To the Editor—On 22 February 2020, news media reported an unattended 4-year-old girl who fell to her death from a window in her 15th-floor flat.1 The Hong Kong Medical Journal has reported childhood deaths due to accidents and injuries.2 3 4 Injury is a major health problem for Hong Kong children and has surpassed infectious diseases as the leading cause of childhood mortality in Hong Kong.2 5 Approximately 2.9% of children will be admitted to hospital for an injury at least once before their fourth birthday. In a city with many high-rise residential buildings, the risk of falling from height is relatively high, and invariably fatal. Nevertheless, even small falls occurring indoors can lead to severe head injuries or death.6 Preventive measures against childhood injury in Hong Kong are reactive in nature, piecemeal, and usually not subject to evaluation.2 It is recommended that childhood injury prevention be given prime consideration in all policies involving children. Most accidents and injuries may potentially be preventable. Primary prevention by health promotion and public health measures can save lives. Moreover, prompt and effective on-scene cardiopulmonary resuscitation may offer chances of survival and better outcomes for patients after falls.

Both authors contributed to the drafting of the letter and critical revision for important intellectual content. Both authors approved the final version for publication and take responsibility for its accuracy and integrity.

All authors have disclosed no conflicts of interest.

This letter received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

1. Girl, 4, falls to death from 15th floor flat in Hong Kong, father suspected to have left daughters unattended. Available from: https://www.scmp.com/news/hong-kong/law-and-crime/article/3051828/girl-4-falls-death-15th-floor-flat-hong-kong-father. Accessed 22 Feb 2020.

2. Hong Kong Children Injury Prevention Research Group. Childhood injury prevention in Hong Kong. Hong Kong Med J 1998;4:400-4.

3. Hon KL, Ku AS. Tragic deaths by choking in healthy children. Hong Kong Med J 2019;25:413. Crossref

4. Hon KL, Chan J, Cheung KL. Head injuries after short falls: different outcomes despite similar causes. Hong Kong Med J 2010;16:497-8.

5. Hon KL, Leung TF, Chan SY, Cheung KL, Ng PC. Indoor versus outdoor childhood submersion injury in a densely populated city. Acta Paediatr 2008;97:1261-4. Crossref

6. Hon KL, Leung TF, Cheung KL, et al. Severe childhood injuries and poisoning in a densely populated city: where do they occur and what type? J Crit Care 2010;25:175.e7-12. Crossref