THE IMPORTANCE of accidents as a cause of mortality has been highlighted by the continued drolp in the percentage of deaths from other causes, particularly the communicable diseases. Among children over 1 year of age and adolescents, accidents now rank as the leading cause of death, primarily because preventive medicine has succeeded in lowering the mortality rate from infectious diseases. Unfortunately, little effort has been made Ito apply the same techniques toward the prevention of accidents. Considerable progress has been made by industry in the application of safety measures to protect workers. Also,, safeguards have been installed in industrial products, such as automobile seat belts tio protect the wearers and reduce the extent and severity of injuries, and other equipment, such as improved braking systems, directed toward reduction of motor vehicle accident,s. More programs are being undertaken toward prevention of home accidents. However, changes by architects and home builders are not keeping pace with the technical knowledge available for implementing modification, and they are falling behind in the face of technological changes which increase the built-in hazards of the home. Each year more people in Maryland between the ages of 1 and 35 die from accidents than from!any other cause. In 1963 approximately 1,500 persons of all ages died from accidents in the State. Accidents rank fourth among causes of death of Maryland citizens of all ages. Although this figure seems large for a small State, the total accident statistics reflect even greater tragedy when nonfatal injuries are added. U.S. National Health Survey statistics projected for Maryland show an average annual number of 847,686 injuries of all kinds. Of these, 199,206 are bed disabilities and 39,821 require hospitalization. Total cost figures for medical care are not readily available, but in 1963 the inpatient hospital care alone for the indigent accident victims cost the State more than $2 million. Motor vehicle accidents account for approxim,ately 40 percent of all the accidental deaths in Maryland. Also, according to data of the U.S. National Health Survey, 1.6 of every 100 persons are injured in moving motor vehicle accidents. These injuries cause 49.1 days of restricted activity, 14.6 days of bed disability per 100 persons, and loss of 25.3 workdays per 100 persons in the labor market. Home accidents account for approximately 30 percent of all accidental deaths in Maryland. The National Health Survey has estimated that 44.9 percent of all disabling injuries are suffered in or around the home. This percentage is three times greater than the 14.3 percent of injuries which occur in industrial places. Public accidents are the third leading cause of accidental death. These include death from accidents other than motor vehicle, home, and work. During 1962,376 Maryland citizens were killed in public places; 75 of these persons drowned. Work accidents claimed about 8 percent of the total accidental death toll. This low percentage points up the value of good accident control measures which can be stimulated by health departments. Accident prevelntion has been an integral part of the activities of the Maryland State DepartDr. Prather was commissioner of the Maryland State Department of Health when he wrote this paper. He retired from that position in December 1964, and he is now special consultant to the executive director of the National Commission on Community Health Services, Inc., Bethesda, Md.