows — and window stops — which prevent windows from opening more than four inches — can help prevent these injuries.

Other measures, such as moving furniture away from windows and placing soft landing surfaces such as bushes beneath windows, can also help keep children safe, the researchers said.

«This is a continuing serious childhood injury problem in this country, and we know what works,» Smith said. «We need to apply what we have learned in the past from New York City and Boston. This is a problem we can prevent; we need to do more about it.»

Pass it on: Thousands of children suffer injuries each year due to falling from windows, and simple precautions such as installing window guards and moving furniture away from windows can help keep kids safe.

This story was provided by MyHealthNewsDaily, a sister site to LiveScience. Follow MyHealthNewsDaily on Twitter @MyHealth_MHND. Find us on Facebook.

CHOC Children’s Blog

5 ways to protect children from window falls at home

The combination of warming weather and children spending more time at home due to the COVID-19 pandemic prompts an important reminder for parents to protect kids from window falls.

In March and April 2020, the CHOC Trauma Center treated eight patients injured after falling from windows. By comparison, clinicians there treated three patients for window falls during the same time period in 2019.

“Forty-three percent of all trauma cases here at CHOC are related to unintentional falls, and of those, 35 percent were window falls,” says Amy Waunch, CHOC’s trauma program coordinator.

Window screens are no match for even a young child’s weight, and small kids can squeeze through openings as narrow as 4 inches. Any window higher than 6 feet from the ground poses a risk for serious, even fatal injury.

“Boys younger than 5 are at the biggest risk, and the peak age is 24 months,” says Amy Frias, a CHOC community educator and the Orange County coordinator for Safe Kids Worldwide.

With Trauma Injury Awareness Month underway, here are five tips from CHOC experts to help keep kids safe from window falls:

1. Lock them down— Install removable window locks or guards to limit a window’s opening to no more than 4 inches. Be sure the device can be removed quickly by adults in case of an emergency. Keep windows locked when not in use.
2. Open windows strategically – If your home has double-hung windows, which open from both the top and bottom, open just the top to prevent falls.
3. Practice vigilance – If you open windows to let in fresh air, be mindful of closing and locking windows before you leave the room.
4. Position furniture carefully – Keep beds, bookcases, chairs, play chests and other furniture away from windows so your child isn’t tempted to climb.
5. Supervise, supervise, supervise – As with all injury prevention efforts, keeping an eye on kids is critical. As children grow, their abilities, strength, dexterity and curiosity grow too – and they may be able to outsmart your best-laid safety plans.

If your child does fall out of a window, call 911 and avoid moving your child. A traumatic injury to the head, neck or spine may not be immediately obvious.

Falls from windows injure 5,000 kids each year: Study

August 22, 2011 / 11:49 AM / CBS News

(CBS/AP) Why are so many kids falling from windows?

Each year in the U.S. more than 5,000 kids and teens fall out of windows, ending up in the emergency department, according to a new study. That’s 14 per day. And it’s not just urban kids who are getting hurt — the study found most falls are from first and second floor windows.

«This is more than just a big-city problem,» said study author Dr. Gary Smith, director of the center for injury research at Nationwide Children’s Hospital in Columbus, Ohio.

Beth Harlan, suburban mother from Galloway Ohio, knows that’s true.

Two years ago her 6-year-old daughter, Sidney Dillon, was sitting on the sill and leaned against the window screen before falling two stories. By the time Harlan walked into the room, it was too late.

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«I came upstairs just in time to see her falling,» Harlan said. Luckily, Sidney fell into a bush and landscaping mulch without breaking any bones. But, the accident frightened both mother and daughter.

«Don’t ever think that kind of thing can’t happen to you,» Harlan said. «Never in a million years, when I opened up the window, did I think my kid would decide to sit in a windowsill.»

But 6-year-old Sidney was older than the average age of children who fall. The study -published in the August 22 issue of Pediatrics — showed preschoolers are at the highest risk for falls and suffer more head injuries than older children.

«Two-thirds of these injuries occurred among children younger than 5,» Smith said. This is the age group that’s mobile, curious and does not recognize the danger of falling from a window.»

For the study, researchers analyzed data from emergency departments from 1990 through 2008, and found an estimated 98,415 children were hurt during that time. The researchers found less than 1 percent of cases led to deaths, but researchers said the tally likely underestimated fatalities because not all children who die from injuries are brought to the ER.

Other results showed summer months -when windows are left open — saw the most injuries, while one- and two-story falls made up 94 percent of the falls where height was recorded. Overall injury rates from falls have declined 4 percent over the past 19 years — the average yearly injury rate was about 7 injuries per 100,000 children.

According to Smith, increased awareness of the danger, improved window construction and the use of window guards — that allow windows to open but keep children from falling — may explain the decrease.

Some towns may want to take a lead from the big cities to stop falls. New York City achieved decreases in injury rates through public awareness campaigns and laws that require window guards in apartments with kids age 10 and younger.

«The public awareness campaign is an important first step in building consensus,» said Dr. Andrew D. Racine of New York City’s Montefiore Medical Center, where window fall injuries are now rare. «But not until you get the mandatory regulations in place are you going to see the kind of impact you’re trying to achieve.»

Besides window guards, which cost $20 to $40 and have a quick release feature that allows escape during emergency, experts say parents should move furniture away from windows and open windows from the top, if possible.

Dr. Robert Glatter, attending emergency physician at New York City’s Lenox Hill Hospital, told CBS News in an email that cushioning bushes or flower beds below windows » may reduce the chances of a major injury» if a child falls.

«We know what works and yet we still have over 5,000 children a year being rushed to emergency departments because of falls from windows,» Smith said.

First published on August 22, 2011 / 11:49 AM

© 2011 CBS Interactive Inc. All Rights Reserved.

Child Falls from Windows: Preventable!

Mark Meshulam is an expert witness for cases of child falls from windows and a window safety consultant.

As long as there is gravity and windows it is sadly inevitable that there will be people falling from windows, resulting in injury or death. Unfortunately, most who suffer these window fall accidents are children, and most of these child falls from windows could have been prevented.

A number of studies have delved into the statistics regarding child falls from windows. This study, published in September 2011 in Pediatrics, the Official Journal of the American Academy of Pediatrics, took a new and unique tack. It is a study entitled, “Pediatric Injuries Attributable to Falls From Windows in the United States in 1990-2008” by Vaughn A. Harris, Lynne M. Rochette and Gary A. Smith.

The authors accessed a wealth of data provided by the National Electronic Injury Surveillance System (NEISS), a service of the CSPC, the Consumer Product Safety Commission. NEISS uses data from about 100 hospital emergency departments and extrapolates their results to represent activity at 6100 similar hospitals.

Neiss – National Electronic Injury Surveillance System

These data are publicly available. You can query the NEISS system for free. NEISS even publishes a coding manual that helps the user inputting search criteria for injuries associated with consumer products such as windows.

Broad range of data

The authors analyzed the output from their search by tabulating data for years 1990 through 2008. In this data they searched for and analyzed descriptive language filed in the accident reports. They obtained the normally available data fields such as gender, age, treatment level and injury type. Then they teased out additional data, such as height of window fall, status of the window, presence of a screen, involvement of nearby furniture and even the landing surface. The study generated a surprising amount of data.

Product codes used in study

These are the window fall related NEISS product codes studied: Windows (1894), storm windows (1826), window glass (1870), window sills (1870), window blinds (1828), shades or shutters (0638), window screens (1828), plastic window panels (1854), window barriers (1888), and window locks (0707).

Double hung, single hung and sliding windows are similar in operation. They have a similar set of locking solutions. A lock that limits the sash travel to a set maximum is called a limit stop. Use of limit stops can virtually eliminate child falls from windows. Above, a variety of limit stop and window guard solutions are presented

Results of child window fall study

During the 19 year study period, about 98,400 children were treated in US hospital emergency departments for injuries related to falls from windows.

Mortality rates for child falls from windows

.2%, or 197 children, an average of over 10 children per year, died of their window fall injuries. The fatality statistic is unrealistically low because children who fall from windows and die immediately were not taken to emergency departments and therefore were not counted. The true number could be many times that which was reported. The US Consumer Product Safety Commission stated they knew of 120 child window fall related deaths to 1990-2000, which averages to about 11 per year.

Three quarters of those children injured in falls from windows were treated and released. One quarter of children who fell from windows became inpatients.

Worst ages for child falls from windows

Injuries increase with the temperature. Incidence of window fall injuries spiked for ages 2-5, then tapered to a lower level through age 17. Age two has especially high injury rates, giving new meaning to the phrase the “terrible twos”.

Findings presented by Karen Sheehan, MD, MPH, Medical Director Childrens Memorial Hospital. “Lessons Learned: Preventing Window Falls in Chicago”

Gender and child falls from windows

Boys represented 58% of the injured by falls from windows. Thirty eight percent of these injured kids displayed risky behavior such as climbing out of or jumping from a window.

Window height and injury seriousness

31% of the children fell from a one-story window. 63% fell from a window on the second story. The remaining 6% fell from windows three-stories or higher. Understandably, this last group had a higher percentage of fractures or death as a result of the fall.

Insect screens and child falls from windows

83% of the windows had a window screen in place before the fall. The authors state that “Parents and other child caregivers should be counseled not to depend on window screens to prevent children from falling out of windows. To prevent these falls, window guards or window locks that prevent the window from opening greater than 4 inches should be used.”

Window type and falls from windows

Adjacent furniture and child falls from windows

4% of window falls involved adjacent furniture that raised the child closer to the window. This number is also low due to low availability of data. Only 5% of the cases had information on this topic. However if you extrapolate the numbers, you could justify a percentage as high as 80% where child falls from windows involved adjacent furniture or other items they could step upon.

Landing surface and child window fall injuries

There was only information regarding the landing surface in 24% of the child window fall occurrences. Of these, 40% landed on hard surfaces such as concrete or asphalt, 43% landed on firm surfaces such as dirt, and 16% landed on soft surfaces such as bushes. Those who landed on hard surfaces were more likely to sustain head injuries. The authors state, “In a window fall, the 2 factors that determine the amount of energy transferred to a child’s body on impact with the landing surface are the height of the fall and the energy-absorbing capacity of the surface. Therefore, window fall prevention efforts also should consider the properties of the surfaces below windows.”

Public awareness of child falls from windows

The rates of child falls from windows were much higher before 1996. There may have been a positive effect of public awareness and local programs such as “Kids Can’t Fly”, which promoted the use of window guards to prevent child falls from windows.

Window limit stops are critical

The authors conclude: “Prevention measures for young children should aim to prevent window falls by reducing the child’s opportunity to exit the window, through the use of devices such as window guards or window locks and through placement of furniture away from windows, to decrease access to windows by young children.”

This little device (arrows) is built in to many newer single and double hung windows. Unfortunately many people don’t know what the flat rectangle on their window is (left). It is a “night latch”. Flip it out to limit sash travel. This does not comply with the latest standards for WOCDs (Window Opening Control Devices)

European study of child falls from windows

The 2006 article “The silent epidemic of falls from buildings: analysis of risk factors”, by Lena Mayer, Martin Meuli, Ulrich Lips and Bernhard Frey studied seven years of emergency department activity at the University Children’s Hospital Zurich. Their results, which include falls from windows and balconies, will have a familiar ring:

Fifteen children (49%) climbed on a piece of furniture before falling from the window. In almost 20% of the accidents dangerous balcony or house constructions led to the fall. In seven accidents (23%) there was a chair, a bed, or bedside table, a sofa or a ledge in front of the window allowing the children to move up.

They also found that child window falls correlated more strongly with “an immigrant family setting” and low socio-professional category of the parents.

Hopper windows, also known as project-in, are similar in construction to awning windows (project-out), and casement windows (side hinged, inswing or outswing). Two main devices for limiting sash travel are used with these windows. Top left: a limit device that attaches to sash and frame and limits sash travel to prevent child window falls. Lower left shows a closeup of the hopper hinge. The arrow points to a metal shoe that travels along the hinge track. To limit the sash opening, a metal bar is placed in the track and screwed in position.

Window Guards
The American Academy of Pediatrics has issued a policy statement entitled “Falls From Heights: Windows, Roofs, and Balconies”

The policy points out children older than one year old can not pass through a 4-in opening. As a result of this, most regional code agencies have adopted the 4-in spacing standard.

“In 1976, the New York City Board of Health, noting that child falls from windows accounted for 12% of deaths from unintentional injury of children younger than 15 years, passed a law requiring the owners of multiple-story dwellings to provide window guards in apartments where children 10 years and younger reside. The pilot program resulted in a 35% reduction in deaths attributable to child falls from windows and a 50% reduction in child fall incidents; no child fell from a window equipped with a window guard.”

“The mandatory program resulted in a reduction of up to 96% in admissions to local hospitals for the treatment of window-fall-related injuries. Follow-up through 1993 revealed a continuing downward trend. Recent data on the New York City experience showed no increase in the number of deaths attributable to residential fires (in fact, there was a decrease) after the introduction of window guards as required by city ordinance.”

Guidance from U.S. Consumer Product Safety Commission

To help prevent window fall injuries and tragedies, CPSC recommends the following safety tips:

• • Safeguard your children by using window guards or window limit stops.
  • Install window guards to prevent children against falls from windows. (For windows on the 6th floor and below, install window guards that adults and older children can open easily in case of fire.)
  • Install window stops so that windows open no more than 4 inches.
  • Never depend on screens to keep children safe from falls from windows.
  • Whenever possible, open windows from the top, not the bottom.
  • Keep furniture away from windows, to discourage children from climbing near windows.
  • Some jurisdictions require landlords to install guards. Check your local regulations.

Recent News at the time this article was written

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Mark Meshulam, Chicago Window Expert, reminds you to protect our precious children from the danger of falls from window No matter where you are,
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17 thoughts on “Child Falls from Windows: Preventable!”

Yes, there have been several incidents of children falling out windows in our area, with some miraculous survivals. We put bars on the boys’ bedroom windows when they were young.
Cheers,
Randy Fleitman
Fairfax, VA

I always enjoy your missives. The last two were particularly reminiscent for me. One of my very first encounters with the legal system and the window business back in the late 70’s had to do with a child falling out of a window (S/H) and where the window manufacturers liability ended.

The prior article you re did about SAK was amazing and brought back so many memories of my time at CRL, the people that were there and are now gone and the many lessons I learned there.

SAK will be missed as was John Ely when he moved on into a better world I hope. Maybe they are together working on reconfiguring and testing the “Pearly Gates”.

Robert Voigt
President
BV and Associates, Inc.

Your email has inspired me. I hope far more children are exposed to the dangers of unprotected windows. Preferably on YouTube. With sound effects.

Mark and friendss always a pleasure and yet so sad… google up the phrase “children falling high rise dubai” and story after story of children clambering up to and then falling out of high rise… punches me in the gut and utterly common here and the government doing what about it? Hauling the parents off to jail for endangering their kids. And that’s it.

Horrid and so preventable and yet hand wringing does nothing does it? I cannot speak of this further and am without any power to do anything about it… operable windows in high rise? Falling? Children? Architects? Engineers? Building Owners? Anyone interested in fixing this?

No as that would cost money. And not my problem.

Disgusting is too mild a term.

Thanks Mark… with your post maybe you will save a life from someone who reads this.

Preventable? Probably most if not all are with a bit of thought and not much expenditure. Opening limiters are useful to allow windows to open partly but not enough to allow anyone to fall out of. Locking handles help, but only if the key isn’t left in the handle! Properly thought through fastenings; we have a project on where there are narrow floor to ceiling windows in an office building. Each window is about 600mm (2 US feet) wide. The original ironmongery in the aluminium frames packed up years ago and so the managing agents had ‘Brighton’ sash fasteners fitted, designed to lock double-hung vertical sashes, not side-hung windows closed. These have screwed acorns which lock the fastener but these are made of pressure die-cast zinc (crapite) and the threads have stripped. Built ‘under former control’ the windows don’t have a mid-rail at 1100mm (3’7″ US) AFFL as the Building Regulations would now require. Last week a tradesman leaned against a window, the acorn pinged off, the fastener opened, the window swung open and he nearly fell through the opening from the 3rd floor (4th floor US) into the street below. A distinct brown trousers moment for him. It has prompted a radical rethink over all the windows in the building to check how they are secured shut and how effective the fasteners are. As the building is air conditioned, there is no need to open the windows anyway.

As a risk assessment, the answer is yes, there is a likelihood of falls through the windows, falls will be almost inevitably fatal, it is practicable to redesign the system to remove the risk and the cost of doing so would not be unreasonable. The previous ‘repair’ was ill-thought out and didn’t answer the identifiable risk properly. The fact that we did not have a fatality last week is simply down to nothing more scientific than luck. It was an near-miss accident that was eminently preventable.
MIchael Ney
Schroeders Begg LLP
Guildford, United Kingdom

I have to admit that after I wrote the article and as an afterthought googled “falls from windows”, I was horrified at the news stories that abound, and especially the little girl who died in Abu Dhabi only yesterday. I placed links to some recent news article at the bottom of mine at ChicagoWindowExpert.com and hopefully some of these will hit home somewhere in the world.

Have a look at the Angel Ventlock from Mighton Products. It’s designed to meet the stringent standards in the USA and in the UK. It meets ASTM F2090 – 2008/2010 safety codes. This is a global issue.

Thanks for that reference, Iain. Their products look really good. Here is a summary of the ASTM standard, which was posted on the Angel Ventlock site

ASTM F2090-2008 AND 2010

Open Window – No more than 4 inches
When opening control devices or window fall prevention screens are properly engaged, the window opening must be less than 4 inches. Release Mechanism – No tools or special knowledge for emergency escape Window opening control devices must have release mechanisms to allow an escape in case of an emergency. They should be designed to allow an escape without the need for special knowledge, tools or keys.

Release Mechanism – Independent operations of release mechanism
To protect against the unintentional operation by a young child, the emergency escape release mechanism must be operated either by

two independent single actions or
one dual action

The sash and the release mechanism needs to operate independently of each other.

Force Needed – Maximum force 15 lbf
The force required to release the emergency escape mechanism should not exceed
15 lbf (66N).

Automatic Reset
After the window opening control device is released, it must automatically reset when the window sash is fully closed.

Easily Seen Indicator
The emergency escape release mechanism must be clearly visible so that it can be used in an emergency situation without impediment.

No interference with integrity of window
Opening window with the control device must not interfere with the operation, function or performance of the window. The opening control device must also comply with any other applicable code standard requirements.

Instructions / Warnings that must be included
Each aftermarket window opening control device, when sold, must include installation instructions, operating instructions and safety information in the packaging.

Weather
The emergency escape release mechanism must operate properly under all reasonably foreseeable operating – and weather conditions.

Testing
Window opening control devices must be tested and need to meet all requirements in accordance with Section 8b.

Other
Window opening control devices and emergency escape release mechanisms must not prevent the window unit from complying with applicable code requirements for minimum opening size.

6″ to 4″ limit stops are often found in the specifications we receive for condo/apartments. This works provided the tenant leaves them on.

Richard Serzy
Senior Project Manager at Thermal Windows Inc
Tulsa, Oklahoma Area

Horrid. Crying actually now. I am am tough man and live in a tough world. But children falling out of CW windows that we fabricate.
I am without words.
You men of CW I hold liable…

Interesting… I suppose… but did anyone really need to spend money to study this only to conclude that restricting openings to 4 inches will prevent accidental falls through windows? Our building codes nationally restrict the openings (and have for some time) on windows in high-rises, and at guard rails everywhere for this exact (and obvious) reason.

A great example of academic wastefulness, likely supported by ‘free’ money originating with taxpayers. Anyone in the design or building industries could have given you the same answer for free over coffee.

thanks, Mark, I appreciate your work, and this one is a good public safety service.

Howard – well said. Both our Standard Building Code and South FL Building Code addressed this prior to the state-wide FBC. As more consultants jump into the forensics, claims and litigation support pool, they are not aware of all that licensed architects are required to know. No disrespect to Mark as he may be just be inviting discussion.
I never understood how a child’s fall through a casement window in NYC back in 1991 occurred, but the reported details never addressed the how or why, since the accident was so tragic, and the child of a well known individual.

Sorry to know about the topic.
I am a facade contractor. My ongoing project at Mumbai had a problem.
The client needed an Automatic sliding door for which we suggested Dorma, but the client opted for local brand for which We delayed the job for 2 months. The reason was, It has the only one exit. The client was not ready for second / emergency exit.
My concern was, at the time of emergency if the local brand fails & No emergency exit available. THEN WHAT ?
After the client promised for second exit, I executed the job.
Bottom line: The Developers are playing with Human Life– for their own monetary benefits.
Regards
Nasir
Posted by Nasir Shaikh

Mighton Products have the patented Angel Ventlock which meets the ASTM regulations and has even been used on USA military bases. It’s a product designed exclusively for sliding sashes. Even the RoSPA statistics show that 4,000 children are injured as a result from falling from windows every year in the UK. This is 4,000 too many. In the UK we need better legislation.

I cannot find the sash limiter requirements for commercial buildings (incl. apartments, condos, hotels etc) that specifically call for sash limitations. I believe IBC is (Burlingame Ca) the governing code though not sure which year…. But I would like to have whatever codes are applicable to this requirement in general. For years I have alerted salesman to be careful over 3 stories and to be sure to review with AHJ or simply provide sash limiters over the three stories..

Your website is great , I found it with Google!

Let me know and thanks so much for taking your time to help me out.

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Deadly falls or any other kind of falls should be prevented by having a security window with bars in it.