A multidimensional approach to home accidents in children aged 0-6: a community-based study

Authors

Abstract

AimHome accidents are a significant cause of injury and death among children aged 0–6 due to their limited motor and cognitive abilities. This study aimed to investigate the prevalence, characteristics, and associated risk factors of home accidents in this age group.
MethodsA cross-sectional study was conducted between March and May 2024 with 652 mothers of 1,003 children aged 0–6 attending Family Health Centers in a southeastern province (blinded country). Data were collected through face-to-face questionnaires covering sociodemographic information, maternal perceptions, and accident-related variables. Descriptive statistics, chi-square tests, and logistic regression analyses were performed (p<0.05).
ResultsThe annual and monthly rates of home accidents were 21.9% and 12.8%, respectively. Falls were the most frequent accident type (59.8%), followed by burns (14.8%). Risk factors included being male, age 2–3, and being cared for by someone other than the mother. Logistic regression revealed significant associations between accident incidence and maternal age (<25 years), employment status, number of rooms in the home (≥5), and protective or fatalistic maternal attitudes.
ConclusionIdentifying maternal, environmental, and perceptual risk factors can inform effective prevention strategies and parental education programs. Findings highlight the importance of culturally appropriate safety interventions to reduce accident-related injuries in early childhood.

Keywords

Introduction

Accidents are defined as sudden events that occur outside of human control and lead to physical or psychological harm. Depending on their location and cause, they can be classified as traffic accidents, occupational accidents, industrial accidents, home accidents, school accidents, and sports accidents.¹ Home accidents are defined as unexpected events that occur within the home or in connected areas such as the yard, garage, or garden.² Although data related to records kept in our country are limited, studies indicate that 18-25% of all accidents are home accidents. Children, especially those in the 0-6 age group, are particularly vulnerable to home accidents as they have not yet fully developed their motor skills and cannot foresee dangers. Due to their frequent occurrence and potential to cause disability or death, these accidents are considered a serious and preventable public health issue.³ These accidents typically involve falls, burns, drownings, and poisonings.⁴ In particular, the perceptions and behaviors of mothers, who are primarily responsible for the care of children, are important in the prevention of home accidents.⁵
This study aims to identify home accidents and related factors among children aged 0-6 years, as well as to evaluate mothers' perceptions of accidents. Additionally, it is anticipated that our study will increase mothers' awareness of home accidents and contribute to the literature.

Materials and Methods

This is a cross-sectional study conducted in the central districts of a southeastern province between March and May 2024. The study population consists of children aged 0-6 years, and a representative sample from the central districts of a southeastern province is planned to be taken. According to TÜİK 2023 data, the total number of children in the 0-6 age group in the central districts of a southeastern province is 401,313 .
In calculating the sample size, recent studies in (blinded country) have been considered, and the prevalence of home accidents among children aged 0-6 years is assumed to be 30% . The sample size was calculated using Epi-Info version 7.2.5.0 with a 95% confidence interval, a 5% margin of error, and a design effect of 2. Accordingly, the minimum sample size was calculated as 644, and it is targeted to reach 644 mothers of children aged 0-6 years to collect data. In the central districts of a southeastern province, a total of 80 family health centers (FHCs) are located; considering the socioeconomic differences of the districts, 11 FHCs have been randomly selected. Data collection has been proportionally conducted according to the total number of doctors in the selected FHCs to cover our target sample size.
The study included mothers who have at least one child in the 0-6 age group, are over 18 years old, and agreed to participate during the working hours of the designated FHCs. The dependent variable of the research is the occurrence of a home accident, and the independent variables are characteristics related to the family, home, mother, and child. Data collection tools were specially developed for our study through a literature reviewSurveys were filled out through face-to-face interviews with 670 mothers, averaging 25-30 minutes each. Due to some participants leaving the survey incomplete, data from 652 mothers were included in the analysis.
Ethical ApprovalThis prospective study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and was approved by the Harran University Clinical Research Ethics Committee (Date: 2023-03-18, No: 24.09.27).
Statistical AnalysisResearch data were analyzed using SPSS (version 27.0). Descriptive statistical analyses used mean ± standard deviation (Mean ± SD), median, and minimum-maximum (min-max) values. The Chi-square test and Post-hoc Chi-square analysis were conducted for categorical variables. Factors that could affect the occurrence of home accidents were examined using Binary Logistic Regression Analysis (enter method). Variables with significance found in univariate analyses and a type-1 error level of less than 0.20 were included in the model. The Hosmer-Lemeshow test was used to check model fit. All analyses considered a statistical significance value of p < 0.05.
Reporting GuidelinesThis study is reported in accordance with the STROBE guidelines.

Results

In the study, the 652 participating mothers have a total of 1003 children aged 0-6 years. Of these children, 21.9% (220 individuals) had a home accident in the last year, and 12.8% (128 individuals) had one in the last month.
Supplementary Table 1 shows the incidence of home accidents in the last year and last month among children aged 0-6, categorized by their characteristics. Statistically significantly higher rates of accidents were observed in children aged 2-3 years compared to other age groups. Boys have been found to have a higher rate of home accidents compared to girls. There is a significant difference in the frequency of home accidents depending on the caregiver during the day; according to the post-hoc analysis, the frequency of home accidents is higher among children cared for by grandparents or in daycare compared to those cared for by their parents.
Supplementary Table 2 includes 122 cases of the most recent home accident within the last month. The most common type of home accident is falling (59.8%), followed by burns (14.8%). The most affected body part is the head and neck area, accounting for 52.5% of injuries. In half of the accidents, the mother was present with the child, while 24.6% of the accidents occurred when the children were alone. Approximately 46.7% of the incidents took place around noon, and 49.2% occurred in the living room used during the day.
In the study, the average age of participating mothers is 30.65 ± 6.23, with a median age of 30 (min: 18, max: 49). Supplementary Table 3 displays the occurrence of home accidents among children aged 0-6 years in the last month, according to the family, home, and sociodemographic characteristics of the participants. Accordingly, the frequency of home accidents in children of working mothers is significantly higher than in children of non-working mothers.
In the study, the average number of children per mother is 2.8 ± 1.66 (min = 1, max = 11). No significant difference was found in the rates of home accidents based on the mother's total number of children, knowledge of home accident prevention training, and emergency call number awareness (Supplementary Table 1).
When examining the occurrence of home accidents in children based on the number of rooms in the home, a statistically significant difference was found. The post-hoc analysis revealed that the accident rate in homes with 1-2 rooms is significantly lower compared to others, while the accident rate in homes with 5 or more rooms is significantly higher (Supplementary Table 1).
In Supplementary Table 3, a statistically significant difference was observed in the incidence of home accidents among children based on their mothers' perceptions and behaviors concerning protection and fatalism. According to the post-hoc Chi-square analysis, children of mothers who agree with the statement "Mothers should always think there is too much danger around their children" have a significantly higher frequency of home accidents compared to those whose mothers agree with "Mothers worry unnecessarily about their children." Regarding fatalism, the frequency of home accidents in children of mothers who agreed with "All children's accidents are due to some negligence" was found to be lower than that of those who agreed with the other two statements.
Supplementary Table 2 presents the logistic regression analysis of variables that could affect the occurrence of home accidents among children aged 0-6 in the last month. According to the established model, the mother's age group, employment status, number of rooms in the home, and the mother's perceptions of protection and fatalism towards accidents have been identified as significant risk factors for home accidents in children aged 0-6.
For the mother's age group, children of mothers under 25 years of age have a home accident risk 2.3 times that of children of mothers aged 30-34. The risk of home accidents for children of working mothers is 1.83 times that of non-working mothers. Regarding the number of rooms in the home, children living in homes with 5 or more rooms have a home accident risk 5.77 times that of those living in homes with 1-2 rooms.
For protection-oriented perceptions, children of mothers who agree with the statement "Mothers should always think there is too much danger around their children" have a home accident risk 1.6 times that of those who agree with "Mothers can fear their children getting hurt." For fatalism, children of mothers who agree with "All children's accidents are due to bad luck" have a home accident risk 2.2 times that of those who agree with "All children's accidents are due to some negligence."

Discussion

In the study, approximately 22% of children aged 0-6 years experienced a home accident in the last year, while the rate of home accidents in the last month is 12.8%. Studies conducted in our country have found the frequency of home accidents among children aged 0-6 years to be between 14.1% and 57.3%.^6,7,8 In their study, Erdem et al. investigated the occurrence of accidents in the last two months and found the frequency of home accidents to be 12.8%.⁹ The frequency of home accidents is closely related to the time period surveyed. Additionally, these differences may also stem from the environmental conditions in which the children live, as well as the educational and socioeconomic levels of the family.
Studies conducted in (blinded country) and around the world have shown that home accidents most frequently occur in children aged 0-4 years . In our study, the frequency of home accidents in the last year and month for children aged 2-3 is significantly higher compared to other children in the 0-6 age group. Similar results have been found in Karatepe's study.
This situation may be due to preschool-aged children spending more time at home, their undeveloped manual skills, their increased interest in their surroundings, and their activity levels.
The frequency of home accidents among children cared for by grandparents or in daycare during the day is higher than for those cared for by their parents. Similar to our findings, Tosun’s study also found that care provided by individuals other than the mother increased the frequency of accidents.¹⁰ This situation suggests that the energy levels of caregivers and their awareness of child safety may influence the occurrence of home accidents.
In our study, the most common type of home accident was falls, followed by burns. Similarly, many studies conducted worldwide and in our country have found falls to be the most frequent type of accident.^11,12 There are studies where burns have been identified as the first or second most common type of accident.^13,14 Differences in the most frequently observed types of accidents can depend on the season during which the study was conducted, the type of home, and the environment.
The most affected area in children from accidents is the head-neck region (52.5%), followed by the arms and legs (32.8%). The literature also includes studies where head and neck injuries are commonly reported among children.^15,16
In the study, children of working mothers have a significantly higher frequency of home accidents. There are separate studies that have found both similar and different results compared to our study.^17,18 This difference may stem from whether working mothers have support from helpers or relatives for child care and household chores.
Another significant factor influencing home accidents is the physical condition of the home. In our study, children living in 1-2 room homes have the lowest frequency of home accidents, while those living in homes with 5 or more rooms have the highest frequency. Consistent with our findings, Onal's study found that the number of home accidents increases in homes with many rooms.¹⁴ This situation indicates that the risk of accidents can increase in homes with many rooms, where children are more likely to be unsupervised.
According to TÜİK 2023 data, in our study conducted in the province with the highest fertility rate of 3.27, the average number of children per mother was found to be 2.8 ± 1.66 (min = 1, max = 11).¹⁹ An increasing number of siblings within a family can lead to a reduction in the amount of care a mother can devote to each child, potentially leading to an increase in home accidents.²⁰ However, in our study, no significant relationship was found between the number of children mothers have and the frequency of accidents among children. There is also a study that has found similar results.¹⁷ This situation could be due to families with many children being more experienced in child safety, or a mechanism of solidarity and supervision among siblings coming into play in such families.
In our study, it was found that children of mothers who agree with the statements that children's activities need to be constantly monitored and who are more protective have a higher rate of home accidents. Particularly in early childhood, mothers' overly protective approaches can hinder children's decision-making abilities, affecting their independence and self-confidence. However, another study found that children of mothers with a protective approach had a lower frequency of injuries resulting from home accidents.²¹ This suggests the need to balance between overprotection and adequate supervision. It has been found that children of mothers who believe accidents are due to bad luck, displaying a more fatalistic approach, have significantly more home accidents compared to children of mothers who think accidents are due to some negligence. A study conducted supports these findings.²² In a fatalistic approach, mothers may accept that accidents are unavoidable and neglect taking necessary safety precautions at home.

Limitations

The findings of this study are limited to the opinions of the mothers who agreed to participate, and the data collection was based on parental self-reports, which is a common limitation of survey studies.
Nevertheless, our study stands out due to its large dataset and high number of participants. These characteristics enhance the reliability and generalizability of the results, allowing for comprehensive insights into home accidents

Conclusion

This study highlights the significant factors influencing home accidents among children aged 0-6, including maternal employment status, home environment, and parental perceptions of safety and fatalism. While protective parenting was associated with a higher frequency of home accidents, a fatalistic approach was linked to inadequate safety precautions, further increasing risk. These findings emphasize the importance of balancing supervision and independence in child-rearing while also underscoring the need for targeted educational interventions to improve parental awareness and accident prevention strategies.

Declarations

Abbreviations

FHC: Family Health Center
SD: Standard Deviation
SPSS: Statistical Package for the Social Sciences
STROBE: Strengthening the Reporting of Observational Studies in Epidemiology
TÜİK: Turkish Statistical Institute

References

1. Kıran S, Şemin S, Ergör A. Kazalar ve toplum sağlığı yönünden önemi. [The importance of accidents from a public health perspective] Sürekli Tıp Eğitimi Derg. 2001;10(2):50-51.
   PubMed Google Scholar
2. Akbaba M, Nazlıcan E, Demirhindi H. Characteristics of domestic accidents and related factors in Karataş district of Adana province, Turkey. TAF Prev Med Bull. 2015;14(3):229-234. doi:10.5455/pmb.1-1419858142
   Article PubMed Google Scholar
3. Kılıç B, Demiral Y, Özdemir Ç, et al. İzmir’de bir gecekondu bölgesinde evde yaralanma insidansı. [Incidence of domestic injuries in a squatter settlement area of İzmir] Toplum Hekimliği Bülteni. 2006;25(3):27-32.
   PubMed Google Scholar
4. Köse O, Bakırcı N. Çocuklarda ev kazaları. [Home injuries among children] Sürekli Tıp Eğitimi Derg. 2007;16(3):31-35.
   PubMed Google Scholar
5. Kurt FY, Aytekin A. 0–6 yaş grubu çocuklarda ev kazaları. [Home injuries in children aged 0–6 years] Sağlık Bilim Meslekleri Derg. 2015;2(1):22-32. doi:10.17681/hsp.26873
   Article PubMed Google Scholar
6. Erkal S, Şafak S. Determination of the risks of domestic accidents for the 0–6 age group in the Tuzlucayır Village Clinic neighborhood. Turk J Pediatr. 2006;48(1):56-62.
   PubMed Google Scholar
7. Büyük ET, Çavuşoğlu F, Teker E. Sıfır altı yaş arası çocuğu olan annelerin ev kazalarına yönelik güvenlik önlemlerinin tanılanması. [Assessment of preventive home safety measures among mothers of children aged 0–6 years] Düzce Univ Sağlık Bilim Enst Derg. 2015;5(3):17-22.
   PubMed Google Scholar
8. Gündüz G, Aytekin A. Annelerin çocuklarını ev kazalarından korumaya yönelik tutumları ve etkileyen faktörler. [Attitudes of mothers toward the prevention of childhood home injuries and influencing factors] İzmir Dr Behçet Uz Çocuk Hast Derg. 2015;5(3):184-192.
   PubMed Google Scholar
9. Erdem SS, Bolu F, Mayda AS. Annelerin ev kazalarına yönelik güvenlik önlemlerinin tanımlanması. [Assessment of preventive safety measures for home accidents among mothers] Konuralp Tıp Derg. 2017;9(2):40-46. doi:10.18521/ktd.304120
   Article PubMed Google Scholar
10. Tosun MÇ. 4–6 yaş grubu çocuğu olan annelerin ev kazalarını önlemeye yönelik önlemlerinin incelenmesi ve eğitimin bilgi, tutum ve davranışlara etkisi. [Evaluation of home accident prevention practices among mothers of children aged 4–6 years and the impact of education on knowledge, attitudes, and behaviors] [thesis]. Kayseri: Erciyes University; 2016.
    PubMed Google Scholar
11. Erkal S. Identification of the number of home accidents per year involving children in the 0–6 age group and the measures taken by mothers to prevent home accidents. Turk J Pediatr. 2010;52(2):150-157.
    PubMed Google Scholar
12. İnce T, Yalçın SS, Yurdakök K. Çocukluk çağında ciddi kaza sıklığı ve risk faktörleri. [Frequency of serious accidents in childhood and associated risk factors] Çocuk Sağlığı Hast Derg. 2014;57(3):173-182.
    PubMed Google Scholar
13. Demirköse H, Yapar D, Özkan S. 0–6 yaş grubu çocuğu olan annelerin sağlık okuryazarlığı düzeyi ile çocukların ev kazası geçirme durumu ile ilişkisi. [The relationship between health literacy levels of mothers with children aged 0–6 years and the occurrence of home accidents in their children] Sağlık ve Toplum Derg. 2021;31(2):74-82.
    PubMed Google Scholar
14. Önal H. 0–6 yaş grubu çocuklarda ev kazaları sıklığı ve etkileyen faktörler. [Prevalence of home accidents and influencing factors among children aged 0–6 years] [thesis]. Kayseri: Erciyes University; 2019.
    PubMed Google Scholar
15. Pervane SŞ, Halil H. Evaluation of children applying to emergency service after motor vehicle trauma. Injury. 2024;55(12):111925. doi:10.1016/j.injury.2024.111925
    Article PubMed Google Scholar
16. Fidancı İ, Derinöz O, Tokgöz A. Çocuk acil servise düşmeye bağlı travma nedeniyle getirilen olgular. [Cases admitted to the pediatric emergency department due to fall-related trauma] Pediatr Pract Res. 2021;9(1):5-10. doi:10.21765/pprjournal.874688
    Article PubMed Google Scholar
17. Karatepe TU, Akış N. 0–6 yaş çocuklarda ev kazası geçirme sıklığı ve ilişkili faktörler. [Epidemiology of home accidents and associated factors in children aged 0–6 years] Uludağ Univ Tıp Fak Derg. 2013;39(3):165-168.
    PubMed Google Scholar
18. Aksakal FNB, Çetin FE, Özdemirkan T, et al. 0–6 yaş çocuğu olan ebeveynlerin ev kazaları konusunda bilgi, tutum ve davranışları. [Knowledge, attitudes, and practices of parents with children aged 0–6 years regarding home accidents] In: 15th National Public Health Congress; 2012; Bursa, Türkiye.
    PubMed Google Scholar
19. Turkish Statistical Institute. Statistics on child, 2023. TurkStat; 2024.
    PubMed Google Scholar
20. Nathens AB, Neff MJ, Goss CH, et al. Effect of an older sibling and birth interval on the risk of childhood injury. Inj Prev. 2000;6(3):219-222. doi:10.1136/ip.6.3.219
    Article PubMed Google Scholar
21. Morrongiello BA. Understanding toddlers’ in-home injuries: context, correlates, and determinants. J Pediatr Psychol. 2004;29(6):415-431. doi:10.1093/jpepsy/jsh046
    Article PubMed Google Scholar
22. Boztaş G. 0–48 aylık çocukların ev kazaları sonucu oluşan yaralanmalarına ilişkin annelerinin davranış ve görüşlerini etkileyen faktörler. [Factors influencing mothers’ behaviors and perceptions regarding injuries resulting from home accidents in children aged 0–48 months] [thesis]. Ankara: Hacettepe University; 2008.
    PubMed Google Scholar

Additional Information

Publisher’s Note
Bayrakol MP remains neutral with regard to jurisdictional and institutional claims.

Rights and Permissions

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0). To view a copy of the license, visit https://creativecommons.org/licenses/by-nc/4.0/

View full license details →

About This Article

Received:

December 22, 2025

Accepted:

April 15, 2026

Published Online:

April 15, 2026