The lives of dozens of children in Scotland could be saved every year through better accident prevention measures, a report has suggested.
The study looked at accidents inside and outside the home
The EuroSafe study, based on 2001 figures, concluded that 62 out of 150 accidental deaths in under-20s that year could have been avoided.
The death rate per 100,000 was 10.95 in Scotland, compared with 5.77 in Sweden, the country which performed best.
Scotland's figures ranked it 10th out of the 18 countries studied.
The report examined areas of safety including falls, water safety, poisoning, burns, choking dangers and road injuries, as well as accident prevention leadership and infrastructure.
The countries which scored best were the Netherlands, Northern Ireland and Sweden, while those doing least well were Spain, Greece and Portugal.
The European Child Safety Alliance EuroSafe results and ratings for Scotland have been published in a Child Safety Report Card.
It recommends measures including legislation making cycle helmets compulsory, adding water safety education to the school curriculum, increased enforcement of playground equipment standards, the redesign of potential strangle hazards - such as blind chords - and better public awareness campaigns.
It concludes Scotland needs "stronger leadership from government" on issues of child safety, with "child safety leadership" receiving only one-and-a-half stars out of five, in a five-star rating system.
There is praise, however, for the potential future of Scotland's child safety projects - "child safety capacity building" received five stars.
EUROPEAN SAFETY RANKINGS: SCORED OUT OF 60 MAXIMUM
1. Netherlands: 40 (Good)
2. Northern Ireland: 40 (Good)
3. Sweden: 40 (Good)
4. Denmark: 39.5 (Good)
5. France: 37 (Good)
6. Germany: 35.5 (Fair)
7. Norway: 35.5 (Fair)
8. Hungary: 32 (Fair)
9. Poland: 32 (Fair)
10. Scotland: 31.5 (Fair)
11. Czech Republic: 31 (Fair)
12. Belgium: 29.5 (Fair)
13. Austria: 27 (Fair)
14. Estonia: 27 (Fair)
15. Italy: 27 (Fair)
16. Spain: 22.5 (Poor)
17. Greece: 21 (Poor)
18. Portugal: 20 (Poor)
Scotland's overall performance for child safety was graded as "fair".
The steering group involved, Child Safety Action Plan for Scotland, aims to prevent accidents to children and young people across Europe.
It consists of the Royal Society for the Prevention of Accidents (Rospa), the Child Accident Prevention Trust and NHS Health Scotland, among others.
Elizabeth Lumsden, of Rospa, said: "The Child Safety Report Card identifies some of the major successes in injury prevention work.
"But we cannot ignore the fact that Scotland scored poorly in relation to its national political leadership of child safety and lacks the data that can enable injury problems to be identified and prevention programmes to be properly targeted and evaluated."
She added: "We acknowledge that safety and injury prevention are everyone's responsibility, but we believe that the Scottish Government's Health and Wellbeing Directorate is best-placed to co-ordinate a unified national approach to safety across government departments and other agencies."
Ms Lumsden also called for more up-to-date comparable information.
"There is a data collection system available to all Accident and Emergency departments but there needs to be Scottish Government encouragement for its use to enable us to see exactly where the injuries are happening," she said.
A Scottish Government spokeswoman said ministers take the issue of tackling child safety "extremely seriously".
She said: "We agree that a co-ordinated approach across all areas of government is essential when promoting government prevention policies.
"However, as the report shows government agencies such as Road Safety Scotland received top marks for their dedication and hard work in tackling preventable accidents."
The figures were gathered from across Europe, on 0-19-year olds, using computer-based surveys, with the project partners Rospa Scotland and NHS Scotland providing the Scottish data.
EuroSafe is now planning an expanded study, taking in more European countries.