1️⃣ Analytical summary

Context and issues — An underestimated burden, a disappeared policy

Accidents of everyday life (AcVC) cause more than 20,000 deaths each year in France, including 226 among those under 15 (2016), and affect 11.5 million people. Among those under 5, falls, choking, burns, and electrocutions dominate, with a clear overrepresentation of the home as the site of occurrence (up to 89% among infants). The report precisely documents each mechanism — circumstances, French and international epidemiological data, clinical consequences — before making a severe observation: unlike road safety, the prevention of AcVC has never benefited from a structured national policy. The bodies that existed (Consumer Safety Commission, Cediac, National Institute of Consumption) were all dissolved between 2017 and 2026, the information sites closed, and no representative epidemiological surveillance system replaces the EPAC, which is set to cease.

Operational contributions — A toolkit validated internationally

The second part of the report changes register: it lists nine foreign programmes (United Kingdom, Canada, United States, Switzerland) that have proven their scientific effectiveness, and derives from them an operational reading framework, the strategy of the "7 E" (Education, Engineering, Enforcement, Environment, Empowerment, Equity, Economy). For each lever, the HCSP details concrete and transposable examples: home safety check-lists, the ALTER method for individual appropriation, age-specific sheets, security kits for disadvantaged families. The report finally formulates a structured summary of recommendations by target (parents, professionals, public authorities, manufacturers) directly usable to build or argue for a local action.

2️⃣ Key points of the document

1. A total absence of national strategy, unlike road safety (p. 35-36) : the HCSP highlights that there is currently no national coordination of the prevention of AcVC, whereas road safety has a dedicated administration and a budget of 4.5 billion euros (2024) which has allowed for a fivefold reduction in road mortality since 1972.

2. The main steering bodies have disappeared in less than 10 years (p. 38-39) : Consumer safety commission (dissolved in 2017, nearly 300 opinions issued in 35 years), Cediac (abolished in 2023), National Institute of Consumption (dissolution planned by the 2026 finance law). No sectoral exchange structure remains.

3. The multimodal strategy of the "7 E", central conceptual framework of the report (p. 58-59) : Education, Engineering, Enforcement, Environment, Empowerment, Equity, Economy. The HCSP demonstrates that an isolated action (e.g. a serious game alone) is never sufficient; it is the combination of passive levers (automatic safety) and active ones (behaviour) that reduces risk, according to the "Swiss cheese" model of James Reason.

4. International programmes evaluated with quantified results (p. 72-79) : the SOSA programme (United Kingdom) allowed savings of £1.39 per pound spent; the TIPP programme (United States), applied to 0-4 year olds, could save $880 per child; the "Safe at home" programme (United Kingdom, 57,656 families) reduced hospital admissions in the equipped group.

5. An initial training of professionals is almost absent (p. 53-57) : the prevention of AcVC is not included in the initial curriculum of any medical specialty (general medicine, paediatrics, emergencies), and nurses only dedicated 0.08% of their curriculum before the 2026 reform. Only childminders have benefited from structured content since 1983.

3️⃣ Action points for local stakeholders

1. Take ownership and disseminate the ALTER principle (p. 73) to equip parents with a simple and non-blaming method (Activity, Location, Time, Environment, Resources) rather than imperative instructions — a format easily transformable into a workshop or printed material.

2. Use the check-lists provided in the annex (annexes 7 and 8, p. 132-141): a home safety check-list designed by rooms and risks for parents, and an evaluation grid intended for professionals (PMI, TISF, childminders) — directly usable without heavy adaptation.

3. Organise a "home safety week" based on the British SOSA programme model (p. 72), relying on local partners (PMI, firefighters, insurers, schools, health centres) — the report explicitly recommends this community variation in its summary (p. 95).

4. Prioritise targeting disadvantaged families, in accordance with the principle of Equity highlighted by the HCSP (p. 96) : the risk of accidents from fire exposure is up to 38% higher in disadvantaged areas (p. 18), and the most effective programmes (Safe at home) are those that provide safety materials for free or at low cost.

5. Revisit the brochure "Protect your child from household accidents" from the former Inpes (p. 61-62), deemed complete and didactic by the HCSP but not updated since 2016 — a local reactivation (graphic update, distribution in waiting rooms, digital version) addresses an identified and unmet need.

6. Raising awareness without blaming by relying on the identified parental biases (p. 21 and argument) : the report documents that parents underestimate the risk at child height compared to adult height — an educational resource exploiting this finding (videos at child height, role-playing) is identified as an effective lever for raising awareness.

Unmet need identified by the HCSP: the absence of a unique, updated national educational resource, translated into languages and in easy-to-read formats, which the TISF explicitly request in the report (p. 71) — a project that a local structure can initiate on a small scale.

4️⃣ Additional references

Articles on domestic accidents in Pratiques en Santé - https://www.pratiquesensante.com/blog/tag/accidents-domestiques-25

1. High Council for Public Health, Prevention of accidental poisoning in children under 5 years old, HCSP report, July 2025. First part of the same request DGS, on the risk of unaddressed AcVC here (poisonings): www.hcsp.fr/Explore.cgi/avisrapportsdomaine?clefr=1449

2. ANSES, Accidental poisonings in children: what are the most common and the most serious?, April 2024. Report from the Poison Control Centres and Public Health France (2014-2020), methodologically complementary to the EPAC data cited in the HCSP report: www.anses.fr

3. Public Health France, Project Orchid — Organisation of a network of hospital centres involved in epidemiological surveillance, launched in October 2024. The system that the HCSP report cites itself (p. 41) as a possible relay to the EPAC which is being phased out: www.santepubliquefrance.fr

5️⃣ Frequently Asked Questions (FAQ)

1. What is the main mechanism of AcVC in those under 5 years old?

Falls, which account for 58% of emergency visits for domestic accidents and up to 62% in those under 2 years old (p. 11).

2. Why are choking incidents particularly serious in young children?

Because they are the leading cause of death from AcVC in those under one year old in France, representing 84% of deaths in those under 15 years old in 2016 (p. 14).

3. Is there a surveillance system in France equivalent to the American NEISS?

No. The report highlights the absence of a representative and detailed system; the EPAC, based on only 10 emergency services, is being phased out gradually, partly replaced by the Orchid project currently being deployed (p. 41).

4. What is the strategy of the "7 E's" proposed by the HCSP?

A framework combining Education, Engineering, Enforcement, Environment, Empowerment, Equity, and Economy, derived from the expansion of the initial "3 E's" Canadian principle (Parachute programme) (p. 58-59).

5. Which foreign programme has demonstrated the best economic return on investment?

The British SOSA programme, with a measured saving of £1.39 per pound spent according to a cost-effectiveness analysis from 2024 (p. 72-73).

6. Is the training of healthcare professionals in the prevention of AcVC sufficient in France?

No: it is absent from the initial training frameworks for general medicine, pediatrics, emergency medicine and pediatric surgery; only certain pathways (childcare workers, midwives since 2024, nurses since the 2026 reform) explicitly include it (p. 53-57).

7. What are the priority recommendations of the HCSP?

Four areas: to have representative national statistics, to create a National Observatory for AcVC, to conduct an economic analysis of the cost of care, and to deploy a national programme based on the strategy of the “7 E” (p. 94-97).

6️⃣ Rewriting in FALC (Easy to Read and Understand)

The problem

Every year in France, many children have an accident at home.

These accidents are called “accidents of daily life.”

They are also called AcVC.

Children under 5 years old are the most affected.

The most common accidents are:

• Falls.

• Choking.

• Burns.

• Electrocutions (contact with electricity).

Many of these accidents happen at home.

Many could be avoided.

What the report says

In France, there is no national plan against these accidents.

It is different for road accidents.

For the road, there has been a national plan for a long time.

This plan has saved a lot of lives.

For home accidents, several organisations have closed.

There is no longer any coordination between the actors.

We do not know well how many children are injured each year.

What works elsewhere

In other countries, programmes have proven effective.

In the United Kingdom, a programme provides safety equipment to families.

This programme has reduced the number of children hospitalised.

In Canada, a programme teaches parents a simple method.

This method is called ALTER.

It helps parents make everyday activities safer.

What the HCSP proposes

The HCSP proposes a strategy with 7 levers of action.

This strategy is called the « 7 E » strategy.

It proposes, for example, to:

• Better inform parents.

• Manufacture safer products.

• Enforce existing laws.

• Help prioritise the most vulnerable families.

7️⃣ Cross-sectional analysis — Values of Health Practices

• Literacy : Yes, the report explicitly values « easy to understand » materials (checklists, age-specific sheets, pictograms) and regrets the absence of an easy-to-read and multilingual version of the existing documents, a request made by the TISF (p. 71).

• Empowerment : The report actively promotes an individual ownership approach (ALTER programme) rather than a normative and blaming approach (« parents must... »), explicitly relying on the Health Belief Model (p. 73).

• Participation : The international programmes mentioned (SOSA, ALTER) were co-produced with parents and researchers, but no equivalent co-construction mechanism is documented in France in the report.

• Community health: Yes, with the example of the Sherbrooke project (Quebec), a community labelled as a “Safe Community” by the WHO, involving municipal authorities, schools, public safety and associations (p. 76-77).

• Ethics : The report identifies social biases (misperception of risks according to socio-economic status, inequalities in exposure) but does not develop an in-depth analysis of cultural biases in the design of the prevention tools themselves.

• Human rights / equity: Strongly present: Equity is one of the 7 “E”s of the recommended strategy, with explicit targeted measures for disadvantaged families (free materials, priority for home visits) (p. 96).

• Intersectorality : Yes, widely demonstrated by international programmes (manufacturers, insurers, schools, communities, health) and recommended in the mission of the proposed National Observatory (p. 94).

• Partnership : Models are formalised abroad (BPA-municipalities agreement in Switzerland, Parachute-business partnership in Canada); in France, the report notes their near-disappearance rather than their current structuring.

• Fight against discrimination: The report does not address discrimination in the strict sense, but documents marked social health inequalities (fire risk +38% in disadvantaged areas) without addressing the ethnic or gender dimensions of risk exposures.

8️⃣ Assessment of the reliability of the resource

Scientific relevance: High. The report is based on more than 280 bibliographic references, multi-source epidemiological data (EPAC, AVICOU, IHME, US NEISS, Luxembourg RETRACE), and on the documented scientific assessment of nine international programmes (randomised trials, cost-effectiveness studies). It comes from a recognised public expertise body (HCSP), at the official request of the DGS, with a working group led by a specialised professor of paediatrics.

Operational relevance: High also, with two caveats. The proposed tools (checklists in annex, ALTER principle, “7 E” strategy) are directly transposable in the field. However, a significant part of the report (institutional observation) describes a system in permanent reorganisation (dissolutions, ongoing projects like Orchidée): some factual elements about the structures could evolve rapidly after publication. The report itself acknowledges fragmentation and the lack of representative data as a structural limit of the field it documents.

9️⃣ STRATEGIC HASHTAGS

#healthpractices #PreventionCVD #ChildHealth #DomesticAccidents #EarlyChildhood #HealthLiteracy #EvidenceBasedPrevention #PMI

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