Background Child injury mortality and morbidity are a public health concern in European countries and data are scarce. Cross-national efforts are needed to identify high-risk groups, follow trends and assist in establishing European-wide safety legislation. This study investigates fatal child injuries in the home, as compared to those in transport in European countries.

Methods Injury mortality was extracted from the WHO Mortality Database for the years 2002–2004. The mortality per 100 000 population was calculated by age group for 16 contributing countries, grouped by their economic level of development.

Results Fatal home injuries were highest in children under five and then sharply decreased, as opposed to road traffic injuries which increased with age. The majority of the upper middle economy countries tended to have higher home injury incidence rates compared to the high income countries. The top five injury causes all countries aggregated were drowning/submersion, thermal injuries, poisoning, falls and homicide, all of which account for almost 90% of home injury deaths.

Conclusion Home injuries were the leading cause of injury death in children under five in the countries under study and the inequalities found among the countries indicate potential for improvement. Evidence-based interventions exist to prevent these injuries and the barriers to their implementation ought to be determined and addressed.