Background Although the home is a major setting for injury morbidity and mortality, there are few proven effective interventions for reducing home injury risk.

Aims To develop measurement protocols for assessing home injury hazards and practical procedures for making targeted repairs to these hazards.

Methods We developed the Healthy Housing Index as a protocol for systematically quantifying the degree of risk posed by housing to the health and safety of the occupants. We studied in detail a large number of home injuries to identify likely preventive measures focused on structural aspects of the home environment.

Results Approximately 38% of the 1328 home injuries studied were potentially associated with modifiable features of the home environment. We also found a statistically significant association between increasing numbers of home injury hazards and the occurrence of home injury, providing qualified evidence for the potential effectiveness of home injury hazard remediation as an effective injury prevention measure.

Significance The current study potentially provides a path to an effective means to prevent home injury. The expense of making repairs to home injury hazards places greater demands on reliable evidence of the effectiveness of this intervention. This is currently the subject of a large randomised controlled trial, currently in progress.