Accidents are the most frequent cause of death among children older than one year in Germany and Europe as a whole. Conservative estimates for 1995 put the cost for the 788 fatal accidents and the approx. 2 million accidents involving injuries at over 3,600 million DM - to say nothing of the pain and grief suffered by the families. No reliable data are yet available on the frequency of accidents among children in Germany. Only tentative conclusions as to the causes of the accidents can be drawn from statistics on the cause of deaths. Germany has no central surveillance system monitoring accidents involving children or providing information on when, where and how such accidents happen. Statistics on the number of children injured at home and during leisure activities were collected by the Federal Institute for Employment only once (in 1988/89 for the states of the old Federal Republic, and in 1991/92 new the federal states). Germany is one of the few European countries that does not participate in the European Home and Leisure Accident Surveillance System (EHLASS). Not only is the epidemiological situation unsatisfactory, but so too are preventive measures in this area. This is evidenced by comparing figures for Germany with, say, Sweden, which can look back on an almost fifty-year-old tradition of accident prevention. In 1995, the fatal accident rate among young children (1-4 years) in Germany was more than twice as high as in Sweden (8.4 vs. 3.8 per 100 000), and there were four times as many deaths by drowning in this age group. Prevention is of paramount importance in the case of accidents involving children, precisely because such accidents can, in principle, be avoided by taking the proper measures. Such measures should be geared to age-specific risk patterns. The Netherlands and Sweden were deliberately selected for the comparative study because their prevention measures are based on accident monitoring and long-term soundly funded strategies. Recommendations for accident prevention in Germany can be derived from this study. (A)
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