Low-cost home fixes may prevent falls

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[October 04, 2014]  By Madeline Kennedy

NEW YORK (Reuters Health) - Homeowners can reduce their risk of being injured in a fall by making relatively cheap fixes to their homes, according to a New Zealand study.

Installing handrails and edging for steps, outside lighting, bathroom grab rails and slip-resistant surfaces significantly reduced the instance of falls in households where the changes were made.

“We showed that a quarter of all injuries from falls in the home could be prevented for the general population by some simple and relatively inexpensive modifications to homes,” said lead author Michael Keall of the University of Otago.

In the United States, injuries happen more frequently at home than anywhere else and falls are the main cause of these injuries, the researchers note.

To make home safer, “An expert outsider’s perspective is often useful to identity what is needed as people become used to their own homes and often do not see the injury risks inherent in the home setting,” Keall said by email.

The study was conducted on 842 households in New Zealand, with a total of about 1850 residents. Modifications were made to half of the houses and the remainder were placed on a waiting list to act as a comparison group.



Over the course of three years, the researchers report in The Lancet, there were 26 percent fewer injuries from falls and 39 percent fewer falls that were specific to the home fixes in the improved houses compared to the waitlisted homes.

Injuries were defined as falls requiring medical treatment and the researchers collected this information through insurance claims.

The study team described the modifications as “low cost” and the average amount spent per house was 560 New Zealand dollars (about US$442). The maximum spent was NZ$3,000 (about US$2,370).

According to World Health Organization criteria, “this is a highly cost-effective measure for preventing injuries,” Keall said.

The cost of installing outdoor lighting is between $200 and $250, according to House Doctors Inc., a San Francisco Bay-area renovation company. If new wiring is needed, the price would be in the range of $600 to $1000. The cost of a grab rail for a bathroom is between $200 and $300, and a railing for steps would cost $350 to $400.

Tapley Dawson of House Doctors noted that prices may be lower in other parts of the country.

The study’s results may not be applicable to the general public due to certain limitations, according to Stephen Robinovitch, who co-authored an editorial accompanying the report.

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“The study didn't include a large enough sample to allow the investigators to ask whether the intervention was effective for specific age groups - including older adults who are at highest risk for falls and related injuries,” Robinovitch told Reuters Health in an email.

Robinovitch, a professor and Canada Research Chair in Injury Prevention at Simon Fraser University in Burnaby, British Columbia, also thinks that socioeconomic factors, including the general upkeep of the houses, may have influenced the results.

For example, all of the houses involved were built before 1980 and each household had at least one member receiving state benefits, he pointed out.

In their editorial, Robinovitch and his coauthors say that further research is needed to determine which modifications were most effective for which participants.

“A big question is whether a fixed set of home safety modifications, as used in this study, is more effective than a customized set of modifications, based on individual characteristics of the home owner,” Robinovitch told Reuters Health.

But, he said, “Given the positive results of this study, we should all take note of the specific modifications made to the homes, and consider implementing these based on inspection of our own living environments.”

Keall said, “The modifications we carried out in the study are worth doing for any home that needs them.”

SOURCE: http://bit.ly/1vuFnLr The Lancet, online September 23, 2014.

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