By Carolyn Crist

(Reuters Health) – New York City’s window guard rule, which requires building owners to install window-limiting devices in apartments with children under age 10, has led to a dramatic reduction in injuries and deaths, researchers say.

Before the rule was adopted in 1976, dozens of young children would fall from windows as they were propped open during the warm months, the study authors write in the journal Injury Prevention.

“Window guards are something we take for granted nowadays, but when New York residents receive a window guard notice, what’s behind that piece of paper is a full infrastructure that started decades ago,” said lead author Dr. Amita Toprani, medical director of the New York City Department of Health and Mental Hygiene’s Bureau of Environmental Disease and Injury Prevention.

“The program has saved hundreds of children’s lives,” she told Reuters Health in a telephone interview. “It’s invisible in our day-to-day lives, but it’s constantly happening.”

Toprani and colleagues reviewed program records, correspondence and legal decisions and interviewed staff members to outline a history of the window guard rule. A 1971 study found that 201 child fall deaths occurred from 1965-1969 during May through September, and 123 of the deaths, 61 percent, were falls from windows. A large number of those incidents occurred in low-income neighborhoods with poor housing quality in the Bronx and Manhattan.

In 1972, the NYC Health Department launched a pilot program in the Bronx to distribute free window guards, record window falls and increase awareness through radio and TV ads. Window falls decreased about 40 percent in the following years, and the program expanded citywide through 1975. During this time, 16,000 free window guards went to 4,200 families.

Then the NYC Board of Health created the window guard rule in 1976, which was the first such ordinance in the United States, the authors note. It required owners and landlords of buildings with three or more households to install window guards in each apartment where children under age 10 lived, as well as in public hallways. Healthcare professionals were also required to report window falls to the health department.

The initial window guard rule was associated with a reduction in falls from 175 in 1977 to 47 in 1980. Overall, annual reported child window falls declined from 217 in 1976 to nine in 2016, and window fall deaths decreased from 24 to two.

“It was a pioneering idea in the 1970s to think of housing as a driver of health,” Toprani said. “Nowadays we look at housing quality, indoor air quality, allergies and lead poisoning, and this insight decades ago has made an impact.”

In the years following implementation of the rule, legal challenges popped up, with opponents arguing that the rule imposed a financial burden on property owners or was unconstitutional because the city couldn’t impose regulations on rent-controlled housing that required state approval. Courts upheld the window-guard mandate.

In the mid 1980s, the New York City Council required rental leases to tell tenants about owners’ obligations to install guards and in 1986, owners who failed to install approved guards became legally liable if a child fell from a window.

“When the rule first started, people didn’t see it as a right to request a window guard, but that’s the case now,” Toprani said. “We need to remind people that it is their right to have one in their apartment, even if they don’t have children.”

Since 1976, other states such as New Jersey and Minnesota have created window guard requirements.

Countries including the Czech Republic and the United Arab Emirates have a high number of window falls as well, noted Michal Grivna of UAE University in Abu Dhabi, who wasn’t involved in the study. In a 2017 research paper, he and colleagues documented 96 falls in Abu Dhabi during the past decade, including from windows and balconies, he said.

Grivna is investigating new ways to create regulations and inspections for window safety for children. “The concept of passive protection is important in safety, including pedestrian crossings and fences around swimming pools,” he said in a telephone interview. “Be aware that this safety issue is part of everyday life. Work to improve your safety and the safety of your home.”

SOURCE: Injury Prevention, online April 6, 2018.