Simple Home Improvement Can Reduce Injuries and Falls Interview with:
Dr. MichaelD. Keall PhD
Otago University, Wellington, New Zealand

Medical Research: What are the main findings of the study?

Dr. Keall: We found that home injuries from falls could be reduced by 26% by making some simple modifications to people’s homes, consisting of handrails for steps and stairs, grab rails for bathrooms, outside lighting, edging for outside steps and slip-resistant surfacing for outside surfaces such as decks and porches.

Medical Research: What was most surprising about the results?

Dr. Keall: We were not surprised by the results as some cross-sectional studies we had undertaken had shown that home injury rates increased when the home had more injury hazards. It therefore made sense to conduct a randomised controlled trial in which we monitored injury rates in homes where some of these hazards were addressed. Previously studies have shown some benefit for older people when their homes were modified in a manner specific to their type and level of disability. This was the first study to show that a non-targeted approach (where the same hazards were addressed, whatever the state of health of the occupants) could have important safety effects for the general population.

Medical Research: Medical Research: What should clinicians and patients take away from your report?

Dr. Keall: Falls in the home present an extremely important risk for all age groups, although older people suffer the most from home falls. Our study showed a high level of preventability from an environmental health perspective: some simple, relatively low-cost safety and design features can reduce fall injuries by about a quarter. From a public health perspective, the study emphasises the importance of having housing stock that is safe for whoever may occupy the homes.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Keall: Injury prevention via home modification has received little attention from researchers, mostly because conducting randomised controlled trials in the community is difficult and requires large sample sizes and considerable expense. Our study clearly justifies further work in this area. For example, we would like to know which of the modifications we made to homes were the most effective.


 Home modifications to reduce injuries from falls in the Home Injury Prevention Intervention (HIPI) study: a cluster-randomised controlled trial
Dr Michael D Keall PhD a , Nevil Pierse PhD a, Philippa Howden-Chapman PhD a, Chris Cunningham PhD b, Malcolm Cunningham PhD d, Jagadish Guria PhD c, Michael G Baker MBChB

The Lancet, Early Online Publication, 23 September 2014




Last Updated on September 25, 2014 by Marie Benz MD FAAD