Bathroom Safety: A Doctor’s Domain?

 Most people know someone who has sustained some sort of injury in a bathroom. But now we know the impact of these injuries: approximately $67 billion in lifetime medical costs in 2008.

courtesy of flickr user stevendepolo (creative commons)

For the first time, the Centers for Disease Control and Prevention analyzed data from emergency departments across the United States with an eye toward nonfatal bathroom injuries. Using the 2008 national Electronic Surveillance System All Injury Program (NEISS-AIP),  CDC researchers identified 3,339 cases, and estimated that 234,094 nonfatal bathroom injuries in individuals aged 15 years and older were treated in U.S. emergency departments that year. The results appeared in the Morbidity and Mortality Weekly Report (MMWR) on June 10, 2011.

Approximately 81% of the injuries were from falls. The number of cases in each 10-year age group was similar, but injury rates increased with age, the researchers said. The highest injury rates occurred in or around the tub or shower (66 per 100,000) and on or near the toilet (23 per 100,000).

But when the injuries were broken down by age, some interesting statistics emerged.

The shower was the main danger zone for teens and young adults, and the toilet was associated with the most injuries for adults older than 65 years. Some numbers: The percentage of injuries sustained while bathing or showering was 34% among 15- to 24-year-olds vs. 16% among those aged 85 years and older. By contrast, the proportion of toilet-related injuries was only 2% among 15- to 24- year-olds vs. 37% among those aged 85 years and older.

What do the findings mean for doctors? According to the report, “These findings suggest that all adults, especially older adults, their caregivers, and their family members, should be educated about activities in the bathroom that more frequently result in injury, notably getting out of tubs and showers and getting on and off toilets.”

One could argue that there should be some personal responsibility for safety at home, and it’s not a doctor’s job to remind people to use common sense and caution. Bathroom safety is not going to make the list of what to talk about during a too-short office visit, but it might lend itself to a handout or brochure that could be available in the waiting room, given the high costs associated with these injuries.

Although the injuries in this report were treated in the ED rather than in a clinician’s office, doctors who treat older adults might think about how to prevent these injuries by making older patients more aware of the risks. A handout reminding older adults to be aware of bathroom hazards might, if done correctly, catch patients’ attention (or that attention of their family members) and provide some suggestions for preventing these injuries (grab bars, floor mats). But what about those teens? Handouts about the dangers of texting while showering? Perhaps more research is needed before that brochure comes out.

–Heidi Splete (on twitter @hsplete)

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Filed under Emergency Medicine, Family Medicine, IMNG, Uncategorized

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