Secular trends in fatal and disabling child trauma

Types and rates of childhood accidents are constantly varying. From the point of view of the potential child victim, the danger-safety equilibrium is disturbed by changes in lifestyles, availability of new consumer goods, and changes in social order. Balance is achieved by the implementation of preventive measures, particularly safety legislation. 'Old' hazards affecting children in pre-industrial societies can re-emerge at any time as wealthy sophisticated societies aspire to recapture the delights of open space, the water, and 'country-style' living. Age-specific fatal accident rates are given for Australian children for the period 1960-1982. Whereas the total child (1-14 y) death rate has fallen from 159 per 100000 (in 1960) to 86 (in 1982), road traffic deaths have risen from 8.3-11.7 (1-4 year olds) and have remained static (8.3-8.9) for 5-14 year old children. Drowning in older children has been reduced, but drownings among toddlers are still high (9.2 in 1960; 11.7 in 1982). The causes of secular trends, and factors which are known to influence these, are discussed.