Home/Toy Safety

Elizabeth C. Powell, MD, MPHPediatric Emergency MedicineChildren’s Memorial HospitalFeinberg School of Medicine

Northwestern University

Objectives

To describe types of injuries to children in the home

Baby and toddler equipment Toys

Small parts, balloons, and magnets Lead, phthalates, cadmium

Injury rates in US children – hospital

< 1 yo 3.4 per 1,000 1 yo 5.0 per 1,000 2 yo 3.9 per 1,000 3, 4 yo 2.9 per 1,000

15-19 yo 6.6 per 1,000

17 hospitalizations per death ED care-far more

Types of injuries

Common Falls Struck by/against Poisoning/transportation

Serious Suffocation Choking Falls Burns

Children’s equipment and toy safety

Parent perception that equipment and toys on the market for children are safe

Children often cannot recognize and avoid hazards

Parent education important

Falls

Furniture Other from height Stairs Buildings Playground equipment

Fall prevention Education

window guards, stair gates behavior restraint use

Engineering equipment design (infant chairs,

strollers) Building codes

Suffocation/strangulation

Beds Portable cribs Drop side cribs Bedding and bumpers

Burns

Thermal – common Scalds – serious

Developmental capabilities younger vs older children

Prevention - Microwave oven latch

Drowning

Fatal Prevention-fencing, covers, alarms

Toys

Estimated 15 to 30 deaths per year, but reporting is incomplete

Airway obstruction/suffocation from small toys, balloons

Small Parts Regulation

Bans toys intended for use by children <3 yo that have small parts

Small parts present a choking, aspiration and ingestion hazard

“Small part” defined using a truncated cylinder of designated diameter (1¼ in) and depth (1-2 ¼in)

Small balls (diameter < 1 ¾ in) are also banned for children < 3 yo

Small Parts Test Cylinder

Toy Safety Labels

Explain that a hazard exists if the toy is used by a child outside the recommended age range.

The cautionary labeling for a toy or game is: Warning: CHOKING HAZARD – Small parts. Not for Children Under 3 yrs

Marbles and small round objects

Small round objects can easily block the back of the throat and be a choking hazard for children as old as 5 years old

Compared to other shapes, toys with a round shape pose the highest risk of choking death

Foreign Body aspiration

Peak age is between 1 and 3 yrs Toys/small plastic objects account

for 5-15% Diagnosis may be delayed

History not diagnostic Physical examination normal Plain films insensitive

Toys with small parts

Many parents aware of choking danger

Older/younger siblings and shared toys

Small parts that detach

Deaths from Toy Balloons

1970’s 3-11 deaths/year 1980’s 2-11 deaths/year 1990’s* 4 deaths/year 2000’s 1-4 deaths/year

In US, cases appear to be decreasing*limited data

Small magnets

Current technology allows the manufacture of small powerful magnets that are inexpensive

Single magnet similar to other small FB that are ingested-pass

Multiple magnets or magnet + other metallic object-potential for bowel complications

Toys and toxins

Lead – neurotoxin Learning, behavior, seizures

Phthalates - ?Abnormal genital development,

lower sperm counts Cadmium

?Kidney, bone

Home/Toy safety issues- Summary

Injuries are common; deaths less so

Safe toys and equipment Education

Thank you