The "National Institute of Statistics (Istat) defines how domestic accident that type of injury that:
- occurs in the home (this term means both the actual apartment and the external areas such as balconies, cellar, attic, garage ...)
- it is not voluntary
- temporarily or permanently changes a person's state of health
Domestic accidents represent a health, social and psychological problem of particular interest, as well as having an economic impact on the costs of the National Health Service.
A home accident can cause injuries and injuries of varying severity, disability or even death. It can happen to any person regardless of age although, according to data from the World Health Organization (WHO), this type of accident is one of the major causes of fatal trauma and trauma is the leading cause of death in children worldwide. , currently the second in Italy, after tumors.
Although one's home is traditionally considered as one of the safest places, from ISTAT data it is estimated that more than 3 million cases of domestic accidents occur every year in Italy. A number, however, lower than the real number also considering all those accidents which, not needing a specialized medical intervention or hospitalization, are not reported.About 1,800,000 people involved in domestic accidents require first aid assistance.From the data of hospital admissions it appears that over 80,000 per year are performed for this cause.
The greatest risks and the most serious home injuries occur as a result of falls, burns, poisoning and suffocation.
A very widespread phenomenon, therefore, which requires urgent prevention and control activities.
The most affected categories
According to Istat surveys, women, in particular housewives (with over 70% of injuries), are the category of people at greatest risk of domestic injury (about 600,000 in 2019).
From the data from the hospital emergency rooms, the groups of the population at greatest risk of domestic injury are children, the elderly and adult women engaged in domestic work.
Among women, one in three states in the Istat survey that they have had an accident at home in working age. This depends on the longer exposure time to the environment and to domestic work.
In general, women who work in a home, for example serving children or the elderly, are also at greater risk of injury on a daily basis.
Two other categories of people at risk are the elderly and children (especially under the age of 5).
The former, especially those over eighty, are at greater risk due to a reduction in psycho-physical abilities due to the natural process of aging or health problems. In old age, in fact, a reduction in autonomy in general is observed. difficulty seeing and moving. In particular, the ability to coordinate movements, the maintenance of balance and visual depth decreases. The health problems that arise are of a broad spectrum, from cardio-vascular to articular ones, from bone diseases (in particular the "osteoporosis for postmenopausal women) to reasoning, memory and language problems (cognitive problems).
Furthermore, the role of taking many drugs at the same time should not be overlooked, in particular anti-depressants and other psychotropic drugs, which can further contribute to the loss of attention.
Children, on the other hand, especially the very young ones, from 0 to 5 years of age, in their growth process tend to explore the surrounding environment without having full control, full awareness and ability to react to possible risks and dangers. older children, on the other hand, it is the natural exuberance that can lead them to exceed their limits or to act without properly assessing the risks.
The most frequent domestic accidents
Based on data collected by the SINIACA system (National Accident Information System in Civil Housing Environments), set up at the Istituto Superiore di Sanità (ISS), the most frequent domestic accidents are:
- falls (one in two people and especially elderly women), can cause not only physical damage, and consequent disability, but also psychological disorders, anxiety and depression due to the fear of falling again
The main factors that cause falls in the home are:
- stairs (fixed or removable)
- chairs, stools
- smooth, wet or uneven floors
- electric wires or extension cords
- bathroom mats
- various obstacles (protrusions and edges, feet or legs of the furniture)
- insufficient lighting
- taking medications, capable of causing drowsiness, motor disturbances and blurred vision
- diseases such as osteoporosis
Other frequently observed injuries are:
- sprains, bruises and fractures, especially in the lower and upper limbs
- stab wounds, generally borne by the upper limbs of men and housewives. They are mostly caused by the use of small appliances and utensils in use in the kitchen such as knives, sharp objects, glasses, bottles, cans, metal cans, jars or pieces of glass
Less frequently observed injuries in the emergency room, but which can have serious consequences are:
- ingestion of foreign bodies, impact or crushing, particularly in children and young people between 6 and 17 years old
- sunburn and burns, especially in children between 2 and 5 years of age and in adult women engaged in domestic work. Mostly they are caused by boiling water and steam, boiling oil and fat, stoves, ovens, stoves, hot pots and pans, irons, etc. Among burns, very serious damage can be determined by the electrocution. It can be caused by:
- malfunction or incorrect use of electrical appliances (touching hair dryers, razors or other appliances plugged into an electricity socket with wet hands or feet on damp surfaces)
- presence of multiple flying sockets or use of unsuitable adapters, with current overload and risk of sparks, flames, short circuits, fires. The latter can also be caused by stoves, fireplaces, lit cigarettes and overheated surfaces
- electrical systems not up to standard, (protection by "earthing" is mandatory)
- suffocation, intoxication, poisoning, especially in children between 2 and 5 years of age and in adult women engaged in domestic work. In this case, the risk factors mainly depend on the chemicals contained in household cleaning products (detergents, descalers, deodorants, etc.). The more aggressive ones can be very harmful especially if they come into contact with the mucous membranes, with the eyes or if they are inhaled or ingested.
Among those with a higher degree of toxicity or causticity are reported:
- mothproof (mothballs, camphor)
- bleaches (sodium perborate or sodium hypochlorite)
- toilet cleaners (benzalkonium chloride, phosphoric acid and surfactants)
- dishwasher detergents (caustic soda, chlorine salts and surfactants)
- descaler (hydrochloric or sulfuric or phosphoric or formic acid)
- drain cleaners for sinks and toilets (caustic soda or phosphoric acid)
- products for cleaning the oven (caustic soda and butylglycol)
- stain removers (trichlorethylene, perchlorethylene, white spirit, acetone)
SINIACA data also show that the domestic environments in which the greatest number of accidents is observed are:
- kitchen, 20 per 100 of cases (20%)
- living room and bedroom, 26 per 100 of cases (26%)
- stairs, 10 per 100 of cases (10%)
- bath, 7 per 100 of cases (7%) due to slippery or wet surfaces of bathroom fixtures, bathtub, shower, floor
- other internal rooms, 8 per 100 of cases (8%)
- garage and cellar, 13 percent of cases (13%)
- garden and other areas outside the house, 6 per 100 of cases (6%)
The main causes of a domestic accident and the consequent injury depend on:
- structural characteristics of the house (stairs, floors, furniture, lack of protection for children, ...)
- wrong behaviors (improper use of household appliances and objects, poor knowledge of risks, underestimation of dangers, etc.)
- factors related to health conditions (disabilities, chronic diseases, etc.)
- risk conditions not always easily identifiable, but which are part of everyday styles and habits (presence and accessibility to detergents, cosmetics, drugs, alcohol in places without safety locks for children, improper storage of dangerous liquids in bottles / containers for food and drinks or use of packaging without child safety caps)
- lack of or insufficient supervision of children
- isolation and lack of adequate means of communication for older people
To try to prevent accidents at home, you first need to help people change their risk behaviors and make their homes safer.
Useful tools for preventing domestic accidents are also:
- information and education campaigns (especially towards the elderly, children, parents)
- dissemination of information material (brochures, leaflets, posters)
- training activities for health professionals
- low cost supply of safety devices (non-slip handles, fire warning lights, etc.)
From a legal point of view, the 2006-2008 National Health Plan and Law no. 343 of 3 December 1999 ("Rules for the protection of health in homes and institution of insurance against domestic accidents") Assigns to the Prevention departments, in collaboration with the local services, the tasks of risk assessment and prevention and health education on domestic accidents.
Specifically, art. 4 of Law 493/1999 establishes that the Prevention departments, in collaboration with the Higher Institute of Health and the Regions, must activate a National Information System on Accidents in the Civil Housing Environment.
On the basis of these legislative provisions, a surveillance system for domestic accidents was therefore established at the Istituto Superiore di Sanità: the SINIACA system, with the aim of launching a national surveillance program for domestic accidents and identifying appropriate measures and prevention strategies.
SINIACA has directed its surveillance and investigation analysis on a sample of over 40 hospital emergency rooms, distributed throughout the country, for the dynamics of accidents and current data relating to arrivals in the emergency room and hospitalization. following a domestic accident.
With regard to sample surveillance, the System provides for the possibility of receiving information on:
- activity carried out at the time of the accident
- environment in which it occurred
- accident dynamics
- products involved in the accident (for a sub-sample of 12 hospitals)
- nature of the main injury and affected area of the body
- destination of the patient and health treatment
EpiCentro (ISS). Domestic accidents
Higher Institute of Health (ISS). National Accident Information System in Civil Housing Environments (SINIACA). Siniac surveillance
A. Pitidis, F. Taggi. Home environment: home safety from knowledge to prevention. Report of the National Information System on Accidents in Civil Housing Environments (Siniaca). Franco Angeli Editions, Milan 2006.
Pitidis A, Longo E, Giustini M, Fondi G and SINIACA working group. Accidents of housewives: a hidden phenomenon. Newsletter of the "Istituto Superiore di Sanità". 2012; 25 (7-8): 13-16
National Institute of Statistics (ISTAT). Aspects of daily life - People: accidents in the home - detail age
De Santi A, Zuccaro P, Filipponi F, Minutillo A, Guerra R. (Ed.). Health promotion in schools. Prevention of road and domestic accidents. Rome: Higher Institute of Health; 2010. (ISTISAN reports 10/3)
EpiCentro (ISS). Domestic accidents. Falls in the elderly
National Institute of Statistics (ISTAT). Press release. Domestic accidents
Ministry of Health. Prevention guidelines. The prevention of domestic accidents in childhood
Observasalute Report 2019. Accidents
Domestic accidents. Iss: 23% of all hospitalizations for trauma and the second leading cause of death in pediatric age. Health Newspaper. 2014; May 14
National Institute for Insurance against Accidents at Work (INAIL). Domestic accidents epidemiology of the phenomenon and insights into the injured population. Technical Papers for Health and Safety, 2012